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YHM - 080 Preparing for Parenthood: A Guide to Preconception Health and Pregnancy Expectations
41 Plays1 year ago
Join hosts Calvin, Cameron, and Alanna in this insightful episode of YHM as they sit down with Naturopathic Doctor Annaleeza Caputi to explore the essentials of preconception health.
Discover the importance of preparing before trying to conceive, with tips on optimizing nutrition, tracking ovulation, and managing stress for both partners.
Plus, learn how to support male reproductive health and navigate the journey to parenthood with confidence. Tune in for expert advice and holistic approaches to ensure a healthy start to your family's new chapter!
Follow Dr. Annaleeza:
@drannaleezacaputind
linktr.ee/drannaleezacaputind
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Transcript
Introduction and Guest Overview
00:00:10
Speaker
Hello, everyone, and welcome to another episode of Your Health Minute, brought to you by Aqua Omega. I am your host today, Calvin Morrow, and with me moderating is Alana, and we also have Cameron, who's gonna be having a baby soon. And the reason Cameron is in this call is because today's episode is gonna be able to act as a guide to preconception health and pregnancy expectations. And with us, to talk about this very important topic, is Dr. Analisa Caputi. Welcome to the show. Thank you so much for having me. Cameron, congratulations, I didn't know that.
00:00:40
Speaker
Yeah, yeah, you know, it's funny when Calvin just just came to me having a babysitter. And the reason I think the reason he's having a baby is we're gonna get into that 100%. But yeah, thanks. Yeah, we're really excited.
Family Dynamics and Considerations
00:00:55
Speaker
You know, I have a son and he's five.
00:00:57
Speaker
And okay, I'm not, you know, I like to talk a lot. So I make sure I'm not going to monopolize the show. But my wife and I like I'm very close to my brothers, I have three brothers, and there's like a one year that separates all of us very, very close. And that's what I attribute to us, like our closeness and why we're friends, and we still talk every single day. And my wife has a sister and they're one year apart.
00:01:16
Speaker
So, you know, that and my son's five were having another, we were like, oh, you know, what's the age gap gonna be like? It's funny, I saw Calvin last week, and he has the exact same situation. So it's gonna be a little new and different for me, but we're very excited. Yeah, you should be. My sister and I are five years apart, and there's no issues with that age gap. So don't even second-guess that. There it is, yeah. They're out there. They exist, and they still love each other. You're gonna have a great time. I was just 10 years younger than me, and I love her dearly.
00:01:44
Speaker
There you go. Wow. That's a huge gap. That's double. Wow.
Journey into Naturopathic Medicine
00:01:50
Speaker
So Dr. Andeliz, I want to give you a chance to maybe introduce yourself to our audience. And also one question we like to always ask is what was like the moment that made you decide you wanted to kind of get into the health and wellness space?
00:02:02
Speaker
Love that question. Yeah, so I'm Dr. Analisa Caputi-ND. Thank you so much for the introduction. I'm a naturopathic doctor who practices in Ontario, but I have a physical practice in Guelph as well as in Poor Credit in Mississauga. And I have a pretty general focus in women's health and hormones, which is a very broad category. But I became really passionate about preconception, fertility, and pregnancy relatively recently. I'm actually newly postpartum myself. I have six-month-old twins.
00:02:32
Speaker
Oh, congrats. And you're already on this podcast. And I'm on the podcast. Yeah, so that's kind of where my practice has shifted just because of my own personal experience becoming a mom to two. But why I wanted to be part of the health and wellness space, I always knew I wanted to be in health care. I just didn't know in what capacity. I loved the idea of being a primary care physician, but just the morals and values of the conventional medical world just didn't really align with me.
00:03:00
Speaker
And I'm sure the story is very similar to a lot of people, but I was a patient myself of a naturopathic doctor and that's kind of what exposed me to what that world was like. And I always say this story because I was in the chair and I kind of had this epiphany as the ND was talking to me. And I said, that's what I want to do. Like I want to go to the other side of this chair.
00:03:19
Speaker
Um, and you know, she helped me with my own health issues, but then at the time I was kind of at a crossroads in terms of what I was going to do career wise. I was actually already planning on going into nursing. Like that's the advanced program I was accepted to. And within two weeks I changed my plan and I got accepted to CCNM, which is the naturopathic college. And here we are.
00:03:40
Speaker
Yeah, I love that story. Yeah, it does seem to always be from like a personal experience that, you know, drove you out and I love CC and we were there. I think Cameron, you were there just this week, right? Yeah. Well, it was last week. They had their one of the student fairs. It seems like they have quite a few of those, but I always enjoy it.
00:03:57
Speaker
And just like yourself, Dr. Analisa, I went to IHN, so I did holistic nutrition. I found myself, every single person that attended the school, including the teachers, it was like some kind of personal story. And I found it was like two different things, so maybe we can get your input.
00:04:13
Speaker
Um, I mean, you mentioned you were in Andy's office, but it's either like, okay, someone had a negative experience with a traditional medicine, like allopathic care. And like, I want to stay away from this because it had this ABC bad experience or like you, they saw something, um,
00:04:30
Speaker
you know, on the holistic or natural side and had this experience like, wow, this really works. This happened to me. I'm experiencing it now. I want to give it to other people as well.
Integrating Medical Approaches
00:04:40
Speaker
Exactly. That's exactly where I was at. And I'm very integrative in my practice. Like I do work with a lot of other medical professionals just because of the nature of what I practice. So it's not even a matter of like allopathic versus naturopathic. I think a beautiful thing happens when you combine the two.
00:04:55
Speaker
and that's where I get really excited. And that was my patient experience and I'm happy to provide that to my patients as well. So yeah, I'm happy that naturopathic medicine found me.
00:05:05
Speaker
That's great. And it feels like it's on the rise as well. I'm hearing more and more about it, seeing more and more online. Yeah, it is really fantastic.
Preconception Health Strategies
00:05:12
Speaker
And today we're going to be talking about, well, let's start with preconception because preconception health is something that I never really knew. I, I have two children now and I never knew I should have been like considering health before the baby is even existing. So maybe we can talk a little bit about that.
00:05:28
Speaker
Yeah, this is a really, really important piece of the puzzle, right? And I don't think it's our fault. I think that evolutionarily, like we just weren't trained to like worry about our health preconception wise, because you just kind of made the call that you were ready to have kids and then tried and then dealt with it then. Whereas I think now with naturopathic medicine, we have this ability to be preventative in the sense that, you know, six to 12 months before we know that we want to start trying to conceive, why don't we make sure that everything is in line and everything is optimal?
00:05:56
Speaker
so that when we're ready to start trying, we're not running into these roadblocks or obstacles at that time. Because that's where it becomes more stressful and more frustrating for the parties involved. And it's not just about the female counterpart, right? It's also about the male counterpart as well. And I think that's something that we typically don't speak about often, is that they're 50% of the equation. And usually when we do identify obstacles or roadblocks, they're part of that, right? So this is a conversation I have with all of my patients.
00:06:25
Speaker
I get eye rolls all the time because they'll say, oh, no, no, we're not going to start trying for a year. And I say, well, this is actually the perfect time to start talking about it. And it's nothing crazy. Like we still go through all of the main things like nutrition and exercise and supplementation that we would have anyways, but we just gear it more specifically to the fact that in the next year or so conception is something that we're going to try to achieve.
Impact of Lifestyle on Fertility
00:06:50
Speaker
That's great. That is interesting. I'm curious if maybe it's someone, it's me, it was me. What if I really had a lot of alcohol in my system? Could that affect anything? My kids are great and healthy just so everyone knows, but they were definitely conceived out of the night like that.
00:07:09
Speaker
That's a really great question. The way that I run my fertility appointments is a lot of the times I'll do a couple's consult. So I'll see the female counterpart and then the male counterpart after. And with the male, it's really important that we talk about sperm health. That's really what we're centered around. So how healthy are your sperm? Are they really motile? Are they really mobile? Just so that we can improve the rates of a successful pregnancy.
00:07:32
Speaker
And when we go through nutrition, we do talk about alcohol consumption because in the research it is shown that the more alcohol we consume, the more impaired our sperm can be. So it's not even about the pregnancy itself or the baby. It's about the chances that we have to increase the rates of conception, which is ultimately what we're trying to achieve. So yeah, alcohol is definitely a really big part of it.
00:07:54
Speaker
In terms of nutrition, what I get a lot of too is a lot of red meat consumption. That's a really big one. A lot of processed or refined sugars, which is kind of a no brainer, but it's really important. It's not only about the foods that we should avoid, it's about the foods that we should include. And that's kind of where I focus my time on. So making sure our protein is adequate, making sure our fiber is adequate.
00:08:18
Speaker
making sure that we're having a lot of really great healthy fats because that's super important for hormones and hormone production in both female and males. So I focus more on the foods that we should include and less so on the foods that we should restrict just because again we want to make this a pretty easy process and not something that causes a lot of stress or frustration in the couple involved.
Managing Stress for Conception
00:08:41
Speaker
Could stress like impair your ability to get pregnant as well?
00:08:45
Speaker
Absolutely. And that's again, like not rocket science. Like I'm sure that makes sense. But I think that we, we look at stress as kind of taboo, right? Like we say, Oh, stress causes everything. It kind of does. Right. And specifically when it comes to preconception, whenever we do start trying and we have to be a little bit more mindful, that in itself causes a lot of stress. And sometimes if I notice that the couple is getting too stressed out, we actually take a bit of a break because that itself could impair the rate of conception itself.
00:09:15
Speaker
Yeah, like snowballs. Yeah, exactly, exactly. So that's another really big part. And stress management is something that we talk a lot about with the couples too, because if that's if that foundation of health isn't super duper solid than anything else that we do isn't going to reach its maximum benefit if stress is playing a big role in the picture. What are some easy ways to kind of manage stress?
00:09:37
Speaker
Mm-hmm. Good question. So with couples in a fertility journey specifically, I always, always, always talk about like having open communication, like having check-ins with each other about, okay, where am I at today? Where are you at today? How are we feeling on the stress scale? Because if we can already point out that that's something that's an obstacle today, then maybe it's not the best day to try, right? Another thing that I love is something as easy as like guided meditations or just like
00:10:04
Speaker
you know, organized breathing that we can do intermittently throughout the day. An exercise that I love is just called box breathing. So if at any point of your day, if you're feeling more overwhelmed and anxious than usual, you would basically imagine a box and you would inhale for two seconds, hold it in for two seconds, exhale for two seconds, and then hold it for two seconds.
00:10:26
Speaker
And that itself kind of helps our nervous system switch from that fight or flight, go, go, go mode to a more rest and digest and a calmer state so that you can approach the rest of your day a little bit more calmly. And this is something that I recommend couples do individually and also together as well. So those are just some ways. But another really big thing is again, making sure that our nutrition is adequate and also that we prioritize movement because that alone helps our mental health and our anxiety as well.
00:10:56
Speaker
And then all of this just increases your chance of having a successful conception.
00:11:01
Speaker
Exactly. And it sounds fairly simple, but I always talk about those foundations, those pillars of health, because those small changes can add up to a really big drastic outcome like getting pregnant. And they're the hardest things to change, right? It's really easy for me to tell you what you should be eating for us to make a movement goal together for us to talk about stress management strategies together, but the patient has to implement them.
00:11:28
Speaker
And we're not robots, right? So how you implement it one day might change the next day. And our journey is never linear. You're going to have some really good weeks where you're meeting all your goals and then there's going to be a week where something stressful in life happens and we kind of throw everything out the window. And that little divot is usually where we have to catch patients the most because that's where they become demotivated and their whole health plan becomes derailed.
00:11:54
Speaker
And with preconception and the fertility journey, it's very time sensitive because usually these couples have a goal in mind and they're like, I want to get pregnant yesterday, right? Yes, it is. So that's why it's a little bit of a different patient relationship because we have to catch them when they're down so that I can help hold them accountable and be supportive and be motivating so that we can kind of get back on track with our plan.
00:12:17
Speaker
and reach that goal together.
Accountability and Male Involvement
00:12:19
Speaker
So these foundations seem simple when we talk about them out loud, but they're the hardest to implement and they need the most accountability from the ND standpoint. Thanks. That's really interesting. And can I go back like five minutes? Yeah. Cause you just mentioned stress and that's something we all feel. We understand when we're stressed, we're all aware of it for the most part at least. But you're talking about even like, like in men, like sperm or motility,
00:12:41
Speaker
Okay. We know we're stressed. We can work on it. Is there a telltale sign, a symptom, uh, something that we can wrap our heads around that we would say, okay, maybe this sperm motility is an issue because that's strictly, I have to go and get a test because I know for like my clients and nutrition, it's like they're looking for that
00:12:59
Speaker
Oh, now I can feel it. I'm aware of it. Now I'm willing to make a change as well. So it's not just about having the data in front of me, but feeling and saying, yeah, I do want to make it. Oh yeah, I do notice those spots on my fingernails. Now when I correct it, I see them go away. So it's that tangible result that kind of makes you stick to the plan or want to start it in the first place. So aside from stress,
00:13:20
Speaker
What would, and I guess I'm asking for males, maybe for myself, but because you mentioned like sperm, is there something that they would feel or that would lead them to believe, yeah, maybe this is an issue for me?
00:13:30
Speaker
Really great question, and this is where pregnancy and fertility becomes difficult, right? Because unlike a lot of other things that we treat, there's not a lot of telltale signs, like you just said. So what would end up happening in this story happens many, many times is we've assessed the female, we've treated the female, everything looks good with the female.
00:13:50
Speaker
We then talk about appropriate sexual intercourse timing around ovulation, and then we kind of try that out for a few cycles. And then when nothing happens, we raise our eyebrow and we say, hmm, okay, this is usually when the partner comes in. And when I assess the partner, I'm noticing
00:14:05
Speaker
okay, stress is looking pretty high, but there's no other way for us to be able to see that objectively just by looking at them. So then this is where we would send them for some further testing to determine their sperm health, sperm motility, and if that could be, you know, a negative side effect and why the conception is not happening as quickly as we want it to.
00:14:30
Speaker
And again, this is a very big generalization and I'm not saying this is always the case, but I find that the partner is usually a little bit more reluctant to talk to me about things that they're experiencing in their life and the stress that they're experiencing. And I always say to my patients that stress is going to happen no matter what. My treatment goal is not to completely eliminate stress. My goal is to help you become more resilient to stress because when our resiliency increases, then the physiological weight that your body holds from that stress is less.
00:15:00
Speaker
And this takes time. This is not something that can happen overnight. And this is why I'm going back to my point of we want to talk about this six to 12 months before trying to conceive, not at the time where you wanted to become pregnant yesterday.
00:15:13
Speaker
Yeah, I think that I think I knew you were going to say that that there are no tell to that. And I'm always looking to like go maybe even a little philosophical. Maybe that's the way I go with things because it's interesting because I thought you might say that. And I guess that's just maybe you can speak more to this that they look at the female first and then once she's okay, then they go to the to the male. Is that backwards?
00:15:34
Speaker
It's like whenever we talked about this when I was learning about it's like, you know, the soil must be rich in order to plant the seeds, but the seeds have to be good too, which is more important. Neither is more, but it's interesting that
00:15:47
Speaker
I don't want to say that they blame the female first, but almost the way we go about things, it could seem that way to some people, right? And that's absolutely it. Again, I don't know if this is just how like through evolution, this is how we dealt with pregnancy and fertility that we always look at the female counterpart first. This is typically how I see it in my office. I always have the conversation right from the beginning that their partner is 50% of the equation. They always understand that, but then we typically get met with some resistance from the partner.
00:16:16
Speaker
Right? Like, well, I don't think it's me. Maybe we should assess you first and figure things out. So you always have to meet the couple where they're at, but it's always something I'm very forthcoming about right from the beginning. And then I would say about 80 to 90% of the time we end up meeting the partner down the road anyways, because then they do understand after some reflection and some time that they are 50% of the equation and that, you know, their health is just as important as the person who's going to carry the baby.
00:16:44
Speaker
Yeah, absolutely. Good question. It's tough sometimes. It's like you don't want to be held accountable to, you know, it's like it's 50-50, but it's like, if I can't give you a baby, I can end a lot of relationships sometimes, right? Like that was, at least with my fiance, it was like, Hey, if we're not having a baby, then let's not even go on a second date. I was like, Oh, okay. All right. You know what? Let's have a baby then. I like the directness. That's awesome.
00:17:11
Speaker
Yeah, so we thought it was gonna be stressful when it was start and when it was time but luckily she had actually went and seen an ND and It was like okay today's the day we're gonna start and I felt like it was the next day. She's like I'm pregnant. I was like Okay. Wow. Good for us. Look look at that. Yeah did a lot of preparation and she had been preparing honestly like years before because I
00:17:29
Speaker
Yeah, she knew she wanted that. But maybe yeah, absolutely. And I'm and I can even speak to this as an ND from my own experience as a patient because I did something very similar when my husband and I decided, okay, like we want this to kind of happen in the next little bit of time, I kind of took control and I was like, Okay,
00:17:45
Speaker
Let's make sure all of our ducks are in a row. And I'm happy that I did that because there were some obstacles and rope rocks that we did find along the way. So I was able to deal with those prior to actually trying. And then that alleviated a lot of stress and frustration that I can see we probably would have been met with if I had waited. So I'm happy to hear that your fiance did the same.
00:18:06
Speaker
Yeah, that's great. And I mean, he's three now, or he's about to turn three. Oh, wow. He's a handful. He's wonderful. Me and Calvin are going to fight for which questions we can ask. So me and my wife, I mentioned like there's a there's an age gap between our son and what will be our daughter soon.
Understanding Miscarriage Risks
00:18:29
Speaker
And part of the reason is that my wife had a miscarriage. And and I suppose, again, I always tend to lean towards more these questions as
00:18:36
Speaker
diving deep into your brain. So like this birth, she's doing natural. She never did anything the first time. I won't even take an Advil. I'm very supportive of that. And this one she's going to do at home. But in between, she had a miscarriage. So she couldn't get ahold of me. I was at work. She called my parents. I took her to the hospital. And then I went and met her thereafter.
00:18:58
Speaker
And the doctor who was treating her was saying, you know, this is so, so common. You wouldn't believe, and she gave us a stat and you're going to know better than me, but it was something alarming and alarming, I guess maybe more a shocking to me. Like, yeah, like five or six in 10 women do have a miscarriage. Like, really? Is that, is that, and is that, um, do you think, so when she's saying that,
00:19:24
Speaker
Is she just saying that to one, just make us feel better? Oh, this happens all the time. But the other side of that is, well, we shouldn't just say, Oh, it happens all the time. So it's acceptable. Do you think there's a reason or is this, is this rising? Have, have miscarriages.
00:19:37
Speaker
gone up over the last 50 years or so? What do you think about that? Yeah. Well, first of all, I'm sorry to hear about your wife's miscarriage. I'm sure that that wasn't the easiest thing to go through. And I'm happy that now you're expecting, and hopefully her home board goes really smoothly. This is something I was met with as well, actually. And I already knew what the stat was as an ND, but then as a patient, I was also told the same thing. And it is quite alarming, especially because I was told when I think it was only about six weeks pregnant.
00:20:05
Speaker
And I didn't know it was twins yet. So automatically when I found out it was twins, my risk jumped exponentially. So there's multiple layers to this. It's not a straight answer. I think that yes, it is very common. It's more common than we think. No, I don't think that that should just be like we accept it and we just kind of move on from it.
00:20:25
Speaker
I also want to take the time to say that I don't want patients to ever feel like it's something that they did or something that they're doing that's causing the miscarriage to happen. That's a really big piece because I have a lot of patients who, regardless of where they are in their fertility journey, sometimes having a miscarriage or multiple miscarriages as a part of their story. And their first question to me is always, what could I do to prevent this from happening again?
00:20:50
Speaker
And I always take the time to say that there is nothing that you did or could have done differently. This is just how it played out. Now, I do think, though, that this is where we should open our eyes a little bit and say, OK, there are things that we could do preventatively to help reduce the risk of miscarriage happening.
00:21:09
Speaker
We will never say that miscarriage is never going to happen, but there's definitely things in the research that we know we can assess and treat that will dramatically reduce the risk of miscarriage. And the way that we approach this in every patient is a bit different because it depends on if they've had a miscarriage before.
00:21:26
Speaker
where are they on their fertility journey? Are we using any other like IVF protocols or assisted reproductive technologies that some people have to do? It depends on where we're at and kind of what we're assessing in the moment. But there's definitely things that we can do to reduce that miscarriage risk. And that's a really big part of my patient journey for all of my preconception patients, because just like the risk of miscarriage is higher than we think the amount of patients that I have who are
00:21:56
Speaker
trying to conceive that have a history of miscarriage is also a lot higher than you would assume. Yeah, it is very, it's very wild. The stat I was given was I have a 25% chance of miscarrying. And then when I found out it was twins at my seven week ultrasound, that jumped to over 60%. Wow, that's unreal. Yeah, I missed her was was pretty stressful for me. Yeah. Well, you know, and I find that too, when my wife and I are going for our appointments,
00:22:25
Speaker
It's almost like, you know, they scare you a little bit. And I think that some, not all, but some of the midwives or opiates or whatever, they are just looking at you as a patient. And yes, they care for you. So of course, one, one, one. And they're seeing it just as
00:22:43
Speaker
this is their job and they do it and they're stating these stats and facts and you go home and like, I remember one time during my wife's, the first pregnancy with my son, she was crying when she left because like, oh, your baby looks small and this can happen. If that happens, I'm like, please, it's like all these things. And they're just stating because again, it's their profession. They look at it like that, but not realizing that it places tremendous stress on the mother. I mean, I suppose the father too, but certainly the mother.
00:23:10
Speaker
Yeah, absolutely. I was actually told the words exactly where I wouldn't tell anyone because it's too early and you have a very high chance of miscarrying. Yeah, that's why you always hear the three month thing. It's like, don't tell anyone until three months because that's the chance. So the chances must go down quite significantly after three months.
00:23:27
Speaker
They do. It's because in the first 12 weeks in that first trimester, it's really about the baby like becoming a baby, right? And then after you pass the first trimester and you're into the second, that focus is really on just that baby growing. So the risk of miscarrying dramatically reduces. But this is where like my role as an ND in my patient's world when this kind of vocabulary and
00:23:49
Speaker
conversation is being had with them is I want you to be excited about your positive pregnancy test. I don't want it to induce stress because just like how we talked about stress resiliency and the impact that stress can have when you were trying to conceive the same applies when you're pregnant, right? Like the same principles that we talked about trying to get you pregnant, just transfer to when you're pregnant too. So we need to try to keep our stress levels as low as possible to reduce that risk of miscarriage.
00:24:16
Speaker
So I usually have patients that will come for their consult with me and kind of talk to me about this experience that they had. And I just spend time allowing them to feel excited. They almost feel like they can't be happy yet. I had a very similar experience. And I love that you say that I remember when my fiance she got her first pregnancy test and
00:24:34
Speaker
It was, it was a positive and she's like, I don't want to get too excited. Like you never know. I'm like, this is your first ever positive pregnancy test. You, you know, like you've wanted to be able to last 10 years. Like this is it. This is the closest you've ever been like, get high, get excited. And if something happens, we'll manage it and we'll deal with it. But like.
Balancing Pregnancy Risks with Excitement
00:24:49
Speaker
you know, let's get excited. She's like, right, let's celebrate, you know, exactly the keg. Yeah, I love I love that you that you encourage her to do that. That's very similar to what to what I say to and I always say, let's not if we're gonna think about the worst case scenario, let's spend the exact same amount of time thinking about the best case scenario.
00:25:08
Speaker
That's great. That's what I always say. And I find that patients feel a lot more uplifted after that visit and they can get excited. And of course, if something happens, we will deal with it together. You're never alone. Your support team is there, right? But if, like I said, if we're going to spend time worrying about that worst case scenario, we owe it to ourselves to also think about the best case scenario. Nice. I like that. Yeah.
00:25:32
Speaker
Um, we were talking a little bit about the, the trimesters there. What kind of like, does the health journey change depending on which trimester you're in for, for
Trimester Health Recommendations
00:25:39
Speaker
mom and dad? Good question. Yeah. So in the first trimester, well for mom and dad, not so much like dad really just becomes part of the support system support. He's got to step his game up.
00:25:48
Speaker
The mom who's carrying the baby, in terms of each trimester, my approach just kind of changes, but it really depends on how their pregnancy experience is going. In that first trimester, I really focus on survival. That's really what it is about. So some women have fantastic first trimesters, others not so much. This is where we really focus on nutrition because we want to get as much good food in you as possible that you can keep in.
00:26:10
Speaker
We also want to support you in terms of any like sudden fatigue that you experience because this is really common as blood volume kind of increases by over 50%. Women can start becoming more on the anemic side so this can lead to fatigue and just having really poor energy. And then of course nausea and vomiting is something that is super common. So we just try to improve the patient's quality of life during the first 12 weeks and kind of help
00:26:36
Speaker
with those symptoms as much as we can. As we get into the second trimester, this is usually where women feel their best. This is like the best part of the pregnancy. The glow. The glow, exactly. Because they're not, they're physically not super big yet. So they're not too uncomfortable. They're
00:26:52
Speaker
past that first 12 weeks where our body kind of adjusted to that really big increase in pregnancy hormones and we feel pretty good. We might have some heartburn, we might have some constipation, we still might have some nausea, some food aversions and some fatigue, but we've had some time to kind of get in gear and get the right support in so that we can manage it pretty well.
00:27:14
Speaker
And this is typically where we talk a lot about the different imaging that they might go through. This is where we talk about things like different tests, like the oral glucose tolerance test for gestational diabetes that we try to improve your score. And then heading into the third trimester, this is really where we talk about labor and delivery preparation, to be honest.
00:27:35
Speaker
because there are so many things that we can do to help ripen the cervix to improve how your labor goes with less intervention, less need for intervention, I should say. And I also already start talking about that postpartum phase because I find that that's a really big gap that we have in the medical world right now.
00:27:54
Speaker
is we are not screening for mental health during pregnancy enough, and it's coming up postpartum, and it's something that we could have flagged early on in support of the patient before. They have the baby, they have this new life to take care of, and this new version of their self that they're getting to know. Plus, we just went through labor and delivery, which arguably is a pretty traumatic process. I would say so.
00:28:18
Speaker
And then we went from being this pregnant to not pregnant in a very short period of time. So we're experiencing a lot of those hormonal fluctuations too. So that's typically like what the general patient journey is like for me and kind of what to expect in each trimester. But then usually by the six week postpartum check and visit, the patient's feeling pretty good.
00:28:40
Speaker
What are some of those like telltale markers to look for like you said in third trimester might so if you're seeing certain signs that would make you believe that they would be a greater likelihood of having postpartum depression that we say you see some of those what would those be?
Identifying Postpartum Concerns
00:28:58
Speaker
I do. So these are statistics I actually know just because it comes up so often. 88% of pregnant women have indications that they are more likely to have postpartum anxiety or depression. About, I would say over half of those, 88% of people never talk about it and they don't get support while they're pregnant.
00:29:19
Speaker
So then when they become postpartum and now you're no longer pregnant, you're dealing with the hormonal changes and this new identity that you have in this new life you're caring for, this is where then you're finally usually screened by a medical healthcare professional and then it's dealt with then.
00:29:34
Speaker
Um, so the telltale signs that I usually see is definitely any sort of indication that they're feeling more anxious, not just about the pregnancy itself, but they're noticing in their life, they feel like their typical daily tasks are becoming too much. They're having difficulty sleeping. Um, they're having some like interpersonal relationship issues because they feel like they're more irritable, they're more sensitive.
00:29:58
Speaker
A lot of women will report that they just have like a lack of motivation and a lower mood that they can't really identify why that is. But instead of just using those subjective telltale signs that you're asking about, I actually use an objective assessment called the Edinburgh Postnatal Depression Scale. This is typically something that you would give to someone postpartum.
00:30:22
Speaker
usually by the six-week visit that they have with their OB or midwife, they're doing this. I actually do this during the second and third trimester of pregnancy.
00:30:29
Speaker
I do it about three times with the patient before they even give birth. Oh, nice. The reason is because we get a baseline, right, of where they're at. And then we kind of notice how that score changes throughout their pregnancy. And if I see that the score is increasing, then I kind of raise my eyebrow and I say, okay, maybe we need to implement some more mental health support before the patient gives birth and then make sure that we have the support system and tools in place so that after the baby's here, we don't even have to think about it. We just have them in place and they're there to be utilized.
00:30:59
Speaker
There is a lot of prenatal pregnancy and postpartum specific counselors and psychotherapists that I always advocate my patients to reach out to and have a few calls with them before they even give birth. Because even if you don't have signs or feel like anxiety or depression is something that you might experience, there is zero harm in having that extra support. Like there's no downside to that.
00:31:25
Speaker
to feeling more supported, especially for first-time moms. So this is a really big focus of my practice, again, partly because of my own personal experience, to be honest with you, and also because that statistic just really blew me away, right? That 88% of women have the signs, but over half of them don't even talk about it or seek support. Like, that is something we can so easily change. Yeah. Is it just they don't know they're unaware?
00:31:51
Speaker
Um, I think it's a part of that. I think a lot of times they assume, Oh, I'm pregnant. Like my hormones are making me feel this way, or I'm uncomfortable. I'm tired. I'm nervous. I'm not supposed to be happy. I'm not supposed to be happy, which is not the narrative that we should have. Right.
00:32:06
Speaker
Yeah, that's it. It's not I don't even think it's that they don't know I think it's that they almost normalize what they're going through and then until they speak to someone who's like No, you don't actually have to feel this way like we could support you. They're like, oh, okay cool And then their whole experience changes right from the get-go. Yeah, I think a lot of people and more so now at least for what I'm witnessing of the like 10 20 years ago is that people are
00:32:34
Speaker
really struggling on that scale as to yes, some things are normalized, and they shouldn't be. You go to your doctor and not picking on dogs, but you go and then you get but oh, that's normal. So now they say, Oh, well, that's normal. Now next time that happens, I'm not going to tell anyone. And I see a lot of people struggling between where is that balance between yes, I shouldn't complain about every little thing.
00:32:57
Speaker
There are things that happen and that's okay. And it will make me stronger to, yes, I should reach out to support. I know this is very personal. Everyone's going to be different, but I just see with my own clients.
00:33:08
Speaker
most people are struggling this more now than they were before that the attitude of society perhaps has changed or the messaging within the medical naturopathic nutrition has changed too because I remember growing up it was more like you know suck it up and go and that was okay that was fine but now it's more like you know every little thing you should check on I don't know where the balance is and
00:33:33
Speaker
I don't know if even that's a question for you, but I see a lot of people really struggling with that, where they find themselves in that balance.
00:33:42
Speaker
That is a hard question to answer, but I think it depends on the individual. Like if I have a patient who has gone through fertility concerns in the past, they've had a history of miscarriage, they have a history of mental health concerns, automatically you know that this patient is going to need mental health support. So every little thing that they feel is completely validated. And then there's other patients who don't have a history of any of those things. And this is where that gray area becomes a bit skewed because then they will start to experience things as
00:34:10
Speaker
as they're pregnant and they're going to say, oh, it's probably just because I'm pregnant. We have to be very careful with that. And this is actually going back to your question about sperm health, where is it something that you can see? This is actually something we can test for, right? In my assessment through blood work, when someone's trying to conceive, and even when they first become pregnant, there are things that we can identify in lab work that are directly linked to your mood directly.
00:34:33
Speaker
And this is where, you know, in the allopathic world, they might consider it as normal, whereas the way that we interpret lab work is very different. And I always explain it to my patients that when you go to Life Labs or Dynacare, those are the labs that we have here. The ranges that they use are based off of a population average.
00:34:50
Speaker
And I would argue that we don't have the healthiest population. So I don't know if I'd want to be in that range, to be totally honest. So that's why the way that we interpret it is different. One absolutely huge one when someone becomes pregnant is their iron status, right? Like I mentioned to you in that first trimester, their blood volumes increasing by 50%.
00:35:10
Speaker
their iron and their blood is being completely shunted to that developing baby in their uterus. So their iron levels are going to drop. If they become anemic, this anemic state and the low iron is directly linked to low mood. Not indirectly, not a factor of it is directly linked. Another really big one is your thyroid. Your thyroid dramatically changes when you become pregnant and this is a really big regulator of your mood. And another really big one is your vitamin D status.
00:35:36
Speaker
Vitamin D is literally important for everything, but especially when it comes to mood during pregnancy, that's a huge one. So again, going back to that like preventative standpoint, this is why we do these things before. Because if we can adjust all of these levels as you become pregnant, then the risk of you developing those telltale signs of becoming more anxious or having some mood disturbances, we could remove them or potentially decrease your risk of them, which I think is a really great thing to do.
00:36:02
Speaker
Yeah, that Edinburgh scale you're talking about, is that something that anyone can go and do on their own? Good question. Yeah, it's accessible online. It even tells you it's very simple. Like it gives you a series of questions and then it tells you what score you have to meet. This was actually something that I was quite surprised about in my own personal experience, because from all of the moms that I spoke to,
00:36:23
Speaker
I always ask, you know, was your mental health assessed at any point in your pregnancy journey? And most people say no. In my pregnancy journey, during pregnancy it wasn't assessed, but from the day that I had the twins, there was three different times where either their pediatrician, my OB, or someone in the hospital gave me that skill to complete.
00:36:43
Speaker
Oh wow. I've never heard of it before. I was blown away by that. And I think my experience maybe was because it was twins. It was a higher risk pregnancy. I don't know if that had a role to play, but every single time I said, I love that you're giving me this skill because I'm not giving you the telltale signs that I'm struggling. But to be honest, I was.
00:37:04
Speaker
And that was picked up by the scale, right? Oh, brilliant. Yeah, it is something that patients can access on their own. But I would always advise like discuss it with a medical professional, of course, in terms of what to do with that score. But yeah, I love that it's something that's becoming more and more common. And I hope it, you know, starts to become standard of care in most medical professionals hands. Yeah.
00:37:27
Speaker
Yeah, absolutely. A lot of the things, I mean, this is like, I suppose, symptom-based, it's a home assessment. I love that. I did the same thing in my practice because, of course, there's good things that can come from objective measurement. But at the end of the day, what matters more than how you feel, really? I mean, oh, a test said this, well, if you feel terrible, that's what really matters in the moment for the individuals. And if they feel great, then again, that's what matters most of them.
00:37:50
Speaker
I love that. I looked it up quickly when you were asking there. I'm like, I'm going to get my wife to fill it out. It's very interesting. And people like to learn about themselves. And when you become more interested in yourself and your own health, just by virtue of awareness, you tend to be healthier.
00:38:06
Speaker
And I'm reminded of this really cool story that my father-in-law told me. And he says whenever he wanted to improve something about his health, he treated himself like a sick person. I said, what do you mean? He says, I asked myself, what can a sick person do? Because if I wasn't sick, if I think I'm not sick, then I wouldn't have this problem. And for him, it was weight. He wanted to lose some weight. And he says, I have to think I am sick. So what can a sick person do? Well, a sick person
00:38:28
Speaker
Can't go to the gym cuz they don't feel it so he's like give himself every excuse he says but a sick person can put a scale beside his bed and waking wakes up he can stand on it okay that's it so he did that and just by virtue of seeing his weight he started make healthier choices and they did this study so this was actually a big site and people put a scale beside their bed lost weight.
00:38:48
Speaker
Yeah. And I was like, wow. So he said, if you treat yourself like a sick person, you know, not feeling sorry for yourself, but what's this minimal thing that I can do? And even it's like, Hey, I can fill out this test online and learn something about myself. Oh, I see this. And you just tend to make one more better step in one more.
00:39:05
Speaker
I always think the success of tomorrow comes from how successful you are today. The most likely deterrent of if I'm going to work out tomorrow is if I worked out today. So I think those little things are great. So yeah, I looked up that test. I think it's a wonderful thing.
00:39:19
Speaker
Yeah, and I think that what you just explained with your father-in-law can kind of apply to, and this is kind of a segue, but how we approach post-partum in general,
Postpartum Recovery Expectations
00:39:28
Speaker
right? Like, I think that the kind of society that we live in, there's this expectation that the person who was pregnant and just gave birth will bounce back in six weeks, right? There are...
00:39:38
Speaker
They're expected to like take everything on. Like they have to be the best mother that they can be for this new baby. So everything that they have to do for themselves kind of goes out the window. And we're really trying to change that because there's a duality, right? There is, I could be so happy and so blessed and so grateful for this beautiful baby that I have, but I could also absolutely hate this time of my life right now. Both of those things can coexist.
00:40:03
Speaker
And I'm not saying that's everyone's story, but this is what I hear a lot about in my patients journeys is that they almost have this guilt where they're like, why do I feel this way? Why am I feeling sorry for myself? Why is my body against me right now? Why do I feel overwhelmed? And I think it's because we set the bar over here for how we expect to respond and bounce back. And that's just not how our body recovers, right?
00:40:25
Speaker
Like in the research, it shows that physically, mentally, emotionally, and spiritually, it could take up to two years to feel back to your normal self. And if you think about it by the two year mark for a lot of people, they're ready to have another, right? So the journey really never ends, but that's something that really ties in with that mental health piece. And at the end of the day, even having a diagnosis, like does it really matter or can we just validate how you feel and support you?
00:40:51
Speaker
Like even that score on that scale that I'm talking to you about, even if they don't meet, you know, that cutoff for like a diagnosis of postpartum anxiety or depression, that doesn't mean that I treat them any differently, right? Like if they're showing me indications that they're struggling, we're going to support you in whatever way that makes sense for that person. And I think just opening that door to that conversation for the patient already makes them feel supported because no one's ever talked to them about it before.
00:41:17
Speaker
And validated too, for sure. Exactly. And validating their feelings no matter what their experiences are. Because your experience and the person next to you can be complete polar opposites in the way that you respond and the way that you heal our individual. And that's kind of the beauty of what we do is we can embrace that individuality. Whereas, you know, I would argue sometimes the allopathic world doesn't necessarily treat the individual, right? They kind of just treat you as a patient who's going through this experience and then they send you on their way. So.
00:41:45
Speaker
after the six week checkup too, it does really just feel like you're dropped. Oh yeah. So you kind of like build this relationship with your doctor and you know, everyone in the light. And then after six weeks is like, Hey, later, I feel like that needs to change a little bit, even just knowing that, okay, six weeks is my first one. And then three months later, so that way you can kind of build up questions, just having that little kind of carrot on the stick.
00:42:06
Speaker
Absolutely. And this is where, again, like private health care, we have our benefits because if I see them at the six week mark, I'm really just focusing on recovery during that visit. I'm checking in like, how are we doing? Six weeks is not that long. And kind of troubleshooting any obstacles that they might have with breastfeeding or feeding the baby in general.
00:42:24
Speaker
and even their own recovery. That's what we focus on at the six-week mark. But then I always book a visit at a three-month mark and a six-month mark because that's where you're kind of more in your groove. You kind of have your routine and you know what you're doing. You're less overwhelmed. But then there's still so many changes that come along the way.
00:42:40
Speaker
And I know everyone's experience is different, but I have this like vivid memory of my six week checkup where my husband and I brought the twins to my OB's office and my OB was amazing. I had a fantastic experience. I had them via C-section. The C-section was phenomenal, like no issues there.
00:42:55
Speaker
but I remember on the way to the appointment I was like breaking down in the car because I'm like there's these two babies I don't know what I'm doing I feel like I'm literally running on empty and I hope that I'm giving these babies what they need and at the visit she checked them she said they look great she checked my scar and like sent us on our way and then my husband and I were like oh okay so now we just have these like two like six pound little six week babies that we just have to
00:43:22
Speaker
And that's everyone's experience. It doesn't matter if you have a single multiple, it doesn't matter. Like that's, that's the experience everyone gets. And it really motivates me to just change that because the patient that you get at the three months and the six month mark is completely different than the patient that you get at the six week mark. For sure. It's funny you mentioned that.
00:43:43
Speaker
My wife and I, we moved during our first pregnancy, so we lived in Mississauga, because when you mentioned Port Credit, I'm like, oh, I know that area so well. I grew up in Mississauga. So we had a baby, a Trillium, but we had already moved to Milton.
00:43:57
Speaker
Oh, wow. And you know, when you're driving, like, when we left the hospital, even we're like, you know, okay, we just leave now. Like, nevermind the six week, the day of, we're leaving the hospital and you're expecting, you know, when you leave the store and they try to take the security alarm off. And I'm like thinking, is the baby going to do that? Like when we leave the doors, we're just leaving, like no one's saying bye to you. Just walk out. That's it.
00:44:18
Speaker
And then we go in the car and we're driving and we're driving slow, you know, extra slow. So, so the drive back to Milton is like 45 minutes. And I swear to you, we still talk about this day, maybe about halfway home. We're just talking. This baby was sleeping. You know, one day we look back, we're like, holy shit. Like we have a baby in the car. Like it's just there. Suddenly it's there. And you, yeah, you just released from the hospital and that's it. You're suddenly on your own and we found it so, uh,
00:44:43
Speaker
Weird? I don't know what the right word is. It's a different, yeah, surreal, because I swear I thought of that. That picture kept going ahead and the baby's going to like beep when I leave the door. Like we're not supposed to be, and you're just out in the world and there you are. Goodbye.
00:44:55
Speaker
Absolutely. Have fun. Yeah. And it's funny that the way that you're describing your experience is the same as our experience. And I'm sure every parent has had that same experience, but nobody talks about that, right? Like we almost feel like, okay, we should be grateful that we have this, which we are, right? Like that's inevitable. Um, and almost like you feel like you can't talk about the negatives. You almost feel guilty for talking about the negatives in the sense of, Oh, my life just completely got flipped upside down. Everything changes. Like I don't even know who I am anymore.
00:45:24
Speaker
I think that's the problem is that we don't have that space. We don't give people that comfort to talk about those things and they don't feel well supported. And that's a really big deal. And at this phase in my life, I have a lot of, you know, friends and colleagues that are also first time parents. And, you know, everyone's always hesitant to be the first to bring it up. And then once we do, it like explodes into this.
Personal Parenting Reflections
00:45:45
Speaker
I feel so good to be like, Oh my gosh, you're grumpy too. Thank goodness. So I'm just here to like not view the whole like preconception, fertility, pregnancy, and postpartum as like a black or white scenario. Like I think that it's a spectrum, right? And how you feel today can be the complete opposite that you feel tomorrow. And that's part of the beautiful journey, but we just have to talk about it. And then maybe we won't have a statistic that 88% of pregnant women have symptoms of anxiety or depression. Like maybe that stat will change.
00:46:15
Speaker
Is that 88% have you followed that throughout the years? I don't know how long you've been practicing for. Has that gone up? Like 80% seems so high. And I wonder, I know they said even you know, with the
00:46:28
Speaker
COVID and all that thing like depression now is much higher than before. Is that the same with what you're seeing? Yeah, so I started practicing in 2022. So I'm fairly new. This statistic was from 2019. I would argue that it's probably more than that because you have to remember that a statistic is just what's been reported.
00:46:47
Speaker
right? That's just what we know. But there's for sure more that we don't know. So probably it's more than that now, not only because we noticed that like mental health struggles are on the rise, but because there are patients that just haven't reported that they're feeling this way, which motivates me even more knowing that we have this statistic, but it's probably a lot higher than that. Yeah, I know.
00:47:10
Speaker
Don't be, to all our listeners, don't be afraid to reach out. And if some of them want to reach out to you, what is the best way for them to get a hold of you? Yeah, so I'm on Instagram, Dr. AnalizakapudiND. My website is also dranalizakapudind.com. I would be happy just to chat with whoever might be at this stage of their life, whether you're trying to get pregnant, in the process of being pregnant, or
00:47:33
Speaker
newly postpartum. I talk to patients all the time about this and I love kind of hearing everyone's experience as a parent first time or not and I'm just ready to help empower couples on this journey and kind of open that conversation so everyone feels supported.
00:48:05
Speaker
because I see people who want to change to get pregnant which again we talked about before you should almost prepare your body before you get pregnant but that doesn't always the case. Are you seeing more patients who come to you because they want to get pregnant or are hey now I'm pregnant and I should make changes or sometimes it's after say oh my god now I have kids I should make changes. What are you seeing?
00:48:09
Speaker
I love that.
00:48:27
Speaker
Yeah. And this is what I love about this area that I work in is because I'm noticing that a lot of people want to be preventative and proactive. So I'm seeing them at the beginning of their fertility journey. And this is typically where, especially with the person who's going to be pregnant, we talk a lot about menstrual cycle education. We talk about ways to know if we're ovulating and kind of optimizing that first, doing a proper assessment. So we're able to kind of be preventative with anything that we can adjust right now before trying to conceive.
00:48:56
Speaker
right? And then, you know, bringing in that male counterpart if we need to. And then what ends up happening is these patients become pregnant. And then now I support them in their pregnancy journey. And then I support them in their postpartum journey and help them with their baby. And then they bring their babies to me. And it just turns into this whole, like family cycle. And that's the really beautiful part of it.
00:49:18
Speaker
and then they come back to me when they're ready to have their second. I've been in practice for a couple of years, so that's only happened a few times just because of how that cycle works. But I'm noticing that people really want to be proactive and preventative, and then it turns into this lifelong patient journey that's just such a privilege and so beautiful for me to witness and be a part of. It's truly an honor.
00:49:40
Speaker
It sounds like you're in the right line of work. I think so. Yeah. You can hear it. You can hear the passion and the enjoyment. It's exciting for me to listen to you. It is, honestly. I hope you know that. Yes, it's really nice just to listen to the way that you explained it. I mean, now I have more questions. I love it. Yeah, I mean, we barely scraped the surface. We'll have to get you on to the next season. If you're down, we would love to get you in the next season. Oh, I love it. I want to thank you again, Dr. Annalisa. You've been so wonderful. Wealth of knowledge. And I feel like Cameron is more than ready to have to be. What is it? How many weeks?
00:50:10
Speaker
Well, she's in her ninth month. OK. Any day now. Yeah, I forget the due date. No, I think it's within the next three to four weeks. She just entered her ninth month, I guess. So it's the next three to four weeks. I don't think they can ever nail the due date right on the nose, you know. But three to four weeks, if all things go as planned, yeah. I wish we were listening to this podcast right now. You know, Cameron is a new dad again. OK, here I go again, yeah. Awesome.