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15. Why You Need a Doula, with Jayde Wilkinson, CD
114 Plays1 year ago
So… What Do Doulas Do? Explaining the Expansive Role of A Doula (AKA Your Birth Tour Guide)
On this week’s episode, Jen sits down with Jayde Wilkinson - Jayde is a Doula, Birth Educator, Doula Mentor, and founded her own doula agency called Birthwise located in northern Indiana. She also hosts a podcast called Birthwise which is geared toward educating other Doulas. Jayde is a leading voice in the discussion around the role of doulas in filling the gap in maternal care, including maternal mental health care.
If you’re not familair with the role of a doula, the difference between a doula and a OBGYN or midwife, or if you’re wondering if a doula could be a good fit for you on you, Jayde breaks it all down.
In this episode you’ll learn:
- All about the emotional, physical, and educational support doulas provide during pregnancy, birth and beyond
- Dispell myths around doula care - How doulas do not interfere with medical care but rather work collaboratively with healthcare providers to ensure holistic and personalized care for mothers-to-be.
- How doulas play a role in mitigating postpartum challenges
- How doulas promote mental health by incorporating discussions in prenatal visits, identifying concerns early, and establishing a support system for new mothers
- If and how to decide if a doula is a good option for you during your pregnancy and birth journey
Resources and links :
Jayde Wilkinson, Birth and Postpartum Doula (@doulajayde)
- Doula Mentorship Program launching February 20th "A 12-week program giving doulas the tools to build the birth business of their dreams and make a lasting impact in their communities." www.birth-wise.com/mentorship
- Nest and Grow Co. Non-Profit Organization: www.nestandgrowco.com
If you enjoyed this episode and appreciate what we share here, please rate and review the show in your favorite podcast app! And come find us on Instagram @bloomafterbaby!
*Please note that this podcast is intended for educational purposes only, and is not a substitute for seeking individualized care from a mental health or medical professional*
Stay Tuned for more to come from Rachel Daggett and Dr Jen Jordan on all things motherhood and mental health - real mom experiences and insights from a licensed psychotherapist and medical doctor.
Learn more about us and access all of our courses, services, and free resources at bloomafterbaby.com
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Transcript
Introduction to 'Bloom After Baby'
00:00:02
Speaker
You're listening to Bloom After Baby, the podcast. We're your hosts, Rachel Daggett and Jen Jordan. We're a therapist and a doctor and both moms of two.
Unique Mental Health Needs of Mothers
00:00:13
Speaker
We're here to discuss the mental health and wellness needs that are unique to motherhood. From confusing hormone swings to your expanding body to boundaries and tricky relationships, we'll give you the information you need to experience motherhood in a way that feels good to you.
00:00:30
Speaker
Thanks so much for tuning in. Let's get to it.
Interview with Jade Wilkinson
00:00:36
Speaker
All right. Hello everybody. This is Jen here today.
00:00:38
Speaker
And today's episode, I had the privilege of speaking with Jade Wilkinson. Jade is a doula. She's also a birth educator and doula mentor. And she actually founded her own doula agency called Birthwise that's located in Northern Indiana. And Jade also posts a podcast called Birthwise, which is geared towards educating other doulas. So not only is she helping to expand services and access to care for families in her community, but she's really a leading voice in the discussion around the role of doulas.
00:01:04
Speaker
and their role in filling the gap in maternal care, including maternal mental health care.
Role of Doulas in Maternity Care
00:01:09
Speaker
Jade is also championing for access to quality care and education resources for families through her nonprofit organization called The Nest, which is a community center for birth and family services in Northern Indiana. So if you're not familiar with the role of a doula or the differences between a doula and an OBGYN or midwife, Jade breaks it down. We'll dive into some of the distinctions between
00:01:30
Speaker
care practices that she provides as a doula and standard medical maternal care. And if you're wondering if a doula could be a good fit for you, Jade explains what you need to consider. She also dispels some of the myths around the limitations of the role of a doula. And we talk about what information expecting moms need during the prenatal period, not only for
00:01:47
Speaker
preparation of a healthy pregnancy and birth, but also in creating personalized care plans that include mental health discussions and for the postpartum period as well. So this is a super informative episode. You'll walk away with all the information you need to understand the role of the doula and if it might be a good fit for you and your perinatal experience. So let's jump in.
Jade's Personal Postpartum Experience
00:02:13
Speaker
All right. Hello, Jade. Welcome to the podcast today. Thanks so much for being with us. Hey, thanks for having me. I'm so excited to talk with you. And like I mentioned, we gave a little bit of an introduction, but I'd love to hear a little bit more about your background and your current practice. Do you mind giving us a quick overview before we get started? Yeah, absolutely.
00:02:34
Speaker
I'm so excited to be chatting with you guys. I started doula work after my first baby. I kind of had a rough first time around and was left kind of searching for answers and discovered this kind of underground thing or at least it seemed underground to me to serve other women through birth and postpartum. I particularly had a rough postpartum experience similarly.
00:02:59
Speaker
to what you both experienced and was left kind of trying to understand why I somehow was getting it wrong and then I really started to uncover how it wasn't me that was getting it wrong. It's very much like society's expectations and how we're set up in motherhood. So I just kind of like set out to make some big changes in my community and support other women to have a different experience.
00:03:24
Speaker
And so that's really grown. I have been serving families since 2017. And now I focus on helping other doulas serve their
Motivations in Maternal Care
00:03:33
Speaker
communities. And I've started a nonprofit with a friend of mine to make even more of an impact in our community through funding services. And that's going to be really great too.
00:03:44
Speaker
That's incredible. Thank you. So that's so interesting. I feel like the more professionals I meet within this realm of maternal and perinatal care, the more I hear that similar narrative of having a less than ideal experience and that being kind of what propels you into the field. So that's, that's interesting. So before this, had you had a doula as any part of your team and your perinatal care experience? Yeah, with my first baby, I didn't know what a doula was at all. So that wasn't on my radar.
00:04:15
Speaker
Yeah, and then I had a doula with my second baby who I had a March 2020 baby. So as you can imagine, that was chaotic and it was a birth center transfer. So like lots of things kind of went awry but I still feel like that was my best birth and postpartum even though it was the height of the pandemic because I had so much more information and support and I was so much more prepared. So I think that makes all the difference.
00:04:43
Speaker
Yeah, so you had both personal experiences to kind of compare both of those. So that's a really unique experience to have had seen like completely both sides of it and then now to be on the other end on the professional side of it. I'd love to hear a little bit more about that too from the professional side. I think that a lot of people, myself included,
00:05:04
Speaker
before having a baby was not familiar with the role of the doula and definitely not familiar with what the differences are in the type of care. And like I mentioned, I listened to the episode on your podcast about consultation with the doula and then especially what the prenatal care looks like with the doula. And I was fascinated. You mentioned
00:05:26
Speaker
a lot of things.
Comprehensive Doula Care
00:05:27
Speaker
So just to give people a little bit of a background, I'm a family med physician and have some experience with obstetric care in my training and definitely have that, that standard Western medicine, OB-GYN and midwife specialty maternity care background. And so when I heard you talking about how as a doula, you approach prenatal care, I was really impressed. You talked about that when you have these conversations with potential patients, you talk about what the prenatal visits will look like, how many they'll have,
00:05:55
Speaker
what communication is going to look like, texting, emails, phone calls, like go into all the details there, labor when you'll join them, how long you'll stay, what postpartum looks like, what those visits look like, and what you'll cover. That's extensive. So I definitely have not as a patient received that type of care from the OB-GYN type of services. So I'd love to hear a little bit more about that and kind of where you see as a professional
00:06:21
Speaker
those distinctions being. Yeah, I think people have a lot more experience with medical professionals and understanding that relationship and the dynamic and what your responsibilities are in that relationship. I feel because doulas are still somewhat under the radar for most people and most of the people that I'm working with have recently learned what a doula was.
00:06:46
Speaker
and haven't had one before. So it's a very new experience for them. And I think also they are probably a little bit, it's so much of a cash investment a lot of times for people that you want to just make sure that they have a full picture of what to expect. But also I think there's a piece of, this is a very intimate relationship. As the doula, I am very much in the trenches with them.
00:07:15
Speaker
and very invested in their experience. I think as the medical provider in that scenario, you have to be somewhat removed and focused on more of your tasks and responsibilities in order to be that keeper of safety for the family. So I think it's just a lot different relationship. And so I want to set that up with like really excellent communication, being abundantly clear about what they can expect from me.
00:07:42
Speaker
And then, you know, really coming through for them. So they feel like they have good trust in me. I think that's very important. Yeah. Yeah. And having those expectations laid out, I think as a patient that felt was maybe one of the most uncomfortable parts about standard prenatal care was really just the unknowns, not knowing what the cadence would be of visits, what information would be covered, and just kind of having that lack of transparency around.
Personalized Doula Services
00:08:09
Speaker
what the goal was of each visit. And so it sounds like that's something that you've identified as really important or that your field is identified as, you know, really vital information. And also you mentioned even kind of tailoring your approach and your style to the patient. And it sounds like that's something that is on your radar. And also you're sort of able to do is kind of vary what that care looks like a little bit is that
00:08:32
Speaker
Yeah, absolutely. I think everyone's coming into birth, whether it's the first or the fifth time, with a different set of information. They're at a different spot in their life and their lived experience, their expectations of what parenthood is going to be like or what birth is going to be like.
00:08:50
Speaker
their desires for their birth experience. I work with a lot of people who want a birth out of hospital. I work with a lot of people who want a birth in hospital. Those visions look very different. And so in that way, what can feel traumatizing might be very different. So just really taking into consideration their personal history, their desires, their dynamic within the relationship and how I can support them.
00:09:14
Speaker
or a single person the best that I can. So it is, it does have to be extremely different every time, but I think that's what makes it so fun because it never gets boring. Every family is so different. Every birth experience is so different. There's people that I've been with for, you know, three babies and each time, you know, is very different. So yeah, I think you just have to be really intuitive to their needs and meet them where they're at and just give them as much as you can to help them
00:09:44
Speaker
cross this transition with as much power and information and connection as they can.
00:09:50
Speaker
Absolutely. Yeah. And that's something that really isn't built into routine care. And with a midwife or OB-GYN group, a lot of times it's not so much about the provider not recognizing that there might be additional needs or that additional touch points might be beneficial, but it's just not really built into the structure of those groups, those clinics, the schedules. And so there really isn't that flexibility. I think sometimes, especially with your first baby, if you've never
00:10:20
Speaker
been in OB-GYN care or obstetrical care, I guess specifically. It does kind of feel like you have a blindfold on. You're walking into every appointment, not really knowing. Sometimes you feel, am I going to have to undress for this appointment? I have no idea. Am I getting tested for something? What can I even expect? They don't even know what they don't know. They don't know what questions to ask. So I think I kind of envision having a doula as having like a tour guide.
00:10:44
Speaker
through the whole experience, I talk to them like, hey, you're coming up on 20 weeks. What do you think about your anatomy scan? What questions do you want to ask? Or like 36 weeks, we're going to probably be getting a GBS swab. Here's what that looks like. Here's what this test is. Here's the evidence. That way they don't feel like they're just going in blind. And that gives them so much power to take over their experience because you want this provider patient relationship to be supportive and empowering. And sometimes because of the way that it's structured,
00:11:14
Speaker
it can feel really disempowering and sometimes almost traumatic just because you don't feel like you're involved in your own care. Absolutely. Absolutely. And maybe you could even elaborate on that a little bit. I think probably a lot of people, if you haven't had a doula, especially don't realize where there is that kind of interdisciplinary collaboration. So maybe you could talk a little bit more about what that looks like and where you see some of those most important
00:11:40
Speaker
points of communication being?
Setting Expectations with Clients
00:11:42
Speaker
Yeah, I talk a lot about what they can expect from their prenatal care and their birth experience and what decisions they might need to be making through that experience. And I give them access to evidence so that they can feel like they're making informed decisions. And then when you say interdisciplinary care, what do you mean specifically?
00:12:01
Speaker
Oh, sorry. So I'm referring to if they're working with, also working with prenatal care through an OB-GYN or midwife with some of the labs or some of the scans, those visits that you might not actually be performing. Yeah. So I'm not a medical professional. I'm not going to, I'm not performing any of those visits, but yeah, communication about what they can expect from those visits, all the information, like I mentioned, and evidence about those things that they feel like they're well-informed.
00:12:27
Speaker
And then even just coming up with what questions to ask. I find a lot of people leave prenatal visits feeling like, I don't know what I should have asked, but I don't feel like I understand what's happening. Or I feel like I should have more information, but I don't even know what those questions are. So giving them the language and the questions to be more involved and ask more questions and get more curious can be really helpful too.
00:12:50
Speaker
That's a great description to the serving as a tour guide for your medical prenatal care. And yeah, I mean a lot of that, most patients, even myself, you know, having a medical background and it sounds like what you've experienced, you're piecing that together on your own. Oftentimes you receive like a one page sheet that lays out what the appointments will be, maybe what scans or labs, but not a whole lot of narrative about
00:13:14
Speaker
what those mean, why they're important, or what to do with that information. So I love that tour guide description that makes a lot of sense. Yeah. Yeah. I think it plays in well to the birth experience too. Cause that can be really fractured and you might not understand every piece that comes up. And then sometimes those things can feel traumatic. You know, like if you don't know what, why they're breaking out an oxygen mask to put on you because your baby's heart rate dropped, it can feel like something's seriously wrong.
00:13:44
Speaker
when that might not be a huge concern. We just need to understand why we're using the tools that we are and what's happening. So giving them really good context for what's going on in their birth, which is why it's so important to be there in real time. To just say, hey, I'm noticing that your nurses are getting concerned about baby's heart rate being a little low. This is what we might expect to come up in conversations.
Doulas and High-Risk Pregnancies
00:14:06
Speaker
in the next couple of hours. Or, hey, I think your provider is going to want to come in and do a cervical exam here soon. How are you feeling about that? What do you want to talk about in regards to that? So getting ahead of those things and having open communication in real time. Absolutely. Yeah. Because in the moment, I mean, there, well, one, isn't necessarily even the time or space to have those conversations.
00:14:30
Speaker
to without being able to anticipate some of that information or what it means. There's obviously a ton of heightened anxiety and discomfort around not having that information. So yeah, that idea of just being able to anticipate better. And then I also think that kind of brings up a thought about a pretty common myth with doulas. I think a lot of people perceive if they maybe have some medical comorbidities or sort of a higher risk
00:14:57
Speaker
type of picture with their pregnancy that they might not, a doula might not be appropriate for them, not recognizing that there's still that medical support. And maybe you could talk a little bit more about that, about with people who maybe do have other medical complications, if and when that a doula is appropriate, or maybe even some of the variables they need to be aware of when they're making that decision, whether or not to involve a doula. Yeah, I think people have
00:15:25
Speaker
varying kind of context when it comes to how they view doulas. I see a lot of people talk about doulas being for like out of hospital birth only. And that can definitely be the way it's portrayed on social for a lot of people. I think doulas have a place at any type of birth because it's about giving the parents power and supporting them emotionally, mentally and with education and information. So I
00:15:53
Speaker
I don't think that there's any birth scenario where those things aren't playing a factor. Whether you're having a scheduled cesarean or you're having, you know, an out of hospital home birth, I think those things play factors at different levels at different layers for all types of birth. So I think if you have
00:16:12
Speaker
Like you said, some comorbidities or some other factors to your birth that might make you feel like you're going to need more intervention. I still think you could really benefit from being extremely informed and brought into the shared decision making process.
00:16:28
Speaker
So you don't feel like these are happening to you. These things are more of like active choices you're making with your medical team to feel like you're getting the best experience possible. I think just because you have some sort of diagnosis or, you know, high risk pregnancy doesn't mean that you have to relinquish all autonomy, you know, in your birth experience. I think there's definitely still room.
00:17:11
Speaker
either wouldn't be appropriate or could potentially hinder the care that you need to receive in your labor and delivery setting. And you explained that so well that that's absolutely not the truth. And I remember as a resident seeing the patient rooms on the L and D service, the patient that had a doula has someone right by our side. And so the idea that you're actually having someone who's helping you make those decisions, navigating that with you, that you actually have an additional support in those settings as opposed to a barrier or something that's going to take you down
00:17:11
Speaker
for these conversations and that type
00:17:41
Speaker
a path that's less efficient.
Collaboration with Medical Providers
00:17:43
Speaker
So yeah, I mean, I think you explained that really well. Yeah, I think sometimes people can have a stigma with doulas that we do kind of create this barrier between you and your provider. And maybe that has been the case in certain situations with, I'm sure there's a doula out there who has maybe made that mistake. But the goal is that we bridge that gap and help you meet your provider
00:18:11
Speaker
in a space where you feel like you're an active participant rather than creating like a wall between the two of you. I don't think that's helpful for anyone. We want, you know, that birth team to feel really cohesive and not have animosity in the birth space. I think that can be really negatively impactful for your client. Yeah, absolutely. Yeah. And I think, I don't know where that bias comes from or stigma comes from, but even from the professional side, I mean, I felt like there was always a lot of positive
00:18:41
Speaker
collaboration and positive sentiment towards doulas from the OB-GYN and midwife services that I've worked with. And so yeah, I don't know where that stigma comes from, but it is definitely an important one to talk about and debunk because yeah, totally not the case. Not in my experience at least. Yeah. Yeah. No, same, same. And I'd love to hear more about that from your experience too. I know we're going to talk a little bit about the postpartum care aspect and what that looks like from
00:19:06
Speaker
the doula team and from maybe the medical team. But yeah, I'd love to hear more about kind of your experience with working with providers in the medical setting and L and D and where you feel like maybe some of the gaps are or breakdowns in that communication, either around the time of birth or in the prenatal period setting patients up for success. Sure. Absolutely. I think, yeah, prenatally, there's obviously not, I think the way it's structured, there's not a lot of time built in.
00:19:36
Speaker
for providers to spend going over these things with clients. They just don't have that time built in and that's a barrier for them to get access to information.
00:19:46
Speaker
I think in the birth space I've had a lot of really great experiences collaborating with providers and nurses specifically. I find that the nurses and I always are like a really great team because we want that same outcome. I find that I either get like one of two extremes with providers, some that are really excited to work as a team. I had a birth recently that
00:20:09
Speaker
You know, we actually stepped out into the hall, the OB and I, and we're brainstorming about like what positions we should try and like what things we could be doing differently because we were kind of at a rough spot. And I think that's like the best kind of collaboration. And then we have other, you know, kind of providers who feel like maybe they feel threatened that I might be trying to overstep boundaries and they might not be as open to that collaboration.
Impact of Birth Experience on Mental Health
00:20:35
Speaker
So then my role becomes more of just helping
00:20:38
Speaker
bridge that communication between them and the client a little bit and giving the client the language to ask questions. But I think as far as preparing for postpartum, birth trauma really plays a huge factor in postpartum mental health.
00:20:52
Speaker
Um, so the more I can be upstream with birth and preparing them for an empowering birth experience as much as we can. Obviously we can't control birth, but we can influence it is what I like to say. So we can set ourselves up for success with birth and then also prepare really intentionally for postpartum. I find that those two things can stack the deck in our favor as much as possible. And that can look like.
00:21:18
Speaker
preparing for logistical things like meal time and maybe getting a postpartum doula or planning for friends to take shifts and come by and just spend some time with you or talking about shared responsibilities in the home and how those are going to change. I love that you talk about just the overall shift in identity and postpartum and how you exist in the world, I think is what you've said in a different episode. And I really like
00:21:44
Speaker
that language because it is it's about every way that you exist in the world and it all shifts and that can feel intense so sometimes we think about those things beforehand before we're in it and really break down how we think we'll feel what we think we'll need and try to prepare for that then when we get into it it's a little less
00:22:04
Speaker
overwhelming. Right. So are those conversations that you at this point are already having with your patients? Is that kind of a common part of your prenatal care right now having those conversations? Yeah, absolutely. I usually spend four hours in home with my clients, two separate sessions of two hours, and at least an hour, sometimes two full hours, we're talking about postpartum.
00:22:28
Speaker
We, I have a postpartum plan that we go through with like conversation starters for them and their partner or a support person to go through. How do I think I'll feel in this experience? What do I need from you? What can you look out for as a sign in me that I'm not doing okay? And then vice versa for the partner as well. Things as simple as what do we need for our relationship to stay consistent with in the postpartum so that we feel anchored in each other.
00:22:55
Speaker
or what do our other kids need to stay consistent so that they feel so like they're anchored in their place in the family and really getting into those deeper things that we just don't think to think about if we haven't done this before. You totally don't think to. Yeah, I mean, and it's not something that is
00:23:13
Speaker
Unfortunately talked about just kind of in common culture, right? Like we don't talk about that with our mom friends. And it's definitely not something that we talk about in medical care, in prenatal care. And I think that was really a lot of the reason that Rachel and I felt so passionate about going this direction with our careers is that as moms and as people with
00:23:30
Speaker
medical and mental health backgrounds.
Preparing for Postpartum Mental Health
00:23:33
Speaker
We were blindsided. It wasn't on our radars. And so that idea that it's so important not only because it helps you know what to expect, but why does it matter why you know what to expect? And that's because one,
00:23:49
Speaker
It's going to be uncomfortable. You're going through this massive transition, the matrescence, this hormonal shift, this societal identity shift, this whole person shift. And so it's tough and it's uncomfortable knowing that really helps you prepare for it and also identify what things are quote unquote normal and not normal. And I think that was one of the things that really stood out to us sort of alarmingly is that you're going through these transitions that
00:24:19
Speaker
that are supposed to feel uncomfortable and difficult. You're going through hormonal shifts that are supposed to affect your mood. Those undoubtedly should be impacting your mood and you should have low moods immediately after birth from a hormonal neurochemical perspective. But for us not to have some information about what are red flags, what are indications for more support or to be evaluated further. When we know that
00:24:45
Speaker
the leading morbidity in that period is mental health related. So not to kind of have awareness around what to look out for is alarming and it's incredible that that's something that you've incorporated or that you incorporate in that care. So I'd love to hear a little bit more about
00:25:01
Speaker
what you see being maybe some of the ways that there needs to be potentially even additional support for some patients to prepare for that transition. Mental health professionals are definitely a resource, but there's tons of other resources that we're talking a lot about on our end and would love to hear kind of
00:25:19
Speaker
your thoughts about what that should or could look like? Yeah, absolutely. I think the postpartum piece was such a focus for me because of my own experience of just struggling through it. And like you, I couldn't identify it. With my first baby, I thought this must just be how moms feel. I must just be anxious because I'm a mom now. And it took me like a year to realize that like, oh, okay, this is not actually what a healthy version of me as a mom looks like.
00:25:48
Speaker
And that was a big eye opening experience and seeing a therapist was a huge catalyst for me to like finding a better mental space as a mom. But I think you're right, it is a missing piece and it's confusing. Well, why that is a missing piece when it's so clearly a huge issue. It's like, you know, a blinking arrow in our face and we're just like, you know, not seeing a lot of resources.
00:26:11
Speaker
in that area. I think it's hard. People don't always understand how to get upstream from something like that. If they're not really in this work, they might not realize how much influence we do have over it.
Postpartum Education and Community Support
00:26:23
Speaker
So I think having, like you've said before in other episodes, I've heard you mentioned just like having knowledge and expectations of what this might be like is huge. So in that factor, I think birth education courses could do better.
00:26:37
Speaker
So much is really invested in birth education. I think that needs to be equally invested in postpartum, which is why that's how I like to structure things. And then community is just missing from our modern life. It's just, we just don't have connection. So often we're away from family. We don't have, you know, the time and space to spend in connection with other moms, like I think we're designed to.
00:27:02
Speaker
So that's a piece. And I've had a postpartum support group since 2018. And it's just been such a beautiful experience to watch moms find that connection and have friendships and see some real resolve within themselves just from that just from connection as medicine.
00:27:22
Speaker
But therapy, the problem that I see most in my area is the cost barrier. So with my work through the nonprofit, our goal is to have free clinic days regularly in our community center so that women who find that cost to be a barrier can come in and get some help. I really feel like moms are kind of like the way we can heal the world, I like to say.
00:27:49
Speaker
Like everything begins with how we raise our babies and then how that changes through generations. So I think if we pour into moms, then that's just going to have ripple effects throughout community and then throughout the generations that follow. So that's really where all of my focus goes into loving moms, supporting moms, and then seeing that ripple out into other areas. So I think that therapy community.
00:28:16
Speaker
And then just information and preparing are the ways that we can see change there. It's just hard to implement that on a mass scale.
00:28:25
Speaker
Absolutely. I love how you phrase that. Yeah. Pouring into moms and that really, the healing starts with moms and unfortunately, yeah, most of the postpartum care, medical care is focused around baby and your screen for things, your screen for things like, you know, mental health and mood related issues. You're screened, but if you don't actually stand out from that screen and you're not actually someone who falls under that umbrella of a potential disorder,
00:28:53
Speaker
There's nothing else there. People are afraid they're going to get their babies taken away. They don't know even what the support would look like or how they're going to afford it. So they don't even select the right answers or sometimes I've heard, and this was my experience. I was screened. I failed the screening and they said, you should go see somebody about that.
00:29:11
Speaker
Okay. Yeah, so access to that care is just hard too. There's some big barriers. So I think what you're doing online is going to be really accessible and really great. Oh, that's so true. Yeah, that the screening isn't always accurate for those confounding reasons.
Barriers to Postpartum Mental Health Care
00:29:29
Speaker
Also, a lot of times what
00:29:31
Speaker
I found personally, and I know we talk about a lot online, Rachel had a similar experience. A lot of times the screening isn't accurate because we can't identify the symptoms because they're so different in postpartum, right? You know, terms like mom rage or postpartum rage, right? A lot of us have never experienced that before. Really common in postpartum, but also a really common symptom or manifestation of anxiety and depression in the postpartum period.
00:29:53
Speaker
We don't know what to call it. And so having a lot of new symptoms or new experiences that we can't put a name to, right? We can't label. And so I think that's another reason that the screening isn't often effective. Yeah. Yeah. So it's fine. It's making it effective and then making the follow-up care accessible. So there's some hurdles in that area.
00:30:16
Speaker
Totally. Totally. Yeah, you're right. And I think with the follow-up care, access to care, financial restrictions, time, right? Like how are you actually supposed to set aside an hour for even a virtual visit in that, especially in that early postpartum period that can just feel like so, so overwhelming. And especially if you're having to navigate where, you know, where you even find that carrier hand and maybe a list of referrals and nobody can take for three months, what are you going to do with that?
00:30:41
Speaker
One thing we found and I know you're utilizing too is that social media was ironically such a big support in that period. And thankfully there's a lot of professionals that are turning online.
00:30:52
Speaker
and using this as a platform for education and information. So I love that there's becoming a lot of less formal resources for support. And particularly if you aren't necessarily in that category of a diagnosis of a mood disorder, but you still need a lot of additional information and support that there are those virtual resources now that are free. And then also, like you said, the mom groups and mom support and being able to compare experiences with people to know
00:31:19
Speaker
Yeah, is this normal? Is this something that you've experienced? What do you do about it? So valuable. Yeah, so valuable. And I wanted to mention too, kind of getting ahead of it prenatally has been really beneficial. I have found too, if I have a mom who's got a history of anxiety or depression or who has, you know, some of these risk factors, like an unplanned pregnancy or some
00:31:43
Speaker
some big life events that are going to maybe compound her risk for having something in the postpartum. We talk about, hey, do you want to consider finding a therapist now prenatally and just having some preventative appointments set up? That way you're not looking for a new person.
00:32:00
Speaker
trying to navigate that when you're in the postpartum. And I have had a lot of people really take that advice and find it really helpful. They meet with them prenatally. They feel like they've established rapport. And then when I'm postpartum and struggling, I feel it's easier to reach out. Yes. Oh, that's brilliant. Yeah. And I think, I mean, it sounds like you're doing a really good job of talking through some of the areas that might be the most likely pain points, like things having to do with mood.
00:32:26
Speaker
relationship changes but having that person in place where regardless of kind of what does crop up for you that you have a resource to reach out to that's that's such a that's brilliant do you find there that then the main barrier is just kind of like the financial aspect to it.
00:32:43
Speaker
Yeah, I do. And that's really unfortunate. I think, um, there's a lot of the population that I work with is not, doesn't have like commercial insurance. So then, you know, we're looking at $150, $200 for a one hour session. And that is a huge barrier for people. Yeah, that's definitely a factor. So I think, you know, I'm, I want everyone to have that support, but my goal is to then offer as much as I can within my scope, support community education.
00:33:13
Speaker
if they can't get access to that, you know, that more specific care, then I can just do what I can on my end. But yeah, I find, I find it a real issue. I talk to women every week, someone reaches out to me and says that they're struggling and they're in a tough place. And a lot of times a piece with that is that they don't know how to get the care that they need. Absolutely. Yeah. Yeah. I think one of the other workarounds we've tried to lean into is some of the kind of mental health and mindfulness
00:33:43
Speaker
type of practices that patients can start doing on their own and ideally doing in the prenatal period to learn some of those skills that really do.
Mindfulness and Partner Involvement
00:33:51
Speaker
I mean, evidence shows that really the first line treatment for mood and anxiety disorders usually is
00:33:56
Speaker
a combination of mindfulness meditation, like cognitive behavioral therapy type techniques that you can implement on your own. So trying to point them towards some of the free or low cost type of training that they can do virtually to learn some of those skills to start implementing later as a first step. Yeah. Is there anything in that field that stands out to you as being really effective or that you point people towards?
00:34:23
Speaker
Yeah, I love the idea of trying to implement more meditation. I'd like to make that more of a focus. That's not something that I spend a lot of time talking to people on. I think, I don't know if it's my specific area and demographic. It's not always received as something that's super practical, but it is. I find benefits from it and it's accessible. So that's something that maybe I should work
00:34:47
Speaker
more on trying to sell as a skill that can help with the symptoms and help them heal. Because there's so many podcasts that have great meditations. And I use meditation for birth preparation. So it makes sense to do that in the postpartum as well.
00:35:06
Speaker
I love that idea. You're right though. It is really a big ask for a patient to be able to reflect on like how difficult that period might be and feel motivated to start when they're already preparing for a new baby and they're preparing for what they think the birth might be like. And so that is a really big ask to say, Hey, also work on this mental health preparation too. Yeah. Yeah. But it's, I can only provide them with the resources and the options to do some things to prepare.
00:35:35
Speaker
Maybe they'll just pick and choose a few of those, but it would make sense to definitely throw that one out there. And I think in the postpartum, it's hard to continue that, especially just to find a quiet moment to shower or eat or sleep. Meditation's probably not going to be top on their list.
00:35:52
Speaker
but even maybe just having them try to set aside once a week where someone can hold the baby for five minutes while they do a meditation before they get in the shower or something like that. Right. Yeah. Yeah. Yeah. And even like you talked about even just knowing what those resources are going to be. And so if I need that, like this is the, these are the three podcasts I'm going to listen to, or this is the online course I can take.
00:36:15
Speaker
if, you know, if I feel like at that time I need it, this is the mental health professional I've already vetted online that I'm going to reach out to if I need that. This is the mom group that is in my area that I'm going to participate in if I need that. So even just kind of selecting those ahead of time, it's huge because that I mean, and especially when you're in the thralls of it, if you really are struggling with depression or a mood condition, it can be
00:36:38
Speaker
debilitating, paralyzing to be able to lift a finger or scroll through that list of options can just feel like too much. Yeah, absolutely. I think having really bringing partners on board is huge for that too. I like to leave them with kind of a list of symptoms to keep an eye out for and encourage them to have a conversation of
00:36:59
Speaker
You know, when I'm feeling really down, this is what it looks like in me. And, and for dads too, to voice that. Cause I definitely didn't recognize it in my husband and we were both struggling and looking at each other. Are you okay? Cause I'm not okay. But we didn't know what was going on. So learning how to recognize those things and then giving them steps to do the other benefit to having a dual on your team is like, I am, I'm there for them long haul. So I have people text me six months postpartum.
00:37:25
Speaker
with a random question. And I've definitely had dads call me like, I think we need more support. I think these are the things that I'm seeing. And I don't know who else to call. So it's nice to have that kind of like touch point person who says, okay, this is now this is where we go. And I can connect them with a therapist or back to their their OB or whatever, you know, the most immediate need is. So I think that's helpful to have that person act as like a liaison.
00:37:49
Speaker
as well. Absolutely. Wow. That's incredible. I mean, to even just have that touch point of someone to reach out to that isn't just an office admin that gives you another number to call someone else who gives you another number, just that one touch point to kind of put you on the right track is critical and so comforting, I think, to just know you have that resource if you need it.
00:38:10
Speaker
Yeah, absolutely. It seems like we are just so disconnected from our communities, too. We don't even know who to reach out to. And so I feel like it's my job to know all of the providers and where they are and what insurances they take. And that way, when someone reaches out to me, I can get them to that person. So that's a big piece of being a doula, too. I consider myself kind of like the community coordinator. Yeah. Gosh, yeah. All-encompassing. Community coordinator.
00:38:38
Speaker
tour guide, kind of social workers slash long friend. Yeah, it is kind of like social work. I've thought that too.
00:38:46
Speaker
You know, I'm not a social worker. I don't have a degree in that, but if you are a social worker, you might want to consider dual work because that definitely carries over. Yeah. And it is, I mean, it's a corner pin in the medical field. A lot of times, I mean, that's what all services kind of use as like their point person to sort of facilitate coordination between everyone. So it's critical, but you're not assigned a social worker in routine medical prenatal care. Right. Yeah.
00:39:11
Speaker
Yeah, so you've talked about how you feel like there's gaps in the work that you do and trying to fill those gaps. Can you talk about how the prenatal experience and the birth experience play into that and what you would like to see change? Yeah.
00:39:27
Speaker
This is a perspective from a medical perspective as a primary care physician and then also someone who's provided obstetric care. And as a patient, my personal experience is that prenatal care is focused around the medical piece, right? We don't really talk about mental health in the prenatal care setting unless
00:39:48
Speaker
you potentially are someone that's flagged with some of the screening tests that are performed during that period. And then oftentimes that's just a referral, right? And so for sure, I think one of the most glaring gaps or deficiencies is really incorporating that mental health piece into the prenatal care. And as a primary care physician, that's huge. I mean, mental health is something that we talk about within the context of
00:40:11
Speaker
overall physical health, right? And so it's not something that's really integrated the same in prenatal care. And so I would say kind of that, that's the most glaring gap in my mind of where we fall short. And then I also feel like that really carries into the point that you made that anticipating birth trauma, anticipating experience around the birth and what that might
00:40:34
Speaker
look like, but then into the postpartum period.
Integrating Mental Health in Prenatal Care
00:40:37
Speaker
And so we really don't just kind of fall off a cliff in the postpartum period in terms of support from your maternal care team. And so we're not setting up patients for really any sort of planning or preparation around one, what that's going to feel like in terms of mental health and two, where you're going to go with if you have need for additional support. Yeah. Does that make sense?
00:41:01
Speaker
Yeah, absolutely. I think that's a great way of explaining it. I was just thinking that I remembered I must have been maybe two weeks postpartum and feeling very much in crisis because I think I hadn't slept in four days and it was getting a little sketchy. And I called the labor and delivery floor because I didn't know who else to call. And they were just basically like, if you're not in labor, we don't know what to do for you. And that was it. That's all I had to, I didn't know what to do. So I think,
00:41:29
Speaker
Yeah, there's definitely that. We do just throw them to the wolves a little bit and then we're like seeing six weeks and then in six weeks you've been to hell and back and you know, you've got, you've dealt with everything already. So I see something that I see it as a huge benefit with out of hospital providers, particularly the home birth midwives. They offer home visits at one day, two weeks and six weeks postpartum. And that is,
00:41:56
Speaker
so impactful. And then, you know, we have so much connection with lactation, especially in hospital, you've got lactation a lot of times right there. But by the time your supply is in, and all the problems are coming up, you're already home. And, you know, there has we have to have that follow through. I'd like to see more of that in the postpartum from like the medical perspective. No, you're right. I mean, other cultures, it's
00:42:21
Speaker
Usually it's a huge part of it that you have those aftercare visits in the home or just in closer sequence after birth so yeah you look like you said the six weeks i mean you've been through home back in the six week visit itself is pretty.
00:42:37
Speaker
you know, it's focused on mostly kind of medical considerations. And again, you have some screening in there that might capture some mental health related things, but otherwise it's pretty sparse. Yes, absolutely. Yeah. Sometimes you were left feeling like, okay, so now that's it and I'm a mom and what do I do about how I'm feeling? It seems like that six week visit is kind of like, we're officially done with you now and you need to figure it out on your own. And that piece is missing of really helping them.
00:43:08
Speaker
feel like they've gotten the whole person care before we graduate them from that time. Absolutely. And I think not only we're talking about the overall mood-related things around mental health, but this applies to everybody, not only those who maybe actually fit a clinical criteria for a mood-related condition.
00:43:31
Speaker
anxiety or depression or other PMADs. This applies to everybody that your mental health is absolutely impacted after babying in any other way. You know, when we talk about
00:43:41
Speaker
When we talk about holistic care and in primary care, talk about maybe your blood pressure or sleep and sleep issues, anything we're going to tie in. These are behavioral and lifestyle modifications that you could make and provide some robust coaching around what that looks like. The fact that within the postpartum period, you're going through this huge transition.
00:44:02
Speaker
whether or not it's a clinical, fits a clinical criteria. But where is the coaching around those lifestyle and behavioral modifications that you can be making to really support yourself as best as possible? And yeah, it's not something that's built in. That's for sure one of our goals with kind of everything Rachel and I are doing is at some point to have some courses really focused around that. But yeah, otherwise you're figuring it out as you go. There's a lot of work to do.
00:44:29
Speaker
Yeah, so like I mentioned before I think it's moms have the power to really Influence the health of their family as a whole and then that becomes like the health of the community So I'm just curious. I've heard you mentioned before how culturally impactful maternal mental health and mental health in general is So how do you think that impacts? Culture and how would we see that shift if we took better care of moms? Yeah, I will
00:44:58
Speaker
thinking about it from two angles. First of all, like we talked about, there are a lot of cultures that have really built in support around that period.
Cultural Comparisons in Postpartum Practices
00:45:05
Speaker
And again, we use that term matressins, talking about the transition or transformation into motherhood. And a lot of cultures have really like this whole kind of regimen around that about how many days you need to stay within the household and certain meals that you need to have who prepares those meals for you, even built into the policies or around the
00:45:27
Speaker
postpartum care. And so the number of visits that you have if those visits are within your household. And so from a cultural perspective, there's a lot of differences there. And the US really doesn't stack up in rates in maternal morbidity and mortality. And then a lot of comparable socioeconomic societies and a lot of that attributed to what that postpartum care looks like. And
00:45:53
Speaker
in terms of how maternal mental health impacts our culture. And you touched on this earlier when you said really that healing the family starts with the mom and subsequently I'd say really the health of mom or poor health of mom impacts the family massively. And not only does it impact things like maternal and infant bonding and infant bonding and what that says about outcomes for baby later on, the health of the relationship with your partner and how health of your
00:46:22
Speaker
relationship translates to your mental health, your partner's mental health, and the whole household. And then really culturally, there's this focus on even past the initial postpartum period, but this return to yourself, bouncing back, getting back to work, getting back in shape, what that all looks like in this focus there that really shifts the focus from the needs of moms, and then also kind of perpetuates this narrative about how transient this postpartum experience is.
00:46:51
Speaker
pushing past that and not giving moms the space to actually step into that whole new life and identity and brain and mind. And so yeah, does that sort of, well, tell me your thoughts on that. Yeah. No, I love what you were saying just about how the negative side, if we have poor mental health, how that has huge impacts too. We think about, you know, all of the ways that that can impact the family structure. There's so much culturally that you said that we're
00:47:21
Speaker
really missing the mark on. And I hope to see some big shifts and improvements in that, especially with the use of social media and people just stepping out and saying, you know, like this narrative that we've been following is really not the best way to look at it. And how about we look at it from this angle. And I think that can be really helpful too, as much as social media can be
00:47:42
Speaker
not helpful, it can be helpful in the opposite direction too. So I think that's huge. And yeah, being a mom, becoming a mom, that matrescience experience is so transformational and we really should just have more reverence for it and more understanding for the time that it takes and the shift that's happening internally.
Social Media and Maternal Mental Health
00:48:05
Speaker
And I think that would be a great place to start for sure. Yeah. Yeah. And you make a good point. I mean, social media,
00:48:11
Speaker
for sure has given a voice to women, to moms about what that experience feels like. And there really is a law, I think we can go a long ways in supporting moms with just shifting that narrative and our cultural attitude towards it. And those aren't huge infrastructure, societal, economic lifts. Those are things like just having different conversations around it amongst your family, your partners, each other, and
00:48:39
Speaker
shifting that narrative in a way that is more validating and real and supportive to moms would go a really long ways in supporting their mental health without adding on any additional services. Yeah, absolutely. And then podcasts can be probably thrown in that bucket too. Having these conversations like we're having now and the ones that you have on your podcast in general are huge and are really helping tip the scales to have a different perspective on motherhood and postpartum.
00:49:08
Speaker
Podcasts save lives is my opinion.
Unexpected Aspects of Motherhood
00:49:11
Speaker
Yeah. All right. Before we wrap up our conversation today, Rachel and I always close with the same two questions. All right. So the first one is just fill in the blank with one word. And the statement is, I didn't expect motherhood to be so blank. I didn't expect motherhood to be so
00:49:38
Speaker
lonely. That's the first, that's the first lonely response we've gotten since we've been doing this. I feel like everybody can relate to that. It's so true. So true and so paradoxical. Yes. Yes. Not what you would expect. Yeah.
00:49:59
Speaker
Yeah, simultaneously touched out and lonely at the same time. Okay. And then the second one is one thing I wish every new mom knew is blank. One thing I wish every new mom knew is that you're probably not doing anything wrong or getting it wrong. It's the way that our society is set up. So if you feel like it's off, if you feel like something, um, doesn't feel
00:50:29
Speaker
like it's coming naturally or you feel lonely or you're not finding your footing. It's just because we weren't meant to do motherhood alone in this way. You're supposed to be surrounded by community and close relationships of women who have gone before you and can
00:50:48
Speaker
can show you the ropes and help you find your identity as a mom. And we just don't have that anymore. So it's not you. It's really just society. Completely agree. I love that response. Yes. And that alone just really embodying that concept is so comforting.
00:51:03
Speaker
to know that and to be able to lift some of that guilt and really feelings of inadequacy. I think it's huge. Thank you so much for all your time today. I think you've done a great job really giving us an overview of what doula care and services look like of debunking some of the myths and misconceptions around what care with a doula might look like. And I'm really glad that we got to delve further into what mental health
00:51:29
Speaker
support can and should look like and some resources hopefully that our listeners will find helpful.
Finding Jade Wilkinson's Work
00:51:35
Speaker
Before we sign off, do you want to give people some information about where they can find you online and then social media or any other resources? Yeah, absolutely. Thank you so much for having me. It's been such a great conversation to have and I'm just happy to be able to spend a little bit of time with you focusing on this. People can find me on Instagram. I'm at doula jade. So D O U L A J A Y D E. And my
00:51:59
Speaker
podcast is called the birth wise podcast and I create mostly content for birth workers who are looking to serve their clients in a bigger and better way so if there are any birth workers out there listening you could definitely come over and check out my free resources there and I'm at birth-wise.com wonderful all right and we'll make sure we include those in the show notes and
00:52:24
Speaker
Thank you again so much. It's been an honor and a pleasure today and hopefully we'll circle back and continue this conversation around the mental health piece as both of us are working on the resources that we mentioned and have more to even offer you guys. Yeah, absolutely. I love that. Thank you so much for your time.
Closing Remarks and Resources
00:52:43
Speaker
Thanks so much for tuning in with us today. If you enjoyed this episode and feel like it brought you value, don't forget to rate the show and leave a review. Your feedback means the world to us and helps us know which conversations you are needing the most. And we'll keep bringing you new episodes every week, so hit subscribe so you don't miss a thing. Also, be sure to check out the show notes for any links or resources that we mentioned.
00:53:06
Speaker
We're on this journey with you, so be sure to find us on the gram and TikTok, plus go to bloomafterbaby.com and grab our free guides on all things motherhood created just for you. Breathe, be well, and keep growing, Mama.