The Sad Moms Club
A podcast to connect Utah women--especially those who are infertile, pregnant, or postpartum--to the local maternal mental health resources available. I interview providers around Utah to help bring therapy tips and coping skills conveniently to your ear-holes.
The Sad Moms Club
28. Planning for the Postpartum Period with Dr. Allyce Jones, DNP, PMHNP
Dr. Allyce Jones is a psychiatric mental health nurse practitioner who specializes in reproductive psychiatry. She started her own private practice called Felicity Women’s Center which I have joined as of August. I have worked with her for the past couple of months and have learned so much from her.
Today we discuss postpartum planning: making plans while pregnant for a more successful postpartum period. We touch on topics such as sleep, nutrition, feeding support, support with house and family, self-care, and therapeutic support.
Links:
- Postpartum Planning PDF
- Postpartum Planning Group through PSI
- PSI support groups
- Postpartum Frontloading by Thoughts on Thoughts
Follow along on The Sad Moms Club's Instagram: @the.sad.moms.club
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Follow along on The Sad Moms Club's Instagram: @the.sad.moms.club
Hello. Welcome back to the sad moms club. I'm going to forget to do this. So I'm going to do it right off the bat. I believe that's the phrase back. Pretty sure. It's bat. Right off the bat. Um, well now I have to Google that. Is that right? Uh, the bat. Right off the bat. Okay. Yeah. I have this thing about getting, I get phrases wrong kind of often. Anyways, I just want to say, if you could rate the podcast. That would be so great. You can literally just put five stars. You don't even have to write something better. If you write something. It's simply just because it helps people find it. And that's the whole reason I do. This is just so people can find this podcast and benefit from it. Otherwise. What's the point. I'm doing this. Um, So, yeah, if you could do that for me, that would be super fantastic. So today we have Dr. Elise Jones. She is the owner of Felicity women's center, which is where I work. So she is like my mentor and she has really helped me to continue learning after I graduated from the U. Just to like brag on her for a minute. We have an hour and a half every week where we read from a textbook and then we talk about it and go over it. So I'm constantly learning new information. And then she does supervision with me regularly twice a week for half an hour, where we can talk about clients I saw that week and she can answer questions I have about. Treatment as far as medication or therapy suggestions. I just feel really, really lucky to, I have met Dr. Elise Jones and she's truly going to like change my career and make me a far better practitioner. So today we're talking about postpartum planning. This is something that she does with all of her clients at around seven months into their pregnancy with their partner or support person. So here's my recommendation. If you're listening to this episode, go ahead and listen to it. If you already started. But maybe you can send it to your partner or your main support person. Maybe it's a parent or a friend. Um, Ask them to listen to it as well, and then have a conversation about it. Start these conversations now. Prior to having your child, and if you are already postpartum great, you can still learn a lot and maybe learn some ways to have these conversations with your partner. If you're needing help with sleep. Nutrition self-care. Seeing your friends. Finding support, et cetera. I'll link the document that we used as a guide during the conversation in the show notes. So. You can look at that or print it out and use that to actually. Dive into this. Um, And we talk a little bit about why it's important to think about this prior to having your child. Yeah. I think you're going to love it. Alyssa's just really well-spoken. I really admire her a lot. And that's all I have. Let's get started.
Joni:Thank you, Dr. Jones for being on. My podcast today. I appreciate it. Dr. Jones or Elise as I call her is my mentor and my boss and my hero. So a lot of things. But do you mind introducing your background, your education, how you ended up working in this space?
Allyce:Sure. So I'm a psych mental health nurse practitioner also, just like Joni. I worked as a nurse and mental health and newborn screening, for quite a while, and I noticed that there was a gap in care for women who were pregnant or postpartum, and also there wasn't a lot of extra training available. So after I graduated with my doctorate in nursing practice, I did a one year fellowship at Case Western. in University Hospitals Cleveland in Women's Mental Health. And then I came back to Utah and started a private practice called Felicity Women's Center.
Joni:So cool. can you explain what the extra year entailed? Just for someone who's not as familiar with that.
Allyce:Yeah, so a fellowship year is just like sub specializing in something. I had a bunch of different clinics seeing people in community mental health, in an OBGYN office a different community mental health setting Had access to women who were hospitalized for preterm birth. So all sorts of experiences, but it was fantastic and a really good learning experience.
Joni:it sounds like such an incredible learning opportunity. And you just have lots of supervision and lots of opportunity to learn from people who've been doing it longer than you. Correct.
Allyce:Yeah. And experts in the field. There are so many great professionals at Case Western that I was able to work with and continue to have relationships with now.
Joni:And just so people know, most nurse practitioners don't do a fellowship. This is like an Elise specific thing. It's very impressive.
Allyce:yeah, I don't know a lot of other. Nurse practitioners who have done fellowships, I think residencies are a lot more common.
Joni:Yeah. Yeah. Okay, so today we're going to talk about postpartum planning. Why don't you just first explain what it is and how do you set up your postpartum planning sessions with your clients?
Allyce:I think lots of people have expectations for postpartum, but they don't talk about them and they don't talk about them with others. So then they're disappointed when their expectations aren't met. And I think that there's lots that can be done for planning in advance to make sure that the postpartum period is as successful as possible. I like to think of it, hopefully, as preventing or... At least helping to minimize any sort of postpartum mental health or maybe even relationship challenges that might come up. So usually with my patients, I'll meet with them and their partner or whoever will be in there closest support network after they have the baby and talk about postpartum planning. I think it's important to talk about what concerns the parents have about the situation. Sometimes they have concerns about sleep or about navigating relationships with grandparents or other family members or navigating relationships with. Older siblings or going back to work. It depends a lot on the couple and their situation, maybe what their highest needs are for a successful postpartum.
Joni:And usually meet with them... at seven months pregnant. Is that right?
Allyce:Yeah, that's when I like to meet with people because you never know if people will deliver earlier than expected. And it also gives the parents time to talk about things and get things straightened out. If maybe they need to ask more people about help for example.
Joni:I got to sit in on one of these and I thought this would be so helpful for so many people just to kind of start cluing into some of the concerns they have that maybe they haven't expressed, but also things that might come up postpartum. I thought it was a really helpful Our long session that you conducted with them, so I'm hoping we can get into some more of the details of things you ask them, things you ask them to think about, suggestions you make yeah, and go throughout that postpartum plan if someone doesn't have a great provider like you who does that with them.
Allyce:Yeah, and I think most people spend a lot of their time thinking about... Like labor and delivery and pregnancy and so they don't even think about postpartum until they're in it and then it's really hard to do planning to make it more successful if you're already in the thick of it.
Joni:Totally. Yeah, you're like sleep deprived at that point and your hormones are. Out of whack yeah, that's a good point. There's someone that just commented, I think, on Instagram that was like, I did so much to plan for my birth, but literally nothing to plan for postpartum. And it's great to plan for birth as well. The more planning, the better, but it's good to have this as something else to plan for. First is sleep. What do you tell people about sleep?
Allyce:I tell people that the three most important things postpartum are sleep, sleep and sleep. So I think that this is the thing that most people need to make sure that they have a lot of planning around. Most people function really well when they have adequate sleep If you think about a time when you were sleep deprived and how you functioned, and maybe you were more susceptible to illness or more irritable it just can impact all areas of life. And when you're adding a new human to the family, then it makes sleep more challenging. Especially, babies have a one hour sleep. Wake cycle a lot of the time so if the parents need four hours to get a full sleep cycle Then that's not working out very well.
Joni:Yeah. my husband and I have joked because when I'm sleep deprived, everyone could think of a time they're sleep deprived prior to having a child. So when I'm sleep deprived, I get angry. My husband's sleep deprived, he gets weepy, and so we just imagine me yelling at him and him crying. That doesn't sound like a good experience.
Allyce:And I think that happens a lot in the postpartum.
Joni:Someone's crying. Someone's yelling. So what are some. I guess, Do you make suggestions for people about how to get more uninterrupted sleep? How do you go about having that conversation?
Allyce:I think about if you were on an ideal vacation with no interruptions How much sleep would you be getting a night because I think most people are not getting adequate or the appropriate amount of sleep to begin with so We really want to be planning for an ideal situation for sleep, especially in the postpartum, your body is going through a lot with physical recovery and the hormone shifts and everything. So if you do great on nine hours of sleep a night, then. We should make a plan so you're able to get at least nine hours of sleep in 24 hours, hopefully with at least a five hour chunk at least some point of time.
Joni:Yeah, that's interesting to talk about setting it up for the ideal instead of being like, just expect to sleep three hours and be sleep deprived. It's like, how can we actually just plan around this to get you what you need so you can function well?
Allyce:and lots of times there's lots of logistics involved because it could be that the baby sleeps in a different room than you had expected. So that one of the parents is able to get good sleep in the bed that they're used to sleeping in, for example. Maybe you're able to have a family member or a postpartum doula or a night nurse helping with the baby at night. Maybe the baby would be sleeping in an area that's more convenient to whoever else might be helping take care of them during the night. So even just figuring out the logistical components and is there a bed? Is there blankets? Is there a pillow? Would whoever's taking care of the. Baby at night, be comfortable that can take a lot of planning
Joni:Yeah, that's a great point. And I think also it might be good to talk about who's the lighter sleeper in the relationship? Except who? Might benefit from not having the monitor on their side, or some people want the baby in their room, or they just don't have an extra room to put the baby somewhere else. And can you move the bassinet a little bit further away so you're not hearing every single movement that they make. And then I had a postpartum doula recommend, and I think I've heard it from a couple of postpartum doulas and maybe from you as well about the value of a noise machine, a white noise machine from the beginning so that you don't hear every single movement and you can sleep a little bit better too.
Allyce:and even noise canceling headphones if someone else is going to be the primary care of the baby. So hopefully you can continue to get some sleep. But oftentimes people go into postpartum sleep deprived. Lots of people just expect they get a great night of sleep and then they have the baby and then they get a great night of sleep. But usually it's several days of. Poor or no sleep and then they get home with the baby and then it's Oh no, I'm going into this in such a sleep deficit. It's really hard to catch up.
Joni:Yeah first let me just clarify you're talking about like during the hospital or like the time they have the baby they're getting less sleep than they anticipated or like pregnancy caused the sleep deficit or both.
Allyce:All of them we know that 98 percent of women in their third trimester are waking up during the night. So that's a barrier, but also lots of people don't go into labor at the exact moment they had expected, or maybe they have a long labor and they're awake for a prolonged period of time, or maybe they have frequent interruptions after they have the baby by people who are watching their health, the nurses and such. Also it can be exhilarating to have a baby and you can be so excited and just want to spend all of the time awake with them. There's lots of barriers that make it hard to sleep. Maybe you're in pain and it's hard to sleep because of pain.
Joni:Those are all great points. So what are some questions you might ask them to get their mind thinking about help during this time so they can get more sleep.
Allyce:It's nice to know how. Both parents do a sleep if those are who will be the primary caregiver for the baby and who's available to help. So it could be some people have a family member who can come over in the early mornings and can come over at 5 a. m. and stay till 10 a. m. And the parents can get some of that sleep in the early morning hours. Some people have a relative who likes to stay up at night, so they can go to bed at 8 o'clock and have someone else come and stay over and watch Netflix and take care of the baby till 1 a. m. And then parents can resume responsibilities for the baby. But I think it's important to have some sort of sleep support for at least two weeks after having the baby and often. For longer. It may be it's only like two nights a week someone can help with sleep or a partner agrees to facilitate sleep for a whole night or something like that.
Joni:I'm guessing one question people might have is if I'm breastfeeding, what are my options? And like, how can I still sleep since I'm food source as well?
Allyce:Someone is breastfeeding. It's nice to have someone else do all of the other care with the baby. Even burping the baby, changing the baby, getting the baby back to sleep. You could spend 20 minutes feeding the baby, or you could spend 50 minutes doing all of the other things around a feed and wake cycle. So I think that can be helpful for lots of people. And if you have the ability to pump more milk and give the baby a bottle at night or something like that when you're feeling comfortable with breastfeeding, then I think that's a great option too.
Joni:I also imagine I've heard from people and I've even thought this myself, like when you first have a kid, you want to spend time with just like your little new family. But as I've learned more about postpartum. sleep really and like how hard it is to get. I've been able to be like, maybe that's not as important right now. Maybe it's more important to like use my village instead of just kind of like functioning within our family. Do you have any advice around that or do you hear that?
Allyce:Yes, I think most people want to just have all of these quiet moments with their little tiny family and then they get home and they're like, Oh, no, there's so much stuff to do. It is actually not too many hands to have three adults and six hands for one little baby. So everyone can make sure all of their other needs are being met, even eight hands for one baby. I think that also goes really well. And this is. That's why it's important to talk to the visitors and say, maybe from two till four in the afternoon, you want to have alone time with your little family and do something you had been planning on doing. And maybe you can use their help for the other 22 hours of the day or something like that.
Joni:Yeah, I fully plan on having my mom stay with us for a long time because I have realized how I think that there's like this Picture of what postpartum is going to look like of oh, we're going to get to just enjoy this little baby. And that's true, but there's also a lot of sleep deprivation. And so getting that help to be able to get sleep is huge to enjoying that postpartum period a little bit more.
Allyce:And also the U. S. is like one of the societies where we don't value support from other people, lots of other cultures. The mom is expected to stay in bed for 40 days or around the bed for 40 days and they're getting lots of extra support. I think that it's the individualistic nature of our society that makes us think oh yeah, we should be able to do this on our own, but that's not how things have been historically. And it's not the best way of doing things for most people.
Joni:Yeah, that's a really good point. If you think like a few hundred years ago, that's probably not happening. Women were helping women when they have a baby. One last question about sleep or anything else you want to add, how do you get those five hours of uninterrupted sleep? I guess like you're saying, like from eight to one, if you have a family member that stays up late, that's your five hours of uninterrupted sleep or like, how have you seen people do it and work around that five hours?
Allyce:Lots of couples have different times when they love sleeping. So if someone's a late night person, then maybe they can take the first five hour shift and then the next person can take the next five hour shift. If you don't have outside help, but that's usually how people do it having a more set schedule. And then maybe some people have the person who's watching the baby sleep in the area with the baby and the person who's not in charge of the baby sleeping in their own room or in their own bed. So that way. Hopefully they're getting more uninterrupted sleep and also not hearing the baby and the caretaker too.
Joni:I thought one other thing I thought was if someone's more prone to anxiety, they may really struggle to have someone else take care of the baby. And I guess that is really the value of. Postpartum planning is hopefully being able to treat that anxiety prior to birth. But do you have any thoughts or recommendations around that?
Allyce:Yeah, I think it's always fine to go check on the baby. If you wake up and you're worried about the baby and you're not able to go back to sleep because you're just like, is my baby okay? What are they doing? Then you can just go check on the baby for three minutes and... Hold them and give them a kiss and then go back to bed. And usually people can get back to bed a lot faster if they can have reassurance. I also talked to my parents about a sleep contingency plan, especially for later in postpartum, so say the baby's teething or something is happening and the parent only gets four hours of sleep during the night. It's nice to have someone or know of someone who might be able to help during the day, facilitate a nap for the parent. Maybe they plan to do pizza or something simple for dinner, and then the mom goes to bed much earlier than expected to catch up on sleep, but some sort of plan can be helpful, so then they're not sleep deprived and Oh my gosh, I wish I really had help today, but I hadn't even thought about what I would do if the baby only slept for four hours during the night or something.
Joni:Yeah. Even maybe making a list of people you can ask. I guess it is hard when you don't feel like you have people, but yeah, that's a different thing to solve. Hopefully have someone that can come over for a little bit and help you out with that.
Allyce:And lots of people love babies and are willing to do it. You might be surprised your village might actually get bigger when you have a baby with lots of people wanting to come over and help.
Joni:That's interesting. Yeah. I've talked about this before on the podcast, but if someone asks, like, how can I help you? Instead of having them give you more stuff, you can be like, oh, can you just watch the baby for two hours while I go take a nap asking for your needs to be met. And maybe they won't be able to do it that day, but just. Asking for that more consistently so you can get your basic needs met instead of maybe stuff or maybe meals Aren't something you need maybe sleeps more important than meals for you, whatever
Allyce:Agreed.
Joni:Okay What would be the next topic you would talk about?
Allyce:Then I usually talk about nutrition or eating. Lots of people just end up eating. Out every meal after they have the baby, because it's so hard to be doing that. So I know lots of people do some sort of meal prep or freezer or get a meal subscription plan, which can be really helpful, but even grocery shopping is a lot harder with a baby. Maybe you don't want to take the baby to the grocery store. Maybe you don't already do online delivery and you shop at Trader Joe's. You actually have to go inside the store. It's nice knowing easy meals that you could eat, having a list of them on the fridge that you already have the ingredients for, or who could help facilitate meals, or restaurants you could order healthy foods, take out that sort of thing. And I think lots of people benefit from having food wherever they're feeding the baby. Cause often life revolves around feeding the baby, taking care of the baby. And then once you're sitting down to feed the baby, you're like, Oh my gosh, I'm starving and I have no food. So I think having. A basket of high protein, healthy foods, and also lots of water near wherever you're feeding the baby can be helpful because then hopefully you can be eating nuts or beef jerky or something while you're also feeding or burping the baby.
Joni:Yeah, if I were to be getting this conversation potentially two months before delivering, maybe you could even make a list of these are restaurants that I like to eat at. And this is what I would order. And then there's not this decision of what should I eat? What should we get? What's easy? And then also, yeah, maybe putting 10 meals in the freezer or learning how to do Instacart or subscribing to Beehive Meals or whatever other meal delivery services there are.
Allyce:DoorDash is a great idea of a gift card to give to new parents.
Joni:that's a great idea. What if someone's maybe in a tough financial situation and they don't feel like they could, door dash or eat out or do a meal delivery service? Do you have any suggestions around that?
Allyce:Just having a list of easy, quick meals. Spaghetti is really quick. Lots of rice type of things. You could cook a bunch and eat over several days. I think that does become a lot more difficult. But maybe you can get other people to bring you meals too, and that can be helpful.
Joni:Yeah, maybe emphasize the meal train. Maybe that's more of what you need for the first couple weeks. I love the idea of having baskets everywhere where you feed the baby of food and water. There was one therapist that said like, when baby feeds, you feed or when baby feeds, you eat. When baby eats, you eat. That's what she said.
Allyce:If you are... breastfeeding or formula feeding. I think it's nice to know who you can go to for support too. If you are breastfeeding and that's very important to you, then maybe don't call a relative who's not supportive of breastfeeding. If you are looking for support and call someone who has lots of experience or La Leche League or an IBCLC or something like that. And if you are formula feeding and having a hard time about that, then don't call someone who thinks that breastfeeding is the only way to feed a baby. Call someone who's supportive of your choices, especially in the immediate postpartum where people are already sensitive to feedback that other people might have, but I think lots of people don't do a lot of research on feeding support. They hope that their pediatrician can connect them with the lactation person if they need it, but it's helpful to know if your insurance covers lactation and what sort of resources are available to you before you need it. So then it's one less thing you have to. Research before you can schedule an appointment if needed.
Joni:Do people typically, if they're breastfeeding, go to the I B C L C, is that the right letters?
Allyce:Yes, I think it stands for International Board Certified Lactation Consultant. But yeah, they have the most training in infant feeding. And even if you're bottle feeding, an IBCLC can be very helpful with latch and choosing the right nipple and all of those things.
Joni:Also postpartum doulas can provide some feeding support. That could be a good, again, a good gift to ask for, or they can come just once. I get that they're pricey, so they don't have to come multiple times. They could come one time and just help you with some questions you have or make a meal for you and allow you to get some sleep. So that's another good resource. Hopefully one day it'll be covered by insurance. Right now it's not.
Allyce:Agreed.
Joni:Okay. What's the next topic you like to talk about with them?
Allyce:I like to talk about self care, things that they might be doing already for coping or things that they enjoy doing and that we should try to build in postpartum. Lots of people use exercise as self care and maybe that's not something that will be as easy to do in the immediate postpartum, so they might have to brainstorm other things that are helpful for them, whether it's Taking a bath or getting a massage or going to a soda shop or just going and sitting in the park and watching nature or something. Just thinking about whatever you would do for self care and also your partner. Whatever they like to do for self care and how you can facilitate that whether it's making sure you have extra hands available So your partner can still go to the gym every morning And stay in their routine
Joni:It's good to figure out what you like beforehand because I feel like I have a lot of conversations with women that I'm like, what do you enjoy? And they're like, I don't know. I don't remember what I enjoy. So thinking maybe pre pregnancy even, like what did I used to like to do? And for a lot of people, Social support is huge. I like to go see my friends and now I don't feel like I can okay, can you schedule a walk with a friend or can you go hang out with them for 45 minutes so you can just have some adult time? Or if you like to exercise and maybe it was more high intensity, can you just go to a yoga class, go on a walk around the track at the rec center. So yeah, getting curious with yourself. What is it that brings me joy? Maybe it's reading a book. Can I go to Barnes and Noble and just pick up a book and read for a little bit or even go to the library and browse? So there's lots of options and everyone's different, but really getting curious about what it is you enjoy, I think is a great idea before you have a baby because then it's just so hard to think.
Allyce:Yeah, and I think reaching out to friends or social support can be really helpful for self care Lots of people love to tell their birth stories. So Finding which friends would love to hear your birth story after you have the baby and scheduling a time to talk to them I think that can be helpful for lots of people
Joni:Yeah, I think that's a great idea. Maybe even if it was a rough birth, having someone to process it out loud with because especially if you have a friend who's had a child and your partner has not had a child and so they may not understand like the pain you experienced or the frustration or, whatever. So being able to process it with someone might be really helpful. What about the time as a couple? How do you talk about that?
Allyce:I think date nights are always important, so I would think about what you like doing with your partner now and how you can make sure that you can continue doing it in the future. Lots of times you have to be a lot more intentional about scheduling things, whether it's scheduling 20 minutes after the baby goes down every night to spend time together, but also if you like to go to a movie together, making sure you can go to a movie once a month or go bowling or go to dinner, whatever you might enjoy, but I think it's also helpful to get out of the house and have experience with leaving the baby earlier in the postpartum period. So it's not as anxiety provoking in the future.
Joni:I think that's a good idea too, because it seems like the more time you go without leaving baby, the harder it becomes later on. You've never done it and you're like what if they need me? What if this, what if that, what if they start screaming? And it's good to be like, my partner can take care of them or my family member can take care of them for an hour while I go do something for me.
Allyce:Yeah, and even if you're breastfeeding, you can still get away for short intervals of time.
Joni:Yeah, totally. What if they have other kids? How do you talk about that?
Allyce:Other kids can be difficult because it's such a huge transition for the family, adding a new family member, and often the... Mom is less able to take care of everyone. Just such a huge transition. I think it's important to still spend individual time with the other children or siblings. Think about what would fill their bucket the most. So maybe they would have the most fun if you. took them to the park for 20 minutes, or if you went rollerblading outside with them, or went and looked at a fish tank or something like that. So thinking about whatever could be most helpful and letting them know when the next scheduled alone time will be. And sometimes the dad takes the majority of taking care of the older siblings, but I think the mom should still hopefully make time including to get outside of the house with the other sibling, go get an ice cream cone just something quick and easy like that.
Joni:Yeah, I think that's a great idea. And maybe even if you maybe just want to spend time with just the baby. Who can take care of the older kiddos while we go on a date if we want to bring the baby? Whatever, just exploring those. Who are our support people? Who could we ask if we need it?
Allyce:And some people have the baby, give a gift to the older siblings or Get some toys or activities for the older siblings that will take them a lot of time, especially if you have a toddler while you're feeding the baby, you're pretty stationary. And that can be a time when lots of toddlers like to get into trouble because they know that the parents are stationary during that time. So it can be helpful to have activities for them to do.
Joni:That's a great idea. What other topics do you like to discuss with them?
Allyce:I like to talk about chores. It's not the most fun thing to talk about, but it's something that still needs to happen, including in the postpartum. And usually the mom is not feeling physically well enough to be able to do it. So sometimes it's helpful to have a list of chores you do and how often on the fridge so other people can know what needs to be done. that way if someone comes over and says, can I help? And you can say the bathrooms haven't been cleaned for two weeks, then. They can clean the bathrooms for you, or if you need help folding laundry, or doing vacuuming this is an area where lots of people will get outside help if they can, whether it's a mom, or a mother in law, or a sister or hiring a housekeeper who can help with upkeep of the house during this Period of huge transition
Joni:That's a great thing to think about and that seems like that can be something that is really overwhelming for some. Women because they're like, oh my gosh, I'm falling behind on everything. I can't get anything done. I feel like I have nothing to show for what I did all day long And so having other people that can help with that and stay on top of it. That's a great idea
Allyce:and even at the end of pregnancy, usually it's hard physically to do lots of these tasks because it might be harder to bend over and you are probably not as mobile as you used to be. So even planning for late in the pregnancy who can help with chores can also. be helpful.
Joni:Yeah, who do you suggest like people tend to think of their parents as being helpful support people, but are there other people that you suggest to look into and have conversations with?
Allyce:Siblings, friends, people in the neighborhood often people's support system is a lot bigger than they imagine it is if they just reach out and ask. And lots of people hate asking. I tell people if you're asking for support in the postpartum and you hate the idea of asking for help, then you should ask for recurring help. So instead of asking someone to come help with the baby. This Tuesday morning, ask them to help with the baby every Tuesday morning. It's a lot easier to cancel help than to add help.
Joni:That feels like that could be scary too. Regardless, it's hard to ask for help.
Allyce:it is hard to ask for help, but hopefully if you can get several days of help out of one ask, then that can,
Joni:Yeah, make it more worth it.
Allyce:Yeah, and before you have the baby, it's helpful to make a list or think of who would be best at helping with what thing. If you know someone who's a terrible cook, then don't ask them to cook you dinner, right? Maybe ask them to help pick up your older kids from school or... Ask for help with cleaning or babysitting or something. And if you know someone who's a great cook, then yeah, definitely ask them if they can bring you dinner every Tuesday in October or something like that.
Joni:I love that. Okay, what other topics have we not touched on?
Allyce:I also like to talk about mental health resources that are available and signs that they might need more mental health care. I know these are things that you've already touched on, but like the baby blues and how you might know that you would need extra help. But I think it's also great to have an idea of who you would want on your mental health team. If you do need to seek services. We know people with a history of anxiety or depression have a high risk of. needs in pregnancy or postpartum. So thinking about care providers and maybe even scheduling an appointment because many providers have a list that's several weeks out. So it might be helpful just to schedule something with a mental health provider in the postpartum. So you have something available and set up already.
Joni:That brings up a good point. When you have a patient that goes from pregnancy to postpartum, how frequently do you meet with them after they have their baby?
Allyce:I meet with them usually at two weeks postpartum, four weeks postpartum, and then eight weeks postpartum. Because usually at six weeks they're seeing their whoever helped with the birth of the baby.
Joni:And I think you can just schedule a two week appointment with a therapist. With any kind of perinatal mood and anxiety disorder, specialized therapist, and then you can always cancel it. Like you said, like it's easier to cancel than to go and find one. Or if you're already struggling in pregnancy, starting to get that support around you from when you start experiencing mood changes yeah, there are other people other than like a therapist or maybe a prescriber that you would recommend getting. around you.
Allyce:There's lots of support groups, so being aware of support groups that are available can be helpful for lots of people. There's lots of self care things. Like If you know, a massage therapist that you would love to have or acupuncture or chiropractic care or whatever you think might be most helpful for you, knowing who might be available can be helpful too.
Joni:Yeah, that's a great point. The support groups, if someone's listening to this podcast for the first time there's a lot of free support groups on PSI's website that I'll link. And there are several support groups within Utah. Some that are virtual, some that are in person. If you're more looking for like friends, that might be a better fit right now, but yeah, I think that's a excellent idea. Oh, one thing I wanted to mention, because you told me before we started recording, is that there are postpartum planning groups on PSI. And you said they just meet once and they go through this with you. Is that right?
Allyce:Yeah. With you and your partner or whoever you want to be involved, but it's just such a great. Conversation to have so you can make sure that you're planning for I always say plan for the worst case scenario. Hope for the best
Joni:Yeah. Any other suggestions you have for people who are about to be postpartum.
Allyce:I think just being patient with yourself and realizing it's such a big transition for everyone here renegotiating relationships with everyone, your partner, your parents, who are now grandparents to your kiddo, your siblings, who are now aunts and uncles. So there's so many relationship changes that I think it can be really hard to navigate. And I think that's okay.
Joni:Yeah, that's a good advice. Oh, I forgot. We did want to talk about one more thing. Deemer.
Allyce:You want to talk about Demer today?
Joni:real quick?
Allyce:Yeah. Dysphoric milk ejection reflex. They think it happens in about 8 percent of. lactating women. There's several hypotheses of how it works, but we know when you're breastfeeding, your prolactin has to go up, and prolactin and dopamine, two hormones, are on a teeter totter, so every time your milk releases, your dopamine level has to go down, so your prolactin can go up, so you can keep making more milk. Dopamine is a great hormone and very helpful for mood. If you have a low level of dopamine and it goes down even further, that's what's thought to cause the dysphoria, which can look like lots of physical symptoms or mental health symptoms. Some people get agitation, rage, irritability, suicidality. The physical symptoms would be like a pit in your stomach, feeling really cold nausea, super thirsty and often it only lasts for maybe like 30 seconds to two minutes. Some people have a post steamer haze where they like continue to feel the symptoms a little longer. But it's happening multiple times a day. We know things that make demur worse is sleep deprivation. Often it's worse if someone is pumping and not breastfeeding directly. But there are medications that we think are helpful and lots of other interventions that are helpful, but it's very commonly confused for postpartum anxiety. But it would be treated very differently, so I think it's important to at least bring awareness to so people can know if that's what's happening to them. It's not that anything's wrong with them, it's just that their body is reacting abnormally to a normal shift in hormones.
Joni:Thank you for explaining that. So well yeah, at least it's the one that taught me about this. So I had no idea it existed until six or seven months ago. And I was like, what, how did we not talk about this all the time? Because that's like. What about 10 percent of women are experiencing this and it would just be so surprising to feel like garbage. Suddenly, whenever you're feeding your baby, it'd be very easy to be like, is this how I feel towards my baby? What is this? Especially if it's like your first time breastfeeding.
Allyce:And it's thousands of Utah moms who are impacted because I think the birth rate is around 50, 000 a year. So if between 000 moms a year have demer, then that's very significant.
Joni:Totally. Yeah. Yeah. Thanks for teaching us about that. Let's talk about how people can reach us. What's the best way if they want to work with you or I? To get ahold of us.
Allyce:Usually phone is the best way to contact us. 801 893 9564. And Brittany. Our assistant can help with setting something up. We also have a contact form on our website, felicitywomencenter. com that lots of people use too. So
Joni:Yeah. And we take, I am now paneled with HMHI BHN as well. So we take that insurance, which is blue cross blue shield for university of Utah employees, and then cash pay, which you can use your HSA, your FSA or any major credit card. Cool. I think this is a really, this was a very helpful episode. Thank you for your time, Elise. I appreciate you.
Okay. So things I'm linking first, the post-partum planning PDF that Elise used during this episode and in her sessions. Second, the PSI postpartum planning group so that they go through something similar, but it's with a real person. And something you can attend once. I think it's about an hour. Next I'm going to include. Postpartum support groups in general, because there are so many of them you may have heard. We talk about them before. I've gone to one personally. It was really, really helpful. I felt really understood by the end of the hour. And then the last thing I'm linking is, an episode to a different podcast called thoughts on thoughts. It's KJ Taylor and Jess, or you might also hear them call her bod. They were on my podcast recently. But months ago, back in December of 2022, they did an episode on postpartum front-loading. All three of them are mothers and they discuss some things they've done personally, prior to having a baby that's helped them better in that postpartum period. They recommend things you might consider beforehand. And it can be helpful to listen to if you're pregnant, if you love someone who's pregnant, if you're hoping to be pregnant. And even if your postpartum, it can give you some ideas of how to offload your mental and emotional stress. They're very finally, I'm a big fan. So if this conversation was really interesting to you, this might be a good way to continue learning. And then remind her, like I said, in the beginning, if you could rate it, it'd be awesome. If you're going to put four stars, like maybe don't, but think of it as. Service to your fellow women and helping them find the help that they may need. So just five stars real quick. I promise. It's so easy on apple podcasts. And then last thing, if you are interested in going to the candle making event it's October 15th. So just in a few days, It's at the neighborhood hive in salt lake city. We're making candles, we're having discussion. We're learning a little bit about trauma. And how it's stored in the body. It's going to be really good. There's going to be a postpartum doula there. A pelvic floor, physical therapist, a somatic practitioner, one of the partial owners of neighborhood hive, who does the Oleo skin products and also will help us make the candles. It'll be a really great time and i hope you guys have a great week and if not a great week at least a neutral week and i'll see you next time.
