Tanya Tringali 0:05

Hey, everyone, I'm your midwife, Tanya Tringali. Welcome to the mother wit podcast, a show about the issues we healthcare consumers and providers face every day as we interact with the medical system. We'll talk about its blind spots, shortcomings, and share strategies we can use to feel seen and heard, no matter which side of the table we sit on.

Hey, everyone, it has been a long time since I've recorded a podcast, I really didn't realize how much of a break I took, I took a bigger break than I thought I was than I expected to. But I was really enjoying it. And I think sometimes that happens, you love something, you give it your all, and then you can get a little burnt out on it too. And it becomes a source of pressure, right? So I think everybody knows I do this podcast on my own by myself every bit of it soup to nuts. And it gets to be a lot, you know, the like finding guests and figuring out if it's a good fit, and then having to, you know, read their book, or whatever it is that goes into having them on figuring out what questions to ask them. For putting it together. From a technical standpoint, it's not like I have any skills. When it comes to this, I've had to learn all my all by myself how to edit. And then the social media piece, which really, to be honest, is the piece that I dislike the most. So those of you who listen and follow me on Instagram, you'll notice my prolonged absence there as well. You know, I just want to explain that a little bit, I will put together a post to promote whoever's on my podcast, which again, I'm probably going to be doing fewer podcast episodes for a while moving forward. But beyond that, I am not going to continue making content for Instagram, or whatever. It's never fed my soul. It's not how I get clients. It's how I stay engaged with former clients, which I love. I love, love, love. But it's not the only way for me to stay in touch with my former clients. And I think that my former clients can speak to this, I build enough of a bond with them, that they're in touch anyway, people who have worked with me just reach back out periodically to give me an update on their life to ask a quick question. And I adore hearing from them. And yeah, it's like, a specific kind of friendship that forms over time. Anyway, the other thing is that I, and I think people know this already. But you know, I never know when somebody's listening who's not familiar with me and the way I roll through this world, I do a lot of different things. And I struggled to figure out where to put my focus. Because sometimes when you have your own small business, or your own podcast, or whatever it is, you feel a sense of pressure to grow it to make it bigger to make it better. There's these messages in our modern world about how we're supposed to do that. And I also know that I wouldn't be happy if I only did those things. And so I do lots of other things. One thing that I have recently done that I think you guys have probably seen because I did actually make a post on social media about it is for the first time in my life, I was an editor on a textbook. And that was an enormous undertaking. Over the course of two years, I learned so much I shed tears, I worked hours and hours and hours. On this, it was an enormous piece of my life for two years. And now the book is sitting on a table in front of me and I almost can't believe it. And the life I've set up for myself doing a lot of different things is what allows me to take on these projects that I wouldn't be able to do if I still worked full time clinically. So anyway, you know, I am always working in education in some capacity. I'm often working as a consultant in a wide range of different capacities, often learning new things, while also bringing the expertise I have to other things. And then there's the fitness angle, right. So like in three weeks, I'm doing my CrossFit level two certification. I don't even coach CrossFit classes, but CrossFit is the modality that speaks to me the most, and I work with people who do CrossFit, who also become pregnant and become postpartum and experience the challenges that come with some of those things. And that's really important to me to stay grounded in that space. So anyway, I've got my hands in a lot of pots and that's why you're not seeing me or hearing from me as much. But my thinking moving forward is that I hope to put out a podcast about once a month, if there's anyone listening, whether you're a midwife, or a birth worker, or a health care consumer who spends a lot of your own mental energy in the women's healthcare space, or the reproductive healthcare space, and you're interested in maybe volunteering your time to work with me on the podcast, or social media, or the things that I'm having to lower on the list, because they're not my natural skill set, and they take up a lot of time. If anyone's interested in helping out, reach out, I would love a partner in crime. And I actually do better work when I work in a team than when I work alone. being beholden to somebody else helps me being beholden to myself, I'm pretty good at that. But again, spread kind of thin. So anyway, I just wanted to give you guys that update on what's been going on. On a personal level, part of the reason I was away for so long is because my husband and I, you know, I got married in January, we took an epic honeymoon, epic, epic, epic, we went all over Europe, Germany, Czech Republic, I mean, we were we went so many places, I can't even like spit it all out at once. I have to like I wrote it down, I wrote down where we were every single day, because I can't retain it. We had one day where we were in three different countries in one day, which was maybe a little over the top and unnecessary. But it was a dream of my husband's and we did it. Yeah, saw some amazing things. We love old old walled cities, and really old churches and things like that. And I mean, we just we walked easily 10 kilometers a day, every day for 23 days. It was definitely epic. And from there, I had some health care related stuff to deal with. So we were gone for 30 days, like I turned off my whole life for 30 days. So I stopped taking clients before that I wrapped up recording podcasts. And then I came back and it's just been kind of hard to get back into the groove because some of my work commitments have really taken priority. And I'm really just getting back into podcasting again. So anyway, that's a really long update. But I thought those of you who were consistent listeners really deserved that from me. All right, love you guys.

My guest today is Emese Parker. She's a registered nurse, board certified women's health nurse practitioner and certified perinatal mental health specialist. She has been working for over 20 years in health care, she's partnered with people of all ages, advocated for all their needs and empowered them to make health care decisions about their bodies. I was thrilled to have connected with a Mesha because her new book to carry wonder sounds very much like my online course thriving after birth, except that it's a book. And it's very expertly and thoughtfully woven together with her own personal story experience and expertise as a healthcare provider. And she's way better than myself at talking about certain things that I think you all deserve. That sometimes I forget to talk about, like naming babies and keepsakes and all sorts of things that are part of your everyday journey when you are pregnant that I haven't thought about for over 20 years. So with that said, welcome Emese (mispronounced)... Her name is spelled e m e s e and I read it many times before I ever said it and so she has become Emese. It is ah-meh-sha. Yeah, I know it throws everyone off.

Emese 9:07

But yes, I'm very glad to be here regardless of how you pronounce my name

Tanya Tringali 9:13

I was saying it in my head like this for so long that I am going to have to practice. Alright. Well, thank you so much for joining me today. I'm really looking forward to this conversation. Me too. Thanks for having me. So before we get started, why don't you tell us a little bit about yourself. I mean, I realized there is like the personal version of you. There's your healthcare provider persona. You are now an author, which is so super cool. So feel free to weave in whatever parts of that you feel like are appropriate.

Emese 9:43

Oh, sure. So I live in California and work in OB GYN as a women's health nurse practitioner. I've worked in OB GYN, my whole women's health nurse practitioner and career and have always enjoyed working with women in college as a resident assistant or as summer camps for like women's leadership programs. So being in women's health is something that I've always loved. And I have three children who are in our elementary school age. And yeah, I went to grad school on the east coast where it was much colder in the winter. And now, around November, I can enjoy the warm California fall weather. And I'm super excited that my book is finally done, and so is my family. So it's just very exciting to be on the other end where I get to advocate for women's health and wellness. And not be writing all the time. So yeah, very excited.

Tanya Tringali 10:52

Yeah. Amazing. A couple questions. Where did you go to school?

Emese 10:56

Yeah, Boston College, and then Johns Hopkins.

Tanya Tringali 10:59

Oh, cool. Very cool. All right. So that was one question. The other question I had was, how old are your kids?

Emese 11:06

Oh, so I have a 7, 10 and 11 year old?

Tanya Tringali 11:10

Wow. Yeah. So I started busy life.

Emese 11:13

It is I started writing this book when I was pregnant with my first. So it is like my fourth baby. So it's, it's been a long time coming. And I've learned a lot over the years. And yeah, it's really interesting, like she turned 11 is when pretty much my book was finished and coming out on the market.

Tanya Tringali 11:39

Was it a lack of time, which clearly is part of it? Was it a lack of time? Or was it just something that you needed to put aside for periods of time? Because maybe you needed time to process where to go next? Or how to change up the format or whatever?

Emese 11:55

Hmm, yeah, both. I don't think I've really had a break from this. Sometimes I'd call my book The Beast, but I've never really had a break from it. But yeah, it's, it's tricky to come up with a format that actually achieved what my goals were. So I really wanted a book that would nurture, inspire and equip women in a new way. And so I was really hoping that it would just captivate people in a different way using stories and evidence based information mixed in with artwork. And so for that, to be digestible for people, and for it to be just kind of streamlined. The book went through very many format iterations, and took a long time to figure it out just for it to be conversational. Like, initially, I was just planning on doing a memoir. And then I have a podcast recording of how I mentioned this. So my sister repeatedly can feel blamed, but it's basically she read my book. And then she said, well up at Meshi, which is my nickname. So you are a nurse practitioner. So I mean, don't you think you should have some information in there, not just your own experience. And I was like, well, that's a good point. But I thought I was done with a book. That was in the very beginning after she read the memoir entries. And, and so I took that to heart and I didn't realize what I was getting myself into. But originally the like, the way that the book is formatted it for the reader listeners. Basically, there's it goes week by week, from the beginning of pregnancy all the way to the first like actually four months postpartum. And each week, there's like two memoir stories that hopefully help them relate and reflect on their own pregnancy experiences. And then there's a let's talk about it, where we go deeper into some kind of a topic. And so originally, I wasn't planning on having an educational topic in each week. And it was just like, like, maybe every month or something. And then the book, I had all the education in the back of the book, but then it felt like a separate textbook, and it felt like two books. And so then it was like reintegrating it in to the book and how like just finding the tone that was easier to read and was cohesive. That took a long time. So I worked with a wonderful editor, Rachel Richardson. And then as we're working together, she's like when you told me you think we should have an educational topic in each week. That was like each week. That's, that's a lot of content. And I really was wanting this book to also be able to be a supplemental textbook for like nursing or Midwifery, broke maternity care courses. So I definitely wanted to have the research backing what I'm saying and those, those let's talk about it. So that took a lot of time. Extra time doing that. So here we are.

Tanya Tringali 15:05

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I imagined as I was reading it, that you probably had just started out as an intense journaler. And you were just journaling about your pregnancy. That was what I sort of imagined. That's true.

Emese 16:05

Yes, that is true. Because I couldn't have imagined any other way how you could remember in such detail those similar moments, I have a 23 year old and I only have one child. So at this point, like a lot of those simple moments are gone. For me. They're just poof, gone. Yeah. And you recounted them with such detail. And with such a nice story telling tone. And then it you know, it changes over, but it doesn't change over in a harsh way. Like I think people listening might not understand how these two pieces come together so nicely. But they do because you remind us that you're a real person who experienced pregnancy multiple times. But that you work in the field, and you have this way of melding the the experience, and then it kind of takes you off into the the educational piece. And you know, as far as the consumer is concerned, I think what's so special about this book is the way it has taken a book, I don't love that I you know, I don't know what people are going to think about what I'm about to say. And maybe this book is too old, and people don't even know it any more the way I think people do but you know what I'm gonna say already. What to Expect When You're Expecting? Yeah, it's like you took What to Expect When You're Expecting a book I don't like a never liked by always found a way to fear mongering. Despite the fact that no topic goes on for too long. Somehow, they managed to just terribly fear monger. Now I realized that book went through many, many, many iterations over the years, and it probably still has a current iteration. And maybe it's much, much better now. But I know the version from when I was pregnant in 1999/2000. So and maybe I even had a used copy that was older, I don't know. But um, what you did, I feel like your book is in that genre. But you really modernized it and softened it. And the piece that I find most interesting. And I'm assuming you know this, you're like, yeah, thanks I know, is you when you say let's dig deeper, you... that's what goes in the back of the book, so that people are choosing what to dig deeper on. And that's so important to me for two reasons. One, I feel like we live in an age of information overload. We also live in an age where people are really traumatized by all the things they're told they need to do to be the perfect vessel. And there's such an intense balancing act that each individual experiences as they go through that and I think your book gives people choices. So I'm wondering what you think about that, if that was like really intentional, involved over time, if you realize that that's impactful.

Yeah. Well, thank you for all those thoughts. Yeah, it was intentional, because I just felt like in the the run of the mill prenatal appointment that people have, there is a lot of important content that's not covered. And, and we focus a lot on blood pressures and fundal heights and labs and those visits are really fast. And, and so people miss out on some really important transformative even just the transformative topics and even just acknowledging that their experiences of pregnancy and motherhood are going to be really different, possibly from what they expected, or from what their mom thought it would be or from their for what it how it looked for their friends. And so my hope was that they could have a space to authentically experience their own pregnancy because so much changes in the bio psycho-social-cultural career, I mean, everything changes, and we don't necessarily expect that to happen. And so by having these different topics, I'm hoping that people have like the opportunity to learn the basics of some very simple things even like how do you connect with your healthcare provider to have you talk with your partner about difficult things? And how do you process what you're going through? And where does maternal mental health fall into this and how common it is? So there's some really important things that I was hoping that most people would want to just quickly skim and let's talk about it. But yeah, if they're wanting to go deeper on like, Well, can I take psychiatric medication when I am pregnant? Or breastfeeding? Or should I automatically stop? Because I'm pregnant? You know, I'm, I'm pregnant? Or, you know, how do I know if I have a healthy relationship with my body? And so some of those are, what are the birth control options? So there's like some of those more specifics are in the back. And hopefully, people find it, like easy to find, because there's a lot of bulleted and like, kind of like down and dirty topics that are meant to be easily found. So yeah, I'm hoping that people can like pick and choose what they want to learn more about.

Tanya Tringali 21:14

Well, and I think the reason why that really spoke to me is because in my comprehensive postpartum care program, which is the thing that most people come to me for, I do work with people from preconception all the way through pregnancy and postpartum. But I would say majority of people join me in their last month of pregnancy, and through at least three months postpartum, no two people will follow the same timeline on what they need. And when, when it comes to those deeper dives. And so while I have mapped out everything I think everyone deserves to at least hear once, just because thinking about returning to sex or fitness might be on my list to start talking about as soon as four weeks if somebody's ready. I don't push that down their throat, we might not talk about it till six months if they're not ready. Yeah, you know, they can push that topic off as long as they want. As long as they know, I'm available to have that deep dive discussion when they're ready, and then that we do that then. So I feel like your book is doing a lot of the same things that I do with people one on one, it's such a nice accompaniment of, you know, it's like choose your own ending almost right, like, I'm gonna skip this for now. Because I'm not prepared for that information. Or I've heard that too many times. I don't need anymore. It doesn't matter what the rationale is, yeah, that person just skips the deeper dive right. And so I think what's cool is, if someone were to buy your book, and read it, just week by week, it's really only a few pages of reading each week. And so I think that was what I really loved also about that information overload piece, right. But then when you take it to the other side of the discussion, when it comes to like that triggering thing, I was thinking about the way you handled food, for example, I have learned, sometimes the hard way that food is a triggering conversation for people. And it's one that it can be hard to have, sometimes you hit it on the nose, and people love your approach. And sometimes they don't. And I'm learning how to be very different with different people about how I do that. But what you did was bring it up, say this is an important thing. Explain why tell your personal stories. Here's more information if you want it in the back of the book. But in the meantime, here's some like super simple snack options for you. And it was so not threatening, but it gave people some tools that they didn't even realize they were looking for. But every pregnant person is looking for some snack options. Let's face it.

Emese 23:47

Yeah, I've had a lot of people ask me for that. Because it's so easy to just grab the quick, like the chips or grab the soda. And so like how, what are other options, like wasn't let's try popcorn, if you like the crunch, or if you want the bubbly, like try sparkling mineral water and put a little bit of juice like there's just like ways, so we can slowly start in, like getting more nutrition into our bodies. And I am really grateful because I think originally where I started learning more about that was as a diabetes case manager. So that was actually my first nursing job in inner city Boston Health Center. And, you know, we we had to figure out how do we engage people in eating more nutritious Lee but you know, we don't have to do something super dramatic, like let's just like realize that they're, you know, how we eat has a lot. There's so many things that influence that, how we were raised, what our culture is stress eating, I mean, what's available to us, and I think about you know, those food deserts across the US where huge populations don't even have access to nutritious foods as easily so a lot of things play into it. And if we can work together and start slowly, Lis exploring options that are not that hard, but maybe new, then then then we have a place to start.

Tanya Tringali 25:16

Yeah, no, you did a really nice job of just opening the door to some simple additions, right? Like, what I'm learning from working with people when it comes to talking about food is, and certainly this isn't new. I think a lot of great practitioners know this, but it can be hard to put into practice, we would do a lot better. And people would listen to us more, if we talk about healthy things to add in, rather than talking about what they need to get rid of. Anytime you have someone adding in healthy options, it will naturally reduce the unhealthy. And the second you say to someone, you can't have this, yes. makes them want it.

Emese 25:58

It's like don't think of the pink elephant. Right?

Tanya Tringali 26:04

And your your your options in there were like I was like, hey, I need to review these again. We all knew that. It was great.

Emese 26:11

Yeah, I had a really great nutritionist, registered dietitian, actually who helped review my content for for the book, Veronica Benjamin, and she was really helpful because she reminded me how let's not talk about foods as good or bad. Let's think about foods as nutrient dense or nutrient and light. And how do we so when we're thinking about eating for two, were really not trying to eat double as if we had a whole adult inside of us. But thinking about how to like reminding our patients or, you know, for pregnant reminding women that we're trying to get nutrition into our bodies that benefit both us and our babies. And that doesn't mean we have to eat perfectly. It just means we need to kind of keep tabs on like, okay, are we are we generally getting what we need. And then that's when I remind people first trimester, you know, just the goal is survival. Just try to get food down, that you're not gonna throw up. And then when you're nauseous, better, then we can start thinking about more, more options.

Tanya Tringali 27:22

Exactly, exactly. Another thing I really appreciated as a health care provider, was that you were inclusive of all health care providers. And I realized, because you're a women's health nurse practitioner, that put you nicely, I think, right in the middle between a bunch of other provider options. And so I think it was came natural to you. But so many books, just still to this day, just say the word doctor as if they're the only option. Of course, as a midwife, that annoys me. You know, you talked really broadly about different types of providers, the benefits of all the different provider types, you even talked about switching providers, which is something I find myself talking about more often than I wish were true. And people have a really hard time coming around to making a switch, even when it's in their best interests. Right. That's that feeling. And I, you talked about it in the book that you feel beholden to someone, because they took care of you for a long time? Or maybe they were your mothers or your sisters? Or maybe they delivered you Right? Like, yeah, there's these ideas that people get in their head about why they have to stay. And they really have to soul search and realize that it's not the end of the world if you have to change.

Emese 28:34

Yeah, I think that's so true. And if people and health care providers looked at that health care provider, patient relationship, and thought about it more like a collaboration as opposed to a hierarchy, I think we would have better experiences within the healthcare system and and more meaningful. But I think about, like, the most effective relationships that I've seen between health care provider and and patients, and it's when there is that trust. And there is that comfort level for people to really be able to say what's on their hearts, their concerns, and when were dismissed, that we don't they don't have time to address our issues or being disrespected or not having our questions answered, or with a decision to be made and we don't have the pros and cons explained to us. And if they just don't get us like they're culturally or what in whatever way we want to think about diversity, if they don't respect us, and understand what our needs are, then it's really, yeah, go find someone else. Because Because you're not only is it a disservice for your own health, it's also your your baby that we're talking about, or your child that we're talking about. And it affects everything. And so I yeah, I am a huge proponent of people just evaluating that relationship with their healthcare provider. And then if, if for whatever reason, that's not going well, after multiple attempts to, you know, to improve that situation, then, yeah, please go and, and find someone. And then for healthcare providers, like let's, it's really hard, because we don't have that much time built into our schedule to really delve deep with our patients sometimes. And so just the way that the healthcare system is set up can be limiting, in how much we can really, really sit down and have a heart to heart with our patients. But as much as we're able to, you know, when we're in that room for us to ask, ask our patients like, what is what is your priority you have any questions or concerns for me for today, and not just going in with our own agenda can be really helpful, I think.

Tanya Tringali 31:20

Hey, everyone, it's me, Tanya, your host here at the mother whip podcast. You know, I sometimes invite my clients on the show to talk about their birth stories and postpartum experiences. But I want to tell you a little bit more about what those clients and I actually do together, I started mother wit to help people in the perinatal period achieve their health and wellness goals. That means whether you're hoping to conceive and struggling with high blood pressure, or high blood sugar, or you're having trouble managing anxiety, or depression in the postpartum period, or maybe you just need support and advocacy between prenatal or postpartum visits, I can help get a discount on your first consultation with me at Motherwitmaternity.com, using the code, firstconsult10%off, that's one 0% symbol, all one word, I'm looking forward to working with you, and maybe having you on the show too.

And to take it just a step further, and it's a big step, I think we also have to know when to suggest to someone that maybe this practice isn't the right practice for you. And I've worked in practices were occasionally or a little bit more than occasionally people come. And they think, Well, you're a midwife, you're gonna be what I was looking for. But midwife practices come in all shapes and sizes, too, and volumes and acuity levels and all of that. And, you know, I have looked at people and said, I adore you. But I think you might be better off over here. And you know, those people will often sometimes they take you up on it, and sometimes they don't. And that's okay. Sometimes I say thank you for saying that. I understand why you said and I really respect you and appreciate you for your willingness to say that, but I've grown to like you guys, and I'll put up with those other things or whatever it is right? And then sometimes they go and then they thank you for going. rarely have I ever had someone come back and say why did you tell me to leave? Right? Yeah, if you pick and choose, do you say that to wisely? That's not usually the way the conversation goes. But yeah, I think that that's, that's a big leap to ask providers to make. And I can see why that can be challenging. But I think sometimes that needs to be said.

Emese 33:29

Yeah, I agree.

So okay, something I found a slightly humorous and my own midwife brain and I think you'll get it, but I'm wondering what your personal experience is. So like, when you were talking about fundal height, and using fundal heights as as an example of something I can't remember what I don't remember whether you were just teaching about it, or whatever. But I thought to myself, I could tell you're such a lovely provider, because you you state your information about fundal heights as everybody gets them. And my experience and I think you know, what I'm gonna say is, there's a shocking number of people out there who will tell me that they're usually doctor have never put their hands on their belly in this manner. They have no idea what I'm talking about when I use that term, or I mentioned a measuring tape. And that was news to me. When I left full time clinical practice and started doing the work that I do now. I remember the first number of times being like, What, no one puts their hands on your belly. And this way, they don't feel the position of your baby. It's all done by sonogram and it was like, my mind was kind of blown.

Yeah, I think we going along with that there's so many things that we quickly can do with a patient or, or to a patient that we don't really explain what what the purpose is and what the limitations are. And we're if someone's measuring larger or smaller, authentic, you know, their gestational age. So it's just an estimate, and hopefully it's somewhere close. But if it's smaller or bigger doesn't mean your babies younger or older. And so trying to explain the very basics. Yeah, that's surprising to hear that some people would just never even, you know, just evaluate their their cute little belly.

Yeah, it made me realize, well, I now know you're someone who touches bellies every day. And you think everybody does that too? Crazy news to me. Yeah, totally. Yeah, I mean, I think the reason that I take the position that I take on this is, it seems to me and I cannot prove this. But it seems to me that the same people who haven't had their belly touched in the thoughtful ways that we touch when we're doing fundal heights and Leopold's Leopold's is when we're feeling the position of the baby and seeing, you know, is it dipping down into the pelvis yet all of these things? Those are the same people who tend to have a provider that's also amping up some amount of what is often fear mongering about the size of their baby as they approach term. And it's always very interesting to me to see that and I'm not sure the extent of those sonograms, right, I don't think they're getting like full biophysical profiles with estimated fetal weights every visit, that doesn't make any sense. That's not a standard of care that anyone follows as far as I know. So I don't really understand how those discussions evolve when it's a sonogram for the purposes of, you know, is the heart beating appropriately? Where's the spine? Where's the head? Okay, that's that. And then there's commentary about the weight. And that's something that I find myself unpacking with people a lot.

Yeah, yeah, I in my, I think just have worked more in settings where we are routinely putting our hands on our belly, so their belly, so maybe I've gotten lucky in that way. But when I think about the variety of health care that people are getting across this, the US, I mean, it is very different in some places. And I hope that that changes, and my my other hope was that through just talking about some of those topics in my book, that that people would really feel empowered, to know when to speak up, and when to seek out other resources. So that they are not just unaware of how their healthcare, like what quality health care looks like.

Tanya Tringali 37:36

Absolutely, absolutely. Did you always intend to go as deep in the postpartum realm as you did in the book?

Emese 37:47

Um, so going back to what you were saying about Asana, like I was journaling, through my first pregnancy, I've always journaled my whole life. So ever since like fit, I still, I can find my fifth grade journal. Like I've journaled. They're all in boxes journal throughout my whole life. And when I started writing the book, I thought, okay, I definitely want would like to journal throughout pregnancy and into the postpartum. Because it's, I was hoping that people could see the day to day changes and challenges and transformation that we all go through, but maybe in different ways. And so yeah, I journal through the postpartum, like, through the first four months. And, yeah, I really feel like we focus so much on pregnancy in prenatal care, that postpartum hits. And that's where things get crazier and trickier. And I won't say more difficult, but it postpartum is, I think, an unexpected time challenging time for people because we have so many myths out there on what motherhood or parenthood will look like. And so, thing I'm thinking about how we think that it's going to be so intuitive, and even, like, you know, those who choose to breastfeed, okay, that's, you know, have two breasts attached so that how hard that can that be to figure it out. And it's hard. And, you know, we need to have our house together and juggle going back to work for those of us who choose to do that. And there's, we don't have a very realistic understanding of what postpartum looks like. And so my hope was to kind of vulnerably share some of those things that whether it's what it's like to drive home, in the car with my baby, to what it's like to have sex for the first time, you know postpartum, or what it means about my own fulfillment as a woman now who's a mother, I really was hoping to just help people explore that more. And what's really interesting is, even though I've been in women's health for so long. I only recently heard this word, which is matrescence. Haha. And it's like, how can that be? So I basically wrote a whole book on matrescence through an experiential lens. And that term has, even though all the research I've done, it's like hidden is a hidden term that has not penetrated mainstream culture, or literature, when I do the research, and what, for those of us who don't know what it means, basically just like adolescence is a child becoming an adult matrescence is women becoming a mom. And it's the same major transformative process identity shift that we go through, and it lasts for years. And so we, we don't have that most of us don't have that validating term to understand why is motherhood so hard? And why do we feel not like quite like ourselves, and our bodies are changing out of our control. And if we could just help women understand what, like when they're pregnant, they're starting the matresence journey actually starts preconception. But when they're on this journey, they are now engaged in this adventure, that is going to be really transformative. And it's, I like to tell people, if it's an adventure, it has its, you know, it's fun parts, and it's unknown parts. And it's scary parts. And so not all of it is enjoyable. But if we can understand that that's what that is the the process that we're on right now, then I think we're going to understand more of what we are going through. So hopefully, the just having those vulnerable stories in the postpartum kind of helps shed those myths of motherhood, and helps people think about what their own experiences are.

Tanya Tringali 42:35

So something really funny, as you described your definition of mattrescence, I, I noticed that there's something that we you say that is the exact opposite of what I say. And yet, if you listen to you fully, it we're saying the same exact thing, even though we say it in a different way. So what here's the interesting thing, you talked about how it happens over a long period of time, and I have never actually thought of it quite that way. Because when I make the comparison to adolescents to explain it to people, I see that adolescence is more forgiving, because we give people about 10 years to make that process. But when we become mothers, we do it in an instant. So I although true, both are true, even though we're saying exactly oppositely. So I realized that I in making that bold statement, and up erasing the journey, the journey that starts preconception. And that was really like special for me to hear you say that, because I realized that I have not pointed that piece out that it can be stretched out in this way. Because I have focused on it as a direct comparison to adolescence being a slow process that doesn't have a pinnacle.

Emese 43:52

Yeah, and actually, I can relate to the way that you described it because I now that I've been re like, I've been thinking more about motherhood through this matrescence lens, I look back at like one of the entries. I have a med book on becoming mom and yeah, and I have like it's, it's a process. But yeah, you become mom. Obviously, when your baby comes out, or when you have your baby that you've adopted or the child, you are then a parent. But the other part of it is it goes on for a long, long time. So I'm already thinking like, Okay, for the next version of the book, I need to just explain that a little bit more. And this is not my own concept. So this was originally coined by Dana Rafael way, like decades ago and then in Columbia University. Dr. Orly Athan is the one who is really studying what this looks like and how it goes on for a number of years.

Tanya Tringali 44:57

Now, whenever this comes up on the show, Ialways link out to a TED Talk by Alexandra Sacks. Have you heard that one? Yeah, I think it's just such a nice one that I think people really enjoy listening to. And it gets to the point. And you know, our listeners get the gist without having to like take into the academic side of it. Yeah. So I will link to that, again. For our listeners, it's a really beautiful talk. Yeah, there's so many ways to unpack that. So kind of on a related note, I guess I'm curious if there are things in the book, be they part of pregnancy or postpartum that may not have been there for you had you not had your own pregnancies and postpartum. So what I'm getting at is providers, I don't want to talk about whether or not a male or female provider is preferred, or whether someone who's had babies or not is better at their job, I kind of I really disliked that discussion, because I know male practitioners that are fantastic. I know many, many, many female identified providers who do not have children, and they're incredible as well. So I never want it to be from that position. However, there's no denying that when you have your own experience, you have some aha moments. And I, I had my baby and that's what got me into midwifery. I was a young young mother and I got into midwife midwife Midwifery, then so I don't have the before and after. Whereas, because I was a young provider, I got to watch many of my colleagues go from not having children to having one, two or three children, and see how that changed them. And it was always fascinating to me to watch them come back to work after maternity leave. And sometimes they would get a little emotional at something that they had previously talked about 100 times and now it hits them differently. So I'm kind of curious how your own experiences changed you as a provider and how that may have affected your book. Because you don't know what you don't know.

Are you pregnant, or a new parent looking to ensure a better postpartum experience? Or are you a birth worker looking to improve your postpartum care skills? Check out thriving after birth, an online self paced course by me midwife and educator, Tanya Tringali. It's 10.5 hours of video content featuring experts in lactation, mental health, pelvic floor health, pediatric sleep issues, you also get worksheets in a workbook as well as options to have a one on one session with me sign up at Motherwitmaternity.com/thriving. And let's improve postpartum care together.

Emese 47:38

Yeah, so that's a really good question. I think that's again, the benefit of a book dragging on for a long time is that it grows with you. So I kind of dove into the the perinatal mental health world about seven years ago, when I was trying to find a group of people who really were trying to look at the wellness of women, and not just the physical experiences of pregnancy and motherhood. And so as I started going to more of those conferences and attending more of those talks and reading more, that's when I started really understanding the how parent how common perinatal mood and anxiety disorders are. And that's like one in five people, if you think about from pregnancy to the first year after you have your baby, like until a baby is one. And we're I mean, it's that's a very big window where those are really common. So the book just as I was, as I was learning about these things, I was integrating them in, I would say what was what has helped going through pregnancy? In my own experiences in providing health care to others, I would say yeah, the awareness of that journey of motherhood and pregnancy, it's there are so many other things that we are not routinely talking about in prenatal care, that were just surprising to me. And and how difficult like even though I've been taking care of, you know, pregnant women for a couple years before I got pregnant, it was eye opening. And I just still remember my mom who would tell me that pregnancy is like the best time in a person's life. And that was very true for her and she, I think would be serially pregnant if she could because she just loves that time of her life. And so when I became pregnant, it was very different and like this is really hard and it sucks to have pregnancy nausea, and as you just feel it can feel depressed and down from that. And oh my gosh, like my, what is my body going to do and look like? And and I remember journaling, like this seems kind of like petty to think about, like, am I gonna have hemorrhoids or like am I gonna have stretch marks or, but really, when it's your body and you're you've lived in that body for a long time, you kind of want to know what it's going to do, and how it's going to change and how you're going to change. And so I think the just going through the growth, Inside Out figuratively and literally was way beyond what I expected. And as far as postpartum is concerned, it was, I mean, I think I was pretty much clueless about how intense motherhood is, especially the first few months postpartum. I mean, I still remember taking, you know, bringing our daughter home. And the first night, she literally screamed from morning until night, literally, like, I remember, like the hardwood floors, reverberating like, oh my gosh, like I just had a really long, difficult, exhausting labor experience. And now my husband has a cool, so we don't want him taking care of the baby. And it's me and her. And that morning, I thought it was gonna die. Like, I don't think I cut out from other who's like, how am I going to possibly survive 18 years of this when the first night I feel like, I cannot go on and. And so I think I that taught me, okay, well, yeah, it is really hard, we really do need a community. And I was grateful that my mom and my sister came and helped and gave me a chance to sleep. And breastfeeding is a lot harder than I anticipated. And I remember just feeling very sure that I wanted to breastfeed for the recommended amount of time as long as possible, and at least a year, and when I was in the throes of it, I just thought oh my gosh, I don't know how far I'm gonna get. We'll be able to take it day by day, but it is the around the clock aspect of it. And the sleep deprivation is, is really exhausting. And so that has, I think, allowed me to give people more permission, like okay, you know, there, it's not all or not, you can breastfeed if you want to. And you can also formula for you too. And, and we have to think about the mother's wellness, that's the biggest gift we can give our babies is, isn't as ourselves being well. And so we can have like, we can be a little bit more creative about how how we can support you postpartum.

Tanya Tringali 52:40

Yeah, and I think you know, all that you're saying about postpartum and all that we said a little while ago, a few questions back is with the backdrop of next to no care in the postpartum period. Yes. And I think that memo has gotten out to people. But what hasn't really gotten now and I think it's in part the responsibility of health care providers to be to admit this more readily. We don't actually know the answers to most of the things that are troubling people. Because we only see you at very particular points. So if you work in the hospital, you might see someone those first one to four days. And in some situations, we see people at one or two weeks postpartum, if you're lucky, and then most people are seen or hope or offered to be seen anyway, many people don't come we know, to the six week postpartum visit. And that's really not a lot of touchpoints. And so when people call on the phone to their medical provider, with the seemingly air quotes, small, little questions, you're often getting answers that are coming from one's personal opinion. Yeah, not from extensive experience in working with people through this time, or from even the literature because that is not where we focus our attention when we are learning in our educational programs. And so we learn with time, we learned by asking colleagues questions, but then sometimes we're just repeating things that were said to us that we don't even know if they're true. And this is how I you know, just a little context is how I got interested in pregnancy and postpartum exercise as a specialty because I recognize that most of what we healthcare providers were telling people was simply untrue. And so it became a big focus of mine in terms of just like digging into the literature. Anyhow, it's the same for postpartum. And I learned so much from my clients in the early years of doing the work that I do virtually with people, because I encountered every little question I asked them to tell me what they were. And I dug very deep to get to the bottom of the answers. And then on top of that, I started to see what are the common themes here that people are coming to New with over and over and over again, and how can I give these people the tools to get ahead of it to be preventative to be proactive, whatever it is, which is what led me to get people on board around 36 weeks saying, hey, now's the time to change gears and start thinking about setting ourselves up for success. Because we can't do this alone. Yeah, and we never think about postpartum not, we never, but oftentimes don't think about postpartum until the baby's already out. And then it's too late for planning. Yeah. Now we're just in the throes of it. So, you know, that's been my big like, push. And, again, I love that your book goes into that, hopefully, what happens is that, obviously, some people lucky luckily, will get this book while before they're pregnant and plan to read it as they go. Some people might get it a little bit later. But people once they should get a little ahead of where they are. And, you know, get to that read, they gotta read the postpartum piece while they're still pregnant, at least those first couple months, but preferably, they got to squeeze in that extra postpartum reading. So maybe they do it out of order. I don't know, maybe they read the week they are pregnant, and then they read the first bit of postpartum and get a little ahead, who knows that maybe you have an idea of how people should approach that. But they shouldn't wait to read that part. Until they're postpartum. Because who's reading when they're postpartum? You can take you can keep your eyes open if you have a chance. I mean, I think I put me to sleep early postpartum.

Emese 56:12

Yeah, that's actually why some of the entries are most of the post five entries are shorter, because people have less time. But yeah, if there's a way that they can read that earlier, so they're more aware of what commonly people go through that I think that'd be awesome. And yes, there, there needs to be so much more advocacy and change on supporting people postpartum, which is why I'm like, so thrilled to hear about the program that you have. And, you know, hopefully, you know, we can just continue also, educating our healthcare providers and our students. This is something that I'm hoping to do in the coming year is just talking to more nursing and midwifery students and just talking about perinatal mood and anxiety disorders, may trust and so they, even if they haven't gone through that experience themselves, they would have a deeper awareness of that transformation that people are going through and the type of care that they need.

Tanya Tringali 57:12

Yeah, definitely. Well, is there anything else specific about your book that you really want to share with our listeners that perhaps I haven't touched on?

Emese 57:22

Well, you've touched on so much, which I really appreciate. I think the one fun thing I did want to mention is that it is part of the proceeds do go to International Justice Mission. So IJM is a global nonprofit that is trying to reduce violence and slavery. And the statistic is quite frightening where we have 50 million people still held in slavery today. And human trafficking generates about $150 billion a year. And two thirds of that is from commercial sexual exploitation. And a lot of that is in children. And that's a really horrifying statistic. These are horrifying statistics, obviously. And I love that this organization is working to eliminate that globally. So I'm excited to partner with them and just some of the for the some of the proceeds to go towards that.

Tanya Tringali 58:18

Awesome. Well, I will make sure that that is in our show notes so that people can check them out. My last question for you is other than your book, what is your favorite, favorite reference or resource that you share with clients that you want people to know exists out there for them? Okay. Yeah, I love Postpartum Support International. They're amazing for those who have not heard them. And they're not just supporting women birthing people through in postpartum but actually also in pregnancy. And they have lots of free online groups that people can join and then the other one is the maternal mental health hotline. So that's a really cool resource that's available 24/7 And they can also get really good support.

Awesome these are both been in my show notes a number of times they will be up here for this episode. I love it. I love it. Tell me what your Instagram handle is so that people can follow you if they'd like. Yeah, it's @ToCarryWonder Yep. So they can follow me there. And then also on my website, which is to carry wonder.com There's freebies on there for people, everything from like a pregnancy, postpartum roadmap on kind of like what to expect in the healthcare in general changes that we go through tasty snack handouts there for free. There's a postpartum care planner, and different things. I'm always updating so and different resources as well so they could check that out. Sweet. I will be sure to share those cool.

It has been so lovely chatting with you today.

Oh, well, thank you. It's been fun talking with you. I really enjoyed it. Thanks so much.

Emese 1:00:14

Thank you

Tanya Tringali 1:00:20

Thank you for listening to the mother whip podcast. If any of the issues we discussed today resonate with you or your experience, I'd love to hear from you. Leave me a voicemail at 917-310-0573 Or better yet, email me a voice memo at Tanya@MotherWit Maternity.com. I really want to hear what worked for you what didn't work, what support you'd wished you had, how you got through the tough times how you advocated for yourself, or especially any tips you want to share with our listeners. I want to hear all of it. And if you'd really like to work together, you can get a discount on your first consultation with me at Mother wit maternity.com using the code firstconsult10%off. That's one 0% symbol, all one word. Okay, that's all. That's wonderful being in community with you all. Thanks again for listening and see you next time.

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And remember, listeners, nothing we discussed on this show should ever be considered medical advice. Please speak to your local provider about anything that comes up in this show that resonates with you and your needs and your health care.

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