Questions Women Secretly Google at 2AM - With Dr. Sara DeNolf

This week on Navigating Between the Lines, Maggie sits down with OB-GYN Dr. Sara DeNolf for the women’s health conversation that usually happens in group chats, late night Google searches, or quietly in our own heads.

They get into pregnancy, miscarriage, fertility, postpartum recovery, painful periods, hormones, birth control, aging, and the pressure women constantly put on themselves to “do it all.” But beyond the medical side, this episode is really about normalizing the things women carry silently every day.

It’s honest, funny, emotional, and full of the conversations more women need to hear out loud.

Questions women secretly Google at 2am? Yeah… they covered those too.

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Transcript

SPEAKER_00 0:00

I love it. I'm going to take one little sip.

SPEAKER_01 0:02

Oh, yeah. Thanks for the coffee.

SPEAKER_00 0:03

Mm-hmm.

SPEAKER_01 0:04

Gives me a life.

SPEAKER_00 0:05

Oh my gosh, it gives me this is my third one of the day. Oh, yeah. I think so. I will rip it. All right, guys. Welcome back to Navigating Between the Lines. My name is Maggie, your host. Okay, today's episode is one of those where I'm like, why have I never done this before? Because today we are getting into women's health, the real version, pregnancy, miscarriages, fertility, all the things we don't always say out loud. And definitely Google at 2 a.m. And I brought in someone who has literally seen me at my most vulnerable. Like, really, there's no secrets here. Dr. Sarah Dinoff, who I will call Sarah, but just know she's a real OB and she has also seen my vagina. So we are starting there. Sarah, welcome. I'm so excited you're here because I feel like women talk about all this stuff all the time in a group chat or whatever, but we don't actually know anything. Just a quick reminder, you guys, this is an educational and general information only. She's a doctor, I'm not. This does not constitute as a patient-doctor relationship. And you would need to consult your own physician for any medical advice. Okay, I'm gonna dive right in. And just to say it, some of this gets a little heavier, but also remember we're all navigating these things. And it's what a lot of women are quietly curing. So welcome to Navigating Between the Lines.

SPEAKER_01 1:30

Well, thank you so much.

SPEAKER_00 1:31

It's great to be here. Thanks for having me. Of course. Before we go on a deep dive, I just wanted you to tell me what's the most common question you get in your office?

SPEAKER_01 1:41

Oh my goodness. Number one most common. It's is fill in the blank normal. And it's almost always, yes, it is normal. I think like women in general are so hard on themselves and critical on themselves. And so they are always coming in wondering if this smell is normal, if this feeling is normal, this amount of something is normal, um, you know, is the way I'm feeling about something normal. And it's always like, yes, your experience that that can be normal. How can we help you navigate that?

SPEAKER_00 2:11

And like such a wide range, right? Like that's the biggest thing. Even when I was sitting down thinking about this, if you like line up all your friends, everybody probably has a different, a different body, a different experience, a different story.

SPEAKER_01 2:25

Right. And everyone tries to fit themselves into one thing that they think they should be, but it's like you can be who you are. It's okay.

SPEAKER_00 2:32

Okay. What's something women worry about that they do not need to?

SPEAKER_01 2:37

Oh, this is a great question. I'm really passionate about this in my office specifically. Okay, we'll do if you come to see me and then a diagnosis. Okay. Okay. If you come to see me, we do not care if you shaved or if your socks are mismatched or any of that. I promise you. I always tell like my friends when we're at dinner and they're worried about this, or if I'm talking to a patient and then I'm like, we should do an exam, and they're like, Whoa, I was not prepared for this.

SPEAKER_02 3:01

Yeah.

SPEAKER_01 3:01

It's like, it is fine. I promise. If I left a room and someone was like, Can you describe the pubic hair on that person? I couldn't do it. That's just not what we're focused on. That is okay.

SPEAKER_00 3:11

That's funny because oh my gosh, no, yeah, I would for sure say that. I probably have said that in 10 plays today. Yeah.

SPEAKER_01 3:17

It's totally fine. The socks are mismatched. That is also fine. It is all good. It does not matter. We don't care. Yes. Or I'll say if if something is bleeding, that is fine. I say to people so many times, like, I knew that this organ bled when I signed up for this. You know, it's okay. It's okay. We're just here to kind of help and see.

SPEAKER_00 3:34

And see everything.

SPEAKER_01 3:35

Yeah. And if you want to talk from a diagnosis perspective, like the things that I just feel like people worry so much about, and it just makes me sad sometimes because it really is okay. We're gonna help you manage it, and it's everywhere. There's two specific things. One is HPV.

SPEAKER_02 3:50

Oh.

SPEAKER_01 3:50

HPV with an abnormal pap, you know, and things we have to manage with that.

SPEAKER_02 3:54

Yeah.

SPEAKER_01 3:55

Um, the second would be herpes. So many times in my office, I'm like, listen, everyone's got it. It's fine. There's nothing wrong with you. So many women, especially, are like, I'm like dirty. I should have done something different to protect myself against these things. And it's like, no, HPV, especially 80% of sexually active people have HPV. So, really, unless you're going to not have sex, yeah, you might be exposed to it. Like, there's nothing wrong with you. It's okay. The important part of both these things are you're seeing us and we can help you manage these things. But people do just feel so awful about these things. And it I'm constantly trying to reassure people.

SPEAKER_00 4:35

I mean, five minutes in, you're blowing my mind already. Like, so I like that's amazing. Okay. But I would not know that. Yeah. All right. I was at lunch with a friend. This is a few weeks ago, and we got into this conversation about getting pregnant after miscarriage. Um, and just how different that experience is for everyone. Totally. Someone are like, okay, like let's gonna we're gonna try again. Some are terrified. Some don't even know if they can try again. This is where it gets a little heavier for a minute. Um how common is miscarriage and do we always know that it's happening?

SPEAKER_01 5:20

That's a great question. I think, especially because newer pregnancy tests and like the availability of checking your beta HCGs earlier and things like this, people find out they're pregnant more than they did in the past, if that makes sense. So it's just like go back really quick, like beta HCG.

SPEAKER_00 5:37

That's the well, like that's the Yeah, it's a good question.

SPEAKER_01 5:40

That's that hormone you can check to find out if you are pregnant. Yeah.

SPEAKER_00 5:43

Okay. So that's if you pee on a stick.

SPEAKER_01 5:45

Yes, that's what it's detecting, that in your urine. Okay. Yep. And people will get that tested at their doctor more frequently now than they used to, also. So sometimes people will see like a faint line or will get a very small level on their blood work, and then that'll end up fading away. And we call that kind of a chemical pregnancy. So it's like the hormones were like starting, like there was a start of a pregnancy, but it ended very quickly. Um, but there wasn't an actual fetus like pregnancy material, that kind of stuff. So it's man, it just kind of resolves itself rather than needing management from us. So I think people are more aware of losses in general, yeah. Whether they be like miscarriage or chemical pregnancies because of that. The ability to test is so much better now than each other.

SPEAKER_00 6:29

Because I guess would you say, do you think people find out on average sooner? Yeah. Oh, wait, just is just like a random thought. Did you ever watch that show? Like, I didn't know I was pregnant. Oh, yeah, such a great show. Oh my, but I always was like, how what? I could never imagine that. How would you never know that you're pregnant?

SPEAKER_01 6:49

It's amazing. I've seen it.

SPEAKER_00 6:50

I've seen it in real life. It that's another that's probably a whole nother different. Is there anything you wish women understood about miscarriage that we might just not talk about enough?

SPEAKER_01 7:06

Yes. I think women just blame themselves so much. And like a miscarriage happens 25% of the time.

SPEAKER_00 7:14

Okay.

SPEAKER_01 7:14

And almost always the reason is, and we can't always test this or find it out definitively, is because the way the genetics came together to form that baby was not successful. And your body detects that and then disposes of the pregnancy or terminates the pregnancy physiologically. And that's almost always the reason. But when I see people in the office, I have, and I always say this as part of my part of my miscarriage counseling, I always say it's like the most important thing for you to know is like, you didn't do anything to cause this. This is not your fault, is like being on the wrong side of statistics this time. And I have heard it all of what people always have something in the back of their mind, like a workout class or that glass of wine I had before I knew I was pregnant, or once someone was like, I went whitewater rafting, like whatever it is, it's like that did not cause this. Right. You know, it's important that I wish like people really did believe that more. It really is true.

SPEAKER_00 8:12

Well, the mind's a crazy place. And said that you probably do become the therapist in those situations a little bit, right? What do you see from the husbands of amazing?

SPEAKER_01 8:23

Yeah, that's a great question too. I think like a huge variety. I don't always see them. Sometimes like people are there without partners. Yeah. Um, other times, like partners are really sad. Sometimes they're both so sad. I've seen patients there with their moms, and sometimes people are mad. You know, there's a wide variety of emotions. I think a lot of times, sometimes when I see people for miscarriage, they know before they come in. But a lot of times what happens is they're in my office for a scan and we find out and it's quite a shock. Sure. So, like really sitting with people in that space, you get every reaction, and that's okay. Ugh, that's horrible for you. Yeah. Right? Yeah, it's horrible.

SPEAKER_00 9:02

But like it's like that's part of that's uh not a great part of your job. What I think to further on that question, what would you tell a patient to let maybe like their partner in on? Mm-hmm.

SPEAKER_01 9:15

Um, I tell patients in general, and I think I hope that the spillover is like for the people in their lives, especially if they're not there to just be like kind to themselves. Yeah. You know, I usually say it really doesn't matter how long you were pregnant, like you had hopes and dreams and like a plan for this baby. Yeah, you know, and it takes a minute to mourn that. Yeah. And also you're usually resolving the pregnancy physically somehow, whether we're treating you medically or surgically, or your body's doing it. And I really believe uh after watching so many women go through this, that it takes time to heal emotionally and that you really need to heal physically first. And so it's a two-step process, and um, the amount of time it takes for everyone is different. And you might not be ready to try again right away. I think partners find that surprising sometimes. Um, you know, and it's just different when you are the one that experiences it physically. I think you just feel that so differently.

SPEAKER_00 10:12

Yeah. I feel like I was getting kind of like emotional there. I feel like we could sit, that's a conversation we could sit in for a long time. But I also want to zoom out for a second because I feel like there's so much like so much information about women's health in general. And we said at the beginning, everybody's bodies are different. So I want to do a section called what your OB actually wishes women knew. Because I feel like there's so much we think we understand and then we just don't. Okay, so are painful periods actually normal, or have we been just told that they are?

SPEAKER_01 10:54

You know what? I think this is the trickiest question. It is so hard because I don't ever want to tell someone like, um, yes, being in pain is normal. However, when you have a period and your body is releasing all those prostaglandins, like it can be uncomfortable and crap, you can have cramping and people experience that in different ways. So I think some discomfort with your period can be normal. I think when it becomes abnormal or you should do something about it, is when it really starts interfering with your life.

SPEAKER_00 11:26

So I mean, personally, as I've gotten older and I know I've texted you about this on the side. Sorry about that. I know that's annoying. No, it's all good. But I feel like every few months, my periods, like I have the worst cramps. And I also bleed like I'm like, am I should I be bleeding this much for the first like 24, 36 hours? I'm like, where am I? Like, I no, I it's crazy. Like, that's is that would you say, quote, normal or not normal? No, no.

SPEAKER_01 11:56

Um I don't know how personally you want to get here, but uh the amount of bleeding that you've been having is not is not normal.

SPEAKER_00 12:03

However like if I'm changing like a super plus tampon every hour. Not normal. Okay.

SPEAKER_01 12:10

And I will say this. So, and I tell patients this when I'm trying to convince them like you should treat these things because there seems Did you guys know we were gonna get stuff?

SPEAKER_00 12:19

Like we were gonna talk about all the things. If you're uncomfortable with any of this stuff, sorry.

SPEAKER_01 12:26

Spotify's gonna give us like an additional warning.

SPEAKER_00 12:28

If my dad's listening, like turn it off now.

SPEAKER_01 12:32

It's so great though. Like I love normalizing these things, which is part of the best. That's part of my job. And I tell patients this all the time is like I myself had periods that were far too heavy outside of what should have been normal. And I did not realize this until I was a board-certified OBGYN. I mean, like, that's how far in my career I got when I was like, oh my goodness, I had menorgia this whole time. My periods were bananas. It's just menorasia. That's when you bleed more than you probably should.

SPEAKER_00 13:01

I've never heard that word.

SPEAKER_01 13:03

It doesn't always mean there's something like wrong with you. You know, we look at those things, we do an ultrasound, we make sure there's not a structural issue. We check a thyroid. It's good to make sure there's nothing that we need to fix, but sometimes we don't find anything, you still have heavy periods, and we just need to treat those.

SPEAKER_00 13:20

Okay.

SPEAKER_01 13:20

Um, and I can say from personal experience, it's worth it when you start trading out.

SPEAKER_00 13:25

But yes. We're gonna come back to that. Birth control. Yes. Are most women on the right one for them? Or is typically like there's just one you typically No, there's so many.

SPEAKER_01 13:36

Okay. That's I I think that women, not to like say everyone, but I think in general right now, there seems to be this feeling like people use birth control as the whole big entity that they like, I don't want to do anything with birth control. And they'll kind of put it all in the same box.

SPEAKER_02 13:55

Okay.

SPEAKER_01 13:55

But birth control has so many options now. And some are hormonal, some are non-hormonal. Some of the hormones are estrogen and progesterone, some are just progesterone, some are different doses, different amounts throughout your cycle. Some, like an IUD, will just act like not very systemically. Others are. There's things for people who can take pills every day for people who can't. There's implants, there's nevering. I mean, there's so many different options and different doses. Yeah. Um, I do wish more people like engage with that conversation a little bit more or understand like if they try, if they want a pill and they're trying one and it's not working well for them, there's probably a lot of other options we can try.

SPEAKER_00 14:40

That's a good answer.

SPEAKER_01 14:41

Yeah.

SPEAKER_00 14:42

Okay. Um, let's talk about sex neurons really quick. After kids, especially what happens to your body sexually that no one warns you about?

SPEAKER_01 14:53

All right. This is one of my favorite things too. Okay. This is my my favorite. I try to tell everyone when I see them postpartum because no one talks about this. So especially if you're breastfeeding, but even sometimes if you're not, but especially in breastfeeding, the hormones that you need to breastfeed will also make your vagina really dry and sex really uncomfortable. And I think that was probably evolutionary to like protect us against another pregnancy while we're taking care of this new baby and all that. You guys, I had this after Chloe. It was like knives in my vagina. And I don't think people talk about it. I don't think friends talk about it much.

SPEAKER_00 15:29

No, because it's like embarrassing, or like you think like, oh, I should be my husband or this, or there's all these other things that go into it.

SPEAKER_01 15:37

There's so much of the postpartum period that is I should be filling the blank, right? And I think this is just part of it. You know, you go through pregnancy and you want to get back to normal. And a big part of that is your sex life. You want your sex life to go back to normal and suddenly everything hurts. It's, you know, it's really can be devastating and make it just tougher to feel like yourself after you have a baby, which is a huge challenge, anyways, right? So a big thing that can be helpful in that period is using a little like vaginal estrogen, which it's great. Yeah, no, I don't know.

SPEAKER_00 16:10

It's just the you know, vaginal the word.

SPEAKER_01 16:14

We're normalizing it here, Meg. Oh, I like it.

SPEAKER_02 16:17

I love it. I love it.

SPEAKER_01 16:18

Yeah. I mean, and you can use over-the-counter vaginal moisturizers too. There it is again. I'm just trying to give it to you there. It's great. But um, vaginal estrogen, I think, like works the best for this setting. And it's very easy. It's like a couple times a week, and that can be life-changing for people for this postpartum. And I just don't think that it's talked about enough.

SPEAKER_00 16:36

No, I I wish I knew that yeah 10 years ago. For sure. Because it was, you know.

SPEAKER_01 16:40

And I think it's something I even no one really taught me when I was in residency. Like I kind of learned as I was practicing. Like, I just don't think many people discuss it enough.

SPEAKER_00 16:49

For sure. Okay. Um what's something trending right now that you're like, please stop? All right.

SPEAKER_01 16:59

That's a great question. Um I think, well, to kind of like bring things out wide, it's just people without expertise who are claiming to have expertise and then trying to sell you something. Oh it is everywhere right now. And it kind of preys on what we were just talking. Like, as a woman, you should be filling the blank. You know, they'll say, okay, at this age, you should be doing X, Y, Z or feeling this way. And then also, like, here's a supplement that you can have.

SPEAKER_00 17:30

Well, at 2 a.m. Google, and then you're turning. Exactly. Yeah.

SPEAKER_01 17:33

Exactly. I'm really happy that, especially like the last five years or so, like, especially menopause and um perimenopause and all those changes are getting like the buzz that they're getting, and a little bit more research funding. And we're doing really important things like um taking the black box warning off of estrogens and making hormones more accessible to women, going through that in this country. That's all wonderful. But there's a lot of people on social media who are like taking that and then kind of taking it a little bit too far and trying to sell random things, or again, like just kind of preying on how vulnerable women are and how hard we are on ourselves.

SPEAKER_00 18:12

You know, percent. No, I I can agree with that in a lot of avenues. Okay. Um, what's something about postpartum that shocks women every time? That was the same answer.

SPEAKER_01 18:26

I guess that's kind of the dry sex. Yeah.

SPEAKER_00 18:28

But also I can we just like talk about like if you're pregnant right now or you've like the first time. I feel like the first time you have sex after you have a baby. Yeah. And would you agree with us? It's like I feel like it's like worse than like losing your virginity.

SPEAKER_01 18:46

It's just really scary. Like what scary? Here's a question for you. Oh, what do you think is more scary postpartum when you have your first poop or first time you have sex?

SPEAKER_00 18:58

I I I think they're both scary. I think they're both scary. I think actually I can remember with William, you know, remember he was a preemie. So I was pumped full. Yeah. Bef with all these like steroids and all this stuff. Um, and I had to go to the bathroom before they would let me leave. And it was I like I'm not even going to it. It was worse. That was worse, I think. It was horrible. Yeah, it's stressful. You think that's true? People don't talk about that really. No, they don't. You're welcome for that story. Uh yeah, we can edit all that out. I'm gonna definitely keep it.

SPEAKER_01 19:35

The other, the other thing I think like women, and I think people are talking more about this, but like postpartum, it everything just takes time. Like it takes time for you to learn how to take care of a baby. Um, if you're going back to work, it takes time for you to learn how to do that and take care of a baby. Your body takes so much time to go back to not I don't like saying go back to normal, but like to a place where you feel like yourself.

SPEAKER_00 20:02

Totally.

SPEAKER_01 20:03

Um, and I think that's true of like every aspect, you know, and parts of you are never the same.

SPEAKER_00 20:08

Well, I think I I don't know if it's trending like for you or what you see, but I feel like a lot of stuff I see right now is like if I could go back to when my kids were little but feel like I feel now. Oh sure, you know, and I'm like, but it's so true because when you have some people, it can experience that like no anxiety, and they're just in this like motherhood bubble. And then there's other people like me that are as like a lunatic, you know, like in the mind. No, like in my mind, you know, and I'm like, oh, if I only had a quiet mind during some of that time, I mean it was like wonder, you know, great or whatever, but yeah, anyway. Yeah, it's stressful. It is very stressful. Um, what symptoms do this is like 30s, 40s, aging, kind of like going through all this stuff. What symptoms do women brush off that are actually tied to maybe like a hormone imbalance? Okay.

SPEAKER_01 21:00

Um I gotta think about how to answer this because loaded question. Yeah. Well, I I have like I'm hesitant to call it like a hormonal imbalance because your hormones are constantly fluctuating throughout the month every month as you cycle. And this is what you're gonna have most of the time in your 30s, unless you have a bigger issue where you're not cycling, which it's always important if you're not cycling, not on contraception or anything, to see a doctor for that. But as you get into your 40s and closer to menopause, which average age in this country is 51.

SPEAKER_00 21:35

Okay, that's I don't know that.

SPEAKER_01 21:36

As you get closer to that, you can go through times where cycles and things get more erratic, irregular, unpredictable, because you're having cycles that sometimes don't ovulate, sometimes you're ovulating multiple follicles. They can be irregular, kind of like teenage cycles is how I think about it. A lot of us when we're teenagers and we have our first cycles, they're maybe heavier, irregular, that kind of stuff. That can help. happen in the perimenopausal period too. So it's a great time to see us if you're starting to have those menstrual irregularities or if you start to have all those menopause and perimenopausal type symptoms that you hear about, such as like hot flashes, irritability, sleep disturbance, all of that stuff can kind of go together during that phase.

SPEAKER_00 22:19

Okay. That's good to know. Um Okay. Think about this for a second. If every woman listening wide range of no pressure. Yeah. If they could sit in your office for five minutes, what would you want to tell her?

SPEAKER_01 22:39

Oh man. I want two things. Okay. Five minutes we could do it too. Five minutes. Um the first is kind of encompassing I feel like that's been the theme of today.

SPEAKER_00 22:50

Like everything's normal.

SPEAKER_01 22:52

It's okay. Like yeah you're okay. You don't have to put yourself in this box. You sh you don't have to be anything. You know women are like should I be doing this or that? Am I you know just pinting off like our sex conversation. Am I having enough sex? Am I having too little sex? Should it be this way? Should it be that way?

SPEAKER_00 23:07

Should totally it's be who you are on that side. Exactly. Okay.

SPEAKER_01 23:12

Who you are is probably okay. You know? Um and then the second part of it just riffing off of the stuff you just talked about and like being someone who's just entered their 40s and I'm talking to a lot of women now that my patient population is like entering that decade. Yeah. Is the best thing that you can do for yourself going into the next 10, 15 years perimenopause, menopause, this phase of life is you made it through probably like having these small babies, your career, whatever it was now is a really good time to take care of yourself. And I have this conversation with people a lot where the best thing you can do for these symptoms are very difficult but very simple. They're like sleep enough, like limit alcohol, watch what you're I know it's a rough I love an espresso martini too, okay? Kind of sad we're doing this in the morning.

SPEAKER_02 24:02

I know.

SPEAKER_01 24:03

No, it's tough. But it's true. That's why I say it's not easy. They're just simple. Exercise, getting enough water. I can never drink enough water. It's always coffee for me. You know, these things they have a lot of data behind them that they help you feel better in the next 10 to 20 years. So the most that you can do now that you have a little bit more time theoretically or energy like you were saying for yourself now in this phase of life is help develop whatever habits you can to help keep yourself feeling good for the next 20 years. Okay. I think that's a really good answer.

SPEAKER_00 24:37

Okay. Um definitely like segmented this out. I kind of like it. But now I want to go to like what I would call the group chat questions or like maybe it doesn't even have to be a group but what you would text maybe like some friend. What is the average age you're seeing for pregnancy right now?

SPEAKER_01 24:58

That's a great question. I think I know the average age is increasing in general. I don't know the exact age off the top of my head. Okay. It's always getting older though. Yeah for sure. And then for me personally like your patients kind of age with you. So like I am seeing more people who are older who are pregnant because that's where I am in my career. Yeah. I mean we still see a lot of like younger people too but just personally yeah I would say it's not uncommon to be pregnant in your late 30s. I actually people hate that um diagnosis like advanced maternal age.

SPEAKER_00 25:27

Well that was my next question why it's 35 considered geriatric because I feel like women are just getting started at that age.

SPEAKER_01 25:34

Sure. Well that's the first thing I say to people who I can tell are like really nervous about that label or whatever. And I'm like girl who isn't like it's everyone's right. You because you had to live your whole life like and I usually say you know that label is just a diagnosis that this country that is driven by healthcare that's reimbursed by insurance companies and stuff decided that at that age the risk is enough that they'll pay for more testing in pregnancy right. We're all on this graph of risk and we should have all had babies down here when we're 17 and that's the lowest risk time to have babies like probably 17 to 19 physiologically. Oh my gosh. You know, I know no one could do that. So we gotta be on this curve somewhere, right? And 35 just happens to be the point on the curve where the risk is increased enough that we've decided we'll pay for some more testing. You know, that's it. It's not like 34 you're super safe and 36 is really risky. Which you'd want that right like there's exactly in having more and I tell people too like I care far more about your general health than I do about where you are on that graph. Like you know like how how is your health otherwise what other you know and I feel like like you said to normalize it I mean I'm 39.

SPEAKER_00 26:52

But it's I have friends who have just had babies 100% trying to conceive and you have like people with their kids are going, you know, their high school and going to college it's like all over there's no yeah correct way to do it. You just has to be on your own timeline. For sure. Okay. How long should it actually take to get pregnant before you worry?

SPEAKER_01 27:14

All right. That's a qu good question too a little bit complex like I think the textbook thing for me to say is if you're under the age of 30, it's normal for you to take up to a year to get pregnant. Okay. Okay. Um if you're over the age of 30, we say, you know, come see us after about six months. But fertility in general when you want to do more testing be more aggressive maybe have intervention all of that stuff is optional. So a lot of when you want to kind of move forward with that stuff is personal too.

SPEAKER_00 27:45

So such a hard mental game I feel like for younger we're like ingrained like you have sex, you're gonna get pregnant. I know it right so you're so nervous and then you you get married and then you're like ready to and there's a lot of women right now that have fertility issues. Yeah.

SPEAKER_01 28:04

And fertility decreases as we age and so we're all waiting longer to get pregnant. So we are seeing more and more of that.

SPEAKER_00 28:12

What sub thing women blame themselves that everything isn't their fault. Okay. It's not their fault. Yeah.

SPEAKER_01 28:20

It's not their fault no women blame themselves so much. It's like I think that's probably the biggest battle I'm trying to fight every day is like like I said earlier like this HPV is not your fault. This mis miscarriage is not your fault. This is not your fault. You know there's nothing wrong with you that landed you in whatever situation might bring you to my office it's not your fault.

SPEAKER_00 28:41

Yeah. What do you wish women knew maybe before they start trying to that it can take a year or six months.

SPEAKER_01 28:48

It takes some time.

SPEAKER_00 28:49

You're not just gonna like, we're gonna Yeah what's the what's the slogan? We're gonna pop the goalie what is it? We're gonna move the goalie. Pull the goalie we're gonna pull the goalie let's talk go back to fertility a little bit. Do you have any theories on why you feel like that might be rising or is it I really just think it's primarily well two big things.

SPEAKER_01 29:12

One is we're talking about it more and it's more of a common thing to bring up amongst friends and things like that. Like it definitely was more taboo to talk about even 10 years ago I'm thinking like around my groups of friends, you know? Sure. Um so people are talking about it more there's more awareness which is wonderful. And then the second part is just women are waiting longer because they're building lives, careers, whatever it may be, taking longer to find a partner. Um so as you wait longer, it's a higher chance that you're gonna have fertility issues.

SPEAKER_00 29:43

And you know, just from like a friendship standpoint, what would you say or what do you hear the most? Like what do you think you know the women who it is maybe taking a little bit longer what do they need from their friends because or that that you would see.

SPEAKER_01 29:58

Yeah that's that's a really great crush question too and that can be highly variable because I think some people are very uh stoic and pragmatic about the whole process and are just like all right we're gonna do next step, next step, next step. And then some people are like quite emotional every month when they are finding out they aren't pregnant. I think that's gonna be a different answer for everyone. Uh my hope would be that if you're close with someone who's going through this, you kind of know what they need. I actually I don't know to this day really if I should ask her now if I handle this well or not. But I remember when I got pregnant the first time, the biggest reason one of the biggest reasons I decided to get pregnant at that time I was still a resident and I did not think I was going to do that in residency was I had a close friend who was just going through years of so much fertility issues. And I started to think wow like I'm 30 now maybe I should at least try in case I'm looking at a few years of this in my future and then I ended up getting pregnant immediately. So what I did with her is I can't remember if it was a text or an email but it was like not a face-to-face conversation where I said I want to give you some space to process this I just found out I was pregnant just you know and I mean she was thrilled for me of course but I knew that that would probably be hard news for her. So I think understanding what the people in your life need at least a little bit from support wise.

SPEAKER_00 31:22

Yeah. Is freezing your eggs something you're seeing more of yes um finally I would say okay who should actually be thinking about that?

SPEAKER_01 31:34

So theoretically anyone who is considering pushing off pregnancy and who has the means to do it should do it. Also like is there like an ideal age or like I Oh sure and you I mean as soon as you can okay yeah but you know like any before 35 would be great if we can get those eggs before 35. And really I'm not a fertility specialist so I might be, you know, mis saying some things here but closer to 30 it would probably even be better if you can have like your eggs from your late 20s would be wonderful. People who should freeze their eggs are people who aren't sure they want a childbear but know it's going to be a little bit in the future and who have the means where there's a lot of employers now that offer some financial assistance or benefits to help take care of this. Like if you had that as part of your shouldn't be a thing, right?

SPEAKER_00 32:22

Like that's I think the biggest it's that's not it's still really freezing your eggs or it's yeah something it's smart I think. Okay.

SPEAKER_01 32:30

Yep. It's it's a difficult process. You know I don't want to think about it like oh it's super easy just run on over. Totally it's a difficult process but I think it's really smart to be thinking of okay.

SPEAKER_00 32:41

All right let's debunk some things. Um maybe you already answered this but biggest myth about getting pregnant that it happens fast. Okay. For everyone.

SPEAKER_01 32:52

Uh or that it happens long for everyone actually because I think like people live on either side of that spectrum depending on who their friends are what happened.

SPEAKER_00 32:59

No for sure. Biggest mistake women make when trying to conceive I don't know I don't know if I have a good answer for that one. I'll tell you I would take a million pregnancy tests like day one.

SPEAKER_01 33:14

Oh like even though no knowing nothing would be there I'd be like okay two days later I'd be like let's just see let's see if this is no really common yeah I know I would say along those lines this is not a mistake but like you do not need to lay with your feet out no that's good.

SPEAKER_00 33:31

People love that one people love that one you don't you don't have to do that.

SPEAKER_01 33:34

It's okay. Oh that's good okay what's something women worry about that actually doesn't matter as much as they think I know you said everything but let's take it should we relate it to pregnancy or just do you have another I mean I think I think the biggest thing is like hygiene when you come to see us. Okay. We we do not care.

SPEAKER_00 33:52

Okay. Something TikTok says that drives you insane it's a whole different episode everything.

SPEAKER_01 34:00

I just don't like when they um try to put everything in a box. Like one TikTok person will be like all hormones are bad. You need to stay away from them. Another TikTok person's like everyone needs to be on hormones and no one's doing you know like all the extremes. You gotta just like tune out the noise.

SPEAKER_00 34:16

Yeah. Um okay those are all really good answers. Um also I would say you know I'm fascinated by your job, right? By your life. Because did I ever tell you that I wanted to be an OB? Did I tell you this?

SPEAKER_01 34:34

You did tell me that that one time you almost delivered a baby in my office.

SPEAKER_00 34:37

Yes I was gonna get to that but I you guys I don't know if I told you guys this button make that happen for you. I know I took chem 103 in college and I was like yeah I'm out it was like the first 15 minutes but enough smart to know. But I'm fascinated like by that like I feel like as a young age I always was like pretending to deliver babies like like weird, right? Probably I love it. Okay. How many babies did you deliver last year?

SPEAKER_01 35:09

Okay, that's a great question. I have no idea I tried to look at my EMR I couldn't tell I don't know what I will say this I'm on call like four to six days a month where I do 12 hour shifts and I deliver babies and I probably deliver between like one and five a shift five babies I delivered three babies yesterday 12 hours yeah look at you okay so we don't know but a lot. Yeah at the end of residency I think I was between like five and six hundred and that was 10 years ago. Oh my it's wild.

SPEAKER_00 35:37

It's a lot that's a lot what does a normal week like even look like for you like I want to talk about job wise.

SPEAKER_01 35:44

There is no normal week but I actually do like that about my job. Like this week I was in the office two days and then I had one day of operating where I did hysterectomies and took out tubes and things like that. And then I had one day in the hospital yesterday where I was delivering babies and then today I'm off.

SPEAKER_02 36:00

Okay.

SPEAKER_01 36:01

Next week I think I have two office days and then I have a night shift and then I work the holiday weekend. Every every week is different but I kind of like that irregularity. Yeah for sure.

SPEAKER_00 36:12

I'm kind of that way too I mean not with my OB job but just with with a schedule. I don't like a regular schedule. Yeah. So how many hours are you working?

SPEAKER_01 36:21

That kind of changes quite a bit too okay um like what's the most hours? Oh geez like if I have like three calls and a couple of office days in a week which I'm trying to not do anymore. I'm trying to have a more humane schedule even on my busy weeks then I'll probably work like 55 hours or so. Okay. Yeah trying to not do that anymore.

SPEAKER_00 36:42

Yeah.

SPEAKER_01 36:43

Do you still love it? Most of the time yes. Okay. I do. I love the work. Yeah like I love the work. I have always been like a feminist at heart. So being in a place where I can empower women, give them choices, make them feel safe, make them feel supported is like delightful. Top. Always the best. Um but it is very tough and it's hard. You know when I was um like interviewing for my jobs and stuff when I wanted started this career I never really cared that much about research or that kind of stuff. And people would be like what are your career goals? And I'd be like I want to be like the person in town that people want to recommend their friends to like my colleagues and their friends and that's what I said in my interviews which I think back now and think is kind of a funny answer. Well I feel like you've done that I did that I do I think so too like my physician colleagues send me their friends and their family and themselves and I love my practice. It's a lot of friends and sisters who like come. However, the other side of that that I was not prepared for and I'm like constantly struggling with in like a good way but a hard way too is that it's so much easier to take that stuff home with you. Like I care so much about these people sometimes and then that's a good thing but it's really tough to navigate through life you know when you help someone through something really difficult that you care a lot about and then you're going to field day, you know, right after no totally. It's very tough. Very tough what is something about being an OB that people would be shocked to know I actually think that like it's really it's hard to we carry a lot of it with us. Okay. All the time. Yeah and where we work is a little unique in that we see a lot of high risk things and it's really high risk obstetric heavy and you know a lot of us do a lot of work to take care of each other. We like share a trauma therapist and we speak to each other a lot and we try we're constantly trying to give the parts of ourselves that we need to give to work and then save the parts of ourselves we need to save for home and that is really really tough.

SPEAKER_00 38:50

Well I know there are really some dark days probably um in your job and I don't I don't want to ask about that stuff here. Um but is there anything you feel like maybe you wished more people knew or would recognize more or again is it back to what you just said.

SPEAKER_01 39:14

Yeah I think I think just what I just said probably yeah. Yeah but but it's it's worth it. Like I think it's important to say it's worth it. Like I said I think most of us really do like love the work and love the fact that we get to like I said just empower women in their like choices and how they're feeling and going through these phases in their lives. Like it's it's amazing.

SPEAKER_00 39:37

I love that okay well I I think it's easy to look at someone like you and think okay she's got it all figured out but you went through residency. You got married you had kids was that all at the same time right kind of all melded together.

SPEAKER_01 39:55

I got married in med school okay and then started residency. I had a baby right before my last year of residency and then my second baby during my first or second year I wasn't attending it's wild.

SPEAKER_00 40:07

What did that season of life actually do you remember it? Actually do you remember? Yeah.

SPEAKER_01 40:13

No, um I mean it it was hard. It's there's parts of it that are still hard but I got really lucky like first of all the person I married is wonderful. And like when we got married we were like we're gonna be partners he has a big career I have a big career we have like goals and I mean we still argue about who does more chores or who goes to more field days but like sure you know in like a FUD way. Yeah in general like we really do try to support each other in our careers and the things we want to do in our lives like outside of our home.

SPEAKER_02 40:44

Yeah.

SPEAKER_01 40:45

And so that's been wonderful like getting married in med school is delightful not a problem at all. Having a baby in residency I like I said I wasn't going to do that and then kind of decided to and we got really lucky because she was the best baby ever. I mean it's crazy though. Yeah I mean she was like a dream. How much time did you get? Great question. So that's what I was going to say next is it's never easy. So I had to go back to work at eight weeks. Okay. And that was really hard because it's just like dropping an eight week old baby at daycare is something no one prepares you for. That was really tough. Um but you know overall she was great and my husband was great. We made it through it. I think the baby I had as an attending was the hardest my job at that time was like pretty um I can't think of a way to say it without using really harsh words like it was not fair the way it was set up. Sure. And um that was tougher uh which is why I kind of like the position I'm in now. I have some leadership roles in my role now and I try to make sure life is better for everyone who's in this field. So hopefully we can keep more people in it. But that one was tough.

SPEAKER_00 41:52

Would you do it the same way all over again?

SPEAKER_01 41:55

Oh my goodness. I feel like probably yeah probably I think the only difference is back when that job was like pretty unfair I wish I would have had like a mentor or someone in my life to be like you don't have to work like this. Like this is actually not right, which is what I try to do for people now.

SPEAKER_00 42:16

Which is good. Yeah. What advice would you give to women trying to build a career and a family at the same time?

SPEAKER_01 42:24

I love this question. I'm really passionate about this with all my friends. It's like I think riffing off of what I just said before, you have to have good like partners in your life. One is the partner I'm married to okay but also I have like four or five solid babysitters who partner with me all the time to take care of my kids. Yeah. When my husband has to travel for work sometimes with no notice my mom will like come stay with me for a few days if I have an early shift. I have a friend across the street who has recently stopped working and she takes care of me because she's like hey school's doing this like send in this permission slip all the stuff that would slip through the cracks. I have a friend that I hired recently to be a house manager who helps me with like organizing the kids' clothes and all of this stuff. And I think like people need to know that if it looks like someone is doing everything, they're not doing everything. I have so many people in my life that help me keep everything afloat. And I only have two kids like you know a bunch of so much help.

SPEAKER_00 43:30

Yeah because I I I get it. So no I mean I think that's that's great. Okay I you kind of already told this story but I was gonna tell the story you guys I was in her office and there was a woman in labor and she was like grunting or like how I howling maybe I was like should she be here so I get in the office and they take me back to the room and I can stay Hear everything that's going on. And I did not know this at the time. You just saw her in the waiting room. I didn't know this was happening. I am like, was I getting like an annual or something? So I'm on the table, just giving you a full visual. And who comes in? My PA. The PA comes in and she's like, We gotta, we got a situation. And I'm like, I can help. I can help. I'm ready to like deliver this baby.

SPEAKER_01 44:22

Maggie for real in her gown stood up and was like, let's go. Let's go down the hall. Like she was ready to go.

SPEAKER_00 44:29

Like I'm thinking, like, whatever you need, I can give it to you. You know, like a graze, like scalpel, like the whatever. I don't know. I was like, I can do it. Who's the best? That was really, really good. Um, okay. Well, we're kind of, those are kind of all of my questions before we wrap. Is there anything we didn't talk about that you wish we would have?

SPEAKER_01 44:53

You know, no, I think the things that I really wanted to make sure people knew was they don't have to shave to come to the office.

SPEAKER_02 45:00

Yeah.

SPEAKER_01 45:01

HPV is not their fault. And if you yeah, if you want to be a woman and have a career and have a life, it takes a whole lot of people. Yeah. Yeah.

SPEAKER_00 45:11

Yeah. And the pregnancy piece too. Yeah. It's different for everybody. For sure. Um, and with all my guests so far, I have given them an opportunity to ask me something. Zero pressure, but if you want to turn it around, is there anything you would want to ask me?

SPEAKER_01 45:30

I feel like, you know, you've given a lot of good answers throughout this so far. Um what has been the thing that surprised you the most about doing this podcast?

SPEAKER_00 45:40

Oh, that's a really good question. It's funny because I'm kind of great timing actually that you said that because well before we started recording, I think I said this is gonna be like the 37th episode. Yeah, that's a lot. Which is a lot. And I think it took me just the last couple. I'm like, okay, I get it. I get why people say you have to keep putting yourself out there and it becomes more natural. I would say, even maybe like 10 episodes, I was like, oh no, I'm getting the hang of it. No, no, I'm just getting the hang of it. Um, I really love it, and I feel like you said, what's the most surprising thing? Yeah. Probably it's healing something inside of me that is, I would never have thought that. Just like having these conversations with people, talking out loud. You know, I write all my thoughts down all the time now, more than I ever have. Oh, sure. Always writing and always like, you know, no note voice texting, like in my car, like I just thought of this. And then putting all that stuff together. So it's been like a little like out loud therapy. Yeah for me.

SPEAKER_01 46:52

That makes sense.

SPEAKER_00 46:53

And I love it. That's great. I'm glad. Okay. Rapid fire. Okay. Don't overthink it. Um, epidural, yes or no? Yes.

SPEAKER_01 47:02

But it's okay if you don't.

SPEAKER_00 47:04

For me, it's a yes. Yeah, for sure. Um, coffee while pregnant, fine or not?

SPEAKER_01 47:10

Oh, it's fine. Just not a lot.

SPEAKER_00 47:13

Okay. Birth control, love it or hate it. For the most part, love it if you're on the one that's right for you. Okay. Do you actually take your own medical advice?

SPEAKER_01 47:26

Uh, that's trickier for the most part, yes, but I am like a really terrible patient because I don't like to be down for any amount of time. So I postpone things. But yes, for the most part.

SPEAKER_00 47:36

Um are you a like sweets or salty person? Salty. A morning person or night person?

SPEAKER_01 47:44

I have no idea. I so 24-7. Yes. I burn it at both ends. I actually talk with Garrett about this a lot because I'm like, what do you even think if I had the option? Because I start really early because I need to, but then I hang out late because I like to. I mean, I have no idea.

SPEAKER_00 47:58

Okay. Uh, group text or one-on-one text are all of it.

SPEAKER_01 48:02

Like the group text and then like the side chat with like part of the group and then like the one-in person. I can't help it. They're all there. I love that.

SPEAKER_00 48:10

Um, what's one thing you do that you tell patients not to do?

SPEAKER_01 48:16

Drink espresso martinis, probably.

SPEAKER_00 48:20

I like that one. You bring me joy. Um, and the best part of your day. Oh man. Just like a regular day? Yeah.

SPEAKER_01 48:29

Oh, jeez. Best part of my day. I mean, I feel like anytime I get to hang out, have a conversation like this, like whether it's like with a friend or with my family or whatever, downtime where you get to chat. That's my favorite. Like one of my favorite hobbies is having a few espresso martinis at dinner. Like, I love it. Like, let's have a couple glasses of wine and chat is the best.

SPEAKER_00 48:55

I love that. I mean, we just talked about how much we carry as women and also how different everyone's experiences, even when we're all technically going through the same thing or have been through the same thing. And Sarah, I think what makes this conversation hit the way it does is you're not just showing up for women in one way. You're a mom, you're a wife, you're a friend. You've lived so many versions of life right alongside us all. Personally, I've been in a Miami nightclub with you. I've been at an 8 a.m. Soul cycle class with you. Barely. You're yeah, I almost threw up. And you're the person that I called after peeing on a stick once. I was like, I'm just a didn't take. Didn't take, but we tried. Fair enough. Uh like you're in it with us, and that matters. And you said that. So I like love that that was your ultimate goal that you're living that.

SPEAKER_01 49:53

And I do love that. Like, I love being there for all those moments. I'm like a yes person, and that certainly translates into this work and answering those texts and all that stuff too.

SPEAKER_00 50:03

Something we didn't talk about, which we had would be a whole nother episode. Sarah is an avid traveler. I love traveling. She loves traveling. She always has the best trips. So we do talk about some of it. Oh, yeah. Yeah. Well, thanks for being here. Thank you for having me. This was fun. And showing up for in all the ways that you do, not just for me, but for so many women. And if you're listening and this conversation gave you something, whether it's clarity, comfort, or just that feeling of, okay, me too, send it to a friend. Make sure you're following along here and over on Instagram because that's where we keep these conversations going in real time. Because if you're thinking it, probably somebody's talking about it. Reminder we are all navigating it just in different chapters. That's all I got.