KRISTAL LAU- Postpartum Rest

Today I speak with Dr. Kristal Lau, a Physician-turned-Postpartum Wellness Consultant and the author of 'Postpartum 30'. She brings over 10 years of collective experience in clinical medicine, scientific research, and public health along with her personal experiences of navigating postpartum and motherhood as a mom of 2, an Asian expat in the West, and a U.S. military spouse. Dr. Lau delivers insights and actionable strategies for postpartum wellness, including balancing traditions and cultural practices with modern postpartum care.

Kristal shares her experience with her first confinement practice, and how it lead her to finding ways to respectfully modernize this postpartum practice that is sacred to her culture while incorporating her medical background.

We talk about:

-confinement in Asian cultures

-massage as part of postpartum care

-herbs in pregnancy and postpartum

-Traditional Chinese Medicine 

-exclusions of birth partner 

-confinement centers in Asia

-roll of family in postpartum

-struggles with postpartum depression

-life of a military family

Time Stamps

1:00 introduction

2:20 postpartum period in Malaysia

8:03 trusting pregnant moms

12:38 living in Alabama 

17:50 Traditional Chinese Medicine and postpartum recommendations

21:00 what happens after second child

26:45 transitioning out of confinement period

30:19 parental leave & supporting moms

39:40 military moms and families

44:50 rapid fire questions

CONNECT WITH CARRIE

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Website: https://carriepagliano.com

CONNECT WITH KRISTAL

IG: https://www.instagram.com/mamaswingwoman

Website: https://mamaswingwoman.com/

'Tea Time with Kristal' package. Get 20 euros off the package price with the coupon code "mwwcarrie".

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Get this intimate meet the author experience bundle where you'll receive a signed hardcover copy of Kristal's book (plus the e-book as a bonus!) and chat with Kristal about anything you desire, especially about postpartum and motherhood.

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Transcript

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SPEAKER_01 0:00

If you're tuning in to the active moments to physical therapist, Dr. Harry Ticley Anno, a real mom's guide to all things postparted with turn to work out after baby. If you're a postparta mom, coach, trainer, or physical therapist looking for answers on how to get back to running yoga pull out, you name it without the fear of public court issues or doing something wrong, this is the podcast for you. Let's start the show. All right, so one of the things that we've been talking about a lot lately, it's been coming up with a lot of guests, is the idea of postpartum community. And our guest today, Dr. Crystal Lau. She is a physician and postpartum wellness consultant. And she's also the author of the book Postpartum 30:30 Days to a Nurtured Fourth Trimester, a balance of traditional Chinese and Modern Postpartum Care. And I was so excited when Crystal reached out because I was like, I've seen this living in the DC area. We have a lot of clients from everywhere in the world. And I was like, we need to talk about this. So Dr. Crystal, thanks for being on the show. Thank you for this invite, Carrie. I'm really excited to be here. So you are in Germany right now. Yes. But by way of you said Malaysia and Australia. Unpack that quickly.

SPEAKER_04 1:20

So born and bred Malaysian, I left home to complete med school in Australia at about 20, 21 years old. Graduated in Australia and then worked there for about six years, met my husband, and then moved with him to the States. And then from there we moved again to Germany. And next up, we don't know yet what's happening.

SPEAKER_01 1:41

That that sounds about right. We were just talking before before we uh hit record about that's very common where I live. It's a lot of my kids' friends. Dad's getting ready to retire. We don't know where we're gonna end up. Um, and so that community continues to change and evolve, especially as a military family. So for you, like, you know, you you've almost got like two aspects of this. You have like your cultural aspect and then also like the military constant changing sort of aspect. Um, for you growing up in Malaysia, what was your experience kind of watching women, pregnant women give birth? And what what is that kind of traditional experience?

SPEAKER_04 2:22

Yeah, so growing up, the word that comes to mind is the word confinement. And I've realized ever since being away from Malaysia and the Asian side that when I bring up to friends who are pregnant or you know, having more kids, and I ask them, Oh, so do you guys do some kind of confinement? They give me a question mark, especially if they've grown up in the West or they are of you know Western um heritage, they're like, confinement, that sounds like jail. Right? And I'm like, and and I I do tell them, I said, you know, the running joke back home is um people do ask, so you're gonna be in mommy jail after you have your baby, but the most luxurious type you can think of, because so confinement is um Malaysians, Malaysian Chinese, we're like second up to fourth generation from South China when you know the Brits were there, and they brought in the South Chinese to work in the tin mines, so that's where a lot of our ancestors come from. And the concept of Tuoyet's or sitting the month loosely translated, that's that postpartum recovery practice. That's where in China they definitely do it. Um, and there are variations of it in the other Eastern Asian cultures, like the Koreans and the Japanese, um, and even the Indonesians as well, and the Malays, they call it Pantang. Pantang is like taboo, and for them it's a duration of 40 days. The Chinese, Malaysian Chinese, depending on your family, my family does 30 days, just because it makes sense with the calendar month. It you know, it that that's where I like about it because it makes sense with um the modern times, right? You know, so so you still, you know, you still perform your confinement practice and all that. The crux of it is just rest and recovery for 30 days. So once you come home, I mean, ideally it starts immediately after you've given birth, but nowadays with us going to hospitals and things, we start it once we get home. And all you do is you're supposed to just rest, nurse your baby, or feed your baby, uh, care for your baby, and that's it. Usually, yeah, and usually traditionally, the maternal elder will come in to look after the new mother and her baby. So that could be your mother, a mother-in-law, or if you don't have those, maybe an aunt or an older sister or a cousin sister. They'll come in, they'll cook all your meals for you, soups, teas. And the first time I did it, I was in Alabama. My mom came to stay with us, and she was there for the first 30 days. And gosh, Carrie, I was just sitting, she's like, Crystal, so are you ready for lunch yet? I'm like, sure, and she'll go cook. And she's like, Okay, you need to drink this, you need to drink this soup, you need to drink this tea, and she'll just give them to me. Oh my gosh. But at the same time, because she was there cooking, I mean, she cooked for everybody, right? And then that sounds amazing, yeah. And not only that, so the nutrition part is huge because we know how important that is postpartum. You're, I mean, you literally just you know brought life to earth. You are recovering from so much that's going on, you know, you need every single building block inside to nourish you back to, you know, whatever semblance of energy you need for the next phase of motherhood. Um, so on top of nutrition, what my mom or most of uh the people who help the moms during confinement, they'll do your laundry, they'll clean your house, they'll do everything else at home. So you literally, you literally rest and recover. That's all you do for 30 years.

SPEAKER_00 6:01

I'm just gonna start with that one right now. Like, I I yeah.

SPEAKER_04 6:04

And and the thing that I notice a difference being in the West as opposed in Asia is the massage part of this practice. And so in the West, I notice um they, you know, any physical therapist or masseuse who can do post uh postpartum or prenatal massage, they're very cautious, even when I say, Hey, I'm fine. They're like, No, no, let's wait till you're six weeks, you know, after your baby clears you. So I'm like, you know, okay, I won't force you because you know, you've got your licensing or insurance, whatever stuff you need to follow. Um, but back in Asia, uh, you start massage immediately.

SPEAKER_01 6:43

Oh my gosh.

SPEAKER_04 6:44

So they're massage, um, you know, gentle around the belly, but your arms and your legs, because you still have so much swelling in that immediate postpartum. Yeah, so that's where the massage comes in.

SPEAKER_01 6:54

And oh my gosh, super. That sounds amazing. Well, that's the thing that I'm kind of just as you're talking, I'm thinking, I don't know that I've ever heard of a massage therapist offering specifically postpartum massage. You see prenatal out the wazoo, you see that everywhere, um, but not postpartum. And for us, at least in the last several years in the states, probably since even before 2018, there's there's been a growing trend of earlier access. And part of that is um ACOG is like, hey, we need to get earlier access to to moms. And and of course, now we know even more that moms are at at risk in that fourth trimester. Um, but no, I've I don't I don't know a single massage therapist that's like, yes, I do postpartum massage, I'll come to your house, I'll I'll I'll make you feel good. That's a great business idea, right there, because I know a ton of women that would pay for it.

SPEAKER_04 7:50

It is. And what's interesting is I think there's just a lot of worry in the West about like, oh, you know, because and the thing is, I think because there's not enough knowledge out there in in in every way, you know, the scientific community, academia, clinical, and even just the the rest of the other health professionals, like you guys, physical therapists, everyone, there's just not enough knowledge there to be like, hey, let's just go and do this, it'll be okay. Or okay, let's hold backgrounds.

SPEAKER_01 8:21

Which is which is interesting and sad at the same time. Even even though with prenatal, and I remember with my in the with my first pregnancy, I was of course, you're gonna tell like everybody on the street that you're pregnant. The second the people find out you're pregnant, they don't want to touch you because they think if they touch some certain spot on your body, it's gonna spontaneously burst you into labor. I got news for you. Like, both my kids basically had to be pried out of my body. We tried all the spots and all the things. If they're not coming, those spots don't matter. Yeah, it's like like orthopedic therapists, it's the funniest thing. They're like, Oh, I can't do this. You might go into labor. I'm like, trust me, I'm not going to.

SPEAKER_04 8:58

You see, I like that you say the word trust me. And that's the thing that we don't empower women and mothers enough. When you're pregnant, you really know like all the feeling, especially once you have more children, because you've gone through the first time, you kind of know this feeling means that. I and to be honest, even in the medical field, and now that I'm you know out of clinical practice, but looking back through my whole med school teaching and then my intern year and then my like junior doctor training time, yeah. Unfortunately, the bias is there. Of course, that women and even women doctors, because of the training we go through and the curriculum we have, the syllabus we have, I would say I I had that viewpoint too. I I am kind of sad that I, you know, I guess bought into it. But then again, to be kind to myself, I'm like, well, that's all I knew. I was right I went into and I went to this training to learn, right? Hoping that they would give me the balance of both sides. Because I have, and the thing that you said about people not wanting to touch a pregnant woman, that was me. So when I did my emergency term, I avoided pregnant women like the plague because I was so afraid that I would mess something up, and I was like, I cannot handle two lives in one, like right.

SPEAKER_01 10:18

Well, especially first trimester, too, because again, nobody noise no one's gonna do the study that says if you do this, it will harm your baby. First of all, let's just be clear about that. But yeah, again, and I think it's also hard, especially with first-time moms, because you're questioning everything. I mean, you you've lived in the states, like we get freaked out about deli meat, you know, all crazy things. And and I have a friend I went to PT school with, she's Greek, and she's like, You cannot tell a Greek woman she cannot have feta. And I'm like, Valid, like totally valid. I see her point. So, but we we just I think there's all these kind of things get perpetuated out of fear. Um, I mean, when I was nine weeks pregnant with my oldest, we went to Costa Rica and I did waterfall repelling and we did zip lining, but I wouldn't eat the unpasteurized cheese from the farm from the cow that was like right there. And the guy who was doing our boat, he's like, wait a second, you did these other things, but you won't do that. I'm like, Americans, you know, like what else are you gonna say?

SPEAKER_04 11:21

It's that's where I think I mean I'm hope I'm hoping just with you know more more moms, I would say getting into science. I mean, let me rephrase that. There are already moms and women doing a lot of science, but I think getting just going out and challenging status quo or whatever stereotype or you know, biases are out there right now, I think that'll be really interesting because um, like right now, there is a there was a paper last year um that is actually reframing motherhood or matrices as a neurodevelopmental stage that has greater impacts on you know a female or a woman who has a child. Like it's it's they can they're proposing that it's bigger than puberty, like the effects on us is bigger than puberty. And I don't think they're wrong. I know reading that paper, I I can't remember the last time I got so excited about a scientific article. Right? I read that I was like, Yes, this is me, this is me. And I was like, wow, finally, someone is saying it and I guess validating all these things.

SPEAKER_01 12:31

Yeah, no, I I I I totally agree with you. So so for you living in Alabama, which is an experience in and of itself, uh it's like different from other places in the United States. I've never lived there, but um it's the South. How do you like did it seem hard to be able to have um kind of this traditional experience where you were living? And I'm assuming you run a military base. Um what was what was that like? And then what did what was kind of the reaction of some of the other mothers around you that maybe were from the states and you know were trained, you know, walk out of the hospital in your pre-pregnancy genes, you better be walking, you better be like, you know, doing all these things. Like, what was that experience for you?

SPEAKER_04 13:17

Yeah, so firstly, when we were planning on how to how to do the confinement month, um there were no, I mean there was some Asian grosses around because because of the military base where we're at, there was a smaller town that was actually a pretty huge Korean community because of the influx of military families. There was even a Korean mayor in that town, which was pretty cool. Oh, okay. But when I went there, very basic, and they didn't really even have the basic herbs that I, you know, normally would take, or that my mom has advised me like, you know, when you're in the confinement, you should at least have these herbs like red dates or certain roots and stuff. So we actually made a trip. Um, so happened I had to renew my passport. So we had to go to New York to the Malaysian consulate or embassy. So I took that chance. I was eight months pregnant. We went there. That's a trip.

SPEAKER_01 14:10

New York in general is hard, but like New York in eight months pregnant is really hard.

SPEAKER_04 14:13

It was, I don't think I'll do that again. Okay, fair enough. Um, but when we went there, we did go to see a traditional Chinese medicine practitioner, a doctor. And then he did the thing. He I really liked that he asked, Do you plan to breastfeed? Because then he would prescribe herbs that will either stimulate or you know, reduce your lactation. So I said yes. And then he said, Okay, um, you're fine, and don't force and you know your OB said they don't foresee any complication. So this is what I prescribe. And they have a herbal um, I guess, dispensary downstairs. So I just packed up 30 days worth of herbs. Nice, brought it back, stuck it in my freezer, and yeah. So that's one way of doing it. But the and the good thing now is a lot of these herbal dispensaries or traditional Chinese medicine clinics, they actually offer teleconferencing or phone consults again. And this is where I think I really feel like the traditional Chinese medicine community are ahead of the Western medical side because they understand their limitations and they work with modern health practitioners. Even in Malaysia, all the TCM doctors I've seen, they will always say, Bring your latest medical report from your regular doctor. Because I want to, you know, and they know how to read the stuff, they understand what those things mean, and they'll go like, okay, if you have this issue, maybe get that sorted out first, and then we'll add on TCM treatments and remedies once you're cleared. Or collaborative, yes, very even for me at before I had my first kid, I thought because I've always had like irregular menses, and I thought, oh, maybe that could affect fertility because I I didn't know very much, and honestly, I wasn't that interested in my own physiology in med school. Um, so I went to see a TCM doctor because my mom said, Why not try? Okay, you know. First thing she said was, Okay, just go get a latest update from uh at least a family doctor. And she even wrote a form for me to get an ultrasound on my ovaries and everything, just to make sure there are no cysts and all that. And I was like, Wow, that's amazing. And she's like, Okay, will you do that? She's like, All right, come back and then and then she applies all her TCM stuff and then would advise me, okay, do this, do that, or eat this, eat that, and that should strengthen your fertility kind of thing. Gotcha. So that was interesting, and I really love that because and I think that's what miss is really missing from our you know, Western medical training.

SPEAKER_01 16:47

Yeah. That conversation has come up a lot um in the context of both pregnancy and postpartum. And I do think in in our space, PTs, we tend to be collaborative anyway, especially in pelvic health. We we we work with dietitians, we work with you know psychologists and coaches and trainers and physicians of all sorts and that sort of thing. That's a little bit of our nature, but it really is this hodgepodge of, hey, these are people that I've been connected with over the years that I know do a nice job. It's not anything that's ready-made, and you have to find us that have the networks already built. And I think that's the part that has been lost to a degree is that those communities within the medical profession, at some point, ideally they were inherent. It was like organic, and and now it's like you really have to go out and seek that out. And if you don't know that that exists, it's like this whole other world that you know sometimes you don't realize until after the fact, which I I don't think that that's super fair either. What do the um TCM providers like is there an opinion as far as like early activity, walking, exercise, that sort of thing? What's what's the mindset as far as that goes?

SPEAKER_04 18:02

Yeah, so traditionally for this confinement period, they asked moms to bed rest, but now we know bed rest is just not great for your muscles at all. Right. So for my book, I did reach out to a TCM practitioner in LA. Um, and we actually sat for a couple hours to really chat about that. And then followed up, she actually reviewed my you know chapters on the TCM stuff and um the modern recommendations that I make because I wanted to make sure we we kind of straddle both sides and are fair, and people can choose which you know you can do traditional or modern, you know, when when you read my book. So she actually said right now the TCM side, because she's also my generation, and her grandfather was also a TCM doctor, but she says we're going towards light activity. She's like, don't at rest anymore because the science says it's just really not good. So, I mean, yes, traditionally that's what they recommend, but that's what those doctors and physicians knew back then. Right.

SPEAKER_01 19:07

But now that we know better, we're shifting a little bit. Um that's good to hear. I I was telling you a little bit um earlier. I had a client a number of years ago. I was fortunate enough to be able to work with her after her first through her segment pregnancy and afterwards. And her first pregnancy parents were here. I can't remember where what her background was, but it was very strict traditional bed rest. And when she came to me, I think she was probably somewhere between eight to 12 weeks, and we didn't have a lot of time before she was supposed to go back to work, and just the atrophy alone, and she had other pelvic floor issues and leakage and things like that, and then her parents were leaving, and so it was I was trying to wrap my head around you know, we're trying to honor this culturally, but it really set her up physically in a not so great way to dive right into Western culture, back to work, drop off, pick up daycare, all that kind of stuff. Um, it through her second, and her second was during COVID. So it was good news, bad news, right? Um, she was like, you know what, that that strict did not work out. And I think with a toddler too. And so I'd be curious too, like, you know, depending on what how many kids you have, like what maybe going to the center's vacation, I don't know. But she she very much consciously was like, okay, we're not gonna do that. I cannot do that. I don't think her parents could come because of COVID and travel restrictions and that sort of thing. So the circumstances, but her choice also said, Hey, that's not gonna work for me. Um, that was not something that was a great experience for her. So, in in kind of what you've seen, like, is it different the more kids you have? Is the purpose different? Like, what's that role of that rest period? What does that look like?

SPEAKER_04 21:06

So the purpose remains the same. Still rest and recover, focus on giving mom the space for those full 30 days. So the idea again, and this helps if you really have that tribe or community around you, is someone looks after that toddler. New mom does nothing again. So this worked out for us here in Germany. So I had my second 2019, no, 2021. So that was when Germany still had the heart locked down, hospitals were like, you know, and travel was still restricted. Um, and it was nice to have my mom the first time, and the stress that we got was mostly just you know, generational differences. She wasn't as strict, my mom wasn't as strict. Uh, plus, I can kind of sometimes throw back things at her. I'm like, Well, you asked me to study medicine, so this is the knowledge, don't force me to do that.

SPEAKER_00 21:59

Like, you did that. Yes, not me. You did this.

SPEAKER_04 22:02

So, you know, but my husband, um, he's you know, he's Caucasian American. So he he's and he's been away from home since after high school in the military. So he's not used to living at home with a parent figure for a long time.

SPEAKER_01 22:17

Let's just put that one out there for what it is. Yes.

SPEAKER_04 22:20

Yeah. So to us, that was the stress that we got from her being there. But otherwise, you know, she she cooked like food, helping us care with a baby was amazing. Um, so the second time around, we thought, you know, let's just do the 30 days ourselves. And my husband, one thing as well, the first time he felt so excluded, so excluded. And that is also a very traditional thing because, and I think this permeates any culture, Western or Asian, is the male figure, the husband, the father, or I guess the non-birthing partner is usually excluded from the childcare, the baby stuff, or even caring for the mom, because people just assume they don't know anything. Right, you can't do this, and you're not useful, so please step aside. Right. So frustrating. So my husband was just mad because to him, he couldn't do anything when I was pregnant, and I had the worst pelvic pains and all that stuff. Yeah. And then the birth, he can't do anything either, but just be there. So he felt like the only place that he can really, you know, I guess be what he wanted to be for me throughout this process was the postpartum. And then the first time he felt he was not given that chance, it was taken away from him because of the traditional cultural nature of this practice. Right. So the second time I said, You're gonna be my confinement nanny. That's what we call that's that's what we that's what we call them in Asia confinement nannies. So in Malaysia and a lot of parts in Asia, there are agencies that um allow families to hire confinement nannies. So you have this motherly figure, um, woman, who comes and stays with you for 28 to 30 days. They do so so they do all this stuff, and it's helpful for those who live away from their parents, or they want to do this with someone who's not a parent because then you kind of remove that. Yes. You know, and you can't really smart. Yeah, and you can set your boundaries and they'll follow through the boundaries that you set. Um, or if you really have the money, they have confinement centers.

SPEAKER_01 24:28

Sounds jail-ish, but um I I had a client the other day, she uh she's from China, and um she was telling me all about these because I told her that you and I were gonna talk, and she was telling me all about it in China. I was like, really, this is a thing? I need to go.

SPEAKER_04 24:44

I mean, one thing I think they would actually benefit is having some folks come from your background because of the whole bed rest thing. If someone comes in to you know educate them, like, hey, it's important to like not do bed rest or even just do the simplest exercise. I mean, not even exercise, just what's good bodily motion to maintain your muscle during that time. I think that's what those areas are lacking. Because from what I understand from those centers, it's really luxurious, Carrie. Like, I mean, you pay tens and thousands for the 30 days, but you have a chef that cooks you all this Chinese food. Yeah, you have a masseuse that comes in, they give you a family suite. Oh my gosh. And they're like the herbal baths, provided you know, you don't have stitches and stuff that you can't soak. And you know, and if you need rest and baby's crying, there'll be someone to come help you at least for a while with the baby and take them away to a nursery. The only caveat is because they all operate again, it's you know, it's not registered, it's not licensed, it's a center, it's not clinical. So, so they don't really need to follow any guidelines, really, because it it's it's like you know, hey, come check into this luxurious hotel experience. Um, so when it comes to breastfeeding, lactation, or certain other more, I guess, health-related things, they may not provide something that's consistent with right now because they don't have to, they just provide you the best experience. So I think if there's a collaboration there, you know, we could do this better, you know, right? Absolutely, absolutely. So I I know in the US, um, these type of places they call them postpartum wellness stays, I think. And it sounds better than confinement sexually.

SPEAKER_01 26:30

Well, and and I was thinking as you were talking, a couple of things. One is, I mean, uh, thinking back on just even my first getting out of the house and going for a block down the street. I I had an unplanned C section after a three-day induction, and just like at that point, you're swollen. You just like, can I even move? Can I even get out of the house? Like that was my saving grace was just getting out of the house and starting to move. But the other thing that occurred to me as you were talking is what is the transition out of that period look like? Because again, for my client here, it was a very rude awakening to go from doing nothing to all of a sudden she's supposed to be back to work and doing everything again. Is the transition a little less abrupt?

SPEAKER_04 27:14

Um, for me, no. Because it's it actually, you know, it it can seem abrupt and it's kind of up to you to plan your transition. But uh so so normally what they do is this this the strictness comes from following the rules, like you can't drink cold water, you can't eat cold stuff. So it's very heavily nutrition-based, and once you're done, then you kind of just start eating, you know, whatever you would like and see how you go. And then the other practices is like, don't wash your hair for 30 days. No, not for me. Um, I lasted two weeks and that was it. Um, the compromise I did with my mom was I'll make sure I blow dry my hair really nicely in the bathroom before I step out. Okay. And and that and that works. The TCM, you know, doctor that I was to touch with, she's like, she's like, okay, we can compromise on that part. Oh my goodness. Um, and and some some women, I know even in Malaysia, they just don't even follow that. They're like, no, this is ridiculous. I'm not doing it anymore. Um, and some the very strict one tells you no baths and showers, also for 30 days.

SPEAKER_01 28:22

No, no, so no, that shower was like, I I I'm going to live, I'm going to survive this. If I got a shower in a day, I I knew I was gonna make it.

SPEAKER_04 28:31

Yeah, so so for us, a lot of that transition out is just transition out of those practices, which means you just go back to your normal. But in terms of your modern day-to-day, that actually doesn't really, we don't really talk about that very much because and I think a big part of that because we're so used again, we're so used to living so close to family or multi-generational household that even when you do transition, help is still there, yeah, still available.

SPEAKER_01 29:02

That's a great point because um, again, so many, at least here in the states, people have traveled so far away. I mean, my parents are on the West Coast, um, they had to fly and come and stay for a week. Granted, my in-laws are were lucky enough that they're close by here, but not everybody has that. And to your point, too, sometimes you need help, and it probably shouldn't be your family because you you want them to be your support. Not, I mean, like I are I love my in-laws, I do. Um, I remember our first nanny experience was going to be my mother-in-law coming 30 minutes across the beltway to to help us, and that lasted about a hot second. One, because it's just a hard drive, and then two, I can't have my mother-in-law as my employee. Like, we know those two things need to be separate. I need to tell you what I need and what I want as a mother and not worry about what your mother-in-law thinks.

SPEAKER_04 30:02

No, you're absolutely right. It really the emotional part is just so strong when families involved.

SPEAKER_01 30:08

Such a mess there, too, anyway, like hormonally and um figure that stuff out for the first time, you know.

SPEAKER_04 30:16

This is a great tie-in to put parental leave. That to me is where, and so, like in Australia, six months maternity leave. Yeah. So you have your fourth trimester, and then you still have another three months to kind of, you know, and a lot of and at least in in the department I worked with, oh my god, they were amazing, Carrie. It makes me feel like if if this entrepreneurship thing for me kind of fizzles out. I have I have the best backup job and the best like ex-boss to go back to. Yeah, and I love I I love everyone there, like, because in I so I used to work at geriatrics, and I I still I'm very close to my ex-boss and the physiotherapist there, actually. So I still email them, text them. We're fun people. It's it's great. Um, and I remember I had a senior colleague who had a baby, and you know, they said, sure, go do your thing, six months, your job's still here, nothing's gonna change. And you know, if you get you know, you want to start coming back slowly, we can talk about doing part-time or a few hours, like maybe do clinics first, and so accommodating, and that's the culture there. And I know in Germany, definitely the um first eight weeks, if I'm not mistaken, it's like enshrined in their law. There's like a maternity protection law that if any employer tries in any way to get a new mom to work in that first eight weeks, they can be like jailed for a criminal offense. Oh my goodness, wow. Yeah, it's it's like it's like a document you can Google that. It's serious. And um, a lady I spoke to here, she said when she had her two children, she took up to three years to go back to full-time work. So she kind of eased into it, did part-time and eased into it, and they cannot take her job away.

SPEAKER_01 32:11

That's nice, and that's the thing that I I think there's such a broad expanse, just a big dichotomy here in the States, because if you are, you know, working at a job where you don't have maternity leave, you're expected to be back within that six weeks. You're not getting paid during that time. Child care expenses here are insane. Um, so that's like one end of the spectrum. And then the other end of the spectrum, if you're lucky enough to do it, like I mean, I was working full-time up until I had my oldest, then shifted to clinic care two days a week and then was home with him three days, kept that through till I had my daughter. And then when they went off to school, now obviously when I work for myself, I kind of do whatever. Um, but having that balance of um being able to do parts and pieces, but at the same time still be integral. Like basically, you're not working just to pay for your child care for your kids. That's the part that and a lot of people they're forced to do that and and and fast. Um, and then I think at that point, you're going if you're going back to work at six weeks, um, you never really get a chance to kind of fully do that recovery. And I think that's one of the the the downfalls here in the states. And and again, you too, now that we've got more information about um, you know, that beginning of the first or the fourth trimester be really dangerous, especially for a lot of black and brown women, like that sort of thing. It's just what are we doing over here? Like, I really you've got like that one end, and on the other hand, end is like the a lot of the women that I work with that are like trying to over-train and undernourish and breastfeed their baby and do all the things and end up with like bone stress fractures because essentially they're like overdoing underfueling and trying to do all this stuff. I'm like, how can we have like what what happened? Like, how can we have these kids? Neither of them are good situations. How can we find a situation in which moms feel supported? We can still be active, but in a very supportive way that takes into account work and sleep and nutrition and you know mental health for crying out loud. Like, where do we go wrong in all this? Now I'm expecting you to find the solution, Tom.

SPEAKER_04 34:31

No, I I think it's I mean, this as I this book has really started me on a journey I did not expect to take. Like postpartum, like maternal health was really because I ended up doing a master's of public health when I was in Alabama because it's been an interest of mine, but I kind of gravitated towards healthcare um organization policy because in my geriatric work, I realized even as a health professional, if you really, really want to try and make any change, even if you become the top specialist, professor, doctor, doctor, whatever, yeah, if you're not up there in the policy level. Yep, exactly. Nothing is gonna change, or it's gonna take someone else to you know bring your dreams to fruition. So I kind of studied that, and then maternal health. I was like, yeah, you know, dip a little bit because public health always covers maternal and child health. Always, yep. So I did that, but then actually becoming a mom and then going through the emotions and seeing all these things. I'm like it's next level. This yes, exactly like you said, what's going on here?

SPEAKER_01 35:33

Yeah, and and then I we're in the 2020s. I know, and that's the part that just there's still things are just so antiquated. I mean there there are I I forget the the bill name that's in the house right now, trying to go through to get basically early postpartum care covered under I think I know which one you're talking about. I've been following, yeah. It was it was 8181 last year, and then it didn't go through, and it's two something now. I can't remember because they make it so easy to follow this stuff with how a bill becomes law. Of course. Um, so but I mean, like I feel like there's efforts there, but again, I mean, what was it last week? Um, oh bless, I can't remember her name. Um, the Olympic sprinter that died in childbirth at home and wasn't found for three weeks. Like again, like I and out of that, like out of that relay team, three out of the four of them had some sort of life-threatening birth experience. I'm like how can we have these conversations? Again, it comes back to advocacy and policies and and those sorts of things, and and having just some appreciation for the fact that this is a major medical event, and we're literally not providing our moms with clear guidance and support from a straight medical perspective, and not to mention, you know, cultural and that sort of thing, acknowledgement there.

SPEAKER_04 36:53

Absolutely, and it really for me personally, I feel like a lot of things I'm seeing, it's also linked to the messages that I grew up with about what motherhood means to a woman. And I mean, I had really bad postpartum depression with my first um kit because man, Carrie, I was so bitter, bitter, resentful, and and I really allowed all that messages of like, oh, once you're a mom, that's it. Your life's over, your dreams over, everything you want to be. Like you should have you should have done all that before you had a kid. Like you should have listened to all those messages just sunk in our hormones, don't help.

SPEAKER_01 37:36

No, and but you're sitting here as a physician, like you're like, I I'm an incredibly intelligent, accomplished person, but also now that I've done this, that like it's that identity struggle that I think it really just messes with.

SPEAKER_04 37:49

Yeah, and then because you know, I had left Australia and everyone was like, Oh, you like you had such a promising career, and right, you know, and then the whole you're just a housewife, if you my little quota heirs, and as if that's you know, and oh, the nice thing is my husband some months ago, he sent me one of those reels that you know, I think someone somewhere did a study that uh what a stay-at-home mom with young kids, your net value is like what about at least 180 to 200 grand per year. When am I gonna see that?

SPEAKER_01 38:20

Right? I would like that along with my maternal massage.

SPEAKER_04 38:25

Yeah, and it's to me, it's interesting because like if society in general and all the messages that you know we feed to young girls that motherhood is like so like the value is zero. Yes, it's it's better to pay someone else to raise your kids, like they have more value than if you choose to stay home with your kids and raise them. Like, I even grew up with the message of don't become like your aunt, and I'm like, why? She's happy looking after her four kids, and like, well, she got a degree and never used it. And I'm like, Yeah, she's happy, and my gosh, and looking back now, I'm like, you know, I hats off to my aunt because she put up with all that crap and still persevered with a smile on her face, showing up for her kids and just enjoying motherhood. And you know, I like so going through therapy and all that stuff, and even up till today, I still actively remind myself I really want to enjoy motherhood so that my girls, specifically also because they're girls, they see me enjoy it. Yeah, my mom was a trailblazer, and I really admire what she's done, but at the same time, I could see the stress, and there were moments where I felt like you know, maybe she had a feeling like, oh, if I didn't have kids, I could have done more, you know, just the vibe.

SPEAKER_01 39:39

She never said it, but it's the vibe, the body language, you know, the funny they raise us to be independent, achieving women, and then yeah, and then they want to have their grandbabies and that kind of stuff, and they they don't know how to reconcile that. But the the other thing I want to add on here, too, is um, you know, hats off to the military moms. Like, I I'm fortunate enough that again, we've got a a ton in this area, and to constantly have to pick up house, recreate a home quickly and a place of um y'all are badass at that, by the way. Like, thank you, thank you, and to create a home and safety for your family. Meanwhile, your husband's God knows where. Um, you're trying to find medical providers and this and that, and you're all amazing networkers, by the way, too. Um, and I have realized that that that's basically what I needed to do. Yeah, that's a skill set. And and and okay, and after this too, I have friends that their husbands are retiring, and now the husband's coming home, and mom's run the show for this many years, and now dad's trying to run the show, and it's a little bit different.

SPEAKER_04 40:49

Yes.

SPEAKER_01 40:49

Uh, that's handling that transition. Like, I have a few friends going through that right now, and I was like, Y'all are badass. I'm just gonna put that one out there.

SPEAKER_04 40:58

Thank you. Actually, I do want to touch on something, and this is something I'm actually working on. Um, not just for clients who come to me for postpartum planning or postpartum coaching, because I I want to incorporate like fourth trimester and for the postpartum year, really. Um, so from because because I volunteer a lot with the soldier and family readiness group with my husband's army, so part of his unit, I and I have like amazing friends who invited me into what they were doing, and they made it so like they made advocacy work fun. It was like learning all these things and learning how to, I guess, own our spots. Because yes, there is still a bias, like, oh, you're a military spouse, uh, you just you're just a housewife, you know, the just thing.

SPEAKER_01 41:43

No, I've so you're amazing PTA moms, too. I I'm like, you guys got all this stuff down. You you know how to do the communication. I I bow down to you, I will Venmo you anytime, whatever you need.

SPEAKER_04 41:55

So it's it's been a very interesting journey because the more I learn, and one thing I've been exposed to is a lot of garrisons have what they call the command readiness and resiliency council. So they invite high leadership, so like you know, battalion, brigade. So you got you know your company level, then your I think battalion and brigade and so on and so forth. So it's battalion and brigade level commanders who go to these meetings and they talk about their soldiers, yes, and these councils they go by the five pillars of soldier readiness and resiliency, which the idea is that if my so one soldier has their five pillars fulfilled, then they are mission and combat ready for whatever.

SPEAKER_01 42:35

Right.

SPEAKER_04 42:36

One of the pillars is family, yeah. Guess who falls under family?

SPEAKER_01 42:40

You it is you, it is all you, and it always has been. And that's the part that I think again, if you're if you if you've not and those of you that are listening, I we have a lot of um slam moms um that listen. Um, there are a lot of military moms that listen. You know what I'm talking about, but if you don't military moms are amazing, and I I I think it's such a gift to be able to support them because they support so much um their spouse or their family or that sort of thing there.

SPEAKER_04 43:11

So yeah, I really want to yeah, I really want to say that you know to all of you guys listening, definitely, because this family pillar, and that's something the whole army-wide, they're moving towards making things more you'll bring bringing back the family orientation. Yeah, and that family pillar is you because just like Carrie said, you're there, you're holding the fort, you're raising the next generation so that so that your soldier can go do their thing for the country. And if that family pillar, i.e., you, the spouse and the mom, is not supported, they are not ready out there. Yeah. And honestly, and this is from my personal experience. So the Ukraine Russia thing, and I can talk about it now because it's public news is last year. My husband got deployed. A bunch of people from here got deployed because Germany's right, you're close close. Yeah. And there was a huge, huge thing that it was quite messy, but as soon as we figured out that supporting the spouse and the military moms that helped the soldiers' mental health out there. Yeah. Directly.

SPEAKER_01 44:15

Not to leave out our our moms that are service members themselves. That's a whole nother thing that are having to return. That's a whole other that could be a whole separate podcast. And again, I'm I'm fortunate enough to work with a bunch where you're not only expected to handle this part, but you're supposed to meet your your return to fitness requirements and serve and be deployed and all this other stuff too. Like that could be a whole nother conversation, but absolutely it's a lot. It's a lot. But um, no, thank you guys for for your service for sure. Um at the end, I always kind of ask a few questions um of our guests. Um, this one, your favorite activity since becoming a mom. And it doesn't have to involve your kids.

SPEAKER_04 44:59

Yeah, favorite activity volunteering. I never thought I would enjoy volunteering so much. So I I volunteer with a USO and base as well. I fantastic. Yeah, I pitched to them, but hey, can I do a birth story support group once a month? And they're like, sure. So I have that. And then the yeah, Army Community Service here, they run the Army Family Action Plan Program or Army Family Team Building. And again, with my girlfriends here who started, I kind of just ended up there. And now that two of them have moved away, one is retiring. I'm kind of you know still here, but I continue doing that because I had fun. And the people here in this garrison is they're they're amazing in supporting the volunteers, even I would say the garrison commander himself. He invited a bunch of us to attend the garrison strategic uh conference thing, which I was like, wow.

SPEAKER_01 45:53

He is a smart guy to invite you.

SPEAKER_04 45:55

Yeah, and they're trying to revamp the spouse sponsorship program here. So I think also just being in this environment to support volunteers. Uh, yeah, I that's fantastic. I highly recommend it now. As you know, if you're not able to go back to work, especially if you know the military life, um, there's also a lot of push towards converting volunteer experience into a professional experience and using that in your resume because that's really the only way we can do it.

SPEAKER_01 46:25

Right if you can't, especially depending on what country you're in. Yeah, absolutely. All right, one piece of advice for new moms.

SPEAKER_04 46:31

This big thing. So I want to tie this in with my freebie because there are at least two big things in my freebie I talk about that I think new moms, we need to advocate for our health whenever we see fit. So, first, Carrie, it's down your alley, it's the pelvic floor stuff. Yeah, and if my own physical therapist didn't remind me, she said, your urinary leakage and all those problems, she's like, they're common, but they're not normal. Yep, not normal. If anyone tells you that, I don't care what professor, doctor, doctor they are, leave that office, go get a second opinion, or just go see you directly because you can diagnose, you can, you know, and even for me, she had to tell me Kegels are not gonna work for you, Crystal, because you carry your stress in your pelvic floor, you need to relax it. And I was like, Oh wow, okay, because I've been doing Kegels before I see it.

SPEAKER_01 47:19

So happy to hear you say that. Because I on Instagram, I will get daily DMs from all over the world, and depending on where people are, like I have a client right now that she's in a different country, and um, she's an expat, and her PT is telling her one thing, and I'm like, that's not what's happening, but that's what we have on the ground. Um, so we're we're having to navigate what information is standard of care in different countries. It's it's tricky, it is.

SPEAKER_04 47:46

And the last thing is if you encounter tiredness despite you having your naps or your kids are not going through growth spurts and you still have daytime sleepiness, and ask your partner or anyone around you if you snore, yeah. Postpartum snoring and the sleep disordered breathing is so severely I mean, not just underdiagnosed, yeah, not just underdiagnosed, but nobody even asks you. And so I recently got diagnosed with sleep apnea, and because I have the medical background and I know, so I thought it's time to go see a doctor. I'm a bad, I'm a bad patient. I admit that.

SPEAKER_00 48:22

We all are, it's all good.

SPEAKER_04 48:23

And and I started snoring with my first pregnancy, and I just never bothered. I I nobody asked me, and I thought it'll go away, and it never did up until like now my second kid, yeah, almost two years old. Yeah, and finally saw the doctor, did the sleep study, and gosh, it looked horrible. No wonder I'm so tired. So oxygen is a game changer, yes. Yeah, so moms, you're not just tired because you're doing we already do so much, you already stretch thin. And you know, when the kids go through all their behavioral and sleep changes, usually moms stay up to do that. But bear in mind you're sleeping, your oxygen could also be another factor. So don't doubt your body. Don't doubt your body. Yeah, like just go go find someone and find someone who believes you. And unfortunately, that's the work we have to do today until that changes.

SPEAKER_01 49:12

No, I I think that's a really good point. All right. Anyone in kind of this space that we're in that we should know about or we should follow or pay attention to?

SPEAKER_04 49:22

Oh, there is someone I really like um on Instagram. I think they're called My Connected Motherhood. Oh, okay. They do a lot of sleep stuff, but they challenge the notion of sleep training. I love it because I tried sleep training with my first. It was miserable all around, both for me and my child and my husband. I I'm I'm with you, yes. Yeah, and and I I love how they really reframe how we see infant sleep, like all the kids, all the all that babies need, and them waking up often, that's literally their survival mechanism. It's normal. And this is where I think pediatricians and family doctors, if and again, time, because I know from experience that the system doesn't give us that time to connect with our patients as much. But if somehow they can include more education on what's normal to expect from your baby, then I think managing that expectation on sleep is gonna help a lot.

SPEAKER_01 50:20

And that would probably also help with mental health for moms. Um, my oldest barely slept until he was five, but you know, we're I had another barely sleeping. I I usually don't tell that to people unless like they ask because no one wants to hear that.

SPEAKER_04 50:35

That's true.

SPEAKER_01 50:37

All right, and then finally, what does it mean to you to be an active mom in postpartum?

SPEAKER_04 50:41

Um it's just getting to know myself again. Getting that's been huge for me. Getting to know myself again, finding that spark that I thought I had to just snuff out because I became a mom.

SPEAKER_02 50:55

Yeah.

SPEAKER_04 50:55

And um, you know, I I I will say this on air because I'm not shy anymore, but I I dabbled in pole dancing in med school. If anyone asks me what I learned in med school, I learned to pole dance, I learned aerials. And I think, you know, um I'll I want to go back into that sometime once you know my husband like life settles because the places we moved to so far, I haven't really been able to access such studios, dance studios and fitness studios. So when we move next, I think I want to go back to that just to see how I feel again doing that. All right.

SPEAKER_01 51:26

Well, then after you do that, then we'll have you back on the show. How about that? You can tell me all about pole dancing. I would love to. I would love to. If you'd like to know more about Dr. Crystal's information and her courses and her book, you can find her at www.mamaswingwoman.com. Love that URL, by the way. Thank you. Dr. Crystal Loud, thank you so much for being on the podcast. We appreciate it. Thank you. Did you enjoy the podcast? If so, leave us a five-star review on iTunes and tell a friend to do the same. Register now for the free on-demand post-part of mama masterclass how to overcome the three most common return to run mistakes. You can skip to the good part and get back to running while missing these mistakes. Find this in more free resources under the pages section on carrying out.com. This podcast represents the pages of Dr. Cherry Peccano and the chat. The content should not be taken as medical assignments and it's for entertainment purposes only. Always consult your healthcare professional for any medical questions.