The Motherhood Survival Manual: A Perinatal Physician's Approach to Preventing PMADs

Dr. Jill Zechowy, MD, MS, is a perinatal mental health physician. Motivated by her own struggle with postpartum anxiety, she combines her knowledge of perinatal psychology and family medicine to help pregnant women and mothers thrive. 

Dr. Jill is the author of Motherhood Survival Manual: Your Prenatal Guide to Prevent Postpartum Depression & Anxiety. Available on Amazon. She is also the creator of the  Motherhood Survival Manual Masterclass. This online course is a prenatal class teaching effective strategies and practical tools to reduce their risk of postpartum depression.

In addition to her clinical work, Dr. Jill regularly speaks at conferences and workshops to educate therapists and healthcare providers about perinatal mood and anxiety disorders.

You can learn more (and get in touch with her) by visiting her website www.Motherhoodsurvivalmanual.com. You can also follow her on Instagram @motherhood_survival_manual. 

Transcript

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Rebecca Gleed  0:03  

Welcome everyone. I am thrilled to have Dr Jill Zeke, a perinatal mental health physician and author. I am so excited to have you on today. Thanks for coming.

Unknown Speaker  0:18  

Thank you very much for having me Becky, it's my pleasure.

Rebecca Gleed  0:22  

Well, tell our audience and listeners a little bit about yourself and what led you to the space of perinatal mental health.

Dr. Jill Zechowy  0:31  

Absolutely. So my background is quite atypical. I'm not actually sure if there's anyone with my exact background out there? Yeah, yeah. So I'm not a psychiatrist and I'm not just a perinatal psychotherapist. I initially started out as a family doctor, and when I was in medical school, I was had a hard time deciding, do I want to do family medicine, or do I want to do psychiatry? I knew I was interested in people and families, and then my psychiatry rotations were working in locked wards with violent offenders, and six weeks working with people who had done unspeakable crimes, I was like, Oh, this isn't really the mental health area that I'm interested in. I'm glad that there are people who do it, but it wasn't really for me. But meanwhile, my medical school, when you were first years, you could sign up for a program in which women who were pregnant volunteered to work and be paired with a medical student, and you would follow them to each of their prenatal visits and then deliver their babies and then go to the well chair Well Child checkups later on. So I was paired with this lovely woman who volunteered to have this person who knew nothing, deliver her first baby. We were pretty bonded. By the time she was in labor, I'd been to so many of her visits, and this was just a wonderful introduction to family medicine and and then I loved caring for her baby afterwards, you know, it was all supervised. It wasn't me winging it, but it was such a wonderful experience. And so I thought, Now Family Medicine, that's the way I want to go. So I stopped thinking about psychiatry, but not completely in my first position. After all, I completed all my training. I had a position with the National Health Service Corps, in which I repaid part of medical school by working in underserved areas, and we took care of a lot of refugees from around the world that were coming into the United States, and we were screening them, making sure they didn't have any infectious illness that would come in. And I met these amazing people who, within six months of arriving, where they arrived with nothing but a single backpack, I ran into one guy at a gas station. Six months later, he was a refugee from Bosnia, and he pulled up in his SUV at a credit card and clearly had a job, and it was like just, you know, made me so proud, but we were not screening these people for PTSD, and they came with horrendous traumas, because most of these countries were very war torn, and that's why we Were taking people. And so I saw how much the their trauma affected their physical health, and so we implemented the screening program so we could get people. I became the medical director there, acting Medical Director while I was there, and really created some changes so we could hook them up with mental health. And then that was all in the Boston area. I moved out to California when I was eight months pregnant, and I took a job as Assistant Professor of Clinical Medicine at UCSF, they have a family medicine residency program where they train family medicine doctors here in Sonoma County, and so I took that job while I was pregnant. I started three months after I gave birth, and a lot changed in between taking that job,

Unknown Speaker  5:10  

and it's transformational. Oh my

Dr. Jill Zechowy  5:13  

gosh, yeah, it really, really was, and I, like so many moms, was like, How come nobody told me, You know what? What's this? You know, everybody's Oh, well, when you have the baby, well, tell me, you know

Rebecca Gleed  5:28  

So, what would that, looking back on that, what would you have told yourself in preparation?

Dr. Jill Zechowy  5:35  

Oh, it's really hard to narrow it down. I uh, how to get a sleep plan, how that the having a baby is the equivalent to three full time jobs. So where are you going to find the hours? And how are you and your partner? If you have a partner, how are you going to redefine your roles to make this shift, because if that those three full time positions are being born by one really needs to be shared, otherwise, it's going to be a rough road. I I knew that I was at risk for postpartum depression. I had had depression as a child. My mom had told me how rough things had been for her after having a baby, and that she'd had depression, and they didn't even have a name for it, and they didn't ask about it, and they wouldn't have had any resources, even if she had told them so, and plus, I'd had four years of infertility, and I was moving to a place where I knew no one and had no support, so I knew that I was at big risk for postpartum depression. So being in medicine and kind of education minded, I started doing research, what is out there for prevention, and there was nothing, nothing on how to prevent the most common complication of pregnancy. We didn't even know that at that time because we hadn't studied rates like we have now. We didn't keep statistics on this.

Rebecca Gleed  7:27  

This is so set out about you. Is your emphasis on prevention, and we can speak to that, especially our course and your book so beautifully focus on that. But something I want to highlight for our listeners, for those who don't really understand when we say risk factors, you pointed to a few of you know, social support, family history, you know, pre existing depression, that those risk factors can be predictive of, you know, perinatal mood and anxiety disorders. And thank you for bringing light to that, because so many folks don't realize or can't do that kind of pre screening on themselves. Hey, I have some of this history. Do I need to do some prevention work, you know, in the perinatal period, so I can decrease the likelihood that it'll manifest, or at least curtail a little bit

Dr. Jill Zechowy  8:31  

Absolutely. And we need to do more screening to help women identify if they're at risk. So, yeah, I glad that there have been some changes, and it's really important for people in their pregnancy to do a little bit of thinking on, you know, what are risk factors out there? Because there's over 20 that are tied to increased risk of postpartum depression, but also balance that with the knowledge that you can have many risk factors doesn't necessarily mean you're going to get postpartum depression, and you can have zero risk factors and still get postpartum depression. So it it gives some indication of the type of preparation you need to do, although I think all moms should do some preparation that isn't covered in prenatal classes, where they just prepare you for the birth, but not once the baby's handed to you, or how To prepare your relationship and all of that. So I How did I shift though from I'll get into how I shifted then from family medicine to mental health, even though so for my daughter, she was my first who was born, I knew I was going to need support. I had. My husband's sister come and help. She was free and wanted to visit California for five weeks, so she stayed with me, helped me get my house set up, and stayed with me for the birth. And then I asked my cousin, who lived in England, she is the oldest of seven kids. She was between jobs, and I was also an exercise physiologist and personal trainer. So really, the perfect person to come out, yeah, yeah. So she came out, yes, and it made all the difference because I didn't have any family or friends in town. My mom passed away when I was young. My in laws are more the type that tell you what you need to do rather than help you. And so I knew that was going to be maybe more work rather than them less, although they ended up being quite a bit of comfort when it came time to that first bath and things that are scary to do and and so I didn't get postpartum depression the first time, but it was still A huge shift, and it was still hard. I definitely had some postpartum adjustment. And then after my second, I did have postpartum anxiety, really badly. It felt like my body felt like a guitar string that had been plucked and was just reverberating. And that feeling lasted for weeks, maybe longer than that. It was miserable.

Rebecca Gleed  11:47  

I think that resonate with so many people, that guitar string,

Dr. Jill Zechowy  11:51  

yeah, compelling anxiety is so uncomfortable to feel in your body, and that really propelled me to further go into this field of motherhood, and how can I support women in their transition to motherhood? And so then I got my Master's in Counseling Psychology and did two years of post grad work, working with moms. And babies together doing what we call dyad work, where you work with them together and help them recover, and then open my practice in women's mental health in 2010 and I have been living this work ever since. So deeply satisfying,

Rebecca Gleed  12:42  

isn't it? Yeah, I thought this may be, you know, just a small part of my practice when I started about a decade ago, but it really is so fulfilling, and is is such a need, yeah? So thank you for rising to the occasion and this dyadic work, I'm wondering how much stood out from that, that case during your residency, of following that, that mom from conception until postpartum, did any of that get pulled in to your work? I just can't help but wonder of yeah, it's just seems like such an intimate relationship and and the inner circle between the physical and the psych piece

Dr. Jill Zechowy  13:25  

that relationship happened in medical school, in residency, I worked with lots of women through their pregnancy that like that experience of medical school told me family medicine is right for me. And what I loved about family medicine is that you see the mom through all their prenatal visits. You're there for the delivery, and then you're there for the both of them and the partner as well postpartum, and so you see them at their well child visits. And I loved that continuity and that experience definitely to your question that really informs the work I do tremendously. Because whenever I'm treating Mom, I'm thinking, how does this affect her baby, and how does this affect her marriage or her relationship, and I think of them as a whole. I never want to do a medication or or an intervention that is unrealistic, like sometimes pediatricians will say, feed your baby every two hours. Well, every two hours is doable in the daytime, but at night, that's a recipe for postpartum depression. So what can we do to make sure the baby gets what they need without affecting mom's well being or harming mom's well being? So I help moms. I. Talk with their pediatricians, you know, well, does it have to be through the night as well? Is there somebody else? Can we do a bottle so I can get four hours in a row? Things like that can make a huge difference, and my background helps me take ownership of that part, to help them navigate all those decisions that are so hard postpartum.

Rebecca Gleed  15:23  

Yeah, and it's not always a plus b equals c. In the complexities of I'm hearing the the mental health piece, the physical piece, the family piece, the dyadic parent child piece. There's so many components, and for you, I hear the creative solutioning of really looking at the person, looking at the family system, and seeing, how do we creatively solution nighttime, feeding, sleeping, and doing it in a way that is attuned to the person in the system?

Dr. Jill Zechowy  15:57  

Yeah, I go a lot of that in my book motherhood Survival Manual, because it's the same scenarios over and over again where breastfeeding, certain difficulties with breastfeeding, can really push a parent to be so exhausted or demoralized that it's a risk for postpartum depression. So how can we tweak it to make it or shift things so the baby gets what the baby needs, and parents aren't left so depleted?

Rebecca Gleed  16:35  

Yes, and maybe that's a segue into your book, if that's okay, because I want to make sure everyone hears about it when I was looking at it, just sifting through the different topics. How, number one, I wish I had this, but also that it can be such a gift to prevent and so if you could speak to the emphasis on prevention, as well as highlight for anyone interested in purchasing it or purchasing purchasing it for a loved one, what? What's in it? How can this be a supportive resource during this period?

Dr. Jill Zechowy  17:20  

The motherhood Survival Manual. I wrote it so it would be the book that I wish I had, and the book I wish my clients had. And thank you for saying that you wish you had it beforehand. I so many of the books are written for after the baby comes, and once you have a baby, you are sleep deprived. You are constantly busy. There's always a diaper to change laundry, to do different responsibilities, not to mention work, relationship home and the desk. Desperation for sleep. So this book is written preventative to reduce women's risk. So you read it during your pregnancy while and you're not just learning about, oh, what do I need to know for the birth, but what do I need to know to have a happy life with my baby afterwards? So it goes into ways to set up how you want to take care of your baby at night, so you can have everything within arm's reach, so you don't have to get out of bed unless you really want. Yeah, yes, yes. Different techniques so that you can get enough sleep, like the five and five, where you divide the night with your partner, so you can each get five hours of solid sleep and then five hours of interrupted sleep. So because five hours has been shown to be the number, the kind of the magic number that helps you feel functional, and is

Rebecca Gleed  19:05  

everyone listening? Five partners. They're part of five,

Dr. Jill Zechowy  19:10  

absolutely and and partners. There's a chapter in the book for partners on ways that they can be not just supportive, but integral parts in this. Because when the invisible load, as we call it, all those responsibilities fall just on one person, she gets exhausted, she gets resentful, and then tempers flare and partners don't know what's going on, they get sidelined. One way of dealing with the stress and all the worries of motherhood is to be more controlling, so moms begin wanting things done exactly their way, and this can further. Sideline the partners, so and so I try to appeal to partners, because when Mom has resentment or is exhausted or is stressed, those are the top three causes of decreased sex drive. So partners listen up if you want a happy mom, and if you want to get will return. Yes, these are things you can do, yeah, and it makes a huge, huge difference. So and speaking to my book, it is available on Amazon, motherhood Survival Manual, your prenatal guide to prevent postpartum depression and anxiety. And I think it's a great gift, great baby shower gift, so that moms have that plan beforehand. We call it a your survival plan. So you create survival plans using the cues in the book, and there's worksheets that you can download so that you know you are doing everything within your power to have the best start with your baby.

Rebecca Gleed  21:05  

Yeah. What an incredible resource. Could you give our audience one more, maybe technique or tip from the book that they might benefit from?

Dr. Jill Zechowy  21:20  

Well, it's so hard always for me to, like, pick one and like, my mind thinks of sleep, because everybody, everybody needs sleep. And that's one of the biggest risk factors for postpartum depression, is bad sleep in pregnancy. So, but I'm there. I have 20 tips for that. So one tip, I think, would be to really, before you have your baby, to create your circle of support. Who are all the people that you can call upon, or that you can create this sense of connection that, hey, I want you to just check in on me and make sure things are okay. Who are the people that you can have come over? Maybe ones that will help with loneliness, ones that have lots of great information about motherhood. It can be your friends, it can be family, it can be online networks of support. It can be paid support, whether doula, nighttime nurse. I love postpartum doulas. I think amazing. I think that insurance should cover that. But that's

Rebecca Gleed  22:45  

I'm seeing a trend, at least in Northern Virginia. I saw a couple and I said, Am I reading this right? There's, it's awesome. I think so too. I think so too

Dr. Jill Zechowy  22:54  

full that will make a huge shift. And then neighbors, and then things like peanut VENA and the mom walk collective, that's a group where you can find out where a walk of other moms are, and then and join them, or mothers club. These are all ways of getting connections so you don't feel alone. So you get lots of tips. It just normalizes and validates your experience. Because life is so different after you have a baby, and it's like, is this, am I doing this right? And it's like, oh, oh, honey, yeah, yeah. And here's what helped me see, what helped you?

Rebecca Gleed  23:39  

Yeah, I love this idea of circle of support and we need, we need each other during this major life transition. Yeah, speaking, speaking of transitions, one of the questions I was hoping you could speak to surrounded motherhood challenges, as opposed to when it starts to trickle into a perinatal mood and anxiety disorder. And I love you know on your website pointing to and normalizing, there are going to be motherhood challenges. But where might a mom, someone listening to this episode pause and be able to differentiate between, okay, what are the normal? Not normal, but what are what falls under the motherhood challenges, and where does it start to morph into perinatal mood and anxiety disorders?

Dr. Jill Zechowy  24:37  

Yeah, it's a great question. So first off, I don't think someone needs to wait until they're depressed or anxious to see a perinatal psychotherapist, because why not make it better? You know, these people are wealth of knowledge. They're talking to women in your exact situation all day long. They know a lot. Lot, and especially if it's someone local, they know things in the community that can be of support. But still, it's really important to know when, when it's not just normal, versus postpartum depletion, where you're exhausted, but not quite depressed. And then the next one is postpartum depression. And you know it is depression when you start having thoughts like someone else would be a better mom to this baby than me, that is a sign you need help. Urgently. You need to call your doctor, or call the motherhood, maternal, sorry, the maternal mental health line, and we can provide that number at the end. That'd be great. But sometimes you just feel like I'm just not doing a great job. I'm not attached to my baby. I feel like I should I should feel more connection, having this sense of feeling like you're failing at motherhood, or even when the baby sleeps, you can't sleep because you are on high alert, all of those are signs that it is time to talk to somebody, because that shift really needs to happen. No one is a better mom to your baby than you. Depression makes it hard and then makes you feel like you're failing. So if you feel like you are failing at motherhood, it is a sign that it is actually postpartum depression and that needs treatment.

Rebecca Gleed  26:52  

Yeah, and what I loved, what you said in the beginning was you don't have to wait for those symptoms or those negative thought patterns to pop up. You can use this again. Prevention might be the title of this episode is you can do this before any of that, and to use this as a resource, not just more broadly, but they might be immersed in your community, and might know those specific resources to tap into absolutely

Dr. Jill Zechowy  27:21  

so many people think that they have to be if they're seeing a therapist, they're failing, and, you know, failing in some way, and that's, you know, let's be proactive. Let's make the best of this life and motherhood. Let's make everything as good as we can make it and great if we can, you know, so I really don't want people to feel pathologized if they're getting little extra support and some extra tools to make this the best phase of their life yet. Yeah.

Rebecca Gleed  28:01  

And what might you tell a mom or birthing individual? I hear this a lot of I don't know if I have the time or I don't know if I really need it. It's so expensive, like all of these barriers or hesitations around it, what might you say to that individual? A little bit on the hesitant side.

Dr. Jill Zechowy  28:24  

So this is an investment in your well being, your connection with your baby, and it is a way of strengthening your relationship. Postpartum depression has a strong association with divorce like it. Not everybody who gets postpartum depression gets divorced, but it is a risk factor for divorce. So, and that's very expensive if you're concerned about money, so it is an investment in your baby's well being, and you were worth it. If money is super tight and it's, you know, not, therapy would be cutting not into luxuries, but into basic needs, there are sources of support, and that number, number the motherhood sorry, the maternal mental health hotline, they can help connect you with affordable therapists in many states, Medicaid pays for therapy. It depends upon your state's benefits. I'm in California, and it pays very well, and therapists are signing up for to cover people with Medicaid, and then there are also. Many people who do sliding scales, if, if the finances are tough, and then you, if you have health insurance, you can contact health insurance to find out what, what, who is covered on your plan. And now, with telemedicine, there are many resources that accept insurance, that can have your visits covered. So there's a lot of ways to do it.

Rebecca Gleed  30:29  

I don't know if I've had anyone on this show. Just outline so many resources for mental health. Thank you so much for pointing to all of those, and I will absolutely include some of those resources in the show notes so you can call and there's just to add to even Postpartum Support. International has free groups with facilitators and peer mentors. Wow. Thank you for for underscoring all of that. And

Dr. Jill Zechowy  30:56  

I'd love to add that depression makes everything sound overwhelming. It makes getting a therapist sound onerous, just too difficult to do, and it will also depression gives you this sense, oh, what's the point? It's all hopeless anyway. So if you are having difficulty navigating this, recognize it might be the depression that is adding another layer that makes us sound too hard or too pointless or just overwhelming,

Rebecca Gleed  31:30  

yeah, such a gift of hope. Like someone listening, if you're having that hopelessness, I think what I'm hearing is that might be depression talking, if you could just move a little bit toward the hope that with treatment, you will feel well, and perhaps that's another runway into if someone comes to you for that perinatal mental health, what can They expect, and what might treatment look like, and how can you speak to also some variation.

Dr. Jill Zechowy  32:07  

So there is a I have a variety of approaches in working with clients, because I have clients who come to me and they have no interest in talk therapy. They just want a medication. And I need to get an assessment of what's going on, and then we come up with a medication plan. We just discuss the risks and benefits of medication and versus the risk and benefits of not treating so if someone has untreated depression, there are risks to that to both mom and baby. So some people come just for medication. Some people say, I really don't want to do medication. Let's see if therapy is going to work. And so I'll begin meeting with them weekly, sometimes a little more if things are quite serious. And we work on tools, we look at what is going on that created this depression. There's hormonal stuff, but then there's also your own childhood that suddenly comes back when you are holding your own baby and so past hurts. There can be, for many women, the huge fear of what am, what is this baby going to have? What? What can I protect them from that I you know, what pains and hurts that I experienced? Can I protect my baby and it it's a lot of feelings can come up. Relationship issues can be at play, work, stress, how we can navigate balancing work and baby and setting boundaries around work so that you have time to be the mom you want to be. And some women want or need both and so both medications and therapy. So it's always a little bit different. Each client is a little bit different that I work with some just need some sleep tools, and then they feel so much better. But one of the things I love so much about perinatal mental health is how women get better. They do great. Oh, it's so nice. Like treating hypertension is so depressing. Yeah, we gotta increase the dose. It's not very satisfying. But postpartum depression when they come in with their baby, and maybe it was a mom who felt no. Attachment when I first met her, and this felt horrible to her, and then you see her giggle, and her baby giggles, and they're just like the baby looks up at the mama during Yes, magic. It is magic. It's so rewarding. It's

Rebecca Gleed  35:16  

so easy to get caught up in, you know, the hard aspects, but you something I hear a lot is I finally see color again. But it's like you went from black and white into seeing color.

Dr. Jill Zechowy  35:32  

Yeah, yeah. And it happens so subtly that many women don't realize they're depressed when they are. It just feels like, well, this is how life is. Yeah, no, that's postpartum depression,

Rebecca Gleed  35:48  

I think too. What I also see, and I'm not sure if you're seeing this too, is when you start to feel better. It's almost insights grief that you didn't have those first maybe six nine months. Yeah, of color and magic and so there's sometimes a grief component. I also wanted to ask you about, you know, there's often stigma or misunderstanding around medication for treating depression as you as a prescriber, that I'm wondering, if you have any wisdom or nuggets to offer the mom who might be afraid or hesitant to consider medication.

Dr. Jill Zechowy  36:35  

Yeah, I think that's a really important thing to talk about, because there has been controversy, but there isn't so much. In the perinatal mental health professional world, we see the benefits and we see the harm of not treating i i have a strong inclination to do things as naturally as possible, unless, unless I see that not treating is is really doing more harm, or the risk is, you know, this woman is losing these six months with Her baby this you can't get that back. So I don't like to leave women in a depressed state and not treating depression in pregnancy. Has risk factors. We know that depression increases cortisol, the stress hormone, and so if a woman has depression in pregnancy, which is actually quite common, untreated depression in pregnancy, there by therapy or by medications, increases multiple risk factors in the baby, they don't grow as well. They don't do as well. If mom has untreated depression postpartum, there's more attachment issues in children, more behavioral issues that are long standing, sometimes without intervention, without help and treatment. So some moms think that the best thing they can do for their baby is to white knuckle it through postpartum depression, and that is not the best thing for their baby. Many medications have been studied. We have a good understanding now of the benefits and risks

Unknown Speaker  38:43  

of treatment data

Dr. Jill Zechowy  38:46  

exactly so. So this is an important thing to talk to you, your doctor, your your prescriber, about, because you really need to make that discussion together with someone who is informed and knows about medications and pregnancy. A reproductive psychiatrist is often the best person to speak with, because untreated depression has its risks, so people who don't know say, Oh, you don't want to take a medication in pregnancy, but they don't realize what what that truly means for the baby and the mom. So this is something that's a very personal decision, and it's also part of why I am so big on prevention, because if we can just, you know, reduce the risk. And the studies show that often, as much as 50% of postpartum depression can be prevented. So I'd like. See those changes happen where we put prevention as part of our preparation in pregnancy, yeah,

Rebecca Gleed  40:09  

preparation underscored three times, and you bring up a reproductive psychiatrist. Thank you. I Not, not everyone knows what that is, but reproductive psychiatrists have that extra level of training for treating perinatal mood and anxiety disorders, anything under the umbrella of reproductive psychiatry, and if they're not available, even in my area, which is saturated with you know, specialized folks in the DC area, some areas do not have reproductive psychiatrists. So another resource through psi is there's a doc who is on call that can do a doc to Doc consult for anyone listening who doesn't have access to a reproductive psychiatrist. So thank you for reminding reminding us of that resource.

Dr. Jill Zechowy  41:03  

Postpartum Support International is such a wonderful organization for helping birthing individuals through this entire process. It's and families and partners, it's it's wonderful the amount of resources they have,

Rebecca Gleed  41:19  

yeah and hopefully more folks are coming to this space. I keep hearing more and more practitioners and organizations finally giving a little bit of space to the perinatal and reproductive communities. Are you seeing anything trend in terms of new resources or innovative treatments that we should keep our eyes on,

Dr. Jill Zechowy  41:47  

there's a lot happening right now and Perinatal mental health, the statistics are now being followed, and they they have been very eye opening, so that now research dollars are going towards this field. We have a new medication, the first oral medication that is FDA approved, specifically just for postpartum depression, called zuranolone, or the brand name is Sir zu VI is came out just last December, December a year ago in 2023 actually, and this Medication is a game changer for people who don't respond to SSRIs or have some trouble taking them this medication, you only take it for two weeks, and sometimes people are better within three days, and it works right on that hormonal we have a drop in a type of progesterone at birth, and it replaces it, and it makes you feel calm, it boosts your mood just really rapidly. We've also seen changes in policies where there's more support that the pregnant workers act so that women can have support to go to prenatal visits or therapy and work has to allow for it. There have been a lot of changes, and there's a lot more movements of women getting together saying, hey, let's get a national policy for parental leave. We're the only developed nation on the planet that doesn't have a national paid policy for leave, and we know Studies show that leave less than 12 weeks really increases your risk of postpartum depression, so we can make a big difference with the policy change right there.

Rebecca Gleed  44:07  

Yeah, we can do better. Thank you for highlighting those. I want to make sure that everyone can find you, and before we highlight where they can find you, I also wanted to make sure to mention you have some type, of course, that if you maybe can't sit down and read the book, or maybe it's you're later in the postpartum, you have something that's like a master class I saw. I wanted to make sure that you could speak to Yeah, so

Dr. Jill Zechowy  44:37  

I created that a couple years ago when I could not meet the demand of my community, the awareness and the rates of postpartum depression were really surging during the pandemic, and I was working very long hours and could not meet the needs of my community. So and I really wanted more people. People to know about these simple tools and strategies for preventing postpartum depression. So I created the motherhood Survival Manual master class, and it is an online course that teaches many of the tools in my book, and you create your survival plan, and you learn techniques for better sleep, how to talk with your partner about sharing the load of motherhood and parenting and and it's basically a companion to any birth class. It it starts where the birth classes kind of end. They give you the beginning of swaddling in that first latch, and then this says, Alright, we'll take it from here. Yeah,

Rebecca Gleed  45:50  

thank you, yeah. And where can everyone find you?

Dr. Jill Zechowy  45:55  

The probably the best place to reach me on the web is motherhood Survival manual.com,

Unknown Speaker  46:04  

Amazing, and you're on social platforms. I am.

Dr. Jill Zechowy  46:07  

I'm also on Instagram. That's, that's the main one. And we are downloading a little bit of the online course on YouTube shortly.

Rebecca Gleed  46:20  

Okay, I want to make sure that everyone can get a copy of your book. If you know of anyone who could benefit, or if you're you know in your perinatal season and could use some preventative support, this book will definitely help. It's saturated with incredible resources and guidance. So thank you so much for coming on today. I think this will help so many transition to motherhood. And you are also, if you're looking for a provider in California, you are locally aware and then also reachable via telehealth. I'm

Dr. Jill Zechowy  46:59  

located in Sonoma County, which is just north of San Francisco, but I can see people clients through telemedicine anywhere in the state of California. Incredible.

Rebecca Gleed  47:13  

So anyone in California, you have someone to support you. So thank you so much, and we'll be in touch. Sounds

Dr. Jill Zechowy  47:21  

good. Thank you very much for having me. Becky. I really appreciate it.

Unknown Speaker  47:26  

Yeah, thank you. Take care.