Fertility Forward
Fertility Forward
Ep 175: Postpartum Care with Dr. Jessica Vernon
Dr. Jessica Vernon is a board-certified OBGYN who has cared for thousands of people throughout their reproductive journeys over the past 15 years. She is an Associate Medical Director and Director of Mental Health at Oula, a women’s health startup in New York City offering comprehensive maternity care, from expert midwives to board-certified OBGYNs. It was Dr. Vernon’s personal experience that first inspired her to start Oula, and our conversation begins with unpacking the circumstances that followed the birth of her daughter. Next, we unpack the perinatal mental health work that inspired Dr. Vernon’s first book, Then Comes Baby, and the experiences as client and consultant that informed its content. Dr. Vernon shares some fundamentals of her approach to care, all centered around finding grace for yourself and your body after giving birth. Join us today to hear from a truly informed and compassionate guest!
Hi everyone, we are Reena and Dara and welcome to Fertility Forward. We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai Hospital in New York City. Our Fertility Forward podcast brings together advice from medical professionals, mental health specialists, wellness experts, and patients because knowledge is power and you are your own best advocate. We are so excited to have on Fertility Forward today, Dr. Jessica Vernon, who is a board-certified OBGYN, who has cared for and supported thousands of people throughout their reproductive journeys over the past 15 years. She is the Associate Medical Director and Director of Mental Health at ULA, a midwifery-based women's health startup in New York City. Her debut book is titled, Then Comes Baby, an honest conversation about birth, postpartum, and the complex transition to parenthood. Thank you so much, Jessica, for taking the time to come on. We're super psyched to have you and to hear all about you and your new book.
SPEAKER_00:Thank you so much for having me. I'm really excited to talk a little bit more in the fertility space as well, because that's such an important aspect of the whole journey.
SPEAKER_02:For sure. I'm really impressed. to see an OBGYN who also marries the mental health component. So I would love to hear from you first, kind of how that came to be in terms of your practice and how you brought that to OOLA.
SPEAKER_00:Yeah, it all came from my own lived experience. After my first baby was born, I had postpartum anxiety, depression, and OCD. And I didn't even know what I was struggling with until my daughter was almost two years old and New York was the epicenter of COVID. And my mental health just really deteriorated. And so I started on a medication for anxiety and depression. And And once I got better and got the rest of the help I needed with therapy and other support and resources, I started supporting my patients differently, asking them the right questions, screening them regularly, and found out that even if you live in a place like New York, where there's lots of mental health resources, it's very hard for people to get to a good therapist, a good prescriber, psychiatrist who really knows how to treat people throughout the journey to trying to conceive pregnancy and postpartum. So I worked on educating myself to have the comfort and knowledge to be a prescriber for people who weren't that complicated and only sending the high risk people to those specialists and did a lot of work with organizations like Postpartum Support International to get my own training. And now I'm on their board and they provide tons of free resources to people throughout this. So I've really kind of built my practice around providing holistic care. And I do a lot of specific Wow. I mean, that's
SPEAKER_01:such an amazing story. And I think we're so blessed to have on our podcast so many women who have created careers or made changes to careers based on their own experiences. And so I'm so sorry that you went through that. But it sounds like you really came out the other side and it really informed your practice. And I'm sure your patients also really like that. that when you speak to them, you also speak to them through the knowledge of having personal experience. And that just gives you all the more empathy and compassion.
SPEAKER_00:Yeah, it makes a huge difference in how you practice what you've gone through and experience yourself. And also just knowing what questions to ask and what's really going on. Because in training, we don't talk a lot about postpartum. People have one visit six weeks postpartum and that's about it. You know, if you talk about infertility, there's really nothing. You're given a referral to the fertility specialist and often there's not much in those conversations around mental health or resources in those offices. So it's a huge area that we just need more resources and need more awareness around.
SPEAKER_02:Well, yeah. So I'm interested. You said it's really important for you to know the questions ask, but as a patient, are there specific questions that you think would be helpful going into their first or second meeting with their doctor that they should be asking on their end?
SPEAKER_00:Specifically in regards to mental health or just in general?
SPEAKER_02:Yeah, I would say for mental health, especially with regards to fertility and beyond.
SPEAKER_00:Dr. Anneke Vandenbroek and going into another medicalized system, preparing for birth, all of that can bring up a lot of triggers and mistrust around systems sometimes. So it's just important to be aware of those things. Talk to your doctor about your specific risk factors And if you need resources, if your provider is not very knowledgeable in this area or kind of dismissive, one, try to find a provider if you can who is more holistic in care, but also Postpartum Support International has free resources. Anyone can call and join. There's even lots of support groups, peer mentors, all of these things. So you can get some support for your mental health during pregnancy and postpartum.
SPEAKER_02:I think that's great. I think that's great that there are places to go to. And I just love that you have created this kind of niche career based on your own unfortunate personal story. But we can be there to help create support for people in our wake to some degree. Hopefully they don't have to suffer the way some of us did, you know, or many of
SPEAKER_00:us did. Even if they're like, they're going through something difficult, just knowing that there's other people going through it, other people who've been there, the validation, the community, that's so important. And that's what you're creating too, because feeling isolated and alone in your struggles is
SPEAKER_01:really, really hard. Absolutely. So tell us a little bit about your book and the topics you cover and who you wrote it for.
SPEAKER_00:Yeah, so Then Comes Baby is my first book, and it was written after doing perinatal mental health work and continuing to take care of people throughout pregnancy and postpartum with obstetrics. And seeing these common threads keep coming up over and over around the birth experience, the early postpartum days that people just weren't prepared for, didn't even know existed or thought could never happen to them and often led to feelings of being a failure, maybe feelings that they shouldn't be a mom or that they'd done something wrong and a lot of guilt and shame around these things. And so I wanted to give people something to look at earlier on in their journey so they have an idea. of what things can look like physically, mentally, emotionally throughout birth in the early postpartum period. And also people who've gone through things that can provide some validation that they aren't alone in what they're experiencing. And for topics that I'm not the expert on, like couples therapy, sex after baby, that type of special therapy, trauma therapist, I brought in specialists to help me in those aspects to bring in some extra knowledge and good insight for people.
SPEAKER_02:That's incredible. Are there any specific chapters or topics that you found really interesting when you were doing the research?
SPEAKER_00:and has a lot of good insight and things I brought from the specialists I spoke to as well. So that's definitely one of my favorite topics. But I think other things like exercise after baby and resuming intimacy and sex after baby, I had some basics, but really bringing in other people to help with those, I think gave some really good tidbits of advice and information that I share with my patients now too. You want to share some of your tidbits of this? Yeah, I think the biggest thing to always let people know around exercise is bouncing back is a myth. You took 10 months to grow and birth a baby, and it's going to take at least that amount of time, often before you feel like you're back at your baseline. And so just really... working with your body, starting with the basics. If you have access to resources of people like physical therapists and trainers who work with you postpartum, that's really helpful. But just trying to like treat your body with grace after giving birth. And it's the same thing when you're going through fertility. If you go through like a retrieval cycle, it really does a lot to your body. And so acknowledging that and treating yourself and your body with grace during that time period is really important. And the same with intimacy. People feel a lot of pressure to get back to having sex as soon as they're cleared at their six-week visit. Majority of people that I talk to, sex is the last thing on their mind at that point. From a physical healing perspective, often emotionally as well, especially if they had a traumatic experience that came from getting pregnant, which they often are equating with having sex. And so they don't want to think about that at all. But you also have a newborn infant and you can feel very touched out. And another thing people don't realize is postpartum, your hormone levels dump to kind of like menopausal levels. And so often you don't have the desire, there's no lubrication, there's no real feelings that you want to get back. So finding other ways to create intimacy with your partner is really important in that time period. I love that you touched
SPEAKER_02:upon, because I was thinking, I was like, what about hormones too? I mean, out of whack. But those aren't really things that are typically discussed with your OBGYN postpartum, which I feel like it should. Like maybe like a quick little mention, but I think outlining, which I never even would have thought of, but it makes sense. Like there could be trauma surrounding, okay, I had sex and that's what led to my pregnancy, right? but I'm not ready for another pregnancy. And so that idea of, you know, just maybe bringing that back in and of itself could maybe spark some sort of trauma. Never worked out of that, but that's interesting. And then the idea of the bounce back, I'm also thinking about like, we don't typically bounce fully back. It's like the new normal in a way, a new baby.
UNKNOWN:Yeah.
SPEAKER_00:Totally. Even if things physically may look similar or the same for some people on the outside, internally, a lot of things have shifted and changed. Your brain undergoes neuroplasticity. So your brain has changed and there are so many hormonal shifts as well. It's just a lot going on in that period of matrescence that we are just on like the tip of the iceberg of understanding because people weren't doing research in this area and giving it the credit that it deserves of this whole completely transformative experience.
SPEAKER_01:And can you tell us, our listeners, what matrescence means?
SPEAKER_00:Yeah. So matrescence is similar to adolescence. And it is that transformation that you go through when you are pregnant, give birth, have a baby. Some people say it lasts a lifetime because, you know, you keep experiencing these changes. If you have other children, then that adds to it as well. But it affects every aspect of your life. Like we were saying, the hormones, the physical changes, everything. It affects how you view yourself, how you view like your life, your goals, your career, your relationships to others. It's very similar to like an adolescence, only you're also very sleep deprived and caring for a newborn and healing from birth at the same time where you're going through these tremendous sudden shifts in your body and your mind.
SPEAKER_02:I would think even with, with matrescence, you know, as an adolescence, hopefully you have your parents to help guide you. They've been there before, but I would think it could be somewhat isolating too. If you don't have a support system during that.
SPEAKER_00:And often today we're not in community. We're experiencing these things in isolation or when you go out and see other people, they're like, I'm fine. It's great. I love being a mom. And so I, Really opening up the conversations. A lot of people feel guilty or bad or shameful if they're like, I love my baby, but I also want to run away and hide and disappear for a few weeks or whatever. I love being a parent, but I really miss having that autonomy and being able to go out with my friends and focus on my job. And so like integrating who you used to be with who you are now is not a this or that. It's kind of an and both conversation where you're allowed to have complex feelings and emotions around it. And it doesn't mean that you're not meant to be a parent or that you're a bad
SPEAKER_01:parent. And what you touched upon that doesn't have to be and both, right? You can have juxtaposing emotions.
SPEAKER_00:Yeah, exactly. It's
SPEAKER_01:interesting
SPEAKER_02:that it's not necessarily spoken about so much. I think people aren't necessarily always honest, maybe partially because they don't want to admit that there are challenging moments, but I would presume that that makes it that much harder to mentally be in a good mental space.
SPEAKER_00:Yeah. And then if you're struggling with your mental health on top of it, and especially for people, a lot of your audience who went through so much to get pregnant to get that baby, they feel like I should just feel better. so grateful that I have this baby and I can't complain. And why am I feeling all of these difficult emotions along with it? And so it can be really hard for people to express what they're feeling, which is why it's important to find those people who are authentic. And often you can find that in support groups and And whether it's online or local, and even if you find a couple people that the way they're speaking, you're like, yes, that resonates, that's validating how I'm feeling, can make a huge difference in how you go through this time. So
SPEAKER_01:do you practice at, whether you have your own practice or where can people find you?
SPEAKER_00:I practice at ULA. So we have three offices in Manhattan right now and are expanding to other states, sorry, Manhattan and Brooklyn. And we have an OB at each of the offices and then midwives. So they see a majority of the prenatal visits. We're there for consults and things that need escalating and then on labor and delivery because we deliver at a hospital, even though it's with the midwives. The ULA OBs are always there as well as backup. So if something needs to be escalated, you're not getting a random person on labor and delivery. you're getting one of the ULA doctors who really like, we have the heart of a midwife only we operate as well. So you still get that like person centered holistic care, no matter what happens. And then a
SPEAKER_01:big fan of ULA and we've had some other ULA guests on the podcast too. So any listeners should go back and check for those episodes also.
SPEAKER_02:Definitely. And I was going to ask, do you meet with patients postpartum as well? And how often is it recommended?
SPEAKER_00:Yeah, so I often see people like from the time they're on the postpartum floor after they've given birth and start having the conversations then around their physical recovery and emotional well-being and start delving into how their birth experience was and let them know if they have any risk factors for postpartum anxiety, depression, the whole spectrum, even then. We routinely see people for their six-week postpartum visit. If there's any complications or they had a cesarean birth, we do a two-week check as well. If it's someone who's high risk for anxiety, depression, or other mental health disorders, I'll also schedule a visit with them one to two weeks after giving birth. Or if they have an outside psychiatrist, therapist, make sure that they're connecting with them soon after birth and having more frequent visits afterwards. But I'm lucky in the practice I'm at that we have a whole remote care team that is just handling calls, talking to people. And so anytime people call, I always tell them like your postpartum the whole first year, call us anytime, anything that comes up and they can speak directly to a provider 24 seven, whether it's the person covering labor and delivery or during the days or remote care team. So I always encourage people to remember that like you're still in this transition period and things can come up at any time.
SPEAKER_02:That's great. to check in with a provider to get that support, to get that care. And I think it's great for our listeners to be hearing this in advance. So it's not something that, you know, they're scrambling when they're suffering, if they suffer, but at least getting the knowledge and information beforehand, that there's support out there.
SPEAKER_00:Yeah, it's so important. And sometimes you have to advocate for yourself to get the right care and support. Sometimes your initial provider is not receptive to questions or concerns. And so you, your support system, if you have a doula involved, get them involved as well to make sure you find the right people who will listen and answer your questions and you feel like you're taken care of and you're not still having concerns that are left out there and being dismissed.
SPEAKER_01:Right. And we say on here all the time, advocacy is so important.
SPEAKER_00:Yeah. And it sucks that in this day and age, people still have to deal with that. But I hear it all the time when I get people coming for OB and GYN care. Like I've had pain for years. I've had abnormal periods for years and people just give me birth control pills and send me away, you know, those sort of things. And so if you don't feel that it's right, that your symptoms have been acknowledged and cared for, go somewhere else. Right,
SPEAKER_01:exactly. And find a provider that aligns with you.
SPEAKER_02:Well, Rena says knowledge is power. And I feel like it's so great to meet a provider who really has the knowledge and care and concern for her patients, it sounds like. Where's the best way in terms of is it your website? Is it Ula's website? How can our listeners find you?
SPEAKER_00:Yeah, I have a website. I don't have a direct way to contact through that, but you can definitely reach me through ULA or on Instagram. You can always DM me with any questions. I'm always happy to talk to people and help them find the right answers, whatever they're dealing with. And of course, a lot of the things related to birth and postpartum, a lot of that knowledge to empower yourself with is in my book, which you can get anywhere you can buy your books.
SPEAKER_01:Amazing. Well, we're so happy to have you on. And I think this is amazing information and will be so helpful for our listeners at so many stages, pregnancy, postpartum, and so happy that you're spreading the word and awareness about this also such an important topic.
SPEAKER_00:Thank you. Thank you for having me.
SPEAKER_01:Well, the way we like to wrap our podcast is by saying a gratitude to something that you're grateful for today.
SPEAKER_00:Something that I'm grateful for today. Oh, there's so many things. I'm grateful for my kids because I wouldn't be here doing this work if it wasn't for them. I wouldn't. be helping people the way I am if it wasn't for them. And often we take some of our biggest struggles and turn them into the best thing. So even though the first couple of years after she was born, I was like, oh my gosh, is this the rest of my life? Now I'm really grateful that I went through that and, you know, have them in my life and they're still teaching me lessons every day. Beautiful.
SPEAKER_01:What about you, Dara?
SPEAKER_02:Well, I'm going to piggyback on that similar vein because I started working at RMA through my own fertility struggles. And as I mentioned before, it's so nice to be able to help those behind you and hopefully support them so they don't have to struggle as much and be there to comfort them and to empower them and to give them the confidence and knowledge so their experience is that much better. And I'm also, on a side note, totally different, especially today. I've been listening to a lot of live music. It's the summer. It's nice and warm. My kids are at camp. And so I've really been listening to a lot of great music and forgot how much it brings me joy and how it's my happy place. So I'm very grateful for that. What about you, Reena? I
SPEAKER_01:will go with a combination, maybe. You know, I know a lot of us had visiting day. So super grateful to be able to see my daughter and see her living her best life at camp and be with family and just really grateful for the family that I've created, which is not super traditional, but it works. And it was really nice to be there with everyone this weekend, all in support of my daughter. So very grateful for that.
SPEAKER_02:So nice, Reena. Well, Jessica, thank you so much again for coming on, sharing your knowledge and expertise. Everyone go get out her book. Then comes baby. Amazon, I'm sure, is a great place to get it. And we really appreciate you taking the time out of your, I'm sure, very busy day to be here. Thank you.
SPEAKER_00:Thank you. And thank you so much for all you're doing and treating people holistically and caring for them during their fertility journey, because so many people feel like just a number. And so to feel seen and heard is so wonderful and hopefully helps them. So by the time they get to me, they're in a better space. Thank you so much.
SPEAKER_02:Thank you so much for listening today. And always remember, practice gratitude, give a little love to someone else and yourself, and remember, you are not alone. Find us on Instagram at fertility underscore forward. And if you're looking for more support, visit us at www.rmany.com. And tune in next week for more Fertility Forward.