Dr. Melissa Drake, MD pulls the curtain back on obstetric care and take us behind the scenes, discussing commonalities about the typical patient experience. Why do appointments feel rushed? Why do doctors seem burnt out? She discusses how she found herself drained by the demands of the modern medical system and decided to transform her practice model. She stepped away from the larger insurance driven system, seeking a new offering of personalized, patient focused care.
“we don't even have to do it today. The fact that you made it in the door is fantastic.”
“Sencal was paying like 1,500 bucks. And my highest payer, which was Anthem Blue Cross, I believe at the time, was paying, I think, 2,400 bucks.”
“Pregnancy care is a time that really affects the entire lifespan. So it's a time where it shouldn't be rushed. You shouldn't have a five minute visit after waiting for a month.”
“I thought the people that really know how to do obstetrical care are the midwives. They've always known how to do it. I call them like the keepers of the flame”
“You're catching up with a friend over coffee, over tea. In the same way that you would catch up with a friend, except your friend is your doctor.”
AI-generated transcript with speaker labels — may contain errors, especially names and medical terms. Dr. Elliot Berlin, DC appears in blue; Dr. Melissa Drake, MD in orange.
Dr. Elliot Berlin, DC[1:00] In today's episode, we're pulling back the curtain on the realities of modern obstetric care. My guest will take us behind the scenes, exposing the hidden factors that shape the typical patient experience with their OB. Why appointments often feel rushed? Why so many doctors seem burnt out? And what it really takes to provide personalized, high-quality care. She's an experienced OB-GYN who built a thriving practice, but found herself completely drained by the relentless demands of the medical system. Instead of walking away from medicine, she made a bold move. She completely transformed her practice model. What happens when a doctor steps away
[1:36] from the high-volume, insurance-driven system to create a more sustainable, patient-centered approach? And what lessons can both healthcare providers and expectant parents take from her journey? I'm pregnancy-focused chiropractor, Dr. Elliot Berlin, and you're listening to the Informed Pregnancy podcast. Dr. Melissa Drake, welcome to the podcast.
Dr. Melissa Drake, MD[2:10] Thank you so much.
Dr. Elliot Berlin, DC[2:12] Just by everything I know about how you run your practice, if I get pregnant, I'm coming to see you.
Dr. Melissa Drake, MD[2:18] Thank you, it's an honor.
Dr. Elliot Berlin, DC[2:20] Let's start at the beginning. What drew you to medicine in the first place?
Dr. Melissa Drake, MD[2:23] I don't come from a medical family necessarily. My dad was a planetary geochemist. My mom was a librarian. My brother ended up going into medicine. He's a pulmonary critical care doc, but we always were very interested in science, always interested in how the human body worked, but I was always really interested in helping people and always really just drawn to that aspect of it. I got specifically interested in women's health in medical school itself. I initially thought I wanted to be a dermatologist. I liked skin. I liked skin ailments. I have terrible eczema.
Dr. Elliot Berlin, DC[2:58] Oh, yeah, I was wondering, were you one of those teenage girls that just spent hours doing skin?
Dr. Melissa Drake, MD[3:03] No, actually, weirdly. I was one of those teenage girls who couldn't apply anything to her skin because I had atopic triad.
Dr. Elliot Berlin, DC[3:09] Okay, that's our first thing we have in common. We didn't apply anything to our skin.
Dr. Melissa Drake, MD[3:13] Exactly. I had to like dance around with lactic acid lotion because I was so eczematous. So yeah, I thought I wanted to be a dermatologist.
Dr. Elliot Berlin, DC[3:21] Oh my God, if I start a band, it's gonna be called eczematous. Metal, super metal.
Dr. Melissa Drake, MD[3:27] Yes, very metal.
Dr. Elliot Berlin, DC[3:29] Okay, sorry, back to you.
Dr. Melissa Drake, MD[3:31] But no, so I had actually, I had a negative experience with OB-GYN when I was a medical student. I had a really nasty experience with an OB-GYN. I had a bad experience with a pap smear with some results and with getting results conveyed and then with another procedure. And I had somebody during the procedure sort of not give any, you know, I was a busy student. I should have probably looked up what the procedure was. I probably should have informed myself a little bit more, but I didn't. So I sort of showed up blind to this procedure. I didn't really get much in the way of any information about it, much in the way of any consent. I'm sure I signed a consent form.
[4:14] But I got into the cervix and then had a biopsy performed with really no conversation, no kind of heads up. And you know, a biopsy on the cervix really hurts. I mean, it can hurt. You say you know, I don't really know, but I-
Dr. Elliot Berlin, DC[4:31] It doesn't feel great.
Dr. Melissa Drake, MD[4:32] Yeah, I mean-
Dr. Elliot Berlin, DC[4:33] Everyone has varying degrees of discomfort on the cervix. Some people feel a lot, some people don't feel much. Oh, I noticed that as a doula. Yeah, like anybody who says there are no nerves on the cervix.
Dr. Melissa Drake, MD[4:45] Oh yeah. Cause you know, they were telling us that even when I was a student, it's totally absurd.
Dr. Elliot Berlin, DC[4:51] Yeah, no, cause I've seen people as a doula. I've witnessed people have like the foley balloon placement.
Dr. Melissa Drake, MD[4:56] Oh yeah.
Dr. Elliot Berlin, DC[4:58] Some people are like, oh, did you do it? And then other people are screaming in agony. I mean, like really-
Dr. Melissa Drake, MD[5:02] Or vomiting or-
Dr. Elliot Berlin, DC[5:04] Yeah, like big reactions.
Dr. Melissa Drake, MD[5:06] Totally.
Dr. Elliot Berlin, DC[5:07] Okay, so throughout that series of unfortunate events, is it primarily bedside manner? That was the issue.
Dr. Melissa Drake, MD[5:15] Yeah, so this person like sort of, so I like, I yelled and started to tear up and this person came up from between my legs and said, I don't know why you're making such a big deal out of it. You shouldn't be crying. And I was so embarrassed because I'm a medical student. I felt like I really should have had a better handle on myself. I don't know.
Dr. Elliot Berlin, DC[5:33] Wow.
Dr. Melissa Drake, MD[5:33] So anyway, I left the appointment, never went back. It was a terrible experience. I probably got fired as a patient and I did not get another pap smear for years.
Dr. Elliot Berlin, DC[5:44] Oh my.
Dr. Melissa Drake, MD[5:45] It was terrible. It was awful. So I really got into my head.
Dr. Elliot Berlin, DC[5:47] Obviously traumatized.
Dr. Melissa Drake, MD[5:48] Yeah, I was like, I never want anyone to feel this way. I never want to feel this way. That was really what drove me into women's health. And that's really how I approach all of my appointments. Anybody who shows up for a pap, some people are really anxious. Some people just want to get it over with, but some people are like, look, I haven't been in in years. And it may be because they had a previous bad experience. And I told them, I'm like, we don't even have to do it today. The fact that you made it in the door is fantastic. We can just talk it out. We can go in and do an exam. We don't have to. We can always do something else later. Just acknowledging that there may be trauma from the past.
Dr. Elliot Berlin, DC[6:24] It was sort of a joke when I opened up and I said, if I get pregnant, I'm coming to see you. But there are things, I'm 50, that it would be nice if doctors had your refreshing approach just for other medical things, like colonoscopy, let's say. A little spooky, but if you have somebody warm and gets it and explains everything and sort of holds your hand through it, then I think even just for medical safety, like you're saying, you didn't get a pap smear for years, I think people push off these medical procedures for years and sometimes till it's too late because they're just not good experiences.
Dr. Melissa Drake, MD[7:00] A hundred percent. I think there's something that I think the medical community does not acknowledge about the fact that a lot of the stuff that we do is unfortunately unpleasant. Exams, injections, surgical procedures, dental work. So much of this stuff can be unfortunately unpleasant. There's a ton we can do to make it less so. And there's a ton we can do to make it more comfortable for people and just more pleasant. But there's a lot that we have to answer for as a profession. You're totally right in terms of bad health outcomes for people because people have been avoided about it because it's scary.
Dr. Elliot Berlin, DC[7:45] Right, I mean, I could have something unpleasant but feel safe. And then my fight or flight response isn't going off I'm not loaded with adrenaline. It's not a war zone where my body feels like why are you not running for your life right now and just using everything I have to just stay there and endure it. That can be turned off just with some simple interactions, just human kindness warrants interactions and explaining things. And I could even say joking about it once the climate feels right. And then going in, I see, also from my work in birth is that someone's laughing, body knows they're not in danger.
Dr. Melissa Drake, MD[8:27] Yeah.
Dr. Elliot Berlin, DC[8:28] And so if you can get to that point you can have a much more pleasant experience doing almost anything. I always say you can't be scared and laughing.
Dr. Melissa Drake, MD[8:36] Right, exactly.
Dr. Elliot Berlin, DC[8:37] If you've got that smile on it's like the adrenaline's leaving your body. Okay, so when you had that experience as a med student were you already doing rotations?
Dr. Melissa Drake, MD[8:46] I had not done rotations yet. So I, that was, I think it was like a first or second year. Yeah, when I started rotations I was nervous because I was like, oh man, OB-GYN was presented to me. I think, I don't think I'll ever forget this quote. OB-GYN was, the various groups came in and they were like, well, here's what we do as internal mom, here's what we do as surgeons, here's what we do as blah, blah, blah. But OB-GYNs came in and they said, we are the kind of people that wake up at four in the morning, run a marathon and then go to work. And I was like, oh my God, man, I don't know if that is for me. I really like, I mean, I like to sleep. I don't know if I can wake up at four in the morning
[9:26] and do that. I don't know if, I don't know if this is for me. So-
Dr. Elliot Berlin, DC[9:31] So you went and did it.
Dr. Melissa Drake, MD[9:33] So I, you know, started doing it. I did that rotation first because I was like, I got to tear this bandaid off. I really got to make sure that this is a thing I can do. And I fell in love with it. People who do birth and birth work find that they really either love it or they don't.
Dr. Elliot Berlin, DC[9:50] And- It seems like you have to love it to keep doing it.
Dr. Melissa Drake, MD[9:54] Yeah.
Dr. Elliot Berlin, DC[9:54] Because I mean, that description is not wrong, especially for private practice. I always wonder like what, even for me doing birth work as a body worker, as a doula, the difference between going to sleep with both eyes closed and the phone off is worlds apart from going to sleep with one eye open and the phone on.
Dr. Melissa Drake, MD[10:14] 100%, yeah.
Dr. Elliot Berlin, DC[10:15] And so even if you're not waking up at four o'clock, you're not asleep at four o'clock.
Dr. Melissa Drake, MD[10:19] Yep, yep.
Dr. Elliot Berlin, DC[10:21] So you specialize in OB, which takes a long time also. Not as long as like brain surgery, like for neurosurgeons, they seem like they're 70 when they come out of residency. You know, those poor guys. You know, it's four years in medical school, four years of residency, which I'm sure feels like an eternity, but it's not as long as some. And then do you go from there to private practice?
Dr. Melissa Drake, MD[10:46] From there I did, yeah. So I did four years of medical school at University of Arizona. And then I did four years of residency at George Washington University in DC. And then came out to Santa Barbara.
Dr. Elliot Berlin, DC[10:58] What drew you to Santa Barbara?
Dr. Melissa Drake, MD[10:59] My husband's job, actually. So he is a fertility doc.
Dr. Elliot Berlin, DC[11:04] Yeah.
Dr. Melissa Drake, MD[11:05] And they very rarely have open jobs anywhere. So they occasionally have an open job here and there, three or four open jobs anywhere at a time in the country. And he had an open job here in Santa Barbara. We came out and I thought, no big deal. I'm a generalist OB-GYN. This is gonna be a breeze. Someone's gonna wanna hire a young generalist OB-GYN. It's a small town. There's some older folks here. Someone's gonna wanna get a new partner, a young person, a hungry young person. I did not anticipate at all how difficult it would be to break into the OB scene here. Oh yeah, it was tough. It was really, really tough to get hospital privileges initially to…
Dr. Elliot Berlin, DC[11:48] Oh really, just getting privileges?
Dr. Melissa Drake, MD[11:50] Just even getting privileges. To get hospital privileges here, you have to have two people who will sign for you. And when signing for you means that you would potentially be a competitor,
Dr. Elliot Berlin, DC[12:02] it's really tough. Oh right, who's gonna do that? Yeah, I mean, it is…
Dr. Melissa Drake, MD[12:05] Exactly.
Dr. Elliot Berlin, DC[12:05] At the end of the day, there's a business.
Dr. Melissa Drake, MD[12:07] Yeah.
Dr. Elliot Berlin, DC[12:08] There's competition going on.
Dr. Melissa Drake, MD[12:10] Exactly. I never even thought about it from that perspective. Yeah, and I of course had no idea at the time. I look back on my poor naive little self and I just had no clue. So I'm sending out my CV and a cover letter and I'm just not getting any response and I had no idea why. So for a while there, I was doing gynecology only. A very kind gynecologist here, Dr. Duncan Turner gave me some space for which to do gynecology out of his office. And I was doing gynecology only because I couldn't get hospital privileges to do OB.
Dr. Elliot Berlin, DC[12:42] Wow, how'd you overcome that?
Dr. Melissa Drake, MD[12:44] Somebody hired me. So I was hired and finally was able to break into the OB scene and was in a group practice for a while and then eventually branched out on my own.
Dr. Elliot Berlin, DC[12:54] All right. That practice, based on the introduction that I heard myself say, led you down a path that I think most doctors today, especially OB-GYNs, end up in that didn't quite work well with your life. And you took a big turn. Let's take a little break. When we come back, we'll find out what that was like for you and why the turn and where you are now. We'll be right back.
Dr. Elliot Berlin, DC[13:27] Welcome back. We are talking to Dr. Melissa Drake. Okay, so from skin to OB through an unpleasant experience, to say the least. And then you moved to Santa Barbara and you're struggling to get privileges and break-in and then you do get privileges and you're in what sounds like a typical practice, like a sort of a volume practice. And what's that experience like for you? I mean, it's what you wanted to do.
Dr. Melissa Drake, MD[13:56] Yeah, yeah. So I sort of broke out on my own, started seeing patients solo and I didn't have a ton of focus, I would say, in terms of practice management, in terms of how to structure things, I guess. I also had a sense of, if I had to say I had any overarching practice management philosophy, it would really be just a sense of service to community. I wanted to just serve the community. And that meant take every kind of insurance. The only insurance I didn't take was emergency Medi-Cal. Those patients would go to the county. I took everything from Sencal to Anthem Blue Cross. And I essentially didn't say no to any appointments. My staff eventually was like,
[14:46] you have to cap the number of births you're gonna get because the most intense month I had, I think I delivered 45 patients in the month.
Dr. Elliot Berlin, DC[14:53] Holy cow, that's a big half every day.
Dr. Melissa Drake, MD[14:56] It is. They were whole babies. That was my biggest month.
Dr. Elliot Berlin, DC[14:59] Thanks for clarifying, Doc.
Dr. Melissa Drake, MD[15:00] My lightest months were never less than 30. And so my staff was like, you have got to start capping. You cannot do more than 35. But so I capped at 35 births eventually, but I never capped or stopped taking certain insurance plans. I was consistently told you really should stop taking Sencal. You should stop taking Sencal. They're your lowest payer. But so many teachers in town, there were so many just like really lovely folks on Sencal. I really couldn't justify not taking it anymore. So it was the community. That's the thing. I just was like, I have too many lovely folks using it. So I can't stop taking it.
Dr. Elliot Berlin, DC[15:39] Can you explain for a minute? Cause I think a lot of people don't think about it. I have insurance for my family that costs a fortune of money. And I think probably 20% of the doctors we go to take it. And 80% of the doctors we go to don't take it. And I don't take insurance. And now I assume you don't take insurance. So spoiler alert. But can you explain, I know how it is from the chiropractic perspective, but from an OB perspective, what is the difference for you for somebody who has, let's say insurance that's a better insurance, insurance that's a less quality insurance and somebody who just pays out of pocket.
Dr. Melissa Drake, MD[16:18] Yeah. So this is the wacky thing about insurance. And this is why I was so busy. I didn't even have a moment to sit down and take an admin day, for instance, to wrap my brain around what any of this meant. But a pregnancy and birth is billed globally, similar to how a surgery is billed. Surgeries are billed globally, meaning the actual surgical procedure and then a certain period of time after the surgery, including post-operative visits, and then any period of time after that. I don't know what it is for surgeries. I think it's like 90 days. That's all included in like a global package. So the insurance will pay a fee for this entire period of care.
[17:04] So for pregnancy, it's the prenatal package. So it's however many prenatal visits there are. So if you see the doctor five times, 13 times, whatever, and then the birth, and then one or two postpartum visits, that entire package of visits is a single fee. That's what your doctor will get paid. And so in the United States, when people talk about like, my birth cost $30,000. My birth cost $15,000. You hear about these insane prices that people are paying for their births. And that's an uncomplicated birth in the United States. That's not counting a NICU stay, or God forbid, an ICU stay for somebody. So, I mean, you hear about these things. People are paying these ungodly amounts of money
[17:52] for their births. That is not going to the doctor because for that global pregnancy and birth package, 13 prenatal visits, a delivery, which for some people, that's four hours of care for me, you know, delivery. For some people, that's 12 hours plus of care. And then two postpartum visits. Sencal was paying like 1,500 bucks. And my highest payer, which was Anthem Blue Cross, I believe at the time, was paying, I think, 2,400 bucks. And that really sort of just boils down. That tells you why people are being rushed through their appointments in most offices. That tells you why so many doctors have to operate at scale.
Dr. Elliot Berlin, DC[18:41] I mean, it's not very much per hour. Even if you're moving fairly quick, it's not very much per hour.
Dr. Melissa Drake, MD[18:46] Exactly. Especially in light of, you know, the expense of running an office.
Dr. Elliot Berlin, DC[18:52] Exactly.
Dr. Melissa Drake, MD[18:53] Just malpractice insurance alone on the other side. Malpractice insurance. And then you have like slip and fall insurance for your waiting room. And then you have health insurance for your own employees. Oh yeah, some worker's comp. Exactly. Because, you know, your own employees are usually, in healthcare, gonna be young women who are also needing their own healthcare, getting pregnant themselves, which is legit. That's what we all do, you know. And, you know, you want to pay them a fair wage. You want them to have their own good health insurance. You want to make sure they have paid leave. You want to make sure they can go out and like take their kid to soccer practice
[19:28] or take a sick day for their kid. You know, those kind of things.
Dr. Elliot Berlin, DC[19:31] So they make you need to earn to make your first profit dollar in a month. And that is substantial. And if that's the hourly rate essentially that you're getting because of that global package, you have to see a lot of people just to break even at little internal profit. And so you end up, I mean, 45 babies in a month, that doesn't sound like you even have time for the marathon. It just sounds like you wake up at four in the morning, you know, deliver a marathon. Having gone to bed at 3.30, you know?
Dr. Melissa Drake, MD[20:00] Yeah, exactly.
Dr. Elliot Berlin, DC[20:01] I mean, it's just so taxing on the body. People want more time with the doctor.
Dr. Melissa Drake, MD[20:06] Absolutely. And they just deserve more time. People deserve more time, you know? Pregnancy care is a time that really affects the entire lifespan. So it's a time where it shouldn't be rushed. You shouldn't have a five minute visit after waiting for a month. That's not how any of this should work. You know, when you do a five minute visit after waiting for a month and then you wait another month and have another five minute visit, and then we have bad health outcomes, nobody should be shocked at that.
Dr. Elliot Berlin, DC[20:36] Sure. I mean, that makes sense. You know?
Dr. Melissa Drake, MD[20:39] Right.
Dr. Elliot Berlin, DC[20:40] And people don't like the group model where, you know, you have a group and you don't have a doctor assigned to you per se. You just see whoever you see, even though that makes- It's not ideal. It's not ideal, but it's not ideal for the patient, but seeing that many patients, it makes the life of a doctor a little bit more livable. I mean, the way you're describing it just sounds like it's impossible just to have your own healthy life, nevermind being someone's spouse or someone's parent, you know, and those people depending on you and you're not able to be there for them. And so, yeah, I suppose that's one of the reasons why there's a high burnout rate among obstetricians.
Dr. Melissa Drake, MD[21:19] Yeah, absolutely. And also we're human. I mean, you have high stakes there. Like humans make mistakes and humans who haven't slept make more mistakes. You know? That's one of the most interesting things. So my oldest daughter is in the Air Force and she took some time after she graduated. She went to UCLA, she graduated and she took some time before she got orders. And she took that time, she was working for a private jet company and she was scheduling the flights. And the aviation industry takes pilot health and specifically pilot fatigue so seriously. And she, you know, she was doing all this scheduling and she would take this extremely seriously.
[21:59] She would say, you should be on the phone scheduling these guys. And she would be like, well, this guy can't fly, he's grounded. He's had too many hours. I've got to get him a hotel. I've got to make sure he gets enough sleep. It's not safe for him to be piloting at all for at least another 18 to 24 hours because I've got to make sure he's rested. This is serious stuff. And I'd be like, my God, think about it. You know, if only we took medical care that seriously. We've got doctors that are completely fatigued doing care. It's wild.
Dr. Elliot Berlin, DC[22:32] Doing surgery, sometimes doing emergency surgery, not under the, you know, smoothest of circumstances. Yeah, it's a recipe for disaster. So you left that model.
Dr. Melissa Drake, MD[22:44] Yeah, I had to.
Dr. Elliot Berlin, DC[22:45] Was there a breaking point?
Dr. Melissa Drake, MD[22:47] I got so unhealthy. So I truly like, we talked about the complete lack of asleep. Like there were moments when you're doing that many births, thinking back on it, it's really hard to, it's hard to even talk about what the sleep schedule was like because I would be waking up at like five in the morning going to round in the hospital, round on patients before the office started at eight. So I'd round on anybody that was laboring and anybody that was postpartum. Office would start at eight. I'd see patients throughout the morning hoping not to have to dash out for a delivery in the morning. Before I would leave the hospital, sorry, I would grab a coffee, a free coffee,
[23:24] and then a free croissant or something like that in the doctor's lounge. That would be my breakfast. I'd come over.
Dr. Elliot Berlin, DC[23:29] Wow, two different types of vitamin C,
Dr. Melissa Drake, MD[23:31] coffee and croissant. Exactly. Yeah, I don't know how I didn't get scurvy in this time period, but I don't know how my scars didn't open out and my teeth fell out. And then I would, you know, hopefully complete the morning, come back at lunchtime to complete the rest of the rounding, see anybody who else was, you know, if anybody was still laboring, I'd check in on them, complete the rest of the postpartum rounds, take any more free food that I could find, get another coffee, maybe an energy drink. I'm back to the office for the afternoon. Hopefully not have to dash out for a birth in the middle of the afternoon, although I'd often have to do that.
[24:03] I had a fantastic nurse midwife that I worked with who, if I had to dash out for a birth, could complete the afternoon appointments and then I'd come back and finish the rest. When I was finished with the afternoon appointments, I'd go back to the hospital, check in on people again, and then go home, usually 6 p.m. Then I would finally be able to look at labs. I'd look at labs, you know, make phone calls to patients about any lab results while usually like watching the news, which is, of course, you know, great for your cortisol levels in the middle of COVID. You know, my poor kids would be like, hello, are you still there? And I'd be on the computer making phone calls,
[24:37] sending emails.
Dr. Elliot Berlin, DC[24:38] Yeah, it's an impossible life. It's impossible.
Dr. Melissa Drake, MD[24:40] Maybe fall asleep around midnight. And then most phone calls are coming in because most births happen between two and four in the morning. So then, you know, you have a birth almost every night. I'd be back at the hospital between two and four, hopefully get back around 4.30, back up at 6 a.m.
Dr. Elliot Berlin, DC[24:56] Wow.
Dr. Melissa Drake, MD[24:57] So I just kept doing that over and over.
Dr. Elliot Berlin, DC[25:00] That's insane. You could almost understand sort of why like a young med student would have a doctor who comes in and just doesn't have the wherewithal to give her proper informed consent and spend time with her. And I'm not justifying it, I'm just saying like, you end up on that treadmill that just gets faster and faster and then hurdles pop up. You're just trying to stay on the treadmill without falling off, you know? Dreadle the balls without dropping any. And it's easy to see where patient care just falls apart.
Dr. Melissa Drake, MD[25:32] Totally.
Dr. Elliot Berlin, DC[25:33] All right, so you moved away from that. I want to find out about your new model of care and how it's working out for you. Let's take one more break and we'll be right back. Welcome back. We're talking to my new general physician, Dr. Melissa Drake.
Dr. Melissa Drake, MD[25:58] Thanks.
Dr. Elliot Berlin, DC[25:59] It's kind of interesting. I don't know if you knew Dr. Jay Goldberg. I've told this story on the podcast before, but when I went to Cedars-Sona with COVID, like alpha COVID, one of the first people around here who got COVID and I was in the ICU trying to stay alive and somehow he knew, OB that I'd worked with many times, he knew that I was in the hospital. I don't even know how he knew I was in the ICU. And he sent a sweet text message that just said, I'm so sorry you're here today as a patient and not as a provider. And if there's anything I could do for you at all, personally or professionally, don't hesitate to reach out. And I immediately started thinking to myself,
[26:35] like, you're an OBGYN, what are you gonna do for me professionally? So as a joke, I just wrote, well, I haven't had a Pap smear in forever and without a beat, he wrote back, I'll be right up.
Dr. Melissa Drake, MD[26:46] I love that.
Dr. Elliot Berlin, DC[26:47] It made me laugh, which we said is great medicine. And I started breathing and I came home soon after that. Okay, so back to you. So the burnout, it's very real. I think people can start understanding. We want our doctors to take our insurance. We want our doctors to be easy to get into, be able to see me next week. We want our doctors to spend a lot of time with us and be very thorough and never make mistakes. But those things kind of work against each other for like, doctors are human. There's only so much you can do. Something's gotta give. And for you, it sounds like patient care wasn't what you were ready to give on.
Dr. Melissa Drake, MD[27:22] No.
Dr. Elliot Berlin, DC[27:23] So what's your new model?
Dr. Melissa Drake, MD[27:24] And that was the thing, it's like even throughout my whole, the practice felt like a Mustang that was running away. Like I was on the back of a Mustang, like a wild Mustang. And I was holding onto the main of it and I couldn't get control of it. It was just running away with me. I still couldn't do five minute visits with people. I just can't do it. If somebody's crying in your office and like pouring your heart out to you, I cannot interrupt somebody and say, I'm sorry, our time's up. Don't just set the timer when they come in. I'm physically incapable of it. I simply cannot do it. The people that know me, like know I'm incapable of doing that.
[28:00] I'm way too talkative.
Dr. Elliot Berlin, DC[28:02] So tell me about your practice now.
Dr. Melissa Drake, MD[28:05] Yeah. So when I reopened, I thought the people that really know how to do obstetrical care are the midwives. They've always known how to do it. I call them like the keepers of the flame because they've been quietly and like consistently doing full care this whole time, just properly. We've been bumbling along and sort of trying to do it and putting our own model onto things. We have good skills. We've got great surgical skills. We have great tech, but the true, the deep care, the care that really matters that carries on throughout history, the midwives have been doing that the whole time.
Dr. Elliot Berlin, DC[28:42] Right. I guess the old adage, you spend an hour waiting to spend five minutes with your doctor and five minutes waiting to spend an hour with your midwife. Their model is just very different. Of course, they're not doing surgery and they're not doing high risk things for the most part, but it's a totally different model. It's very holistic. They look at a person and different than allopathic does when they look at the whole person. When I was in chiropractic school, they said when you step on a dog's tail, it barks. And if you're looking too zoomed in, you're gonna be looking at the vocal cords and they're making noise and that's a problem. You gotta get them to stop so you anesthetize them.
[29:17] And it does stop, but you still have somebody's foot on the dog's tail. So I think that holistic care just kind of zooms out and the midwives are looking at your life in general and your relationships and are you taking care of your health or getting enough sleep? And what are you eating and are you exercising? And have you thought about what postpartum is gonna look like? And all these things. And I remember Stu Fishbine used to tell me, he's like, I have no idea what they talk about. I can't think of more than five things to talk about with five minutes with my patient. Also very supportive and working in tandem with midwives. They're definitely onto something.
[29:52] I think everybody has their place.
Dr. Melissa Drake, MD[29:55] Well, when I tell my colleagues that my visits last for 50 minutes to 90 minutes, when I tell them that those visits last that long, they're like, what on earth are you talking about for that long? And I'm like, honestly, everything, truly everything. Because it's been a month, two weeks, a week since we've seen each other. And so there's a ton to talk about. How have you been? How are the kids? How's your dogs? What have you been eating? How have you been sleeping? You're catching up with a friend over coffee, over tea. In the same way that you would catch up with a friend, except your friend is your doctor. And your friend has all this advice for you.
[30:36] And your friend is gonna be with you throughout this really significant life experience. And it's gonna help you prepare for this really significant life experience and be with you every step of the way. And so I was not planning on all these developments. I didn't know how long the visits would last when I thought I'm only gonna do all house calls, because I only do house calls. I had no idea how long the visits would last. I was like, I don't know, maybe it'll be a half hour. It turns out they're always at least an hour. Sometimes they're two hours. They don't feel long. They don't feel excessively long. They just feel like I'm meeting with a friend.
Dr. Elliot Berlin, DC[31:12] My observation sometimes, again, I come from a medical background myself. When I heard that people still do home birth today, I didn't even realize it was happening 20 years ago when we moved to Los Angeles. I was like, wow, that's crazy, spooky, scary. And once I started attending home birth, I noticed something really interesting, which is that relationship between the midwife and the patient, because of all the things you're talking about that you now do as well, the time that you spend in. Just being in someone's home, you can learn a lot about them from just being in their environment with them and seeing how it affects them in lots of different ways,
[31:48] mentally, physically, spiritually. And what I noticed about midwives is sometimes they'll realize something is not quite right before any alarm bells go off, like just from the way that you're talking or the way your skin looks or feels or your responses in a way that they're sometimes really able to find pink flags, things that are maybe going to become an issue long before I would see those same things be recognized in a hospital setting where somebody's not really with their provider, A. There's nurses, but they're not often in the room. They're monitoring remotely. And even when they come in the room, they don't know you. They have no experience, no relationship with you.
[32:31] And so it just became clear to me that sometimes one of the things that makes home births can be safer than a hospital birth is that they're gonna pick up things much, much earlier because of that deep, intimate relationship that they have and be able to address it and take care of it before you would even realize that it was an issue at the hospital. And so-
Dr. Melissa Drake, MD[32:52] Yeah, before something's gonna show up on a blood test.
Dr. Elliot Berlin, DC[32:55] Right, and the description you're giving of going into their environment and spending all this time with them and really getting to know each other on multiple wavelengths, so to speak, is an entirely different model. It's like the polar opposite of what you were just describing. How does that feel for you?
Dr. Melissa Drake, MD[33:13] It's amazing. It's just the best.
Dr. Elliot Berlin, DC[33:16] It's what you wanted. It sounds like what you dreamed of.
Dr. Melissa Drake, MD[33:19] It's just what I dreamed of. It works out so well. And I have to tell you, it works out so well for the patients because it works out great for me because I'm completely at ease with people. I'm completely at ease with myself. I love not being in the office. I love being able to move around. I love being able to feel like I have enough time for people. I used to feel in the office, if I did have someone who was having a really emotional day and having a really emotional visit and I was trying to comfort them and give a listening ear, even while doing that, if I could still feel the waiting room piling up behind me and it would just be making me feel almost itchy
[34:02] because I knew back out in the waiting room there were other people having an emotional day waiting for their turn. You know, like- Getting worse as they wait. You know, and I was just like, oh God, this is just, you know. So the fact that like, I'm able to really give 100% of my attention to each person is just such an incredible blessing. But then additionally, people who have other kids, people who have other obligations are not having to drive out to an office. They're not having to wait in an office waiting room for 30 minutes, 45 minutes, whatever. They're just waiting for me. I'm coming over to the house. If they need to reschedule, they just give me a text.
[34:40] If I'm running five minutes late, I just give them a text. If we need to meet somewhere else, we text each other. If they're at the grocery store and they can't remember if their kombucha is safe to drink, they're gonna shoot me a picture of it. You know?
Dr. Elliot Berlin, DC[34:53] And also how many people could even say that they have, you know, text connection, text access to their doctor, to their OB-GYN?
Dr. Melissa Drake, MD[35:00] Yeah. It just works. It's just functional. It just works.
Dr. Elliot Berlin, DC[35:04] The way you talk about midwives is not typical for an OB either. Sort of, I remember when I got into chiropractic care, there was still a lot of tension between medical doctors and chiropractors. There still are in large areas, but I have great relationships with medical doctors and I feel like our patients get the best care when we work together on a team. Sure, there's a little bit of overlap here and there, but for the most part, we're like yin and yang, giving them the full perspective, the full spectrum of health. I still feel that kind of tension between the OB community and the midwife community to a large degree. Do you find that too? I mean, are you like a rebel in that way?
Dr. Melissa Drake, MD[35:45] I feel sometimes like that exists a little bit. I think it's improving, but it's a shame because like we should be working hand in hand. We really should just be working hand in hand because we have so much to learn from the midwifery community. Like the obstetricians have so much to learn from them and we have so much that we can offer them. So when I was in training in DC, there were in-hospital midwives that we provided medical backup for and they were some of the first vaginal births that we saw as residents. And I just remember being like a first year resident. I'd been a doctor for like three weeks, just sort of coming to the door of the room.
[36:27] These women who were like, midwifery patients did not wanna see a doctor at the door. And I'd be like, hi, I'm Dr. Drake. I'm just here. I hope you don't have to see me again. I just wanted to introduce myself. If there's any emergencies, I'll be here on hand. So there's such an opportunity for synergy and collaboration and it just needs to happen more. And I find so many of my good friends are midwives and doulas. And I love having that ability to collaborate. It's a shame it doesn't happen more.
Dr. Elliot Berlin, DC[37:01] I have a question. So I feel the conflict from you because of your deep, big hearted passion for service to the community. And now the type of care that you offer is the type of care that you want to offer and the type of care that people want to receive. But obviously it comes at a higher cost and lower accessibility. How do you navigate that trade off?
Dr. Melissa Drake, MD[37:23] Yeah, there are times where I am able to provide discounts to folks and I'm also trying to work with groups to work with creating scholarships. So that's another hope that I have is that I'll be able to offer scholarships in the future. The other thing that I feel super strongly about is teaching. And my hope is that at some point in the hopefully not too far future, I'll be able to maybe bring a residency up here and have some ability to… Yeah, to teach and to bring my particular brand of OB strangeness to the world.
Dr. Elliot Berlin, DC[38:06] Doc, as we're winding down, just practically speaking for somebody listening, any tips for finding the right OB-GYN for you?
Dr. Melissa Drake, MD[38:15] Yeah, I think one of the most important things that I find and one of the really key values is autonomy. And so I really think that finding a provider that's not afraid to have questions asked because you will find some people that are a little sometimes taken aback by questions or maybe put on the back foot by questions. And so that to me is sometimes a concern. So if someone is welcoming of questions, doesn't find that weird and somebody also who isn't afraid or ashamed to say, hey, I don't know the answer to that, let me get back to you.
Dr. Elliot Berlin, DC[38:52] Oh, that's a good one.
Dr. Melissa Drake, MD[38:54] There's nothing wrong with that. And that's sometimes a thing that I feel like doctors are not, they don't feel like they're allowed to say.
Dr. Elliot Berlin, DC[39:03] Right, we're supposed to know everything.
Dr. Melissa Drake, MD[39:05] Right, they're not allowed to say, I don't know the answer to that, I'm gonna get back to you on that.
Dr. Elliot Berlin, DC[39:09] Right, you know what you know.
Dr. Melissa Drake, MD[39:10] They feel like they need to be an all-knowing automaton, right?
Dr. Elliot Berlin, DC[39:13] That's a really good one.
Dr. Melissa Drake, MD[39:14] And so being okay with like, hey, I'm a lifelong learner, I'm gonna be able to get back to you. Like my whole part of my knowledge base is knowing how to get to more knowledge for you. So that's, I think, a really key element.
Dr. Elliot Berlin, DC[39:27] I love that. Well, thank you so much for sharing what goes on behind the scenes here and why the system sort of is the way it is and ideas on perhaps how it can change. I think we're both in agreement the whole system needs a major overhaul.
Dr. Melissa Drake, MD[39:43] Definitely.
Dr. Elliot Berlin, DC[39:44] And until then, there are gonna be different models of care and each one will have pros and cons. And you just pick a provider that has the pros for you that outweigh the cons. And that's gonna be different for each person. Doc, where can we find you online?
Dr. Melissa Drake, MD[40:00] I am at MelissaDrakeobgyn.com. And then I'm on Instagram at DrMelissaDrake and Facebook at the thing.
Dr. Elliot Berlin, DC[40:11] Perfect. Thank you again for joining me. Your story is both eye-opening and inspiring. And I appreciate you helping us reimagine what sustainable patient-focused care can look like. To our listeners, if this conversation resonated with you, share it with a friend, leave us a five-star review and explore more pregnancy and parenting information just like this at InformedPregnancy.com.
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Garrett Kusmierz conceived on her first try but it led to a challenging postpartum journey. Her experience inspired her to change careers and create innovative products for new parents, like a biodegradable postpartum bra. What comes next for this momtrepeneur?
“Is this sort of a gaslighty experience of like, am I missing something that my body's telling me? And mind you, I've been so in tune with my body”
“But I felt like a prisoner of war because the pain plus the lack of control of my own body just felt like pure torture.”
“but I joke that bra shopping is like jean shopping. Like who has the bandwidth after a traumatic birth to go out and bra shop with a newborn baby? You know, you're likely not even leaving the house.”
“I'm wearing an adult diaper because of my vaginal birth. Why can't I have something to keep me cozy and dry up here? So I had the idea of inventing this absorbent disposable bra,”
“Company is called Cozy Cozy and our mission is to bring comfort to moms so that they can better bond with their baby.”
AI-generated transcript with speaker labels — may contain errors, especially names and medical terms. Dr. Elliot Berlin, DC appears in blue; Garrett Kusmierz in orange.
Dr. Elliot Berlin, DC[1:00] My guest today conceived on her first try, but a traumatic birth led to a challenging postpartum journey, and the road didn't get any easier when she began trying for her second child. Her experiences inspired her to change careers and develop innovative products to support new parents. She's the host of the Cozy Cozy podcast and the creator of a biodegradable, disposable postpartum bra. Plus, she has an exciting update to share about her fertility journey. I'm pregnancy-focused chiropractor, Dr. Elliot Berlin, and you're listening to the Informed Pregnancy podcast. Garrett Kozmeyers, welcome to the podcast.
Garrett Kusmierz[1:52] Thanks for having me.
Dr. Elliot Berlin, DC[1:53] I'm excited to learn from you. I mean, once in a while you bump into somebody who gets a bad hand of cards dealt to them, and not only picks themselves up, dusts themselves off, and tries again, but along the way tries to learn from what happened to them and help make sure it doesn't happen to other people, and you're one of those people. So let's jump into the journey. Where are you from, and what were you doing before the first baby came along?
Garrett Kusmierz[2:18] Yeah, so I'm from the Midwest. I somehow, well, a real estate job brought me to the East Coast. It was supposed to be for one year, and I'm still here 10 years later. I was coaching, helping people with what started as fat loss, weight management, strength training, turned into mindset and more of a life coaching style of supporting people. I was writing books and podcasting, and I was very happy in that career. I wanted to change nothing about it, but as you mentioned in the intro, once I had certain pain points that really, really disconnected me from my baby, I wanted to make a change.
Dr. Elliot Berlin, DC[2:54] Well, how do you get started? At one point do you say, I wanna help people in the ways that you were helping people before, like fat loss, coaching, any of those things. Those fields always make me scratch my head and say, when you were a kid, did you be like, I wanna help people lose fat?
Garrett Kusmierz[3:11] I am kind of a teacher by nature. I'm a big sister. I'm the oldest child. I feel like I was always teaching my brother's things or mainly bossing them around, and out of pure passion for fitness, I was sharing my journey through blogs and Instagram posts, and I found myself sending more direct messages to followers about what was in my protein shake or how many reps I did of that thing that I posted in the gym earlier that a guy I was dating at the time was like, you should charge for what you're doing. Like you're spending time helping people put it into a structure and start guiding people for money. Like, don't just do this for free. And so I started that business in 2014
[3:48] and it just evolved as people continued to ask for whatever they were asking for, really. And that naturally led to other types of coaching. Yes, and that was very much informed from what I was also passionate about at the time and from the mentors that I had, taking me through spiritual journeys and my own life coaching experience.
Dr. Elliot Berlin, DC[4:08] And then writing books. I mean, that's a whole skillset of its own. You might be sort of a born leader and interesting and motivating, but writing is a whole different world. And then starting a podcast. What are the books about and what's a podcast about?
Garrett Kusmierz[4:23] So the first book I wrote was just an e-book that was supposed to help my clients so that they could learn without me having to tell them in our sessions. The second one is a story based on my life. It's a novel form. I did study journalism and writing in college. My professor said I write like a downhill skier. So I am not a good writer. I'm a good storyteller. And so it took a lot of editing, three years of editing, over 300 pages. It's on Amazon. And what it's about is my journey moving from Chicago to Boston for a job. At the time I was in a victim mindset. I felt like the job was ruining my life. And as soon as I found my footing on the East Coast,
[5:00] the job fired me. I found out later that was because they had closed the deal with my dad. And I was just in complete shock that I had kind of changed my life for this company that was using me. And I wrote a book about it. So it's kind of a crazy story.
Dr. Elliot Berlin, DC[5:14] Interesting. Okay, it makes sense that you studied it. But I've been told that I downhill ski like a terrible writer. I haven't been told that, but that's how I do feel about myself. Okay, moving forward. And then the podcast.
Garrett Kusmierz[5:25] Yes, I was sick of writing actually. And that's why I wanted to start a podcast. The Cozy Cozy podcast.
Dr. Elliot Berlin, DC[5:31] What's the overall genre?
Garrett Kusmierz[5:33] Right now we're filed under parenting and health and wellness. I think it's a secondary title. It started as a podcast called Dare to Move, which was the name of my book. And I was just interviewing people that I found inspiring, that had unique stories to tell, that had overcome obstacles and also using it as a place to solo cast that I could create content for my clients. And when I started the company, Cozy Cozy, I changed the name to Cozy Cozy podcast. And now we interview anyone in the birth space, anyone giving birth, all things birth and actually business as well. We interview a lot of mompreneurs.
Dr. Elliot Berlin, DC[6:09] Oh, that's great. These are all things that our listeners will be interested in. All right, so speaking of pregnancy and birth, you had a lot of success with your first try at having a baby in terms of conception. Where were you in life? And was it like a conscious choice?
Garrett Kusmierz[6:26] Yes. Susan and I are both very health conscious people. I had been bodybuilding and powerlifting in the gym, building a lot of strength for the seven years before I conceived. I got off of an IUD about nine months before we tried. And I felt like I was really walking towards getting pregnant. And it was all based on this idea that we were gonna try the night of our wedding, but COVID happened and COVID canceled our wedding. And I looked at my husband and I said, if our wedding is really canceled, I want a puppy or a baby. And we were kidding because I'm allergic to dogs. So I was like, this is where this is going. And we ended up getting pregnant
[7:03] on what would have been the night of our wedding, which was really special. But I used to tell my husband, I said, don't joke about how we're gonna get pregnant first try because we don't know. And there's a lot of people that are struggling right now. I don't think at the time the global rate was one in six struggle with infertility, but I'm sure it was somewhere not so positive. And so I didn't have that expectation, but then it happened. So it kind of took us by surprise, but we were excited. And I approached pregnancy like it was nothing. I ran, I sprinted, I lifted, I dead lifted 135 pounds the day I went into the hospital for an induction.
[7:41] Like it was the easiest thing I've ever done. And I really enjoyed being pregnant.
Dr. Elliot Berlin, DC[7:45] Wow, okay. That's an amazing story all by itself. In terms of conception, were you tracking your cycle? Because sometimes bodybuilders don't have regular cycles and with the IUD, sometimes that interferes with your cycle even after you take it out.
Garrett Kusmierz[8:01] That's such a great question. I started tracking my ovulation in May. That was my plan. It was my grand plan to start tracking. And that month I had a 45 day cycle. So I didn't ever catch an ovulation. I was like, I don't know what's going on. And so then in June, I was like kind of tracking ovulation, but I wasn't really looking into exactly, the strips are kind of hard to determine sometimes. And so we were like, we think we got the window, but we're not sure. And then four days later, I had a traumatic event where my husband and I hit heads and my two front teeth fell out. And in that moment, it was cycle day 21, I started bleeding. And I was like, that's so strange.
[8:39] I'm not really sure what's happening, but I had a 21 day cycle. And then about 15 days later, we conceived my son. So it was sorta, I didn't have tracking strips with me. I was at a dude ranch in Colorado. It felt like miraculous. Nature wanted this baby.
Dr. Elliot Berlin, DC[8:53] Did you get pregnant without two front teeth?
Garrett Kusmierz[8:56] I had them in my head, but we weren't sure if my body was going to accept them or not. And then they did get accepted by my body. And this is actually a really interesting thing. Maybe you've even done a podcast on it, but I ended up doing root canals throughout my pregnancy, which the dentist wouldn't normally do, but it was the only way for me to keep my teeth. And what I found out the day flash forward, almost three years later, the day I started IVF treatment for an egg retrieval, I found out that those two root canals were infected.
Dr. Elliot Berlin, DC[9:24] Oh, you're kidding.
Garrett Kusmierz[9:25] And that could have been one of the root causes of my infertility.
Dr. Elliot Berlin, DC[9:27] No way. Okay.
Garrett Kusmierz[9:29] Isn't that crazy?
Dr. Elliot Berlin, DC[9:30] Well, this seems like an ideal place to take a break because I need to download all that information. We'll be right back.
Dr. Elliot Berlin, DC[9:48] Welcome back. We are talking to Garrett Koesmeier. Okay, so bodybuilding, healthy. Your husband's healthy, but he's not your husband yet because there was a pandemic. And pregnant on the first try, essentially, despite unusual cycle patterns and not tracking, just the will, hey, we're gonna do it now. And it happened. I love that. And how was the pregnancy? I know you said it was fairly easy and that you were deadlifting on the day that you went to the hospital, which I think is pretty awesome. I hope you have pictures of that for us.
Garrett Kusmierz[10:17] I do.
Dr. Elliot Berlin, DC[10:18] Awesome. How were the different stages of the pregnancy?
Garrett Kusmierz[10:22] Yeah, my spiritual teacher at the time, call her my life coach, was almost like trying to shake me, like you are about to go through a transition. You are about to become a mother, like stop acting like this is no big deal, like really embrace this time. And it's not that I wasn't embracing it. I just felt so good. So when I was eight weeks, I was running, I think I did, in New Hampshire, it's all hills. You're committing to a hill run. Three miles of hill runs. I was doing chin-ups till I was 13 weeks pregnant. And I continued to feel good. The only, I guess, ailment that I had, this is very obscure, but I had these like little scab bumps on my scalp
[10:56] and I used some special shampoo. And then I also learned that I have a torn labrum from years of cheerleading and gymnastics and power lifting, that my hip was giving me a lot of trouble, which is why I was actually seeing chiropractor and getting regular massages. And I just kept telling myself, when I give birth, this is what I'm gonna focus on, is really rehabbing my hip. Maybe I need surgery, I don't know. And I continued to just listen to my body. People found it hilarious because I'd be posting 39 weeks, doing jumping jacks and deep squats and back squats and all of these things, but it just really felt good. And what I didn't realize is that
[11:33] I was preparing myself for a four-day long birth. It was like I was training for the Ironman.
Dr. Elliot Berlin, DC[11:39] Wow, okay. So first trimester, did you have the typical nausea and low energy? I can't imagine you with low energy.
Garrett Kusmierz[11:47] A little bit, a little bit. I would lay in bed a lot. I was just coaching and it was all on Zoom. So when I wasn't coaching or I taught some Zoom workout classes as well at the time, I would lay in bed. I remember that. And I do remember feeling nauseous, but nothing that like totally took me out.
Dr. Elliot Berlin, DC[12:02] And then it sounds like second and third trimester, back to your typical workouts, almost like, okay, me and the pump are gonna do what we used to do.
Garrett Kusmierz[12:09] Yeah, all the way through. And I spent time at 26 to 27 weeks. I was out in Snowmass, Colorado and my grandma's house, six at 9,000 feet. And I'm used to living at about sea level. And I did 90 minute walks every day. And I still don't know how I did that.
Dr. Elliot Berlin, DC[12:24] I'm already out of breath just hearing your story.
Garrett Kusmierz[12:26] Yeah, same.
Dr. Elliot Berlin, DC[12:27] All right. So what was the plan for birth? We know it didn't go according to plan, but what was your plan? What did you have in mind?
Garrett Kusmierz[12:35] What I had in mind is as low intervention as possible. I hired a doula. I really loved her. She was also the one giving me my prenatal massages. She's a jack of all trades, sort of a person. And she said, look, you know, I want you to know that I will help support your birth plan. And should there be a point that you aren't able to surrender and an epidural can help you calm down, you know, I may suggest that. I may make suggestions throughout your birth. But one thing I think that's really important to note is the end of my pregnancy experience with certain OBs really put a lot of fear and judgment and discomfort around what I was walking into.
[13:17] And that was, I think, also very foreboding about what happened.
Dr. Elliot Berlin, DC[13:21] So you said more than one OB. So was it a group practice that you're with?
Garrett Kusmierz[13:25] Yes, I got kind of the, I joke, I got the world tour because I started my pregnancy with a Boston-based OB. And then when I was traveling, I saw an OB in Indiana. And then I ended up at the OB in New Hampshire from weeks 30 to 41. And at 37 weeks, I had someone come in and basically start the GBS swab without really telling me what he was doing. So one interesting note, I think, is that I had gained over 30 pounds by 30 weeks, but I'm still deadlifting, I'm still jogging, I'm still lifting weights, and my blood pressure is excellent. The only ailment I didn't mention yet is that my asthma got a little bit worse during the end of the pregnancy.
[14:07] I had a doctor tell me I had gained too much weight and that I should watch it before asking about my nutrition habits or my exercising habits, my steps, any of that. And then I had a doctor notice that I had a doula on my chart, and she came in and lectured me about how I needed to really understand that they were in charge and that they wanted to use interventions that I couldn't say no to. And I then, you know, I let her speak, and then I said, did you wanna know what my birth plan is? You know, I'm open to whatever. And so that was kind of strange. And at 38 weeks, they told me I should do an induction. And I said, I wanna make it to 40 before we have any reason, you know, to induce.
Dr. Elliot Berlin, DC[14:46] What was the rationale behind the 38-week induction?
Garrett Kusmierz[14:50] Nothing. They just said it was easy for their schedule.
Dr. Elliot Berlin, DC[14:53] Wow. Okay. Backing up a tiny bit, because who cares that you gained 30 pounds at 38 weeks?
Garrett Kusmierz[14:58] Right. When I was healthy. And it's within normal anyway.
Dr. Elliot Berlin, DC[15:02] Are you asking a diet? Even if it was a lot. So even if you're above normal, but you're doing healthy things, that sometimes happens, it's not normal, it's average, right? Even if you're above average. But you weren't, and I mean, just not adding up for me, like, why would they panic on you? You're clearly super healthy. Separately, I just wondered for you, being someone who, if you're a bodybuilder, you're really inspecting every ounce of you all the time and how you look. How did it feel for you to all of a sudden have a different shape?
Garrett Kusmierz[15:28] You know, I had a very rough eating disorder, maybe three, four years before I got pregnant. And so I felt like I had completely collapsed that version of myself. So I was just happy. I was excited to be healthy and I was excited to have a bump. I was excited about how I could, you know, I'd been collecting resources and following certain people. I was excited to like recover at a nice slow pace postpartum. I felt so good that the reason that her comment upset me so much is that it didn't seem medically substantiated. And I was like, are you gonna ask me about my eating habits? Are you gonna ask me about my exercise? Are you gonna ask me about how I'm feeling?
[16:05] And by the way, I'm 31 weeks right now. Are you telling me to go on a diet? And she said, I'm not telling you to go on a diet. I'm just telling you to watch it. And I said, well, I'm gonna continue to keep doing what I'm doing because I feel really good and I'm eating really well. I ultimately gained about 55 pounds total.
Dr. Elliot Berlin, DC[16:20] Again, it's above average, but if you're doing healthy things, you're eating well and you're exercising, then that's just the way your body handles pregnancy.
Garrett Kusmierz[16:27] Exactly.
Dr. Elliot Berlin, DC[16:28] Wow. So it's kind of amazing. I don't wanna just let that pass by that you went from having an eating disorder to embracing your bump and also pushing back a bit against bad advice about essentially dieting while you're pregnant. Okay. So you had this idea, you're a healthy person, you wanna have a relatively natural birth, especially in your case. In one try, your body took a sperm and an egg and made a whole human being out of it. Clearly it knows how to deliver the finished product, but you're getting a lot of medical model dialogue is how I would chalk it up. We need to induce a huge distrust in your body's ability to do what was about to happen.
[17:07] And you mentioned getting induced. So I assume that they succeeded in twisting your arm.
Garrett Kusmierz[17:12] Yeah, unfortunately. Part of those discussions between 38, 39 and 40 weeks were so confusing to me because my body wasn't giving me any signs that it was ready. And at the same time, it was my first. So I was like, maybe I'm missing something. Is this sort of a gaslighty experience of like, am I missing something that my body's telling me? And mind you, I've been so in tune with my body through exercising, through meditation, through massage, just really trying to stay in my body. And so at 40 weeks, they said, we'd like to induce you. I said, can I have an extra week? And they said, only if you come in for a non-stress test. And then they continued to follow me.
[17:50] Everything looked normal. And then at 41 weeks, we did an ultrasound. They're like, he looks great. He looks happy. He looks awesome, like all is well. And we need to induce you. And I said, can I have a couple more days? And they said, if you don't call us by tomorrow, we can't guarantee we'll have a spot for you on our floor. Yeah, and so it was really scary for me because I'm like, well, I can't be a bad mom. You know, I can't like put my son in harm. My intuition was obviously like, you're not ready yet. I personally, as the first child, my mom, my mom didn't give birth to me until 42 and four. She was on a Air Force base. So they didn't induce it because during Desert Storm
[18:24] and different reality. But I went in, I went in on a Monday afternoon and that's when the induction started and it was a four day process.
Dr. Elliot Berlin, DC[18:33] Do you remember at the beginning your stats in terms of, did you have a facement dilation?
Garrett Kusmierz[18:39] Nothing, nothing. Well, I guess I had lost a mucus plug. That was one positive thing. And they said that my cervix was softening but that I was zero dilated. So they started with the, I'm gonna pronounce this wrong but it starts with an M, the mesoprost.
Dr. Elliot Berlin, DC[18:54] Mesoprostol.
Garrett Kusmierz[18:55] Yes, they started with that as the induction process. And I was really scared because I was just like, I don't know what to expect and my body's kind of being told what to do now.
Dr. Elliot Berlin, DC[19:06] Yeah. And how did you react to it, the medication?
Garrett Kusmierz[19:10] My body did not react. The first pill, I think they inserted vaginally, I think at seven hours they checked and there was no change. They put in another one. And I think I got to a half centimeter by the morning. They put a third one in. So a lot of cervical checks going on which is important to note because I ended up with an infection. And it was, I wanna say, if I'm timing this right, by Wednesday, they didn't do a folly balloon until Wednesday morning.
Dr. Elliot Berlin, DC[19:39] Well, did you feel anything happening?
Garrett Kusmierz[19:42] I started getting some pretty painful contractions but they were erratic. They weren't in any sort of pace or I guess rhythmic sense.
Dr. Elliot Berlin, DC[19:54] Okay. And did that change after the second one?
Garrett Kusmierz[19:58] No. It was, I wanna say, middle of the night, Tuesday, that they started with the folly balloon. And right before they did the folly balloon, they started pitocin. And so it was two ways of attacking it at once. And as soon as the folly balloon went in, which by the way, all of the cervical checks and the inserting of the folly balloon, they really put a lot of fear in me and I was really uncomfortable but I kept telling myself, I'm about to push a baby out. So I have to be brave and I have to be comfortable with it. But it all felt really kind of abrasive and I felt a lot of fear, which was I think also making my body tense up. But I wanna say 20 minutes into the folly balloon,
[20:41] my son's heart rate began to drop. And that was a little scary because they were like, we're gonna watch it. They monitored it. Maybe we had it in for another hour. I'm trying to do some squats with my doula to kind of work the baby down. And then his heart rate got worse. So they took the folly balloon out. And at that point, I think I had made it to four centimeters.
Dr. Elliot Berlin, DC[21:03] Wow. And which is all the folly balloon can get you to anyway. It's about four centimeters. So once you tug on it, it'll come out. So you so far have a sort of a triple induction going ahead of the misoprostol, which is Cytotec is the brand name. And it's supposed to cause your cervix to soften and open and cause contractions, but it really isn't. And then the folly balloon is mechanical pressure. It's inserted like during a pelvic check where they can put the tip of this thin capillary that's like a balloon on the other side of your cervix so that it's in your womb pushing down on your cervix and mechanically trying to dilate it. And also pressure against the cervix
[21:43] is what releases oxytocin. And then once that gets to four centimeters, like I said, it can come out. And at the same time, they're giving you a pitocin to make your uterus contract. It's a lot going on all at the same time. And it sounds like your baby didn't really like it, but on top of everything else, the way you're talking is that you are in fight or flight mode.
Garrett Kusmierz[22:03] 1000%, yeah.
Dr. Elliot Berlin, DC[22:04] There's a lot of fear. And so, you know what? On one hand, we're giving you synthetic oxytocin, which has the effect on your uterus to make it contract, but not the effect on your brain that calms you and makes you experience the things that are pleasing physically and mentally pleasing doesn't enhance them for you. The adrenaline is making you tighten your whole body. And so, we're trying to force all this pressure mechanically and medically into a body that's very, very tight, into a mind that's very tight and just full of adrenaline, it sounds like to me. And your baby wasn't having it.
Garrett Kusmierz[22:36] 1000%. I remember I had made a playlist that was supposed to be calming and supportive. And there was the, maybe it was an hour or 45 minutes or so when we were trying to really lean into the volleyball and keep with it despite the questionable heart rate. And I put the playlist in and I just remember being like, this is really not doing much for me. Like, I really can't get there. I really can't get to that place of relaxing and calming down. And it felt really defeating when they told me I was only at four centimeters, cause it's Wednesday now. And I've been in the hospital since Monday. And it just felt like, is my body feeling. And of course at the time,
[23:10] I'm not like having totally conscious thoughts, but the kind of next step, they had given me fentanyl during the volleyball and to try to help with the pain, but it didn't feel like it was-
Dr. Elliot Berlin, DC[23:19] So that was my other question, no epidural at this point?
Garrett Kusmierz[23:22] Not at this point, no. And so after the volleyball came out, they cranked up the pitocin again. And they said, this is the point where you may decide that you're ready for that epidural. And I said, you know, I want to try to move through it cause I want to stay active. I want to be able to move my body. Let's keep with it. And there were a few hours. So it's like midday, I think when the volleyball came out a few hours and I'm getting into a lot of pain. And at some point they broke my water, I think. The little hazy on the Wednesday timeline, but I finally decided, you know, I think I want to do this. And it depends on how far I am. Like maybe I've progressed.
[23:56] I've been experiencing these contractions. And they said, you're just under six centimeters. And I looked at my husband and I was like, give me the epidural. I need this. Problem was the hospital had one and they weren't going to be able to get there until pretty late. And so there was also a question of whether, yes, and so they'll come in, but they're with someone else right now. You know, it's going to take a little while. So I'm breathing through it, breathing through it. And I felt so exhausted. And so nervous, like I couldn't eat, but no one told me, hey, this is the time that you should eat because if you get the epidural, you're really not going to be able to eat.
[24:28] And on Wednesday with all that went down, I didn't eat because I just felt so scared and unsure and what's a poly balloon and you know, moving through that. So there was also a question of if I was allergic to lidocaine or not. And it was listed as uncertain in my chart after something I had done years ago. We decided to go through with it. I'm going through like the teeth chattering. And as soon as that happened, they said, okay, just so you know, you can't eat now. I was like, oh no, like I'm starving. And they looked at my husband. They said, go to sleep. She's going to wake up tomorrow, Thursday, and she's going to be ready to push. Like this is looked at my dual.
[25:01] It's time to get some rest, time to get some rest. So everyone gets quiet and I feel the worst pain I've ever felt in my life. And I just instinctively thought I'm transitioning. Like I'm transitioning. I started calling out for my mom. I felt like I was dying. And a nurse said, hold on, hold on. Like what's wrong? I was like, I feel everything. And she said, no, you don't sweetie. Like it works. Like the epidural works. Like you're going to feel fine. You're just nervous. And I'm screaming out. My doula wakes up, my husband wakes up there next to me. And they're like, something's not right. And I also had spiked 105 fever. So I have a fever going on.
[25:32] I'm feeling all the pain. And they said, you know, what we're going to do next is we're going to give you a catheter because we do have to do that based on the epidural. And it'll prove to you that your epidural is working because you're not going to feel anything. And when they put the catheter in, I screamed bloody murder because I felt everything. And then they said, look at the anesthesiologist and redo this. It looks like her epidural is not working. But at this point, I'm, I guess transitioning and I have a fever and the anesthesiologist was like, it's too late for me to redo it. So I had to figure out how to move through that pain. And my doula really stepped in to be like,
[26:05] I mean, essentially like a motherly figure to just stoop me. I remember her kissing me, hugging me being like, it's okay, sweetie. Like we got this. But I was truly calling out. I screamed like, I want my mom in that moment.
Dr. Elliot Berlin, DC[26:15] These are the kind of births that, you know, I was a doula for many years and I still work with the doula community pretty closely. These are the kind of births that sometimes will make a doula no longer support birth in the hospital. Like switch to only out of hospital birth and home birth. And I have to say the overwhelming majority of births that I've attended in the hospital are not like this. But this kind of thing doesn't happen. I've never seen it happen in the midwiffic model. And I'm really sorry that happened to you. You're calling out for your mom, but she's not there.
Garrett Kusmierz[26:45] No, and I don't know if it felt like I was dying. Like literally, I don't know. But it was really scary, really intense. And this one nurse brought me a Popsicle and she was like, if this can calm you down, you know, Popsicle, I'm not supposed to give it to you, but it's something to feel like you're chewing on something. And you know, between my husband and my doula, because the epidural kind of finished on 10, 30, 11 o'clock, if I remember. So for a few hours I'm progressing and I just remember they came in about 3 a.m. and they're like, you're gonna be ready to push soon. And I just remember thinking like, well, I don't really feel like I'm ready to push.
[27:23] So, okay. And so at 4 a.m. they brought like a bar in that I could hold down. And I love chin-ups, it's like my favorite thing. Weighted chin-ups, all the chin-ups. So I was like, born ready for this. This is the best type of birth physician for me. And you know, we're moving through that. And it just felt like hours and hours and like nothing was happening. So 4 a.m. we start. And again, nothing, nothing, nothing, nothing, nothing. I'm pretty exhausted. And at about 9 a.m., so what is that? Five hours later? The one doctor that I really didn't like that did the swab on me comes in and said, if you don't get this baby out in 15 minutes I'm taking you to C-section.
[28:00] Which I kind of in hindsight, I'm like, why didn't they not move me sooner? Like, were they short-staffed? Like that is always a mystery. Not that I wanted a C-section, but when he came in I felt so defeated. And this sounds negative and I don't say this to like scare people from birth. I can't wait to give birth again. I've done a lot of work around it. But I felt like a prisoner of war because the pain plus the lack of control of my own body just felt like pure torture. But once he said, you have this time, something kicked in where I was like, I'm gonna do this. I'm gonna get this baby out. And my body started doing the fetal ejection reflex,
[28:33] which was really cool to experience.
Dr. Elliot Berlin, DC[28:35] Wow, okay. We know how to get you motivated. Throw down the gauntlet.
Garrett Kusmierz[28:40] Yeah, I needed the all in, I guess. I ripped my robe off and I was like, all right, this is it. And they could tell that I was experiencing some level of natural push to there. Like, whatever you're doing, it's working. And I said, I'm doing nothing. I just feel like I'm gonna throw up. But instead of throwing up, my body was bearing down. So we just rode that natural wave. And then the OB ended up getting held up in surgery. So he didn't come back until 950 when my son was born.
Dr. Elliot Berlin, DC[29:07] Congratulations.
Garrett Kusmierz[29:09] Thank you.
Dr. Elliot Berlin, DC[29:10] I mean, was there a moment of joy when the baby came out that you could feel either physically, mentally, spiritually, or was it just pure exhaustion?
Garrett Kusmierz[29:20] It was really complex because the first thing I noticed when I looked up, because I'm kind of looking at him was, okay, he made a noise. I was like, okay, so there's initial relief. But then I kind of peered to my right and there were like six or seven people in the room that I hadn't even noticed with an extra monitoring system for him. So then they took him from me and I was like, I want my baby, why are you taking him? And the doctor said, you have an infection. Oh, then he started tugging on the placenta. And I was like, I want to take my time with this. Please don't pull. I can't take any more pain right now. Like if you're gonna do anything, like stop, stop.
[29:54] And he said, you have an infection, which was the first time anyone had pulled me to my face that I had an infection. He goes, I need to get this out immediately. Placenta comes out and then he goes to stitch. And I'm like, if you're gonna like, give me lidocaine, give me numbing, give me something. I can't take any more pain. And he did it anyway. And then he stood up and said like, thank you and have a nice day and walked out. And I looked at my husband and I said, I am so sad. And my husband was like, why? And I said, because I wanted more kids. I can't.
Dr. Elliot Berlin, DC[30:23] My heart is melting for you so badly. I'm really sorry. It was a terrible experience. It sounds also like it kicked off what happened next in postpartum didn't get much better. So let's take a little break and find out about your postpartum experience. And again, I think anybody listening to you can hear this incredible strength that you have inside and this almost nuclear energy that makes you one of those people that stands up, recovers and helps other people. And we're gonna find out how when we come back. Welcome back. We're talking to Garrett Kozmeyers. And if you are listening, you can hear how strong Garrett is in many different ways and how she got crushed
[31:16] by the system. And I was just thinking in my head, this whole time we're ramming pitocin, synthetic oxytocin, just forcing your uterus to go, go, go like the gas pedal. And at the same time, your body is releasing adrenaline, which is the brake pedal. And it's just fighting. We're making your body fight your body and not giving your mind a chance to catch up. And I'm sort of grateful that at the end you were able to bring your baby out vaginally and not have to have surgery on top of that, but still very traumatic. How was postpartum? We know it wasn't great.
Garrett Kusmierz[31:49] Yeah, you know, obviously after that, I mean, it was the hardest thing I'd experienced at that point in my life. And you always think about in hard times, what do you need, what do you want? You wanna be gentle with yourself. You wanna go to the people you love. But at the same time, now I have to care for this little newborn who's been through this crazy experience and we haven't slept for four days. So we were zombies and we slept for about two hours while they took him for monitoring. And I felt like the worst mom. I'm like, I can't fall asleep, I can't sleep. My body just really passed out. And then when we got home, my mom was there to meet us.
[32:21] I was so grateful. And she said, you're the kid I never worry about. She goes, but when I saw the look on your face, when you pulled up and you fell into my arms, my mom was just like, I knew, it was rough. So we were really lucky to have my mom. We basically gave her the baby and we said, wake us up in 90 minutes when he needs to eat because we are exhausted. We slept again. And then is when things kind of got rough, which was I experienced this severe, severe, severe engorgement and severe breast milk leakage that luckily I didn't have any extra complications from the infection, but I had cracked raw bleeding nipples from differing opinions of how to breastfeed
[33:01] that I got in the hospital. And I continued to breastfeed through that pain and soreness. But on top of that, this engorgement and people just kept saying, put pads in your bra. And I'm like, well, my bras don't fit. Even the ones I was wearing at the end of my pregnancy, I'm so engorged. And I couldn't even put the gel pads or silverettes or any of those nice cooling things for your nipples because I didn't have a bra to hold them. And so I tried a cami, but even that got too tight and I had red marks on my skin from the cami. And so I had Googled what to do. And it was like, if you don't want to catch it, it literally said sleep on a towel. And I was just dumbfounded.
[33:37] So I was literally sleeping on a towel to avoid having to change my sheets every single day from leaking breast milk. But that amount of personal hygiene attention that I needed to put on myself made it harder to obviously focus on my son. I did my best, but I really needed the extra hands of my husband and my mom due to those challenges.
Dr. Elliot Berlin, DC[33:57] Is that something anybody prepared you for? And did you have a lactation helper to try to work through it together?
Garrett Kusmierz[34:05] You know, I was so lucky from my podcast. Before I even went into the hospital, I had interviewed doulas. I had interviewed midwives. I knew so many things about what to do to be prepared. I had scheduled a lactation consultant to come to my house the day I got home from the hospital. She came and helped. And you know, I had a lot of resources available and I knew that my mom had a lot of leaking, but I didn't really know how hard it would be to like live through it.
Dr. Elliot Berlin, DC[34:34] And was there professional support while you were going through it? I mean, just sleeping on a towel, it's helpful advice, but was there nothing else?
Garrett Kusmierz[34:43] You know, there are amazing devices out there to be, you know, there's hands-free pumps. There's the HACA, which is like sort of a suction cup, but it helps you collect milk while you're nursing. So I had these sorts of tools for when I was nursing and when I wanted to collect that milk. But when I wanted to just try to sleep in those precious 90-minute windows, two-hour windows I was getting, or when I was walking around the house, I couldn't find anything that was comfortable enough. And by the way, it's not to say that there aren't real bras out there that I could have gone to purchase, but I joke that bra shopping is like jean shopping. Like who has the bandwidth after a traumatic birth
[35:23] to go out and bra shop with a newborn baby? You know, you're likely not even leaving the house.
Dr. Elliot Berlin, DC[35:27] That's a good point because I was wondering that and I bet a bunch of people were wondering that, but it's a really good point. Even if the birth goes great and they're just like, Garrett, you just had a baby after a great nine-hour labor. You're like, I wanna go to Disneyland. No, you can't, that's just the beginning. That's not the end of the story. You're just like thrown into a world of essentially self-sacrifice for this little being. That's if everything goes just fine, which it didn't for you. Okay, so when you didn't have a solution for your problem, you created one at some point.
Garrett Kusmierz[36:00] Yeah, I was changing a lot of diapers. Actually, initially my husband was changing all the diapers, but then eventually I'm home and I would basically walk around in a fitted rib-knit tank top, no bra and a sweatshirt over it because I kind of hoped that the sweatshirt would absorb some of the milk. And I also, I was changing these diapers and I'm like, why is there not a diaper for my boobs? I'm wearing an adult diaper because of my vaginal birth. Why can't I have something to keep me cozy and dry up here? So I had the idea of inventing this absorbent disposable bra, but I also had zero bandwidth to even think about where to start. And so I sat on it until,
[36:40] it kind of hit me like lightning again when my son was about 16, 17 months old. And I was like, okay, I'm gonna go explore this.
Dr. Elliot Berlin, DC[36:48] And had you ever created a product before?
Garrett Kusmierz[36:51] Just my book, which, you know, the book is more about the writing, you know, finding a cover artist and having Amazon print books is not as complicated as I guess I would think. Creating, developing, bringing to market a product,
Dr. Elliot Berlin, DC[37:04] what was that like for you?
Garrett Kusmierz[37:07] Well, what I didn't know is that it was going to directly parallel my experience with trying to get pregnant a second time. We started basically right before my son turned one. And so for the first four months, we weren't getting pregnant. I was like, well, we had our wedding. You know, we had two other weddings. We had a bachelorette party. Like I was busy, it's okay. And then I was like, okay, and I wanna get pregnant and I wanna start this company. And we had no idea it would take us two and a half years to create this bra. I thought it'd be done in six months. And so ignorance is bliss. We started doing it, but as soon as we kind of figured out
[37:39] that it might take a little while, we started inventing other products and creating other products as well.
Dr. Elliot Berlin, DC[37:45] What were some of the bigger roadblocks?
Garrett Kusmierz[37:48] I think having other people help you design something that don't have the inspiration and the pain point. First and foremost, it's about like enrolling and engaging them in the idea and the pain point, but then having it meet our specific conditions, like biodegradable materials, having it come in at a certain unit economic price so that it's viable in the market. And we were working with a company that is sort of a liaison to other countries, which is amazing and so helpful. But we were in the beginning a little bit misguided, not by any ill will, but people who didn't fully understand what we were doing. And then it took many iterations of design
[38:26] and trying those designs. So I guess there's no one major roadblock I can point to, but really just building the relationship with the factory and helping them understand what we were doing, building the team internally to make it all happen. It just took way longer than I ever anticipated.
Dr. Elliot Berlin, DC[38:42] Flash forward, you did it.
Garrett Kusmierz[38:45] Yeah.
Dr. Elliot Berlin, DC[38:46] So tell me about that product and the other products that you've developed.
Garrett Kusmierz[38:50] Yeah, so we actually just launched not too long ago, which is crazy because again, I have other news that I'll share with you soon, but I have other things going on that it's been a very surreal few weeks recently. And so the product, it comes in a set of seven, just like when you buy pads or tampons or diapers, you're not just buying one because it is single use, but it's made of biodegradable materials so that anyone that would feel guilty doesn't need to feel guilty because it's good on the environment. And what was really important to me is that it had a soft interior for the raw, cracked, sore, bleeding nipples that women experience, but also the ability to nurse while wearing it.
[39:31] So it has five snaps on the front so that you can undo the first two to three and keep it connected at the bottom so that if you don't have your milk collector device handy and it's in the middle of the night and you are super leaker, you can just leak into the other side while you're nursing on one side.
Dr. Elliot Berlin, DC[39:49] Oh, nice. And what do you call it?
Garrett Kusmierz[39:52] The nipple diaper.
Dr. Elliot Berlin, DC[39:53] Oh, perfect. Very descriptive. And then you have other products as well?
Garrett Kusmierz[39:58] Yes. So we were thinking about, what are the main pain points you're going through if you are a leaker, which would be raw, cracked, bleeding nipples. And so we wanted to put an innovative spin on a nipple balm. And that was the first product that we actually were able to come out with. It got done the quickest. But my pain point with nipple balm was that I had to dunk my finger in a jar and I had accidentally got these, there's a misunderstanding at the nail place, these long nails. So I'm dunking my finger in a jar sitting with a newborn in bed and I'm wiping the gunk off on my burp cloth or whatever I have handy. So we have a nipple balm, we call it nip gloss,
[40:30] that opens with one hand because moms do everything with one hand and a ceramic applicator, which just makes it easier to use. It also feels quite cooling when you use it and it's also made of sustainable material.
Dr. Elliot Berlin, DC[40:41] Oh my gosh. Nip gloss is amazing. I'm all about the puns. And that looks like an incredible product and also just like a great innovation, like a product that-
Garrett Kusmierz[40:52] Yeah, I just thought, why not? Why not make it better? Yeah, why not make it better? And we also have fertility products because of my fertility journey that I didn't expect to be on.
Dr. Elliot Berlin, DC[41:03] What kind of products for fertility?
Garrett Kusmierz[41:05] We have an easy to use ergonomic pea collector and we call it the Cozy Pea and it's for collecting your urine, whether you're testing for LH or you're testing for pregnancy early. I would basically test for my LH strip about five days out of the month and then I would also start testing for pregnancy as early as eight or nine days post-obulation, which would then create about seven to nine days of testing for pregnancy because after such a long journey, sounds kind of grim to say, but I was like, what if I catch at least a chemical pregnancy? At least I'll know that something's starting, but maybe it's not working so I'd always test as early as I could,
[41:43] which created about 10 to 15, sometimes 20 days a month of peeing on my hand, trying to put my pee in something to test it.
Dr. Elliot Berlin, DC[41:51] Oh, you're an innovator, a thinker and someone who recognizes a need and comes with a solution. What's the company called?
Garrett Kusmierz[42:01] Company is called Cozy Cozy and our mission is to bring comfort to moms so that they can better bond with their baby.
Dr. Elliot Berlin, DC[42:07] I love what you're doing. Okay, we've alluded to the fact that although your first pregnancy was a one-shot deal, trying for a second pregnancy has not come easy to you. I feel like we can do at least a whole podcast on your fertility journey, because I'm so curious actually how you with your dynamic and personality have handled it and how the experience has been. But we're at the end of this episode, so where are you in the journey?
Garrett Kusmierz[42:35] The exciting news is that I'm pregnant. I am seven and a half weeks pregnant and do not take any of the nausea for granted and we ended up conceiving through IVF. It took us two and a half years to agree to do IVF, a few attempts, and we're so grateful to now be pregnant.
Dr. Elliot Berlin, DC[42:53] I am a better person for having spent this hour with you. I've learned a lot from you. I'm inspired by you in many different ways and I'm excited for you. Congratulations on this next step.
Garrett Kusmierz[43:04] Thank you.
Dr. Elliot Berlin, DC[43:05] I'm again super curious about how the fertility unfolded for you and what that journey was like. I have no doubt that you're gonna come up with a bunch of new products and remedies for people who struggle with what you've been struggling with. And I'm super curious about what your plans are gonna be for this next birth with everything that you have behind you that you've learned from. So I hope you'll come back and do another episode with us.
Garrett Kusmierz[43:30] Thank you. I'd love to. Thank you so much for having me.
Dr. Elliot Berlin, DC[43:33] My pleasure. Garrett, tell us where we can find you online.
Garrett Kusmierz[43:36] You can find us at CozyCozy.com, which is spelled K-O-Z-E, K-O-Z-E, and on Instagram and TikTok, CozyCozyMama, and I'm at Garrett N. Wood on Instagram.
Dr. Elliot Berlin, DC[43:49] Amazing. Garrett, Kaz Myers, thank you for joining us and at home, thanks for listening to the Informed Pregnancy podcast. For more pregnancy and parenting information just like this, visit us online at informedpregnancy.com.
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Dr. B is joined by special guest Dr. Alyssa Berlin, a perinatal psychologist, self trained chef, and his partner in parenthood as a mother of four. They discuss why stress, anxiety, and feelings of overwhelm are skyrocketing, especially for new parents, including clinical and non-clinical ways to reset and reclaim balance like culinary therapy and EMDR.
“clients, I say all the time, we live in a world now where there's more to do than hours to do it. And so it's not surprising that parents are running on fumes. And that's without even adding the digital world”
“And so I recommend that people kind of breathe backwards in the sense of breathing in through their mouth and out through their nose. It really stops your brain”
“Find 10 colors in your world. The first few are pretty much a gimme. They're pretty easy. The red, blue, yellow, green. And then people start to have to work for it.”
“And I'll liken it to, you know, playing a game of whack-a-mole, right? Where if you've ever been to one of those, you know, arcade type places, you've got the giant foam hammer and all of those moles popping up and you're in a constant state of trying to keep them down. And it's exhausting.”
“understand that when you take care of yourself, it's things that you are doing for your kids. It's things that you are adding, you know, to your kids. And it's not something that is being taken away from them. It's an additive thing, not a subtractive thing.”
AI-generated transcript with speaker labels — may contain errors, especially names and medical terms. Dr. Elliot Berlin, DC appears in blue; Dr. Alyssa Berlin, PsyD in orange.
Dr. Elliot Berlin, DC[0:00] Today's episode is a special one. It's our 450th episode, and to mark this milestone, we're making some exciting changes. We've got a new intro, fresh music, and a slightly different opening format, but our mission remains the same. To bring you entertaining, informative, and engaging conversations about pregnancy, birth, and parenting. In this episode, we're tackling a topic that's more relevant than ever. Stress, anxiety, and the overwhelming feeling of running on adrenaline. So many people, especially parents, are struggling with mental and emotional exhaustion, and we're going to explore real, tangible ways to reset and reclaim balance. We're going to talk about why anxiety and stress
[0:41] levels are skyrocketing, especially for new parents. We'll talk about some simple at-home outlets, maybe like culinary therapy and lifestyle shifts. And we'll talk about professional and alternative reset mechanisms like EMDR. You've probably heard of it, but what is it? And to help me navigate this incredibly important discussion, I'm joined by someone very special. She's a psychologist specializing in perinatal mental health, a self-trained chef who has turned food into a therapeutic outlet, and most importantly, the mother of our four children. I'm pregnancy-focused chiropractor Dr. Elliot Berlin, and you're listening to the Informed Pregnancy Podcast. Dr. Elissa Berlin, honey bunny, welcome to
[1:36] the podcast.
Dr. Alyssa Berlin, PsyD[1:37] Hi, sweetie. Thank you for having me.
Dr. Elliot Berlin, DC[1:39] Thank you for coming back on the podcast. We have an episode 183 where we talk about postpartum transition, and it's an extremely popular podcast. Anyway, I'm glad that you're here for the rebirth.
Dr. Alyssa Berlin, PsyD[1:50] Yeah, that was pre-COVID days. That was a whole different world at that time, but I'm so happy to be back.
Dr. Elliot Berlin, DC[1:57] All right, let's talk about stress and anxiety. I mean, I feel like whenever you ask somebody how you're doing, it's always like, I'm so stressed, and maybe even more so for parents. I'm so stressed. I'm burnt out. I'm wiped. I'm fried. I'm wired. However, they're going to say it. There's just an overwhelming feeling of stress today, and it feels like it's built over the years. Like, it's more now than ever in my lifetime. Like, not just for me, but around me, in the community around me, in the country, and even globally. What's going on?
Dr. Alyssa Berlin, PsyD[2:27] Yeah, I think it's a very astute awareness. It's true. Parenting has always been a demanding job, right? There's no way that we could get around that. It's just it's an all-encompassing thing, and those sweet little buggers of ours, they need 24-7 something, right, irrespective of age. But today's parents are dealing with a whole different set of pressures that I think we've never actually encountered before, and it's exhausting. Lots of people like to talk about, you know, the village, that we lost the village, that we lost the support, and that our generation, you know, is doing so much more on their own than ever before. I think the thing that people don't talk about as
[3:07] much is the idea that there's been a lot of societal expectation shifts that happen. And, you know, parents in today's day and age are expected to do so much more, to be more hands-on, more emotionally available, more deeply involved. You'll hear buzzwords like attachment parenting. And these are things that we want. We deeply want to have this time and connection with our kids. At the same time, we're balancing careers and household responsibilities and personal relationships. And when I talk to clients, I say all the time, we live in a world now where there's more to do than hours to do it. And so it's not surprising that parents are running on fumes. And that's without even adding the digital world
[3:49] to the mix. I mean, in case our kids listen to this episode, we won't go too deeply down that path. But we've lived the struggles of media and the digital world, you know, firsthand. And, you know, the digital world is a bombardment for the nervous system. There is constant information that is, you know, coming at us from all sides. We are struggling, and we're thrown into a comparison culture. And it really just leaves most people, or many people, I should say, and definitely parents feeling just struggling with this overwhelming sense of not doing enough, or not being good enough. So it's exhausting. I can't talk about parenthood without talking about the chronic lack of sleep. And so when you
[4:33] take all of this together, yeah, parents are utterly depleted in today's day and age.
Dr. Elliot Berlin, DC[4:38] Yeah, I mean, the chronic lack of sleep, I guess, in general, but even more so now, I think, not just with babies who, you know, haven't sleep trained just people just not sleeping as much, you know, I'll raise my hand guilty. I think that you also said a couple of things that really resonate. Number one, the village, because I see postpartum, my clients come back into the office, you know, if they have a village here, if they do have family around people willing to come over and help out and pitch in, it just makes it possible for them to be available to come to the office and get some postnatal care, that the moms who I see, the parents who I see that don't have any
[5:16] support like that, and may or may not be able to buy support like that, they can't do it, they can't do the same kind of self care. And that's just coming to see me at the office. It translates into so many more things, you know, being able to just have mental time for themselves while somebody else is helping out or caring for the baby or someone to do things, the things that you mentioned, the household things or other responsibilities, someone to be able to do those things and give you a little time to unwind or just even be with the baby without having other distractions. So I think that's a big deal. The other thing is the technology is also interesting because in theory, the technology is
[5:57] going to be able to afford us more time to do other things like whatever I used to have to spend my time doing X, Y or Z, and now there's a software for it or an app for it. So now I should have more time. But I think that for many of us it translates into now I have pressure to do more stuff because a tool to be able to do it. And so I think as these tools, these quote unquote time saving tools come out, they actually not really saving time. They're just putting more pressure to be more productive.
Dr. Alyssa Berlin, PsyD[6:28] Yeah, it's really complicated. You talk about support or lack thereof. And that was our story. We don't have family that live around us, you know. So when family would come to visit, sure, it was a nice reprieve. But for the most part, and on the day to day, we had to figure out how to juggle all those things alone. And I mean, some of the most challenging moments for me would be, let's say when you were at work and the baby was sleeping, but the two year old needed to be picked up. That's stress, right? That is just overwhelming stress and navigating on our own without that village. So yeah, I definitely identify with the beauty when you can have
[7:04] supportive help. And let's not assume that all help is supportive, but good quality supportive help is huge. And the things that you have to navigate when you don't. It is a challenging, you know, here we are in 2025. And the two things we still haven't figured out how to do is either add more hours to the day, or you know, get life to slow down. And I feel like in some ways really, since COVID, you know, you get nothing for free. So we got that little reprieve of, you know, sheltering in place and we were home and we're like, wow, all this time. I feel like the world has been on this vengeful act to somehow make us pay it back faster and faster. And so yeah, all these great
[7:45] technology, we just say, great, it'll help me move faster and do more, as opposed to, oh, maybe I need to use this to slow down.
Dr. Elliot Berlin, DC[7:54] And then to me, stress is how much stuff you have to do in the numerator and how much time you have to do it in the denominator. So more stuff adds to stress, less time adds to stress. And when a baby comes, you have a lot more stuff to do and seemingly a lot less time to do it. So it's stressful. What does it look like symptom wise? What are the signs or the effects on the body when someone specifically parents, but anyone really is under that kind of stress for prolonged periods of time?
Dr. Alyssa Berlin, PsyD[8:25] Yeah, it's a great question. It runs the gamut. Really, stress takes no prisoners, it'll hit every facet of the body. A lot of my clients will talk about fatigue, if not utter exhaustion on the physical side. It may present as headaches, chronic headaches, digestive issues, and, you know, trouble sleeping. And the sleeping one is really a paradox, right? We need the sleep, we want the sleep, we lay our head down and we have trouble staying asleep because there's so much swirling inside. On an emotional level, people talk about overwhelm, irritability, mood swings, or it being so intense and so much that you just short circuit and people just go numb. And
[9:10] it's like they lose all feeling from those sensations. And it's a go through the motions more robotic act just in an effort to get through the experience and the day. I mentioned, you know, a moment ago, that part of what can interfere with sleep is, you know, not being able to shut your brain down. So cognitively with chronic stress, you will hear people talking about racing thoughts, trouble focusing, attenuating to something in front of them, forgetfulness, which can be really upsetting. I'll hear people say like, my brain just feels foggy. And it's so frustrating because that was never me. And then little things, little things that you know, little decisions also
[9:48] become overwhelming. And we feel stuck. We feel stymied between what do I want to eat? Or what am I going to pack, you know, my kid for lunch? Or do I want to leave before a feeding, right? Leave the house before I feed the baby or after. Little things that seemingly would not otherwise impact us all of a sudden feel so big. And all of this, you know, long-term chronic stress, if unchecked, and if we don't do anything to address it, can absolutely contribute or lead to the development of perinatal mood and anxiety disorders. It strains relationships and it leaves us feeling just not good, right? Life just feels overwhelming in that state.
Dr. Elliot Berlin, DC[10:27] How do you know when you're crossing over the threshold? Because stress is not inherently bad. Sometimes we need stress. It invokes that fight or flight response, which can be survival, necessary for survival, help us survive. And then sometimes the stress is just not normal. The body's reaction to the stress is not normal. How do you tell when you or someone around you is going over that cliff?
Dr. Alyssa Berlin, PsyD[10:54] If it's okay, before we go there, even you're talking about, you know, the sympathetic nervous system, right? The fight flight system. And unfortunately, I'm seeing people live in an almost constant near state of fight or flight. And what we know about that system is your body is releasing cortisol, it's releasing adrenaline, and all of that is meant to help you have these short, big bursts of energy to get through a specific moment. The problem is, you know, the sympathetic nervous system was never meant to be a marathon system. It was never meant to be a place that we stay in for long periods of time. It was meant to be a sprint system, right? Something
[11:37] comes up, get in, get out, take a deep breath. And when you stay in that place for an extended period of time, it can be very harmful. It can lead to all of those symptoms we were just talking about. And people, you know, and one of the common things I'll hear clients say is that they feel like they're reacting. They feel like they are just living in a world where it's not their best version of themselves because they're just constantly going from one fire to the next, as opposed to being in a place that can be thoughtful, that can be intentional and mindful, where they can respond to things as they come. So it's a really intense place to be. How does someone
[12:14] know that they're there? I think the thing that we want to think about is a person's ability to adapt, a person's ability to move out of that place versus getting stuck, right? So if you find yourself just perseverating or just stuck in this unending loop of ruminating thoughts, and you're just not able to cope, that's usually an indication that, you know, there's more going on, that there's something bigger to look at. You'll see people talk about little moments of joy being overshadowed by exhaustion, kind of things along those lines. And it really leads to short tempers. It leads to little things creating big frustration. And it evokes our feelings of
[12:59] guilt, which again, not a good place to live.
Dr. Elliot Berlin, DC[13:02] Hmm. Well, it seems like it would be great to tackle it before it gets to that point. But if not, at least recognize it when it gets to that point, so that more advanced help could be brought in. I think we're going to have some solutions here. In the second segment, we'll talk about things that anybody can do at home to sort of vent off the natural buildup of stress. And then in the third segment, we'll talk about more professional help and modalities that people could seek out if things are going out of control, or you don't want them to. Let's take a break and we'll be right back.
Dr. Elliot Berlin, DC[13:49] Welcome back to the second segment of Episode 450. So maybe you don't relate at all, listeners. Maybe you're not stressed at all. Maybe you're just smooth sailing for all of you. But if you know somebody who is struggling a little bit with the buildup of tension and feeling that there's too much to do or there's starts to turn to a lot of worry or other feelings like guilt. We have some remedies, some ideas. So you are a cookbook author and I am the beneficiary of your amazing cooking all the time. You're self trained and it's an outlet for you. It's a therapeutic outlet for you. And I know that you encourage your clients and other people to develop therapeutic
[14:28] outlets. Tell me how this became a therapeutic outlet for you and how something like this could help counter some of the buildup of stress for someone at home.
Dr. Alyssa Berlin, PsyD[14:37] It's such a curious question because it's not like I consciously set out to do it. I think it was something that really just developed organically. If we go back to, you know, our earlier days, you know, at the beginning of marriage, we were, I'm sure you remember we were both in graduate school and looking for, you know, intentional time to spend together so that we didn't completely lose sight of each other. And we would do things like, you know, until we got in trouble cake decorating classes or we just found ourselves spending time in the kitchen. And it was really just a fun, enjoyable place to be. And it was really like the yin to my yang, if you will,
[15:15] in the sense that, you know, I spent all day in school and loved my graduate studies, but it was very cerebral. It was very exhausting. And the kitchen was just a happy place. It was a place that I could zone out and really invoke my more creative side. And I found that I really liked it. It was my medium, right? More than painting or sculpting. Loved combining flavors in unique ways that you wouldn't think about using things that were typically savory and sweet dishes and vice versa. And really plating, plating was the thing that I enjoyed the most, taking something and making it look pretty and presenting it in a way that was really exciting
[15:56] for other people. So, I mean, I think we kind of discovered it a little bit together.
Dr. Elliot Berlin, DC[16:01] Yeah, you ran with it. I enjoyed it mostly because we were doing it together. But you had an enjoyment of it beyond that.
Dr. Alyssa Berlin, PsyD[16:10] Yeah, I could appreciate that. I mean, you really did run with it.
Dr. Elliot Berlin, DC[16:13] Oftentimes, you know, making dinner is not fun. It's just something that has to get done. But also oftentimes you make it fun. And I think that you're always experimenting with flavors and textures and culinary techniques. And you make it fun for us and exciting. You make food exciting for everyone in the house. So much so that, you know, people will be at other houses or sometimes even out to eat. The common is, I prefer mommy's food. And I mean,
Dr. Alyssa Berlin, PsyD[16:46] if ever there's something I would love to help people. I would love to help people improve their relationship with the kitchen and to improve their relationship with cooking, help people reconcile. I think cooking is something that often scares people. There's a fear and expectation if it doesn't come out right. And it's a pity because, you know, if you have time to devote to it, it really is a bevy of mindfulness opportunities. I mean, it sometimes is surprising to me. People search for mindfulness opportunities. They'll search out a piece of grass to put their feet in it, to have that tactile experience or, you know, a really nice scent or spray.
[17:24] And yet all of that exists within the kitchen if you're not afraid of it. And yes, I don't think there is a food network game out there that we haven't played. And so, you know, my comfort being able to translate to the kids and the idea that the kitchen doesn't have to be even a solitary place. Right. Who says that it only is for the cook? I mean, one of my earliest memories of Yosef, our oldest son in the kitchen, is him making eggies on the inside of the oven alongside of me and then playing food network games and really moving towards you know, now Dina's in Israel and cooking for herself and sending us pictures of the cool, well-balanced plated meals
[18:05] that she's making for herself. So, yeah, I think it can be contagious if you can remove the anxiety and the stress. Although cutthroat kitchen not pre-cutthroat. Yes, it did. But that was part of the plan. I never took it.
Dr. Elliot Berlin, DC[18:18] Yeah, I think that's a great point. So if you have something that needs to get done anyway and you can turn that into a therapeutic outlet, there are many elements of cooking that can be meditative, almost. You know, rumor has it Russell Crowe knits on set between takes to clear his mind because he's just doing something that is almost mindless and repetitive and, you know, maybe he's counting the stitches.
Dr. Alyssa Berlin, PsyD[18:41] Just like chopping vegetables, right? Just like, you know, washing dishes. But you said something that that is my jam. That is the secret to self-care in 2025. Got to check something off of that to-do list. The only way that people will really invest in that. Yeah.
Dr. Elliot Berlin, DC[18:59] I mean, that goes back to the stress equation. If you take something off the stuff to do, then the level of stress goes down. But if you can do it in a way that's also helping your mind, you know, zone out and reset, then it's a win-win, a double whammy. It's therapy that you can eat. Well, there's some other things like that that maybe people could do at home that could be a therapeutic outlet.
Dr. Alyssa Berlin, PsyD[19:21] That could be a therapeutic outlet or specifically to like, you know, take some of the stress off of cooking specifically. But I mean, both. So I am the queen of freezing. If anyone wants to know what can freeze well or how to freeze food, you should flash my number somewhere on this podcast because I am happy to help. But but freezing is is a huge way to remove pressure from day to day. Take a step back. I very much recommend people do bulk cooking, ideally on, let's say, a Sunday or a Saturday, a day that you're not otherwise busy with the hustle and bustle of a busy week. And if you could really allow yourself to kind of set the stage and get in the zone,
[20:04] doesn't have to take a lot. Put on some music, a glass of wine, if that's OK. Or I prefer, you know, different like health shots, anything that's enjoyable to you. And then cook in bulk, right? Make a lot of food or components of a dish that you can then use throughout the week. It doesn't take more time to double a recipe truly than it does to take a single recipe. So stick one in the freezer. I can't even tell you, especially when the kids are little, how many times I would just laugh out loud, you know, in a moment of stress and, oh, gosh, and kids are going to want dinner again. And I'm like, yes, I have a lasagna in the freezer. Like, oh, my goodness,
[20:41] I figured out how to pull this off. Or we've had it a lot of times that company shows up at our door. Very unexpected.
Dr. Elliot Berlin, DC[20:47] We do get that. And it's startling. And then I don't know where you pull stuff out of. But all of a sudden, there's a meal that seems like you were expecting them and you've been cooking for days. That's it.
Dr. Alyssa Berlin, PsyD[20:58] And everyone is welcome. We are very inclusive and inviting of anyone who wants to stop by. But I couldn't do it without the freezer. And so that's huge, right? Cooking in bulk, freezing, freezing components of dishes, doing at a time that doesn't feel so overwhelming and stressful are all things that are going to help de-stress the food section.
Dr. Elliot Berlin, DC[21:19] I see people doing before they have a baby, you know, every time they cook a meal, just cook a little bit extra and put it in the freezer so that once that baby comes, you can have a couple of weeks of meals without really having to think about it and still get the more healthy and nutritious food rather than, you know, just being overwhelmed and ordering in.
Dr. Alyssa Berlin, PsyD[21:36] Totally. We did that the first time that we traveled internationally, not knowing what we'd find food wise, right? And we just kept freezing and scrolling it away. We ended up not eating it, right? We ended up getting the mad dog hookup of kosher food coming with us. But it was good and it works. Yeah.
Dr. Elliot Berlin, DC[21:51] Outside of food, are there other recommendations that you give that people could just do at home? You don't need a specialist or any big special tools for to kind of vent off some of the steam.
Dr. Alyssa Berlin, PsyD[22:02] Yeah, there's a lot of wonderful things that you can do. I mean, we could start with breath, right? Breath is often the difference between being in a state of arousal or being in a state of calm. And so focusing on your breathing. Sometimes it's harder than it sounds. And so I recommend that people kind of breathe backwards in the sense of breathing in through their mouth and out through their nose. It really stops your brain in its tracks. It really requires your brain to focus on what you're doing because it's so antithetical to how we normally breathe. And it could be really helpful and effective. Other things that we can do, you know, at home
[22:37] to relieve stress is engaging with your outside environment. So, you know, I'll talk a lot about the idea that throughout a day we're moving between two different worlds. It's the world that lives inside our bodies and then the external world, you know, where things are happening. People live, you know, there's butterflies and unicorns or maybe not unicorns, but, you know, rainbows and good things like that. And I'll think about stress or being triggered as when we fall inside our internal world and things just kind of ping pong with, you know, all the unfinished stuff that needs our time and attention. And it could be a really hard place to be.
[23:12] And so something that will really help with that type of stress is engaging with your outside world. And so one of the most common ways to do that is I'll tell clients all the time and if they're listening, I'm sure they're saying it right along with me. Find 10 colors in your world. The first few are pretty much a gimme. They're pretty easy. The red, blue, yellow, green. And then people start to have to work for it. And as soon as you're starting to scan and have to work to find it, all of a sudden we're shifting our attention from that internal world of stress and triggers. And we're now engaging in that outside world that allows us to ground
[23:46] and decompress. And just so that I'm true to all my patients, usually the recommendation is 10 colors, then five shapes and five textures. And there's nothing magical about those numbers. You do them and you feel like you're a little bit better, but still could use some extra decompression. Do it again, right? And just keep doing that until you're feeling much more grounded and much more engaged with your external environment.
Dr. Elliot Berlin, DC[24:12] That's a really good one. And I couldn't agree with you more about breath. Breath is the autonomic function that you can take over. So, you know, we have our voluntary nervous system, things that we can move, generally skeletal muscles. I can walk, talk, move my body, however I want to. And then you have the autonomic things that are just on autopilot responding to stimuli in you and around you. So, you know, if it's hot, your body will automatically try to make you colder and it controls your blood pressure and your pulse and where blood flow is moving into and away from and how open or closed your pupils are. So many different things and your breathing rate
[24:49] and your breathing depth. You don't normally think about it just happens in the most optimal way. But you can take control of your breath and that autonomic system is where fight and flight lives. It's one polar end of the mode of operation of the autonomic nervous system. When you are being chased by a tiger and you need to survive, your body does everything hardcore and quickly for survival brings a lot of blood flow to the arms and legs and away from your spine and posture and speeds up your heart rate and it opens your pupils so you can see the battlefield really every detail and you're only supposed to be there when there's an emergency when you stay there
[25:27] for long periods of time. It does more harm than good. So how do you bring yourself down? How do you reset that thermostat? And what you are saying is breath is an incredible way to do that because it's really the one autonomic thing you could just think about and do it. Say I'm going to take the reins on breath. I'm going to slow it down and I'm going to demonstrate to my body, to my nervous system that I'm not in danger and I'm not in survival mode and then all the other components have an opportunity to reset also and to move down towards the more normal function, the more maintenance area of function where the body takes care of itself instead of trying to not die.
[26:04] I recommend that. We're on the same page. All right. There's also things that people can go for professionally for help. We're going to take a break when we come back. We'll talk about a few of those things, including the buzzword EMDR. We'll be right back. Welcome back to the third and final segment of episode 450, that special, special episode where we hung out together talking about stress. Feeling within real time the stress of our daughter. Oh, yeah, we just had in the break. It's funny. How did she know? Maybe she will listen to this episode, who knows?
Dr. Alyssa Berlin, PsyD[26:51] It's so indicative of life, right? That's just how it rolls. And two parents on the same podcast, both getting attacks from feverishly. I need you now. I need you now. It's going to create a vacuum, so we'll have to decompress later together. OK, if you cook, I'll eat.
Dr. Elliot Berlin, DC[27:06] Hey, it's Tuesday day and night. Why am I cooking? Oh, you love it. All right. Segment three is going to be about professional alternatives for things that people can go see somebody for to help reduce stress. There are many, many, many, many. But you hear a lot about EMDR lately, and I know that you do it and you get great results with it. So I'd love to learn more about it and share with the audience.
Dr. Alyssa Berlin, PsyD[27:32] Amazing. Yeah. And if anyone's listening and stress, give me a holler. But I do. I love EMDR. I love how quickly we can get results compared to talk therapy or straight talk therapy. So what is EMDR? It stands for eye movement, desensitization and reprocessing. And it's a wonderful therapeutic technique. It's one of few empirically validated technique to really help process and heal trauma. It's based on the premise and uses something that we call bilateral stimulation or BLS. And, you know, bilateral stimulation is any type of stimulus that we're going to introduce that goes from side to side. You know, so the ways that we do it is, you know, through guided eye movements.
[28:16] So your eye is darting back and forth with the help of a light bar or following my hand is an example of BLS. You could do it with sound, right? Sound that moves from side to side in the body or tapping or any kind of physical sensation. And anyone who's ever done EMDR will know about the buzzy's, right? These devices that I could put in your hands and they vibrate and they take turns vibrating right, left, right, left to really activate the brain's natural ability to reprocess trauma. Helps unstick memories and emotions that get stored in a heightened stress state. And it allows the body and the brain to integrate those memories in a healthier way.
Dr. Elliot Berlin, DC[28:57] So somebody's coming in and they're experiencing all the symptoms that you talked about of stress. They're feeling overwhelmed, they're feeling worried. It's difficult to sleep. Is EMDR something that a single session would do something or is it a process?
Dr. Alyssa Berlin, PsyD[29:11] So it's definitely a process. You know, when we talk about EMDR, we say that it's an eight phase therapy. Don't be discouraged. You go through them pretty quickly. But the idea being that we're never going to go in and try to heal or address trauma until first we make sure that you have what we call resources and resources are things that you and I were talking about before. Ways to ground yourself, ways to help regulate that nervous system, regulate breathing and the different stress responses if it becomes too big and too overwhelming. And so the process of EMDR requires first taking a history. I have to know what it is that we're talking about,
[29:52] what it is that we want to target before we jump in. And it's more of a thematic history than necessarily a chronological history. I'm looking for themes, major themes that have existed in your life. Then I'm working on resourcing, making sure that if again, if at any point it gets overwhelming, then you have the tools to be able to bring it back down. And then we move into the BLS or the bilateral stimulation components of it. So if someone comes in and they say, gosh, I have one session, I'll probably focus on resourcing more than anything else and ways that they can in a very real day to day way, just bring down the overall threshold of stress.
[30:32] EMDR definitely takes more time. But again, fastest modality that I've experienced with all the different therapeutic modalities that are out there.
Dr. Elliot Berlin, DC[30:41] And, you know, there's lots of different practitioners and lots of different modalities that can be helpful. And I think everybody relates differently to the different choices and options that are available. One of the ways I know that stress is creeping up is that I've always incorporated some level of energy work into my hands on structural body work, whether it's cranial psychical therapy or reflexology or chakra balancing. But of recent, I've been getting the request more and more to do whole sessions of energy work just to help calm that central nervous system and make the mind, body and spirit more relaxed and more functional. And, you know,
[31:20] it's another powerful tool. Energy work is another powerful tool. And there's hypnosis and hypnotherapy, yoga. There's sound baths. There's meditation. Some people do really well in float tanks. There's just lots of different things that you can do in this world that just seems to have us running on high octane. And as if there is some kind of emergency going on where really the emergency is coming from the inside. The stimulus is from the inside, not the outside. And there are a whole bunch of things you can do about it. And I think that anybody knows the more grounded you feel, the more that thermostat on the autonomic nervous system is in line with reality,
[32:03] the more productive we become, the better we become at anything, including parenting, to bring it full circle. Because it's really hard to be present with your kids when you're in fight or flight mode.
Dr. Alyssa Berlin, PsyD[32:14] Absolutely. Energy healing works. And we've been the direct recipients of all these new things that you're doing. It works hand in hand with therapy. And it really helps to address something that a lot of people don't realize, which is that stress and trauma and emotions don't just affect our minds, but they deeply impact our bodies. And I'll use the analogy a lot of times for people. I mean, I'll define trauma amongst other different definitions. One is unmet needs or wants that live in our system that still live in our body or an incomplete fight or flight, an incomplete sympathetic arousal. And I'll liken it to, you know, playing a game of whack-a-mole, right?
[32:52] Where if you've ever been to one of those, you know, arcade type places, you've got the giant foam hammer and all of those moles popping up and you're in a constant state of trying to keep them down. And it's exhausting. And so the more energy that's trying to keep those unresolved, unfinished things in your body down and, you know, keeping them from intruding on day to day functioning, the less energy we have to actually engage with life. So it's exhausting before you've ever opened your eyes and got up to brush your teeth or, you know, engage with your baby for the first time. So stress and trauma deeply in our bodies. Dr. Bessel van der Kolk
[33:28] has a great book. It's a dense book for anyone who wants to read it. And anyone who's read it, I applaud you because it's a lot to get through. But I love the title, The Body Keeps the Score. And it's the idea that trauma affects the nervous system, right? We've talked a lot about the nervous system. And when trauma affects the nervous system, it leads to chronic tension. It's leading to pain and difficulty feeling present in your own body. And so any type of energy based healing that you talked about is so wonderful because it helps people be more in touch with their body and helps them then access that trauma that's locked inside. And so your work really does
[34:06] make my job easier and enhances the therapeutic process.
Dr. Elliot Berlin, DC[34:09] Well, I guess that's why lots of people see both of us for the full mind, body experience. Your whack-a-mole is a really great visual. And I think in my mind, something that I've pictured in the past is a Tupperware that's just a little too full. And you can get three corners down. As soon as you put down the fourth corner, a different one pops up and, you know, it's frustrating and it feels like can I ever get all of these down and can I get the beast contained in there? All right. So much to talk about that we could talk about, but we're almost out of time. I think that's something that I hear from our parent patients is that I want to do these things.
[34:47] I want to take care of myself. But because I'm so busy taking care of my baby or my family, I just don't feel like there's time for me, almost like there's a guilt in taking time for me. How do you address that?
Dr. Alyssa Berlin, PsyD[35:00] It's a very real struggle. We talked again about the idea that there's more to do than hours to do it. And we do need to address that paradox, which I will in a moment. It's one of the biggest struggles that parents face, that feeling of guilt for prioritizing or doing anything for themselves. I always like to start with trying to create a paradigm shift, a shift in our thinking. And it's one of helping people understand that when you take care of yourself, it's things that you are doing for your kids. It's things that you are adding, you know, to your kids. And it's not something that is being taken away from them. It's an additive thing, not a subtractive thing.
[35:38] For all the reasons we talked about already, we know how much chronic stress interferes with functioning. We know how little we have to offer and to give if we're running on fumes. And so anything that you're doing to charge your batteries is going to directly enhance your ability to parents, your experience with your kids, creating a peaceful home. It really allows you to show up as your best version of yourself. And I think that that's really huge, that that cognitive shift is step one. Recognizing I'm doing this for them. You know, it's also and I remember, you know, almost 21 years ago when we had Yosef, when we were new parents, I remembered you asking someone,
[36:19] like, what's the secret of parenting? And they were very clear with you and they said, if you want your kids to do it, do it. Because kids will model what they see. So as much as I could tell my child, hey, it's really important to nurture yourself. If they don't see me doing it, they'll be like, oh, got it. It's something that sounds good. I would make a nice bumper sticker, but we don't actually do it. And that's usually something that helps kind of give parents a little bit of a nudge in the direction of doing something for themselves, because parents are very clear that they would not want to pass on this method of existing or this mode of existing to their kids.
[36:54] And so if we want to create change, it has to start with us. We can talk about trying to approach self care, not as an extra, but seeing it as a maintenance thing. And I do think that, again, the secret is if you can check something off of that to do list and it could double as self care, then you're going to navigate how to be ahead of the game. And so, you know, I can't say that, you know, our sweet little Aussie doodle always gets the robust walk to get on a daily basis. But definitely in moments where I'm like, OK, this is my opportunity to get a little bit of exercise and get a little bit of fresh air. Having him there to kind of nudge me out the door
[37:35] can be really helpful, because, again, right, feeding two birds with one seed.
Dr. Elliot Berlin, DC[37:39] Well, thank you very much.
Dr. Alyssa Berlin, PsyD[37:43] So it's really hard. It's really, really hard. We are a generation that's kind of stuck between the old generation that things are only worth it if it hurts and if you sacrifice. And on the other side, the generation that says, I don't do it unless I like it and it feels good. And so we're navigating how to bridge those two.
Dr. Elliot Berlin, DC[38:03] I love it. We could go on. I guess we'll have to do another one, maybe four seventy five or five hundred.
Dr. Alyssa Berlin, PsyD[38:10] I'm holding out for a date first,
Dr. Elliot Berlin, DC[38:11] but sure, I could be persuaded. Honey, thank you so much for joining us. If our listeners want to find out more about you and your work and your cookbook. Cookbook is on Amazon plated Dr. Alyssa Berlin and your psychology work is on our website, Dr. Berlin dot com D O C T O R B E R L I N dot com. Thank you again for joining me and at home. Thanks for listening. If today's episode resonated with you, see what I did there. Share it with someone who might need it. Stress, anxiety and the burnout are real, but there are ways to reset and find balance. As always, thank you for tuning into the Informed Pregnancy Podcast. If you enjoyed the episode, don't forget to subscribe,
[38:54] rate and review. It really helps us continue to bring you valuable content. Until next time. Stay informed. Stay empowered and stay tuned.
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Jennifer Campbell, a mother of eighteen (18!), might have the most unique background in birthwork. She discusses her work as a certified birth, bereavement, adoption, and surrogacy doula, childbirth educator, certified lactation educator, including how she’s currently pursuing her IBCLC.
“Where I felt alone and my goal was that you know people shouldn't have to feel alone When they're going through pregnancy labor and delivery”
“Oh, they're so lucky to have you and that's not true and that's not how they feel a lot of them feel like they've lost Everything that they had and you're not this big blessing coming to save them But I was sure lucky to have them”
“You can't save the whole world you have to really decide what you can handle and stick to that”
“But just like with me going through birth and feeling alone When you're losing a baby, you definitely don't think that there's anybody there for you and they give you all the information”
“That's the best for them and that's not always me and that's okay I just want to get them to who and what they need in order to answer any questions that they have”
AI-generated transcript with speaker labels — may contain errors, especially names and medical terms. Dr. Elliot Berlin, DC appears in blue; Jennifer Campbell in orange.
Dr. Elliot Berlin, DC[0:36] Welcome to the informed pregnancy and parenting podcast. I'm your host pregnancy focus chiropractor. Dr. Elliot Berlin Today's guest has one of the most unique backgrounds in birth work She's a certified birth bereavement adoption in surrogacy doula a childbirth educator and a certified lactation educator Working towards her IBC LC and also she's the mother of 18 kids Jennifer Campbell Welcome to the podcast. Thanks. Nobody heard anything else except Want to get to all of it let's start at the beginning where you're from originally and how'd you get into the work that you're
Jennifer Campbell[1:11] Doing originally I'm from Rhode Island, which I don't think anybody's asked me. That's crazy. I was born in Rhode Island in 1970 I got into the work because of the same reason most people do I got pregnant my first time I Went through about 10 months of infertility had a very rough pregnancy was kind of set up to know that things might be a little challenging for me and I was planning on delivering at a birth center with a nurse midwife and she looked at me at 37 weeks trying to stop me From being in labor. I've been in bed rest for a week and she said you can choose Dartmouth Hitchcock Medical Center or Burlington Hospital and I chose Dartmouth and
[1:49] I showed up that day never having set foot there never having met anyone had a baby 19 hours later. I was told that when she was born They would do a bedside evaluation and if she was really critical for some reason she had IUGR a growth restriction and Just things were not right, but nobody could figure out exactly what wasn't right or why and the OB even said You know, it's always a crap shoot. Will she do better inside you or better outside of you? We don't kind of know that but you're 37 weeks and your labor has been getting stopped So why don't we just let you have her and they also asked me if I minded students and residents which I didn't
[2:27] So when I started to push the hot button was hit and I looked up and there were 23 people in my room And I was like, well, welcome to the vagina show So they did an evaluation they took her away so I knew if they left they were doing life-saving procedures I didn't hear anything for nine hours when the head neonatologist came back and said that she was the most critical baby She was four pounds four ounces she was born with severe hyaline membrane disease and PDA which is the valve between the heart and the lungs that didn't shut when she was born and Ended up with secondary pneumonia. She told me the first time I would hold my daughter was after she had died
[3:10] So when they released me at 24 hours, obviously not going to Ronald McDonald house I was sleeping in waiting rooms and a nurse found me on day three Took me to the nurse's station had me shower sat me down in the pump room got the lactation consultant she hooked me up like I'd been pumping but I didn't know what I was doing I'd never seen a breast bump and she touched me on the leg and she said tell me about your birth experience and I sobbed for 20 minutes because nobody in three days had asked me how I was and After that she showed me how to store everything made sure I was doing it everything correctly That was the night that my daughter turned the corner. She turns 33 on April. Yeah
[3:45] So, you know happy ending she was in the hospital for a month I breastfed for a year and a half But I had a situation that was pretty traumatic really hard really hard You know a hospital birth after thinking I was going to be at a birth center with a midwife So I'm back up to that. Yeah you before all the experience that you have. How old were you then? 21 21 and oh at 21 years struggled with fertility Yeah, I had gotten I was the it was the silly You know got married at 19 guy in the service who wasn't even able to be present for the birth had no periods No pregnancies nothing for a year. So I got switched automatically into infertility because for one year nothing happened
[4:26] You know, I was either a menoretic or I wouldn't have a cycle or I would have one that would leave me hemorrhaging in The hospital I had cysts that were rupturing. So from the time I was just before I was 16 I had had issues. I've been on the pill You know just trying to basically manage things until I got old enough to try to figure it out Interestingly that 33 year old daughter cannot have children of her own and has gone through all the same Infertility tests that I did it's basically trying to figure out what's wrong when you really don't have any clue So flushing fallopian tubes taking Biopsies from your cervix and the inside of your uterus and you know
[5:03] I went through seven day surgeries and was maxed out on clomid and provera to regulate a cycle and We got to the point where the infertility specialist said your IVF is maxed and I said, no, thank you Wave in the white flag. It's not my path I would rather adopt kids then go through IVF and he was weaning me off and he told me One day was this little Asian guy in Hawaii where we were stationed and he came in and he hugged me and he said This is your miracle from God. You shouldn't be able to get pregnant. You got pregnant off the cycle We put you on I don't know how it's possible You have a high chance of miscarrying because of your hormone levels and you can expect tough pregnancies
[5:45] So, you know from the beginning I was anticipating the very real belief that I wouldn't be able to have biological children of my own and When she survived the lung disease and I brought her home I just realized I really didn't care if I got pregnant again, so I never used birth control I did get pregnant seven times total had four babies and lost three pregnancies for babies My seventh pregnancy. I was twins twins at 16 weeks Yeah, which resulted in a DNC and then a hysterectomy at 33 so my biological journey was pretty intense from 15 to 33 and You know my kids joke because I have 18 obviously So I did do foster care for 12 years and then I worked to recruit and train foster parents to work with treatment level kids
[6:38] so I was involved in foster care for 15 years and It's a very open family and you know, one of my daughters was like I hate pineapple and the oldest one was like How can you hate pineapple? What were you adopted? She's like, yeah, I was adopted weren't you like mom chose me special You were a crapshoot So we just had a really good open fun relationship about that and really for me though people would say oh you took on all These extras, but they were planned the extras really were the kids that I was able to you know Keep a pregnancy with and give birth to and the next three deliveries were fine. They were at home to water births I kind of got everything that I wanted in the gamut of biology
[7:18] But foster care really was the expectation that I had when I was going into that parenting journey
Dr. Elliot Berlin, DC[7:24] so at 21 Especially with the things you had been through What influenced your desire to have a baby outside the hospital? Oh my gosh, that's a fantastic question
Jennifer Campbell[7:36] I don't know. It's kind of the same thing where I knew I was gonna breastfeed I remember seeing one of my aunt's breastfeeding. I think that there's something in me that just has more of this natural Disposition I was also more afraid of an epidural than I was of the labor pain And so like lots of things go hand-in-hand although in that first delivery The nurse finally wore me down and I said I get the epidural and the anesthesiologist came in and he put the needle in My back and he took it out and said she's pushing so, you know I got stuck by a needle in my back, but I didn't ever get the epidural But I would have and I knew then my mother and my 18 year old sister were present for that delivery
[8:14] Don't necessarily recommend that although my sister was there for three out of four. She was great But just wanting to have support from my husband at the time who I really wanted to have there who couldn't be and then Feeling like I had no clue and I was unsupported I felt very alone and I felt that way through the labor and delivery and I felt that way You know through the days after my daughter was born, but I had a hard but really positive hospital experience And A year after she was born. I was a breastfeeding counselor and I was in birth work So I think that a lot of people get into birth work because they have a traumatic experience and don't want anyone else to
[8:58] Have a traumatic experience. I didn't feel like I had a traumatic experience I felt like I had an overwhelmingly positive but challenging experience Where I felt alone and my goal was that you know people shouldn't have to feel alone When they're going through pregnancy labor and delivery It's not a time that's comfortable to feel alone And I think that's why so many people feel steamrolled or railroaded during their labor and delivery. So that led you to Do the work it led me to Being an apprentice with the midwives that I chose for my next three deliveries So I worked with them off and on for about seven years I was involved with breastfeeding and birth work for 12 and seven of that was with them and
[9:39] My goal was to be a lay midwife at the time and you know things happen life changes. I did a lot of foster care I was adopting kids. I moved I was divorced and so that moving and getting divorced Situation made it so that I had to go back to a more corporate job and I gave up birth work and that was Devastating it was the toughest most challenging couple years of my adult life And then a few years ago my husband were I'm remarried for 11 years and he said You are the happiest person. I know but you don't do anything that fulfills you Why don't you go back to doing what fulfills you so I got the gift of being able to go back to birthwork again
Dr. Elliot Berlin, DC[10:21] Wow Yeah, and it's not just a gift for you. It's a gift for everyone who gets to work with you
Jennifer Campbell[10:26] Thanks. I did a delivery last night
Dr. Elliot Berlin, DC[10:31] All right, well that's a great place to take a little break when we come back I want to find out how you got into foster care and adoption and What that experience is like because a lot of us don't know so let's take a little break and we'll be right back
Dr. Elliot Berlin, DC[10:54] Welcome back. We are talking to Jennifer Campbell a traumatic first experience mostly unsupported You didn't have the people around you that you wanted led you to Wanting to make sure other people are supported in their experiences and then a midwifery trail turned Well combination of midwifery lactation and then do the work and you do all sorts of unique to the work Now, of course, you're not just the plain old birth to look you've got a lot more going on than that But before we get to that foster care and adoption what led you down that path and are the biologicals all together? And then the adoptions afterwards or they're intermixed. No, they're all interspersed after Brie was born
Jennifer Campbell[11:33] I wanted to do foster care So by the time she was between three and four we were licensed for foster care I got pregnant twice in there in law had two miscarriages in there and You know, those were within the first 12 weeks and easier I think because I had an expectation that I would have a higher risk of miscarriage and I was okay because my goal was foster care. I grew up pretty dysfunctional probably should have been in foster care Definitely should have been in foster care on more than one occasion And I had a third grade teacher that made such a pivotal difference in my life That even though things in the house after third grade got worse. I knew I was worth it to her
[12:15] She was a really amazing example And I think between that and not being sure if I could get pregnant and feeling okay about that I thought if she could make a difference to me in passing as my teacher just kind of doing her job Then what if I did that with more intention? I wanted to do the foster adoption program and I lived in Alaska at the time and I wanted kids to know that when they came to the house to my house, it could be their last stop and At the time I had given birth to the four kids and I'd had four adoptions and they were all interspersed in there and Then two kids one a foreign exchange student that had stayed with us for quite a while and then one foster child
[12:57] That stayed with us for long term So we had ten kids and that's when I was divorced and I continued to do foster care and I took in a sibling group of four They were great I gave up I moved a divorce. I was single I gave up birth work. I was working two to four jobs I kept doing foster care. It was a really tough time at first, you know making that transition But then by the time I started foster care and took in this sibling group. I was doing better They were worth it. So I think that's the biggest point here is that it was hard and they were worth it and That had been my goal that they could come and they could stay so I did two more adoptions of that group and
[13:43] Yeah, you know I was single and again that oldest daughter man about over 11 years ago She and a good friend of mine We all worked together and they decided my picker was broken and started fixing me up on dates and one of the dates That I went on which was Dane and he had four children and his wife had died So we blended my 14 and his for although I only had nine living at home at the time when we met Well out of 14 nine doesn't seem like a big deal and then one moved out and then he moved in so I've never Had more than 12 kids in the house at the same time But 10 to 12 I've had in and out and off and on for years. I've also never had more than 12
[14:28] We're like twins 20s. Yeah, so I think that tangent it a little bit but my goal was to make a difference like someone had in my life and That was my driving force behind foster care and having it be the adoption program meant that those kids knew that this was The last place they'd be bounced to I wanted kids whose they're called free where rights have been terminated and they're free for adoption They're open for adoption and that didn't happen all the time and I had lots of kids in and out You know, I mean it wasn't I only take these and nobody else can come in I don't know how many kids that were in and out of the house over all the years that kind of came and went
[15:05] But the core of them were those 14 for me. So yeah, it was hard and it was great. It's worth it It's a tough system It's very broken and you have to really want to do it and want to make a difference and to do that You have to get out of your own way people are like Oh, they're so lucky to have you and that's not true and that's not how they feel a lot of them feel like they've lost Everything that they had and you're not this big blessing coming to save them But I was sure lucky to have them
Dr. Elliot Berlin, DC[15:33] I wonder because is some of the fostering you do with the goal of getting them back to their biological parents
Jennifer Campbell[15:41] reunification I preferred termination so kids who had the rights terminated the parental rights were terminated or they were headed that way and That's just because I wanted them to come in my home and stay I did work with reunification on several occasions and That takes a different mentality and mindset. I think and it's hard It's really hard to kind of let go and hope things go well and know that there's a high chance that they won't But that parent deserves to have that chance. So I did do some reunification. Yes
Dr. Elliot Berlin, DC[16:14] For someone considering fostering or adoption any thoughts on like what makes somebody a good candidate or not? Such a good candidate and like first steps or places to look for information
Jennifer Campbell[16:26] You go to the county website usually and they have training courses So that's the first step in wanting to do it My first advice is if you're considering it and you think you want to just do it You don't know until you kind of get there. So go through the 27 to 40 hours of training Ask all of the questions Make the decision based on going through the process. You can become licensed first You can decide not to become licensed if you want to you have to go through with all the classes in the home studies You can decide to be licensed and you don't have to say yes. I said no, it's remarkable I said no more than I said yes to kids coming in my house. They weren't the right fit
[17:04] I knew they weren't the right fit and I said no and there's nothing wrong You can't save the whole world you have to really decide what you can handle and stick to that Knowing that that may shift a little I said I would never take kids that have been sexually abused Because I had children that were in the house already, but I took several kids that were sexually abused So really set your limits But then be open to the situations that don't maybe look the way you think they're going to and I've also have foster Kids where I've made the call and said this child needs to be picked up today And this is a situation they should be put in this is a child who can't be around young kids or whatever
[17:41] So I think you know your limitations and you speak up for yourself and for these kids and you don't take things that you Don't feel comfortable with but you can make an enormous difference in the life of someone, you know
Dr. Elliot Berlin, DC[17:54] Thank you for sharing that let's shift a little bit towards your do the work I mentioned in the opening lots of different subcategories of doula bereavement Adoption surrogacy and then on top of that childbirth educator and your lactation or you know I think we talk a lot on this podcast about typical doula birth work postpartum doula work Tell me more about bereavement adoption and surrogacy work
Jennifer Campbell[18:21] With adoption and surrogacy three of the kids that I adopted of the six were newborns I was at the hospital one. I got called on the day that he was born and The other two I was actually at the hospital one was a c-section So I waited outside of the surgery room and the other I was actually her doula for her birth and I cut the cord So I breastfed all three of those babies the first one. I was an IBC LC So I was a lactation consultant. I had a lot of support and knowledge and the first baby I had a one-year-old that I was breastfeeding So basically I took him home and just latched him on and went from there the next two Relactated for I took medication to induce lactation and I used an SNS a supplemental nursing system that you put the milk in it
[19:06] And hangs around your neck and there's a little tube So they latch on to you in the tube and it was amazing. So I had had those experiences When I went back to birth work a few years ago I didn't go the midwifery route Like I thought I would just pick up where I left off and become a lay midwife But things had changed I live in a different state The political climate over it in this state is a little different and I honestly just didn't want that kind of liability So I went in to do the work. It was faster. It was easier. It was less expensive. It's a lot less liability I'm a non-medical provider. So it's been really fun because I can do a lot more with it than I could have with midwifery
[19:44] With adoption and surrogacy, I think for my time in foster care and adopting three babies at newborn. I'm good at it I'm good at adoption. I'm good at understanding There's a birth mom who's going through a lot and there's an adoptive mom that's going through a lot Surrogacy is absolutely no different except that the pregnancy was planned. It's not that person's Biological child but they're physically carrying a baby to turn over to someone else So they mirror each other as far as the needs of the pregnant woman and the needs of the parent That's getting this infant and I love it because I've done it and I think it's exciting There's different challenges in it different emotions
[20:27] Postpartum is handled differently, but it's really fun and It's really helpful the women who are choosing adoption and we have a lot of programs here to support women Who are struggling and want to keep their baby which they didn't have 20 plus years ago when I was adopting So if they don't want to take the option or the avenue of trying to seek the help and support they need to keep Their own baby and they make they elect to do an adoption Then I understand the emotions behind that so I just felt like it was an easy place that's unique But that I have some very personal experience in and I've done several surrogacies and a couple adoptions
Dr. Elliot Berlin, DC[21:08] And it's been really fulfilling. I have so many questions for you about Surrogacy it seems to be rising in popularity and it's interesting. There's a lot of moving pieces Let's take a little break and when we come back, we'll try to learn more We're talking to Jennifer Campbell and you know, you paid for content in a podcast. This would be Value episode you have so much experience and information You're talking a little bit about the unique doula specialties so to speak and you were talking about surrogacy and it's really interesting Surrogacy, I mean you have two people that need support kind of during the pregnancy during the birth and postpartum and
[22:01] Really different experiences. So if you look at it from the point of the intended mom who is Expecting but not pregnant. That's a whole set of interesting feelings usually and as your doula Do you work with them during that time?
Jennifer Campbell[22:17] Yeah Not to do with the birth but to do with the pregnancy Yes, I do two prenatal appointments and they can all be there and sometimes that's the case the surrogate and the intended mom Are both present. Sometimes it's Predominantly the surrogate who's going through the pregnancy But for sure and even if it's an expected adoption I was in a birth six months ago and it was a planned adoption and the birth mom changed her mind like 20 days later when she was still in the hospital and so Working with that family the intended family that had spent ten grand in attorney fees knowing that it could fall through There's a lot of emotion. There's a motion of maybe not being able to carry a child
[23:01] definitely in surrogacy often in adoption or Just the uncertainty the lack of being able to control anything You know the intended mom's always the one like well, when do you think she's gonna go into labor? Like I'd be a billionaire if I could wave that man you know, there's a lot of hope and excitement and wanting the baby in your arms and appreciation for this woman who's going through this with her body and also Wanting the baby and is she gonna breastfeed and you know, it's a lot of different emotions We set up the birth plan differently based on whether both are gonna be in the room You know that the mom who's pregnant is gonna have the baby and they'll put the baby on her stomach
[23:42] And then usually the intended mom will cut the cord and then sit in a chair and do the skin-to-skin I mean, there's this whole different process of how things happen when you're Splitting a labor and delivery into two women as opposed to one right and also, you know
Dr. Elliot Berlin, DC[23:58] When you talk about a birth plan, let's say birth intentions Some of the things that go into that planning are about the person carrying the baby Correct some of them are about the baby and so those decisions are essentially being the wishes of two different people and I could see how that might get complicated sometimes like if let's say an induction is recommended and It's recommended they say because we need to get that baby out for X Y or Z reason But the surrogate doesn't really want to be induced, you know or things like that I could see how that can be really complicated
Jennifer Campbell[24:35] Their conversation similar to something more traditional like, you know when I was pregnant and married to someone so my husband and I having those Conversations it's similar in that that it's generally the two moms Having the conversation instead of the mom of the dad, but there are things that are common like, you know I'm totally okay It's your body if you want to get an epidural But I'm not comfortable with you using narcotics because it passes the blood-brain barrier to the baby So there are definitely conversations like that that happen and part of that is your surrogacy contract initially and You know, some people are great at navigating that and some are less
[25:16] Sometimes the intended parent is not present for the labor and delivery So I've done them all different ways but I love when they're both involved the most because they can really talk about how they feel about it and There's a lot of gratitude from the woman who is intended because you know on the last one Delivered just a couple weeks ago. I had a surrogacy deliver and She had her first baby was IVF and born and then she miscarried twice with two IVFs And they had one shot left and she knew that she wasn't the best candidate and it was her sister-in-law That they asked who ended up being the surrogate who had her own child with you know, the intended mom's brother
[25:56] So that was a really interesting dynamic because I had two couples It was a sister and brother and the brother's wife was carrying the baby Their dad was there through some of the prenatal appointments You know, it was really great and I've had others where it's just the surrogate and I alone in a room and I'm it I'm all she has and then baby gets handed over to the intended parent so there can be a lot of conversation and You know in this last case There was a lot of gratitude because she'd been through three pregnancies and two losses herself and They had one embryo left and she knew she had one shot and her body wasn't the best to do it So, you know, it's really incredible. I love doing them. The needs are very different
[26:38] So you just have to be aware of that, but I knew that because I had gone through three adoptions So yeah, that one was easy and fun and then afterwards you have two very different clients
Dr. Elliot Berlin, DC[26:48] Also one who just went through a pregnancy and a birth and her body's expecting what comes next but it isn't and One who hasn't been pregnant and didn't give birth but now has a baby and you know Both of those probably seem confusing to the body. Yeah And the baby. Yeah. Yeah as well So just a big orchestration of things that need support all around very interesting sub segment of doula care You also do bereavement
Jennifer Campbell[27:17] Yes, tell me about that. I had three miscarriages and like I said that last one was twins at 16 weeks it was very traumatic and You know I think it when you're in situations that you haven't experienced before and you don't necessarily even know the questions to ask You don't even have the information I didn't know I could keep the remains and cremate them up because until recently you couldn't cremate remains below about 16 weeks gestation and under 20 is considered hazardous waste, you know, I mean, it's like it's not A baby, right. So I think I didn't have any type of closure I also had a hysterectomy and it all saved my life and You know, I lost the babies. I couldn't save the babies and I did get saved myself
[27:57] I mean I ended up open hip to hip had five blood transfusions They used the machine to suction the blood out of my stomach and three of the blood transfusions for my own blood recycled Back into me. I was dead on the table. It was a very traumatic three surgery process And it was traumatic to lose twins The whole thing was pretty awful and I kind of walked away like like you're not pregnant. You don't have babies I was only 16 weeks. So nobody really pays that much attention to it and that sort of Sadness, I guess doesn't just go away that loss. You just keep that with you So when I went back to birth work and decide I go the doula route I heard about a bereavement class and I think it's one of the hardest classes
[28:40] I've ever had to take because you're your own client first and You have to figure out how to work through the loss I had to work through the loss that I had in order to be able to turn around and really Support someone else going through that loss. So I'm called in sometimes on fetal demise My birth last night. I had gotten called in on her miscarriage a year and a half ago Baby was born about seven weeks ago and I was there for their 25 week delivery fetal demise And so one thing that happens is that you have to be really clear and okay with your own grief Sadness trauma, whatever it is Because you can't support anyone else if you're not real clear with that
[29:25] But it also gives you a level of compassion and empathy Like there's not a woman who has gone through this that I don't understand where she's at We may not respond exactly the same or react exactly the same the situation is not the same But just like with me going through birth and feeling alone When you're losing a baby, you definitely don't think that there's anybody there for you and they give you all the information At the hospital and you can't even read through pamphlets After I did all my training one of my daughters was pregnant and she called me one morning I'm in Reno, Nevada and she's in Arizona about 14 hours away and We were on the phone FaceTiming and she looked up at me
[30:05] she was going to the bathroom while we were chatting because you know, that's just something we do and she said mom I'm bleeding and I was on the phone with her that day and the next day when she passed her baby and Going through it myself is not nearly as bad as watching your daughter Lose a child in front of you and not being able to stop it and she was in her first trimester So you can't cremate and I was calling funeral homes trying to figure out like how can we take this fetal tissue the fetal remains the placenta and the baby and cremate it and one of the women at one of the mortuaries said Have you talked to somebody who does placenta encapsulation and I immediately knew who we would reach out to it was a
[30:48] Dula that lives near my daughter that I had heard about we had kind of been connected She was gonna be her doula for this baby's birth and she did placenta encapsulation she and I got on the phone and created cremation for babies born under 16 weeks gestation and she now does that as part of her business and my daughter's baby was the first cremation So I know again that was a tangent But I went through my own experience and realized that because I have that I also lost my son eight and a half years ago at 23 and When you have gone through grief and loss and you come out of it the other side Definitely changed but handling it fairly. Well, I think especially in birth work
[31:34] It's just that heartfelt work. You want to help other people you want it to be faster easier and more supported for them You want to give them information and having just finished that class and then have my daughter have a loss I realized it was very easy very quick to realize where the gaps in my training were and The biggest thing was being able to cremate so We have an answer for that now now when people contact me and they're under 16 weeks I can send them and my friend Emily in Sierra Vista, Arizona You can send her your remains and get cremation and then through this process of creating this with her and her doing this For my daughter. She said, you know, Jen, you never had anybody do that for you
[32:17] What if I created remains which obviously they're not from fetal tissue But I sent them to you to represent the babies that you lost and she did that for me Which I mean at the time I was like, yeah, you can do it. That would be fine But when I got it in the mail, it felt a little different So it's just a representation of the loss that you have and naming that baby Feeling like you have something tangible from the grief in the loss that you're trying to manage So it's a really hard part of what I do. I don't charge for it. It's pro bono and When I get called in I get called in when I get a referral and on my website I created the grief survival guide and so it's kind of a DIY
[33:01] You could have a loss 20 years ago you could have a loss two years ago and you can kind of go through this and I take people through the steps of How to get your medical records how to understand them how to deal with how some of what is said in your medical Records because women who miscarry don't want the word abortion in their medical records and it is it's a special spontaneous abortion So kind of dealing through that putting together some of the puzzle pieces of what happened in that pregnancy and then healing from it naming the baby Creating something like you know The little baby booties that you picked out for them putting them in the shadow box and hanging them up creating your own birth
[33:39] Certificate that you don't get before 20 weeks So it was just a way after going through the process myself to help other women heal Who are one out of four women, you know pregnancies and in miscarriage in the first trimester Most of them are in the first trimester. So this is not a little thing It's not something that happens infrequently and to be able to give them the ability to process through that better and recognize it I went a long way in healing my own grief
Dr. Elliot Berlin, DC[34:07] There's so many different types of support that you offer to so many people who need the support I learned a lot really I've been doing this for 20 years and I learned a lot by talking to you today. Thank you. Thank you Jennifer where can people find you online?
Jennifer Campbell[34:23] Dula in Reno calm is the website. It's my email I'm Janet Dula in Reno But basically if you go onto the website You can hit the contact form or comment on something and that's the easiest way all my social media links are there I'm Dula and Reno on Instagram on Facebook page. So pretty consistent to find me And do you offer some of these services virtually? Yeah, actually, you know, there's childbirth education I volunteer that for a place called real choices here in town So it's free to the community and my times volunteered childbirth education classes are easy to do virtually prenatal classes getting people Connected to the resource or what they need
[35:01] That's easy. You don't have to live right here near me for me to connect you with resources I think you know part of one of the classes that I've gone through was to create a resource Database and that just became massive for me. I actually have four different resource pages. So there's one for adoption and surrogacy bereavement Pregnancy and then the grief survival guide So two of them are devoted to grief one of them has resources and one of them takes you through the guide to kind of go through your grief and loss on your own and So a lot of that can be virtual I think what happens most of the time is people reach out to me and I want to connect them to the person
[35:40] That's the best for them and that's not always me and that's okay I just want to get them to who and what they need in order to answer any questions that they have
Dr. Elliot Berlin, DC[35:50] Amazing Jennifer Campbell, thank you so much for joining us today at home Thanks for listening to the informed pregnancy podcast for more pregnancy and parenting information just like this Visit us online at informed pregnancy
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“Birth doulas are often described as providing educational, emotional and physical support during labor, birth and postpartum. I would also add advocacy into that mix, frequently partnered with training in trauma-informed care and anti-racism…”
What is a doula? Interestingly enough, this question can be difficult to answer directly, and for many reasons. Some would say a doula is an advocate, while others would sum up a doula’s role as “witness.” Some might describe doulas as comforting, soft, and supportive, while others might hire a doula because they want a fierce, bulldog defender or tough-loving coach.
There is also the word’s problematic origin—“doulē” which is Greek for “female servant” or “female slave”—and the fact that some people might want to take a step away from this etymology. In fact, “doulas” as we know them in the modern western world have been called many things: In ancient Greece, “maiai” (meaning “great” or “mother”) would attend births, taking on both the role of a doula and a midwife. Supporters or guides of birth might be called “birth attendants” or “wise women” in places like South America or Africa. Some doulas in North America prefer to call themselves “birth coaches” or “birth keepers.” There are many times I see my work as a doula as “companioning,” a term I borrowed from Dr. Alan D. Wolfelt’s keynote at an Association of Death Education and Counseling conference in Chicago.
And yet another element spicing up the answer to this question is the definition of a doula as a “guide through transition.” These days, we see doulas helping people through many different transitions: In addition to birth and postpartum doulas, there are death doulas, adoption doulas, abortion and loss doulas, divorce doulas, and the list goes on. As a person passionate about cycle education and empowering women to have healthier and happier periods, I’ve considered also taking on the title of “period doula.”
But I was asked to write for Dr. Berlin’s blog, which gives me the hunch that many of you are here to learn more about birth doulas and what exactly we do. Birth doulas are often described as providing educational, emotional and physical support during labor, birth and postpartum. I would also add advocacy into that mix, frequently partnered with training in trauma-informed care and anti-racism (critical elements of our work, considering over 50% of women will experience sexual violence involving physical contact in their lifetimes and BIPOC birthing people are 2-4 times more likely to die in childbirth compared to their white counterparts.)
Often we meet with parents early in their pregnancy journey (sometimes even before) and help them navigate the ins and outs of prenatal care and birth plans or preferences. As their due window approaches, we equip them with comfort measure tips, self advocacy tools, and the risks, benefits, pros and cons of any option they may consider. We are there as family-centered support, a listening and affirming ear, and a comforting, warm touch. We protect and preserve the “labor bubble” by keeping the lights dim, encouraging privacy, and mediating where needed.
Many of us are also nerds. I’ve heard it said that “OBs are surgery and high risk experts, midwives are physiological birth experts, and doulas are labor experts.” We’ve got tools in our pockets for an asynclitic baby, a sunny side up baby, a baby stuck too high in the pelvis, a stalled labor, and the oh so dreaded back labor. But don’t rush to put us in the “crunchy only” box just yet, because we’ve got other cards up our sleeves—Doulas can assist with productive epidural positions and acupressure, or help clients advocate for a family-centered cesarean birth, too.
All this said, doulaship is not a regulated profession. There are certified doulas and doulas who choose not to certify. There are doulas who choose to only attend hospital births and doulas who specialize more in physiological or out of hospital birth. There are doulas who will pray for you and doulas who will push you, and doulas who will do both! This is why it’s important to think about why you want a doula and how you see one supporting you.
Meet with 3-4 doulas and ask them prepared questions. It is important to find a doula who feels like the right fit for you—not just the one who knows the right maneuvers, but the one whose presence alone makes you feel how you want to feel as you bring your baby into the world.
And while we’re discussing what you might want in a doula, it might be important to point out a few things that doulas do not do: We do not do anything medical like take vitals or perform cervical exams. We do not replace midwives. We do not replace your partner. We cannot promise a perfect birth or a birth exactly how you planned it. And lastly but actually very importantly, we cannot have your baby for you. Instead, we strive to equip you to birth positively and confidently.
Midwife Ashley Booth Young once said “Although the popularly desired outcome is ‘healthy mother, healthy baby’, I think there is room in that equation for happy, non-traumatized, empowered and elated mother and baby.” And I think that encapsulates the united goal of doulas beautifully.
Need some questions to ask potential doulas? Here are a few to help get you started:
1. What got you into birth work and why do you do what you do?
2. Do you work with a back-up in case you can’t attend my birth, and can I meet them ahead of time?
3. I’m particularly nervous about ____ happening. Can you walk me through how you would support us if it were to happen?
4. What do your services include?
5. How would you describe your practice in one (or three) words?
About the author: Eryn Shaffer Davidson is a doula based in Waco, Texas. She is certified through Carriage House Birth and is also training to become a childbirth educator with Evidence Based Birth. Beyond birth work, she is passionate about empowering women through the entirety of their reproductive journeys, and could go on for too long about how periods shouldn’t hurt and how contraceptive options extend far beyond the pill.
An avid Informed Pregnancy Podcast listener, she is driven by the desire to see women fear birth less, and instead experience joy, support and clarity in their bodies and their choices. She dreams of a world where the evidence-practice gap is a little smaller, and collaboration between home birth and hospital providers is the norm. When she’s not at a birth, you can find her working with production company Stork Films, reading the latest Evidence Based Birth article, detoxing in a hot yoga class, or watching Grey’s Anatomy (seasons 1-8 only.)
