Pregnancy, Birth, Postpartum & Burnout With Diana Spalding of Motherly

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Hello, and welcome to “The Wellness Mama Podcast.” I’m Katie from wellnessmama.com and wellnesse.com. That’s “wellness” with an “E” on the end, which is my new line of personal care products including hair care that is food for your hair and a naturally whitening toothpaste that gives your teeth the minerals it needs. This episode is about all things pregnancy, birth, postpartum, and avoiding mom burnout. We also talk about the language of motherhood and advocating for what you need during all of those different phases. I’m here with Diana Spalding, who is a digital educator and editor at Motherly, and also a certified nurse-midwife, a pediatric nurse, a TEDx speaker, a mom of three, and the author of “The Motherly Guide to Becoming Mama.”

And I hope that you will enjoy this wide-ranging conversation about all things motherhood. Diana, welcome to the podcast. Thanks for being here.

Diana: Thank you so much for having me. It’s such an honor.

Katie: I think this is gonna be just a super fun chat about all things related to pregnancy, and birth, and motherhood, which are all some of my favorite topics. But with any new guest, I always love to hear a person’s story. And I know that you are a midwife, but I’m really curious and would love to hear how you got into this world, and especially now being the author of a book called, “The Motherly Guide to Becoming Mama,” how did you enter this whole world?

Diana: Yeah, you know this has been a journey, for sure, and not one that I ever could have predicted, but one that I feel so lucky and excited to be on. I am the daughter of a midwife. My mom has been a midwife. She’s retired now, but she was the director of the midwifery practice in Boston for 30 years. So I grew up around birth. And I never actually outwardly at least wanted to be a midwife because that was always her thing. But looking back at it, I realized that, you know, I’ve always been destined to be a midwife. I used to line up my, like, dolls and teddy bears, and instead of having, you know, like tea parties or whatever, like normal kids do, I used to, like, deliver their babies and have them sitting on my bed, and I’d be like, “Push, push.” So I’ve always been a midwife at heart. But I went to undergrad and studied anthropology, and fell in love with public health, then I decided to be a nurse. And so I worked as a pediatric oncology nurse for five years in the Bronx. And during that time, went back to grad school, thinking I was gonna go to become a pediatric nurse practitioner, but I took one class in midwifery to, like, check it out, and I was like, “Oh, okay.” So I switched over and birth has had my heart ever since. I then worked at a hospital in New York City for a few years. Then we moved to Pennsylvania, and I started a Motherhood Wellness Center.

Because I felt like, you know, one of the things that I was missing in the clinical setting as a midwife, was having time really, time to connect with women, and time to really hear their stories, you know, address their fears. And so the Motherhood Wellness Center allowed me to have classes with people when they were pregnant and do a lot of sort of one-on-one work with people about their sort of individual concerns and hope for their pregnancy and birth. And then as part of that, I decided to start a blog just because I was like, “Well, that seems like a thing I should do. I should have a blog.” And so I wrote a few articles, and Motherly, found me from one of those articles back when Motherly was pretty brand new and reached out and said, “Hey, we wondered if maybe you could write a few articles for us?” And I said, “Yes,” obviously. And then we, you know, kind of fell in love and dot, dot, dot, it’s almost four years and I’m now the digital education editor at Motherly and it is my full-time job. And I spent a lot of days writing that book. And now that that is done, I spend my days still writing and speaking about pregnancy and birth. So, you know, certainly, this was not what I thought I was signing up for when I started midwifery school but, you know, I love it. I love the work that I do each and every day.

Katie: That’s so great. And I have a huge soft spot for midwives because I’m a doula and also a midwife, and just haven’t had time to finish that yet. But I think and really believe that the way we give birth can have a very dramatic impact on women, you know. And, like, you always hear that saying like, “All that matters is a healthy baby.” And I always respond to that with, “That is certainly the most important outcome of a birth is we want a healthy baby, but it’s not all that matters.” And when a woman has a baby, she also becomes a mother. And that experience is very, very transformative. Even if it’s not your first child, I feel like birth always has the ability to change us. And I think midwives, especially have a very unique space in holding the place for that to happen and letting it have the calm to happen naturally. And I in my own life have seen contrast with different births both in the hospitals with doctors, in hospitals with midwives, and then at home with midwives. And just the difference in the level of care with midwives, and also just as a doula and assisting midwives, I’ve had a couple of times when the midwife couldn’t make it in time with very fast births where I got to catch the baby. And those have been some of the more memorable moments of my life beyond my own births as I think there’s this beautiful culture around birth, that women are the gatekeepers of and I love midwives who do that beautiful, beautiful work.

Diana: Oh, thank you. Thank you so much for saying that. And we’re gonna have to trade, I’m gonna need to hear those stories at some point. Yeah. No, it’s true. You know, I often will say that it’s not so much about your birth experience, it’s about how you experience your birth. And by that, I mean, you know, it’s not like a certain type of birth, in quotation marks, it’s like the best type of birth, you know. Because for some women, that’s gonna be an unmedicated home birth and for some women, that’s gonna be a planned C-section, you know, but it’s about how you experience that birth. So if you experienced it, you know, feeling empowered, and trusted, and supported, and like you were an active member of your team, that’s what matters, you know, when it comes down to your birth. And certainly I mean, if you have goals for your birth, you want, you know, that unmedicated home birth or whatever, like it’s great, and you should be supported in that. But ultimately, yeah, it’s about the experience and how you felt through that experience. And I completely agree with you and feel really deeply and passionately about supporting women, people through that statement of, “Well, at least you and the baby are healthy,” you know, because I agree with you, I mean, of course, ultimately, that’s what we would choose, but it is about so much more than that. And that was, you know, a huge piece of and is a huge piece of becoming a midwife for me, is helping women feel honored through that experience and beyond.

Katie: Exactly. I think one of the beautiful lessons I’ve learned from my time working with midwives and also birthing with midwives is just a shift in the language surrounding birth because, you know, like, we don’t always get to choose our birth scenario. And that was hard for me as a very type A person with both my first birth and my third. You know, with the first one, I was determined that I was going to have the perfect natural birth in a hospital. But I was young, I had never had a baby before. And I just assumed like, “I’ll just pick a doctor. And of course, they’re gonna support me. And it’s all gonna happen. And of course, I can handle it and it’s gonna be great,” and ended up with a different doctor who was on call who I didn’t know, who was not on board with any of the things I wanted, and ended up with a different birth experience than what I had hoped for, and had to kind of wrestle with that. And then with my third was set up for a home birth, I had actually 2 ultrasounds, they did not catch placenta previa in either one, and at 35 weeks, I hemorrhaged and had a not optional even a little C-section. And I struggled with feeling like a failure in that.

And I really just think, like, midwives have helped me with my last few births to heal from those experiences and also to change the way I talk about birth. Like, the first few times that I worked with a midwife was in, like, those first pregnancy appointments after the C-section. I would ask questions like, “Well, am I gonna be allowed to…?” And they would stop me and say, “No, no, this is your birth, I don’t allow or not allow you. You are driving this,” or I would say, “Well, when you deliver the baby,” they’re like, “Oh, no, no you deliver the baby, I just catch the baby.” And it just helped me reframe my power in that. And I think that’s something that… And certainly there are incredible doctors who, you know, are incredible at facilitating those birth experiences. And I think it is absolutely possible to have an amazing birth experience in a variety of situations. I just think midwives are uniquely exceptional at helping support women in the beauty of that power they already have in birth, and helping them remember that, and being that calming force. Certainly, for me, every time I hit transition, even though I know all this and even though I’ve helped with all these births, and I know all the data, I reach that point where I go, “Oh my gosh, I can’t do this. I can’t do this. I can’t do this,” which in my head I’m logically going, “That means you’re in transition, you’re almost due. You’re gonna be fine…”

Diana: Transition is, like, the great equalizer, right? Like, everything that you thought you knew, you’re like, “But I read about this in that book. What’s happening?” I hear you.

Katie: And I heard it said that birth is your ultimate reality, and I think it helps you face some parts of yourself that you maybe don’t have to face in a lot of life situations. But as a midwife, what advice would you give to women, especially if they’re in a first pregnancy for being able to as much as possible, because certainly, there’s always extenuating circumstances like I learned but as much as possible, to facilitate and learn about, and create, and curate the kind of birth experience they hope for?

Diana: I love that question. Thank you for sharing your story with me because I love that. And it’s on a personal note, well, that’s not personal to me, but on a very personal note, it’s ironic today is my…we’re speaking today on my daughter’s birthday, my eldest’s birthday. And so today is like the anniversary of me becoming a mother. So, you know, like, anytime your kid has a birthday, you’re like, “Okay, and, you know, I was in transition now. Oh, this is when I got my epidural. This is…” You know, it’s fate to be talking about this as a midwife on, like, my birthday as a mother. You know, I think that one of the things that makes becoming a parent so challenging right now is that there’s so much noise. There’s so much, you know, access to so much information. We have access to social media, and that means that we have access to really rich, wonderful, evidence-based information. And we have access to people’s opinions and people’s judgments. And we on social media are very vocal with that judgment, especially when it comes to pregnancy, and birth, and parenting. And I do believe that it mostly comes from a good place. You know, we want to, like, protect each other. We want to share our experiences. And that comes from love, and community, and togetherness. So I don’t think it’s a bad thing. However, when you are the one who is being told all of these opinions and all of this, like, “Oh, well, you know what you should do,” or, “Oh, well, you know what happened to my sister so, therefore, you should blah, blah, blah, blah.”

And it can be really overwhelming. And it can, I think, drown out our connection to our own inner voice. And so to the extent that you want to and everyone’s gonna feel differently, you know, talk to people, get your friend’s sister’s birth story if you want to, you know, ask opinions on social media if you’re brave. You know, go for all of that information, and then tune it out and tune into yourself. Remember that every single pregnancy and birth story is gonna be different. So just because something happened to, you know, somebody that you read about doesn’t mean that’s gonna be your experience. When you feel anxious or fearful about something that you’ve heard, go and talk to your provider about it because so often your provider can be like, “Oh, well, it sounds like that happened because XYZ and you’re really at a low risk for that because ABC,” or whatever. So, so often our providers can help us to, you know, relax any nervousness that we may feel about things that we hear coming up. But ultimately, you know, with the guidance of your provider, tune into what it is that your intuition is telling you and what you really want. You know, I promise not to talk the whole day about my transition into motherhood, which is nine years ago today, but I thought that because I was a midwife, I was, like, I’m one of the midwives, you know, midwives give birth in birth centers and we don’t get epidurals because that’s what we do. So that’s the kind of birth that I’m gonna have.

And I think that had I tuned out…you know, not that anyone was telling me that, but I had this, like, perception, you know, and I think if I had tuned that out, and if I had just listened to myself, and trusted my inner wisdom, I would have known that I am a midwife that gets epidurals. So I wouldn’t have waited as long as I did. And maybe I wouldn’t have… You know, I had a lovely birth, but maybe it would have been different and even more lovely. So I really encourage people, to you know, again, to tune out the noise and trust that you will be able to figure it out, even if that means that you don’t know what you want right now. I work with so many people who say, like, “I don’t actually know if I want an epidural or not. I don’t know.” Like, that’s okay too. It’s okay to trust that in the moment, you will know. Your body will tell you, your providers will help you, you know, you will be able to figure out if you need pain medication or not. And, you know, that’s just one of many examples of decisions that you have to make. But in motherhood, in general, you know, it’s listening to your intuition, and trusting your gut, and trusting that even though you’ve never done this before, be it giving birth, changing a diaper, raising a human, you know, you possess an inner wisdom, and you can trust that inner wisdom.

Katie: That’s beautiful, and happy birthday to your daughter and happy mom day to you too.

Diana: Oh, thank you. Thank you.

Katie: I love what you said because I had the same type of mental filter. Before my third I had this, like, “I have natural births, I am never going to have a C-section.” And then when I would read pregnancy books, I would skip the C-section part entirely because I’m like, “I don’t have C-sections,” and until I did. And in hindsight, I’m a huge fan of the quote, amor fati, which means love your fate or love what is, and not just like it or accept it but, like, learn to be absolutely grateful and to love what it is. And that was one of the more challenging experiences in my life and I actually almost died, but it also was extremely transformative, and I think it gave me an empathy as a doula, and as a friend, and as a mom that I wouldn’t have had if I still had that filter of, “Well, I don’t have C-sections because I’m better than that.” And it made me realize, you know, all that we want in life is not always in our control, but beauty can still come from that.

Diana: I love that…

Katie: And so I love that perspective. And I think you’re right, like, we can plan and hope but also our perception is so important. And I see so many women who beat themselves up because they didn’t have the exact birth experience that they want. And that makes me so sad to see because, at the end of the day, even if it doesn’t go how we went, every birth is incredible, and beautiful, and how it should be even if it wasn’t exactly how we hoped. So I love your perspective on that as well.

Diana: Thanks. And I love that you say that. Yeah, I always tell people, you know, “Listen, at the end of the day, like, a human has come out of your body, like that is amazing.” You know, I’ve been doing this for, like, a decade now and I’m still like, “Wait, what? really?” It’s just so fascinating and that that can happen, you know, any way that that human comes out of your body is amazing, and whether that’s, you know, through surgery or through pushing, or maybe you know, your journey to motherhood is through adoption, or surrogacy, or gestational carrier, you know, there are so many ways into motherhood and none of them are, like, more than the others. You know, it is your story and your story is perfect.

Katie: And at the end of the day, the thing I always come back to that all moms have in common is that we want the best for our kids and we want the best for their future. And I’ve always said that moms are the strongest force of nature on the planet. And if we could unite around what we agree on and not what we don’t, which we tend to get stuck on in social media, that we could, I think, change many, many things in the world, within the course of a generation. But to shift gears a little bit, I’d love to just go into the practical a little bit and kind of touch on some of the different phases of growing a baby. The first being pre-pregnancy because I think often this one gets forgotten. People start thinking about pregnancy and having a baby when they find out they’re pregnant. But at least from the research I’ve seen, there’s so much we can do pre-pregnancy that can affect not just birth outcomes, but how you feel during pregnancy and even your child’s future health. So from a midwife’s perspective, what are some of the common things that you often recommend for women preconception?

Diana: Yeah. No, I love that question. And it’s interesting because, you know, almost 50% of pregnancies in this country right now are unplanned. And so, you know, some people plan and, you know, get pregnant or some people try very hard to get pregnant for a long time, and some people find out that they’re pregnant well into their pregnancy. So I think that one of the things to keep in mind is that wherever you are in your journey, like, even little steps can make a really big difference. You know, sometimes, like, people feel like, “Oh, I didn’t totally go on this, like, fertility cleanse diet thing.” And, you know, you can still make really small but meaningful steps, wherever you are in your journey. So I just wanna convey that. One of the things that I think is really helpful if someone is planning for pregnancy is to do what’s called a preconception health visit with your provider. This is going to be probably the person who you go to for your GYN care. So maybe it’s already a midwife, maybe it’s already an OB, maybe it’s a GYN. You know, so you can go to them or you can…like, if you’re thinking maybe you want to switch practices, you can start sort of scouting around, but go to somebody in women’s health for a preconception health visit. And this is generally done, you know, ideally 2 to 3 to 4-ish months before you wanna start trying to conceive. And they’re gonna help you look at your specific scenario and help you make decisions that are right for you.

The tough thing about pregnancy and, you know, all of health really is that we all come from such different places. You know, we have different medical conditions. We have different beliefs about health care and things that we’re, you know, wanting to deal with, and things that we’re not wanting to do. We have access to different resources. We have different risk factors. And so meeting with someone prior to getting pregnant if you can, can help to look at your specific story and then you can help, you know, to make tweaks to that story as appropriate. So, you know, maybe they’re gonna look and they’re gonna say, “Oh, you have such and such chronic health problem and you’re taking this type of medication for it, we need to look and make sure that that medication, you know, is safe for pregnancy. Should we have you continue it? Should we stop it? Would stopping it be worse than continuing it?” You know, so they’ll look at the different aspects of your story and help fine-tune it so that you can get as healthy as possible for your pregnancy. And then the other piece is mental health. You know, even if you don’t end up having a prenatal or postpartum depression or anxiety, this is a humongous transformation that you’re about to go through. And there are lots of hormones, and there are a lot of changes, and there is a little bit less sleep, and there’s all of that good stuff.

And so I think that we would all do well to look at our mental health as we go through conception, pregnancy, and beyond. And also, you know, statistics there rules that, you know, upwards of, like, one out of four, one out of five people will experience a postpartum mood disorder. And so having a mental health therapist that you trust and like on board should that be the case for you can be really helpful. And even if not, even if they’re just helping you with, you know, coping skills for when things get stressful, or if your conception journey turns out to be a challenging one, or if pregnancy, you know, brings around complications that are really hard for you, you know, I think whatever your story looks like, paying really close attention to your mental health is always going to help you. And, you know, as a midwife, I believe that there’s a very strong mind-body connection. And so helping to ensure that not only your, like, uterus and blood is healthy, but also making sure that you’re, you know, emotionally and mentally as healthy as possible is a great place to start.

Katie: Great advice. Okay. So what about when it comes to pregnancy? I know that there’s many phases. And just, like, any aspect of health, this is, of course, very nuanced, and very personalized. And of course, someone should be working with a practitioner who they share an outlook with and have in their corner during this time. But what are some of your common recommendations or maybe potentially overlooked things that women can do during pregnancy to improve both how they experience the pregnancy and also to lead to a healthier birth and postpartum?

Diana: Yeah. So, you know, again, like you said, with all recommendations, you know, certainly check in with your provider before trying any of these. But one of the big ones I think is movement, I think is finding ways to be active, you know, every day of your pregnancy and that’s gonna look really different. If you are already, like, a runner, you know, talking to your provider and checking in if running can continue through your pregnancy in a safe way. If you don’t do any exercise, would be more my camp, you know, thinking about, “Okay, what are some gentle ways that I can start incorporating movement into my pregnancy?” Movement and exercise have been found to have so many positive effects on pregnancy. You know, it’s gonna help with fatigue. It can help with, like, morning sickness. It can help with blood pressure. It can help with weight gain…you know, so many aspects of your pregnancy. And then as we move closer and closer to birth, movement can help the baby to be in a more ideal position, which can help to have your birth be a little bit easier. And then it can also help when it comes to your postpartum feeling. So finding a way to move your body that feels good, whatever that means for you, as long as it’s safe is really important. And I think starting to reframe how you think about healthy foods. We have this, like, diet culture, right, that we are constantly bombarded with as women.

And one of my, like, so least favorite expressions is this sort of bounce back, you know, mentality like, “Oh, you got the baby, it’s time to bounce back.” I don’t know about you, but I do very little bouncing when I’m postpartum, first of all. And second of all, you know, it’s not about losing the weight, it’s about being healthy and healing your body. And I think that that starts during pregnancy. So thinking about foods that are deliciously nourishing, as opposed to, what are all the things that I can’t eat? I don’t wanna gain weight. I don’t wanna, you know, sort of this, like, restriction. Certainly, there are foods that you know, many recommend that we don’t eat. But really reframing how you think about food during your pregnancy as a way to nourish yourself, and as a joy, and as a delight, so that you can take that attitude into your postpartum experience.

Katie: Such good advice. What about when it comes to birth itself? Obviously, this, again, is very nuanced and individualized. But are there things that people can do to help have that birth experience that they want while also keeping in mind and being okay with the fact that that birth is often very unpredictable and could change at any moment?

Diana: Yeah, I believe a lot in education. So taking birth classes. You know, obviously, I believe in reading birth books. I think that can be really helpful. I think it can be really empowering to have as much information as possible about as many aspects of birth as you’re comfortable learning about so that you feel empowered going through your journey. The other piece is thinking about your support team. So I’m chatting with you, a doula and soon to be a midwife. So, you know, I know I am preaching to the choir here. But considering who is going to be your support when you are in labor, and considering if that person should be a doula. So doulas are, you know, people who provide expert level coping skills and support during your birth. And research has found that people that have continuous support through their birth, have fewer interventions, have shorter labors, and report a higher level of satisfaction with their birth. Now, doulas are not gonna be an option for everyone. Certainly, there is a financial investment involved. And also, you know, we are talking during June of 2020, when many hospitals are not allowing doulas to be, you know, in the hospital because of COVID-19. So, you know, it’s not an option that’s gonna work for everyone, but we are able to consider who that support person or team is gonna be, and choosing them very carefully, and remembering that you don’t owe anything to anyone. So, you know, you’re like mother-in-law’s cousin who desperately wants to be at your birth, like, I’m sure she does, but you don’t owe her anything. If she’s gonna be helpful and she’s gonna be a positive support to you, then go for it. But if she’s not, you can politely decline and choose the support team that’s gonna help you get through this difficult but awesome experience.

Katie: That is such a key I think often overlooked. I think women, it’s hard to know until you’ve been through birth, how you are gonna feel during your birth experience. And I’ve had a couple where there were people there who I wasn’t completely comfortable with and it definitely makes a huge difference. I think that your birth environment, like you said, is a very important key to how the birth is gonna go. And of all times, certainly ever, you don’t wanna do anything during your birth experience just to appease someone else. And also to echo what you said, I’m certainly biased but having served as a doula and also having hired doulas, I also believe that quote, that if a doula were a drug, it would be a crime not to use one.

We know the outcomes are so much better. And certainly many midwives I feel like do double duty and support the mom even while facilitating the birth experience. And so often maybe it’s just having a calm, experienced woman there makes a tremendous difference. There’s a sisterhood of birth, and that, like, rite of passage into motherhood, that only a woman who’s been there can truly understand, and I think maybe that’s why we see really good outcomes with midwives and doulas is just having that calming force. For me, I know it’s made a huge difference. Like I said, even in those times when I start panicking, even knowing all of the data, just to have someone outside me saying, “You’re almost there. This will be over soon. You’ve got this. You’re made to do this. Your body’s got this.” And even though you already know it internally, just hearing those words can be so, so reassuring in that moment.

Diana: Yeah, I absolutely agree.

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Katie: Okay, so you touched on it a little bit about the lack of sleep and becoming a new mom, and all of that. I think another thing I’d love to delve into with you and you can probably speak to as a mom as well as a midwife is self-care, and managing overwhelm, and burnout during motherhood. And this is actually very close to home for me because I’m working on another book right now, that will be called, “Zen and the Art of Dirty Dishes.” And it kind of touches on this entire idea of the fact that as women, we have so many beautiful opportunities in today’s world, and many of us are involved in careers or business or work in some way, but that doesn’t take away from the fact that we’re still moms and we’re still birthing the babies, and often we’re still managing the emotional responsibility of a household. So we’ve added many things to our plates. And we now are responsible for all of those things. So I’d love to hear any tips you have on managing burnout, and avoiding it, and making time for actual self-care that’s regenerative during, especially those busy times of motherhood.

Diana: I love that title so much and was just, like, laughing to myself because, like, 10 minutes before we were supposed to talk today I was doing dishes, and my husband was like, “Babe, don’t you have, like, a podcast with that person that you’re…like, Wellness Mama. Like, isn’t that a really big deal? Shouldn’t you…?” And I was like, “I know. I just have to do the dishes really quick.” And my husband was like, “I think you can just go to your podcast. I think it’s okay.” So, I can literally identify with that. I love that. Yeah, and this is a huge, like, thing for me. This is, like, the hill I’m probably gonna die on is working on burnout with mom. Motherly every year does a state of motherhood survey. And this year, we found out that 89% of women do not feel that our society does a good job supporting them. And the result is that many, many moms feel burnt out either chronically or occasionally, but it’s all something that we can identify with. And the reason that burnout is a big deal is it’s more than just, like, “I’m so tired. I need to, like, take a bath and go to bed early tonight.” It’s like a real embedded chronic health problem. And the World Health Organization has recently added burnout as a diagnosable occupational phenomenon. So it’s like the real deal and it has real health consequences. People that experience burnout have more heart disease, more diabetes, more mental health issues, high blood pressure. The list kind of goes on and on. And so it’s really something that we need to address.

And the problem with burnout is that it ends up being about more than, like, simple acts of what we sort of have come to know as self-care. You know, so this idea of, like, “Oh, I’m just gonna take a bubble bath and have a glass of wine tonight,” like, okay, that’s lovely. That’s not going to fix your burnout. Burnout is the manifestation of, you know, pretty significant shortcomings in our society, in our culture, many of which women bear the brunt of. You know, no federally mandated parental leave, the cost of child care in this country, you know, racism, sexism. I mean, there are so many layers to it that make becoming a parent right now really hard, and moms are really having a hard time of it. And a lot of moms are getting burnt out. And again, it has pretty significant consequences. And so one of the things that I think is really important is talking to people during their pregnancies. And, like, one of my other pet peeves is this sort of like, “Oh, you think it’s hard now. Just wait until blah, blah, blah.” I don’t like doing that. But I do think that it’s important to let soon-to-be parents know, you know, some of the realities of it so that they can prepare and help prevent some of it for themselves. So while people are doing the work of improving those sort of foundational problems in our society that lead to burnout, there are some things that we can do ourselves to help minimize the impact of it. One of which is just sort of being able to recognize it, knowing what the sort of symptoms of burnout are, and then finding little but meaningful ways in your life to prevent it.

So maybe that’s, you know, having a really good look at your work, whatever your work is, and I say the word “work” broadly because we all do work. It’s just a matter of where it happens. Is it taking care of toddlers in your home? Is it working in an office? But looking at your work and thinking about, you know, are there ways to make small but meaningful changes so that your work isn’t as exhausting, you know, who can you have conversations within your community, in your family, prior to parenthood or, you know, in the middle of parenthood about helping you to manage the load? You know, we were not meant to parent alone. This sort of time in parenthood is uniquely challenging because even before the pandemic, we were doing this very alone. You know, 100 years ago, we, like, lived in villages, and our mom lived next door, and our aunt lived across the street, and we’d seen a hundred births before, and we were just around it, and we were around each other. And now we’re very isolated. So finding ways in your community, in your family, to breach that isolation can be incredibly meaningful.

And the last piece, I think, and this is, you know, certainly an ongoing quest for me, is finding grace and finding gentleness with ourselves. We are so hard on ourselves. I think as a culture, I think particularly as women and particularly as moms, like, we’re so mean to ourselves. You know, the way that we talk to each other or the way that we talk to ourselves and each other, the expectations that we put on ourselves. And so really paying attention to how you’re talking to yourself and how you’re thinking about yourself, and seeing if you can start to shift the inner dialogue to one that is more compassionate and one that says like, “Yeah, leave the dishes in the sink. It’s okay. Like, you’re still a good mom.” You know, yes. You know, say no to joining the PTA, if it’s gonna stress you out. Like, say no to extra soccer practice, whatever it is, giving yourself permission to put yourself first and trusting that that is actually the best thing for your child.

Katie: Absolutely. I love that. That’s an amazing statistic to me that you said that 89% of women don’t feel like society does a good job of supporting them. And I echo what you said about community. I think that’s something we’ve lost to some degree in our modern times that people used to have. And certainly kind of right now and all the chaos of everything that’s going on, we’ve lost that in-person community that’s so, so important. So, I think to the degree possible that we as moms, especially, can really help curate that and create that community. And we know from the Blue Zones that having strong relationships and a support system is actually one of the most impactful things you can do for lifelong health as well. So really, I always encourage moms to be the force of creating that community. If you don’t already have it, find ways to create it and reach out to other moms, and really start to build that because it’s dramatic, not just before pregnancy and birth, but throughout all of life to have those solid relationships, and friendships, and women in your corner.

Diana: Yeah, absolutely.

Katie: Well, I had a feeling our time would fly by because I knew we could talk about so many things about birth. But as we get close to the end, there’s a couple of questions I love to ask. The first being, if there’s a book or a number of books that have had a dramatic impact on your life, and if so what they are and why.

Diana: So I love this question. And I immediately thought of two, so I hope that’s okay. The first one is called, “Infections and Inequalities” by Paul Farmer, and I read it back in college or maybe high school. And it was the first time that it really made sense to me, that it connected, that somebody’s health is deeply connected to, like, the society around them. And that it’s about so much more than, like, making healthy choices, you know, because for some people, for a lot of people in the world, like, there are no healthy choices to be made. Because there is a system around them that’s really sort of crushing every aspect of their life. And so that was the book that sort of turned me on to the concept of public health and sort of started me, I think, down this path. So that’s one and the other one was, “Taking Charge of Your Fertility,” by Toni Weschler, I think another public health person, maybe that’s like my next thing, public health, but I read “Taking Charge of Your Fertility” actually after I graduated from midwifery school. So after, like, I was, like, supposed to know all of this stuff. And it still revolutionized the way that I thought about ovaries, and the body, and just how the whole system works. And I remember being, one, like, having this moment of being like, “Oh, I’m gonna continue to be amazed by this process forever. Like, there’s never a time when I’m gonna not be.” And two, I loved the accessible way that she wrote about the information. And I think that has always inspired me in the way that I write about, you know, birth, and pregnancy, and bodies, you know, to make sure that it feels acceptable and empowering always. So those will probably be the two big ones.

Katie: All right, I think we’re gonna have to go a couple of minutes longer. I love that you brought up “Taking Charge of Your Fertility” because this wasn’t actually on my list to talk to you about but it’s something I get a lot of questions about. And a lot of women wanna know when you are past the point of wanting to have more kids, what are some of the natural ways that you can avoid more pregnancies? Because it seems like at least from my research, there are not any conventional kind of hormonal options that don’t have potential side effects. And I know this is an area of frustration for a lot of women. So if you don’t mind, speak from a midwife’s perspective on how we can manage our fertility once we are either done having kids or wanna delay having kids for a little while.

Diana: Yeah, yeah. It’s a great question. And, like, you know, my soapbox answer is like, it’s not fair. It’s not fair that, like, it has to be so hard. You know, so one of my favorite parenting books, “You’re Not Doing It Wrong, It’s Just That Hard”, and, like, that’s very much the case here because a lot of times people feel like there is no great option for women, you know. So I think that first of all if you are in a relationship with a person who produces semen, and you are having intercourse with that person, you know, depending on how permanent you want the fertility control to be, you know, don’t forget that there is another person that you can talk to about, you know, vasectomies, and remembering vasectomies are actually incredibly effective and are, you know, in the grand scheme of things. You know, it’s an in-office procedure and if they’re uncomfortable for a weekend-ish, and then it’s usually fine. So let’s not forget that we don’t necessarily have to be in this alone. Beyond that, you know, there’s certainly, you know, fertility methods…or, you know, birth control methods where you’re charting your own cycles. And for that, I mean, I cannot recommend taking charge of your fertility enough if you’re considering, you know, natural fertility, natural birth control methods, simply because Toni Weschler breaks it down so beautifully.

And, you know, the book is about, like, how to get pregnant and how to not get pregnant. So that would be a really great place to start. Another important thing though is to talk to your provider if that’s something that you’re considering, simply because it can be a very effective method, but it sometimes doesn’t work as well, depending on certain health, you know, things that you have going on. And then, you know, so I guess those would be the two that I would really consider if we’re talking about non-hormonal. Now I did just get an email that there is a new non-hormonal birth control foam, I think. I don’t even know what it’s called. I just read the headline quickly, so I have to go and read the article that was just approved by the FDA. And it’s like one of the first, you know, advancements in a long time in female birth control. So, that might be exciting. And then the other option, you know, that I would consider is IUD, especially if we’re talking about longer-term. There’s hormonal IUDs, but there’s also non-hormonal IUDs. So, that might be an option for somebody who was hoping to have a longer-term birth control method but is not interested in hormones. And that is something that is inserted…you know, just an in-office visit with your OB, or your midwife, or your GYN, or your nurse practitioner.

Katie: Great rundown. Thank you for that. And lastly, any parting advice, it doesn’t have to be birth-related or pregnancy-related, but it could be that you wanna leave with everyone listening today?

Diana: You know, I think I shared about, you know, being gentle with yourself earlier. I think the thing that, you know, is really striking me today, again, about this moment in history where we are, is about the disparities in healthcare. You know, and I think it’s really important that we continue to pay really close attention and advocate for everybody, and all women. Black women are three to four times more likely to die from pregnancy, birth, and postpartum complications. And so as we go on our own wellness journey and our own health journey, which is incredibly important, we also need to continue to do the work of being allies, and helping other women in our community, and outside of our community. So reading, and advocating, and writing letters, and, you know, speaking up, and all of that stuff, because ultimately, you know, we were talking earlier about the importance of community. And that is like the foundation of community, right, is making sure that everybody has the same rights, and the same access, and the same potential for health, you know, that everybody else does. So I think that would be my sticking point for right now.

Katie: Beautiful. I absolutely agree. I think that is an absolute travesty that in today’s world, the U.S. ranks so low in some of those key factors, like maternal mortality, especially for minority groups. I think that’s completely unacceptable. And you’re right. I think as women and moms, that’s something we all need to be part of the change on because certainly, we know we can do better. Lastly, where can people find and learn from you? Obviously, I’ll link to your book in the show notes. But where else can people find you?

Diana: Awesome. Thank you. So you can find me over at mother.ly, so it’s mother.ly, and I have all articles all over the place over there. And you can also find us on Instagram, and Facebook, and Twitter, and Pinterest, and all those places that I’m like starting to be like, “I don’t know that much about social media,” but there are people that do and we are on them, so all the social media places you can find us @mother.ly.

Katie: Beautiful. Diana, thank you so much for your time today and for all the work that you’re doing for women.

Diana: Thank you so much for having me. This was so great. And thank you for all the work you’re doing.

Katie: Oh, and thanks as always to all of you for listening and sharing your valuable time with us today. We’re both so grateful that you did, and I hope that you will join me again on the next episode of the “Wellness Mama Podcast.

If you’re enjoying these interviews, would you please take two minutes to leave a rating or review on iTunes for me? Doing this helps more people to find the podcast, which means even more moms and families could benefit from the information. I really appreciate your time, and thanks as always for listening.