LadyGang - Reproductive Mental Health with Dr Sarah Oreck

Episode Date: May 28, 2024

Whether you are TTC, currently preggers, in a postpartum meltdown, questioning your entire life as a mother, or questioning your decision to never have kids. Something that is rarely discussed is our BRAINS ON BABY. Dr. Sarah Oreck, MD, MS, is a Columbia University-trained psychiatrist focusing on Women’s Mental Wellness. In this episode, the ladies have the most wonderful conversation about all things brain, body, and baby. Plus, an extra special good week bad week!  Check out our great sponsors!!! Skims: Shop the SKIMS T-Shirt Shop at Skims.com - After you place your order, select "podcast" in the survey and select LADYGANG from the dropdown menu! Progressive: Quote your car insurance at Progressive.com to join the over 28 million drivers who trust Progressive! Huggies: Get your baby’s butt into Huggies’ best fitting diaper! Huggies Little Movers. We got you, baby.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

well what is this welcome to the lady gang that's amazing say that again the lady gang things are about to change around here each week we catch up with hollywood's hottest girl posse kelty knight becca tobin and jack vanik hello hello hello welcome to lady gang i am becca tobin here with jack vanik and kelty knight hello hello everyone welcome to the lady gang podcast If this is your first podcast with us, we suggest you go back and listen to some from the beginning to get the full vibe of us, but we'll give you some vibes today too. I think the beginning kind of sucked. That'd be really weird to go back to the very beginning.

I don't ever want to revisit that. Well, if you're new, it's fine because there's nothing, you don't need to go back to the beginning. No. This is your first time is the same as all the times. That's right. Do you think instead of Good Week, Bad Week, we should each give a description of each of ourselves?

Wait, what do you mean a description? I'll describe you to the audience, Kelty can describe me and you can describe Kelty. okay i'm gonna give a description of jack vanek okay everybody jack vanek is uh she's been part of the cultural zeitgeist for many many many a year thank you she um came onto the scene as a young young girl who loved emo music and jack daniels so i met jack you know when she was she had jack vanek her clothing line which she was their og graphic designer putting funny things like i'm a ray of sunshine on t-shirts long before other people were doing it hot topic could never she has been a influencer before influencer even had a title she was the myspace queen katie perry

was one of she was in katie perry's top friends wow this is accurate right top eight yeah top eight and um she has been the penny lane of emo music if you will wow she's an entrepreneur she's an only child to may and bill vanik they worship her more than anyone could worship anyone or anything on planet earth kelty and i are both jealous um and she's loves curb your enthusiasm she loves to day drink but don't ask her to go to dinner at 7 p.m she has a husband who's a musician shocker in a in a band called the main and he has long flowing red hair they are a beautiful couple. Everything she does is cool. She loves a crop top and she's just a good time gal. She's also got a heart of gold. Yep. If you need anything from Jack, she is there. She will

be there for you. And she loves weird reptiles. Oh my God. I'm overwhelmed. Yeah. Should I do you Kelsey? Do me, do me. Oh my God. Well, I don't, can't do it that good. You're so good at that. Sorry. Incredible. Thank you. Um, Kelty Knight. Oh my gosh. Where do I begin with Kelty Knight? Um, she is the glue that holds the lady gang together. It would not be the lady gang. If it was just me and Becca, we'd still be talking about it over dinner and never actually doing anything about it. You're the powerhouse between behind all of our lives. Um, you are the most messy slash regimented person i've ever met in my entire life you skim every single email but somehow are able to like keep your life together hanging by a thread sometimes um she loved back

in the day a feather earring it was like her calling card go-to lucky charm that she once war when she met matt matt matt nathanson at the airport um who she loves more than her husband yeah she hails from a very small town in edmonton canada yeah or edmonton is the town in alberta edmonton yes um she dreamed of being in hollywood she stole vogue magazines out of the dumpsters outside of cvs or whatever shoppers and isn't that a canadian okay um sorry i took over no you're way better at this than i am you go for it you know this is just like my this is my niche guys. This is your niche. She dreamed of being on red carpets. She danced and sang in New York city and she was a radio city rockette. We're not sure how she can carry a tune, but, um,

she's got gotten better recently. She's actually very skilled in singing. Most recently she auditioned for Broadway a lot, um, became a rockette, Nick city dancers. So she could whip that hair weave all around. She's got the best legs in the business. She started doing a blog in music because she just knew she needed to squeak her way into the business somehow. She has chutzpah more than anyone you've ever met in your life. There's no reason this girl should have ever been at the Met Gala in a nice way. She's not connected. She's not a nepo baby. She didn't sleep with anybody famous and she made her way all right now. She is the host of e-news. she has been doing this for many, many, many a year. She's quirky. She's fun. She's cute. And

she doesn't like to socialize. God, Becca, Grace Tobin, Becca Tobin grew up with two loving lawyerly parents who loved her. And she was the black sheep of her family. Sister Jessica was incredible and regimented and lovely and a good girl. And Becca Tobin came out singing, dancing. She's basically like shirley temple just as lovable doing local theater and because she's so lovable and charming her parents are gay with anything and she was a bad bad girl in high school she peed in purses she was mean she even got kicked out of the prom and that's fine because look at her now then she moved well then she went to school for musical theater and everyone knows that that's like don't do that because it doesn't help you at all so then she moved to new york where she actually

could get on broadway which was her dream and she did it and she was incredible but she was also lest we forget in cats which is very important because my favorite is jack's favorite musical and then she was dating hot guys she's never been dumped um except one time she uh was the hottest person in new york city so beautiful that she was hand-picked it was between her and one other girl to play kitty wild she got picked by hollywood handpicked to go out she did not think she was gonna get that job she's gonna leave the business in fact she was gonna be like screw broadway i'm gonna be a yoga instructor and then at the last second glee called and they were like fame fortune for you she's the most stylish person she if you're ever wearing an oversized suit or a

three-piece suit or menswear in general becca started that she would have to buy men's clothes she was the inventor of menswear she is so true carl laga becca she's married to a wonderful guy she's really really funny she's the most dependable person she cares so deeply but she's like a jawbreaker like she will not give you the good stuff and then she'll just surprise you like one day out of the blue she will just break your heart open to a million pieces and like be the most deep person but she doesn't just give it to anyone just to be liked she doesn't care if you like her she likes her you know what i mean she likes her um and she's so and she's a mom and she's beautiful and she's a dog lover and she's great we should mention also kelty's married to

a lovely man chris knight he is the man behind the scenes the ultimate i don't want the attention and that's why their marriage works because she is the star and he sits back and he lets her spin and sparkle and shine and he is the foundation to this lovely person that is kelty yeah i love it so well okay welcome to the show guys are we gonna do that that's cute no it's so cute i could never what could i'm just so bad at it you guys did a great job i thought you did a great job that's okay be hard we all have our own things don't be so hard on yourself um do you coming up okay coming up. Now back to the lady gang. Well, we're so excited to welcome Becca, the person who's kept Becca together. Dr. Sarah Oreck is here today. She's a Columbia university trained psychiatrist

focusing on women's mental health. In addition to her expertise in general and addiction psychiatry, can I call you Dr. Sarah today? You can just call, yeah. Or it's just Sarah. Okay. No, you did too much school to be Sarah. No, I'm calling you Dr. Sarah, is one of a handful of doctors who was specialized training in reproductive psychology. She runs a private practice in which she combines the most up-to-date medical treatments with talk therapy, meditation, and a whole body complimentary approach. She's also the co-founder of Mavita Health, an app providing mental health care on the path to parenthood. This is what we've needed. we're almost 10 years into the lady gang i've never i didn't we did not know someone like you

existed i mean becca did and now we're giving it to everyone that listens lady gang if you are trying to get pregnant have been pregnant if you know someone this is the episode that you're going to want to share with your friends because she's going to talk us through every single element of the brains of motherhood. No pressure. No pressure. Download everything I know in this episode. That's everything. No, no pressure. So yes, I did not know someone like you existed. And I actually hate myself for not remembering who suggested I see you. That's how clouded and messed up my brain was at the moment. Do you remember? I can't remember either actually. No idea. But I was going through, you know, I'm like a freaking broken. Was it your therapist maybe? Maybe it

was my therapist. Uh, quite possibly. So at the time I was just doing regular talk therapy, which is also a very, very important modality in the fertility times. And, um, I was struggling pretty severely with depression. My second pregnancy in particular, I remember going to you and saying, I don't necessarily want to end my life, but I don't give a shit if it continues. And this was the beginning of a second pregnancy. And I was desperate to find out why I was feeling this way when everyone around me was glowing and beautiful and earthy and happy. And I didn't want to set up a nursery. I didn't want to buy a thing. I didn't want to go. I didn't want to follow anyone with babies or pregnant. It was one of the darkest times of my entire life. So I came to you

and I was basically like, what the is happening to me? So this is common, right? Which I didn't know until I sat in front of you that day. Extremely common. And I think what you're getting at is that the image that we see is this kind of myth of this magical motherhood time, right? Where we're supposed to be glowing and things are supposed to be magical. But in fact, what we see is that for some people, the hormonal changes are so significant and so impactful that they cause other symptoms. And so often, even within mental health, to be honest, there is this myth of like, well, you know, in terms of, and this was before I did my fellowship, even some of the smartest kind of psychiatrists would say, well, sometimes things just get better

during pregnancy. So we just get people off of medications, like there's no problem. And actually what we've learned is that for a lot of people, this time actually exacerbates all of their mental health issues. If they have underlying mental health issues, they may get worse. And for a lot of people, it's actually the first time they ever have a mental health issue. And so this can be really striking. And we can talk about what are some risk factors for having these symptoms during pregnancy, but often we start to see it if you're really sensitive to the time before your period. And it's like a little bit more than PMS. And you're feeling like that week or two before you get your period, like you get into a lot of fights with people, like you're just not feeling right.

We'd sometimes see that as a little bit of a risk factor for what happens in pregnancy, but sometimes it just comes out of nowhere. Yeah. So antidepressants and pregnancy, like I see people in our community being like, oh, I'm trying to get pregnant. Do I have to go off my blah, blah, blahs? And what, like, I think this is probably a really tricky topic, but what are your thoughts? And I can't remember if you were on stuff, Becca, or not, or. I, so after that appointment, uh, we had been talking pretty openly as it was gradually getting worse and you were really gentle with me and just telling me all the information that you're about to share, which I'm really excited for you and what you have to say about meds. The day that I

saw you was the day that you called in a prescription for me to start medication for, um, anti-anxiety. But please, yes, this is something that I had no clue until I was in the office with you. Yeah. So I think there's a lot of misunderstanding here. And I think sometimes mental health issues, some physicians even, and people kind of think like, well, it's optional whether you take medications or not. And that's simply not the case for many people. For many people, these are life-saving medications. They really allow people to function. And in really extreme cases, right, they prevent someone from harming themselves. So it is a big deal. But I think that there's still so much stigma and kind of misunderstanding that some doctors are like,

well, maybe you should just go off of it, try being off of it. But what we see with antidepressants in particular, is that people that abruptly stop them when they get pregnant, have a really high risk of relapsing into their depression or anxiety. So about like, you know, 60 to 85% of people will relapse and have another mood episode versus like less than 30% if they stay on the medication. So that's for someone who's already on medication. But what we actually understand, and listen, this is complex because we don't tend to do what we call gold standard clinical trials on pregnant people. That means we don't do something that's called randomized control trials because there's a fetus. And listen, we have a lot of thoughts around the rights of a

fetus and tube, right? Whether they should be experimented, whatever it is. But this is why we just don't have that many studies that are really high quality on anything, on insulin during pregnancy, on antihypertensives, that's blood pressure medication. But for some reason, I think mental health medications get a little bit of a bad rap. But we actually have the most studies on SSRIs, that's selective serotonin reuptake inhibitors. So this is more people that we've seen and it's observational studies. So we're looking back at records, a lot of them from Scandinavian countries that have like really good databases that know this patient was on this medication and this was the birth outcome. But what's really interesting is that we actually

have more studies on SSRIs than like, I don't know, diabetes medication in pregnancy. And yet no one is blinking an eye and saying, no, no, no, no, I'm not going to take insulin during pregnancy. No, they're like, I have gestational diabetes and it could cause a lot of harm. But what we don't talk enough about is actually the number one complication of childbirth are mental health issues. Really? Wow. It's wild, right? And that's not something that we're talking about. In what way? Yeah. So we know that when someone is pregnant and not taking care of their mental health, they're probably not going to go to all of their appointments. They're probably not going to eat properly, work out, do all those things that we know lead to a better outcome. They might use

substances, a lot of vaping, a lot of cannabis, right? Like all of those things. And we know that those lead to worse outcomes. We also know that untreated mental health issues lead to increased risk of C-section, NICU stays for baby, preterm delivery, small for gestational size. So here's like another whole bunch of stuff that isn't talked about enough. We just talk about what's the risk of the medication. But anyway, the question was about medication safety. There are so many medications that we have really good safety data on, but I always talk about this. It's a risk versus risk discussion. There's a risk of you not treating the mental health issue, all the things I talked about, and there's some risk that we think it's minimal. And for Becca's

case, when we were weighing together what the risks were, it was very clear to me that the risk was much higher if we didn't think about a medication option. Do you find with women who experience this kind of depression during pregnancy, do they usually have it with every pregnancy? Is it the case? Yeah. We usually see that if someone has what we call perinatal mental health issues, so that's during pregnancy or the postpartum, that they tend to recur. So we really like to have a great kind of plan maybe before going into that second pregnancy. I should also say for some people with very mild to moderate symptoms, sometimes therapy is enough. Individual therapy, group therapy, right? If maybe there's a thing around the couple,

which often comes up, couples therapy can be really helpful. But when things get to a level that are a little bit more severe, some of the things you were discussing, Becca, that's when medication kind of comes in. I should also mention that if it's okay with you, around what was, you know, a trigger for some of the things that were coming up. And I think often loss can be a trigger, previous loss. And there's something here in the pregnancy where we come really close to like mortality, right? We're giving life. And so like death kind of comes up a lot for people. And I just remember that being something in your case that felt like a really strong tie. Well, and I'm so glad that you reminded me of this because I think when you've

experienced loss, you know, in previous years before you start thinking about being pregnant, are pregnant. I was like, there's no way that the loss of a boyfriend at the point was like six years before this has anything to do with the way that I'm feeling about being pregnant. And yet the feelings of depression and the lack of enthusiasm for continuing on my life feels eerily the same. And when you said it to me, I just thought I was always looking for permission to not blame it on that, but to tie the two together. And I heard something recently about a lot of men and this is generalizing and you can definitely shed more light on this, but I heard something really familiar where it was like a lot of men with big, big life moments

of marriage and baby, mortality is so present in that conversation that a lot of men feel very dark. And that's why a lot of men don't want to, they don't get all excited and rainbows and cheerful and all that. Cause it's like a weird reminder of mortality. Is that right? Interesting. That's so interesting. You know, I hadn't heard that, but I think it's important to shed light on the fact that part non-birthing partners can certainly, and fathers can certainly have so many symptoms through the pregnancy, through the postpartum, and we don't talk about it enough. We're just like, why aren't you so engaged? And yet they also can have postpartum depression symptoms. Yeah. It's so interesting. I do want to ask you about the app before we get

to our lady gang group questions. Tell me about the app, how it works, why you started it. Can we download it now? Is it available, our girls? It is, it is. And so what always came up is I absolutely love what I did in my private practice. I get to see so many amazing patients, but it's limited. It's very expensive. It is out of network and pretty inaccessible to people outside of California, New York, where I have offices or where I practice. And so what I really wanted was to democratize this. There were so many emails that I would get. It's like, I really want your care, but this is unaffordable for me. I thought that doing some education on social media would get that. And yet all of the messages I would get was like, this is great. Where can I see you?

They were still like this desire for care. And so what Mavita Health really tries to do is to bring all of that to more people. So medication during pregnancy and breastfeeding is actually very tricky. A lot of people don't want to tell you what to do. They're afraid. They don't they haven't read the most recent studies. And so we like demystify that and give that all to you, as well as individual therapy, group therapy and couples therapy, all sort of through our Mavita method. So you're going to get very consistent therapists. Our care is really consistent. And then we also have content, which is fantastic. It's all original. It's based on our therapeutic approaches, as well as community for those that are struggling to kind of meet other people that are in that same place can be really helpful. I love that.

I actually love that. I've had so many women in my life who have had beautiful pregnancies, beautiful postpartum, terrible, terrible. It runs the gamut. But as far as if you yourself or someone you're married to or a best friend or a sibling or whatever. If what is, what are the warning signs, especially with postpartum anxiety and postpartum depression? What are the signs that you should be looking for in yourself or your loved one where you're like, this has gone past the like new mom sadness or the baby blues? Like what are

the things and what are your suggestions to help that person? Kelsey, were you going to say something? Well, I was going to say like, I love this question because when my friends are doing this, I'm like, you know, it, we always are like, well, she had postpartum. And then we read on Dateline that she like murdered the babies. And it's like, no, no, no. Like there's, there's got to be levels to this. And like, how do, what do we see is postpartum or how can we help when it is not there, but we know that they're struggling? Well, I love that you bring that up. Let's bring up the most extreme case, right? Those cases are called postpartum psychosis. They are completely different from postpartum depression and postpartum anxiety. This is literally a

psychotic experience that people have never had before, most likely. And it really is sort of being out of touch with reality. These patients look very, very different. They are kind of in and out. You're like, wait, do you know what's going on? They're kind of disoriented sometimes. It is extremely different. And I should also say, we've treated a lot of these cases. I've treated them in my private practice as well after they are in inpatient hospitals is the one emergency. If you or someone you know is sort of having that type of experience, they need to go to the emergency room and get the care that they need. And I should also say, right, for all of those cases that we see on Dateline that are horrific, you know, most people are treated and

nothing horrific happens. So that's really important because I think there's a lot of sensationalizing of those cases. And that is postpartum psychosis. Those are not postpartum depression and anxiety, which we see a lot more commonly. So for postpartum anxiety, that's actually the most common, but we talk about postpartum depression. And Kelty, it's even really funny that you said postpartum because even postpartum doesn't mean postpartum depression, but that's what it's come to mean. You say she had postpartum. I'm like, what do mean? She's in like, yes, of course. Right. But it's like she had postpartum has become kind of another word to say postpartum depression, which is interesting, but anxiety is more common. And

what we see there is like this, you know, the constantly checking on baby, not being able to fall asleep because you're afraid baby's going to stop breathing, not allowing others to take care of baby is a huge one that I see where a mom might even not trust like her own partner to take care properly of the baby. And then I see a lot of health anxiety, both in mom, that's something that might happen to her, but also particularly around baby. So if that stuff is coming up, if you're just seeing that this person can't relax, can't like actually get the support that they need, even when people are offering it to her, that's a huge sort of red flag for postpartum anxiety. Um, and then for depression, what we often see is just this, like, so we talk about

baby blues, which happens to 85% of new moms. So that happens in the first two weeks. That's like, I feel tearful out of nowhere. I'm getting all these different emotions. Um, but that really only should last two weeks when it goes past the three, four week mark is when we start to think something else going on. And also a huge difference between baby blues and postpartum depression is that baby blues, you can see like, oh my God, my baby's not sleeping at all right now, but in six months, it'll be fine. Right. Or in a year, like things will be better. And in postpartum depression, we start to see like a hopelessness. That's something important for loved ones to kind of think about. The person may say, oh, this baby may be better off without me. I don't see a hope

of things getting better. Like they just, they should have another mom, things like that are really important. But, you know, I think it's also important to note that it can also look like anger and people don't talk enough about that. Um, sometimes, you know, we think about this very typical kind of like, Oh, tearful and weepy kind of postpartum, but for some people it can be rageful. It can be like, I'm pissed off. I hate everyone. Um, and that's another huge sign, but we often ascribe that type of anger or rage to like men and how they deal with depression. Uh, but it can be how many women deal with depression. And it's also what women of other races deal with depression, right? Often we think about, again, this like prototypical white woman

might be more weepy, but then we think about other races is like, no, that's not how it presents. Or, you know, I'm Latina. So for us, like a lot of psychosomatic, it's like, oh, I have pains everywhere. Or like, you know, like I have, oh, I have shoulder pain. And that can sometimes be the presentation because again, different cultures sort of express their mental health issues or or it's appropriate to express them in one way and not another. How do you get that person in your life to seek help if they don't think anything's wrong? I feel like with postpartum anxiety is the one for me that I struggle the most with friends where I'm seeing every moment is worried about the baby dying or something bad happening,

but they don't find anything wrong with it because the vigilance for them is what keeps them feeling safe. So do you have any pointers or tips to get that person to just take one step towards a healthier? This one's hard because your brain is also slightly wired, and this is what we call intrusive thoughts. And I think, Becca, we've talked about these. When you give birth, you're actually, during pregnancy, your amygdala grows, and your amygdala is the alarm system of the brain. And so this is how mom in particular, the primary caregiver can like hear baby crying when like maybe there's a house full of people and no one else hears the baby. And so basically you are kind of your senses are a little bit heightened to kind of be vigilant, right?

This is when we walk down the stairs and this is what an intrusive thought is. I remember with my babies, I'd be like, oh my God, I'm going to drop them. They're just going to fall out of my hand and like roll down the stairs. And so you sort of grab onto your babies a little bit more. And we think that that is very sort of biological, maybe rooted when we were hunters and gatherers and kind of had to see if there's a predator, if there's a tiger coming and we have to like figure out how to shelter and hold our babies. but like obviously life has changed. So I think what's important is to kind of always come with curiosity about what's going on. My other thing is like if there's a baby registry with things that are meant to, I don't know, check baby's oxygen or like don't buy them. Please don't buy them. The 3D choker things that I have all over my house and my vehicles. Those might be a little

bit, um, useful, but don't, you know, don't buy those things that are about like, um, you know, checking the oxygen or the heart rate or those kinds of things. Cause those just increase sort of that need. But I think what it can be is like, um, coming with your experience is something that's really helpful, but also just being curious about like, huh, I, gee, I wonder if that's not letting you sleep that much, right. If you have that monitor on the baby, that's constantly digging because I don't know, they're pulling it off or something. And it's not hospital grade And you don't need to monitor your baby's O2 sat for their first year of life. Plus, what are you going to do with that information? So it's kind of like, can you be curious about like, gee, if I had alarms dinging all night, I don't know if I could go to sleep. What's going on there? Or can I be helpful in this way or that way? I think, again, treading lightly is important, but it's hard because I think sometimes people just have to get there on their own.

Mm hmm. Yeah. You're listening to the Lady Gang. OK, these are questions from our Lady Gang community. There's so many. So I want to get to as many as we can. The first one, I'm going to read a couple because these all sort of are the same thing. can daily stresses of trying to conceive prevent you from conceiving? Everyone just says relax and it will happen. My therapist said stress levels of infertility are shown to be similar to those of cancer diagnosis. I always hear others telling women they're having difficult

conceiving. It will happen when they stop trying. Do you think that taking the stress off trying to conceive and constantly thinking about it helps fertility. And then also, this is all emotional together. How do your emotions impact baby during pregnancy? People say like, stress isn't good for the baby, but like, what does that mean? So stress on infertility was a big question. We got a lot of questions about that. I wish I could answer this one, but because of the lack of funding with women's mental health and women's health in general, we kind of have a half answer. We know that the two are super connected, but we don't know exactly what the mechanism is. But what we find is that people that have high stress levels, especially if they're doing assisted reproductive

technologies like IVF and having fertility issues, can certainly be helped by therapy, group support. Even just a support group can sometimes be helpful in kind of unlocking whatever that stress response is that then allows you to get pregnant. But the other side of that is that we know that people in times of war, in times of famine still get pregnant. So we know that sometimes, you know, stress is okay. Or for some people, it can be, I think this will end up being sort of an individual level thing where some people, yes, can go through the most stressful situation and still be pregnant. And for others, that's not the case. And we're seeing there's a huge change in like fertility rates and issues. And people are increasingly having more difficulty

conceiving, which is kind of interesting and might be due to environmental factors. Obviously, we're delaying childbirth. So that's complex, but we'll have to see how all of these things kind of interface. But I think it's pretty obnoxious for people to say, just relax. I think what is helpful is like going to someone and getting the tools to do that. Yeah. And then as far as I had a lot of anxiety about going through the mental health stuff and then the fetus, are there studies?

Can studies be done with that? Tell me about that. Yeah, so that's exactly what we were talking about earlier of untreated mental health issues like depression and anxiety. We know that when you are, for example, having constant panic attacks, your cortisol level is going to be up.

that transfers to the baby. And we do know that there's outcomes, like we've said, again, we're kind of in the early days of all of these studies, but preterm delivery, small babies, increased risk of C-section. Another is that we see a connection between some behavioral issues that are not related with anything like familiar. So like increased rates of ADHD, when that might not be something that you or your partner has. Interesting. So it's kind of true what they say, Like we got to be a, keep mom happy. That is the most important thing, right? If mom is well, then baby is going to do really well.

And I think too often we're kind of taught or think about being like sacrificial. I'm not going to do this. I can't eat this. I can't have that in order to like have a good pregnancy, but we really need to write kind of like dispel that myth because it's not working. Yeah. This was a question that I absolutely loved. Whoever sent this in, Lady Ganger, very brave. She said, when I had my first child, I didn't have any feelings of love for the baby for a few months.

It was just more of a feeling of anxiety and responsibility. I knew everyone I knew was gushing about how in love they were. And I never had a feeling like that. Is it normal not to connect with your baby? Unfortunately, you know, we do see this another myth, right? That you're supposed to like meet this baby for the first time and it's like your favorite person and it's a magical moment, but you're meeting a stranger. And yes, if you carried that baby, there may be a little bit of a connection, but you really didn't know that baby before. And so certainly we see like a little bit of a letdown, I think for some people where they don't feel as connected. If that continues for, you know, number of weeks, that's a little bit of a red flag for depressive

symptoms. So I wonder if that's what maybe was happening for that person. And I think that connection is a really important barometer of like how you're doing. Though it may take time, right? To be like, oh, I really want this. Especially, you know, we don't talk enough about this, but 50% of pregnancies are unplanned. And that can come with a lot of ambivalence of like, I don't know if this is right for my life. Yeah. It's like an arranged marriage. And then the last thing that I could kind of like group these guys, these questions together is that there was a lot of questions about the guilt of like the feeling of the emotions after a lot of loss. But then the emotions of a new baby after the loss, like a lot of our girls wrote in that, like, you know, it's taken them so long to get pregnant or they had such a hard time that like when they get a pregnant with a positive, they're just like not feeling even happy and they're kind of doomsday. And then also a lot of our women who maybe have one child and then are struggling from infertility or two.

And then people are like, oh, but you have two healthy babies. Who cares? Um, can you talk a little bit about the like aftermath and the, you know, of that? Listen, when there's been a loss, it can feel, you know, really hard to go into the next pregnancy. And what we find is like this, um, it's almost defensive, right? It's, it's a protection. It's like, I see this positive pregnancy test, but I'm not going to let myself be fooled

this time. Something is going to go horribly wrong. So like, that's what I'm going to stick to that narrative. And that's really hard. I think for those people, I really recommend being in therapy to be able to kind of unlock what's going on and have some awareness of it. But yeah, it is sometimes really hard to put your guard down again and have this feeling of like, I could have another loss and this could happen again. But then when you don't or when you don't explore it, what we find is that then sort of the pregnancy goes by and you don't get any enjoyment because you were so

worried about that outcome or like clenching your fists, you know? Um, and so that's something we see so commonly, but I think it's like having grace with yourself, uh, but really trying to get some support so you can have some awareness of it, right? The worst is when there isn't awareness of it and you're just kind of like rolling with it and, and not, not kind of thinking about, Oh, reflecting on what, what's, what's going on here, right? Why am I not excited about this thing that I've been working so hard for. And yes, we had a previous loss, but I can still enjoy this because right now in this present moment, I have a positive pregnancy test. This baby is okay. Do you know something I wish we talked about more as women and people who want

to have babies is that at least from my experience of myself and all of my girlfriends, it's a roller coaster, almost the entire pregnancy, as far as now we have luckily so much testing that can be done on the fetus to see how healthy the fetus is. And that starts as early as like eight weeks, but all the way from eight weeks until pretty much the baby is born. There are all these markers of just the waiting for test results, waiting for an ultrasound, waiting for this, like there's, you're not in the clear the moment you see the positive pregnancy test. And you're certainly not in the clear when you're in your second trimester, like this crazy, weird fairytale we're being sold. But Becca, you're not in the clear ever, right? You're never in the clear.

Even when your kid's driving a car at 16, what is the clear? Nothing's guaranteed. Yes. Nothing's guaranteed. The clear is like, and I think it's this, again, it's a struggle with loss and this feeling of like, well, I want this so badly, nothing can happen, or I'm so scared of something happening and it doesn't allow us to really be present in like, oh, this is so joyful. But Beck, I hear that all the time. It's like, okay, let's wait till the anatomy scan to then finally take a breath. And then it's like, no, then that gets pushed to like, oh, but then I have to wait till the delivery or whatever it is. But I think it's important to reflect on this because when are we ever in the clear? Yeah, that's a good point. Really good point. It's

like being present in the moment that you're not, you know, it's important. But again, like having a baby brings up, like, I don't want to lose this ever. Oh God, it's just gets worse. Everyone just strap up. Get a good mental health therapist. Well, I love this because you know what it means, what this conversation, what I took away from it is Prozac for everybody. You know what I mean? I know that's not what Dr. Sarah said at all, but that's, you know, Um, listen, this was amazing. You guys, the, uh, Mavita app is available right now in the

app store. If you're interested in trying it, we'll link to it. Um, if you want to check out Dr. Sarah, you can follow her at Dr. Sarah Oreck. Um, and you know, try to get an appointment with her, but it's going to be tough, but that's why the app is there. Um, we're so happy. Please come back. This was an amazing conversation. And I'd love to know from the community. Um, if you felt like you wanted to share this episode with someone if you could share it with people that you think this could be good and what other questions you have and should we do more episodes like this are you interested in hearing about this yeah let us know on our socials and we weren't here for a long time but we were here for a good time thank you so much for listening the

lady gang is produced by steve delameter stacy para jared monaco and social support from amy ryerson it really means the world to us when you show up in our community outside the podcast so Sign up for our secret Facebook group. Just search The Lady Gang under Groups. Follow us on Instagram and TikTok at The Lady Gang. And the most important thing you can do is share this episode with a friend. We would love that so much. Thanks for listening.

She talks about etiquette. Get your fingers out of your mouth. She talks about where to find a deal. You know, if you sell me something on Instagram, I buy it. Whoever markets to me does a fabulous job. she talks about the economy we used to joke that'll be the thing to send them to therapy okay we're creating jobs can we look at it that way she talks about parenting these kids want to come home they don't want to leave they don't want to drive they want to stay in the womb let's talk

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