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Today Steph and Dr. Elana recap the episodes on perinatal loss for Pregnancy and Infant Loss Awareness Month. Lindsay Wimmer spoke from a mother’s perspective in Episode 155, and Dr. Brandon Eddy shared from a father’s perspective in Episode 156. Both of these interviews contained insights to help any parent who has either experienced a perinatal loss or who may be having a challenging time during postpartum.
In this podcast recap, Steph and Dr. Elana share their own advice on how to help cope with loss, remind you of appropriate (and inappropriate) language to when trying to support a friend navigating loss, and share takeaways that will benefit parents and those supporting them during these challenging times.
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Elana Roumell 0:05
I find sometimes that it’s a really uncomfortable thing to talk about. It’s a very uncomfortable situation because sometimes you just don’t know what to say. And then oftentimes, we may not even want to say anything and that’s also not good. So I think again, just encouraging what language and helping you guys take like actionable steps, it’s going to be really important for you guys.
Welcome back to Whole Mama’s Podcast. We’re here to give you tools, resources and evidence based information so you can make the best decisions for yourself and your family. Whether you’re trying to conceive, or navigating life with a toddler, or a teenager. We got you covered. I’m Dr. Elana Roumell, pediatric naturopathic doctor and creator of Med School for Moms, an online resource where I teach moms how to safely be a “doctor mom”,
Stephanie Greunke 0:51
and I’m Stephanie Greunke, registered dietitian and program director for Whole Mama’s Club. I’m also the co-creator of Whole Mama’s pregnancy program and upcoming postpartum program.
Elana Roumell 1:00
Today, Steph and I are going to do a recap of episodes that Steph did interviews for on perinatal loss. from both a mother and a father’s perspective. Both of these interviews were full of insights to help any parent who has either experience of perinatal loss or maybe having a challenging time during postpartum. And this recap, Steph and I, we’re going to share our own advice with how to help parents cope with the perinatal loss, remind you of appropriate language to use to help support friends, and maybe some language that you want to avoid using with your friends. And overall, we’ll share our takeaways that will benefit both mother and father during these challenging times. But first, let’s go ahead and start with our “Nourish Yourself” segment. Stephanie, what are you doing today or maybe this week to nourish yourself?
Stephanie Greunke 1:42
So I actually have been inspired by you to start couples therapy and so I’m actually going to use the same person that you’re using for your couples therapy. We have our first meeting this Wednesday, so I’m super excited. We’ve actually never done couples therapy before. We’ve been together for 13 years. So it’s really funny that we’re starting couples therapy now, because we’re actually doing really good. We’re not in the middle of a breakdown. And I say this because I think sometimes when we talk about therapy, we think that you have to be having a very difficult time or being at the bottom of, you know, just really feeling awful to get help. And that’s not the case at all, you can definitely get help anytime and go see a couple therapists even if you feel like things are on the up, and you’re getting better. And we decided to start this therapy because we have a lot of things that are happening; that are coming our way- with moving to a new state, getting out of the military, living closer to families. So I want to make sure we’re in a really great spot and my husband and I have been through a lot together. We met in college, we were all about the keg parties and doing homework in college and now we’re not doing a ton of that. So I’m excited for the therapy to really work through some of our past struggles and start creating a new future together.
Elana Roumell 3:06
Steph, you know how excited I am for you guys. It is so cool. And we- Anthony and I, we just absolutely love this relationship coach. So we’re so happy to share the resource. But I actually never knew you guys have never been to couples therapy in 13 years that is almost like shocking to me because I know how proactive you are and I know how much you value therapy and I just think this is going to be so wonderful and such a cool experience for you guys to do as a couple. it’s very different than going alone and actually Dr. Eddie- one of the podcast that you interview, we’re going to actually talk about how helpful it is for both people to be there to be supportive for each other, so we’re going to get into that during today’s episode, but- I’m just so excited I cannot wait to hear about it. So you guys enjoy. I like literally have it on my calendar when your first session is so I can check in with you.
Stephanie Greunke 3:54
Oh my gosh.
Elana Roumell 3:55
Like, I love you and I want to just see that you guys are all jiving well.
Stephanie Greunke 3:59
Awww thank you!
Elana Roumell 4:00
I love it. It’s nourishing me to to know that I can also support you with all of that. So it’s great. Okay, so something that I’m doing so- as we’re recording this episode, I’m actually still pregnant. But when we air this episode, I’m actually- I would have already delivered a baby boy and hoping that everything goes well. I have to be honest, listening to your interviews was not the best timing for me. I mean, we’re talking about perinatal loss and postpartum challenges and such, but you know what- it’s good, because I think it’s important that we’re all you know, aware of this stuff and and knowing that this is a possibility. So, you know, I’m just I’m really hoping that by the time that this episode airs, everything is going well for me and for baby. But what I wanted to hone in on is that I’m really doing my very best to kind of front load some of my work. So that’s why we’re recording this podcast so early on, so that I can really be fully off for 40 days postpartum and that’s traditional type of all sorts of different cultures that moms will take 40 days to really rest and rejuvenate and recover and bond with baby and do as little as physically possible. So I just want to thank you, Steph, for really nourishing me with the extra support with kind of doing some of our podcasts ahead of time, so that I can be fully on my 40 days of postpartum healing. And I think right when the show airs, I’ll just be coming out of my 40 days. And so I’m really excited for myself, nourishing myself, and making a commitment to doing that as part of my practice. And I hope that can inspire some other moms as well.
Stephanie Greunke 5:33
No, I love that. Of course, you’re going to be proactive like that and schedule it on your calendar to make this happen, so you can have that restful experience.
Oh, thanks. Alright, well, let’s jump in because we have two podcasts that we’re going to recap and, you know, as hard as it was for me to listen to these interviews, I thought that they were really important interviews for all moms and parents really to listen to. And I again, I love that you’re bringing in male perspectives more and more these days, but first we’re going to start with Lindsay’s interview with the mother’s perspective on perinatal loss. One of the things that I just really, really loved about her interview is that she really delved into a lot about the language that we want to use, or the language we want to avoid when we’re trying to support some of our friends who may have had a perinatal loss. So I think that this is going to be really good for us to highlight so that moms can really just leave with those good takeaways. I find sometimes that it’s a really uncomfortable thing to talk about. It’s a very uncomfortable situation, because sometimes you just don’t know what to say. And then oftentimes, we may not even want to say anything, and that’s also not good. So I think again, just encouraging what language and helping you guys take like actionable steps is going to be really important for you guys. Now, before we go into the language part of it. I did love how Lindsay started off the podcast talking about how she still keeps her child that she lost and she still keeps this child as part of a relationship and she says it’s still helped her parent this child. So just kind of to break it down. It was almost like she was saying, even though I may have lost my child physically, I still maintain a relationship with this child and I still parent in just a very different way. And I just thought that was so beautifully said and practiced. And I just wanted to reiterate that just as we start, because this isn’t like a fun topic necessarily to talk about. But it’s a real topic, and it’s something that I think we can still find some good, insightful points. Did you notice that she kind of mentioned that, Steph? I wanted to kind of chat a little bit about that, because I actually have some personal experiences with that.
No, I and I really appreciate her for acknowledging that. I think so often, we have this belief that you just move on and move past it and it’s almost too painful to keep the person that you lost with you. Right. And that’s, that doesn’t have to be the case. I think carrying them with you and using them and learning from that relationship and whatever you need to do to keep that person’s memory alive can be incredibly powerful. And for somebody who maybe hasn’t experienced a loss like this, it can be hard to understand that. But I hope that she kind of opened up the eyes to the fact that even if you lost a loved one, whether that be a little child or an older adult, there’s still so much benefit to keeping them with you at your side. So and I know you’ve had some significant loss in your life. So I was curious, you know, is there something that you do today to keep them with you?
Elana Roumell 8:32
Yeah. So thanks for asking. Because even though it’s not necessarily a baby that I’ve lost, I wanted to share this because it resonated with me so much, and it really helped my grieving process and it happened to be with my father. I haven’t really talked much about him on our podcast, but unfortunately, my father passed away suddenly -now I can’t believe it’s been five years. It feels like it was just yesterday. He was 60 years old, very young man. And it was a- I mean, such a tragic time in my life. I was incredibly close with him. So I know I’ve shared about my brother’s sudden loss. But I’ve also now experienced my father’s sudden loss and obviously two very important men in my life. And I struggled much more with my father’s loss than my brother’s, I think different age, you know, I was 30. I mean, they, you know, I have a different relationship with him. And, I mean, I just- I adore my dad. And one of my therapists that I went to, during my healing- my grieving time, mentioned this concept and said, “You know, you’re grieving the loss of a relationship, but what if your relationship still continued, but it was in a different form. And so it may not look like he’s here with you in the physical form, but he’s always going to be with you.” And I- I’m getting like teary because I mean, I just adore my dad, but like, he’s always with me in some way, shape, or form. And I do believe in that because I feel him- whether it’s a religious thing or not, it doesn’t matter. I just feel him. And so when that therapist told me that I just, it like kind of knocked me off my feet in a little bit. I was like, What do you mean? Like he’s not here? How can I continue a relationship with him? He’s like, Elana, it can look like anything. It can look like you journal to him, it can look like you talk to him. You can look like you dream about him. It can look like you have a ritual every year and it’s around something you guys did together. And I just started thinking about it, like, oh, my goodness, it like opened up my eyes to this other axis of like, yeah, my relationship is not over with my dad, like I get to create whatever I want. And even though it may not be like I pick up the phone, and I get to talk to him or whatever, I get to have a relationship with him. So at that point, I decided to start a blog, a private blog, and every time I had a dream about him, I would write to him- every time I thought about him, I would just like open up my computer or my phone and just like start our conversation and I would post pictures of us- then one day I wanted to share something like we got a dog in his memory and I was like, look at our dog and I explained all about the dog. And that to me was such a great healing process, even though was my own private blog, no one else got to see it. It was a way for me to keep our relationship alive for me to continue to talk to him, to share with him. And it was a beautiful time and a way for me to heal through that grieving time. And I don’t write on the blog as much anymore, but it was great for what I did. And if I ever do want to go back and read or even update it, I always have it as an outlet for me. So I really want to share that, I didn’t realize I would get that emotional about it. But man, I adore my dad so much. And I know he’s with me, always.
Stephanie Greunke 11:32
I think that’s so beautiful. I love that you share that. And I think that’s a great example of something that you can do to carry them with you and to talk to them. And even though they’re not physically with you to have them be present in your life, and I’ve heard moms do this with the babies that they’ve lost too- is they’ll write letters to their baby of like, I’m thinking about you today. And they’ll talk about what they’re doing and like maybe talk about what they’re doing with their siblings and oh, love for you to meet your sibling, Jenny, you know, you love her. And you guys would play so well together and I can picture you and they just kind of like write about this experience. And, you know, keeping it as a private blog, like you said, it just has that level of safety and security that you can just feel free to type whatever you want without judgment or fear of somebody finding it. You can just really keep it close to you.
Elana Roumell 12:19
Mmhmm. Yes, I’m so glad. And maybe that’ll inspire some other moms as well. But I love what you said.
Stephanie Greunke 12:24
Elana Roumell 12:25
But let’s go into some of the language, because I remember even when my father passed, I could just see like people could get like, awkward about it, or even just like shy away from even bringing it up. And that didn’t feel good to me either. Or they would just kind of get like nervous around like, Well, what do I say? And I get it because it’s not an easy situation. So I really love how Lindsay actually brought up some like, really good points of like, what things you could say and here’s a good idea and what things not to say. One of the things she mentioned to say is just kind of giving permission to people to talk about it like hey, I know this is like a challenging time, if you ever want to talk about baby x, or you know, and say their name, I just want to give you permission and invite you to do it. Whatever time, whatever place I’m here for you, and I would love to hear about it. I mean, then the mom or the dad gets to just choose if they want to do it. And it kind of just honors that this child hasn’t been forgotten. You know, the child’s spirit is still here. And if we ever want to talk about it, and that’s a very healing process, then you can. So that’s another way to kind of go about it to bring it up or to support a friend. But what I would love, Steph, if you don’t mind is can you outline some of the like, the key things that she even shared is like, hey, here are the things that you really want to do your best to avoid. And I know when she was sharing that list, I was like, oh, my goodness, I totally say that sometimes. So I need to watch myself. I’m sure we’ve all been there. We’ve all said these things. So it’s not to beat yourself up. It’s more just “Okay, so now we know better and now we can do better”. And I love having this outline of lists. So if you don’t mind sharing that Steph. I would love that.
Stephanie Greunke 13:58
Yeah, and I can get into that later. Said she shared and help us remember, what does they do, what not to say and what might be hurtful. But I think I want to start by bringing up the point that you had of, sometimes if we know this, it can make our fear of talking about it even greater. And that’s not really what we want to do with this type of information. I mean, I definitely caught myself during the interview, even stopping and be like, Oh, did I say that correctly? So it’s about having some humility with this, that it’s a really difficult topic and what you know, some of these things that I’m going to list off that she said not to say might be hurtful to one parent and not hurtful to the next. And I think if you find yourself in a place where you say something, and then you’re like, ooh, I don’t know if that was the right move. Or like you said, You’re going back and you’re like, Oh, I don’t know if that was helpful. There’s still a time to make amends and say, Look, you know, I remember I said this to you, and that was, I see, now that that could be hurtful. I just wanna let you know that I’m sorry. And I’m very sorry for your loss. And I think that’s just the best that we can do just like as parents, we’re going to do things that we may not have wanted to do or say to our kids, but we can always make amends and give them a hug and do our best next time. So a couple of things that she talked about, to avoid are saying things like, when are you going to try again? And that really implies that baby is replaceable? Or maybe the parents don’t want to try again, maybe they’re not wanting to and you’re almost forcing them into this really awkward situation or feeling like they should. Avoiding religious words, like God has a plan or there are angels around you. That may resonate for somebody that’s religious, but not for somebody who doesn’t believe or that doesn’t appeal to them. You can avoid silver linings saying things like well, it could have been worse or at least you have one child or, you know, there’s always next time. I think also saying well, you know, almost giving clinical prescriptions- Have you checked your thyroid, or have you heard about MTHFR? Unless they ask- kind of placing the blame on them. Even if you think it’d be helpful information, I think there’s a time and a place where you can offer that advice. And that time is when they ask you. I think giving false reassurance saying that it will be better next time to a parent who’s had a loss, they wanted it to be that time and this is really hurtful for them. So it just really honoring and accepting that this is hard. And when it comes to loss, what I find is that simple and to the point are often better. So saying things like I’m sorry, or the template that you gave, I love to hear more about your baby if you want to share- leaving that as that I think sometimes we have this awkward silence that we want to fill up but short and sweet is really what parents need.
Elana Roumell 16:47
Thanks, Steph. Honestly even just reviewing that list again helps me- so selfishly, this is why I asked is I just like reviews and I like to hear it again and I can really see how for some that really resonates and for others it doesn’t. So obviously, for listeners is use your judgment. You know, if you are talking to a friend who is very religiously connected to a God, then of course, you know, bringing up God or angels and such could be very appropriate. And you know, I would even go as far as even asking friends like, “Hey, I’m just gonna, like, be transparent. It’s like, this is really hard for me. I don’t want to say the wrong thing. This could be hard. So if I say anything that triggers you, please like, let me know.” Or if you if you hear I say something that really works for you, then please also let me know because I just want to be here and I want to support you, and I’m going to do the best that I can. I mean, even that conversation, do you think- Steph? Can go a long way with with a person?
Stephanie Greunke 17:40
Yeah, absolutely. I mean, it’s going back to having that humility again. And if it is a close friend, yeah, you can personalize it a lot more. And you you also have that ability to say like, I might say something wrong, and I’m sorry and you know- really work to understand because the more that you can understand, like you’re really helping each other. If they can help you understand what’s wrong then with what you’re saying then you know the next person that you encounter that’s experiencing loss. You don’t carry that over into that conversation.
Elana Roumell 18:08
Yes, I totally agree. That’s great. Alright Steph. You talked a little bit about this on the show, but you really didn’t expand much, which is why I really wanted to ask on the recap is, I didn’t even know that these exist, but you call them bereavement doulas, right. So we know a lot about doulas. There’s birthing doulas, there’s postpartum doulas. But I’ve never heard the term bereavement doula. Can you give us an idea of what that looks like and how we find these people? And I just thought, I was so interested in that.
Stephanie Greunke 18:36
Yeah. So this is something that was new to me, when I was living in Monterey after Otto was born. And I just really got interested in perinatal mental health. I was part of this birth network and there was a bereavement doula as part of the network and I went to a training that she was hosting because I personally, you know, I’m not going to be a bereavement doula at any point, but I wanted to know what was there to offer resources and so- the explanation that I got during the training was that bereavement doulas help families through pregnancy loss in any trimester of birth and for whatever reason, including abortion, they help if you have loss from adoption or surrogacy. Say you really wanted a child- they came into your family and then the legal system decided that that wasn’t the right case. Or if you carry the baby and then gave the baby to another family, that is a type of loss that bereavement doulas can help you with even things like NICU grief so let’s say baby is really struggling and then the NICU- you maybe they aren’t, maybe they haven’t passed yet but you’re really worried about that they can help you with that really trying experience. They can help you find peace with a pregnancy after you’ve had a loss. So with rainbow babies, or maybe you lost one of your twins or multiples during your pregnancy, and while they are trained in all these really unique – these special life circumstances, they can even support you like traditional doula would. So they can do both- they can play both roles. So what this would look like if you were to hire a bereavement doula, is they would come and comfort you during the labor, labor and delivery process. So let’s say you’re experiencing a loss and you want to experience that loss at home or in the hospital, they would be with you by your side to help provide that emotional support and tell you what’s going on and what you’re you might experience and help you with the care and healing after that. They might help you fill out death certificates or assist in making funeral arrangements. They might help you figure out what to do when your milk comes in after the loss and coach you and your partner and how to react when people ask like what happened to the baby. So they play a lot of really important roles. And I wish more people knew about them because when I bring it up to the moms that I work with that have miscarriages they just they’re shocked. Nobody, nobody’s ever mentioned this to them. I wish it was something that you know, in the hospital is just, you’re given this referral like, “Hey, take it or leave it, you know, but these people are there.”
Elana Roumell 21:09
I really never knew this existed. So thank you for sharing that with us. My question is then are they trained similarly to like, therapist or counselors because they can do so much emotional support or it’s, it’s more so the like logistical things along with the physical support of this process?
Stephanie Greunke 21:29
Yeah. So they don’t have to be a trained counselor. So that has to be like a clinical social worker or anything like that. But if you think about a doula, it’s really just a mom or somebody you know, it doesn’t have to be a mom but it’s somebody that wants to support parents going through loss or a new parents and so they understand it from their training that they get. So you can actually get training in (being a) bereavement doula- to be a bereavement doula through a couple of organizations- the one that- I did actually get the training because I was very curious. So you know how much I love learning. So I am like trained in it through stillbirthday.com and I’ll put the link in our show notes. But yeah, they do trainings and anybody can take it, if you want to support families.
Elana Roumell 22:14
That’s great. I have heard of also having end of life doulas, like yeah, for elderly. Is it a similar training or this is specific for perinatal loss?
Stephanie Greunke 22:23
Yeah, I mean, this one, the stillbirthday one is specific for perinatal loss. But yeah, there’s definitely ones for end of life as well.
Elana Roumell 22:30
Okay. And where do you find these people, Steph?
Stephanie Greunke 22:33
Yeah, well, stillbirthday.com has a directory.
Elana Roumell 22:36
A directory? Yeah, perfect. Okay, so yeah, let’s put that in the show notes. Yeah, overall, I just I really enjoyed this interview. Again, as hard as it was, it was not ideal to listen to during this end of my pregnancy, but it’s okay. You know, I got over it. And I realized this is important. So I think it is important just to kind of give a warning out to some of the pregnant moms like if it does trigger you then you know, stop listening and you can always listen to it another time. But I do think this information is incredibly important, not only if you have experienced some type of perinatal loss, but also you know, we may know people who have and how to support people and how to encourage them to get the resources because oftentimes we just don’t know it even exists. So thank you, Steph, for bringing this you know, to our show, I think it was a really great topic.
Hey, Mama, Dr. Elana here to quickly remind you that you can safely be a doctor mom. We all want the best for our children. And as a mom, you are automatically your child’s number one health advocate. I’ve created guidebooks and video courses to teach you how to feel calm when your child is sick, how to be competent using integrative medicine tools, and how to feel confident knowing when it’s time to visit your doctor. Or, when you can safely treat your child from home yourself. Head over to medschoolformoms.com/wholemamas and start watching my free mini course where I teach you the mindset, medicine and mastery of being a doctor mom. While you’re there, check out my favorite pediatric and mom approved medicines I use with my patients. I’m always updating my favorite products. Staying up to date is my job, so you don’t have to do it. Now, join our village of supportive mamas visit medschoolformoms.com/wholemamas, so you can make confident decisions about your family’s well being. We love helping moms become Dr. Moms. Now let’s get back to today’s episode.
Now I would love if you’re okay transitioning to now the father’s perspective because you brought on Dr. Eddie. And I just I love listening to him. He was a really cool, was a cool guy and I I kind of loved how his personal experience led him to research this for the last like decade or so. And for him it wasn’t necessarily perinatal loss, my understanding it was more of a type of postpartum depression or postpartum anxiety experience. But since he’s now into so much clinical therapy, and research he also will take on perinatal loss or mental health perspective. Is that correct? I’m pretty sure that’s the case for him.
Stephanie Greunke 25:08
Is that right? Yeah. And it’s also how you define postpartum and so postpartum could include loss. Right. You know, and especially if you have a stillbirth that you you’ve gone through all of that hormonal transition you are, you know, still a mom, like we talked about carrying that with you. So yeah, he does both loss and
Elana Roumell 25:29
Stephanie Greunke 25:30
Elana Roumell 25:30
Okay, great. And I loved his perspective. It wasn’t only from a father’s perspective, but also from like a clinical research perspective. So we’re going to hear and I know you love that stuff. So we’re going to go into summarizing some of his research and findings and also his perspective. But I really first want to start off by just saying how much I agree with him on how influential it is to show up to therapy, when someone in the relationship is struggling together. And we kind of started off by talking about that in the Nourish Yourself segment, which is why I’m so excited for you and Brian. Whether there’s a challenging time or not, showing up together gives the other partner so much insight into the other partner’s world. And I know for me and Anthony, now that we’ve been doing so much relationship therapy, I’ve actually come to have breakthroughs and awareness of things that I actually didn’t know about until he was present. And I was able to talk about his situation and him being there helped me discover something that I don’t think I would have known if he wasn’t there. And kind of vice versa. When I hear him talk to our coach about something, it gives me so much access into his world that I don’t think he would have actually discussed with me without a coach there. So I just thought that it’s so valuable to do whether or not the husband is experiencing postpartum depression for himself, but his wife is, or if the wife is and the husband’s not. It truly is a team approach and when it comes to raising any type of family, it is a team. And so for us not to go together, I think actually could be a disservice to one or both of the partners. So I just loved his philosophy with that. Now, I’m sure you can agree with all of that. But one other thing that he said that I know for sure you would agree, because you’ve brought this up in the past, is how men tend to want to fix things. You know, like he, he felt like his, his wife was having some struggles, and all you want to do is just like, fix it and figure out the solution. And he didn’t really know what to do. And so that’s when he reached out and said, You know, I think going to therapy would be a good idea. And it was like something tangible for him to be like, great. We’re in action, we’re doing something. So I feel like I’m like fixing something or something’s happening, even if it’s not him doing it. He’s actually doing something to move the relationship forward. So anyway, I just wanted to bring those points up initially and see if you think Brian would also kind of resonate with that because I know Anthony would so I wanted to see your perspective, Steph.
Stephanie Greunke 28:01
Yeah, I totally agree. And I think, you know, we do label that as a, like a masculine characteristic of wanting to fix things. But if you see that somebody struggling, any one of us wants to fix things, right? You just want to make that person better. And you know, when you’re talking about your dad, I just wanted to give you a hug and like, figure out what I could do to make you feel better. And, you know, I think what he said about going to therapy is it’s something you can check off your list that even if you’re not making huge strides the first time or first couple of times because that might not happen for you, you know that it’s you’re working towards something, you’re working towards a solution. And what I think is really helpful when it comes to therapy or couples therapy is that sometimes you know, if you are really in it, in postpartum- you don’t even know what you need. You know, I talked to moms and I’m like, Well, you know, what, what are some things that make you feel like you? And there’s often a pause and just I don’t know, like I just have been so focused on fixing things, you know, taking care of the kids and you know, making sure that everybody is taken care of but myself that I don’t even know what I need. And so couples like individual couples therapy can help you start figuring that out. But if you don’t know what you need, how is somebody else going to be able to fix it or give you what you need? So that’s really frustrating because not only is it an emotional thing, often like you can’t fix that emotion but the person isn’t giving you anything to work with. So this is why you know, in my postpartum program, one of the first things I wanted to do is to be able to offer a couple of activities to help moms figure out what they need to feel like themselves and create something that they can work towards and have their partner and vice versa work towards to help them start feeling like themselves and what they need so that they can fix it. And you know, this is something that we talked to Emily Hughes about when she was in the NICU with her daughter for year, she realized that she needed to go back to work and have some time away. And she really needed healthy food. And once we can start identifying like, Oh, those are our needs, then we can work towards taking action and fixing that together.
Elana Roumell 30:14
Yeah, I completely agree. I’m wondering if in your activities in your postpartum program, are you encouraging the partner to do it with?
Stephanie Greunke 30:24
Elana Roumell 30:25
Okay, great. So then the two partners are doing it together. Yeah, I do think that is very helpful. And I like what you said. It’s true. It’s, there’s really no gender role when it comes to wanting to fix things. And again, there’s also no gender role and it could be the father experiencing postpartum depression, the mothers doing actually really great. And I love how he actually brought that up. Because, yes, oftentimes, we think it’s a hormonal imbalance, but there’s also different hormones that come out with the father too, that he may not be, you know, pregnant and, you know, going through the labor and delivery part but his testosterone is lower and we find things that are actually lower. And it could really absolutely hit the father as well. So it’s a very important that we’re both acknowledging in both partners where those needs may be lacking.
Stephanie Greunke 31:10
Oh, absolutely. You know, and if moms struggling, and there’s at least a 50% chance that the partner is going to be struggling as well. And so, yeah, it’s absolutely important that we’re working as a team. And what I loved with Dr. Eddie and his clinical research is that part of it is him outlining six themes or barriers for new dads. And if these barriers are left unchecked, they can become risk factors for postpartum depression, even outside of if mom has it or not. So let’s summarize them again for our listeners who either missed it or just want another review.
Elana Roumell 31:44
Okay, great. I love it. You did a summary for the first one and I’ll do a summary for this one. I like summaries. I think both of us really enjoy this. So again, these are going to be points that Dr. Eddie defined that would make a father more susceptible to potentially having some postpartum or anxiety. And so just bear with us and you can kind of get an idea. So the first one is just lack of education, perhaps dads aren’t even aware that this could actually occur to them. And so after they have the baby, they don’t realize why things are off or why they feel this way or so I think going into it knowing that this is a possibility is going to be very empowering in the end so that they know what signs and symptoms to look for. The second one is gender expectations. Oftentimes, you know, we have the stereotype for men to just tough it, tough it up, you know, don’t be emotional, don’t cry, or don’t express your feelings. And that’s absolutely not what we recommend. This is a very emotional and vulnerable time. And it’s important that none of the gender expectations are here because you really don’t know which role you may take as far as the being the primary care provider or just how you’re going to support each other. And so I think that that’s very important that you just let go of all expectations. The third one is suppressing feelings. This is something that either men or women, women can have an experience with, you may not want to share, you may not feel comfortable sharing. And that actually makes you more susceptible to potentially having some postpartum challenges. And so I think knowing that ahead of time being educated and then having some, some type of ally, whether it’s a therapist, or whether it’s a family member or a good friend to really express yourself could really help. The other one is lack of self care. So again, this is really for men and women. But I don’t think it’s as talked about as much when when we put let’s say, we hire postpartum doulas to really help the mom through the healing and the recovery and the breaks. You know, it’s also really important to make sure dad’s getting the self care as well. You know, dads are also taking off work and then oftentimes going back to work a little bit sooner than mom simply because whatever demands that they may have either financially or just that they want to get back to work, and maybe they’re neglecting their sleep or maybe they’re neglecting their their food intake, because maybe the mother used to be the main cook or you know, there’s tons of things that could be neglected and all the attention then goes to baby. So being aware of that is very important that both parents are getting as much self care in as possible. The fifth one is seeing baby as needy and potentially even resenting the baby. And this is actually not very uncommon that I’ve heard in my practice is men may not be as aware of how much dependency that child is on the mother and how they sometimes feel like they kind of get like the backseat often, like they used to get all this attention from their wife and now the wife is much more inclined from a very primal way of focusing on on baby and making sure that it’s like- is nursing working? Is the baby sick? Is the baby healthy? What’s happening?. We’re so occupied and preoccupied with the baby that we oftentimes do for a short time period neglect the needs of other people in our lives because we’re so committed to focusing on this baby. And so knowing that ahead of time- being aware of communicating that is very important for these males or any partner. And then lastly is just experience of neglect by wife or family members. Oh, and so it’s a very similar topic is, you know, people from the outside are also just checking in on well, how’s mom doing? How’s baby doing and oftentimes neglecting even asking, how’s the partner doing? You know, how are you doing? Oftentimes, so much attention goes on mom and baby, that it really makes men’s oftentimes feel like they’re just like invisible and that they don’t matter. And that’s absolutely not the case. Again, it’s such a team dynamic. And so looking out for these six themes Dr. Eddie has really honed in on with his research, and it really is very powerful so that we can either prevent fathers from experiencing postpartum depression and also just being very proactive in trying to acknowledge if someone is maybe feeling this way and possibilities of why.
Stephanie Greunke 36:01
That was like, amazing.
Elana Roumell 36:02
Anything else you wanted to say, Steph, about that?
Stephanie Greunke 36:04
No, that was such a great recap. And the only thing that I would add to it was just regarding your last point about experiencing neglect by the healthcare system. And I’ve heard stories like this where, you know, when I, when I do work with individuals, I like to work with both of them at one point, just kind of checking in on how the partner is doing as well, as a mom that I’m working with. And I remember talking to one of the partners and, you know, he was saying that he felt really uncomfortable and really frustrated and really resentful, because he was looking at the screening that his wife was taking for postpartum depression, which I was so happy to hear she was being screened by her provider in the first place, but he was looking over her shoulder and looking at her answers, and he was wondering, why isn’t anybody asking me this? Like, why isn’t anybody asking me- I am experiencing this. You know, the provider didn’t give it to him. The provider just gave it to the wife and there wasn’t a discussion about his feelings. That just rocked me. And I’m like, Oh my gosh, like we were really failing our new parents by not making sure that them as a couple are thriving!
Elana Roumell 37:09
Yeah, I think you brought that up on the interview. And yeah, that’s really not okay. But it actually kind of got me thinking since I am a clinician and I have been seeing parents postpartum. And I think oftentimes, I mean, more times than not the dad’s not even present. You know, I’m in for a Stevens screen, which is too bad. And I think that’s actually one of the things that got brought up too, is that it’s really important that doctors start scheduling more time to make it available for the dads to show up. Because, you know, if we had it all of our way, all prenatal appointments, dads, which are the partners, any partner, you know, would show up during the labor and delivery, obviously, the partners there, then the postpartum visits, the father’s there, the partner’s there, and I just feel like all too often, the commonality is like, you know, well, it’s during working hours and there’s no availability. And so we’re just going to report what we got from the session when we go home. And I just wish that wasn’t the case. Right? I mean, it would be so nice that we could do all of this together. It’s actually one of the things I wanted to highlight why I’m so excited. The group of midwives that I, I chose as my team, they actually mindfully choose Sunday hours as their main appointment times because they want the both parents to be involved. And I was like, Wow, that’s so cool. Yeah, we could do Sunday’s. That’s amazing. It was one of actually the biggest highlights that I loved and why- I chose them for many other reasons, too. But I just think if we can move into that type of like health care, that would be great. Just so we do have the opportunity to screen both parents and not to just like shy away from the fact that hey, both are involved.
Stephanie Greunke 38:50
Yeah, no, absolutely. And I totally agree. It’s often not feasible, and we talked about this on the podcast with him of both partners going just because of work and who’s going to watch other kids if you have them and all of those logistics, but you know and that that case like the it was right there- like right in front of the provider’s eyes that they could have given that screening tool. But yeah, it is something where you know, if it isn’t realistic for both partners to go, it still is something where we can as educated listeners and mamas of printing out there’s lots of worksheets on Postpartum Support International’s website looking at signs and symptoms. There’s even a specific section for fathers and just kind of resourcing our community, our loved ones with the information if we’re not getting it from our providers, because we’re not able to go to those appointments. So kind of just being on the lookout for it. But what makes us tricky though, Elana, is that you know, we have so much like as as mamas we are often taking care of others before ourselves. And so that’s why I really want to put the onus on on providers to be asking the questions, even if the partner is not there. Because if you’re struggling, if you are sleep deprived, if you I want you working on you, first of all, you know, we got to put our own oxygen mask on first. But we can’t allow that to just let our partners or other loved ones slip under the cracks.
Elana Roumell 40:14
I totally agree. And now that we know better, we can even ask for it. So if we don’t get that. Let’s just ask. And I actually I was curious because you know much more about this with your expertise than than me- if your doctor isn’t screening, where could parents go to get screened easily? Right. So all right, if it’s not going to be offered on my doctor, how can you be proactive about it?
Stephanie Greunke 40:35
Yeah, so I mean, technically they should, and I’m really hoping within the next couple years, more and more providers will be following the recommendations- because for example, ACOG recommends that ob-gyn and other obstetric care providers screen patients at least once during the perinatal period for depression, anxiety, and even the American Academy of Pediatrics has stepped up and said it’s really important for pediatricians to integrate with postpartum depression surveillance and screen at the 1, 2, 4, and six month visit. So both of those organizations are telling physicians and providers, we need to be doing this! But like you said, sometimes they aren’t. And it takes time for these changes to take place. So it’s a great idea in this time to be an empowered, proactive patient and bring it to the attention of your provider that you want to be screened, especially if you don’t think that they’re going to offer that for you based on history. And these screening tools are something that you can easily find online. So the EPDS, and I’ll put a link to that in our show notes, is one of the most common tools that works for both male and female partners. And you can take it at home. But of course, you want to make sure that with any screening tool, you’re working as a team- so you’re taking those results if you do it at home to your provider, and helping letting them help you figure out what the best treatment plan is. It’s not something that you just want to take at home and then like try to treat yourself you really want to make sure that you are working with a team to help you.
Elana Roumell 42:04
Great. Please do put that in the show notes. Because I think it’s just a good reference to have and resourcethat you can actually even share with your doctor or share maybe with a therapist or just do it at least to be proactive and encourage maybe the partner to do, so I think this is great. Steph, are there any other key takeaways that you had for either other episode? Either interview that you did?
Stephanie Greunke 42:26
No, I just I think this is all such great information. It’s definitely worth listening to. Again, I think sharing with other people in your life, I think, especially when it comes to loss. There’s just a lot of misconceptions. And with postpartum depression, there’s a lot of misconceptions about it only being one sided, and we really can do our part to help spread this information that isn’t getting spread as often as it should be.
Elana Roumell 42:51
Great. I love it. Well, thank you again for bringing those guests on. I got a lot from it, and I hope our listeners did too.
Stephanie Greunke 42:58
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- Personal stories of how we grieve through our own family losses
- What language to use and what to avoid when speaking with friends who have experienced perinatal loss
- What bereavement doulas are and how to find one
- How husbands play a role in the grieving process
- The 6 themes of what it’s like to experience Postpartum Depression as a father
- 6 Themes of PPD in Dads
- PPD screening
- Learn more about Whole Mamas Pregnancy Program
- Sign up for our Weekly Pregnancy Emails
- Take the Free Mini-Course at Dr. Elana’s Med School For Moms
- Schedule an appointment with Dr. Elana
- Follow Steph and Elana on Instagram
- Whole Mamas Podcast Archive