Here in the United States, you know, for better or for worse, everything is a double edged sword. We have much higher standards for female equality and independence here, and that is fantastic, 99.9% of the time. Except for that, you know, the small phase of postpartum, where you are a different person now, and we have those same expectations.
This episode hits close to home for me, because we are talking about the postpartum transition, and I am very quickly nearing my own fourth postpartum transition. With my fourth baby, we are talking about what we can do better in the United States to support women through their postpartum transition. What if we could learn from centuries old traditions that help new moms feel stronger and supported and more seen. That's exactly what we're exploring today, and we're doing it with someone who brings both clinical expertise but also cultural insight. Her name is Khushboo Joshi, and she is a board certified orthopedic clinical specialist and pelvic floor physical therapist with over 20 years of experience, she's taught at Northwestern University School of Medicine, founded her own pelvic health clinic, and spent her career mentoring, advocating and educating women who truly want to understand and care for their bodies. This conversation was sparked by one of her own patients who had a high risk pregnancy in a C section, and then noticed how dramatically different her recovery looked compared to her friends from India and South Korea. So today, Kaesie and I are going to explore some postpartum traditions from these other cultures, and these are practices that have been restoring mothers to health for centuries. Spoiler, one of them involves going to a center just for postpartum care and staying there for a few weeks, so you will not want to miss this. There are some good things that we can do for our postpartum moms. Now, this is not just for women who are postpartum. This is for anyone who cares about women who are postpartum, and maybe even more so, because when you're in the weeds of a postpartum transition, there's really only so much you can do. But all of the rest of us who are supporting women going through having babies, this is where we get to learn how we can support them better. So whether you're a new mom, a grandmother, a partner or just someone who cares about the women and neighbors in your life, I think you'll find this conversation eye opening inspiring with some really great tips that you can start doing today. So let's dive in, and so there's something to be learned from that, and we all have our stories, and we do need to put ourselves as a priority on our own lists.
Khushboo, thank you so much for coming on today. This is going to be such a fun conversation, so I'm grateful for the work that you do, and excited for people to learn more about it.
Well, thank you, Dr Cracroft, I'm very excited to be here, and I've been doing this for a while. So thank you for bringing this to everyone's attention.
Will you start us off by telling us a little bit about your research and what you're doing bringing these different cultural aspects together? Tell us just sort of from the beginning, how did you get interested in postpartum work and where your work has taken you.
Absolutely so I am a physical therapist by training, and I've been a physical therapist for about 23 years, the majority of that time specializing in women's health or pelvic health. And over that time, it's morphed quite a bit. I see women throughout their lifespan. So I see young women. I've seen them through pregnancy, postpartum, perimenopause, menopause and beyond. I became interested specifically in this area through a patient of mine. Actually, she was an educated woman, upper middle class, middle class background, ended up having a high risk pregnancy and a C section with multiple complications afterwards, and had access to really, some of the best health care that the US has to offer. And so she and I were working together, and she said, one session, she said, You know what, Khushboo, are you Indian? I said, Yes, you know I am, and I'm Indian by background. And she had noted that her recovery, her postpartum recovery, was very different than her friends. Some of her friends from grad school were Indian and Asian, and she said it seems like their experience is very different than mine. She echoed a lot of what we hear today in the media about our postpartum moms in the US, they feel isolated, they feel diminished, and they feel sort of broken and not fully put back together yet. And she was navigating that had a great relationship with her family, but she noted that her Asian friends had a lot of family and cultural support, and so she asked me a very intriguing question that sort of catalyzed the whole project that I've been working on. And she said, is it just her, or is that cultural. And I said, You know what? That's cultural, because my postpartum experience was very different. And when you're going through it, you think, you know you've got tunnel vision. You think, this is me. I just have to get through it. So that's what sparked me, digging into this whole aspect of we've got a tough situation with our postpartum moms. Here in the US, we have the highest maternal mortality rate. Everyone's looking around at what do we do? But we have these Asian countries that have been doing it for centuries. They're doing it right in that they have better outcomes for their postpartum moms than we do. So instead of reinventing the wheel. Let's look at what they're doing. And I looked at specifically India and South Korea, and I put together a few things that would be applicable for us right away. So that's, that's the story of how I got into what I'm doing right now with these cultural differences.
I love this. I think it's so fascinating, you know, we I think sometimes maybe oversimplify the idea of postpartum care. So many of us as women have babies, right? And so you get to the postpartum transition, and it just feels like one more normal event in your life. But it really couldn't be a bigger transition in your life. I mean, you're going from your body is going through massive changes, your social situation with the baby, and adding to your family and your relationship with your partner, and the way that you show up in the world has just drastically shifted. And as an OB, you know, I know this firsthand, that we would send people home and be like, good luck See you in six weeks. And just, you know, we give them papers to read, and in the best of situations, maybe we give them a phone number to call, but really so little support. And I think that there could be more cultural support, but at least from the medical profession, we are giving so little support. So tell us a little bit more about the current American tradition of the postpartum experience. Like you mentioned, most of us go through this just as like we don't know any different. You know what? What? What other experience would there be? So give us a little bit of an idea of what that experience looks like compared to some of these other cultures and what they're doing, and what we can do to bring in these other cultural aspects to support the women around us every day having babies.
I couldn't agree more. We aren't doing enough from the medical perspective, even from the cultural government so to give you an idea, and you're an OB, you have a unique insight into this, and as you just said yourself, you wish you could do more, but our system's not set up that way. So when I say the postpartum period, I'm speaking of from birth, when you deliver, to about 12 weeks after that, so the first three months, and that's the fourth trimester, which a lot of people are familiar with. That term. Now, it was coined, actually, from the baby's perspective, right, to say that the baby wasn't ready to be fully independent, but that three months afterwards, for the female that's delivered is also really, it's it's transitional, transformational. Like you said, what happens with us in the states is that you deliver and you have up to, if you're lucky, a 48 hour hospital stay. It could go anywhere from a regular vaginal delivery without complications, to a C section, and you're pretty much released with exactly what you said, some paperwork, some phone numbers, and call me if you need anything you know. Recently, the American College of gynecology came out with some recommendations that said, Hey, let's tap in and let's check in three weeks after birth. But for the most majority of the population, it's six weeks after birth. Now you know that six weeks is a very crucial period of time. We all have our war stories from that. You know, whether you gave birth a few months ago, where you gave birth, 25 years ago, it all ends up sort of being the same. You're alone, there's a lot expected of you, and you're sent home with this baby, and you're now the primary caregiver. I think what's changed over the years is that more is expected from the female.
More is expected from an independence perspective, from a body perspective, and frankly, from an Instagram perspective, you know, yeah, now we've got social media, and we're looking at all of these women who are saying, I do this. I do that. You should do it too, and you can be just like me. So our moms are experiencing not only physical depletion, but they're experiencing mental and emotional depletion. The disparity sort of that difference in our population between that maternal death rate is most noted in lower income and.
Of the black population, the black the Native American population, they're dying at almost three times a higher rate. So if you've got some means to hire somebody great but guess what, most people don't, and that's the current state of affairs in the US. We also don't, from a governmental perspective, like they do in South Korea, we don't support our postpartum moms. A lot of them are expected to go back to work within six weeks. A lot of them need to work. That cultural and societal expectation, just in itself, places a lot of pressure on women, and we didn't have that 50 years ago, that whole postpartum period in the two countries that I've studied, India and South Korea, they're considered almost sacred. These are countries that may not have the best human rights record, let alone the best female rights record, but there is something about that postpartum period that is really sacred and nourishing and restorative for the mother that we don't have here in the United States, and I think we can use some of that to really change what's happening with our postpartum moms. I love that you're saying that I love the idea of it being perceived and and handled as something that is really sacred, because it really, it is quite sacred. You know, you just brought this new tiny life who's brand new to the world, and you're sort of giving them their first exposures to the world. And we know from science and from gut instinct as moms that like that matters. You know, those babies need their moms during that phase, and they need to feel close, and they need to feel that their mom is in a safe space. I always like to think of it from I call it cave women, but you can think of it from the animal kingdom too. You know, you can imagine a cave woman with a brand new baby. Her job is to immediately start teaching the baby how safe the world is. And you can imagine, if the cave woman had a baby in the middle of a million saber toothed tiger attacks that that she's going to teach the baby and pass on hormonal regulation and and chemical cues to the baby to be on guard, right? So that baby is going to grow up knowing this is a really dangerous world and going to have really intense sort of protective mechanisms, and we're doing the same thing all the time as moms, to say, Hey, I feel safe, baby, so you can feel safe. And that's one of the things that makes it so sacred, is if mom can't feel safe, then babies don't feel safe. And then we have generations of people who are growing up with hyper vigilant responses, you know, feeling like, oh, okay, I know how this world works. I need to be over reactive. I need to react to any threat really aggressively. I think another thing that comes to mind when you're talking is the idea of preparation for motherhood and preparation for the postpartum transition. So much of education, and you can tell me if this is different in other cultures, but so much of our education in the United States is built around the birth. And I love that, right? Like I am all about having a nice, smooth birth, but the birth is one day, maybe two. You know, the birth is, is, is a brief, a very brief period in time. And yet, then there's this, like, vacuum of empty space of the postpartum transition, where we really don't get that education. If you're lucky, you may get breastfeeding education, you know. But in terms of, like, other education, there's so much that changes in that time, including what your body is going through and how you might feel with relation to your body. There's a lot of like, separation from your body in that time. How do you deal with the baby who's not sleeping when you need sleep more than any other time in life? How do you feed yourself when you can hardly feed your baby much less, like, go to the grocery store and if you have other children, feed your other children, much less your you know full time working husband, who may not completely understand that you don't just have it all in you to bounce back. There's, there's this gaping hole that we're not educating about. We educate about how to breathe through contractions and how to, you know, fight back against the medical system so they don't steal your birth. And, you know, we have these really intense models of education for the birth, and then it's like it's kind of the same thing. I do think that doulas and
and others who are in that birthing space do a better job of preparing, but they're still kind of a gaping hole of what that actually looks like. So tell us a little bit more than about India's approach. We'll start there. Tell us what is so different about what they're doing with their new moms that that make it feel sacred and make it feel supported? I'm actually going to tie that question into something you said, which was so insightful and just a really great analogy about the cave women and when they delivered and they had their baby, that's all they had to do.
Or if they somebody else fought off the saber tooth tigers, somebody else brought the food to them. And so we just don't have that anymore. In fact, at work,
one of the things that I like to bring up when I'm talking to other physical therapists about this is the whole idea of maternity leave. You know, we call it maternity leave. So the people, when they're talking about you at work, oh, how is Sally doing? Oh, she's on leave. You know, it makes it almost sound like you're not doing your part, right? Other people have to pick up the slack for you. It would be great if they called it restoration period, because you are a completely different human body by physiology. So from a cultural perspective, if we can just shift it to support is needed that, I think that would be the best start. You asked about India, and that's how it is. We have a high you know, the difference between moms that have access to doulas and, you know, wonderful OBS that are not overburdened with a ton of cases, that's a monetary issue. You know, it's great if you have an OB that can help you afterwards and give you a three week checkup. But also, to be, you know, to be totally honest with you, you're an OB, that's a lot of burden on the physician, you know. That's a really big onus that you guys have to carry because you have, you delivered the baby, you know, and with all of the complications that go on, all of the medical issue comorbidities that moms have, you guys do a great job of that. And now you can't also be in charge of this enormous life change if you want. I'm sure half of you guys want to be and that's great, but I don't think the system is set up for that. Well, in the training isn't set up for that, right? We're trained to take care of the bottom, you know, to take care of the stitches and to take care of the bleeding, but not necessarily. We don't have long periods of time, of training, of mental health and like, how's that balance with your husband going? You know, have you guys figured out who's doing what? How's that food prep going? Are you getting enough vegetables and nutrients and like, that's, we get zero training on any of that. And, and when would we, I mean, I'm all for it, and I've done a lot of my own but, but you're exactly right. There is a scarcity of of time there and resources. And, you know, our first country, India, it is just the minute you deliver. There are a lower set of standards expected from you. There are certain things that people understand. It is now the birth of a mother. So they nurture the mother. Here in the United States, you know, for better or for worse, everything is a double edged sword. We have much higher standards for female equality and independence here, and that is fantastic, 99.9%
of the time. Except for that, you know, small phase of postpartum, of where you are a different person now, and we have those same expectations. And with social media, it amplifies. So in India, what they do is you immediately. It's depends on the part of the country you're from, but for the most part, even at hospitals, they qualify you. And there's, there's an you know, name for if you move around too much, if you're doing too much, you're going to get this certain type of condition. And that's a postpartum mom who gets headaches, a postpartum mom who's tired and cranky, and automatically, they attribute that to she's been put upon too much. So the word for that 40 day postpartum period in India is called japa, and in that japa, you are taken care of by extended family members. Somebody moves in, or you go to their house, and the baby is taken care of. It incorporates a three pronged aspect, this japa. One is rest, 40 days of rest. One is nutrition for the mother. Now I'm going to keep reminding everyone that this whole japa, every aspect I bring up is for the mom. Because here, like you mentioned, in the United States, we're so focused on the baby. You know, as soon as the baby's born, absolutely you should be but you can't do it yourself. So it's rest 40 days. It's nutrition. And there's a whole list of foods that they encourage the mother to have. We don't even talk about here in the States. Nobody gives you anything other than the US Food Pyramid as to what you should be. Yeah, if that most people just say, you know, give yourselves grace. This is going to be a really hard transition. Eat whatever you can eat. And I respect that on one hand, because I think if we send people home and say, Okay, now make sure that you're getting this many vegetables a day. The the American mom mentality is like, type a, maybe perfectionistic, like, Okay, let me make sure I get every one of those foods, and so I don't want to add more strain. But also, there's just some scientific logic there that eating, you know, fast food all day, every day, is.
Not going to make you feel the best or recover your body the best, but yet, we give, we give no advice at all. You're right, absolutely none. And I wonder if there's a facet of people being afraid, yeah, to give specific advice that they're going to get backlash. You know, they're going to either get canceled somehow in the public, or they're going to have, you know, they're going to get sued if they're a medical practitioner. But there are very specific nutritional guidelines in India during this Java period. It's warm foods, easy to digest, foods, no spice, no oil. They have a list of things that they eat, and a lot of educated moms and a lot of social media education is based around, take these tablets, right? Take these take a vitamin, a supplement. It'll help you breastfeed, it'll help you feel better. But again, that's access. Do you even have the money to buy those supplements? Whereas, in India, everybody kind of knows, even if you don't have children and you're a woman, it's just ingrained in the culture. Warm foods, easy to digest. There's foods that they stay away from as well, that cause acid and we don't get that education as us moms. Nobody told me, you know, if I have acidic foods, I'm going to feel bad, and that's going to increase my anxiety, and then I'm going to pass that on to the baby. So even if you're not breastfeeding, that care should still apply to you. So it's the rest, it's the nutrition, and it's also physicality for the mom, belly binding, massages, visits from friends and family. That's the health and the social, emotional aspect. The baby is brought to you for feedings, and then they take care of the baby, and you rest and you sleep. Sounds pretty heavenly. It sounds great. I think it's, it's, I want to go back to one of the things you said at the very beginning of talking about India and their cultural support is even the idea of having this, this
concept that if a woman is feeling irritable
and tired, that it must mean that she's put upon that concept is absent in our culture, right? That that I it's almost laughable, because I think all of the moms are like, yeah, yeah, that's how we feel, like, that's how we feel all the time. But our cultural response to that is guilt or shame, or maybe if I do more, that's what I should do. I should do more, you know, maybe if I look up more sleep techniques, maybe if I look up more of this, instead of, you know, asking for help. I you can punt this for later if you want. But one of the questions that comes up for me is, why as as Americans or or in our culture, why are we so afraid to ask for help? What gets in the way? I do think some of it is we don't necessarily have the same family units all the time. I think a lot of people don't have extended family living right by them. So the idea of this is like, yeah, that sounds nice, but like, totally unrealistic. Are there other things that come to mind as you've studied this, looking at American women that keep us from asking for help?
Kaesie, hey, it's Mallory. Can you do us a big favor if you're loving the uplift for her podcast, we would be so grateful if you could leave us a rating or review on Apple podcast Spotify, or wherever you listen. It only takes a second, but it helps us reach even more women who may need to hear our message. Click that five star button and let us know what you love about the podcast. Your support means the world to us. Now back to the show. I grew up here in the States. I'm Indian American, but I've spent majority of my life here, and so I subscribe to those values, and one of those we talked about a little bit of independence and female equality, but it's also the boundaries, you know, which everything has a double edged sword. Everything is
can be fantastic, but those boundaries, I feel restrict women from asking for help because they feel they should be doing it all themselves from a cultural perspective, from a whole societal perspective, and the boundaries also prohibit us from imposing on other people. Yeah, you know that you can ask, Hey, do you you know, let me know if I can do anything. Maybe some better words would be, I'm going to come over for an hour. Why don't you take a nap? Or what is the best hour for me to come over so that you can do whatever you need to do. And we as women should say, Yes, I think there's a lot of shame around like, oh, they'll see how messy my house is, right? Or they'll see that I haven't cleaned out my fridge, or they'll see that I haven't done my laundry. And I just want to shake us all.
To say we're all in this together. Like, like, number one, if you go over to a new mom's house and you judge her because she has laundry out, I'm going to be really mad. Like, can we as women just say, like, truly, we are not going to judge each other for that. And so let's give permission to all women everywhere postpartum, to say yes to someone coming in and not worry about what they're going to think about you or your house if you've showered, or you haven't brushed your hair, or you haven't, you know, all of the things that come up for us. I just wish I could wave my magic wand and have that not be a thing, because I'm sure there are some jerky women out there who would go into a new mom's house and be like,
Is that how you're doing it? But if you are, then shame on you. And I hope that the rest of us can can have that relationship of trust, where, as a new mom, someone can say, Do you know what that would be? Great, yeah. Will you come over and just vacuum my living room. Will you come over and honestly, just sit with my little one so I can be with my baby. I hope we can. We can be brave in that way to sit, to accept it. I think we can all do more to offer it, but, man, as moms, I think we can do better to accept it. Yes, yes. Yes, hit the nail on the head. Accepting it is the first step. Asking For It would be the last I can even just share my personal story. It was very difficult for me to accept help from even my parents, my in laws, all this extended family I had, and in their minds, they expected it to help. I had a hard time wrapping my mind around it, because I wasn't familiar with it. Yeah, I remember distinctly my mom saying, Well, I'm going to pick up your things. You're going to come to our house. And I remember, I'm like, Oh, I'll be okay, you know, I'll be alright. I got this I've pre planned, you know what? You probably would have been okay, right? You would have survived. I would have survived, as does everyone else. And I distinctly remember her saying, You don't know what you're getting into in the beginning, it's gonna feel okay, but it'll be okay. It won't be good. So if you let people help you, it will be good. And that's the thing, it's like we're preparing ourselves for what's to be a tornado or misery. And it doesn't have to be that way, you know. Yeah, and we, like you said, as you know, as moms, as women, as, frankly, multi generational, because your other mom friends, they've just delivered, they're kind of busy too. They're in the trenches with you. Yeah. We just need to support each other without any expectations. Yeah, that's when it will start to change. Well, tell us now, let's shift to one of the other cultures that you've studied a lot about in the postpartum transition is South Korea. Tell us a little bit more about their cultural transition in supporting postpartum women. So this one's great. The Indian culture was, you know, near and dear to me, and it was very familiar. But when I started looking into the South Korean culture, it blew me away. So they started a lot of this movement, because they have a very low birth rate. Now there's about point seven, two births to each mom, okay, to each woman, I should say so not every woman of birthing age is having a baby, and if they are, they're not, you know, they're some are not having any, and some are having maybe more than one. So the government decided to step in. They said, Okay, this could be a national problem. What are we going to do something that was already in their culture in please excuse my pronunciation if any of your listeners are South Korean, but it's sanhu Jori ones, and San who is birth and Jory won, or Jory is, you know, recovery or center. And what they do is, the government has centers, okay, so liken it to a baby hotel, all right, like a postpartum hotel, and 80% of the women go directly to these sanhu s after they leave the hospital. They vary, okay? They vary from lower end, which is supported by the government, to higher end of where women sign up as soon as they find out they're pregnant. And, you know, it's like a boutique hotel, yeah, what they do in these centers is they completely support the mother. So it's very similar to the Indian culture, except it's a little more institutionalized. At these centers, they take care of the baby. It's that same multi pronged approach, rest, okay? They rest, you rest for up to, you know, a few weeks at the center, 40 days, kind of outside, nutrition, nutrition, nutrition. Okay, and so they feed you. You're not worried about where you're going to get your meal from. You're not worried about what's the content in my meal. Okay, do I have to look into it?
And also restoration of the mother, so physical, like the Indians, okay, the Indians do the belly binding and the massages at the sanhus. They also have massages. They also have gentle movement classes that you do in groups, and the social emotional, like I mentioned, in India, you have family, you're expected to interact. In the South Korean centers, they have mom classes together. Okay, so the birthing months, if you're new, you would go to a first time. If you're not, and it's your second or third, then you do different classes. But they just spend time together. There's structured times of where you get social interaction. So again, it's not on you. You know, Dr craycroft, how many times has it been where you have the option of doing something social with your friends and just saying, You know what? I'm kind of tired. I'm just going to skip it. Yeah, for sure. You know, maybe I don't want to get ready to go out because people are expecting me to look much better as this brand new mom, and I'm just not there yet, so I'll skip it. So the expectation is already there. It's structured. No one's expecting anything of what you're going to look like when you show up to these meetings. But those have a very high satisfaction rate. They have a much lower postpartum depression rating. And even the ones they've done studies on the very low end ones that are government supported, and they have extremely wonderful metrics, like the numbers on their outcomes. So I'm a huge fan. I'm huge fan of their system. It reminds me I have not a lot, but I can recall a few patients over the years that had these situations that, as you're talking through them, and they're they have angst because they have to go home to a house full of kids, and the kids are crazy, and maybe their mom is coming to stay with them. And for some people, that's just as stressful, right to say, like, I mean, I'm so grateful my mom is here, but I just can only stand her for about 12 hours. Or, you know, people have these complex social situations. And I have, on occasion, recommended, I think, you and your husband and your baby should go to a hotel, and you should get room service or take out, and you should stay there for at least two to three to four days, like just stay there and be in quiet by yourself, have some things brought in that you need, and just just rest, and it's nothing like what you're talking about. But I do think it brings up an important point that is,
you know, the idea of going home, for a lot of us, it can be great. I mean, some people will be like, Oh, I would hate to go to a center like that. I want to be in my own space, in my own home. But I do think that it brings up the idea that some people life is really complicated. You know, maybe you have multiple children that though you love and adore. Maybe it's a lot when you have a new baby, or maybe your extended family is pushy, you know, maybe they're really happy to help and you're like, Oh, I cannot. I'd rather do it by myself. So I like the idea of just being I mean, in South Korea, it sounds like it's conventional, but in the United States, to be a little unconventional and say, what is going to work for you? How do you get these focuses that you're talking about, of rest and nourishment and physical care? How do you do that, taking into account where we are in our situation? It is so fascinating to learn about the historical traditions of postpartum care throughout the world. You know, older cultures and modern cultures all around the world. But for now, we'll go with these two that you've highlighted and say, how do we borrow some of these emphases and incorporate them into the the United States culture, the American culture, you know, from a perspective of government support, I do think, and you know, I live in the state of Illinois, and there have been some acts passed recently, as well as some money set aside for public health for postpartum mothers. So services, okay, so we can send in services. And you're right, it's kind of stressful to have your family around all the time, because we don't all live in larger joint communities or households. Sometimes you just live you your spouse, or maybe you don't have a spouse. Maybe you don't you know your partner is not really present for you, and it's just you. And so that can be a different type of stress, or all in itself. But I think what makes it stressful for us here, you know, us, here in the United States, is that expectation of what's required of me and what other people are requiring of me. And both of those places I talk to, there is very little expectation for the mom and so that makes it easier to accept help because, oh, I'm supposed to look like this, do this, etc, etc, and they don't have that expectation, because you're expected to be at the bottom of everything. And should you work your way up? We'll help you. So what can we do here right away? Like the Korean medal, I think the government can send in support.
From a governmental perspective, I think all the practitioners in Europe, for example, is not, you know, an Asian country, but in Europe, which we talk about a lot in our postpartum perspective, they give new moms two mandatory sessions of pelvic floor therapy. So that's another medical practitioner. Okay, it's not just, you know, your friend from down the block. It's another practitioner that's coming in saying, hey, you know, taking some metrics and saying, Hey, let's do this. Or, you know what I tell my patients a lot now, and doing it more and more because of what's going on in the media. They want to talk about exercising. They want to talk about working out. And I tell them, Do not strain yourself. I don't want to see any strain on your body to return to its normal shape.
Be mobile. Go for a walk. That's it. Be mobile. Go for a walk. Get some sleep. And as you go on, you can increase that walking. But all of this, like lifting and cardio and all of that's very new, and it's really, frankly, it's not good for you. So, you know, we can insert another medical practitioner, yeah, and just more touch points about what what should be expected and what should not be expected, like you're saying. And I think we take in, in our conventional healthcare system, we're quite good at solving problems, meaning, if you call me and say, I have this pain, I would say most OBGYN not all, but most OBGYNs are pretty good about saying you should see a pelvic floor physical therapist for that, right? But what we're not good about doing is taking proactive, preventative steps. And like you're saying in Europe, to have an assessment by a pelvic floor physical therapist, and having someone say, Do you know what you look okay, you look okay. Keep doing what you're doing. Stay the course, you'll be fine. Or to say, oh gosh, things are not normal here, when patients don't know, why would you know? Your body just went through this huge swing. And I would get patients all the time that would call and say, so I was looking with a mirror. And we always say, like, Don't later, do later. I'm a big fan of it later, but like, don't look day two postpartum. No one wants no no one looks, quote, unquote normal at that time. But regardless, you know, it's so helpful for women who feel like they're in this vulnerable state. You don't really know what's going on with your body. You don't know if it's normal or abnormal, or where you're at on the spectrum. Just to plan on having someone assess you, and to say, from a physical therapy, pelvic floor physical therapy standpoint, you're on track or you're not on track. And let's, let's start doing what we need to do, I think is so valuable, and it is, as you mentioned, it is available. It's not as readily available, I would say, because sometimes insurance will pay for it and sometimes they won't. I would say insurance often does pay for it, but you do have to have a symptom to go with it, right? So if you're just, like, I just had a baby, I want to know how I'm doing. Sometimes you do have to pay for that out of pocket, and from that level of accessibility, there's plenty of people doing it, but not financially accessible for some people, that's how I had a patient when I was working in the city at an academic hospital, and I'm in private practice now, but she came and she was from France. She was here on a contract with her partner, and I'm going through my evaluation checklist, and it's like, fine, fine, no, no to the symptoms. And I asked her, you know? And I said, Why are you here to see me? And she said, you know, all of my friends in France that are giving birth, they all have two to three sessions of pelvic floor therapy. So I told my doctor, I want that too. And I thought, fantastic, you know, because you're not always bad enough. But you know, things creep up later, and if we can nip it in the bud from a preventative perspective, you know, that's great. And to even as a mom, have somebody else look at you and say, check. Because, like you said, insurance doesn't always want to pay for it, but I think with with the shifts that are happening now, they probably would,
I'm often asked exactly what items I use and recommend. So I have a little gift for you. I have gathered my go tos in one spot on our Amazon storefront. If you need deeper sleep, you'll find the light blocking sleep mask that lives on my nightstand and that I use every night. If you're working on your bone density or your posture, check out the weighted vest I recommend for walks and workouts. We've also added the magnesium body lotion I reach for to calm the nervous system, my favorite laundry soap and cleaning products, and even the cast iron skillet that's currently sitting on my stove top. All of these and more are organized by category, so you can browse trusted products without the overwhelm of trying to figure out what's the best thing to buy. You can head to amazon.com, backslash shop backslash uplift for her, or tap the link in the show notes, or from our website to explore the items I personally use and love. I hope this makes your life just a.
Little bit easier. Now back to the show. Well, and I you, you sparked a you hit a nerve. There for me with women, because so much of the medical model now is based on what insurance companies find is bad enough to pay for. And when did we give that power away? Now I get, I'm glad that it exists, because for for people who financially can only use insurance Absolutely, you got to play by their rules, etc, etc. But the idea that if insurance doesn't think you're bad enough, then therefore you don't warrant care, makes me boil like you get to decide if you are, quote, bad enough to require an assessment, and if for you, that means I just freaking had a baby, and that's enough for me to be assessed, then you should get to do that. And I see this a lot in the conventional medical world of doctors saying, Why would you do that? You're not even that bad, you know. Or patients who go to the doctor and say, I don't feel like myself. Well, what are you feeling? And they'll go through this list and they'll say, Man, I don't think it's that bad. Like, who are you to say it's not that bad? If the patient thinks it's that bad, she deserves care. And insurance companies can do whatever rules they want to do, to say they'll pay for it or not, but insurance companies don't decide if it warrants care. They're only deciding if they get to pay for care, but whether you warrant care is up to you as a patient, and don't stop looking for practitioners to help you until you find the one who matches that if you say something's not right, then we as practitioners, whether it's a physician or a physical therapist or a therapist or a coach or whoever it is, our job is to listen to you and say, I'm sorry you feel that way. Let's, let's hear more about that. So Rant over. But that idea of maybe it's not bad enough, like, if you think it's bad enough, it's bad enough, like, you get to be assessed. You get to have care if you feel like it's bad enough, sorry. No, you do not have to be sorry, because that is brilliant. That is brilliant. And anybody who is still working in the medical or the healthcare profession couldn't agree with you more 100%
and tying it back specifically into our new moms, if you have an instinct about your baby, or even if you're a mom of a 25 or a 35 year old, when you have an instinct about your child, you act on it. You're you feel empowered when it's about yourself already, you're sort of placing yourself on the back burner, on the bottom of your to do list. But you know, it can be an instinct, and you don't act on it. You know, I don't want to go into side stories, but that personally happened to me, and I work in this industry, you know, and so it is very easy to slip through the cracks. And as you know, you know you're a physician, and can talk to the listeners about if you're even considering going to see any medical practitioner. We're patient advocates, so we can help you with the insurance companies, even if it's one visit and you were Hey, turns out you were fine. There's ways that we can say, you know, this was important to look into because this patient was expressing concern, and that's a very reasonable, ethical way to go about getting you covered. Yeah, for sure. Well, maybe from your perspective, then, what advice do you have for women who maybe are struggling to put themselves first, or don't want to put themselves first, or feel like, nah, nah, nah, I'm fine, like, I'll get through it. What advice do you have to incorporate some of these other things? I guess we kind of talked about it before, with asking for help, but in terms of just putting yourself first, how do we how do we do that? That's really the million dollar question from the beginning. If we were told through our Maternal, you know, through our peripartum care while they're going through pregnancy, that you should expect to set up one appointment, you know, with exposition, you should expect to set up one appointment with a physical therapist. Those are also touch points where people are looking at where are you, and helping you assess as far as and this is something that I have found to be anecdotally helpful for women to put themselves first when they have trouble, especially with the first baby, that your well being is your responsibility towards that child.
And so if you are not well from a fatigue perspective, from an irritability perspective, from a depression perspective, then rather than saying if I just work harder or if I focus on what I'm supposed to focus on, which is the baby. It's just a phase, and you actually see that as your responsibility, if you can't do it for yourself, as your responsibility to your child. I think that really empowers women to come forward. Yeah, yeah. I love that. As we're talking I'm pregnant with my fourth right now.
And and trying to be really honest with myself as we talk about this, because, because, if I'm being honest, like, completely hypocritical, right? Like, if I think about my postpartum transitions, like, I did not ask for help, I suppose I accepted help because I'm pretty good at that. I don't, I'm not. I'm not afraid to say yes if someone offers to help. But as I'm preparing for this fourth and thinking, you know, how am I going to do this? And how am I going to balance it? I don't have any wise words here, but just full acknowledgement of, like, man, it's complicated. It's tricky. I think even taking time off work, if you're a working mom, like some some work that's really easy and seamless, and you can do it, but a lot of people, when they take time off work, their job might be threatened, even though they're, you know, they have legal reassurance that their job will be there when they get back, but it doesn't mean that they'll be that they won't transition them out after that, right when they've already replaced them and so, or will They? I think a lot of women in our culture, when they do take maternity leave, are looked down on, you know, I think some people may hesitate hiring a woman because she'll take a maternity leave. Why would I do that when I could hire a man? You know? I It's complicated. It's really complicated, and I wish I had really wise words, but more just these are the thoughts that come up for me as a mom and as a pregnant woman, of like, Oh, we're fighting an uphill battle. And if anything else, I guess, just drawing together and saying, let's, let's at least do it together. Let's at least not abandon each other as we're going through this. You know, to say, let me, I'm at the grocery store. What can I bring you, right? You know, I'm, I'm running to get some new shoes for my toddler. Can I pick some up for your toddler? You know, I'm just thinking through, as a mom, the things that are the hardest to stay on top of. And Dang it, it's shoes for little ones,
but getting them in the right shoes, and you're like, you just had three pairs of shoes, and now none of them fit. So what can we do as moms too and women and grandmas and aunties, you know? What can we do to support each other, hopefully, to shift the culture to being okay to ask for help and without judgment and without demeaning I think in our culture too, we're pretty good at having kind of a two faced approach, sadly, you know, to say, like, oh, let's support women. And like, oh, that's how you're doing it. You're having another baby. Or, you know, like, I think that we are, we can be a little judgy sometimes as a culture, and so I hope we can, we can let some of that go too, and just say, like, Hey, I respect you for being a woman and for doing what you want to do as a woman, and I'm going to empower you. And how can I show up for you as a friend and a neighbor and a family member? Absolutely, and you touched upon it. The multi generational aspect is really important too, because you know when you have even if you're not postpartum, but you have a one and a half year old at home and you're pregnant with your second there's not a lot of bandwidth you have, right? You're sort of doing it yourself. So the older the grandmas, the aunts, the just the neighbors, after doing all of this, I have more women just in my community, in my periphery, that I see around, and I'm more interactive with them. And so, as you mentioned earlier, just coming over and saying, Okay, what time can I come over for X dropping off groceries? My children are now 16 and 14, and when I had my 16 year old, I remember looking online and the only grocery service offered was Peapod. And I remember this was before Instacart, before Uber and all of that. And I remember thinking like, You're kidding me. There's no setup here unless I ask, you know, unless I ask someone for a favor, which you don't want to do. I want to bring up one aspect when you mentioned the South Korean construct. You know, there's one section of the United States, and that's the Veterans Administration. The VA there is
they sort of, you know, for people that aren't familiar with it, they practice outside the medical model, and they take care of all of the veterans, you know, in our military branches. So needless to say, there's not that many birthing age and actual birthing women in that subset that they have, but because they've got access to doing kind of whatever they want, without worrying about insurance companies, without worrying about a lot of the other things we have to worry about outside of that system, they follow their Moms after birth, and they've got that three pronged approach, and they're not afraid to give nutritional advice. They're not afraid to have mandatory just virtual meetups with other women. So let's say you know you're not going outside, or you don't want anyone to come over, or you know you feel like you don't know that many people that will support you.
That's That's true there, it's one thing to ask for help, and it's kind of another thing to maybe feel like you don't have anyone to ask for help. There are virtual groups all the time. Almost everyone has access to a phone of some type that they can log on and meet. And you know what? You'll get ideas, someone will talk to you online, and that's enormous in its health, because that approaches that social aspect and that rest aspect as well. So the VA is doing a wonderful job following their women with wonderful results. That's good to know. And I'm actually, I am happy and proud to be a part of this movement, of, probably you'd call it unconventional medicine, you know, of, I think more and more there are people who are stepping outside of, well, insurance won't pay for that, so we can't do it. And turns out, that's not true, like you can, we can offer services that we as healthcare practitioners are passionate about, even if insurance tells us that there it's not worth it because people aren't sick enough, or people aren't bad enough. So I think there are more resources now than ever, of coaching groups or even postpartum clinics we've had. Dr Candice wood owns a postpartum recovery Clinic in Arizona. We had her on the podcast. There's more of these clinics that are popping up that are really just focused on, how do we help this subset, this gap of women's health care? How do we help them do it better? Because it is so essential, and it's so many of us that go through this. This is not that niche, right? Like it's a small period of time, but it's not a small subset of our population. So I'm glad that people are kind of taking these less conventional approaches. I think even some of the pelvic floor physical therapists now have postpartum groups where they're starting early to offer the type of care you're talking about, of assessments and touching base. And I think that the social aspect is so pivotal. To talk to another woman when you have all these thoughts racing in your head about how you're not a good enough mom, or you don't know if it's if you're doing it right, or you're afraid something bad is going to happen. To gather with another group who's in exactly the same position and hear them say the same things is hugely healing for women to hear like you thought that too. Oh, I'm so glad I'm not the only one. I was so scared that I was so unique and so different. And it turns out, we're all flailing for a little bit, but we can flail together and and have that support. So I'm so glad that there are these unconventional approaches. Well, you mentioned because I kind of cut you off before in talking about South Korea, and I'm not going to attempt to say that, but the Recovery Center,
what you mentioned that there are some in the US. How would someone find those? What? What are they and where are they? So there are at this point. They're more higher end, they're pretty expensive. They have, you know, centers in New York, San Francisco and LA that I know of to be large. And they are essentially like hotel rates, okay, where they go through these things, if you want to stay in your home, there are, like you said, smaller clinics that are offering these types of
medical perspective on postpartum care. There's smaller groups even. And I believe you you're a part of when you have one yourself. But there's like, leagues and other groups locally that get together and they bring in experts, and they set up no judgment play dates, essentially, where you just show up at the park and get fresh air, and if you have another kid, they can play. So we've got more formalized centers in the US that are on a larger scale in New York and LA and San Francisco. I'll stay away from mentioning specific ones. I do know the rates are expensive. You know, they're essentially like a fancy hotel stay, but you do get all of these services in there. Yeah. I also want to focus, or bring up two postpartum doulas. There are doulas who offer services just for postpartum and even ones that offer just night services. And I think especially if you're hanging in there, you're doing okay, things feel good, then great. But there are some people who go through times where they're not sure they can keep it together right, where baby's not sleeping and mom and dad aren't sleeping, and we're just not sure how we're going to survive. And there are night doulas who will come and just take care of the babies through the night. And some of them, if you're nursing at night, some of them will bring you the baby, let you nurse and then, but they'll do the diaper change and they'll put the baby back to bed. And I think that in our in our cultural brains, a lot of us would think like, well, I don't need that. Like, I can do it, you know, but if you do need it, there's no shame in that, like, you're not a bad mom if you say, I need this extra support. Because all through time, through all time, pregnant women, postpartum women, have had if.
Possible a mom or a grandma or an auntie who came in and did just that. So the idea that it feels like a luxury for us to pay for that, I mean, that finance is a side, right? But the idea that that feels like cheating or like like guilt inducing or shame inducing, that I can't do it by myself, I think that's the non norm. I think the norm would have been and should be, you know, if I need help, that makes sense. Yeah, I just carried a child. I just depleted my body. I just gave birth to a child, and it turns out I'm tired and I don't feel good. That should be the norm that we say, maybe I'll get help, you know, maybe I'll have someone come in and help me with that. So I know finances that's not always a possibility, but if finances aside, I don't think we should have barriers other than that. You know, I think there shouldn't be shame or guilt if you feel like you need some help, like that. Absolutely, you know, if I could put an exclamation mark at the back of what you everything you just said I would, because it is that let's put finances aside, which is, it is expensive, it's legitimate. Yeah, the thoughts going through mom's heads as well. I'm not working right now. This is what I'm supposed to be doing. Yeah, everyone else is doing it. Why can't I? Because they're looking at it from an expectation perspective, ground zero, you start at Ground Zero as soon as you deliver, and if you watch your baby at night, you move up a notch. But there should never be I'm starting from here, so any extra help I get, or any assistance at all brings me down here. It has like too much stress, you know, and now with Instagram and social media, again, the two pronged effect. It's got its benefits. But now instead of starting from here, well, everyone in my community is doing X. Now you think your community's up here, you know, influencers have their space. They definitely have some place in the system, but I do want to tell all postpartum and pregnant moms and just women in general that watch who you're following and for what purpose, if you're they make you feel yes and what your postpartum recovery should look like. Most of that information needs to come from sources that have education or training or a background in that it should not come, you know, mainly from someone else telling you how great they did it, and they want to pull you in on that. Yeah, because I think what we don't realize is a lot of the coaches and and influencers who are talking about things are talking about it from in research, we say n of one, right? We they're talking about their isolated experience, or maybe the 10 clients, or in a great situation, 100 clients, whereas an OB or a physical therapist or a midwife or a doula is talking 1000s or 10s of 1000s of times going through it, that we can bring that wealth of expertise to say what you're saying is normal, like you don't need to feel like, because the influencer said you should be up and out of bed and doing all the things that that's normal, like they're the outlier. Let me tell you what the spectrum is and where you're at on that spectrum, right? And 40 days of rest, okay? It's not exactly 40 days in South Korea. It's a little bit different, but six weeks round about, right? So everything seems to like kind of mesh together in the US. We go in to see our OB at six weeks with basically no support or any instruction in between. But there's something about that midpoint of the 12 weeks. In India, they require 40 days of rest. In South Korea, you're in there for several weeks and about 40 days as you practice some of these things. But
40 days of no expectations and 40 days of focusing on you is a okay. And so, you know, kind of go with that. And so if you're looking at somebody who's six months out and saying, This is what I did from day you know, from week two, you don't know that you know, and frankly, you shouldn't be doing that so
well. I'd love to keep talking forever. I love what you're saying, and I think it's such an important message. But we do need to wrap up. Give us your final thoughts, final closing message for women, as as you've really focused your your career on this postpartum transition, you know, I would say for all of your listeners, even if they're not postpartum, that you know, the restoration, the care, that self care, which you know, isn't always looked highly upon here in the United States, but that restoration of yourself, mentally, emotionally, physically, is something that does happen in other places in the world who have had millennia of population, and so there's something to be learned from that. And we all have our stories, and we do need to put ourselves as a priority on our own lists. Yeah, I love.
That so much. Thank you for sharing that. I hope we will get this message out to women who are having babies, but almost more importantly, to women who can support women having babies, that we can create a safe space for those women having in the postpartum transition, that we can create the safe space to say, I'm not going to judge. I'm going to, you know, stop by at the grocery store, I'm going to take your toddler, I'm going to do whatever I can to support you so that we can hopefully shift our own culture and provide that much needed support in that essential and as you mentioned, sacred time transition. Tell us and our listeners where we can find you and learn more from you. Thank you. And you know, one more aspect is to as you're an OB, you know as well, really encouraging new moms to reach out to their practitioners. Even if you don't know who to call, call your OB and don't be shy about it. They're not going to be annoyed. They will direct you where you need to go, and they're trained for that. They're used to it, so even if they can't answer it themselves, they'll point you in the right direction. One Direction you can go is pelvic floor therapy, and that's my personal background. My private practice is called women's clinic pelvic health. You can find us on Instagram. We're located in the Chicagoland area, and we would love to see you. We see people virtually. And as Dr craycroft mentioned, even if you're not sure if something is going wrong or going right, go ahead and reach out. I love it. Thank you so much for being here. Khushboo. It's been such a fun conversation. It's been my pleasure. And thank you for all of the great work that you're putting out there, it's been really diverse and very informational. Oh, thank you. I love hearing that. Take care. Thank you so much for tuning in to today's episode. A huge thank you to our guests for sharing their insights and time with us. We are grateful for the incredible support from our sponsors and to all of you listening. We couldn't do this without you. If you enjoyed this episode, please consider subscribing on your favorite platform. You can find us on our website, uplift for her calm YouTube, Apple podcast, Spotify, or wherever you love to listen. And if you found value here today, please share this episode with someone who would benefit from it. Leave us a comment or give us a review. It really helps us reach more listeners like you. Thank you for being part of our community. Stay tuned for our next episode. Lastly, this information is for educational purposes only and not intended to be medical advice you.
