Why a Healthy Baby Isn’t the Whole Story with Dr. Jessica Vernon

Introduction and Candle Lighting

Britta Bushnell: Hello, folks, and welcome to Transformed by Birth, a podcast about the rite of passage of pregnancy, birth, and new parenthood. I'm your host, Britta Bushnell, author, mythologist, childbirth educator, and an all-around deep diver with a side of goofball. I'm so glad you're here. Today we're talking with an OB about birth. So grab your comfy beverage of choice. I've got a matcha lavender latte today for myself. Or take us along for a walk as we connect with doctor, author, and advocate Jessica Vernon. Before we begin, we start the way we always do by lighting a candle. If you want to join me, please do, or just take a breath as I light mine. Today's candle is in honor of the vulnerable and brave work of birth and postpartum.

In this modern era, where hustle culture and the cult of productivity reign supreme, it's no surprise that lots of people approach birth, pregnancy, postpartum like a project to tackle and succeed at. We want to set a goal. We do the research, execute the plan, hit the milestones — check, check, check, check, check — and then we want to evaluate our success, where success is often only seen as perfect. This makes a lot of sense. I have a tenderness for this because we're trained our whole lives to treat any challenge before us as a hill to climb, that we then get to the top and we plant our flag in, and the alternative — there isn't one. We reach the top, but birth — birth is different. So is postpartum, and feeding our children, and postpartum mood disorders, and parenting. There are any number of possible unexpected twists and turns on the otherwise deeply hoped for and well-planned journey. Life rarely goes to plan, and this era of life tends to be extra "lifey."

So my guest today knows this both professionally and personally. Dr. Jessica Vernon is a board-certified OB/GYN, perinatal coach, mom, and author. She's an assistant medical director at Oula. She sees private clients as a perinatal coach and serves on the board of Postpartum Support International, also known as PSI. Her first book, Then Comes Baby: An Honest Conversation About Birth, Postpartum, and the Complex Transition to Parenthood, is available now. Jessica brings her lived experience to this work as much as her medical training. She's, by her own description, an atypical OB — which is always fun to talk to. This is going to be fun, folks. She's someone who's done spirit baby work while going through fertility treatment, and who believes there's room for both Western medicine and the spiritual, mystical dimensions of matrescence. I love this. I'm so excited. Dr. Vernon is not an either-or sort of girly. She's like me — she's a both-and.

Jessica and I bonded from afar because we share overlapping areas of passion, in particular helping people prepare for birth regardless of how it unfolds, and building real psychological flexibility for when it really doesn't go according to plan. Doing this work matters deeply — between social media's idealized version of birth and a culture that treats vulnerability as weakness, a lot of people end up feeling broken when their birth doesn't match the picture in their head. For all those reasons and more, I'm really grateful to have Jessica here today. Thank you so much for joining me. I'm honored to get to talk with you.

Dr. Jessica Vernon: I am so happy to be here with you, Britta. And I was just nodding my head the whole time you were giving that introduction into what we're going to be talking about.

Britta Bushnell: Oh, thank you. Well, I do feel like the intersection between what is — you know, as soon as I got your — and started looking at it and saw things that you were posting on social media, I'm like, oh, oh, oh, we are going to have a fun conversation like this. This is going to be good because there is a lot of overlap, and yet we come at it — as we were saying before I hit record — we come at it from two different perspectives. I'm a childbirth educator and a mythologist. I know that's kind of wackadoodle. And you are an OB who is — well, tell us a little bit. How do you practice, and how is how you practice different from what we're seeing, and why do you practice that way?

Jessica's Path: From Traditional OB to Holistic Care

Dr. Jessica Vernon: Sure. So my practice changed dramatically after the birth of my first daughter. So before, I was very traditional OB/GYN Western medicine, very focused on the physical, making sure mom and baby were healthy, and that was it. And after my first daughter, I had severe anxiety and depression and OCD, which lasted for almost two years. I didn't know what was going on, and once I finally got help and felt better, I went on this long journey with myself and making sure I had all the right things in place to take care of myself going forward. But I also started educating myself on perinatal mental health and working with reproductive psychiatrists and other people to build programs within the practice that I was in to help people get that more holistic care. And I started asking different questions, so we weren't just talking about the physical symptoms. We were talking a lot about how people are feeling both before they're giving birth and after, and I really just try to bring that full view into it because a lot of people don't have space to talk about their feelings and any other questions that they're scared to ask or any other thoughts that are going on that they just think there's not a space for in traditional practice.

The Time Crunch in Traditional Obstetric Care

Britta Bushnell: Yeah. Well, and let's speak truth. There isn't very much space in a traditional practice. How long are appointments? Quick.

Dr. Jessica Vernon: They're so quick. Yeah.

Britta Bushnell: So how — I mean, it's not necessarily the fault of the OB or the OB practice, but there is a system in place that is upholding that restriction of being able to give the kind of care that this era of our life really deserves.

Dr. Jessica Vernon: Yeah, and a lot of it is with the insurances — you have to see more people to afford to practice obstetrics and afford the malpractice insurance. And so, even the practice I'm in, which gives us a little more time, is a midwifery-led collaborative care practice. Appointments are usually 20 to 30 minutes, but by the time someone gets in the room, and then, you know, at the end of the visit, having to do all their labs and everything, you really still don't have a very long window, and so it can be hard. And that's why we have to really get to the important things that that person wants to say and needs to say. And sometimes it's creating this space for them where they feel safe. They feel like they aren't judged, and I always have tissues in the room because people just start opening up when they feel that you're there to hold that for them.

Human-to-Human Care: Creating Space for Patients

Britta Bushnell: So, how do you communicate that you're there to help hold that?

Dr. Jessica Vernon: I think part of it is connecting human to human, not going in the room as a doctor. I haven't worn a white coat for a very long time, but I don't even say "doctor." I say, "I'm Jessica Vernon," and then sit with them eye level and look at them, and not look at a laptop, and not have anything else in front of me. And I usually start the conversations with things that I see in their history from their past, and we'll note — like, if this looks like something that might be affecting your pregnancy, or how is this going for you during pregnancy? How are you feeling about this now that you're pregnant? Or if I hadn't seen them postpartum — their birth — and, like, you had an unplanned C-section, how are you feeling about that? And so they really haven't been asked these questions before. A lot of times, not even by their family or close friends, and so they kind of exhale and will open up about it. And so we spend a lot of the visit just talking about how they're feeling and how things are going for them, as opposed to the medical physical stuff, which I can cover very quickly if I've read their chart before.

Britta Bushnell: Yeah, so I love that it's really that human to human, and creating a space for them to share and open up. And why is that radical? Like, I mean, that's part of what I'm sitting here going, wait, wait, okay, I get it, but is that radical? But I mean, I guess there is — in the midwifery model of care that that is more integrated into practice — but it is less available for all the reasons we've already talked about for a lot of OBs. So you're also now practicing separate from your clinical work as a coach — can you talk about that? Like, what does that mean?

Coaching Practice: Filling the Gaps in Traditional Care

Dr. Jessica Vernon: So I decided I needed a space where I had more time and, like, a really good container for people where I could follow them through trying to conceive, through postpartum — at any point they wanted to jump in there and work with me — and really provide all of those layers of care and weave them in and fill in the spaces they're not getting in traditional care, whatever that means to them. So I'm very responsive to that specific person's needs, and like to bring in things besides all of the physical and mental and spiritual. We're talking about matrescence a lot, mindset, self-care, self-advocacy, and empowerment. All the things that we're not traditionally getting in the OB care, and then also doing integrative work and bringing in other specialists that they need to fill the gaps for themselves, so we can give them a really comprehensive team approach.

Britta Bushnell: Oh gosh, don't you want that for everybody?

Dr. Jessica Vernon: Yes, yes, yes, yes, yes. I do. I know, I know. And my goal, long term, is to build out more, like, groups and other things that are more accessible to other people, and also using things like books to get these sort of conversations going for other people. But yeah, it's really hard. A lot of people are living in places where they don't even have an option to switch to another provider if they want to advocate for themselves. So you have to give them tools to do that with what they're working with and what the space they're working in.

Birth Plans vs. Birth Preferences: The Wedding Analogy

Britta Bushnell: Absolutely, which makes me think about your book. So, am I allowed to quote back to you?

Dr. Jessica Vernon: Are you sure?

Britta Bushnell: Sometimes people find it funny when I read something from my book, you know, from their book. But the very beginning of chapter one, which I love — I think one of my first chapters is titled almost the exact same. The title of chapter one is: "There is no one right way to give birth," and I think one of my early chapters is "There's no right way to birth" — I think — the title of that chapter. So there's already that alignment going on. But I found this opening really interesting, and I want to unpack it with you a bit. You say, "I once heard a hospital consultant say that labor and delivery is a cross between a wedding and an emergency room. Just like on a wedding day, you might have a vision for how things will go in a perfect, idealized state, but often things do not go according to plan. It can be disappointing if you are not prepared for all the possible ways and reasons your birth experience may not reflect what you envisioned." Okay, and then it goes on, but I want to unpack this because I found the emergency room and the wedding as very compelling reference points, and I want to hear from you — kind of unpack that even further because it clearly impacted you when you heard it, because it's at the very beginning of chapter one. So talk to me about that.

Dr. Jessica Vernon: Yeah, I think — as we were also talking about before we went on — there are these dichotomies and these tensions between different aspects of things that can happen, whether it's feelings or experiences. And for most people going into their birth, they've created a birth plan. They have a certain way that they want things to go, and it does feel like a wedding day. There's a certain perfect way that they envision everything will look as they're going through the experience, and often, just like your wedding, it can be influenced by other people — your family, your friends, social media, other people talking about how it should look.

Britta Bushnell: Yeah, my wedding was influenced by — yes, all those things — but in reality, I didn't plan for 105 degrees.

Dr. Jessica Vernon: Yeah.

Britta Bushnell: And it was 105 degrees outside, and my wedding was outside.

Dr. Jessica Vernon: Oh my gosh! You know, I didn't plan —

Britta Bushnell: — for the sweat dripping down the back of my leg in my wedding dress —

Dr. Jessica Vernon: But it is —

Britta Bushnell: — what I experienced.

Dr. Jessica Vernon: Yeah, exactly. And so you have this idealized version of what you want everything to look like, and we're told if we plan and prepare, just like other things in life, then we should get that outcome that we desire.

Britta Bushnell: Right.

Dr. Jessica Vernon: But the reality, especially if you're giving birth in a hospital, is that there's also this very medicalized aspect, and things can happen very quickly to go from a setting where you're in spontaneous labor, everything's progressing well, to all of a sudden you need an emergency C-section. And so we're looking at both of these aspects together and really trying to help people know about the other side of things — that things go off course, like, you know, on your wedding day — if it rains on your wedding day, or something's missing, something didn't show up. These things can happen, and we have to have the flexibility to kind of go with the flow. But no matter how your birth looks, there are still ways that you can feel good in it and feel like you have your agency and autonomy, and you were really held by your team. And so I think that's the space that I try to work in a lot now with people — is seeing we can prepare for what you desire, but let's also build in flexibility, and let's look at your individual risks for things like needing an induction or a C-section, so that people do have all of that information, and doing it in a way that they still feel empowered, that they still feel like you believe in them, and you're going to do the best to give them the birth that they desire. It's a really difficult space to be in, and I think that really involves developing trust with your care team and having continuity with them to help you feel good when you're going into the experience.

Control, Planning, and Letting Go

Britta Bushnell: Absolutely. I mean, I think the continuity of care is so valuable, and becoming rare — or rarer — to find. And I, as I said in the intro, I do have a lot of tenderness because I think the desire for that control is actually increasing, and I talk about this in my book — increasing as we become more contemporary, more modern, more technologically engaged and connected, that we are thinking even more that we have control over things, and are moving further away from the animal nature of unpredictability — that we just don't know for sure how something is going to go. And that doesn't mean we throw out planning or learning, and so that dance is really tricky. How do you help people do that dance between planning and letting go?

Dr. Jessica Vernon: Yeah, I think it's something that takes time and having that continuity to build that ability to have these conversations. But when people want to talk about their birth plans and start going through that with me, I'm really asking them about their values and the why behind these things, so that we can talk about — even if it doesn't look this way — how can you still feel like you were able to maintain your values and have those things that are really important to you? And at Oula, they've also started giving out cards with, like, "these are your top three important things to you." So it's not like you have your big birth plan, but you also have, like, "these are the top things that I really want to try to hold on to," and so we can try to work with that even if things change. But yeah, I admit to people, I'm like, "Look, being pregnant, giving birth, postpartum — it's really scary because, for many of us..." Like, I live in New York City, people are very Type A. They've worked hard their whole life, they've planned, and they've gotten exactly what they want, often. And so for many people, this is the first time where they're in a situation where they can do everything right and still have a pregnancy loss or a complication during pregnancy, birth, or postpartum.

Britta Bushnell: Or difficulty getting pregnant in the first place.

Dr. Jessica Vernon: Yes, yes, there's so much infertility now. And so really talking about — like, I know I've been there, how scary this can be — but let's help prepare you so that you're not shocked and feel like a failure, and feel like your body was a failure if things don't go the way you envisioned.

Values-Based Birth Planning

Britta Bushnell: Yeah, and so what is your take on birth plans? Like, what — because I mean, probably for me, the word "plan" is something that can activate me a little bit, because it's not something we can typically plan. You know, although — like, if we're using the analogy of the wedding — it's like, I planned my wedding, and then I planned, like, 10 days before the wedding, the weather was looking like it was going to rain and be cold, and then it flipped. So we had ordered heaters and then had to switch and order umbrellas at the last minute. But so there was planning, but there was also flexibility. And then day-of, it was just — we had to put up our hands and go, "I hope everybody's staying cool," and make a joke about it and just roll with the fact that the weather we got on the day of our wedding was very, very hot. So how do you dance with that with a birth plan?

Dr. Jessica Vernon: I think part of it — I tell them I like to say "birth preferences" and talk about their values. And in your book, you mentioned "intentions" as well, which I think is another great word to use, because a plan is like something that we follow, and if we do it correctly, we'll get the outcome we want. So trying to start with that shift. But I don't mind a birth plan, and I remember being a resident, we'd be like, "Oh, the longer the birth plan, the more likely you are to end up in the OR." I hate that — it's so rigid.

Britta Bushnell: Yeah, I hate that statement too. I mean, because it's so demeaning to the person who's like, "I put a lot of time into really thinking about this."

Dr. Jessica Vernon: Yeah.

Britta Bushnell: I love that you're unpacking a birth plan from a place of values, like a statement of what matters to somebody.

Dr. Jessica Vernon: And sometimes it's hard for them to even know what is based on their values versus someone else's values. And I've seen that so many times with someone who's deciding whether they want to have a trial of labor after having a C-section before. And sometimes I can tell that there are other people who have been really influencing the way they go, and they just seem kind of anxious and almost tearful, and it can be really hard as they're going into it. And so, even like the day before, I'll say, "You can change your mind any time. I want you to sit quietly with yourself and see internally what really feels right — like what feels warm to you, versus what feels like it's going in a different direction — because a lot of these things are very nuanced, and there's no one right answer." And so having people kind of focus on what feels right to them can be helpful in some of these situations. So that's one way that I'm working with people, and they're present.

Britta Bushnell: I love that. And there's also the fact that what we even want, or what matters, can change.

Dr. Jessica Vernon: A hundred percent. Yeah, and that's okay.

Power Dynamics and Medical Hierarchy

Britta Bushnell: And that's okay. And yet that's sometimes hard too. I just got an email from a past client today talking about a change, and a desire to do it this way and shifting, and making a pivot in labor to do it a different way, and that flexibility being really an important part of what allows that to happen. As somebody who is a medical professional, a doctor in the room with folks doing this birthing and shifting and changing and also striving for what it is that they want — how do you actually help with that internal checking for them about what matters? Because one of the things that can be really tricky is medical hierarchy.

Dr. Jessica Vernon: A hundred percent.

Britta Bushnell: And you mentioned you don't wear a white coat, and it's like that element of what happens — and I feel it with myself, too. When I'm the patient, what can happen for me in that environment, where I'm a pretty ballsy, go-for-it kind of human, and I can go into my doctor's office and melt into kind of a puddle of, "Okay, what should I do?" And I'm like, who is that person? So how do you, as a doctor, help with that agency and autonomy and power differential that we can feel, even if it's not technically there?

Dr. Jessica Vernon: Sure, and a lot of this I've learned from sitting with reproductive psychologists or therapists as they're coming in to talk to a patient, or the midwives, who are typically very good at this — is really sitting with them. I'm not above them. I'm either sitting on the bed if they're comfortable with that, or I'm sitting in a chair right next to them, or I'll squat down so I'm looking directly in their eyes, and really talk through everything, see what questions they have, because sometimes people aren't even asking their questions. They're just like, "Okay, the doctor is presenting me with this, they're saying I should do this, we'll go that way," even if they're not really sure about it. So making sure we answer all the questions, and often if it's something like we're recommending an intervention, if they're not sure they want that intervention, again going through the why — "Okay, I see that this is in your birth plan. Can you tell me more about that? What is the why behind this?" And sometimes when I'm able to explain things for them in another way, they're like, "Oh, okay, that's fine. Yes, let's do that." You know, so it's really having that time and space so that they can ask all their questions. They feel like we're providing person-centered care, and it's a joint decision. And I'll tell them, I'm like, "Look, if there's something that I'm really highly recommending — like the baby's heart rate is not looking good, and I really think we should go for a C-section — I'll tell them that." But even then, I tell people all the time: very few things are emergencies. There are very few things where we have to go in the room and we're like, "We need to go into the OR right now, or we need to do a vacuum or forceps right now." And often, even if those things might be happening, there have been things leading up to it that have shown us we might be headed in that direction. And so having those conversations early, saying, "We're going to do everything we can do to get you this vaginal birth, but based on what we're seeing, we might be headed down this path. So let's talk about what that looks like now, before we're in that situation," and going through everything — they have questions about what a C-section looks like, what an OR looks like, who will be in there, what's important to them when they're in the OR and going through that part of their birth plan if they have it, but if not, building their birth preferences for the C-section. And so I think all of those things are really important, and I think it's really important for everyone listening to know that there are very few things that are real emergencies. So if you're feeling pressured, ask: "Are there a few minutes that we can sit here and talk about this?"

Slowing Down: Time, Speed, and Informed Decisions

Britta Bushnell: Yeah, asking for that time to slow things down. One of the things that I hear over and over again from parents is that once a path started to pivot, everything felt fast. That what's going on hormonally, and in the situation, and the unfamiliarity of it — that a pivot turns the speed dial up on the experience. And so taking that time to slow down — and I often will talk about this specifically with partners too, because they will also kind of get into a speedier place and want to slow things down — that even if they are understanding what's being said, to go through all of it with the birthing parent, and at a slow pace, and making sure they understand everything that is being presented, so that they can make an informed choice, an informed decision, and not have all of that speed. That time is so important.

Dr. Jessica Vernon: It's not always able to get it, but really important, right? And for a lot of people, they know how they feel when they're around medical providers, they know if there's someone who's very deferential and they don't ask what they want to ask. And so it's really important when you're thinking about who's in the room. Your partner may be an amazing partner, but they might not be someone who is able to speak up in that way as well. So you can have multiple people in the room. Think about a doula, or another family member, or a friend, or someone you like — I know that they will speak up. They have no problem saying, "Hold up a minute, we need some time." And that can be really important. I see people all the time who regret not taking that pause, not asking those questions, and feeling like they were kind of rushed down a path that they really didn't want.

Britta Bushnell: Yeah, yeah. Slowing it down so that — I often will say, "slow it down to the speed of the laboring brain."

Dr. Jessica Vernon: That's good.

Britta Bushnell: Because the laboring brain is moving not as fast as everybody else's brain in the room. And so, yeah, slowing it down so that later, a lot of the "woulda-coulda-shouldas" have to do with that pace, that speed.

Dr. Jessica Vernon: Yeah.

Birth Trauma: What's Really Going On

Britta Bushnell: I want to talk about a couple of things I know are pretty important to you, both from your book and seeing your presence on social media. Maternal mental health is something really important to you, and your involvement with PSI, and then also birth trauma — and those aren't necessarily separate conversations. They probably intersect in some pretty significant ways, but I want to start with talking about birth trauma, because birth trauma rates are skyrocketing. I think you quote in your book 45%.

Dr. Jessica Vernon: Yeah, it's huge.

Britta Bushnell: What is going on, Jessica? Talk to us. What is happening?

Dr. Jessica Vernon: I think we're starting to ask more of the questions, people are realizing they have birth trauma because they know it exists, and so it's not being hidden as much. But I think, as you were saying, we're also living in this culture where it's very rigid, and we want control, and we want things a certain way. And so, if we haven't prepared and built in that psychological flexibility, those things can really impact us as well. And then, of course, there's so many things in the medical industrial complex, right, that can be out of someone's control and can really affect their experience. And a lot of people are working on that in advocacy, but I see it all the time too, where someone they don't even know rushes in the room and is doing something to them or telling them something, and it can be — what is traumatic can be this, like, what seems like the smallest thing. I've had people who've had experiences that I'm like, "Oh my goodness, they must be feeling so traumatized right now," and they're like, "I felt really held by my team. I felt good. I knew what was going on." And then I'll have people who might have had that spontaneous, unmedicated vaginal birth, and they're like, "This was traumatic." And so we never know what's going to be traumatic to people.

Britta Bushnell: Subjective, not objective.

Dr. Jessica Vernon: Yeah, exactly. And so we — from the outside — cannot know. But I think we are starting to have these conversations more, and I definitely am talking to people immediately postpartum, because we know the sooner that we can get them help, the less likely they are to develop PTSD. And I know of so many people who haven't had another baby, or they've had to take a really long pause between babies, because they had a traumatic experience and they weren't able to process that.

Preventing and Healing from Birth Trauma

Britta Bushnell: Yeah, yeah. Where do you send folks? Like, what kind of work — if somebody has experienced — well, let's take this two different ways. How do we prevent birth trauma, and then how do we help people with birth trauma?

Dr. Jessica Vernon: Yeah, I mean, there's so many different angles to help prevent birth trauma. I think part of it is things we've talked about — how to maintain your agency and feel empowered and feel centered in your care, no matter what happens. I think that's something I speak about a lot.

Britta Bushnell: Aren't those directly related to self-reported experiences of birth trauma? Is feeling like they had autonomy, agency, and the ability to self-advocate — a voice that was being heard and respected — deeply connected to instances of feeling positive about their birth, and not having those things connected to birth trauma? Is that correct?

Dr. Jessica Vernon: Yeah, yeah, totally. And having that psychological flexibility, as we've been saying, to kind of think about all of these things beforehand, and every way that things can go, and then also making sure you have those people in the room with you that you feel safe with, and you feel are going to help speak up for you — because I hear so many times people are like, "Oh, my partner, I told them beforehand I didn't want X, Y, or Z, and in the moment when I'm like, 'Just do it, let's just do it,' they didn't speak up for me, and I wanted them to hold that ground for me." And I'm like, "Well, maybe for some people, that's just not something that they're going to do, and they're also scared, and their brains are working differently in the moment, and they just want their partner to be safe and their birth to be safe." And so if their partner is like, "I've changed my mind," they're like, "Okay, honey, let's go." So making sure you really have people that are there for you and can honor your values and your intentions. And then the other part is, afterwards, making sure you talk about it. You talk about your experience, and the thing I hate the most is people say, "You're fine, the baby's fine, so it's okay." And that's just so dismissive.

Britta Bushnell: Aren't you happy you have a healthy baby?

Dr. Jessica Vernon: Sure. Yeah.

Britta Bushnell: Yes, of course, but that doesn't mean that I'm not traumatized by what happened, or how my baby came onto the planet. Both can be true at the same time.

Dr. Jessica Vernon: Yeah, yeah.

Britta Bushnell: And deep, respectful care honors and acknowledges that.

Dr. Jessica Vernon: Yeah, yeah, and it's so hard these days. I think — I mean, being in New York, we have very busy labor and delivery units, and so it does feel like there's pressure to move things along, and push towards intervention sometimes, to get people to a certain place. And because of malpractice, there's also people watching the tracing all the time, and sometimes they don't have all the context of what's going on in the room, and so any little thing, they're like, "We need to do something about this." And so there's so many things that we have to kind of push back against, and you need the right people there to help with that.

Britta Bushnell: So okay, so prevention is who's in your room, that emotional and psychological flexibility and advocacy, making sure you're working with somebody who can hear you and respond to you when you're speaking up, being able to have that agency — those are all preventative, or can be preventative, for birth trauma. And then in the postpartum, share your story with people who have earned the right to hear it.

Dr. Jessica Vernon: Right. Yeah, and I think something that I do from the very beginning of pregnancy is really go through people's history, and if they have a history of any sort of trauma — even if they processed that trauma — pregnancy, birth, postpartum will often bring it up for them. It'll often come up again for them, and so I'm encouraging them to get a good therapist, because you want someone to start working with you from the beginning of pregnancy, so when you're triggered, you have tools to work with that, and it can make such a big difference.

Postpartum Psychosis and Maternal Mental Health

Britta Bushnell: Such a big difference, which is a good pivot into talking about postpartum mental health and maternal mental health. And I know that currently on my social media feed — excuse me — it's being talked about a lot right now because of the Lindsey Clancy case, and I mentioned to you before I hit record that I think there have been days in the last month where three out of four posts on my social media feed has been about that. So it's really front and center being talked about, and with so much coming up, I'm curious — what is it that you want people deeply to know about, or be aware of, as this is coming into so much of the conversation? What do we need to get about that? And what does the parent who is maybe expecting, or in postpartum — what do they need to know?

Dr. Jessica Vernon: Sure. Yeah. And I've really been grieving for all of the people who've experienced this. I haven't posted on it at all — I think it's just been that really heavy space, and I do know people who've had postpartum psychosis personally, or their family members died due to postpartum psychosis. So I've been just really grieving for all of those people who've gone through this experience, and then are —

Britta Bushnell: — potentially being retraumatized —

Dr. Jessica Vernon: — totally —

Britta Bushnell: — by how much this is coming into our feeds right now.

Dr. Jessica Vernon: Yeah, and we know there are so many people that never had it recognized, especially Black and Brown moms. Their cases are not as likely to get brought up as white moms, and so, really, we need to talk more in that space as well, and have safe spaces for not just white moms, but moms of every background and color. And so when I'm thinking about this, I'm thinking this is something that we need to prepare people for before birth as well. We, as an OB — I spend so much time in residency studying preeclampsia, studying postpartum hemorrhages. I could do an emergency C-section in my sleep, right? But mental health disorders are more common, cause more death, and more maternal morbidity than high blood pressure, than a bleed after birth. And so we really are doing people a disservice by not talking about it and telling them where to go if they have any of these symptoms, no matter what it is — anxiety, depression. If you're not sleeping for days on end, that's going to lead to some symptoms eventually. And postpartum psychosis — it is really scary. I get it, as someone who feels that I could have tipped over into that space easily, and I was lucky I didn't. But for people who are pregnant, thinking, "Oh my god, could this happen to me?" — it's really scary, and we know it isn't selective, right? It can affect anybody. But I think having these conversations with your partner, especially beforehand — because the person experiencing it often won't realize they're experiencing it. I've heard cases of people who are going to the ER with their partner. They think they're going for their partner. They're like, "Oh yeah, he's really out of it right now, we need to get him evaluated," when she's the one experiencing psychosis. And so making sure your partner knows what to look for — things that seem a little bit off — and making sure you have resources in advance. You know that Postpartum Support International has a lot of great free resources. The maternal mental health hotline you can call any time. But just knowing that these are medical emergencies, and postpartum psychosis waxes and wanes, so you can be totally lucid and normal one minute, and then be in the depths of psychosis in the next, which is what makes it so different than other psychosis, and so scary. So just make sure you have these conversations, you have these resources available, and you have other people who are checking on you and looking for these symptoms.

Britta Bushnell: Yeah, yeah. Thank you. That's so important, and PSI offers such a fabulous space for some of that help — for moms, dads, partners. There's a lot of different ways that postpartum mood disorders can manifest, and one of the things that is — I mean, postpartum psychosis is not talked about a lot. It's getting talked about a lot right now, but it hasn't been something that's talked about a lot. And postpartum mood disorders in partners is not talked about a lot, and yet is something that can also happen and be important to pay attention to as well. Like, saying the quiet things out loud — we need to be bringing in the parts that aren't talked about. I mean, I saw a news clip this week that was of a news anchor talking about "having postpartum," and I was like, "Well, if you had a baby, you had a postpartum." But we're conflating the word "postpartum" with "postpartum mood disorders" — PMADs — and, oh, it makes me want to pull my hair out about that. So, in light of that, can we talk about postpartum — the period and transition — and matrescence, and how you like to work with people, or what it is that is important for folks to know about that part of the journey, that transition piece?

Postpartum, Matrescence, and the Transition

Dr. Jessica Vernon: Sure. And I think, as we've been talking about birth plans, people spend so much time preparing for that period — that short period of laboring and giving birth, or having their planned C-section — and we spend very little time preparing for postpartum. And so when I'm working with people, especially people who I know have risks for postpartum anxiety and depression, we're really delving into that and getting the support beforehand. But for everyone, just recognizing that this is one of the most pivotal transformations in your life. You are going to be more vulnerable than you've ever been, and your life is one thing one day, and then you have a baby and everything is completely upside down. And just knowing that there are going to be mental, physical, emotional, spiritual — all of these changes are going on while your brain is also literally restructuring itself. Your hormones have dropped to postmenopausal levels. Your body is healing from birth. There's so many things going on all at once, and so I just don't want people to feel alone when they're going through this, or feel like there's something wrong with them because they're having all of these different feelings that might not align with what they see on social media or online with how things should look and feel postpartum. Because, honestly, it's not all natural. I mean, I didn't fall in love with my baby for a while. I felt very responsible for her — my first baby. But there's so many parts of the postpartum experience that I didn't even know as an OB. And so now we're getting more people talking about matrescence and writing books about it, which is incredible — really great resources for all of us, because we all go through it. People just haven't been talking about it.

Britta Bushnell: Yeah. Well, and naming something is helpful.

Dr. Jessica Vernon: Yeah.

Britta Bushnell: It's helpful to name what it is that we're talking about. And really, it is a transformative time, that matrescence — and I'm wondering if we're going to start using "patrescence" also as a possibility, as a word, because I think there's transition and transformation going on for partners as well, coming into fatherhood and parenthood, even if they're not the one giving birth.

Dr. Jessica Vernon: Yeah, yeah.

Transformation Resistance

Britta Bushnell: And one of the things that you talk about is also transformation resistance. So what is transformation resistance? How does that manifest, and what is it about?

Dr. Jessica Vernon: I think we've been sold this story that we are just supposed to stay the same through birth and just go into postpartum like nothing happened, and go back to work and our daily lives, and there's all this pressure to bounce back, to look the same, to go back and not talk about your baby and motherhood, and switching up your schedule because you had a baby. There's just all of these things that I think, honestly, society has sold us because they're not invested in childcare and supporting new moms. So it's like, "Yeah, this should just be seamless, and you have your baby and you go on with things" — without acknowledging that there are major transformations going on. And people who are experiencing those things often feel weak, or they feel like they weren't good enough because they aren't able to just go right back to life the way it was before.

Britta Bushnell: Yes, absolutely. And what's the antidote, or what helps when we have transformation resistance? Like, what is it we need that we don't have?

Dr. Jessica Vernon: Yeah, when we're resistant —

Britta Bushnell: — to transformation — you know, because all of us are going to have moments of transformation resistance. I mean, that's part of the journey, right? Is to resist it a little bit, because we're like, "Ooh, that's scary." So what is it we need when we're resisting?

Dr. Jessica Vernon: We need community. We need people to talk to about what's going on, and then when you hear other people's stories as well, you feel validated and you know that it is okay. We were talking about this tension, this dichotomy — it's okay to love your new life and grieve your old life, and love your baby so much, but also want to run out of a house screaming sometimes. All of these things can go together, and not wanting things to change, not wanting things to be different at times, is really part of that process.

Britta Bushnell: Yeah, and so while we're holding those multiple experiences at once, we need some bravery, some flexibility. I think you use the word "allowing" — to allow it to unfold. They all feel really important, and yet we've been kind of sold a bill of goods that says that's weakness, right?

Dr. Jessica Vernon: Yeah. So, seeing other people — other people who you view as strong, and people that you want to emulate — and then hearing, "Yes, they've gone through these things too." I think that can really help people, and that's why I started speaking up about my postpartum experience and my transition, which was so difficult that first time, because people think, "Oh, as an obstetrician, obviously she knows what she's doing" — and I struggled really badly for a long time going through it.

Britta Bushnell: Yeah, because knowing something in the head is not the same as experiencing the transformation of the psyche, the identity, the body, the lifestyle. All of those things are very different than intellectual knowledge, or practical knowledge. I mean, you knew what was happening to the body, you knew what was happening hormonally, but that doesn't mean that it then is a hall pass through the transformation.

Dr. Jessica Vernon: No, no, I don't know where that — I feel like that —

Britta Bushnell: — just dated me back to the days, a long time ago, when — I don't know if "hall pass" is a thing that people get these days. But yeah.

Dr. Jessica Vernon: Yeah, I think we all totally still get those. But yeah, it is, because we are really taught about the objective, physical part of things, and not about all the other aspects that you can't see.

Britta Bushnell: Yeah, yeah, and those are what we really desperately need to be talking about a lot. And I'm so grateful that you are, and that's part of why you and I found each other in the world of social media land — because those things matter to both of us. So, where can people learn more about you and your work? Tell us about your coaching practice and your book — give us what we need to know about you.

Closing: Where to Find Jessica, and the Closing Question

Dr. Jessica Vernon: Sure. So I have my website, drjessicavernon.com. I'm also on Instagram at @drjessicavernon. You can reach out to me through either place. My book is available anywhere books are sold. And as for the coaching, if you're interested in working with me, you can either sign up for a call through my website or DM me directly on social media. I can work with people in any state because it's not medical-license dependent, which is really fun. And I just want people to know — I don't have a robot response, it's always me, so I'm there. And if you just want to talk about anything, feel free. I love just hearing from people and helping them be their little cheerleaders sometimes, or just acknowledging what they're going through.

Britta Bushnell: I love that, and that's pretty rare these days.

Dr. Jessica Vernon: We all need it. We all need it.

Britta Bushnell: We all need it. We all need it. I mean, and internet village matters too — you know, we have different types of village, and they all have a role and a value. So as we start to bring our conversation to a close, I end all of my conversations with the same question, and I'd like to share it with you and hear your answer. So here we go — ready? What's one thing that you feel passionately about that you want new or expectant parents to see, hear, feel, or know during this profound period of their lives?

Dr. Jessica Vernon: I think it's just really important to know that you are never alone, and as much as it might feel that way when you're going through these experiences, I promise there has always been someone who's gone through that before. There will be others that go through it, and it does get better. And I see that so many times when people are deep in it, they feel so isolated, and they just don't think they'll ever get out of that space, but you will. And if you reach out for help — even though that's hard sometimes — or you reach out for community, you will find it. I promise. There are people who are there. You are never alone.

Britta Bushnell: Yeah. Even when it's hard to reach out, reaching out matters, and you're not alone.

Dr. Jessica Vernon: We need those lifelines sometimes.

Britta Bushnell: We need those lifelines, absolutely. Thank you so much, Jessica, Dr. Vernon, for being here, and thank you, listeners, for sharing this time with us. If something shared today impacted, supported, or moved you, please share this episode with a friend. I produce this podcast myself, and your support makes it possible. To show a little love for the podcast and these conversations, please follow, rate, and review. If you'd like to continue the conversation, please join us on Instagram at Transformed by Birth. I look forward to being with you on the next episode of Transformed by Birth. Now let's gather what we want to take away from this episode with an inhale, and on the exhale, I'll blow out our candle. Until next time, bye, friends.