The Truth About Fertility, Pregnancy and Labour with Mama Doctor Jones | Transcript
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Mama Doctor Jones
Sometimes people get angry about this. And I just say like, if you're in my office, of course, if you're a woman, I will call you a woman. I'm a woman. I have lots of patients who are women. And it's not about not acknowledging that, but when we're speaking in a large scale, if you try to just be a little bit more inclusive, it really makes a big difference in the healthcare of others.
Hannah Witton
Welcome to Doing It with me, Hannah Witton, where we talk all things sex, relationships, dating, and our bodies. Hello, dear listener, welcome back to Doing It. So a little update from me. If you don't watch my YouTube channel and haven't seen the updates there, my partner and I are currently trying for a baby or trying to conceive - TTC, as I've recently learned the terminology. It's a whole club. Apparently. I'm in the TTC club. And I am sending lots of love and good vibes to any listeners who are also in the TTC club. So as I'm sharing this journey in new episodes of the Hormone Diaries over on my YouTube channel, I thought this would be a great opportunity to bring an expert in all things fertility, pregnancy, and birth on to the podcast so I can learn some stuff about what I'm embarking on, and we can all learn together.
Hannah Witton
So my guest this week is Dr. Danielle Jones, aka Mama Doctor Jones. She is a physician and OBGYN - that's an obs and gynae doctor for us folks in the UK - and she also creates amazing content on YouTube, Instagram, and Tiktok all about periods, pregnancy, and birth. In this episode, I really just take the opportunity of having an expert to talk to for 45 minutes to ask all my questions and ask some of the questions that you submitted on Instagram. We talk about the process of trying to conceive and things to be prepared for, the state of sex ed in the United States, how to be trans inclusive as a medical practitioner in the field of Obstetrics and Gynecology, and I ask for a doctor's opinion on hypnobirthing, if she's had any patients like me with an ileostomy and previous abdominal surgery and what that could potentially mean for pregnancy and birth. I learned about different types of fertility treatment like IVF and IUI. So many initialisms. We chat ovulation tracking, pelvic floor, menstrual health, and how much bullshit information there is out there. And of course, it wouldn't be me if we didn't also talk about poo. So I hope you enjoyed this episode. If you want to hear more about my personal fertility journey, then you can watch new episodes of the Hormone Diaries on my YouTube channel, which is just youtube.com/Hannah Witton. As usual, you can find more info and links to everything we talked about in this episode in the show notes over at doingitpodcast.co.uk. And please let us know what you think over on our Twitter or Instagram (@doingitpodcast). I'm gonna shut up now and let you listen to the brilliant Mama Doctor Jones.
Hannah Witton
Welcome to the show, Mama Doctor Jones.
Mama Doctor Jones
Thank you. I'm excited to be here.
Hannah Witton
Me too! This has been a highly requested crossover collaboration.
Mama Doctor Jones
Well, that makes me happy because I think you're doing really great work and I'm happy that people associate us as being kind of in the same area of work on YouTube.
Hannah Witton
Yeah, thank you. Me too. When people are like, oh, you should do something with Mama Doctor Jones. I'm like, oh, no, she probably like won't reply to me. But then you were like yes! So I was like, oh, my goodness! Um, okay, so I guess to kind of like, start us off, you are an OB-GYN. And what is that? And especially for my UK audience, because we call it obs and gynae here. Um, so what is it? And then also like, what is the obstetrics and what is the gynecology?
Mama Doctor Jones
Sure, so I am a physician, I went to - the training is a little bit different around the world, depending on where you do medical school, but in the United States, we do four years of an undergraduate degree, which is like a uni degree there and then - and my degree's in psychology - and then I did four years of medical school. After medical school, you're officially a doctor, and then you go on to do your training. And for OB-GYN that's for four years of practicing just OB-GYN and kind of learning how to do this specialty.
Hannah Witton
So 12 years?
Mama Doctor Jones
12 years. Yes.
Hannah Witton
Twelve years, oh, boy. That's a lot of training. And yeah, so what is - what does an OB-GYN specialize in, then?
Mama Doctor Jones
The obstetrics side is anything to do with pregnancy and birth: taking care of people throughout pregnancy, people who are trying to get pregnant, and delivering babies, C-sections, taking care of people in the postpartum period. And then the gynecology side is anything to do with the vulva, vagina, ovaries, uterus, fallopian tubes, pelvic floor, pelvis, any kind of problems with those. And a lot of us also do breast disease as well. So that would be the pap smears, STD checks, abnormal bleeding, period problems, and then we do a lot of surgery, hysterectomies, ovaries, all of those kinds of things.
Hannah Witton
Everything to do with the uterus, and its family members.
Mama Doctor Jones
Exactly.
Hannah Witton
All of that stuff. Um, I wondered what you think sex ed, and maybe like, specifically, sex ed in the United States, is missing when it comes to things like about periods, and fertility and pregnancy and all of that.
Mama Doctor Jones
Sex ed in the United States is missing everything. I mean, we do a very bad job of this. And I honestly feel like sex ed should start early - kindergarten, first grade - with just an occasional discussion about normal body parts, what all the names are, how to appropriately consent. And this doesn't have to be like a sex discussion with second graders, it's just normalizing the chatting about this kind of thing. And then that should kind of go on through high school. And what we have right now is basically like, maybe a couple hours of splitting up the boys and girls and talking about periods in middle school. And then maybe if you're lucky, a health ed class in high school that's often taught by someone with no specialization in medicine or sex ed or anything like that. So it's missing everything.
Hannah Witton
Yeah. Even even the basic stuff that you expect it to cover. Like we had, when I was like, 13, and it was in a science class, It wasn't in like a sex ed specific one, but we had to watch a video of someone giving birth. And they, you know, they don't give us like, great sexuality and relationships education, but they do show us, you know, show us the woman's vagina with the baby coming out of it.
Mama Doctor Jones
Yes, it's very fear based.
Hannah Witton
Yeah, we're all pretty much traumatized, because you're not giving any - given any context to like all of these things. It was wild.
Mama Doctor Jones
Yeah, and it's never like a nice happy delivery with pain control. It's always something really scary to watch. And the problem is that, like, people need to know what's happening before they see a video of birth. Because if you don't have context, like you said, it is scary. Of course, that's scary.
Hannah Witton
How many births do you think you've seen at this point?
Mama Doctor Jones
My gosh, if I put together all of them that I have seen, and then overseen for people who are training and then performed or caught babies at myself, and include C-sections, I'm sure it's near 1000.
Hannah Witton
Wow. What do you think is some of the things that people don't expect about birth going into it?
Mama Doctor Jones
I think there's a lot of fear around birth that honestly doesn't need to be there and if people got the right kind of education then I don't think that would be such a big part of birth and cultural birth. You know, we can't fix that in 40 weeks of caring for you in your first pregnancy. But I do see a lot of people who are just absolutely terrified to go into labour and have their baby and I think, normalizing the fact that, you know, you can have a happy, wonderful birth with or without pain control, and, and really end up on the other side of that just having had a good experience should be something that we talk more about. But again, I mean, I think this all circles back to the sex ed thing: it's a big unknown, and people fear what they don't know. So if we could start this education a lot earlier, teaching people to be comfortable with their bodies and to understand what's happening and the physiologic changes that go on with with puberty and then with sex, and then with pregnancy and birth, I think there would be a lot less fear.
Hannah Witton
Yeah, because you want that like foundational understanding and confidence in your body and it kind of like all builds up on top of each other. That's so true.
Mama Doctor Jones
Exactly. It'd be like if someone threw you into algebra, but you never learned how to count.
Hannah Witton
Yeah, exactly, exactly. Okay, I have to ask you this. As a medical professional, what do you think of hypno birthing? Because that's something that I just have heard so much about, and I'm so, like, intrigued by it, but I also have an aversion to, like, stuff that I think is woowoo but then I disregard it, even if maybe it could be really beneficial.
Mama Doctor Jones
I think some of us all get into that kind of head space every once in a while. Hypnobirthing is just one of many options that people have to have kind of an alternative pain control or happy birth, essentially. So I think this is great. I mean, people can look into whatever form of birth that they would like to have. And hypnobirthing is just one of those options. So what I think the important thing is, if somebody is going to give birth, that they figure out what they want out of their birth, and then they prepare themselves for that. So I personally never wanted to have a baby without pain control, like not having an epidural is not something that I ever desired. And so I was fine, just going in getting my pain control and having a baby. And that was okay with me. But for some people, they really want kind of a medication free birth. And that's great, too. But you can't go in without any preparation. So I always tell my parents who are wanting to have a medication free birth, you've got to do something to prepare yourself. And whether that's lamaze or hypnobirthing, or whatever it is that helps you prepare mentally to deal with delivery, it's a good thing.
Hannah Witton
That's a really great point. Yeah, I like that. It's just like a way of doing pain management.
Mama Doctor Jones
Absolutely. And and there's a whole lot more to it than that. That's obviously very simplified. But it definitely is focused on helping people get through that pain and get over that kind of hurdle so that they can enjoy their birth and have a good experience.
Hannah Witton
Yeah, and this is a complete tangent, but it just made me think of when I was in hospital. And I was on like, all sorts of different painkillers and on morphine drip after surgery, um, how there were like specialist pain management doctors that would come round and like check how much morphine I was taking. And like, that was just wild to me. Like there's some people who specialize in pain. And I was like, that's kind of cool.
Mama Doctor Jones
Yeah, we have. It's usually in the United States, anesthesiologists who go on and do additional training and pain management. And they are very, very wonderful people to have around.
Hannah Witton
I love that. I did hear that anaesthetists are like the cleverest people in hospital. That's what..
Mama Doctor Jones
I've always told my patients that - the ones who want an epidural - I come in and they have a happy delivery, and I hand them a baby. And they're like, where's the anesthesiologist, I love her. And I'm like, here's your baby, I helped you have your baby. And they're like, the anesthesiologist was wonderful.
Hannah Witton
Honestly, like I, I agree, like having gone under many times, the people, the last people that I've seen in the room, as I've gone under have always been so charming. And so lovely.
Mama Doctor Jones
They really are wonderful people.
Hannah Witton
Right, back to the OB-GYN stuff. And I am curious. So I have started documenting my experience online of trying to conceive and, and we are six, seven months into trying at this point. And so I guess, what do you wish that somebody in my position knew about this whole process?
Mama Doctor Jones
So I think you really hit on an important point there is that it can take time, sometimes this doesn't happen right away. And I have patients who often get really, really worried about their fertility when they've been trying for three or four months and, and there's only about a 20% chance each month that you get pregnant. So I think -
Hannah Witton
Yeah, when I learned that, I was just like, hang on a second, we could be doing everything right, like sex every other day, like three, four times a week or whatever, like no drinking, no smoking, like making sure our bodies are like not stressed. And like all good. And still only a 20% chance. I was like, *gasps* what?
Mama Doctor Jones
Oh, yeah, that's that is mind-blowing to a lot of people. But I think knowing that, it helps people not get so anxious if it doesn't happen right away. And then the flipside of that is that, you know, this, what I tell my patients is, if you don't have any other problems going on, you don't have severe pain, there's no problems with sex, everything seems to be in working condition and your periods are pretty normal and come at the expected time, then trying for a year before you come in and see me makes sense as long as you're under the age of about 35. But if you have anything else going on - because I think most people know that: try for a year and then come in - but if there's nothing else going on, if your periods are abnormal, or you're only having a period every 60 days, or you're having a lot of pain with sex, or something's seemingly not going right then come in sooner than that, because you can come in for complaints and not getting pregnant. And we can look into that before it's been a year.
Hannah Witton
That's really reassuring to hear, because I have like quite a long cycle. And it's pretty irregular as well. And I've already like started that process of like talking to my doctors and I've got some blood tests planned and stuff. And yeah, we're not a year in even though that is the messaging that I received. But I kind of like I made that decision myself. I was like they say a year, but also my periods are really like long and irregular. So I'm gonna ask about that.
Mama Doctor Jones
Right, exactly. So it's a year in the absence of anything going on that's abnormal.
Hannah Witton
Right. Yeah, that makes a lot of sense. Okay, well, glad I called up my doctor, then.
Mama Doctor Jones
I'm glad. I'm glad that it made sense for you to go ahead and do that, because I hate when people feel like we've left them out in the dark when we have forgotten that little add on at the end of the year discussion.
Hannah Witton
Yeah, that makes so much more sense to me. I feel, I feel vindicated in my choices. I love that.
Hannah Witton
Okay, one thing that I really wanted to ask you - something that you have talked about a lot online is being trans-inclusive. And I wondered how can a field like obs and gynae be more trans-inclusive? What are the things that medical practitioners can do and put into practice?
Mama Doctor Jones
Sure. So I think I've told the story 100 times, but I don't, I have not always been that way because I didn't realize it was so important when speaking to, to big audiences to include everyone, especially people who tend to have more trouble getting inclusive health care. And I got on YouTube, and I was making videos and every once in a while, I would get a comment that would say something like, oh, I wish you would be more inclusive to people who can get pregnant and have periods but don't identify as a woman. And I thought, well, that's - why would I? That's such a small portion of the population. But I sat with it, because it kind of made sense to me at the same time. And I thought, okay, well, I'll make an effort and see how it goes. And it was so easy, it was so easy to include people who tend to be excluded in this discussion, by just, you know, putting even the smallest amount of effort into it. So this really comes down to things like using inclusive language, instead of saying women who are pregnant, you can say people who are pregnant. And sometimes people get angry about this. And I just say, like, if you're in my office, of course, if you're a woman, I will call you a woman. I'm a woman, I have lots of patients who are women, and it's not about not acknowledging that. But when we're speaking in a large scale, if you try to just be a little bit more inclusive, it really makes a big difference in the health care of others. And then there's a whole other discussion about how to be inclusive in your practice as a medical provider. And that's a lot more difficult because I can be the most inclusive provider and accepting of everyone and want everyone to have equal access to education about these topics, but if my front desk is not open to that, or if my paperwork doesn't reflect that, that's the first impression that the patients get when they come in. So it's it's a lot of work on that ends but it's worth it and I think it's important.
Hannah Witton
Yeah, and I guess like, do you have much control over, like, the gender or sex boxes on the paperwork?
Mama Doctor Jones
I don't, it's not something - I mean, in some practices, you would, but in the type of practice that I have, I don't. But I did actually hear you say in one of your videos that you went in, and they asked, what is your sex that was assign- or what is your gender and does it match the sex you were assigned at birth? And I thought, such a great way to put it, because that's just an easy yes or no. And if there's more to add, someone can write an additional, but it doesn't, you know, like, that's how all the paperwork should be.
Hannah Witton
Yeah, exactly. And it's like two separate questions. And when it asked your gender, it also included non-binary. And then yeah, it was a separate question that was like does your gender match the sex you were assigned at birth. And I think what you said about when talking to a broader audience, versus when you're talking one on one with a patient, like that really hit the nail on the head, because the whole point of being inclusive, like you said, is so that people who are more marginalized and don't necessarily get the same access to health care can maybe like find- it's more obvious to them to find a practice, to go, oh, this place actually like they, they've got it, it's clear, like, I know, I can go there. And then it's nobody else's business. It's like that - whatever then happens in that room is between that person whether they are cis, trans, non-binary, and their medical provider. Like, that's what I don't get, like, some people have an issue with like, you use the inclusive language and, and then they're like, oh, but what about biology and what about all of these things and it's like, that's up for that's like up for them and their doctor to discuss like, we're not involved.
Mama Doctor Jones
Exactly. And it's really easy for me to figure out somebody's genetic sex: I just ask them. And nobody gets upset with their doctor when they ask that because, you know, a big point of a lot of these trans-exclusionary activists online is, well, when you get medical care, you need to know someone's genetic sex and like, yeah, you do, but like, nobody who is trans or non binary is not aware of that, like they will tell you.
Hannah Witton
Yeah, because that's relevant information, but it's not relevant information if you're, you know, using the toilet, whatever, but this is a whole other conversation. But it's just really good to see people who are medical professionals and work in I guess a field that could so easily be and is often gendered - because you know, you're talking about, like pregnancy and birth and periods and stuff and it's like, oh, womanly issues - so it's just really good to see people who work in this field being really inclusive about language and being really intentional about that.
Mama Doctor Jones
Well, I appreciate that. But I also just want to add in here that I also appreciate the people who kindly pushed me to do that. And yeah, and that's what makes all the difference: the people who nicely said, hey, let me tell you about my experience and how you could make it better.
Hannah Witton
Yeah, absolutely. Yeah. And also, like you said, it's easy.
Mama Doctor Jones
So easy.
Hannah Witton
Right, so I had so many questions from people on Instagram. And I don't normally dive into the Instagram questions this early in an episode, but there are just so many, and they're so good. And I feel like whilst we've got an expert in the house, I'm just gonna milk it.
Mama Doctor Jones
Perfect, I love it.
Hannah Witton
Get it all out of you. So somebody asked, how does IVF actually work? And I'm also curious about this. And then also, I've recently learned that there are like, other things that you can do that aren't just IVF and I'm just like curious about that whole thing. How does it work?
Mama Doctor Jones
Let's start with the other things that aren't IVF. So basically, this would be steps before you need to move on to IVF. So this goes from things like Clomid, which is an ovulation induction agent or Femara, which is an ovulation induction agent, which if somebody has had a workup and everything looks normal, but they still have really long cycles, or they have really abnormal, like, timing between their periods, or they have PCOS, or something like that, you can start with an ovulation induction, which increases the number of eggs recruited to the ovary and basically makes you ovulate more than once. Or that's the goal.
Hannah Witton
Oh my god, I want this!
Mama Doctor Jones
But you have to be careful with this, there's some -
Hannah Witton
Could you get twins and triplets? Are you more likely to have twins or triplets if you do that?
Mama Doctor Jones
Yeah, so there's about an 8% chance of multiples. That's actually how I had my Clomid twin girls who are eight.
Hannah Witton
Oh, amazing.
Mama Doctor Jones
And so that's an option. And it's obviously not an option for everyone. There's the right patient to go down that road. And then after things like ovulation induction, you have things like injectables. So rather than taking a pill, you inject a medication and it kind of works the same as ovulation induction, you're recruiting more follicles, or if somebody has not been regulating at all, you're recruiting a follicle. And then if - you can add on to either one of those something called IUI, which is intrauterine insemination. And this is essentially taking a sample of the semen and putting a teeny tiny little catheter through the cervix, it's not a painful procedure most of the time, and injecting that into the uterus, which just basically increases the chances that the sperm actually gets to the egg when the egg ovulates.
Hannah Witton
Right, rather than dying inside the vagina.
Mama Doctor Jones
Right. So this overcomes things like - it wouldn't overcome any kind of tubal factor infertility. So if the tubes are the problem, then introducing sperm into the actual uterus isn't going to help that because that's going to be further downstream. So this helps with ovulation issues, it helps with cervical factor problems, and then sometimes we just add it for people who maybe just need a little bit of an extra boost. And then IVF is going to be a completely different process, although it does kind of play on some of those same ideas. It increases how many eggs that are recruited, ideally. So usually, you're gonna be using injectable medication and want to recruit as many eggs as possible. And then when you get close to the time of ovulation, ideally well before that happens, you'll be put under some gentle anaesthesia, usually not completely asleep, and then by ultrasound guidance, the doctor can introduce kind of a long needle into the ovary and recruit some of those eggs out to keep in a little dish and an embryologist goes through and looks and sees how many are viable and how good they are. And then you add the sperm to that and you make an embryo in a lab.
Hannah Witton
And then that's - and then the embryo is then injected into the uterus?
Mama Doctor Jones
Yeah, so you basically do the same kind of process as an IUI would be. You introduce the embryo and at that point, it's really a zygote, I mean, this is like a five cell organism at this point. You can introduce that into the uterus and a lot of times people say it's implanted but it's not implanted, your body still has to do the implanting part. You just put it where it needs to be and hope that that happens.
Hannah Witton
Oh I see. I remember the first time I learned about all these different terms like it's not just an embryo until it becomes a fetus. There's like a zygote and then, what's it, a blastocyst?
Mama Doctor Jones
Yes.
Hannah Witton
I was like, this sounds like a sci fi fiction novel
Mama Doctor Jones
And embryology is a really fascinating but very difficult to learn field. It is so interesting, but it is, it is so convoluted.
Hannah Witton
Yeah, I mean, everything that you just described that I was just like, if you could see my face, I was like, my mouth is, like, open just, like, concentrating. Okay, there's this and there's this. Also, it just made me think of, like, how many different things can go wrong? I don't know if that's like a bit of a, like, negative way of thinking about it. But there's just like, so like, it's - maybe it could be the eggs, maybe it could be the tubes, maybe your cervix, maybe like, maybe it's the implantation like who knows, like all these different things.
Mama Doctor Jones
It really is a miracle. And I don't use that word lightly. And I kind of hate when people refer to things as miraculous but I think conception is quite miraculous. And the fact that it goes right so often still blows my mind.
Hannah Witton
Yeah, that's why we tell teenagers to use the condom.
Mama Doctor Jones
That's exactly right. But the IVF and all that is generally not done by a general OB-GYN. So this would be someone called a reproductive endocrinologist. There's several on Instagram and YouTube. Dr. Natalie Crawford is one of my really good friends. She has a great YouTube channel and talks about a lot of this stuff, too.
Hannah Witton
Oh, cool. Oh, wow. It's just - it can get so specialist.
Mama Doctor Jones
Yes, they trade for three more years after me.
Hannah Witton
Oh, my goodness.
Mama Doctor Jones
They do everything I do and then three more years of training.
Hannah Witton
Right, we need to get on to these other questions, there's so many, there's so many. Somebody asked, how much does diet influence your fertility/cycle?
Mama Doctor Jones
That's a hard question to answer because it's not just like an exact amount. I would, I would say that your diet affects everything that you do. And your diet affects your body in ways that you could never even imagine. And that's why there's you know, entire fields of dietary care, you know, dietitians, and all of these people who specialize exactly in that. So that's not to say if something is going wrong, it is because you have a bad diet, or if something went right, it's because you did the correct diet things. It's just to say all of these things are intertwined and it is important. And I do encourage my patients, especially if they're having trouble with getting pregnant, to go see a registered dietician and talk with them and see if there's anything they could do to optimize that.
Hannah Witton
Yeah, my partner and I have stopped drinking alcohol, that's, like, our main thing.
Mama Doctor Jones
Yeah, and that's, you know, and that's kind of a lot of people recommend that. And for some people, they drink up until the positive pregnancy test, and that's fine, too. So I think everybody has to kind of do what they're comfortable with and what makes them feel good about what they're, you know, doing to try to get pregnant.
Hannah Witton
One of the things that I found from not drinking, though, is that because I have less hangovers, I've gotten into a better sleep pattern and sleep routine. And that just in general, I'm hoping, like, edges my body towards having a bit more of a routine menstrual cycle as well. That's my plan.
Mama Doctor Jones
Absolutely. It is a big factor in sleep, drinking, even small amounts of alcohol can greatly interrupt sleep patterns. So you hit that one right on the head.
Hannah Witton
Okay, good. Also feeling vindicated once again in my choices. Okay, and this is actually another question that I had, um, what is a high risk or a low risk pregnancy? Because I hear those terms all the time. And I'm like, what, what, what actually do they mean?
Mama Doctor Jones
Yeah, there's not - it's a very broad discussion. So most of the time, we consider a low risk pregnancy to be anyone under the age of 35, who has no health conditions and no complications. And anything that is outside of that box is considered technically high risk. But obviously, there are levels of high risk. I mean, someone who has gestational diabetes is technically high risk, but that's much lower risk than somebody who has like Marfan Syndrome, which is a connective tissue disorder. So there's levels of risk. Now also something that confuses people is okay, do I need to see a high risk doctor instead of a general OB-GYN? Most of the time, what high risk means is :you probably shouldn't be seeing a midwife. I love midwives. I think they are absolutely wonderful. But you should be seeing someone as a midwife if they are low risk. Once you move into the high risk category and you have some kind of complication going on, then you need to be seeing a physician. And those people don't necessarily have to be high risk doctors. Usually high risk doctors we refer to, to get them to help with certain things. But we still end up being the primary care providers for the pregnancy and for the delivery, we just have assistance with some different things that may be going on that they can help us manage.
Hannah Witton
Okay. I'm curious, have you ever had a patient who's had a ileostomy, or a stoma? Like, I don't know if I would be high risk because of my condition and because of having previous abdominal surgery.
Mama Doctor Jones
I personally have not, but I would probably have that patient go see a high risk doctor very early on in their pregnancy or maybe even before just to have a chat with them about what to expect in anything they need to do to optimize their care. And then if problems arose, then - and certainly to see your normal doctor who cares for you for for stoma, anything, just like normal checkups. And the one thing you do want to watch for with these patients is if you've had significant abdominal surgeries, and you need an emergency c-section, we need to know about that and have a plan. And that plan would be developed ahead of time with your GI doctor and high risk pregnancy doctor to make sure we know going in what to expect just in case.
Hannah Witton
Makes sense! Yeah. My doctors, like my gastro doctor and colorectal doctor, have both said that people in my condition, it is possible to have like a natural pregnancy and birth and all of that. So I'm like, cool, good to know.
Mama Doctor Jones
Absolutely. And I think that's a misconception a lot of people have, although I haven't had a lot of patients with this issue. It is preferable even to have a patient have a vaginal delivery, because you'd really, I mean, always we'd like to have a vaginal delivery but especially if someone's had a lot of abdominal surgeries, you want to avoid having more.
Hannah Witton
I know and having had two abdominal surgeries in the past: not a fan, personally.
Mama Doctor Jones
I can imagine.
Hannah Witton
Wouldn't recommend. Somebody asked, when should you go see a doctor about irregular periods? Is it worth checking out even if you're not trying to conceive?
Mama Doctor Jones
Yeah, yes and no, it kind of depends. So if your irregular periods are sometimes you have 30 days between cycles, sometimes you have 32, but they generally stay in a in a pattern that is not, you know, 60 days apart, it's probably okay, as long as it's not bothering you or catching you completely by surprise. But if it's bothering you, it's always okay to come in and talk about it. If you have really irregular periods - so one month, that's 30 days, one month, it's 70, then definitely you need to see a doctor, because any time we have someone that's going really long periods of time without having a cycle, there's something we need to identify going on.
Hannah Witton
Yeah, one of the things that I've always heard is that menstrual health can be a key indicator of overall general health.
Mama Doctor Jones
Absolutely. 100%.
Hannah Witton
Yeah, it's key, if there's something going on with your cycle, have a - have a little visit to the doctor. And this is a funny question and this is kind of like where my head is at lot of the time. What should people know about their fertility and what is just bullshit?
Mama Doctor Jones
Oh my gosh, there's so much bullshit on the internet. It's like, I can't even sift through it all. You know, the main thing to know about your fertility is really what you just said. I don't want people sitting around worrying about their fertility if they don't have a reason to. If your periods are regular, if you don't have pain, if there's nothing obvious going on, then I don't want you spending a lot of time just perseverating over the idea that something could be wrong, and you don't know it. And the reason I say that is because I so often see online this predatory kind of content that's like, you know, something could be wrong, and it's hiding and, and there's a lot of fear around fertility problems even when they don't need to be. And so I really don't like these like, I don't want to call out specific companies, but like modern fertility type companies that send you hormone tests to do at your house and all this stuff. Like, that's not really evidence-based, and what we end up having is people who don't need those things doing it and then just having a lot of fear. So my biggest piece of advice is: if something is not seeming right, if you're worried or if you just want to have a chat, just come in so we can talk about it, so we can figure out is there really something we need to be looking into or right now should we just give it a little more time. Because I can't count the number of patients I've had come in after three or four months of trying who are absolutely beside themselves because they read something online that made them think they were infertile, and we calm them, we calm them down, and they come back in two months for their first exam because they're pregnant. So I just wish we could get a lot less fear around this. Yeah.
Hannah Witton
I guess that also made me think does the fear - like causing them stress actually maybe hinder your chances of conceiving?
Mama Doctor Jones
Um, possibly. So there's a lot of evidence about stress and fertility. And what I usually try to - and also stress and pregnancy problems - but what I usually try to focus on here is that it's not stress, like, oh my gosh, today I'm so stressed; its long term stress that plays into basically your entire life. So these are going to be things like food insecurity, like having an unstable household, like having an abusive partner. These are the things that really affect your period and your pregnancy to a big extent. Now, obviously, you can have a super stressful month, and you have a different cycle that month, that, we know that. But really the things that cause actual infertility or pregnancy problems are going to be long term life stressors that are are pretty serious.
Hannah Witton
Okay, that's interesting to know. Yeah.
Mama Doctor Jones
Because I really hate when we hear people say, like, oh, you're trying to get pregnant? Well, it's not working out, maybe you should just stress a little less. Like, that's not helpful information.
Hannah Witton
Just be less stressed.
Mama Doctor Jones
And relax.
Hannah Witton
Relax. Um, this I thought was an interesting question and I wonder if you can help, this person is asking for some help. Um, I'm scared to come off the pill to try for a baby as it keeps my severe period symptoms in check.
Mama Doctor Jones
Oh, yeah, that's I see people -
Hannah Witton
Does this come up a lot?
Mama Doctor Jones
Yeah, yes, a lot. I think the thing here is when you're ready to start trying, come off of your pills and try for a couple of months and see how your pain is. If you're having severe pain off of your birth control pills, then you need to come in. I don't want you trying to suffer through trying to get pregnant because of this. And if your period pain is so bad that you can't be off your pills, we need to look into that and figure out what's going on and why you're having such severe pain.
Hannah Witton
Yeah. And have you found that with your patients there have been ways for people who do you experience a lot of pain with the menstrual cycle to then conceive?
Mama Doctor Jones
Yeah, I think there's definitely options and there's a lot of things to talk about there, including just trying some different pain relievers. And obviously, somebody who's been on birth control pills for period pain that is significant enough to interfere with their life, they're not going to be perfectly fine just on painkillers. Not opiates, we don't prescribe opiates for that, but just normal pain medicine. But if that's - if you can't even function to attempt pregnancy on some basic over the counter medications. I mean, that's something we need to be looking into. And we need to figure out why it's happening so that we can work on fixing it, so that you're not miserable the whole time you're trying to get pregnant.
Hannah Witton
Yeah, that doesn't sound very fun.
Mama Doctor Jones
Exactly.
Hannah Witton
And that's another thing as well, it - people is like, oh, are you trying to conceive like you're having a great time! As well.
Mama Doctor Jones
No, sometimes it's so stressful though. Like people just, you know, they live by their calendar. And they're trying to I remember being in medical school, and we were trying to get pregnant and I was having some fertility issues and we were tracking my cycles and my ovulation. And it was the middle of the night and I had a positive ovulation test, I was on my surgery rotation, and I was, like, so obsessed with the fact that I needed to go home right then and try to make a baby that I, like, told my surgery person, my husband locked himself out of the house and I had to go home and take care of it, it's like, it really gets to your head. And that's absolutely not necessarily, we could have waited until the next day, but it has a way of getting in your head and it can be it can be stressful and it can also lead to anxiety and depression. So I think it's important to have open conversations with your doctor or your healthcare provider about these things, too.
Hannah Witton
Yeah, I mean, this is something that I'm yet to talk about in an episode of The Hormone Diaries but I will soon but I did the, like, ovulation tracking thing for one cycle. And yeah, it stressed me out too much. I hated it. And so now I'm not, I'm just like, nope.
Mama Doctor Jones
Yeah, it can be really stressful for people. I'm glad you're gonna talk about that, because it's really important.
Hannah Witton
Yeah, I was like, I want to give this a go, you know, I'm trying things, for the content, and then I was just like, ahh, nah.
Mama Doctor Jones
Now, for some people, so I'm like super type A, it was like extremely helpful to me to know what was going on. I wanted to do that. And I enjoyed it. But I definitely see a lot of people who say the same thing as you that, like, this is making everything worse.
Hannah Witton
Yeah, and I'm really type A as well. And that's why I did it. Because I was like, my personality type tells me this will be good for me. And then it wasn't. That doesn't mean it might not be good for me again in the future. But I was just like, this wasn't fun. So I'm going to take a step back from that tactic.
Mama Doctor Jones
Good. It's good to be in tune with what you need to do for you.
Hannah Witton
Yeah. Um, this person asked, and this kind of also relates to what we were talking about before about my surgeries as well. Um do pregnancy/labour permanently damage the core or can you regain the same core strength? And I say about my surgeries because - and obviously, it's, it's different because even if you do have a C-section, it's cutting a different part of your body - but my core strength is not the same as it was before. And I'm three years on, and I'm very active.
Mama Doctor Jones
Yeah, um, gosh, this is a hard question. And you do need to split it up between a vaginal delivery and a C-section. So the short answer is, with a C-section, any time you're cutting through the muscle of the abdomen, you're obviously going to have a little bit different healing than what you were born with. But at the same time, you can regain your core strength, even after a C-section. I've had three C-sections and I feel like I'm in similar shape as I was before my first baby. But it does change things. I mean, it's a big surgery. And these things do play into, you know, your overall health and your - it's surgery. I mean, I think that's important to realize. With the vaginal delivery, your body is made to have a baby, I mean, you were not - I don't mean you were created for this, you need to have a baby, but your body is ultimately created to give birth. And so although there are some changes to the muscles, and the pelvic floor and things like that, for the most part, people recover from that and have perfectly fine, you know, strength and ability in the future. If there's problems, pelvic floor physical therapy is definitely my go to I absolutely love pelvic floor physical therapists.
Hannah Witton
Oh my god, now that you've mentioned it, I immediately just like start doing kegels, and it just triggers those muscles to like, start moving.
Mama Doctor Jones
Absolutely. And it's important, you know, sometimes people don't know how to do kegels correctly. And I think that pelvic floor physical therapy can help with that as well. So these are really, really great topics to cover. Because although, yes, there are technically changes to your body and your muscles and your strength and your core after giving birth, no matter how you do it, that doesn't mean you're never going to get back to feeling like normal.
Hannah Witton
Yeah. Can you give us a quick rundown of how to do pelvic floor exercises correctly?
Mama Doctor Jones
That is hard to do as like, just a rundown. But there's some really great like, full - I mean, this is like a 15 or 20 minute discussion of how to do kegels correctly so I would encourage you to look that up on YouTube and find exact information. But a lot of times people are using those muscles incorrectly. It's kind of a squeezing in and sometimes you see people kind of pushing out and that is counterproductive to what you're doing. So find a good pelvic floor physical therapist on YouTube explaining it and watch the whole video.
Hannah Witton
That's good to know. Squeezing in, not pushing out.
Mama Doctor Jones
Exactly.
Hannah Witton
Okay. Yeah, so the opposite of trying to push out some pee. Instead you're like holding it in.
Mama Doctor Jones
Exactly, it should be exactly the opposite of a bowel movement. So when you're having a baby, it's very similar to pushing like having a bowel movement. But when you're practicing kegels, it's going to be an opposite movement. But it's hard to tell the difference sometimes if you've never been shown exactly what you're doing and I think there's really really good videos on YouTube to understand the right movements.
Hannah Witton
Oh, great. And of course, because I cannot do a podcast episode without mentioning poo. One of the things that I thought about like with having a stoma was like I was like oh, I don't have to worry about like, am I gonna shit myself during birth because I already will be shitting myself but there'll be a bag catching it.
Mama Doctor Jones
That is a lovely silver lining and I love that you framed it that way.
Hannah Witton
It's gonna be great. I mean, I can't say for sure that I won't eject any of my rectum mucus like that just comes out on a daily basis.
Mama Doctor Jones
And for anybody listening who is worried about that, nobody in labour and delivery, from your nurses to your doctors to your midwives or your doulas, nobody cares if you poop while you're giving birth and we are very capable of just inconspicuously wiping that away without anybody noticing. And if people notice, it's not a big deal. In fact, it means you're pushing well, it's fine.
Hannah Witton
Oh, I love that. So it's a good thing. I like that framing.
Mama Doctor Jones
Exactly.
Hannah Witton
Brilliant. Well, I think poop is a great place to end this. Because that's how I like to roll. But Danielle, thank you so so much, and where can people find you online and like what you do?
Mama Doctor Jones
Thank you so much for having me and I've really enjoyed chatting with you and your viewers can find me on any social platform, probably have too many social platforms, under the name Mama Doctor Jones on YouTube, Instagram, TikTok, Twitter, all the places.
Hannah Witton
All of the places. Yeah, I don't know how you do all of that and create all the content for all these platforms and to be a doctor. I'm like, okay, cool.
Mama Doctor Jones
I don't know if I sleep, but.
Hannah Witton
There's a lot of stuff. Um, but yeah this has been absolutely wonderful. I really appreciate your time. And dear listeners, definitely go and check out Mama Doctor Jones on all of social media. And thank you so much for listening. Bye.
Hannah Witton
Thank you so much for listening to Doing It. If you enjoyed it, I would really appreciate it, if you left a rating and a review. You can find shownotes at doingitpodcast.co.uk and do go follow us on social media and I'll catch you in the next episode. Bye.
Hannah Witton
This was a Global original podcast.