WEBVTT 00:00:09.999 --> 00:00:12.740 Welcome to Our Voices, Our Future, the podcast 00:00:12.740 --> 00:00:14.980 where we amplify the voices driving change and 00:00:14.980 --> 00:00:17.379 equity within medicine and beyond. Brought to 00:00:17.379 --> 00:00:19.460 you by the Gender Equity Task Force, a committee 00:00:19.460 --> 00:00:21.679 of the American Medical Women's Association, 00:00:22.120 --> 00:00:23.780 we're here to challenge norms, break barriers, 00:00:23.980 --> 00:00:26.440 and ignite conversations that matter. I'm Megan 00:00:26.440 --> 00:00:28.780 Etsy, and in each episode, we'll bring you candid 00:00:28.780 --> 00:00:31.140 discussions with leaders, change makers, and 00:00:31.140 --> 00:00:33.079 advocates working to create a more inclusive 00:00:33.079 --> 00:00:35.880 and just world. No more silence, no more waiting. 00:00:36.340 --> 00:00:38.759 Listen to Our Voices, Our Future. Let's get into 00:00:38.759 --> 00:00:42.049 it. Today we are welcoming Dr. Janelle DeJesus. 00:00:42.729 --> 00:00:46.289 Dr. DeJesus is a passionate OB -GYN, content 00:00:46.289 --> 00:00:49.329 creator, women's health advocate, and brand new 00:00:49.329 --> 00:00:52.130 port mom. She completed her medical degree at 00:00:52.130 --> 00:00:54.969 Nova Southeastern University College of Osteopathic 00:00:54.969 --> 00:00:58.030 Medicine, followed by a transition year internship 00:00:58.030 --> 00:01:01.210 in Middletown, New York, in her OB -GYN residency 00:01:01.210 --> 00:01:04.099 in Gainesville, Florida. She now practices in 00:01:04.099 --> 00:01:06.900 San Juan, Puerto Rico, where she combines bedside 00:01:06.900 --> 00:01:09.659 care with a broader mission, empowering women 00:01:09.659 --> 00:01:12.680 through education and advocacy. On her public 00:01:12.680 --> 00:01:16.319 platforms, Dr. De Jesus engages patients, colleagues, 00:01:16.480 --> 00:01:19.060 and the general public on topics ranging from 00:01:19.060 --> 00:01:22.120 patient autonomy and consent to social determinants 00:01:22.120 --> 00:01:25.079 of health, obstetric violence, and gynecologic 00:01:25.079 --> 00:01:28.040 pathology. She hopes to use her voice to shift 00:01:28.040 --> 00:01:30.400 the culture of women's healthcare toward greater 00:01:30.400 --> 00:01:32.799 equity, respect, and empowerment. Thanks for 00:01:32.799 --> 00:01:35.799 being here, Dr. De Jesus. Thanks for having me. 00:01:35.959 --> 00:01:38.500 Yeah. So just to start off, can you kind of share 00:01:38.500 --> 00:01:40.579 your journey in medicine and what led you to 00:01:40.579 --> 00:01:43.480 an interest and maternal health and that kind 00:01:43.480 --> 00:01:48.340 of perinatal care? For sure. So in high school 00:01:48.340 --> 00:01:52.219 and college, it all started more so with an interest 00:01:52.219 --> 00:01:55.280 in the sciences, anatomy and physiology, how 00:01:55.280 --> 00:01:58.560 the body works. For me, it was super interesting 00:01:58.560 --> 00:02:01.459 to see how the body is able to literally just 00:02:01.480 --> 00:02:05.000 keep itself alive for such a long period of time 00:02:05.000 --> 00:02:08.479 and seeing how the body works both in health 00:02:08.479 --> 00:02:11.400 and in disease, how a tiny little cancer cell 00:02:11.400 --> 00:02:15.520 can grow to potentially cause so much damage. 00:02:16.639 --> 00:02:21.229 So that kind of peaked my interest in medicine 00:02:21.229 --> 00:02:24.870 overall. In medical school I started, I had no 00:02:24.870 --> 00:02:27.669 idea what specialty I wanted to go into. Ironically, 00:02:27.930 --> 00:02:30.330 I was completely uninterested in OB -GYN. They 00:02:30.330 --> 00:02:34.349 put a C -section on the big screen in medical 00:02:34.349 --> 00:02:37.250 school and I was like, oh, not this, this is 00:02:37.250 --> 00:02:42.159 not it. And then I went to an ACOG conference, 00:02:42.479 --> 00:02:44.020 that's the American College of Obstetrics and 00:02:44.020 --> 00:02:47.479 Gynecology. And I did a bunch of simulations 00:02:47.479 --> 00:02:50.639 and practice first, you know, simulations for 00:02:50.639 --> 00:02:54.780 deliveries, ultrasound procedures. And I just 00:02:54.780 --> 00:02:56.840 absolutely loved how hands on it was. And when 00:02:56.840 --> 00:02:59.979 I started my clinical rotations, I just fell 00:02:59.979 --> 00:03:04.069 in love with the patient population. The things 00:03:04.069 --> 00:03:06.949 that came to kind of attract me the most was 00:03:06.949 --> 00:03:09.590 the fact that, you know, when it came to delivering 00:03:09.590 --> 00:03:11.530 babies, for instance, it was the only potentially 00:03:11.530 --> 00:03:14.509 good reason that you're going to be in a hospital 00:03:14.509 --> 00:03:20.099 setting, which was awesome. a universal but still 00:03:20.099 --> 00:03:23.900 such an intimate and mysterious part of so many 00:03:23.900 --> 00:03:26.879 people's lives. And I knew I wanted to be a part 00:03:26.879 --> 00:03:29.080 of that each delivery felt like, oh my god, you 00:03:29.080 --> 00:03:32.280 were winning a Super Bowl or something. I loved 00:03:32.280 --> 00:03:34.759 being able to also follow patients from like 00:03:34.759 --> 00:03:37.939 their first period to their first baby to perimenopause 00:03:37.939 --> 00:03:41.099 to menopause and everything in between most most 00:03:41.099 --> 00:03:43.979 patients kind of feel like close friends or almost 00:03:43.979 --> 00:03:47.419 like they can be my best friend. And honestly, 00:03:47.520 --> 00:03:50.479 that's something that I feel like is so unique 00:03:50.479 --> 00:03:56.159 to this specialty specifically. And then later 00:03:56.159 --> 00:04:00.419 on, I came to fall in love with, like the advocacy 00:04:00.419 --> 00:04:05.199 aspect, the fact that, you know, sadly, there's 00:04:05.199 --> 00:04:07.319 still so much work to be done within the realm 00:04:07.319 --> 00:04:11.120 of like, women's health and in terms of pharmaceutical 00:04:11.120 --> 00:04:15.219 and diagnostic research, patient advocacy, maternal 00:04:15.219 --> 00:04:19.000 morbidity and mortality, obstetric violence, 00:04:19.079 --> 00:04:20.959 like you mentioned, and those are things that 00:04:20.959 --> 00:04:22.779 I can talk about all day. And I knew I wanted 00:04:22.779 --> 00:04:27.339 to be a part of, you know, improving that, improving 00:04:27.339 --> 00:04:30.759 those metrics and, you know, improving women's 00:04:30.759 --> 00:04:34.470 lives in turn. It's incredible. So from your 00:04:34.470 --> 00:04:36.970 experience and the path you've had, how would 00:04:36.970 --> 00:04:40.329 you describe the current state of the pre and 00:04:40.329 --> 00:04:43.170 peri and postpartum care that we have in the 00:04:43.170 --> 00:04:49.329 United States right now? It's abysmal. It's abysmal 00:04:49.329 --> 00:04:52.730 and having experienced, I mean, I knew having 00:04:52.730 --> 00:04:57.300 experienced it as a physician. I knew how difficult 00:04:57.300 --> 00:05:00.899 it was for myself and my colleagues kind of like 00:05:00.899 --> 00:05:04.459 navigating it. But having also experienced it 00:05:04.459 --> 00:05:07.139 just recently from a personal standpoint, I just 00:05:07.139 --> 00:05:12.720 had my baby seven weeks ago now. And yeah, and 00:05:12.720 --> 00:05:15.079 experiencing it from the patient's end was just, 00:05:15.139 --> 00:05:17.899 it was a completely different experience. I really 00:05:17.899 --> 00:05:22.779 thought I knew, but yeah, it's tough. and for 00:05:22.779 --> 00:05:27.439 a myriad of reasons. To start, you know, insurance 00:05:27.439 --> 00:05:31.079 issues amongst both the patient side and the 00:05:31.079 --> 00:05:33.660 physician side. You know, compensation of maternity 00:05:33.660 --> 00:05:38.639 care as a whole indirectly cuts the time for 00:05:38.639 --> 00:05:41.980 prenatal visits. So this is going to give clinicians 00:05:41.980 --> 00:05:45.720 minimal time to address questions, concerns, 00:05:46.199 --> 00:05:49.399 pathologies. follow -up plans for a lot of very 00:05:49.399 --> 00:05:52.180 high -risk pregnancies doesn't give us a lot 00:05:52.180 --> 00:05:55.920 of time to obtain consent in the proper way so 00:05:55.920 --> 00:05:58.180 that, in other words, so that the patient understands, 00:05:58.180 --> 00:06:01.240 you know, what we're talking about. And then 00:06:01.240 --> 00:06:03.639 from a physician standpoint, you know, our average 00:06:03.639 --> 00:06:07.860 time with the patient is anywhere from 10 to 00:06:07.860 --> 00:06:10.139 30 minutes, usually on the lower end of that 00:06:10.139 --> 00:06:12.600 and sometimes even less. So that's going to give 00:06:12.600 --> 00:06:15.879 us minimal time really to address all of that, 00:06:16.040 --> 00:06:18.560 which further leads to issues down the line with 00:06:18.560 --> 00:06:21.720 patient trust, you know, adherence to treatment 00:06:21.720 --> 00:06:25.620 plans, that sort of thing. Today's day and age, 00:06:25.639 --> 00:06:28.600 we have so much information that is openly accessible 00:06:28.600 --> 00:06:34.839 to the patient. Unfortunately, it's not all correct 00:06:34.839 --> 00:06:37.860 information or truthful information or information 00:06:37.860 --> 00:06:40.779 that is evidence -based. And so I would argue 00:06:40.779 --> 00:06:44.079 that we need even more time to kind of combat 00:06:44.079 --> 00:06:47.560 that, build a sense of trust and rapport with 00:06:47.560 --> 00:06:51.469 our patients so that they're able to make these 00:06:51.469 --> 00:06:55.430 informed decisions. So, you know, really it's 00:06:55.430 --> 00:06:58.069 us against the clock, us against insurance companies, 00:06:58.370 --> 00:07:03.110 us against a lot of misinformation online, you 00:07:03.110 --> 00:07:04.889 know, and unfortunately a lot of patients have 00:07:04.889 --> 00:07:11.370 been traumatized by obstetric violence and having 00:07:11.370 --> 00:07:13.769 procedures done on them where they weren't properly 00:07:13.769 --> 00:07:16.430 consented and they've been traumatized by it 00:07:16.430 --> 00:07:20.199 and rightfully so that does form their experience 00:07:20.199 --> 00:07:23.160 or their perception of obstetricians. So there's 00:07:23.160 --> 00:07:27.600 a lot of work to be done internally, both myself 00:07:27.600 --> 00:07:32.339 and my colleagues on that end as well. I think 00:07:32.339 --> 00:07:33.920 we've kind of hit on the next question, but if 00:07:33.920 --> 00:07:35.720 you have anything else to add, what would you 00:07:35.720 --> 00:07:38.680 say some of the biggest challenges for patients 00:07:38.680 --> 00:07:41.620 during pregnancy and after childbirth, and where 00:07:41.620 --> 00:07:44.220 do you kind of see the gaps that are within care? 00:07:45.420 --> 00:07:51.079 No, definitely. I think one of the biggest gaps 00:07:51.079 --> 00:07:55.040 that I see is just an overall lack of resources. 00:07:56.680 --> 00:08:00.220 One of the things that I see very, very often 00:08:00.220 --> 00:08:04.000 is that a lack of resources can sometimes be 00:08:04.000 --> 00:08:07.079 simply disguised as like postpartum depression, 00:08:07.220 --> 00:08:09.810 like a patient will come into the office. She's 00:08:09.810 --> 00:08:12.050 really, really sad. She doesn't have a whole 00:08:12.050 --> 00:08:15.250 lot of help. She doesn't have the ability maybe 00:08:15.250 --> 00:08:17.430 to come to all of her postpartum appointments 00:08:17.430 --> 00:08:19.589 in spite of all of the issues that she's having. 00:08:21.350 --> 00:08:23.829 And, you know, she writes on her questionnaire 00:08:23.829 --> 00:08:26.769 that she's feeling all types of sadness and she's 00:08:26.769 --> 00:08:28.889 not sleeping well and she's not eating well. 00:08:29.910 --> 00:08:33.580 And she doesn't have a whole lot of help. um 00:08:33.580 --> 00:08:37.019 for whatever reason um and many times that you 00:08:37.019 --> 00:08:39.399 know she meets the criteria for postpartum depression 00:08:39.399 --> 00:08:41.820 a lot of the times this lack of resources gets 00:08:41.820 --> 00:08:44.559 um kind of disguised as postpartum depression 00:08:44.559 --> 00:08:48.480 but they're not necessarily the same thing um 00:08:48.480 --> 00:08:52.399 one can lead to the other surely um i can't argue 00:08:52.399 --> 00:08:54.799 that but at times these things can be completely 00:08:54.799 --> 00:08:57.919 isolated issues one is treated with a medication 00:08:57.919 --> 00:09:01.480 and the other one doesn't necessarily need to 00:09:01.480 --> 00:09:06.789 be every single time. And then other challenges, 00:09:06.950 --> 00:09:10.190 I would say, affordable healthcare, of course, 00:09:11.070 --> 00:09:16.429 Medicaid, almost 50 % of deliveries that happen 00:09:16.429 --> 00:09:19.090 or patients that we're seeing are actually Medicaid 00:09:19.090 --> 00:09:23.389 patients, affordable childcare. I mean, I'm looking 00:09:23.389 --> 00:09:26.850 at childcare myself and it's like, in certain 00:09:26.850 --> 00:09:33.860 states, it's like a rent basically. So access 00:09:33.860 --> 00:09:37.000 to mental health, of course, pelvic floor, physical 00:09:37.000 --> 00:09:39.980 therapy. I mean, you know, you go get a knee 00:09:39.980 --> 00:09:41.659 replacement in the first place you're gonna get 00:09:41.659 --> 00:09:44.000 sent is physical therapy. I don't understand 00:09:44.000 --> 00:09:46.860 why, you know, delivering a baby anywhere from 00:09:46.860 --> 00:09:49.539 five to 10 pounds doesn't warrant the same thing. 00:09:50.440 --> 00:09:53.139 And then contraceptive counseling, of course, 00:09:53.620 --> 00:09:58.090 50 % of pregnancies are actually unplanned. and 00:09:58.090 --> 00:10:01.070 many of those happen in the almost the immediate 00:10:01.070 --> 00:10:05.389 postpartum period. Oh wow. So kind of building 00:10:05.389 --> 00:10:07.990 off of those challenges you see, how would you 00:10:07.990 --> 00:10:10.750 say social determinants of health like race, 00:10:11.149 --> 00:10:14.590 socioeconomic status, geographic location, kind 00:10:14.590 --> 00:10:17.269 of impact the maternal outcomes that we have? 00:10:19.230 --> 00:10:22.710 So this is a tough, this one is a really really 00:10:22.710 --> 00:10:26.379 tough topic in part because I think that there 00:10:26.379 --> 00:10:30.100 are many populations and many demographics that 00:10:30.100 --> 00:10:33.779 can look at objective data and still deny that 00:10:33.779 --> 00:10:37.480 this is an issue. But we do have pretty well 00:10:37.480 --> 00:10:39.799 -documented literature that states that these 00:10:39.799 --> 00:10:42.759 social determinants of health impact maternal 00:10:42.759 --> 00:10:48.840 outcomes, that systemic racism is still affecting 00:10:48.840 --> 00:10:52.799 maternal outcomes. Access to care and geographic 00:10:52.799 --> 00:10:57.120 location is also a huge issue plaguing the country 00:10:57.120 --> 00:11:00.500 right now. Labor and delivery units are shutting 00:11:00.500 --> 00:11:02.940 down all over the place, which essentially will 00:11:02.940 --> 00:11:07.240 leave people without care, without a place to 00:11:07.240 --> 00:11:10.279 deliver their babies. Where I attended residency, 00:11:10.539 --> 00:11:13.879 we had people traveling up to two hours just 00:11:13.879 --> 00:11:16.779 to come to a hospital to be able to give birth. 00:11:17.149 --> 00:11:20.309 Um, I've worked out in, you know, rural areas 00:11:20.309 --> 00:11:22.870 of New Mexico and people would have to take helicopters 00:11:22.870 --> 00:11:25.690 and planes over to, you know, either the next 00:11:25.690 --> 00:11:29.750 facility or in Texas, um, just to be able to 00:11:29.750 --> 00:11:32.889 see, for instance, a high risk specialist. Um, 00:11:32.909 --> 00:11:35.669 and of course, you know, these, these lead to 00:11:35.669 --> 00:11:38.549 delays in care, delays in management, um, and 00:11:38.549 --> 00:11:42.190 can sometimes lead to very catastrophic results 00:11:42.190 --> 00:11:46.500 within the pregnancy. Um, so. Definitely all 00:11:46.500 --> 00:11:50.679 of these things play into maternal outcomes in 00:11:50.679 --> 00:11:53.500 this country. So could you share with us kind 00:11:53.500 --> 00:11:56.480 of an example of a program policy or initiative 00:11:56.480 --> 00:11:59.879 that you've seen successfully improve pre and 00:11:59.879 --> 00:12:05.440 postpartum care? Yeah, so my favorite one, and 00:12:05.440 --> 00:12:08.059 I'm so proud of California, even though I'm not 00:12:08.059 --> 00:12:10.600 Californian and I don't claim anything Californian, 00:12:10.700 --> 00:12:16.340 however, the California Maternity Quality Care 00:12:16.340 --> 00:12:21.460 Collaborative, CMQCC is what it's called. Essentially 00:12:21.460 --> 00:12:24.000 what this was, this was a state or what it is, 00:12:24.259 --> 00:12:28.730 it was a statewide initiative. where they wanted 00:12:28.730 --> 00:12:34.590 to implement very standardized protocols and 00:12:34.590 --> 00:12:38.110 trainings and simulations and things like that 00:12:38.110 --> 00:12:43.889 in order and as well as collecting data for outcomes. 00:12:45.289 --> 00:12:48.169 in order to be able to see how they were doing 00:12:48.169 --> 00:12:51.370 in terms of improving maternal morbidity and 00:12:51.370 --> 00:12:55.690 mortality. And this was a huge, huge deal because 00:12:55.690 --> 00:13:00.029 they found that from the years 2006 to I think 00:13:00.029 --> 00:13:07.149 it was 2013, they saw a 50 % decrease in maternal 00:13:07.149 --> 00:13:10.350 mortality while the rest of the country's rates 00:13:10.350 --> 00:13:14.529 were actually on the rise. The reason this is 00:13:14.529 --> 00:13:18.870 such a big deal is because in all of the developed 00:13:18.870 --> 00:13:22.990 nations, the United States is actually one of 00:13:22.990 --> 00:13:25.950 if not the highest in maternal morbidity and 00:13:25.950 --> 00:13:29.879 mortality. I think I read as far as statistics 00:13:29.879 --> 00:13:34.179 is concerned, we have more women who die in childbirth 00:13:34.179 --> 00:13:39.279 than police officers, like active duty police 00:13:39.279 --> 00:13:42.000 officers here in the United States. That's a 00:13:42.000 --> 00:13:45.399 big deal. That's basically saying it's more risky 00:13:45.399 --> 00:13:47.919 to give birth in the United States than to be 00:13:47.919 --> 00:13:50.480 a police officer in the active line of duty. 00:13:51.340 --> 00:13:56.919 So the CMQCC essentially What it did was it set 00:13:56.919 --> 00:14:00.340 a huge example and it displayed the importance 00:14:00.340 --> 00:14:04.700 of having these systems in place in order to 00:14:04.700 --> 00:14:09.679 decrease morbidity and mortality. And in my opinion, 00:14:10.220 --> 00:14:13.100 the rest of the state should follow suit. Many 00:14:13.100 --> 00:14:17.039 hospitals in different states nationwide have 00:14:17.039 --> 00:14:20.220 kind of followed their example. I know the hospital 00:14:20.220 --> 00:14:22.659 from my residency program kind of adapted a lot 00:14:22.659 --> 00:14:25.559 of the things from that. quality initiative. 00:14:27.740 --> 00:14:30.500 And yeah, many hospitals have seen a decline 00:14:30.500 --> 00:14:34.059 in morbidity and mortality as a result of implementing 00:14:34.059 --> 00:14:38.539 a lot of those systems. So how would you say 00:14:38.539 --> 00:14:43.240 that health providers as like a single person 00:14:43.240 --> 00:14:46.460 and then institutions as a whole can adapt to 00:14:46.460 --> 00:14:49.480 kind of better support patients with mental and 00:14:49.480 --> 00:14:51.639 physical health when their these women are in 00:14:51.639 --> 00:14:57.190 their postpartum period? Yeah, so postpartum 00:14:57.190 --> 00:14:59.769 honestly is a really difficult, I mean, I'm going 00:14:59.769 --> 00:15:02.830 through it right now so I can say this. If this 00:15:02.830 --> 00:15:05.110 is the hill I would die on, but it's a really 00:15:05.110 --> 00:15:09.710 difficult time because we as physicians, I don't 00:15:09.710 --> 00:15:13.809 necessarily think that it's just a healthcare 00:15:13.809 --> 00:15:20.820 kind of thing. It's such a unique aspect of of 00:15:20.820 --> 00:15:23.200 medicine and healthcare as a whole, because it's 00:15:23.200 --> 00:15:25.059 not just healthcare that happens after that, 00:15:25.179 --> 00:15:28.320 right? Like your life has changed forever. But 00:15:28.320 --> 00:15:30.879 it's a hard time because we, as healthcare providers, 00:15:31.039 --> 00:15:33.820 we tend to fixate on the medical aspects. You 00:15:33.820 --> 00:15:35.759 know, your postpartum hemorrhage, your severe 00:15:35.759 --> 00:15:39.580 preeclampsia, those sorts of things. When postpartum 00:15:39.580 --> 00:15:42.899 really is so much more than that, obviously. 00:15:43.240 --> 00:15:45.820 This is where I think the lines get blurred a 00:15:45.820 --> 00:15:48.200 lot. So for example, like I mentioned before, 00:15:48.480 --> 00:15:51.720 there's just this notorious lack of resources, 00:15:51.820 --> 00:15:58.379 which, you know, in an ideal world, I would love 00:15:58.379 --> 00:16:02.519 to see more of these things implemented that 00:16:02.519 --> 00:16:06.200 are able to kind of allow for these resources 00:16:06.200 --> 00:16:09.360 to be more accessible outside of the realm of 00:16:09.360 --> 00:16:12.440 healthcare, things, and within healthcare as 00:16:12.440 --> 00:16:16.679 well. things like more affordable child care, 00:16:17.679 --> 00:16:20.799 insurance coverage for wider aspects of postpartum, 00:16:20.799 --> 00:16:23.179 not just your postpartum visit. I mean, that 00:16:23.179 --> 00:16:26.559 just goes in the global fee or whatever, but 00:16:26.559 --> 00:16:30.500 pelvic floor therapy for longer chronic issues 00:16:30.500 --> 00:16:35.480 like painful intercourse after delivery or pelvic 00:16:35.480 --> 00:16:38.200 organ prolapse or incontinence or these issues 00:16:38.200 --> 00:16:44.320 are very, very common. and mental health, things 00:16:44.320 --> 00:16:47.879 like lactation counseling, which I'm learning 00:16:47.879 --> 00:16:50.740 firsthand, breastfeeding is not easy, pumping 00:16:50.740 --> 00:16:53.080 is not easy, and that in and of itself is enough 00:16:53.080 --> 00:16:56.940 to take a toll on like your mental health. And 00:16:56.940 --> 00:17:00.559 so I think that it's more all encompassing. And 00:17:00.559 --> 00:17:03.740 until we acknowledge that postpartum is more 00:17:03.740 --> 00:17:07.500 than just a relationship with your obstetrician, 00:17:08.480 --> 00:17:12.740 I think until we can acknowledge that, it's not 00:17:12.740 --> 00:17:16.680 going to improve. So what role would you say 00:17:16.680 --> 00:17:19.839 advocacy, education, and community engagement 00:17:19.839 --> 00:17:23.319 could play in improving this pre - and post -mortem 00:17:23.319 --> 00:17:31.460 care for women? Like I said, we won't get better 00:17:31.460 --> 00:17:33.640 outcomes without acknowledging that there's a 00:17:33.640 --> 00:17:37.559 problem like to begin with. So we need to have 00:17:37.559 --> 00:17:42.079 these conversations. We need to be less afraid 00:17:42.079 --> 00:17:45.460 to critique both each other, like, you know, 00:17:45.619 --> 00:17:48.519 colleagues, physicians, health care clinicians 00:17:48.519 --> 00:17:51.500 overall. And we need to be able to critique ourselves. 00:17:51.500 --> 00:17:55.160 We need to be able to kind of question our own 00:17:55.160 --> 00:17:58.440 practices and ask ourselves whether or not they're 00:17:58.440 --> 00:18:00.420 affecting our patients in a way that's healthy 00:18:00.420 --> 00:18:03.519 and positive and uplifting, which is fine, which 00:18:03.519 --> 00:18:06.920 is why honestly I find myself on social media 00:18:06.920 --> 00:18:08.759 you know engaging in these conversations with 00:18:08.759 --> 00:18:11.559 both my colleagues and my patients all over the 00:18:11.559 --> 00:18:15.380 country because if we don't have these conversations 00:18:15.380 --> 00:18:21.180 then we're not gonna get anywhere and so that 00:18:21.180 --> 00:18:24.359 is both advocacy and education for me just because 00:18:24.359 --> 00:18:29.029 I'm I'm seeing so much misinformation on social 00:18:29.029 --> 00:18:34.289 media. My stance is that if people will find 00:18:34.289 --> 00:18:37.130 misinformation on social media, I also need to 00:18:37.130 --> 00:18:39.829 be on social media so people can find information 00:18:39.829 --> 00:18:46.309 and education there as well. So definitely. And 00:18:46.309 --> 00:18:48.950 community engagement, of course, the only points 00:18:48.950 --> 00:18:51.549 of view that I see are from the perspectives 00:18:51.549 --> 00:18:54.710 that I have had as a patient. those of my patients. 00:18:55.509 --> 00:18:59.269 But honestly, actually, content creation as a 00:18:59.269 --> 00:19:02.150 whole, not only did I do it for advocacy, but 00:19:02.150 --> 00:19:05.009 I also wanted to be able to hear from the stories 00:19:05.009 --> 00:19:07.930 of people all across the United States to be 00:19:07.930 --> 00:19:10.450 able to talk about these experiences. It's really 00:19:10.450 --> 00:19:13.210 interesting because sometimes people will kind 00:19:13.210 --> 00:19:16.740 of almost, I don't want to say trauma dump. Sometimes 00:19:16.740 --> 00:19:19.460 they do, but a lot of people will kind of like 00:19:19.460 --> 00:19:21.859 share these horrific experiences that I would 00:19:21.859 --> 00:19:23.839 never imagine are actually still happening in 00:19:23.839 --> 00:19:28.079 this country. And, you know, as I alluded to 00:19:28.079 --> 00:19:30.200 before, we have to be able to acknowledge that 00:19:30.200 --> 00:19:32.220 these things are still an issue. The history 00:19:32.220 --> 00:19:34.660 of obstetrics and gynecology in and of itself 00:19:34.660 --> 00:19:38.660 is not a pretty one. It's one that at times, 00:19:38.660 --> 00:19:40.900 you know, we've made a lot of advances, but at 00:19:40.900 --> 00:19:43.799 times you know, it's hard to be proud of. And 00:19:43.799 --> 00:19:48.000 so and some of those elements kind of weave themselves 00:19:48.000 --> 00:19:52.319 into still the care that we give today can sometimes 00:19:52.319 --> 00:19:55.940 be a little bit paternalistic in nature. So we 00:19:55.940 --> 00:19:58.099 definitely need to keep having those conversations. 00:19:59.559 --> 00:20:03.940 So just as a whole, what general piece of advice 00:20:03.940 --> 00:20:06.859 would you give to either aspiring physicians 00:20:06.859 --> 00:20:08.859 or health care professionals who want to make 00:20:08.859 --> 00:20:12.819 that meaningful impact in maternal health? Yeah, 00:20:13.019 --> 00:20:16.279 no. The one thing I would say is that we have 00:20:16.279 --> 00:20:19.700 to keep making noise, especially within the realm 00:20:19.700 --> 00:20:23.380 of women's health. If it took patients posting 00:20:23.380 --> 00:20:26.839 on TikTok about their experiences with IUD insertions 00:20:26.839 --> 00:20:32.200 in order to change guidelines, for pain control, 00:20:32.400 --> 00:20:34.599 for IUD insertions and office procedures as a 00:20:34.599 --> 00:20:38.119 whole, that's proof that, you know, silence and 00:20:38.119 --> 00:20:42.640 complicity does not elicit any sort of change. 00:20:42.900 --> 00:20:46.339 And sometimes in the most unexpected ways that 00:20:46.339 --> 00:20:50.519 you're able to kind of make waves, you know, 00:20:50.599 --> 00:20:52.779 now there are a lot of conversations centering 00:20:52.779 --> 00:20:55.420 around, you know, the Women's Health Initiative 00:20:55.420 --> 00:20:58.339 and why it's so important to have studies centered 00:20:58.339 --> 00:21:01.390 around women specifically as a patient population 00:21:01.390 --> 00:21:03.589 as a whole, because we are still, we make up 00:21:03.589 --> 00:21:05.490 50 % of the population, but when it comes to 00:21:05.490 --> 00:21:08.789 the research, we are still the minority. And 00:21:08.789 --> 00:21:11.569 that definitely plays a role as well. And we 00:21:11.569 --> 00:21:15.470 have to acknowledge that. So we have to make 00:21:15.470 --> 00:21:18.470 noise. Ultimately, if we don't know it's a problem, 00:21:18.650 --> 00:21:20.609 and we can't acknowledge that it's there, there's 00:21:20.609 --> 00:21:23.390 no way we're going to be able to fix it or improve 00:21:23.390 --> 00:21:26.089 it. And we're here. And that's why we're doing 00:21:26.089 --> 00:21:27.750 things like these podcasts and you have your 00:21:27.750 --> 00:21:30.730 social media. Yeah, I love it. Thank you so much 00:21:30.730 --> 00:21:33.750 for this talk today. It's been very nice. Of 00:21:33.750 --> 00:21:36.549 course. Thanks for having me. Yeah. So that's 00:21:36.549 --> 00:21:38.609 a wrap on this episode of Our Voice is Our Future. 00:21:39.170 --> 00:21:41.589 We hope today's conversation inspired you, challenged 00:21:41.589 --> 00:21:44.109 you, and reminded you the power of raising your 00:21:44.109 --> 00:21:46.470 voice. The fight for equity doesn't stop here. 00:21:46.589 --> 00:21:48.849 Join us in the movement. Subscribe wherever you 00:21:48.849 --> 00:21:50.890 get your podcasts. And if you love this episode, 00:21:50.930 --> 00:21:53.180 share it with someone who needs to hear it. Until 00:21:53.180 --> 00:21:55.700 next time, stay bold, stay vocal, and keep the 00:21:55.700 --> 00:21:58.039 conversation going. This is Our Voices, Our Future.