Postpartum University® Podcast

When Postpartum Doctors Get Postpartum Depression | Dr. Jessica Vernon EP 207

• Maranda Bower, Postpartum Nutrition Specialist

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What happens when the doctors caring for postpartum women experience postpartum depression themselves? The truth is shocking—physician mothers are experiencing postpartum depression and anxiety at twice the rate of the general population. 

Dr. Jessica Vernon, OBGYN and perinatal mental health advocate shares about the lack of postpartum education in medical training, the stigma physicians face when they struggle, and why so many provider mothers feel isolated, burned out, and unsupported.

Dr. Vernon gets real about her own postpartum experience—how she didn’t even recognize her anxiety, OCD, and depression for two years, why she had to "prescribe herself" antidepressants, and the systemic failures that push doctors, midwives, and therapists to their breaking point. 

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Key Time Stamps: 

  • 03:08 – How Dr. Vernon’s experience with postpartum OCD, anxiety, and depression changed her career
  • 09:12 – Why physician mothers have DOUBLE the risk of postpartum depression
  • 15:44 – The major gap in provider education on postpartum mental health
  • 19:18 – When providers experience their own postpartum struggles, how do they reconcile it with their training?
  • 22:10 – How postpartum care needs a complete redesign

Connect with Dr. Jessica Vernon, MD. Dr. Jessica Vernon, MD, FACOG, PMH-C is a board certified OB/GYN with a specialty in perinatal mental health. She currently works at Oula, a midwifery based collaborative care practice. She's a physician advocate working to decrease healthcare disparities and bring awareness and better support for women with peripartum mood disorders. Jessica is also a mom, partner, daughter, friend and author of Then Comes Baby. Website | IG 

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Speaker 1:

The postpartum care system is failing, leaving countless mothers struggling with depression, anxiety and autoimmune conditions. I'm Miranda Bauer and I've helped thousands of providers use holistic care practices to heal their clients at the root. Subscribe now and join us in addressing what modern medicine overlooks, so that you can give your clients real, lasting solutions for lifelong wellbeing. Hello everyone, welcome to the podcast. Look, I always come in here super excited because that's what you do when you're coming into a podcast show, but I want to tell you that I have literally been waiting for this conversation for weeks.

Speaker 1:

Dr Jessica Vernon. She's a mom of two and a board certified OBGYN with an emphasis on health equity and perinatal mental health. She's got over a decade of clinical experience and has cared for thousands of women throughout their reproductive years. And she sent me this pitch and she wants to talk about the unique pressures on physician mothers and how the medical community can break the stigma around seeking help. And I will tell you, when I was doing coaching years ago, over 50% of the moms coming to me were in the medical field and that significant portion of those moms were therapists or counselors or supporting moms and perinatal mental health, I would say.

Speaker 1:

A year ago we shared a podcast with a midwife and it was her journey through postpartum depression and how she felt. She couldn't tell a single soul because she's a midwife, and that episode went through the roof. People were messaging me from all over thanking me for bringing light to that conversation. So when Jessica showed up in my inbox, it was a very quick heck. Yes, I have been looking forward to this for weeks. So, jessica, thank you so much for being here.

Speaker 2:

Thank you so much for having me. I'm really excited to continue this discussion. I've been having discussions along these lines in many different ways, trying to break the stigmas and taboos, for many years, so I'm so happy to meet with your audience that not only has a lot of people who are giving birth or who have given birth, but a lot of people providing care for those individuals, so not just doctors, but the whole spectrum of care providers, which is really lovely.

Speaker 1:

Yes, yes, and you were recently a contributor for an article on Medscape on physician mothers and their rate of postpartum depression and anxiety, and I really I'm going to link all of this so that everybody who's listening in you can go see this article. But can you start this conversation and share, kind of like, what led you to contribute to this piece and why this topic is really close to your heart?

Speaker 2:

Sure. So Cassie Shortsleeve, the author, reached out to me and some other physicians who have been vocal about our own experiences with postpartum anxiety, depression, the whole spectrum of disorders really to get some more insight and to bring this to light to the medical community, and I jumped right on it because it is something that I have been very vocal about for many years. After my own experience with my first daughter, I had anxiety, ocd, and then that devolved into depression and I didn't even know it was going on for close to two years, and so I have not only been working on my own journey after that, but I've been working to help patients through that journey of their own and really have been working to bring light to it with my colleagues and other professionals and talking about my own experience and all of the treatment that I underwent to help other people feel less alone and to help normalize the conversation for my patients and my colleagues.

Speaker 1:

Out of curiosity, was this something that occurred? Were you getting into the perinatal mental health field because of your own experiences? Or was it the opposite, where you were already in it, the thick of it, and then you had your own experiences and felt kind of silenced by that. And now it's like, hey, I need to speak up and share this with more.

Speaker 2:

Yeah it. I got into this field because of my own experience. When I went through training, we really weren't taught much about postpartum depression. It was really making sure people were not voicing concerns for being suicidal or saying they were so depressed they couldn't get up and go about their daily activities. We weren't even taught about the whole spectrum of disorders other than severe depression, and we weren't asking people the right questions or doing any screenings or doing anything to really elicit information from them. So I really didn't know what any of it meant, and so when it happened to me, I had no clue. I just thought I was a hypervigilant new mom and I was very overwhelmed.

Speaker 2:

Intrusive thoughts that devolved into OCD and over time it just got worse until I was very depressed because I thought this is just how things are going to be from now on, I guess, and my work was suffering. My personal life was suffering. I was just really struggling, was suffering. My personal life was suffering. I was just really struggling and I had to actually kind of put myself on antidepressants. Through my primary care provider, I asked for a prescription and that was the first step into being able to get some perspective and be like this is what's been going on with me this whole time. But it wasn't until I had that pause after starting the medication that I could see what it was, and then I was able to do all the other aspects of self-care and healing with the therapy and other modalities to get myself back to a state of being healthy again.

Speaker 1:

Yeah, I, everything that you're sharing here is going to be really such a huge necessity for others to hear who people who are in the field, whether you exact same way right, like there wasn't any training, there wasn't any support, and then they went in it and then they were like what am I supposed to do? I'm curious. Did you feel like, having gone through that experience, you were able to really share about that? Did you feel like there was this stigma behind it that, as a, especially as a provider, as a physician, that made you feel like I can't say this, I can't talk about this.

Speaker 2:

Right. It has evolved a lot over the past five years as I've done this work. Initially I was working on creating that safe space for my patients and really asking them how they were feeling and asking the right questions so that they could open up. And then, after I started doing more of the work to take care of people with postpartum anxiety and depression, then I started opening up more about my own experience as well. And it's always a balance to play because you don't want to make it about yourself, but just letting people know like I've been there I hear you, I see you it does get better and over time I've shared more and more of my story.

Speaker 2:

I was on the today show a couple of years ago and spoke about how I was pregnant again and I was staying on the medication because that was right for me. It's not the right path for everybody, but just letting people know that that's an okay option for some people who do need another layer of support during their pregnancy and postpartum. And I feel that it's been great for my patients as well that they see that we're all human. The providers were not on a pedestal. We don't know everything. We also struggle, we also suffer, we also face the unknown and have to go find out more about topics ourselves, and so for me it was important to bridge that gap as well, to show them we're the same, we're both human, we both face these struggles, and I've been there and I want to help you get through it too.

Speaker 1:

Beautiful. One thing that I found so interesting about this article that you had contributed to was the studies that show physician moms experience postpartum depression at double the rate. Double the rate of the general population. What unique stressors really contribute to such an increased risk here?

Speaker 2:

There are lots of different factors that I think create the perfect storm here. Part of it is the personality types of those of us who go into these caregiving, perfect professions and these high stress um, many years of studying type of roles. Often people are very type a perfectionistic. They're used to working hard and being able to achieve their goals. Um, they're also often nurturers, caregivers and people pleasers, and that works really well for medicine and other professions. In caregiving, when you translate that into being a parent, you give and, give and give until you're completely depleted and there's still no end to it. So that is one characteristic.

Speaker 2:

The professions themselves are often not very supportive of new parents. If people are giving birth during their training, they are often coming back within a couple of weeks of giving birth or a month and going back to 80 hour a week schedules. If they are out of training, they are often still pressured to come back early. I know I was after my first because my colleagues were having to take extra calls so that I could be on maternity leave and they were away from their families, and so there is definitely a lot of pressure to come back as quickly as you can and not much leeway for alternative schedules. Going part-time can, and not much leeway for alternative schedules.

Speaker 2:

Going part-time, working from home, even having pump breaks during the day, was a very difficult thing to try to do and navigate with my first baby, and so I think that also makes it hard that there's really no room for work-life balance, and you spent so much time working to get to this professional level that trying to be a parent and still be a clinician is a really hard balance to strike and something has to give, and usually it's the mom and her mental health. There's also studies showing that because we have babies later, when we go through all of the schooling and training, we have more complications in our pregnancy, more infertility, more rates of things like C-sections, high blood pressure, preterm births, nicu babies all of these things which also add to the risks of anxiety and depression.

Speaker 1:

It's so interesting because just last week I put out a newsletter and every week I have a newsletter for those who follow me and share some science, like updated things that are happening in the field and also some personal stories, and one of the stories that I was sharing was how I never wanted to be a doctor.

Speaker 1:

I never wanted to be in the medical field, except for this brief moment where I thought maybe I could become a midwife and it was never, because I didn't like I know that this is my, my field, like I belong in this field, but the very idea of, like the exhausting shifts and the lack of space for self-care and, you know, the idea of going to medical school and having to go through all of the, the rigmarole that is medical school, I felt was an impossible task for the body that God has given me, right, and I didn't want that, that pressure on me, and I knew that my body would never make it through. So like kudos to everybody who has pushed through and made that a reality for themselves. But I couldn't imagine, like, having gone through that and then to have motherhood on.

Speaker 2:

That is just, it's so much to bear, right we are taught to stop thinking and feeling in our bodies and just be more robotic and push through and pride ourself on getting little to no sleep and still being able to handle these high risk, emergency, very complex clinical scenarios. When you try to do that as a new mom and the work is never ending, you don't ask for help because you're used to being the person who can do it all and you feel you can push yourself further and do more. And that's just a recipe for disaster, because we all know sleep deprivation especially big deal for a lot of clinicians who don't do that in their daily life.

Speaker 1:

Hmm, I, you know it's so interesting A lot of the work that we do at postpartum university. We are serving doctors and midwives and nurses and therapists and and all of these people and and many of these who are entering into this space, have this realization of I didn't get the education I needed, which you had mentioned in the very beginning. Like, this is not something we're taught, and what are we doing to help moms heal the postpartum mental health, the nutrition, the mindfulness, the you know true recovery? And so many come into this space realizing that they didn't get that and then you know they're going through their own struggles and their own postpartum health crisis. Do you think that this gap in provider education is impacting a provider's postpartum experience? I?

Speaker 2:

think so. I was extremely shocked and humbled by my own experience and I thought that, as someone who had so much training in this area and I'm also very lucky, I live in New York, I have access to a lot of resources, I'm financially stable I just couldn't understand why it seemed so hard for me and why it seemed like I was struggling so much when other people were able to go about their daily lives with their babies and move on like nothing happened, which we thought we were all supposed to do, or supposed to just bounce back and get back to our lives as before, even though now we have this new little human we're caring for and we're recovering from one of the most intense experiences our bodies and minds and every part of our life can go through Um. So I think that disconnect between expectations and reality really made it harder for me to reach out for help too, because I figured it was something with me, it was a failure on my part.

Speaker 1:

Hey, I know you are crazy busy, but if you just have a second, could you simply hit subscribe and leave a review for us? I'd be so grateful. Yeah, I know that I felt the same way and I wasn't a provider. I was doing, I was a doula and I was on my third kid and suffering immensely. That was when I was diagnosed with postpartum bipolar and I couldn't believe that was my reality, after having spent all of the years that I had spent learning about postpartum, supporting women in postpartum, and here I am in this position like I clearly must be a failure. I clearly don't know what I'm talking about. How in the world am I here supporting women in this space? Like I should just I should quit everything because I'm very much a fake right Like. Those were the thoughts that were going through my head at the time of like this isn't me, this isn't how it is, and it sounds like this is something that a lot of people go through.

Speaker 2:

Right, it shakes you. It's another added layer to the identity crisis we already go through when we're becoming a parent or adding more children into our homes. Another crisis of confidence and who I was professionally, as well as who I was as a parent.

Speaker 1:

Yes, which brings me to another question, like when providers experience their own postpartum struggles and depression, anxiety, autoimmune disorders, depletion and then maybe they go on and find relief and more holistic methods, maybe after getting a prescription, or just like trying all of the things and nothing feels right, whatever it is. That is their journey to find relief and holistic methods you know often lead to like this identity crisis. Right, they start questioning everything that they were taught in medical school. Have you seen this happen among your colleagues and how do you make space for these conversations without providers feeling like they're betraying their training or that they spent so many years learning something and sacrificing life? I mean, to become a medical provider is quite a sacrifice and then was that all for nothing, right? I feel like there's such a huge identity crisis that comes with that in and of itself, on top of motherhood.

Speaker 2:

Right. It is a lot of unlearning and relearning and adding in a whole nother layer and humility that we don't know at all with Western medicine and there are so many other things out there. I am always learning new things from my patients about areas where they've found support or help or things that have worked for them, and I don't always hear it as much from other physicians. Some will open up about their experiences. A lot of the other clinicians I work with like midwives, doulas, therapists they seem to be more open into accepting these other modalities because a lot of them have been recommending them to their clients before.

Speaker 2:

But integrating Western medicine and the ideas and how we're taught to go about looking for solutions with what happens in the peripartum period is hard for a lot of people. A lot of physicians want to look at the data and so it's still an area where it's been really hard to integrate. But I myself I will say I did everything. I did acupuncture, I did Reiki. Before I had my second baby, I did something called an energetic fertility method and was doing a lot of group meditation, and so I have been open and receptive to all of that and I've talked to some of my patients and my colleagues about it, but it's definitely opening yourself up for criticism from the mainstream medical practice.

Speaker 1:

I feel like it takes a really brave soul to do that. So thank you for opening up and sharing those experiences with others. Do you feel like it's kind of like a taboo conversation?

Speaker 2:

It depends on the environment, I will say the practice I'm at now ULA, because it is midwifery led and we are very into holistic care and person centered care. We bring up anything and everything that we people think will help the patient or that the patient brings to us. We will discuss it with them. We will look at it with them. We don't dismiss them or make them feel small because they're bringing something outside of the mainstream practices, because there's always more to add to our knowledge base and I know that so much more after everything that I've been through having my kids.

Speaker 1:

I have a really unique question for you. Sure, if you could redesign postpartum care from the ground up, what would that look like? Like how would we begin that shift now, both in medical training and in provider mindset?

Speaker 2:

I think the first piece is acknowledging that, well, we're postpartum our whole lifetime. Right, we're always postpartum, but especially that first year, not the first six weeks, the first whole year is so important that I think the first step is acknowledging that and making sure that we get lobbies and funding and insurances to get on board with covering more postpartum visits and some of these supports that, like other countries where they have postpartum doulas, they have other people who will come to the parents' house and see them lactations consultants, everything that is built in here with only one visit at six weeks and if you had surgery, maybe another check-in at one to two weeks to see how the incision looks. It's just, it's really sad and it's laughable. And in a provider visit that might last a couple minutes there you just can't even begin to touch the tip of what needs to be covered and a lot of things take multiple visits and follow-ups for them to come to light or for people to feel comfortable discussing certain topics or asking for help, or for you to ask the right question that elicits the information. And so really having more visits in that first year that are automatic and scheduled, whether it's video or in person.

Speaker 2:

I tell patients when I'm seeing them for mental health visits that I'm there anytime, even if they don't need me for medication, if they have a therapist, if they're feeling good.

Speaker 2:

I remind them you are always postpartum and we're here for you, so reach out anytime, because they often feel after that six week visit my provider's done with me, I can't go back to my obstetrician and often their obstetrician won't make time for them after that. But that is still a very critical period and I do see a lot of people who might have been fine the first three months or the first six months and then something happens and then they really need that support and they have nowhere to turn. So really resetting expectations and acknowledging that postpartum people need that support is very important and I know that that really means that as a society we have to change so many things right Maternity leave, child care support, lactation support. There's so many levels to be able to achieve that and I think that's a big part of why the conversation, the shift isn't happening, because nobody wants to put in the resources to support all of that.

Speaker 1:

I think you are so right on in everything that you shared and like the amount of support that women truly need and the handholding right, like how many of us need somebody to be there really in our homes, like holding our hands, telling us we're doing a good job, giving us the support that we need for, you know, mental health, nutrition, breastfeeding all of the things that come with becoming a mother, whether it's for the first time or the 10th time, you know, um, and it it takes a significant amount of of time and attention.

Speaker 1:

Um, I was actually just um reading about a new thing that New Jersey maybe you're familiar with it being where you are in New York that they have come out with a new law that requires physicians give their patients a set like a postpartum plan, a postpartum healing plan. Are you familiar with that? I haven't heard of that. No, I wonder how that's going to look, because if we don't have trained providers who know the tools necessary, or they're walking into a space of saying, okay, well, I'm supposed to give my clients a plan Like, what does that plan even look like? How do I, how do I make this happen? You know, I don't want it to become like the next checkbox thing, so it'd be really interesting how that comes into play as well.

Speaker 2:

Right, and it's always tricky because once you ask providers to ask the patients about something, then they have to have resources and places to send them to get that support. So if they need a pelvic floor physical therapist, do you have people in your area to refer them to? If they need a pelvic floor physical therapist, do you have people in your area to refer them to? If they need a lactation consultant, do you have ones that will go make home visits? And that's what's been really hard with a lot of the mental health work that I've done. When encouraging providers to ask the right questions and do the screenings, they're like that's great, but I don't have anywhere to send them. Who takes their insurance or couldn't get them in within a few months?

Speaker 2:

So it it is part of a broader conversation and that we can ask the questions and try to help prepare people, but then we need to have the right infrastructure in place so that they can get that support that they need and there's just you know there's so many different activities that we could add in to help them heal. I'm sorry there was just sirens and ambulances going by. I never heard it. You're good, but there are just so many modalities that can be added in to provide support, and making sure that people have that is really hard, so providing that infrastructure is one of the first things that we need to do training people to provide the support and making it accessible.

Speaker 1:

In such a short amount of time. I feel like right, because honestly, they push providers to have so many. You must see so many clients, you must do X, y, Z and you must check all of these boxes. And how difficult that must be to do all of that in such a short amount of time with as little resources as you do. It's very frustrating to have that. So thank you for bringing that to our attention here. You have a book releasing soon. Yes, tell us all about this book.

Speaker 2:

The book is called Then Comes Baby an honest conversation about birth, postpartum and the complex transition to parenthood, and it came out of the last five years of my work with these patients and my own experience.

Speaker 2:

And it is really for the birth person.

Speaker 2:

It's not about the baby, it is about the person giving birth, because they matter too, and it covers a lot of the aspects of the whole process that we are just unaware of, we didn't expect, we didn't think could happen to us, and so it often leads to people feeling like a failure. They feel alone, they're in shock, they can't process it, and so trying to bring a lot of this to light beforehand and get the conversation started and have people thinking about the birth and postpartum experience in a way that can really help them feel more prepared and supported and less alone when things go off course from their expectations is really important to me, and so I weave in some of my own stories and some common themes from patients and friends, because everyone tells me their stories now to hopefully provide some non-judgmental support. I cover topics holistically, so it's emotional, physical, mental, because it's all important, and often, like you've mentioned before, you know your doctor covers the basic physical stuff, but they don't go into anything else often, so this covers all of it.

Speaker 1:

I am so excited to read this book when it comes out I think you said it was May. It comes out when I was looking at it. Okay, gorgeous, we're gonna have a link for that. Is there anything else that you would like to cover here before we say goodbye?

Speaker 2:

I just think it's important to always remind people, whether you provide clinical care or not, whatever you're going through, you are not alone and other people have been there before, and it is so important to have community to get that validation. So find those support groups. Community to get that validation. So find those support groups. Talk to people who've been there. Talk to people who are open to sharing experiences authentically and vulnerably, and not turning to social media for all of the answers, because, I promise, some of us have been there before, many of us have been there before and it does get better. Um, so you know, keep, keep pushing through and know that we're here.

Speaker 1:

Ah, beautiful. Thank you so much for your wisdom and your time, Dr Jessica. It's been such a pleasure. Where can people find you and go connect in with you?

Speaker 2:

So I am on my website, Dr Jessica Vernon. I also have Instagram, LinkedIn, and you can pre-order the book through the website or through all major booksellers now.

Speaker 1:

Oh, yay, okay, we're going to have all of those links here for you. Go take a look at her information. She's amazing, thank you, thank you. Thanks so much for being a part of this crucial conversation. I know you're dedicated to advancing postpartum care and if you're ready to dig deeper, come join us on our newsletter, where I share exclusive insights, resources and the latest tools to help you make a lasting impact on postpartum health. Sign up at postpartumu the letter ucom which is in the show notes, and, if you found today's episode valuable, please leave a review to help us reach more providers like you. Together, we're building a future where mothers are fully supported and thriving. Thank you for subscribing.

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