Postpartum University® Podcast

The 6 Critical Blind Spots of Science That Are Harming Postpartum Moms EP 242

• Maranda Bower, Postpartum Nutrition Specialist

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What if the very foundation of modern care—science alone—is the problem?

You see the stats: mothers are drowning in postpartum depression, crippling anxiety, and mysterious autoimmune flare-ups. You're doing the screenings, you're following the standard protocols, but the lasting solutions are elusive. What if the very foundation of modern care—science alone—is the problem? Maranda dives into the six critical limitations of medical science that are actively harming mothers in the fourth trimester. This isn't anti-science; it's a call for a more honest, holistic postpartum health model. This episode exposes the six critical limitations of medical care actively harming the fourth trimester. We break down why relying on RCTs ignores millennia of successful traditional postpartum practices. Discover the Three Pillars of Knowledge for root-cause resolution in perinatal mental health and move beyond symptom management

Check out the episode on the blog HERE: https://postpartumu.com/podcast/the-6-critical-blind-spots-of-science-that-are-harming-postpartum-moms-ep-242/

Key time stamps: 

  • 04:15: Miranda’s personal story: Dismissed with Zoloft, actually had thyroid dysfunction, gut infection, and severe nutrient deficiencies.
  • 09:05: The Three Pillars of Postpartum Knowledge: Science, Women's Stories, and Traditional Practices.
  • 11:47: Limitation #1: Science is money-driven and prioritizes patentable solutions over holistic postpartum practices.
  • 16:30: Limitation #3: Dismissing millennia of traditional care (like warm, cooked foods) as mere anecdotal evidence.
  • 21:20: Limitation #4: Doctors are taught pathology, not how the body actually heals, leading to a focus on pieces instead of the whole.
  • 26:38: Limitation #5: The male bias in research and leadership and why women were historically excluded from clinical trials.
  • 31:45: Limitation #6: Time lag in policy change—it takes 10-15 years for new evidence to become standard practice.
  • 34:23: Clinical Example: Client with "medication-resistant PPD" actually had Hashimoto's and severe B12/Ferritin deficiency.
  • 36:50: Call to Action: Believe your client, investigate beyond basic labs, and hold providers accountable for outdated care.
  • 40:17: Final thought: Science alone is not enough; we need all three pillars for comprehensive, root-cause postpartum support.

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SPEAKER_00:

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 well-being. Welcome back to the Postpartum University Podcast. Miranda Bauer here, and today we are talking about something that might make some of you uncomfortable, and that is the limitations of science in women's health care, particularly in postpartum care. And before you skip this episode, thinking that I am anti-science, let me be very, very clear. I'm not. Anyone who's ever taken any of my trainings and can see how much I love science. I always, always cite science. Science is brilliant. It's given us incredible advances. Science saves lives. But science also has blind spots. And those blind spots are killing mothers. Today I'm going to be sharing the six major limitations of science that specifically impact postpartum care, why these limitations even exist, and what we as providers can do about it. And this is not about discrediting science, it's about understanding where science falls short so that we can fill those gaps. I want to first share some of my own story because this is deeply personal. When I had my first baby, my son, almost 16 years ago, which is absolutely crazy to think about. He's almost six foot, y'all. Nobody prepares you for when your child is significantly bigger than you. But I was crying constantly. I had severe anxiety. I could not sleep even when he was sleeping. I was losing my hair in clumps. I had zero energy, heart palpitations, shaking hands. I felt like I was losing my mind. And I hear the same all the time. Moms share that with the world. They share with their partners, they share with their providers, they're sharing on social media. And it's so incredibly frustrating. You can just go scroll through my Instagram and you can hear the stories of moms where they've gone to their doctor and they, and the doctor said, Oh, yeah, you've got postpartum depression. Here's your Zoloft. Like no blood work, no questions about what they're eating. And for me, that was basically nothing because I felt nauseous all the time. There was no investigation into why I was having physical symptoms like heart palpitations and tremors. It was just, here's your depression. It's just your hormones. You have normal postpartum stuff that needs medication. And here's the thing: I have always been someone who asked questions. Maybe it's annoying, maybe it's my personality, but something didn't feel right about that. The symptoms didn't quite fit what I understood about depression. And so I dug deeper. I dug into what is really happening in my body. And I partnered with a provider. And I said, here's what I'm thinking. Here's what I am experiencing. This is the research that I've done for myself. And come to find out I had severe nutritional deficiencies across the board. I had a massive gut infection. My thyroid was barely functioning. My adrenals were completely shot from months of sleep deprivation and stress. My blood sugar was all over the place because I was surviving on crackers and tea and leftover, you know, foods that my parents were eating because I was living at home. I was a single mom, and the stress of life was unbearable. So when we addressed these underlying physiological imbalances, when we gave my body what it needed to heal, the quote unquote depression disappeared. Not because I had some magical thinking, not because I just tried harder, but because we addressed the root physiological problems that were creating psychiatric symptoms. And that experience launched me into what has now been over 15 years of work in postpartum care. And what I've learned is that my story is not unique. It is, if anything, the normal. And science failed me. The system failed me. And it's failing moms every single day. And that's why we have to have this conversation. At postpartum university, our entire approach is built on what I call the three pillars of knowledge. It's science, women's stories, and traditional practices. And all three of these are essential. Without one, our information is incomplete and mothers suffer. Science gives us understanding of mechanisms, validation of interventions. It gives us a systematic approach to knowledge. It's crucial. Women's stories gives us that lived experience. It's the nuanced reality that doesn't fit neatly into research protocols. They tell us what exactly is happening in real life. So so key. And then traditional practices, they give us thousands of years of collective wisdom about what works. Cultures around the world have been supporting postpartum mothers successfully for millennia. So when we rely on science alone, we miss critical information. And that's what we're going to unpack today. So I'm going to go ahead and dive straight into these limitations. Limitation number one, it is money driven. Science is driven by money. Healthcare exists with capitalism. Science and healthcare are both businesses. The main objective of a business is to make money. And in order to create good science, you need funding. And that funding generally comes from people or companies who know they can get a return on their investment. Look at most large pharmaceutical companies and healthcare companies. Look at their budgets. In most cases, advertising costs significantly exceed research and development costs. You think about that for a minute. And money also creates bias. Studies are funded with specific goals. One of the main criteria for analyzing whether a study is high quality is determining its biases and funding sources. So this information is required when publishing science, though it's not always transparently disclosed or followed through on. And so what gets studied in postpartum care? What's profitable? Medications, interventions, things that can be patented and sold. What doesn't get studied? Things that can't be patented. Traditional food healing support tools, traditional foods, right? Herbs. Herbs that you can grow in your backyard, community support structures, rest. These things don't generate profit, so they don't generate funding for research. And this means that huge gaps in our scientific knowledge about postpartum care, not because these approaches don't work, but because no one can make money researching them. Here's limitation number two ethics. And this one is complex. Science during pregnancy, birth, postpartum, breastfeeding, that poses some major ethical concerns. Any potential to cause harm either to mom or baby becomes unethical and illegal. So whether it's regarding the use of a product or service or prohibiting the use of a product or service, we cannot do a double-blind, placebo-controlled clinical trial on pregnant or postpartum women. And this is good. We don't want researchers doing potentially harmful experiences, uh experiments on vulnerable populations, right? It is also meaning we we get left with only observational, analytical, and perspective studies for most postpartum interventions. These types of studies are considered lower quality in the hierarchy of scientific evidence. So we're stuck in this catch-22. We can't do the gold standard research on postpartum mothers because it would be unethical. But then we dismiss the research we can do as not rigorous enough. And so this leaves postpartum care in this like perpetual state of not enough evidence while mothers continue to suffer. Limitation number three, anecdotal evidence. This is how science treats women's stories and traditional practices. In the scientific community, women's experiences are considered anecdotal evidence. And this means it holds almost no value. Thousands of years of traditional postpartum care across cultures, anecdotal. Millions of women saying this intervention helped me, anecdotal. Your grandmother's wisdom about postpartum recovery, anecdotal. And the problem is this dismissal of anecdotal evidence and entirely dismiss of this. We're dismissing the very people we're supposed to be serving. Let me give you an example. Traditional cultures have emphasized warm, cooked, easy digestible foods for postpartum recovery for thousands of years across vastly different cultures: Chinese, Indian, Latin American, African. This principle appears consistently throughout every single culture who supports postpartum women. But where's the randomized controlled trial comparing warm cooked foods to raw foods in postpartum recovery? It does not exist. So according to strict evidence-based medicine, we cannot recommend this practice. Except we know it works. Mothers tell us it works. Generations of successful postpartum recovery tell us it works. But science says it's just anecdotal. Here's now limitation number four, a logical focus. The fourth limitation is this gets to the heart of medical training itself. Doctors are taught pathology and prescriptions, not how the body actually heals. So part of this problem lies in the challenge of the scientific method and its need for one or very few variables because the body, the healing process and most pathology, and they're multivariable. And this makes it exceptionally challenging to discover the root of disease. A medical myth that science perpetuates is that the body operates in pieces rather than the whole, right? But really, science operates this way because it has to reduce variables. It has to make variables make it exceptionally challenging. And we cannot change this way of thinking if we are going to use the scientific method to support and validate what we believe to be true or want to be true. Women also have bodies that are far more intricate than men's. And for science, this means more variables and more complexity. So it's harder to track needs and behaviors of women because they're much more intricate and sporadic and detailed. Hormonal cycles, pregnancy, lactation, menopause, women's bodies are in a constant flux in ways that men's bodies just aren't. So much of what we don't know about women's health, we don't even know deeper. Like that we don't even know the intricate layers and the complexity. We just know that it exists. So recommendation recommendations are also often based on, you know, quote unquote safe enough standards without combining any other variables. For example, we might study whether iron supplementation is safe in postpartum, but we don't study how iron absorption is affected by inflammation, how inflammation is affected by stress, how stress is affected by lack of support, how lack of support is affected by cultural norms. We study isolated pieces and then wonder why our interventions don't work well in real life as they did in the lab. Here's limitation number five. This is massive. And it's the male bias. And this one makes a lot of people defensive. And we have to talk about it. It actually wasn't until 1993 that the NIH required women to be included in clinical trials. It was illegal for many, many years. This means that decades of medical knowledge is based primarily on male physiology. Women metabolize medications differently. We have different cardiovascular responses, different pain thresholds, different immune responses. But much of our medical knowledge doesn't account for this. Second, male bias is created by men in higher level positions making decisions without knowing or considering female needs. Healthcare leadership is still predominantly male. Research funding decisions are made predominantly by men. Medical school curricula are designed predominantly by men. I'm not saying men can't contribute to women's healthcare. Of course they can, and they do. But when the vast majority of decision makers don't have personal experience with menstruation, pregnancy, birth, breastfeeding, or menopause, they're gonna be blind spots. And these blind spots show up in postpartum care consistently and constantly. Why is there only one postpartum visit covered by insurance? Why is it that at six weeks, when we know many complications don't appear until later on, that's when we have our appointment? Why do we tell mothers to sleep when the baby sleeps instead of providing actual support? Because many people who are making these decisions don't understand the reality of postpartum recovery. And then they try to fit it into the broken system that was never designed for women in the first place. Here's limitation number six time, trends, and change. This is about how it takes between 10 to 15 years for a standard medical practice to change after new evidence has been found. And by the time this ground level change occurs, it's already outdated. Change is difficult within the medical world and it requires new policies, procedures, tracking systems, and so much more. Think about it. When science creates what is deemed groundbreaking research, it generates entire fields and procedures from that research. And then the later discovers, you know, it later discoveries show that it was never accurate in the first place. Then what happens? Often nothing. The old practice continues for years, sometimes decades, because changing them is so difficult. Science is also used to uh, you know, trying to be very clear, right? For the sake of clarity, even when new conflicting data has been presented, there's so confusion and conflict developed from that new evidence, which creates more growth today, but also creates hostility and concern. It takes 10 to 15 years for old practices to dissolve. And science is full of outdated material. Yet these long-term studies, they're difficult to create. So the definition of long-term is reduced to allow for less time. This means that fewer studies on the effects and safety of interventions for women in major transitional periods, including menarchy and early motherhood and menopause. Think about this. When the new postpartum pill came out on the market, there was first the injection drug, and then a couple years later, it was the pill, and it was for postpartum depression. Both of those were the first drugs on the market that was very specific for postpartum depression. Both drugs were never studied longer than six weeks. We have no long-term data on that information whatsoever. It doesn't exist. And there is a lot of information that's finally coming out. There was an investigative research project that looked at these two drugs specifically. And uh it was it was mind-boggling that we didn't study the effects of breastfeeding. We have no data on what happens to a mother five, 10, 15 years after taking those drugs. We we know nothing. We don't even know what happens to baby. What happens to baby if a mother is breastfeeding? What happens to baby? We don't know. We fast track that drug, just like we fast-tracked, you know, COVID uh uh vaccinations and all of the things. Because to do those 10, 15 years, those longer-term studies, it just doesn't sound right in today's world, especially because things move so fast. So we simply don't know what happens to mothers beyond the first year postpartum. And in most cases, most cases, because no one is studying it. There is no research on depletion after postpartum in the first six months. And usually studying six months postpartum is massive. Like those studies hardly exist at all. The fact that there are a few of them is just mind-blowing. Uh, it's it's very, very unfortunate. Okay. How does this impact the real world? And I want to bring this back to a real clinical example because these limitations aren't just theoretical. They're harming mothers right now. I had a client recently who had been diagnosed with postpartum depression and anxiety. She had been on medication for eight months, minimal improvement, multiple medication adjustments, therapy, everything by the book. And when we finally got comprehensive labs done, she had Hashimoto's thyroiditis. She had virtually undetectable ferritin levels, severe B12 deficiency, completely dysregulated cortisol. Was she depressed? Oh, yeah, she was depressed. But the root cause wasn't what everyone assumed. No wonder the medication wasn't working. Science had gave us the label postpartum depression, but it failed to investigate the underlying physiological cause. Why? Because the research protocol says screen for depression, prescribe medication, refer to therapy. The research doesn't say do comprehensive metabolic and nutritional testing on every postpartum mom presenting with mood symptoms. Because that research doesn't exist. It's too expensive, it's complex, it doesn't fit into the pharmaceutical company business models. Or another client who was told that her severe fatigue was just part of being a new mom. Six months of being told to rest more and drink more water and take a multivitamin. And digging deeper, again, ferritin was like at an eight. Her vitamin D was 18. Her B12 was borderline. Her doctors, hey, I'm getting frustrated. You could hear it. And her doctor said these were fairly normal. There's fairly normal. Right? Lab ranges are based on averages of people who come in for testing. They're not based on optimal function. They tell us what's common, not what's healthy. But science uses these ranges as if they were absolute truth. And mothers are suffering as a result. And here's what gets me really fired up. We have thousands of years of traditional knowledge about postpartum care that works. Cultures around the world have successfully supported postpartum mothers with specific practices, extended rest periods, specific warming, and easily digestible foods, community support where other women take over household tasks, herbs, practices that support nervous system regulation, recognition that postpartum is a sacred transition requiring protection and care. These practices have been tested over millennia with millions of women. They work. But because we don't have randomized controlled trials, science dismisses them. And oftentimes cultures will say something like, we don't want the cold to get in your body or your bones. And we automatically dismiss that because they use different language to describe something that might be physiologically actually happening within the body. But we say it in a different way. They say it in a different way. And so that's one of the beautiful things about functional medicine. Uh, the doctor behind functional medicine who created that wanted to blend these traditional practices with modern science, using language that we would understand as modern people. Anyway, meanwhile, we have plenty of, you know, quote unquote evidence-based interventions that are absolutely making things worse. Telling mothers to sleep train at two months postpartum, disrupting both mother and baby's nervous system and potentially affecting milk supply. We are recommending mothers return to intense exercise before their bodies even healed six to nine months postpartum. We're telling her to do that at six months. You're cleared, you're ready. We're pushing mothers back to work at very early weeks postpartum. People who are still recovering from this massive physiological change of pregnancy and birth and psychological changes too. And these recommendations are, you know, quote unquote evidence-based. Because they're but they're they're based on incomplete evidence that doesn't account for the full complexity of postpartum. And this is why I created the postpartum university with these three pillar approaches. We start with science. Absolutely. We need to understand mechanisms and validate approaches and ground ourselves in physiology and biochemistry, but we also listen to women's stories. What are mothers actually experiencing? What helps them? What makes things worse? Their lived experience is data, even if it's not the kind of data that fits into research protocols. And we honor traditional practices. When multiple cultures independently arrive at similar postpartum care practices, that's meaningful information. We should not be studying why these practices work. We should be studying that, not dismissing them as primitive or unscientific. In our perinatal mental health training and in our postpartum nutrition certification training, we teach providers to integrate all three pillars. Yes, understand the science of how nutrition deficiencies affect neurotransmitter production. But also listen when a mother tells you she feels better when she eats warm cooked foods, even if we don't have some RCT proving it. Yes, use validated screening tools for postpartum mental health, but also recognize when traditional support practices like having family bring meals or help with household tasks might be more effective than medication for a particular mom. And coming back to my own story, the reason why I just didn't accept postpartum depression diagnosis or take the medication is because I had access to other information. I had a grandma who talked about how women in her generation were cared for postpartum. I had read about traditional postpartum practices and other cultures. I had an intuition that something deeper was wrong. And a lot of mothers don't have that. They they trust our doctors and we want them to trust their doctors. And when a doctor says, this is postpartum depression, here's medication, they take it because they're suffering and they're desperate for help. The medication might help with symptoms, but if the root cause is thyroid dysfunction or severe nutrient deficiencies or chronic inflammation, the medication is just masking the problem while the underlining condition continues to worsen. And this is what's happening to mothers every single day. So what can we as providers do about these limitations? First, listen to your clients, really listen, follow up with lots of questions, understand their whole body needs, not just the symptoms that they present with. When a mother tells you something isn't right, believe her, even if the labs are normal, even if the screening says she's fine, even if the standard protocol says she should be recovered by now. Second, don't settle for science. Investigate. Connect with colleagues, ask questions, never settle for it's as good as we've got. Especially when mothers are still suffering, or it's just postpartum. If the evidence-based approach isn't working for your client, be willing to look beyond it. That doesn't mean abandoning science. It means recognizing science limitations and filling in the gaps with other forms of knowledge. Third, hold providers accountable. If you see something, say something, have follow-up conversations, send updated practices or policies to colleagues who are operating on outdated information. We can't wait 10 to 15 years for change to trickle down from new research. Mothers are suffering right now. And then, of course, find out who the decision makers are in your area. Voice your concerns about male bias, about the need for more funding for women's health research and the issues that you're seeing in your community. Write letters, make calls, show up to public hearings. The only way these systematic issues change is if we make noise about them. This is also why the postpartum restoration method that we teach in our certifications is structured the way it is. Because we assess the five components: physiological restoration, nutritional foundation, neurological regulation, rhythmic recovery, and identity integration. These components don't come from just research. They come from integrating science with what mothers tell us they need and what traditional practices have emphasized for thousands of years. I can give you a randomized controlled trial proving that addressing all five components produces better outcomes than standard care. Can I do that? Not yet. But we're working on that research. But I can give you thousands of success stories from mothers and providers who have used this approach. I can show you how this integrates cutting-edge research on inflammation, the microbiome, nervous system regulation, and nutritional biochemistry. I can point to traditional postpartum practices from dozens of cultures that align with these five components. That's the three pillars in action. I know some of you are like, heck yes, finally we are having this conversation. And I know some of you might be uncomfortable with this conversation as well. You might be thinking, Miranda, we just need evidence based practice. We can't just go back to doing things the old way without proof. And you're right, we do need. Evidence-based practice. But we also need to recognize that evidence-based doesn't mean science only. Evidence comes in many forms. Clinical experience is evidence. Traditional practices that have worked for thousands of years are evidence. What mothers tell us about their experiences is evidence. The hierarchy of evidence that places randomized controlled trials on the top and everything else at the bottom was designed for pharmaceutical interventions. It makes sense for that purpose. It does not make sense for complex multivariable interventions like postpartum care. We need a more nuanced approach that recognizes different types of evidence are appropriate for different types of questions. The future of postpartum care requires us to be honest about science's limitations while still honoring its contributions. We need more research on women's health. Absolutely. We need better funding, less bias, longer-term studies, more complex protocols that account for multiple variables. But while we are waiting for that research, moms are suffering, and we cannot tell them, sorry, we don't have enough evidence yet. You're just gonna have to cope. We have to use all three pillars of knowledge, science, women's stories, and traditional practices to provide the best care possible right now. If you're a provider listening into this, I want to challenge you to examine your own practice. Are you dismissing mothers' concerns because they don't fit the neat diagnostic boxes? I highly doubt that you're doing that, especially if you're listening into this episode. But really look in, assess where are we relying solely on research? What is not working for our clients? Can we talk about traditional practices in the context of supporting our moms? The mothers you serve deserve better than science only care. They deserve practices who are willing to look, practitioners who are willing to look like beyond the limitations of our current research and provide comprehensive, holistic support. Our trainings here at Postpartum University teach you how to integrate all three pillars into your practice, how to use science as foundation while also honoring women's experiences and traditional wisdom. Because here's the truth when we heal mothers, we heal families. And when we heal families, we heal communities. And when we heal communities, we literally change the world. But we can't do that if we're operating within a system that has such massive blind spots. We have to be willing to acknowledge where science falls short. We have to be willing to fill those gaps. And when we have to be, we have to be willing to fight for better research, better funding, and better care for mothers. Science is brilliant. Science is essential. Science saves lives. But science alone is not enough. We need science plus women's stories, plus traditional practices. We need comprehensive care that honors the full complexity of postpartum recovery. And we need providers who are willing to look beyond standard protocols with these with these protocols that are failing moms. And that's why we have postpartum university. That's why we have the three pillars approach. This is why we do this work because mothers deserve better. And it's up to us as providers to give that to them. Thank you so much for listening to this episode. I know it might have been uncomfortable. I know it might have been revolutionary for some of you. You're like, yes. But sometimes we just we have to be able to sit in this uncomfortableness, if that was you, and to really create this change. So if this resonated with you, please share, share it with other providers who need to hear this message. If you want to learn more about our three pillars approach, you can visit postpartum you the letter you dot com to learn more about our training programs. And remember, when we heal mothers, we heal the world. 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 postpartum you the letter you.com, 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.

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Maranda Bower

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