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Our last episode features an important conversation with Katie Pederson about her experience surviving COVID-19 while pregnant and the effect it has had on her mental health. We will then be joined by Dr. Pooja Lakshmin, a board-certified psychiatrist and author specializing in women’s mental health and founder and CEO of Gemma.
Becoming a parent is beautiful journey, but one that can also be full of uncertainty and stress. Add to that navigating a pandemic through pregnancy, birth and your little one’s first years, and the anxiety can be overwhelming. After all, it’s not just your health you have to be concerned about anymore.
That’s why Dr. Veronica Pimentel – a practicing OB-GYN, pandemic mom, and fierce vaccine proponent – is here to discuss the facts about COVID, vaccines, and motherhood. In Labor of Love, Dr. Pimentel works to alleviate the concerns of new parents who have questions about how COVID and the vaccines may impact pregnancy. In each episode, she’ll talk with real moms who share their stories about experiencing motherhood in the time of COVID, and follow up with maternal health experts who share accurate information so listeners are equipped to make the best choices for themselves and their families.
This podcast (“Resource”) is designed for patients and is for informational purposes only; it does not provide medical advice and it is not intended to replace the advice or counsel of a physician or health care professional. While ACOG makes every effort to present accurate and reliable information, this Resource is provided “as is” without any warranty of accuracy, reliability, or otherwise, either express or implied. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this Resource or reliance on the information presented. Please visit acog.org/laboroflove for more information, including the full disclaimer.
This Resource was supported by the American College of Obstetricians and Gynecologists (ACOG) and the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) as a part of a financial assistance award totaling $300,000 with 100 percent funded by ACOG and CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.
Dr. Pimentel (00:07):
Pandemics are tricky. They may not have a clear end to them. And often the virus mutates and presents itself as other variants, as we saw with the Delta, Omicron and now the BA.2 variant. The COVID 19 pandemic has been a source of stress, anxiety, and depression for so many people, but especially for new mothers and parents. Our first story comes from Katie Peterson. The vaccines became available when Katie was pregnant with her second child, but she wanted to wait and see how the vaccine impacted pregnant women given that no pregnant women were included in the initial first clinical studies. As she waited however, she became infected with COVID and it was a traumatic experience. I got to sit down with Katie and talk about her experience with COVID 19, how it impacted her, her mental health and how she's moving forward.
Hello, our first guest for today's episode is Katie Peterson. Katie is a senior social media manager based in Seal Beach, California, who was pregnant at the time the vaccines were rolling out and decided to wait to get vaccinated. Katie's joining us to share her story on what happened when she caught COVID 19 as a non-vaccinated pregnant women. Welcome Katie.
Katie Peterson (01:32):
Thank you so much. It's great to be here.
Dr. Pimentel (01:34):
Thank you for coming. We're very excited to talk to you. First I wanted to know a little bit more about you.
Katie Peterson (01:41):
So I am Katie and I am a mom of two under two, which is exciting, but also a handful. I am in California. Born and raised near the beautiful beach. And yeah, I am just so thankful to be here after the trauma that I experienced this last summer. So much unknown happened in these last two years and so much learning as well. But it was definitely hard being pregnant on deciding what to do when the vaccine rolled out. And I'm definitely, I'm, pro-science, I'm pro-health and I'm just wanted to do what was best for me and my unborn baby. And it was definitely a scare that we had when I went through what I went through.
Dr. Pimentel (02:23):
Absolutely. Your story is so powerful and in some ways, actually in many ways, scary as a mom and scary as a physician as well. So I would like for you to tell us about what happened and also tell us why did you initially decide not to get vaccinated?
Katie Peterson (02:42):
Absolutely. So I learned I was pregnant in 2021 January. If you can all go back to that time, which feels like ages ago, but it really wasn't, that was the time when really only healthcare providers and people that were in the service industry were allowed to get vaccinated. Or not allowed, but really had the resources to do so. The everyday person wasn't really doing it yet. I consulted with my doctor. I love the team of doctors that I have and they said I'm totally typical what the CDC said. I am a young person that is smart. I would ride my Peloton three times a week and I stayed indoors because I had a toddler. I really wasn't going out. It's not like I was going on trips.
I was really being cautious and everyone else in my family was vaccinated, both of my parents and my husband. So we really weren't bursting the bubble, so to say. So I felt really confident in being like, "Okay, let's wait down the line to hear more cases of those pregnant women, perhaps getting COVID." And at that time, I'm sure everyone heard this, "Oh, it's just a little flu. You'll be fine. Especially because you're healthy." I have no preexisting conditions. I've never been in a hospital before except for to have my first child. I just am total clean bill of health. So I was quote unquote safe.
So I waited and I was actually going to get vaccinated at the end of my pregnancy because I was like, "Okay, this baby's more cooked. Maybe we'll know a little bit more. The CDC will have done maybe more research." And unfortunately I guess I was the case that now everyone's basing their vaccine recommendations in pregnancy off of. Which I feel so grateful to be here today to tell my story and be able to advocate for vaccines in pregnancy, because it's so crazy that when you're pregnant, you feel like you have this whole aura of wellness and you're growing another human. In reality, you are so compromised and nobody really tells you that.
So that's why I'm so sad that you think you're doing the right thing by not, not getting vaccinated. You don't even eat deli meat or sushi when you're pregnant. So the fact that when I was 25 weeks pregnant, unfortunately I was diagnosed with COVID. It was right when the Delta surge hit and as we all know, the Delta surge was the most deadly so far, so I've heard or so I've read. And I unfortunately caught that in the summer, and my son actually caught it first. I think I got it from him because we felt safe taking him to a private swim lesson for 10 minutes once a week. That's the only time we would go ou.t and I don't know what happened if we got it from who knows where the sidewalk, the pool, you don't know, which drives you crazy because you can't pinpoint it.
And I unfortunately got it from him. He was fine thank God, but I kept progressively getting worse. I thought, "Oh, it'll just be a little flu." My fever was really bad. I was really sick, throwing up. Every single thing that you look up, all the issues, check the box, check the box. Yep. All the symptoms, I had them all. And I just kept on getting worse. And we were monitoring my oxygen and my oxygen went down to 91 and then 90 and then 88. And right when I hit 88, I knew I had to go into the ER. When I went into the emergency room and they checked my vitals, that was the last time I saw my husband for about a month.
It was terrifying because you think I'm healthy, I'm going into the ER, they're going to help me and I'm just going to go right back to my house. And that was not the case. I checked into the ER and I immediately was on all these breathing treatments. And at that time too, all these antibody things that you probably know the names that I'm better than I do, but all these drugs, they weren't tested on pregnant women. So, so many people were like, "Oh well did you get this? Did you get this?" I'm like, "I got literally everything." And it even turned to the point where I had to just sign consent. Like, "Hey, we tested this, but this could help." I had a full like Bane mask on my face pushing oxygen down me because I couldn't breathe.
Dr. Pimentel (06:52):
So Katie, you come into the hospital, you're so sick, you can't breathe. And obviously if you can't breathe, we say your baby cannot also breathe, meaning you cannot oxygenate your baby. You're thinking about yourself. You're thinking about your baby. Your husband is at home and now you have to give consent to get these medications to save your life and also save the life of your baby, but medications that you didn't know much about.
Katie Peterson (07:20):
Nor was I in the right mind because you are so desperate to do anything to breathe, not only for your own life, but for like you said your baby's life. And then you're so fearful because you're like, "If I can't breathe and this child, who's not even really developed much inside of me, can't breathe. What's going to happen to both of us?" You don't know.
Dr. Pimentel (07:44):
I am so sorry that you went through that, but I'm glad that you here telling us your story.
Katie Peterson (07:49):
I'm so thankful. All the doctors were amazing. And so just to finish out my story. Day five I had every single, the head of OB-GYN, the head of infectious disease, every single doctor at my bedside, I wasn't getting better. And they had never seen that before. So they had to call the experts at UCLA who, I'm not sure if you heard about ECMO. It's a machine where you don't know about it until you have to have it. It's about basically one inch tubes that are inserted in your femoral arteries, which are your groins. And it is a lung basically that breathes for you. So it took out my blood and it oxygenated it for me and it put my blood back in me.
So I had to be intubated, attached to ECMO, which were stapled to my legs. I call it my blood tubes because blood is very hot and blood is very heavy. So I have like scars of staples from my legs. And I was completely out. And my husband said that the conversation that the doctors had with him were that like, "This is potentially very fatal." Like, "This is her last chance." And it was. I was on life support. So I went up to UCLA and I stayed there for the next three weeks where everyone was incredible. They were on me 24/7. I woke up two days later and I just knew I had to fight for myself and for my baby.
Dr. Pimentel (09:08):
They transported you to UCLA, intubated and unconscious, correct?
Katie Peterson (09:14):
Correct.
Dr. Pimentel (09:15):
And at that point in time, you basically have a machine breathing for you and serving almost like your heart as well, and you're not aware of what's happening.
Katie Peterson (09:26):
Nope. I thought I was going to die. They were debating about taking me up to UCLA or driving down to me. And the fastest way possible was driving down to me because I was in such critical condition that they had made the call to drive down to me as soon as possible and hook me up on the ECMO machine because it was life or death.
Dr. Pimentel (09:46):
Wow. Your husband must have been petrified.
Katie Peterson (09:50):
It's terrible. To this day, we still are really struggling both of us with our mental health and from those moments I get flashbacks daily and so does he. And it's just, it's very scary.
Dr. Pimentel (10:03):
Again, I am so sorry. And I know talking about this, this bring up bad memories and I'm so glad that you are alive, that you're here to tell your story, that you are giving a testimony of what can happen. But unfortunately that was not the outcome for every single person that was pregnant at the time, so in some ways you are lucky to be here. I'm glad that you're here.
Katie Peterson (10:25):
Incredibly. And one thing that happened to me, and I know it was very touch and go because the OB I was getting monitored 24/7, my baby was as well. And they were really, because babies, as you grow in your stomach, your lungs, it's already hard to breathe when you're growing a baby. So when I had gone up to the hospital at UCLA, they were telling me, you will most likely deliver here. It will be early. Your baby will perhaps be in the NICU because it will be early. I was so set on being like, "No, I can't do that. Let's get healed. Let's fight for this." I was so scared because like you said, it's not just your life, now it's another baby's life that you're bringing into this world. So I had to really fight for the both of us.
Dr. Pimentel (11:08):
Are you fighting while intubated at this point in time? You're still intubated making these decisions, maybe alert?
Katie Peterson (11:15):
I was out. Yeah. Thank God. Because the ECMO machine is no joke. It is so painful. I'm so grateful that I do believe that machine saved my life, that doctor and the whole entire team. And I'm so thankful that it was available as well because those machines aren't really available a lot if a lot of people are on them or need them. That saved my life, that machine and those doctors. So I was obviously I was out. I was intubated and my husband was helping make decisions for me and I really had to put faith in God and the doctors at that point.
Dr. Pimentel (11:51):
Many young women yourself have not thought about death. Maybe have not even had these discussions with their partner about what they would want. So what a challenging situation to be in to try to make these decisions. Ultimately you survived COVID 19 illness, thank goodness. And you left the hospital, which as we have talked about is quite rare in your situation. Some would say a bit of a miracle. A miracle of science that came together to help you and your family. Tell us about the experience of giving birth to your baby a few months later. How many weeks or months was the baby by the time the baby was born?
Katie Peterson (12:33):
Yes. So praise God, I was able to leave the hospital fully pregnant. Everyone could not believe it. All of the doctors were shocked because I think I might be maybe one of the only ones that have done that. I was, I guess, 30 weeks pregnant at the time that I left the hospital. And from there I knew I had to just get a lot of therapy, a lot of PTSD therapy, because I'd had a C-section with my first son and I knew that this was going to be a C-section as well. So I knew that I had a date to give birth and I knew that I needed to get a lot of therapy because when you get a C-section, as you know, you get a spinal and you lose feeling from basically your, where is it your waist down, so that they can give you the surgery.
And when you get ECMO put into your ephemeral arteries, you also don't have any feeling in your legs. So I really was scared of that trauma. Plus being back in a hospital, plus being back in an operating room. I was very scared to have that fear again, creep up, even though giving birth is such a beautiful thing. Not only was I asking all my doctors, well, is the baby okay, because I had to go into monitoring three times a week for this baby and myself. And I had so many doctor's appointments. I was sent home on oxygen. It was just a lot of work to lead up to the birth. So I was nervous because no one had really had a rehab plan for somebody that survived COVID so traumatizing like I had.
All my doctors were honestly like, "We are just doing the best we can with what we know and what we've learned, because you're really one of the only cases that we've had to go off of." So I'm like, "Will the baby be able to see? Will he be able to hear?" We don't know any of these things, which obviously is totally fine. Just the fact that he is healthy is incredible, but you don't meet your baby until he comes out of you. So I just feel so thankful that my doctors were amazing. They really, really monitored every single second of my process up until I gave birth. So when I did go back into the operating room to give birth to my son, I did have a little bit of panic when I was numb from the waist down from the spinal. However, thank goodness for therapy and all these amazing psychologists that helped me because I was able to have the tools to calm down and know that this is a beautiful experience versus the pain and the fearful experience that I had had previously with COVID.
Dr. Pimentel (15:02):
Wow. First of all, the fact that you deliver full term, that's amazing. And what I'm hearing from you is that they were monitoring you and the baby was doing well. You were fairly confident that the baby was okay in uterus, but still there was fear whether or not there would be some lasting problems that were not being anticipated or caught in utero, which is totally understandable. And the fear of also being numb is another one that I can completely understand as well. You were anticipating that you were going to have some PTSD in being in the operating room. Is this something that you were able to anticipate on your own or did you have some help from a professional guiding you about expectations and potentially what would happen, and then as a result, treating you in order for you to be able to better deal with that journey of delivering and hopefully enjoying your delivery and not being so fearful at the time?
Katie Peterson (15:59):
That is such a great question. I feel that I'm so thankful to have the doctors that I did because not only did they treat me physically with my sickness, but they treated me with my mental state as well. And my mental health was as important. So the fact that they did talk to me a lot about, you may expect this, you may experience this, please reach out to a therapist, was so great because I feel like that stigma of mental health conversations is still not really fully comfortable for a lot of patients.
Dr. Pimentel (16:34):
Of course, it doesn't end after delivering a baby. Now you are again, a new mom and you have a toddler, correct? And you have gone through one of the most, if not the most dramatic experience of a person's life and you dare nursing a new baby and raising a new human being. You have two babies under two, and there's still a pandemic and there's still stress. We all feel the stress. And we did not go through intubation and being ECMO. So how do you stay so hopeful during a time where it's still very challenging and was still dealing with the anxiety of being in a pandemic?
Katie Peterson (17:16):
Oh, it's so difficult. Every day I have to choose to be thankful. It makes me really emotional that you ask me that.
Dr. Pimentel (17:23):
Keep going that's okay. Take your time.
Katie Peterson (17:26):
There's a lot of hard days, but there's also a lot of good days. For example, it sounds so silly, but we take everything for granted. Like showering, I didn't shower the whole time I was in the hospital, so I probably smelled great. But for 30 plus days, I didn't get a hot shower because I had so many lines and tubes in me. And so when I shower every day, I just give thanks. I pray a lot and I just try to give a lot of grace and like to myself, but also I just try to be so thankful in everything I do.
And it's scary and it's so frustrating. It is so frustrating because I'm fully vaccinated. I'm so thankful that we're on the other side of it now, but my kids are young. They're two under two, and I gosh, I just can't wait for that vaccine for babies because that would make me and my husband both feel like, "Okay, now maybe we can go out to have dinner at a restaurant. Maybe now my kid can go play with other kids." It's so sad that we have to now be so overly cautious because I don't want anyone to go through what I went through, especially in not my family or my kids.
Dr. Pimentel (18:43):
Absolutely. Because you went through again, a terrifying experience. You almost died.
Katie Peterson (18:50):
Yeah.
Dr. Pimentel (18:51):
Can you tell us when you actually end up getting vaccinated, were you still pregnant or was after delivery?
Katie Peterson (18:58):
Absolutely. So it was very important to me to go back into a hospital 100% vaccinated, especially in an operating room. So I was so grateful that the way it worked out, time wise, I was able to get fully vaccinated, the first shot and the second shot, I would say like a week before I went in for my C-section. So it was recommended that I wait after I had COVID, I think it was a 90 day waiting period, and then I was able to start the vaccine process.
Dr. Pimentel (19:24):
Katie, is there anything else that you would like women, expecting mothers, pregnant people to know today?
Katie Peterson (19:33):
I really want people to know that COVID in not over. Don't let it all consume you, but also know that there's people like me that have gotten really hurt by it and whose families are very affected by it. So please protect yourself. Please get vaccinated. Talk to your doctors if you're on the fence about it. Learn people's real stories. Don't just read things on the internet and then run with it. Really do your research in the sense of talk to your friends, talk to your family, talk to your loved ones. Talk to your professionals who know science and who have seen it. The nurses, talk to your nurses. They are incredible and they have seen it. They mask up and helmet up and everything just to come in and give me a glass of water. It's just, they're amazing people. So I would really reach out to anyone that's gone through any sort of COVID experience and then make your decision from there. But please be safe and please protect yourself because it's not over.
Dr. Pimentel (20:28):
Great message. Thank you Katie. For being here. I am impressed by your strength. I am glad that you survive. I'm glad that you're your story. And keep sharing your story. Thank you so much.
Katie Peterson (20:41):
Thank you for sharing my story. I'm very appreciative.
Dr. Pimentel (20:49):
As we move forward, current recommendations may be updated based on new evidence. Like Katie said, it is important to continue to do quality research and talk with your doctor and other qualified professionals. We wanted listeners to have another opportunity to hear from a mental health expert about the best practices moving forward, especially since the pandemic has had such a negative impact on pregnancy and postpartum mental health. Our second guest for today's episode is Dr. Pooja Lakshmin. Dr. Lakshmin is a board certified psychiatrist specializing in women's health and the founder and CEO of Gemma, a digital platform dedicated to women's mental health. She's here today as our health expert to discuss the prolonged mental health aspects of the pandemic has had on women. On a personal note, the pandemic has brought Dr. Lakshmin and I together since 2020. And since then, we have learned so much from each other. I'm very excited that she's here today. Welcome.
Dr. Pooja Lakshmin (21:53):
Thank you so much for having me, Dr. Pimentel. I'm really excited to be here and to be able to chat about a topic that is so close to both of our hearts.
Dr. Pimentel (22:02):
So as you know, Katie, our first guest had a very emotional and very traumatic COVID experience. As a psychiatrist specializing in women's mental health, how has the pandemic impacted women's mental health overall, especially those who are expecting or those who are already parents?
Dr. Pooja Lakshmin (22:22):
Yeah, absolutely. So what we heard from Katie was really such a harrowing and terrifying experience that she went through. And though it is sort of on the extreme side of things in terms of what can happen with COVID when you're pregnant or when you're postpartum, it certainly is really important for us to be exposed to the fact that this is real. This isn't a joke. And so from my side, as a psychiatrist specializing in women's mental health and practicing perinatal psychiatry, my clinical practice is made up of 100% women and about 80% mothers, many of whom are pregnant or postpartum. And the pandemic the past two years, it's hard to overstate just how stressful and difficult it's been for my patients.
Before the pandemic rates of postpartum depression or postpartum anxiety were around 15 to 20% in the general population for people who had babies. Those numbers have almost tripled during the pandemic. I mean, there's even some studies that have shown that for moms who are either pregnant or in that first year of postpartum, that rates are close to 70% for clinical anxiety levels. So it's really a crisis. And certainly from what we heard from Katie, that aftermath of the trauma that could happen, if you have a near death experience, if you have a case of COVID that requires intubation, ECMO, all these other medical interventions, certainly you're going to come out of that a different person.
But for majority of my patients, they're lucky that it's not so severe. But the ongoing mental health burden of the stress and trauma of having to make so many difficult decisions in this pandemic world that we live in and the lack of support and the social isolation, all of that has compounded to just make it a really, really tough two and a half years. And that brings us to kind of an important point is that, how do you tell the difference? Because it seems like everybody is stressed right now. And when you have a group of mom friends and everybody's overwhelmed and everyone's stressed out all the time and everybody is kind of coping with these same issues, how do you know that what you are experiencing rises to the level of a clinical condition where you should kind of reach out?
Dr. Pimentel (25:07):
I'm glad you actually asked the question because that was a question that was in my mind. So how do we tell the difference? What do we tell our patients? What do we tell our friends?
Dr. Pooja Lakshmin (25:16):
Yeah, it's such a great question. It's probably one of the most common ones that comes up for me in my work on social media and with my patients. So in psychiatry, what we think about at the top of our mind when we're assessing somebody is what is their functioning like? How has either your anxiety or your low mood or your feelings of hopelessness or your feelings of overwhelm, how are they impacting or impeding your ability to do your job, to take care of your kids, your relationships, with your partner or other close people in your lives? How is it showing up in your day to day?
So I'll give you an example because this can be sort of abstract for those who are listening in. I had a patient who suffered from postpartum OCD. And the way that showed up for her is that she had intrusive images that were like visual images of her on the second level of her house, dropping her baby down the steps. She didn't want to do this to be very clear. It was not something that she wanted to happen. She was terrified. She was so anxious that it would happen. And the way that her functioning was impacted was when her partner wasn't home, she didn't go upstairs. She stayed on the first floor of her house.
Dr. Pimentel (26:37):
Because of the fear of harming her baby.
Dr. Pooja Lakshmin (26:40):
Exactly. Exactly. So that's an example of how you're functioning could be impacted by either anxiety in that case. In another case, it could be, you feel so guilty because you feel so let down by the fact that you haven't had the pregnancy or postpartum experience that you really wanted to have because you we're in the middle of a pandemic and everything has looked really different. So that frustration is getting turned inward, and perhaps you are beating yourself up. You're feeling like a bad person. You're isolating. You're saying no to requests to get together with your friends. Your behavior has changed because of the way that you feel. So that's kind of the most important sort of clinical indicator, because I don't want to pathologize normal fears or normal low mood. We all have bad days. We all have periods of stress.
The way that we make a diagnosis is looking at how does that actually impact your functioning? And then there's one other important piece that I'll throw out there too, for folks who are listening to keep in mind. There's a specific term that's called anhedonia, which basically means inability to feel pleasure. So while we know that the postpartum period in particular is a very stressful time because you're sleep deprived, you're taking care of an infant. You're trying to figure out how to feed this baby. All of that stuff. It's normal to be stressed and to feel at times hopeless, but you should still be able to have some moments of contentment, of joy, of love, of feeling connected to your baby or feeling connected to your partner. If that is completely absent, if there's nothing in your life that has you feel good, that's another sign that it's reached more of a clinical place and that it would be a good idea to reach out to your clinician.
Dr. Pimentel (28:43):
So if a person's experiencing lack of joy, these intrusive thoughts or feeling of anxiety or whatever it might be, that feels that is not their normal, what's the best way to reach out for help?
Dr. Pooja Lakshmin (28:57):
So your first line of defense really is your OB or your midwife because you're seeing them pretty regularly. You've just delivered. Many OB practices now have online portals. So in my experience, and you can let me know Dr. Pimentel if you feel the same way, OB providers would so much rather hear from you and catch things early than have you wait until you're six week follow up or whenever you're next, supposed to see them. So if there's anything, if you're sort of feeling even just a little bit off, just shoot a message and say, "Hey, can we schedule a telemedicine visit? I just want to check in, I've been more tearful, I've been more stressed. I just want to get this checked out." So that's your first line of defense.
The other great resource is using your network. So, really trying to find other moms who are going through this as well. And if you know someone else that you feel comfortable that you know is seeing a therapist or you know has seen a counselor, ask them. Say, "Hey, do you like your therapist? Or would you be willing to ask your therapist if they have any recommendations for someone in our city or in our neighborhood?" I have my own patients who will ask me all the time, like say, "Hey, I have a friend who's struggling. Can you give me some names that I can pass on to my friend?" And I'm always thrilled to do that.
Dr. Pimentel (30:25):
Great resources. Thank you so much for sharing those with us. I can speak from experience that having a support system, even if it's a virtual one, which at first we were not using, but because of the pandemic we're taking advantage of that, that's a resource that can be invaluable. So definitely something that would encourage our listeners to look into these virtual support groups. Now, going back to Katie, Katie has an unusual story she's a survivor, and very traumatic. What would you say is the impact of someone's life when they go through severe illness, especially a severe illness, like COVID, that was unknown to us up to about two years ago?
Dr. Pooja Lakshmin (31:08):
Yeah, absolutely. So my first thought is that we're still finding out. We're still finding out exactly from a psychological standpoint, how experiencing this type of trauma, because that's what it is. It is a trauma psychologically to go through that, especially when you're pregnant. We're just starting to understand how folks will ultimately be impacted from a mental health standpoint. I will say that there's a couple silver linings here. So one silver lining is that we know that people have babies all over the world in the most extreme circumstances. So there's some solace in sort of knowing that other women have been through this. And like you said, you used that word survivor, that Katie is a survivor. And kind of, we heard in her story how she was able to make meaning out of what happened to her. That she felt like even coming on this podcast and sharing her story, that she's able to impact and help other women who might be on the fence about getting vaccinated.
So when you're able to make meaning out of a difficult experience or a traumatic experience, that shifts the narrative for you mentally, and it becomes less painful. It's still raw. It's still a trauma. It still hurts. But having that meaning for yourself creates a reason that it happened, that you can kind of move forward with and understand that there's a positive that you can make on the world with it. So I think that's another piece to keep in mind.
I think also that with this pandemic, there's been so many different phases and the types of traumas and the levels of trauma have varied, but even, you know what I call the little T traumas. So in my practice, the patient who gets a phone call in the middle of the day, that there's been a COVID case, so daycare is closed. And now she's scrambling to try and figure out childcare and she doesn't know what to do. That's a little T trauma too, because my patients actually are hypervigilant around that. That's sort of seared into your memory of the panic of, oh my God, what if I lose my job? So I think we're only just kind of starting to see, especially for women who are mothers and women in that vulnerable time period of pregnancy postpartum, how all of these different chronic stressors, I think we can call them chronic stressors now, are going to sort of impact things going forward.
Dr. Pimentel (33:49):
Now we don't have 100% control over that, but one of the controls that we do have that we can exercise is getting vaccinated. So before we finish today, can you discuss with us some of your helpful strategies to discuss vaccination with your patients?
Dr. Pooja Lakshmin (34:06):
Yeah, absolutely. So I think that with vaccination, especially in pregnancy and postpartum, actually stories like Katie's are so powerful because it really does bring home that COVID is a serious illness and that it's something that, especially when you're pregnant or postpartum, you need to be vigilant about. So one, I think making it, not that we're trying to scare people, but we want people to understand that this is a real thing. So I take a very accessible and open ended approach when I'm talking to patients. I ask them what are your questions? What are your hesitations? What are your concerns? I really leave this as an open ended dialogue.
And in some ways it's similar to the work that I do in psychiatry, because typically my patients also, aren't happy to take an antidepressant either during pregnancy. So those types of delicate conversations where we're constantly sort of balancing risks and benefits have already been the bread and butter of the work that I do. So here with vaccination, again, we're kind of looking at the risks are quite high and wanting patients to understand when you're making these decisions, that if you do not get vaccinated, that you actually are really taking a pretty big risk. So framing it in that way, I think helps.
Dr. Pimentel (35:39):
And I would add to that, that the risk is not just physical, the risk is mental. It's psychological as well. Dr. Lakshmin, where can our listeners find trustworthy resources to help them during this time of need?
Dr. Pooja Lakshmin (35:52):
Yeah, that's a great question. So there are actually quite a few really helpful resources when it comes to maternal mental health. One of my favorite organizations is called Postpartum Support International. Their website is www.postpartum.net. They're actually an international organization that has chapters in every single state in the United States. And they have coordinators who, if you go to their website, you can find the email addresses and the phone numbers to their volunteer coordinators. And those coordinators will help you get connected with somebody like me, a perinatal psychiatrist, or a therapist or a counselor who specializes specifically in maternal mental health. PSI also has virtual support groups that they started during the pandemic that are for all different types of motherhood experiences. So they have specific groups for black moms, for LGBTQ parents, for military moms. So it's just a really great resource. Their website is really valuable.
Dr. Pimentel (37:01):
Thank you. This is very great information. So where can our listeners find you and find information about you?
Dr. Pooja Lakshmin (37:08):
Yeah, so I have an Instagram page that's called @womensmentalhealthdoc. And on it, I provide education about maternal mental health, about how to make decisions, about taking medications and answering a lot of the really common questions that come up about perinatal mood and anxiety disorders. I also talk about women's mental health in general. So again, that's @womensmentalhealthdoc. And then my website is www.poojalakshmin.com. So that's another place for resources and where you can stay connected with me.
Dr. Pimentel (37:42):
Thank you so much for being with us here today. I could talk to you for another half hour and just keep going, but I know that unfortunately, we have to end. I want to thank you for being here. Thank you for your expertise. Thank you for your advice. We appreciate your knowledge. Thank you again.
Dr. Pooja Lakshmin (37:58):
Thank you so much, Dr. Pimentel and for ACOG for putting this together, it's been a pleasure.
Dr. Pimentel (38:09):
A special thank you to the new moms who so generously shared their stories with us. Thank you to the experts who provided us with evidence based information on how parents can best protect themselves and their families. We hope that these stories and recommendations have been a source of reliable information as you navigate this pandemic alongside us. For additional information, visit the ACOG website at acog.org/covid19 or the CDC's website at cdc.gov/covid19. This is Dr. Vero Pimentel, your fellow mom, OB-GYN physician, and host of Labor of Love. You can find me on Twitter @DrVeroPimentel or on Instagram @DrVeroformoms. I am grateful for the opportunity to bring these life saving conversations to you. I hope they continue to make a positive difference in your lives. Thank you for listening. This is Labor of Love.