Show notes
May is Mental Health Awareness Month and I want to highlight the importance of finding trusted resources women can turn to for maternal mental health support through pre-pregnancy, pregnancy and postpartum. Joining me today is Dr. Tracy Shevell. We'll discuss her almost 20 years of experience in a hospital setting that led her to believe the system is broken and the how she's working to change this by creating Blue Moon Perinatal. We'll also review her 3-step process to help expecting parents feel informed and confident going into their OB-GYN appointments, whether they are having a typical or high risk pregnancy. Dr. Tracy (00:00): And I realized that most of my doctoring was being done outside of really being a doctor in some ways. It was more helping women just navigate their experience. Dr. Sarah (00:19): May is Mental Health Awareness Month. And last week was Maternal Mental Health Awareness Week. While it's necessary to dedicate a period of time to really highlight this need. It's also so important to carry on these conversations and offer women's support throughout the entire year. And that is exactly what my next guest is doing. Dr. Tracy Shevell is a maternal-fetal medicine specialist with almost 20 years of experience. And she's the founder of Blue Moon Perinatal. No matter who you are, where you live, or where you fall on your maternal health journey. There are some universal takeaways that we can all benefit from and use to find appropriate sources for support, and we're gonna cover them all. Dr. Sarah (00:58): Hi, I'm Dr. Sarah Bren, a clinical psychologist and mom of two. In this podcast, I've taken all of my clinical experience, current research on brain science and child psychology and the insights I've gained on my own parenting journey and distilled everything down into easy to understand and actionable parenting insights. So you can tune out the noise and tune into your own authentic parenting voice with confidence and calm. This is Securely Attached. Dr. Sarah (01:31): Hi, we have a very special guest on today's podcast. I'm so excited to introduce you guys to Dr. Tracy Shevell. She is a maternal-fetal medicine specialist, and she specialized specifically in high risk OB-GYN. And she is the founder of Blue Moon Perinatal, which is an amazing resource for women who are experiencing any type of high risk pregnancy or postpartum. So I'm just so excited to have you on today. Thank you for being here. Dr. Tracy (01:59): Thank you. I'm so happy to be on. I'm really looking forward to, to talking about a lot of things that need to be talked about. So thank you for bringing me in here. Dr. Sarah (02:10): Yeah. This is gonna be, this is gonna be a little heavy of an episode, but I think it's gonna be very, very juicy in a, in a kind of messed up way. And I'll explain, but like, cuz we're gonna talk about a broken system is what we're really gonna talk about today, which is unfortunate. But there are disruptors trying to fix this broken system and I feel like that's kind of what you're doing. Dr. Tracy (02:33): Yeah. I completely agree. I mean, one thing I wanna point out before we talk about the broken system is that the system is not broken and I want women that are listening to this to understand this, the system is not broken because your doctors don't care about you. The system is broken, not because your doctors are disengaged or aren't interested. It's something is beyond that. It's something that's out of most doctors' control and we'll get a little bit into sort of why. But you know, I think that it's, it's a much larger picture, like you said, and it's a system error, not a physician error because your doctors care and they're struggling as well. And so that's, you know, I just wanted to make sure that I said that before we said anything else. Because again, it's really important for moms to know, like their doctors care. And that's not the disconnect, it's, it's a much bigger issue it's bureaucratic and it's systemwide and that's really frustrating and I'm not much of a disruptor. I've been a good girl my whole life, but I've had to become a disruptor because I can't handle systems being broken and failing women. Dr. Sarah (03:47): Yes. So let's talk about like what, what you do and how you got to this. Dr. Tracy (03:52): Sure. so I, you know, as I just sort of alluded to, I sort of followed the very traditional good girl path for a long time. I grew up wanting to be a doctor, went to, you know, medical school fell in love with OB and really had a tremendously satisfying career for a very long time. I trained in the city, I worked in our community hospital and I I was at a local hospital for my entire career for 16 years and I dealt with two things. I dealt primarily with prenatal diagnosis. So I saw a lot of women where we discussed, you know, ultrasound findings. And we got referrals for patients who had abnormal findings. And we would often do, you know, tests, amniocentesis or CVS and talk about complicated issues and scary things. And then on the other side, I would help doctors whose patients had complications come up and I would help them care for their own patients to maintain that relationship that we, you know, alluded to earlier and help them manage their patients when they got sick. So if a woman had preeclampsia or diabetes of pregnancy or something else really scary going on on the labor floor or postpartum, I would get involved as a specialist and I would become that patient's team provider. So their doctor was still in the loop and was still taking care of them, but I was helping manage the situation. And, you know, I dealt with some very, very intense things and it was an incredibly, incredibly rewarding job. But you know, over the last five to 10 years, things changed dramatically and that's how blue moon perinatal came about. I started to see patients coming into my office who understood less and less why they were there, who had a more and more difficult time reaching their doctor because their doctor was now in a 10 person practice and they had to call a call center. Someone would answer the phone in, I don't know, you know, Chicago and it would take, you know, 10 layers of bureaucracy to get through to their doctor to discuss their results or discuss what we had talked about doing. And that became more and more frustrating because I wanted to make sure that the women that I saw were informed that they understood what was going on and we'd spend half our time talking about logistics. Dr. Sarah (06:12): Yeah. And these women are being diagnosed with things that are not typical. Like, you know, oh, this is my regular 30 week checkup. This is like, we're dealing with things that are scary. That can cause a tremendous amount of anxiety and fear and other types of mood issues in women because this isn't this, you know, these are very vulnerable patients that you're dealing with. Dr. Tracy (06:36): Absolutely right, Sarah. And you know, when you add to the mix, the fact that, this was a main driver for me. I started to realize that like the whole system in place for getting your care was starting to break doctors. Weren't doing solo practice anymore. They were joining larger groups. So now you'd have, you know, instead of your one doctor that was probably gonna deliver, you you'd have bigger groups of doctors. Those doctors were then being kind of encouraged. And I use that word very gently were being encouraged to, for their own, you know, sort of ability to keep up, see more and more patients. The larger groups of OB-GYNs were then being encouraged to join multi-specialty groups because the larger the group, the more pull you had with insurance companies. And now all of a sudden your relationship is so diluted that, you know, it makes it even harder. And when you combine that with the fact that we about, you know, 10 years ago, started to be tasked with really paying attention to the fact that one in seven women during pregnancy will be diagnosed with a mood or anxiety disorder. Now, I don't wanna, you know, curse on your podcast, but now we've really got like a crap storm. Right. So we're in this system now supposed to also check to make sure if by the way, are you depressed or anxious about the news you've been given or just about your pregnancy, and we're not really prepared to answer the questions. So you put those two things together and you've really got a perfect storm. So I, you know, I started working in the system where I wanted to do more and more. I had a huge toolbox of mental health resources and holistic resources, and it just was becoming impossible to use them within the system. Dr. Sarah (08:29): Yeah. Because, so what you have like 15 minutes with a patient. Dr. Tracy (08:33): It's, you know, and I even had the luxury of having more time. I worked for a hospital, so I didn't have to see 50 patients in a day, but the patients that I saw just needed so much education and so much more than I was able to give, you know, I just was giving out my phone number, constantly talking to patients, you know, all the time. And it was about things that just, you know, were super basic. Like just having an empathetic listener or having someone re-explain what had been explained in lay terms one more time. And I realized that most of my doctoring was being done outside of really being a doctor in some ways. It was more helping women just navigate their experience. Yes. And then I realized, why not make this, you know, COVID hit, we went online, the mental health system went online. And I thought to myself, this could really be an opportunity to change the system really from the inside out. Dr. Sarah (09:37): Yes. And it's, it's interesting cuz like you and I both treat perinatal mood and anxiety disorders, but we come at it from such a different place. And even just the people who come to us are probably slightly different. And I'm so curious, like I wanna know about Blue Moon Perinatal and like what, because you are this amazing hybrid of, you know, you are an OB GYN with a tremendous knowledge, like field knowledge of like some of the scariest stuff that can happen in pregnancy and in postpartum. But you also, like, we both did the Postpartum Support International like intensive training in perinatal mood and anxiety disorders. And I was like, it's so nice to met an OB-GYN who is trained in that because it's very rare. Dr. Tracy (10:26): Thank you. Yeah, I think so. So to that point, you know, there are places in the country where they have reproductive psychiatrists and a lot of OB GYNs, you know, have had a special interest in mood and anxiety disorders. However, for me, it was a very natural extension of 20 years of giving bad news or being there in a scary time or, you know, just being part of a very emotionally intense situation. And I found that, you know, my, the hybrid of sort of information that I've gained over the years, both about psychology and about medicine is, is something that allows me and, and I too am a mother and have gone through some really scary times myself. And so knowing that I had sort of that hybrid, I felt that blue moon perinatal really had a special niche. And there are going to be many things that come in to try to disrupt the system that are app based that will help patients kind of try to navigate the system. But Blue Moon Perinatal is something that is very unique, I think. And I hope because it's so intimate and it's really woman to woman or woman to partner. I always say, if you wanna bring your partner online, like that's one of the benefits of having a practice like I do. And my practice is not one or the other. It's both, you know, I offer women, the clients that I am looking to engage are women who really just feel lost. You know, whether they've received a diagnosis or they really just want extra support to kind of say, okay, let's let's center, you know, what do I need to look at at the next visit? What do I need to ask my doctor? What does this test mean? How do I handle feeling anxious right now? It doesn't necessarily mean that I'll do your therapy but I'm gonna be your cruise director. You know, I'm gonna, I'm gonna be your high class, overly trained cruise director who can really speak to your medical fears, your medical concerns, but also help you with your emotional needs too. And I think you're right. I think it's a unique combination of interests, but it's why I feel like this is such a passion project for me. Dr. Sarah (12:50): Yeah. So let's get clear on what exactly that you do. So if people are listening, they can like look, cuz this does not exist really at all, what you do. And so like my understanding and correct me if I'm wrong is that women who are experiencing some type of diagnosis in their pregnancy that they need help understanding whether it's mundane or very, very scary, and that's subjective, frankly, but who feel like they need more, you know, medical advisement than they can get with their doctor, who they would still continue to see. Right. You still, they still have their OB who's gonna be, you know, managing the pregnancy from a medical perspective, but you are like this adjunctive support that can, that basically consults and helps people process what's going on and then connect them to the resources that they need. Is that, am I getting that right? Dr. Tracy (13:48): That's a great, absolutely right. So the way that I work is I offer either one session, if somebody has a directed question or I offer five hour packages of time where, you know, a client can use those five hours, however, they wish to spread them out into 15, 30 minutes, 45 minutes. And then I offer a larger 10 hour package where if somebody wants me to be involved for the whole pregnancy or they have a really intense issue and that time is yours to use. And I want women to sort of think of me as you know, there, what if, what if your best friend happened to also be a doctor, that's really what I want to be viewed as. I know it sounds weird to become best friends with strangers, but in the era of social media, you make relationships with people that you never even sort of meet. And now zoom has added a crazy element to that. So, just to give you an example, I've had clients call me who have who are struggling through infertility treatments and just need an ear. They need someone to help them sort of oversee sort of what they're going through and what are they missing, or maybe they just need to vent, or maybe they need help finding a therapist or someone who's seen the big picture. Some of my clients have medical issues. They've had either complex pregnancies in the past, or they have a preexisting mood disorder. I'm not afraid of any of that or I have a lot of people are. And I love people who do the work that you do, Sarah, because it's so important. And it's so, so, so needed right now. I also have clients who struggle with with situations, for example, you know, I have a client who I'm, I'm working with right now who is dealing with sort of decision making about how to pursue a next pregnancy, or how to pursue family planning, because she's had some complications in the past. So when a client signs up to work with me, we, I will not be their doctor. I go completely based on the patient's history, if they need to show me a lab result or, or show me something on a portal, I will look at it, but I do…
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