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Preparing Your Mental Health for Parenthood: TTC and Pregnancy Edition
Let’s face it: Trying to conceive can be stressful, and pregnancy can bring with it its own set of anxieties before baby even arrives. In this episode of From First Period To Last Period, Kristyn sits down with Caledonia Buckheit, M.D., an OB/GYN practicing in Raleigh, North Carolina, to discuss how you can mentally prepare yourself for the potential ups and downs of TTC, and why mental health is so important to prioritize during pregnancy (and beyond). Brought to you by ??Rescripted?? and ??Trilastin??, creators of scientifically backed skincare solutions that nurture and treat your skin throughout your pregnancy journey and into motherhood.
Published on July 9, 2024
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S11 EP3 - Preparing Your Mental Health For Motherhood: Audio automatically transcribed by Sonix
S11 EP3 - Preparing Your Mental Health For Motherhood: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Intro/Outro:
Hi, I'm Kristyn Hodgdon, an IVF mom, proud women's health advocate, and co-founder of Rescripted. Welcome to From First Period to Last Period, a science-backed health and wellness podcast dedicated to shining a light on all of the women's health topics that have long been considered taboo. From UTIs to endometriosis, we're amplifying women's needs and voices because we know there's so much more to the female experience than what happens at the doctor's office. With From First Period to Last Period, we're doing the legwork on your whole body so you can be the expert in you. Now, let's dive in.
Kristyn Hodgdon:
Hi everyone, and welcome back to From First Period to Last Period. I'm your host, Kristyn, and I'm here today with Dr. Caledonia Buckheit. Hi, Dr. Buchheit.
Dr. Caledonia Buckheit:
Hello, thanks for having me.
Kristyn Hodgdon:
Absolutely. Dr. Caledonia Buckheit is an OB/GYN practicing in Raleigh, North Carolina, and today, we're going to be talking all about how to prepare your mental health for parenthood, specifically around gearing up for that trying-to-conceive journey that may be more difficult than you expected, or maybe pregnancy after infertility or loss, or even just what is some of the risk factors for postpartum mental health conditions and so on and so forth. But really, I'm just making sure everyone listening is prepared ahead of time because I know I wasn't so excited to dive into that with you today.
Dr. Caledonia Buckheit:
Yeah, I'm excited to be here. I think this topic doesn't get as much attention, but it is very important for moms and growing families.
Kristyn Hodgdon:
Absolutely. So when you have a patient who comes to you saying that they want to start trying to conceive, do you typically prepare them about the mental-emotional component of that? Because I know someone in my life is trying to conceive right now, and she's on like month two, and she's I didn't realize all that went into this like ovulation strips and tracking your temperature and all this stuff has regular periods, but she's not getting positive ovulation. And it's not so straightforward as what we're taught in sex ed, which is if you have sex, you will get pregnant.
Dr. Caledonia Buckheit:
I think I do a lot of normalizing that this process is hard. And like when I have an initial consult with someone who maybe is a few months into trying to conceive and realizing, oh, wait, this is not as straightforward. Just think, I say, this is a lot. I say that a lot because it is a right and normalizing that this is a lot to be going through and a lot to manage. So I feel like that is an important piece of what I do, and just validating that when people come to me, yes, like I recognize that this is not a walk in the park.
Kristyn Hodgdon:
Yeah, absolutely. So, what advice do you typically share in those beginning stages?
Dr. Caledonia Buckheit:
I think, so if I think about an initial discussion with someone, whether they even actively dove into trying to conceive yet, or if they're still thinking about it and preparing for trying to conceive, or if they're coming in and they have been trying for a couple of months, like those visits. I like to think about optimizing maternal health, leading to trying to conceive and while trying to conceive. And so we'll talk about things like what medications they are currently taking, what medical conditions are currently being managed, what supplements they're taking, and go over that information because there's definitely room for optimization. I think there's also a lot of fear around what you should or shouldn't be taking or shouldn't be doing when you're trying to conceive, and going over some of that information early in the game is something I try to do.
Kristyn Hodgdon:
That's so important because we were talking a little bit offline. Still, so many people are on anxiety medication for anxiety and depression and think that the minute they start trying to conceive or the minute they get pregnant, they need to stop those medications. But what is the truth of the matter? I know that mental health is so important during this process. So, are you still allowed to take those medications?
Dr. Caledonia Buckheit:
100%. So if you are taking medication for anxiety, depression, OCD, OR any mental health condition, you should definitely continue taking the medications that you have been stable on and working with your psychiatrist, therapist, or physician who's been prescribing those medications to be on like the most effective regimen for you, and do not stop that just because you're trying to conceive or just because you get a positive pregnancy test. Keep taking your medication, and then come and see your OB/GYN, and we will talk to you. And more than nine times out of ten, 99 times out of 100, it is 100% fine for you to stay on your current regimen. Occasionally, we'll tweak things slightly, like, oh, you're on Lexapro, but you did just as well on Zoloft. Maybe we'll make that switch because you were recently on that one, and there's slightly more safety data, like tiny tweaks like that. But at the end of the day, for the vast majority of patients, the medication regimen that they're on for their mental health is only going to be beneficial when trying to conceive and during pregnancy.
Kristyn Hodgdon:
Absolutely. And I think it's not commonly talked about, but there are perinatal-mental health conditions during pregnancy. I know with my first pregnancy, I didn't get diagnosed, but I felt a sort of perinatal depression. I had just come off of it along a fertility journey. I was finally pregnant, but I felt like I couldn't tell anyone. I was sick to my stomach. I like just all the terrified of miscarriage. There was just this underlying blah to it all, and then I felt guilty for feeling that way because it had taken me so long to get pregnant. Anyway, I think it's important to review some of those warning signs because they can happen, especially after trying for a long time, or maybe you haven't been medicated, but you have been dealing with anxiety and depression in the past.
Dr. Caledonia Buckheit:
Yeah, I think, like the trying to conceive journey, and just in pregnancy, there are so many symptoms that arise that can make you feel worse overall. And so for maybe someone who'd been like making it along, having some mild depression, some mild anxiety, they're trying to conceive journey and or the pregnancy symptoms and reality of pregnancy can be like the straw that breaks the camel's back. It pushes you to need a little bit more support than maybe you did pre that journey. And so I talk a lot about people in pregnancy. If they haven't already established a therapist, like just people talk a lot about postpartum. I think we've gotten better about postpartum depression and like the warning signs and if you like that and ... depression screen and like all of that, like that. I think we're getting better, and that's more well-known, like about postpartum depression and anxiety, but the prenatal piece and the preparation for that, I think, is also equally important. And for anyone who voices these concerns or we're talking about this area, I think establishing with a therapist early on, even if it's someone you see once a month or you have an established meeting where you get to know the person, you have their contact information, because I think that activation energy when you really need it, and you're really feeling bad, is hard at that moment to figure out all the coordination of who I will see. How am I going to see them? Do they take my insurance? All of that stuff? It's really nice to have that done on the front end. And even if it's someone you rarely touch base with, they're primed and ready for you if and when you need them later on, and they are not afraid to do that.
Kristyn Hodgdon:
That's great advice because there are these periods. I haven't publicly said this yet, but I'm pregnant right now, and yay! And I'm remembering. I guess I was pregnant almost six years ago, but there are so many lulls in doctor's appointments that I was lucky—the silver lining of fertility treatments. I had ultrasounds every week, starting at five and a half weeks. But then you hit a point where you're going to go to the regular OB/GYN, and you are getting fewer and far between, and that anxiety starts to build up, and it's, you need someone to talk you down in those moments of, and maybe I'm a unique case because I've experienced miscarriages and infertility, but I still think any normal person has that. If you get pregnant and you find out at four weeks, you're not going to the OB/GYN until nine weeks. With a long time to sit in your own thoughts.
Dr. Caledonia Buckheit:
No, I also think that talking about the prenatal care schedule with your practice or your prospective practice is important. I have a friend who is early in pregnancy, and she was calling around and wasn't going to get in for her first ultrasound until 10 to 12 weeks, which I think is the case for some practices. In my practice, we get a confirmation like viability scan earlier, like at the 6 to 8-week mark, like is this a viable pregnancy, right? Because you may have a positive pregnancy test and you've gotten a period. So you're like, I think I'm pregnant. But if you're waiting all the way till 10 or 12 weeks, there are a lot of question marks there, so ask around and find a practice that's a good fit for you. You may need a little bit of extra support early on, and especially for our patients who have experienced loss, we definitely will do just heart ... checks, right? Okay, you experienced loss previously. Let's make a schedule that you feel comfortable with. But then also yeah, like having somebody to talk to, okay, what are the facts? What are the facts of your situation? Like you said, talking you off the ledge having that resource.
Kristyn Hodgdon:
But you brought up such a good point because after my miscarriage, ... was two years ago, I decided to switch ... because in my previous practice, I gave birth to my twins with them. They were four, like men in their 60s. And, like, when it came to my emotions, they were great doctors, but like, when it came to the emotional component, I was like, I think I need a woman. I think everyone's different, and I'm like, I really think after this loss, if I were to get pregnant again, I really need that compassion of the heart. This is hard.
Dr. Caledonia Buckheit:
Yeah, I think finding a good fit for, like, where you're at with your pregnancy is really important. And I think I live in Raleigh, North Carolina, we're really lucky that we have lots of really great practices in an area, and I genuinely feel like anyone who's pregnant in this area can find their perfect fit in a practice or find a good fit. And I know that's not like people may live in more rural areas and have fewer options. I recognize that, but I think if you live in a pretty highly populated area, look around and find the group and the providers and the doctors that you vibe well with that you feel are meeting you halfway with your concerns or your history.
Kristyn Hodgdon:
Yeah, because when you, if something does happen down the line, I end up going into pre-term labor. And like when push comes to shove, you don't want to feel like you're walking on eggshells, like getting those extra checks or getting those, but you want to feel like, okay, they're going to bring me in no problem because they know how scared I am. This is my first pregnancy. You guys need to find the right care team. What else? Speaking of pregnancy after loss, is there any like specific advice that you give to patients to give them a little bit more peace of mind?
Dr. Caledonia Buckheit:
Pregnancy after loss is so hard, and especially, I think there are so many different flavors of pregnancy after loss, whether it's a history of recurrent miscarriages, a second-trimester loss, or a stillbirth; there are just so many different scenarios. And I think just, really, and this is a little bit on the patient to just try and figure out, even if whether it's talking with a therapist, a friend, writing it down, what are the things that you're most afraid of or most worried about, and communicating that with your care team? Because it's not going to look the same for everyone. So I'll have a patient who said I had a loss at 14 weeks, and I didn't know about it for a whole month because I had my new OB visit at 10 weeks. I had my confirmation at six weeks. Everything looked good at those two ultrasounds, and then I didn't have another ultrasound until my 18 or 20-week anatomy. And then, I found out that my baby had stopped growing at 14 weeks. So if that's your loss story for that person, what they might be most afraid of is that I'm going to have another loss and that it's going to go undetected. And so for that patient, that might be the person we set up a plan for every two weeks coming in for heart tones in between so that we don't have that big gap. And so it's going to look different depending on the loss history. But thinking about, okay, what happened, and what am I afraid of happening again? Because then you can make a plan.
Kristyn Hodgdon:
Yeah, I love that because we have these specific fears. Yeah, for me, my pregnancy loss was a blighted ovum, so I went to my first scan, and there was a sac but no heartbeat. That heartbeat confirmation for me was like so big. Even now, appointment to appointment, I'm like, is the heart beating? I'm just like, is it there? Yeah, what else? So, what about anxiety related to childbirth? Because we talked a little bit about birth trauma in a previous episode. When that happens, or maybe a first-time parent, that can be scary. How do you address the whole idea of a birth plan and all of that stuff?
Dr. Caledonia Buckheit:
Oh, this is such a good topic. I think this is, so it's a hard thing to talk about because it's planning for something that inevitably you can't control, right? Because we don't know when the baby's going to come. We don't know how they're going to come. There's a lot of unknowns, a lot of things up in the air. But we also, I think, really desire a plan because it is something that's scary. It's something that's new, especially for first-time parents or people with a history of trauma, and they have specific fears or concerns about what happened the last time. I think my main advice is to take it as it comes, right, because there are so many different things that could happen. And so having education about the different possibilities, like the suite of ways that babies can come into this world, and having some familiarity with some a range of experiences and a range of possibilities so that then you feel more able to take it as it comes and more comfortable with taking it as it comes, because you've heard about it, you've talked about it, you've thought about potential realities.
Kristyn Hodgdon:
Yeah, if this happens, then we'll do this or if that happens, then we'll do that.
Dr. Caledonia Buckheit:
So a good example would be someone who had maybe had a C-section with their first baby because their baby was in distress and they had an urgent emergency; say that's their birth history, and they want a vaginal birth this time. And so their birth plan is probably going to be around vaginal birth and what we can do to promote vaginal birth, what we can do to do that safely, and how we can make that plan. But then, on the other hand, talking about, okay, well, if the baby's in distress this time or if the baby's not in position and is breech this time, what would a C-section look like? And how could we optimize a C-section experience if that has to be the case this time? In the probably 20% chance that happens, there's a good chance you're going to be able to achieve that vaginal birth, but there's the potential that we end up with a C-section, and how could we plan and talk about that? That's just an example. But I think that can set for a little bit more success. So they're like, I have my focus and my energy on what I want to be the plan, but also having some if this, then that, if this, then that. These are the things that are important to me. If we had an unexpected C-section, it's really important that my husband is there or that I must see the baby right away. It's based on whatever had happened in the past or whatever they're worried about.
Kristyn Hodgdon:
Yeah, I love that advice. Yeah, it's so hard because it's hard to not, especially like your second time around, it's hard not to have past experiences to inform your next experience because I ended up having an emergency C-section with twin B after birthing twin A vaginally, I know, And, yeah, I know, nothing was easy, but we, ... this time, I'm like, oh, I've had a successful vaginal birth. Could I do that again? But then the unpredictability and the idea of that emergent situation is really anxiety-provoking for me. I haven't decided yet, but it's like if the unpredictability will make me super anxious until I'm 39 weeks, do I want to, or do I want to schedule a C-section? And I think you have to weigh that for yourself because there's no right or wrong answer.
Dr. Caledonia Buckheit:
Right. What are you most worried about, and what's your highest priority? Those are like the two questions when making that call, based on that. I do think one thing is a little bit about my story, but my second baby was born at 27 weeks with an emergent delivery because I had listeria, so I didn't have a birth plan per se. First, I was only 27 weeks old, so I hadn't gotten that far into it, but I knew how my first baby had come, which was, unfortunately, it was like a failed induction. I ended up with an unscheduled C-section, but every, all was well, right? There was no, and it wasn't particularly scary. It was more just disappointing, but at the end of the day, it was great. And so I had that experience. And so I had a pretty good sense, okay, I'm probably going to have a similar birth experience this time. I think a lot of the birth trauma from my second delivery, and there were many facets to it, but part of it was that loss of the expected outcome. Like I had to grieve the loss of the birth I thought I was going to have. And so, not that can be prevented necessarily, but I think, like, I just hadn't even given any type of consideration to the fact that I might have a pre-term birth, which is so silly given what I do. I see preterm birth all the time, but I was like, I don't have any risk factors for that. I've had a term birth before, so why should I even think about it? And I think maybe had I given more consideration to that, it wouldn't have been so shocking. It was so shocking to have lost what I expected or had planned for.
Kristyn Hodgdon:
Yeah, and then you see images on social media of people holding their baby after, like their perfect vaginal birth in the hospital bed. Yeah, that did, not how it went for me. And yeah, it can keep you up for a postpartum mental health condition. So you have to be careful with that too because, I don't know, I feel like it can be like a domino effect a little bit.
Dr. Caledonia Buckheit:
Yeah. No, absolutely. Birth plans are important. It is important to think about the ideal situation and what you would want to happen in that ideal situation. But also, keep in mind, babies are totally in charge in a lot of ways, and there's a lot of unforeseens, and thinking about other possibilities and how that would look, and things that would be important in those scenarios, too.
Kristyn Hodgdon:
Yeah, love that. Are there any specific resources that you typically recommend on the road to parenthood for your patients?
Dr. Caledonia Buckheit:
One thing I wanted to mention, and this is a little tangential, is that we were talking about medications and feeling comfortable with medications that you're taking while you're on the journey or thinking about trying to conceive, you are trying to conceive, you are early pregnant, and maybe you're in that period of time where you're not seeing a doctor all that frequently. One resource I love is MotherToBaby.org. I don't know if you've ever used their search engine, but they're an evidence-based resource that pulls together all of the research that we have on medications in trying to conceive pregnancy and postpartum breastfeeding. And so it provides you with a summary of what we know about the medication in all those, through that whole course and then provides the references of the studies at the end. And for someone who says is taking, they're like, okay, I take Prozac and I'm trying to conceive, they can go on mothertobaby.org, they can search Prozac, and they can read. How could this impact my fertility? If so, how could this impact my early pregnancy? If so, how? What is this going to look like throughout pregnancy? What is this going to look like in breastfeeding? What do we know? And most of the medications that we're taking for anxiety and depression have been around for a long time. And so even though we don't have randomized controlled trials where we're randomly assigning pregnant women to take it or not, we do have pretty robust data on a lot of these medications. And I think it can be really reassuring to somebody who is managing their mental health with medication assistance to read about that and just be like, what are the objective facts? Instead of just being like, oh my gosh, I'm sure it's bad for the baby or bad for trying to conceive.
Kristyn Hodgdon:
Yeah, it's funny, I just heard about this site earlier this week through Emily Oster's email list. Yeah, she wrote Expecting Better and Cribsheet, I believe, and actually, she has a new book out about unexpected pregnancy challenges. But she was mentioning that and mentioning how you can actually participate in certain studies that they're doing about, I think it's anecdotal studies, you don't have to take medication or anything, based on what you're already on.
Dr. Caledonia Buckheit:
Yeah, exactly. Yeah.
Kristyn Hodgdon:
Yeah.
Dr. Caledonia Buckheit:
But the, phenomenal resource, and I sometimes like, depending on if I'm doing a new OB visit and I'm looking at someone's med list, I'll look up if it's a medication I'm not as familiar with, I'll use MotherToBaby.org so that I'm able to get a quick summary of the most important facts for pregnancy. So that's a really helpful resource, and I think can be reassuring so that you don't have to stop. Not only are most medications compatible with pregnancy, breastfeeding, and trying to conceive, but there are also real, quantifiable risks to untreated mental health disorders during pregnancy. So, we know that women who have untreated or poorly managed mental health disorders during pregnancy are more likely to experience preterm birth, low birth weight babies, and NICU admission. So these are real, quantifiable problems that we see if mental health is not taken seriously. So you can feel empowered that you're doing the right thing in continuing to manage mental health issues while you're trying to conceive and being pregnant.
Kristyn Hodgdon:
It's so important. One of my biggest anxieties has been my autoimmune condition. I feel like that's so prevalent now. I have a thyroid condition, but obviously, there are many others. Do you see that a lot? Is that a valid fear? What do you typically advise for patients with autoimmune conditions?
Dr. Caledonia Buckheit:
Yeah, I think it depends on the autoimmune condition, because there are some, such as antiphospholipid antibody syndrome, right? That's gonna have a very specific management strategy that will be important for helping you get pregnant and stay pregnant. Things like autoimmune disorders of the thyroid, for example, like very important to have a plan with your endocrinologist so that your endocrine can make sure that you have optimal management because that optimal management of that medical condition is what's going to help improve your pregnancy outcomes. I think it depends a little bit on the condition, whether it's going to be like an endocrinologist managing it, primarily your OB/GYN managing it, primarily a hematologist managing it, but just optimal medical control of those conditions, of course, is going to help with pregnancy outcomes.
Kristyn Hodgdon:
Yeah. No, that makes sense. Yeah, it's just, I feel like your body is attacking itself sometimes, and then it's like, why wouldn't it attack? It's just, then there's this foreign object in your body, and it's hard not to think...
Dr. Caledonia Buckheit:
I don't know if you follow Lucky Sekhon, one of, yeah, amazing, but she is a reproductive endocrinologist and fertility specialist. She was talking about how we think about that with the immune system, and we get nervous like this, our immune system will attack the pregnancy, but the immune system also does important things that are helpful for pregnancy too. And so, just like, the answer is, let's dampen down the immune system. And she was just ... in a really accessible way, and I was like ...
Kristyn Hodgdon:
Thank you for sharing that, love it. What else? So I always like to ask, before we wrap up, what would you rescript about the way people think about starting to try to conceive, pregnancy, and preparing for that postpartum period? Just, there is an element of lack of control in a lot of ways. But like, how can people make a plan for themselves that puts them in the best position possible?
Dr. Caledonia Buckheit:
I think one thing that we should rescript about trying to conceive is that notion that we learn in sex ed that getting pregnant is, if it happens, if you have sex one time, right, and ignoring the fact that there is a menstrual cycle to understand and ovulation to understand, and reproductive anatomy and physiology, that has to be taken into account to successfully conceive. And so I encourage a lot of my patients who are, maybe their timeline to conceive is in the next couple of years, but we'll talk about, okay, you're on birth control pills, say, so I'm going to want you to stop taking those three months before you're ready to actively try to conceive, and you can use barrier methods or something else in the interim for contraception so that you can familiarize yourself with your cycle. What are your cycles like, and what are they telling us about your fertility? I think just rescripting that idea that you can just, if you're not using birth control, you will get pregnant, but instead it's, you use birth control for a purpose, but when you want to understand your fertility and get pregnant in the near-ish future, sometimes it can be important to give yourself time and space to learn about your fertility.
Kristyn Hodgdon:
Absolutely. And then when people have been trying for a while and come to you and say, okay, it's been six months or nine months or a year, what's your advice at that point?
Dr. Caledonia Buckheit:
At that point, it's about a kind of confirmatory testing to figure out if you have all the aspects required, like normal ovulation, normal sperm, and a normal anatomic place where they can meet, right? Answering those questions, that's how I started that initial conversation, and then really going from there.
Kristyn Hodgdon:
Yeah, yeah. There's always a next step that you can take, and well, knowledge is power.
Dr. Caledonia Buckheit:
Exactly. And I'm like happy to see people talk about where they're at. The other thing I would rescript is the idea that you have to try to conceive for 6 or 12 months before you can see an OB/GYN or an REI because that's only true if you're totally healthy, your partner is totally healthy, and you have normal regular cycles that are predictable every month with no concerns. But if you're telling me you have like severe painful periods, you have irregular cycles, right? Your partner uses tobacco and has a chronic medical condition, right? That's not you. Don't wait six months or a year before coming to see us, and so, rescripting that idea that you have to wait before you come and ask questions.
Kristyn Hodgdon:
That is music to my ears because I had a long fertility journey the first time around, but, I am grateful that my OB/GYN at the time, I had come off the birth control pill, three months went by, didn't get my period back, got diagnosed with PCOS, sent straight to a fertility clinic and yeah.
Dr. Caledonia Buckheit:
Someone with the attention and the expectation of telling you what was normal and what was not, right?
Kristyn Hodgdon:
Yeah, I still wish I had known, I'd gotten off birth control sooner and known sooner, but just having that leg up of not having to wait that 12 months, because we would have been trying for 12 months without me even ovulating. But I'm like, yeah.
Dr. Caledonia Buckheit:
No, don't, please don't wait 12 months. You don't have a, there's no chance you can get pregnant if you're not ovulating. So you're not getting ..., there's no way.
Kristyn Hodgdon:
I am embarrassed to say that I was like 27 years old and married before I realized that you had to ovulate in order to get a period, and you had to ovulate in order to get pregnant.
Dr. Caledonia Buckheit:
Again, really, it's dropping the ball for a lot of us, I think, because it's not common knowledge. I don't think I knew until I was in medical school that you had to ovulate to get a period. Nobody ever, I didn't know, I didn't understand the menstrual cycle.
Kristyn Hodgdon:
Yeah. And yeah, and I'm realizing through my friend right now who just started trying to conceive that even for people who aren't in an infertility clinic setting, it's more complicated than I think society lets on and media and all of that. And it's, and the male partner that is 50% of the equation, too. There are just so many things that we don't talk about.
Dr. Caledonia Buckheit:
Normalize the semen analysis.
Kristyn Hodgdon:
Exactly, exactly.
Kristyn Hodgdon:
Yeah, just do your research, be prepared. Although sometimes it's funny, I was going to say this during the birth plan talk, but sometimes I don't like to over-research because I don't want to know too much. Knowing too much is anxiety-provoking too, whatever your level of comfort is.
Dr. Caledonia Buckheit:
Right down those different paths. I had someone today who was like at 27 weeks pregnant, and they were like, so if my baby's breech and then we do a version, I'm like, why, no, we're not there. Let's not go down that whole route because your baby probably, but yeah, it's a fine balance.
Kristyn Hodgdon:
Absolutely. My therapist calls it productive worry versus unproductive worry, which I thought was a cool way to frame it. Thank you so much, Dr. Buckheit. This was so informative, and I think we'll help a lot of women and couples. I appreciate your time.
Dr. Caledonia Buckheit:
Yeah, thank you so much for having me. This was awesome.
Kristyn Hodgdon:
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