Latest / hol+ with Dr. Taz MD | The Future of Medicine is Holistic / The Fourth Trimester: What Really Happens After Birth (and the Postpartum Truth No One Talks About)
Transcript
- (00:00) There's so much excitement about pregnancy, about delivery, but there's not a lot of talk about the postpartum period when moms go home with a baby that they have to take care of, often for the first time. Postpartum is one of the most challenging transitions that women will face in their journey. And unfortunately, we as clinicians, as a community, as a medical culture, do very little to support and educate moms about what that postpartum period looks like. (00:35) In this episode, I want to dive into postpartum recovery and care and help women understand and even the women around them understand what our bodies are going through physically, mentally, and even emotionally. It's a challenging time with all kinds of adventures. And even when I think back to my personal postpartum period, I had two very different experiences. (00:59) One where my husband to this day says I looked like I was depressed and another one where I was up and moving around within just a few days. So again, it's a lot about how we educate ourselves, care for ourselves, build our communities, and build the support that we need to transition into this really important but draining stage of life. (01:21) Okay, before we jump in, quick health check. Are you subscribed yet? You'd be surprised how many people forget the one click that actually helps them feel better every single week. Go ahead, hit it. At Whole Plus, we turn science into self-care that you can actually use. Let's get started. So, let's dive into it. (01:40) What is happening to our bodies when we deliver that magical baby? Well, there are all kinds of physiologic changes going on. Everything from our hormones dramatically plummeting. As soon as we deliver, the levels of hormones like progesterone and estrogen and testosterone all fall, leaving us feeling shaken, a little bit off, absolutely fatigued, and just struggling to get through the day. (02:09) In addition to that, when we look at the literature and the research, there's so many other things that even I didn't realize are happening to our bodies. First of all, fluid is being lost over a period of time. But a lot of us, and this happened to me, I left the hospital puffier and more fluid dense than when I went in. (02:28) And that reflected in my weight. My weight was actually higher when I left than it was when I went in. And that is because the process of getting maybe an epidural, if you've had a C-section, any of these procedures, changes the fluid dynamics in the body, as does delivery. So, when you're leaving in the hospital in that postpartum period and going home, there are rapid shifts in fluid volume. (02:52) But that fluid volume shifting is not really complete until about six months, until the baby's six months and you're at that sort of postpartum six month time stamp. So again, imagine how you might be feeling as some days you wake up and you're puffy, some days your legs are so swollen that you can't get up and down the stairs. (03:08) These are real things, by the way, that happened to me. But all of this is stuff that I don't remember being educated on and I don't think women are educated on today. Something to keep in mind. We also know when it comes to the postpartum period that our tissues because of that rapid drop in estrogen and progesterone and some of the other hormones, our tissues are dry. (03:31) That means our mouth, our vaginal area, our hair, our skin, all of these things feel very dry. And again, add to that element of not wanting to have sex, not wanting to kind of like get out because you don't feel like yourself. And then from just a pure cosmetic standpoint, your hair's changing, your skin's changing, and it all can be a little bit shocking and disturbing and at the end of the day impact your self-esteem and your self-perception. (03:56) Now, let's add breastfeeding and lactation on to this. That's a change in hormones, too. Now, what's happening is oxytocin, kind of the love hormone or the bonding hormone, is going up. And that oxytocin in turn has a lot of positive characteristics. It connects us to our children and to our babies. (04:15) It makes us feel like in a more calmer sort of more nurturing state overall. In fact, they we actually have studies that talk about oxytocin and the suppression of cortisol as oxytocin rises. And in clinic, oftentimes we've used oxytocin for extreme anxiety or depression as a way to help somebody who's not even in a postpartum period of time calm their nervous system down. (04:37) So, we've got this physiology of dropping hormones, rising oxytocin, fluid shifting. I would love to be done, but I'm not. There's more that's happening. You know, again, the endocrine system is is the endocrine system is literally flipping all over the place. Most women that are not breastfeeding will return to getting a cycle roughly in about 3 weeks or so. (05:02) If you are breastfeeding, then often times your cycle can return at that 3 month mark. Now, technically, breastfeeding is supposed to support natural contraception, but often times it doesn't work, and that's where women find themselves surprised when they're breastfeeding a child and turn around and are pregnant again. So, just a warning about that as well. (05:24) Further, your blood sugar levels and your metabolic rate changes as you deliver and go into the postpartum phase. Now, this is where it gets very variable. women that have already had a problem with insulin sensitivity and blood sugar continue to have that issue as they move into the postpartum period. Now, that kind of makes sense because we've talked a lot in the past about hormone shifts and how hormone shifts impact metabolic rates. (05:51) And when you have a hormone shift, if you're somebody who historically has had PCOS or pre-diabetes or any of these blood sugar conditions, as you move into the postpartum period, losing weight becomes very difficult because your insulin sensitivity continues to be blunted. For people that have not had that issue, they seem to lose weight at an appropriate range, roughly a couple of pounds a month. (06:15) Some people lose more rapidly than others, but I have sat with so many women who feel pressured to lose all of that baby weight within six weeks or three months, and it's not happening for them. And the reason it's not happening is that they may have a different insulin sensitivity and metabolic profile than their counterparts. (06:36) So, I'm saying this to urge women to not feel desperate or anxious if they are not losing weight at the same rate as maybe somebody that you know because we're all very different when it comes to the rate at which we lose weight in the postpartum period and it's all connected right back to our blood sugar and our insulin sensitivity. (06:55) All right, moving on from that, there's some other things happening in the postpartum period that are important to understand with the gut. As those hormones decline, specifically progesterone, gut motility slows down. Again, this is very similar in some ways to what's happening in menopause or pmenopause where the hormones plummet and the gut gets sluggish. (07:14) Well, same idea in the postpartum period. That rapid drop in progesterone and some of the other gut hormones results in a digestive system that is incredibly slow. So, constipation may be an issue, reflux may be an issue, and of course, as time passes, it does indeed get better. It just takes a little bit. Now, the more surprising symptoms that might be happening in the postpartum period are things a lot of women didn't expect, and honestly, they're not quite as common. (07:42) So, it's everything from hyperpigmentation to something called telangiactas where you start to see blood vessels kind of pop either on your face or your arms or even veins that are incredibly dilated. Right? So getting those varicose veins. So those are some of the other things women can see and start to notice as they enter this postpartum period. (08:02) So do babies wreck our bodies? They do to a certain extent, but the magic of the body is that it kind of goes back to itself after a period of time. The problem we have in the western world is we expect that period of time to be way faster than what's realistic. And in the pursuit of losing weight rapidly, making sure that you're ready to charge back into your job or all the other things that we expect ourselves to do, women's health, their chi or their prana as they talk about in Chinese and Ayurvedic medicine declines because it's important to (08:35) replenish the body and restore the body before we enter the next major phase of our life. And this is something that is not talked about very much in western medicine. And even when we look at sort of, you know, what women set themselves up for, I mean, I went back to work with within about three months with my first one and literally within four weeks with my second. (08:56) You know, those are things that if you talk to a Chinese medicine practitioner or an eastern medicine practitioner, they were saying you are setting yourself up for depletion. And once you enter life in a depletion state, you indirectly are setting yourself up to be more diseaseprone and more susceptible to the environment, to stress, and to so many other things. (09:16) So again, as we think about the physiologic changes that are happening in the postpartum period, we start to understand we've got to do this a different way. We have to think about nurturing and caring for women in a much different way as they enter into this very important chapter of their lives. And unfortunately, you know, we have not really put the time or the energy into understanding this. (09:40) You know, prior to doing this episode, and many times before I speak, I'll look back into the research in the literature just to see if there's anything new or anything different. And when you put postpartum in, the amount of research being done on the postpartum period is minuscule, very little. (09:58) So, we've got a long way to go when it comes to women's health and we've got a long way to go when it comes to nurturing and understanding how to support all these different changes in the postpartum period. When we take this more comprehensive approach and we really think about postpartum changes by organ system, right? If we think system to system to system, then we also have a better screening tool for when women are getting in trouble. (10:23) For example, things like amniotic fluid emblei or having mental health issues or having other hormone issues because this is a time frame where things like a thyroid disorder may show up or having worsening of blood sugar issues, cardiovascular issues, autoimmune disease. You know, postpartum women, I think, need a headto toe full screening because there's so much shifting and changing and we don't know how the body is going to react to it. (10:53) And the earlier we dive into this, the better. And it helps to turn all of it around. Now, given all these changes that are happening to a woman in her postpartum period, you would think that we'd have an organized, targeted, tactical plan to support women. Well, in Western medicine, we don't. But in Eastern medicine, they thought long and hard about this. (11:14) In fact, the postpartum period was called the golden trimester or the fourth trimester. And most systems of medicine believed in some form of rest. In Chinese medicine, they talked about the sitting period, which could be as short as 42 days, but as long as 100 days. And in this sitting period, they literally expected women to sit, to sit and rest, to sit and be cared for and nurtured by the other women in their community. (11:41) And they didn't want women to move around or to exert themselves. In fact, in Chinese medicine, they had the 555 rule, which is for 5 days, they wanted you in the bed. For 5 days, you could sit up and move around a little bit in the bed, and then for the next 5 days, you were allowed to get out of the bed and actually walk around a little bit. (12:02) Now, some might think that's extreme, and we worry about things like clotting, but the idea was, how do we help women rest when they've gone through one of the major transitions of their life? Now after the 55 period, women would continue to start to loosely do things around the home, but the idea of rest and being fed and being nurtured and cared for was essential. (12:26) In Ayurveda, they had the same idea. They didn't call it the sitting period, but they did call it a period of rest where a woman would go often to her mother's home, not even stay in her original home, and be cared for by the women of the family. And in that she would be given things that were easy to eat, easy to digest. (12:45) And both systems of medicine, when I pull back and look at them, both of them talked about the importance of heat and warming and nourishing the body. So the idea here was that you've gone into a depletion state, right? You're in a lowqi state, a low prana state. The body has not enough blood. That's a term they used a lot in Chinese medicine. (13:06) and the depletion of all of that and the lack of energy and the lack of sort of functional resources that a woman was experiencing needed to be restored. And it's such a beautiful visual because it's almost like they thought of the body of a woman's body as being this incredible vessel to produce life to produce more energy. (13:26) But in the production of energy or a brand new life, there was an incredible depletion that had taken place at the same time. So before a woman could move on with whatever it is she needed to do, she needed to be restored. She needed to be replenished. And in the litany of what there was to do, that central concept of warming kept coming up over and over again. (13:50) So in Chinese medicine, it meant you would have a diet that was warm. No cold foods, no raw foods, no ice water, none of these things that we assume are okay to do or are quote unquote healthy. Instead, you would be given a diet of broth-based soups. And within the broths were all kinds of different herbs to help nourish the nervous system, the gut, the hormones, the endocrine system to bring you essentially back to life. (14:14) In addition to that, they would use nourishing ingredients. These are things including not just bone broth, but leafy greens that were cooked, protein that was also cooked, and anything with iron to strengthen and nourish the body. In addition to food, cooked foods and soups and stews, they would do things like black chicken. (14:33) I don't know if you guys have heard of that. And then add herbs like donquai and even estragalus into the daily regimen to fortify and strengthen both the endocrine system and the nervous system as well. Estraalus and donquay have used a lot in practice. Donquay again remember nourishes the hormones. It actually helps to rebuild estrogen and some of the other female hormones. (14:54) Whereas a stragalus is not just an immune modulator helping the immune system, but it's actually thought to give the body energy as well. We've used it in a lot of our formulas around immune defense, but it's also used in the postpartum period to bring women back to life. Now, it's not just about herbal medicines. They would also do things like acupuncture or moxy bustion to get the energy in the body to flow. (15:16) And by putting all of this together and combining it with forms of Chinese massage that would help both the mother and the baby, they believe that they were not only restoring the mom back to health, but they were strengthening the bond between the mother and the child. Which brings me to another really important point about Chinese medicine. (15:34) And it's actually reflective of how I started my practice. When I was studying Chinese medicine, they talked a lot and I learned a lot from my mentors about how the mom and the baby, the mom and a child were a system and you never treated that system separately. So the health of the mother was directly related to the health of a child. (15:53) The health of a child was directly related to the health of the mom. And that's how we started. If you look at our earliest logos for my practice, which was the Atlanta Center for Holistic and Integrative Medicine at the time, it's the outline of a mother with her baby. And the thought was that we would cater to this dynamic unit that was so interdependent and so symbiotic upon each other. (16:14) Of course, we grew over time at whole plus. We're whole plus now and now we see the entire family, everyone from birth to seniors and it's been incredible fulfilling work. But that is the that was the original thought and the original mission as well. So, one of the things that fascinates me about Chinese medicine and how they care for the mom and then how they care for the baby is that all of these modalities that we're talking about, whether it's food or herbal or massage or acupuncture or twina for the infants, all of these things in some ways calm the nervous (16:47) systems down for both, right, for the mom and the baby. So, something like collic, right, or reflux in a young baby was not as common. And I think, you know, a part of me believes that that was because there was so much attention paid to nurture and rest for both. And there's this idea of energy, right, that we've talked about before that, you know, we feed off of each other's energy. (17:12) And when it comes to mothers and their children, that energy dynamic is very real. And we even see it later in life, you know, even when you have older children. But if the mother is stressed or depleted or withoutq chi, then the babies or the children feed off that as well. So again, Chinese medicine honored and recognized the importance of the mother, how critical it was to care for her and to nurture her so that she could not only be a good mother, but she herself would not be set up to a future of disease and ailments and illness that today we actually translate as (17:46) inflammation, autoimmune disease, weight gain, mood disorders, and so much more. So of course they prioritize rest and they also prioritize community. And this is something that we are tapping into in the western medical model. But in Chinese medicine and Ayurvedic medicine, both of them believe that community and social support was essential for a new mom. (18:11) That's why remember in Ayurveda, you went to your mother's home when you had a children in the olden days. you didn't stay with your husband and the husband wasn't expected to carry this burden or to even understand what was happening with his wife because it was such a female experience in a female body that translating that and having that expectation was deemed a little bit too much. (18:34) So anyhow that was then this is now. Let's take a second to look at how Ayurveda may view this. It's very similar in these ideas of warmth and heat. In Ayurveda they think of the postpartum period as a very vada period. Remember in Ayurveda there are three main doshas. Vada pa and cafa. Vada is the airy or the more windier period. Going into pregnancy no matter what primary dosha you are. (18:58) When you are postpartum you're in a VA state. And in that vada state you need you're prone to dryness, poor sleep, anxiety, trouble focusing, you know, brain fog, uh all the things. So the idea there in Ayurveda was the same. It was how do we nourish, how do we warm, how do we ground this new mom and what can we do? So they also emphasized warm foods and warm soups. (19:24) They used a lot of things cooked with digestive spices and in their digestive spice cabinet were things like cumin seed, cumin, ginger, turmeric. These were all spices that were used to help the digestive system and they're a staple in many Indian dishes today. They also believed in the importance of fat as did Chinese medicine. (19:45) So using ghee was critical in the postpartum period. I clearly remember my mother-in-law chasing me with a spoon of ghee and me being so worried about my weight, saying, "Oh my gosh, you have to have this. It's nourishing. It's going to give you energy. It's going to give you strength." So, ghee was incredibly important and a big part of the diet for a postpartum mom. (20:02) So, taking about a half a teaspoon to a teaspoon a day. Hydration was critical. And again, the overlap, avoiding cold, raw, crunchy foods because those in turn were hard on the gut, hard on the digestive system as well. They also believed in the mandatory 40-day period of rest. And they actually didn't want a lot of visitors or family coming in and out. (20:23) They wanted the women to rest. And then they had very specific forms of massage as well. You guys may have tried these in the past. Abbya, which is a warm oil massage. And they often use sesame or almond oil. And they nourished or they massage the body vigorously um as a way to combat vada or this dryness or deficiency state the moms were in. (20:45) Their herbology included things like shvfury which is an incredible herb. We use it in practice. It helps with lactation. It helps with reproductive health. It helps with uh overall hormone health as well. When I dug into chef and I was trying to understand what it actually is, it's derived from white asparagus and it's actually an incredible source of glutathione. (21:05) Glutathione is a potent antioxidant that we know is regenerative, fights inflammation. Again, we have the science today. back then. This is something they just knew and they would provide their moms or their postpartum moms with this. Ashwagandha, which many of you know, it's an adaptogenic herb and it helps to reduce stress and anxiety, modulates cortisol. (21:25) This was one that was thought to give the postpartum mom strength and energy. Turmeric, again, the anti-inflammatory and fenugreek or holy basil, which was used to promote lactation and help to support the mom's overall well-being. And in both of these systems of medicine, as I as I've talked about, community was critical. So the new mom in Ayurveda was nurtured and motherthered by her network of family and friends. (21:49) And it was important for her to be cared for, to be fed, to not have to work too hard, and even to not they even thought I remember clearly my mother-in-law telling me this, they even thought like showering and bathing or even going for a workout was too much of an energy expense. And so they would actually again, same thing, recommend sitting or some quiet walking, but nothing that would require like you sweating or burning a bunch of calories or doing any of those things in those first six weeks and ideally even going into the first few months. So you can (22:22) see how these older systems of medicine incorporated a lot of community and community medicine with herbs with self-care rituals like massage and acupuncture along with foods that were warming and supportive to really build energy or build vitality in the new mom. So that was how they did it then. How do we take that information and apply it to today's time when many of us have jobs and careers and feel the pressure and feel the stress of trying to do well in both of those worlds? So given the connection between the mom and the (22:58) child, given the physiologic changes that are happening with our bodies in this postpartum or fourth trimester and given the history that older systems of medicine like Chinese medicine and Ayurvedic medicine have taught us, how do we bring this into the modern age? What's the right approach? And this is where a holistic approach or the whole plus approach to postpartum care I think wins. (23:23) We can take some of the ancient practices, merge it with the science, merge it with what we know is happening with women's bodies to create a tactical and strategic plan that helps moms really return to themselves in a way where they're feeling amazing with energy and ready to do whatever is next. Here is sort of how I imagine postpartum care to be and what we're trying to do in our clinics. (23:47) first, even before delivery in that third trimester, while there's so much talk about where to deliver, you know, who your nurse is going to be, all of the things, right? One of the things we need to be doing and checking is what do you look like as you enter the postpartum period? Are you nutritionally optimized with key nutrients that get depleted very quickly as you deliver a baby? This includes optimizing and checking for vitamin B, vitamin C, looking at glutathione levels, D and iron along with the fats, omega-3 fats and omega 9 fats. That (24:24) cocktail of those five or six different things are critical in defining energy and how energy will sustain you, not just through your delivery, but even on the other side of it as you enter that next trimester. What many people don't understand and if we listened to our elders from older systems of medicine, they would tell us that energy is capable of being stored. (24:48) So if we overoptimize some of these nutrients, we would enter delivery in a much better state and do better in that postpartum period. So I think this actually begins with the third trimester and assessing and understanding where you stand from a nutrient perspective. But it's not just all about nutrients. (25:08) It's also checking in with your gut health. Where is it? Are you in a good place from a digestive standpoint? Because that's where you're going to get your energy from. In addition to that, do you have any inflammation? Are there other secondary hormones that need to be managed before you go into delivery? Where's your thyroid? Where's your blood sugar? Where is your cortisol? What do we need to do to take care of those? So, that would be a starting point that I'd recommend many women start to engage in as they enter into thinking about delivering their (25:39) baby. But that's not it. Because remember, it's not just about the physical body. We have a mental, emotional, spiritual, and community body as well. And all five of these bodies need to be addressed when we're trying to come up with a postpartum plan. Another piece of this puzzle is trying to understand who your community is going to be. (26:01) I've got study after study sitting here talking about the need for community when women deliver and how the risk of postpartum depression goes up significantly when women do not feel supported. And so that support should not just come from one person. It should come from multiple people. So your family, your friends, others, even a doula, whoever you need to bring into this circle so that you can transition into this next phase of life feeling supported and heard and seen. (26:31) It is one of the most critical pieces for delivery for women and for success in the postpartum period. I wanted to share a particular study with you that talked about maternal social support, quality of the birth experience, and postpartum depression in women. And essentially they're saying pregnancy is a time of significant life change for every woman. (26:53) And what they were trying to do is understand the influence of social support. In essence, what they were trying to say is that the more support women perceived that they had was a protective factor against postpartum depression. So, as you're entering again your third trimester and you're assessing your physiologic needs, knowing that your body's going to change after listening to some of what we talked about today, you know, another thing to be thinking about is do you have that support in place? Your postpartum support should be in place (27:23) for a minimum of 100 days, right? ideally 3 to four months after delivery so that you have some resources to fall back on as you're transitioning in every aspect of your life. So that's something else to think about kind of in that trimester in addition to the tactics of where you're going to deliver and all the other things that we get excited about as you enter your fourth trimester or your golden period or your sitting period whatever we want to call it. (27:52) That's where again understanding that you have to feed yourself, you have to nourish yourself, you do have to rest, all of that becomes important. And if you've done the work prior to delivery of knowing your nutritional deficiencies, well, you're one step ahead because then your supplement plan can be targeted to the proper diet that emphasizes protein, fat, heat, and good digestion. (28:16) But if you haven't done that work, then what I like to do is go ahead and make sure most of my postpartum patients are on at least a B vitamin and iron and they're doing maybe an IV vitamin infusion to help flood their cells with the nutrients they need in a faster, more efficient manner. So, we love things like the Myers cocktail that has B vitamins, vitamin C, and sometimes we'll pair it with a little bit of glutathione as well. (28:40) And doing that maybe every other week or at least once a month through that sitting period or that 100 days can be incredibly helpful in restoring energy and restoring vitality. Looking at movement as a form of moving your body, but not movement to lose weight. That's going to be very counterproductive through these 100 days. (29:01) So move when you can or as your body allows you to, but going and doing a HIT workout or running right away, those are things that are going to be depleting to the body. they're going to change your energy and impact sort of the bond you have between your child and you because that energy drain is often going to result in an overall higher stress state. (29:20) So thinking about nutrition, thinking about your hormones, thinking about how you can optimize your nutrition using more modern-day technologies and and modalities like IV therapy, incorporating some of the self-care rituals. If you can't do abianga, that's okay. And if you can't find somebody to tweod, that's okay, too. (29:42) But what can you do? And work into a rhythm into your schedule over your postpartum period. That might mean weekly acupuncture and weekly massage or you're going to a yoga class when you can. But what you don't want to do is be locked in and isolated, you and the baby, without the support and the help you need because that will be a recipe for setting you up for depletion and obviously for a lot of struggling kind of in the months to come. (30:08) So that's how I imagine or envision a holistic approach to managing this postpartum period. Oftenimes we'll bring the herbs in too if a woman is very depleted we'll add ashwagandha we'll add sheath you know we'll add holy basil depending on what's going on if they're having a lot of issues with sleep you know we may add some further support for sleep as well so all of this helps to support the woman as they're going into this fourth trimester and this particular phase of time. (30:38) Now, one thing I get asked all the time, and I think we have to address it as sort of the elephant in the room, is, you know, if you're breastfeeding, do you get a night nurse? Does that help? Do you, you know, let them cry it out? Do you sleep train them? I think at the end of the day, that's everybody's individual preference. (30:54) I'm not here to really pass judgment on that. But if we did things the older way or the eastern way and we were allowed to rest for this 90-day period at least, then that's a really precious time for you and the baby. And I think if you and the baby can get into a rhythm where you're breastfeeding kind of every 3 or four hours or so and you're caring for the baby, the baby feels your energy, you feel the you feel the baby's energy, and you're repleted, that's a great plan. (31:23) But if you're walking into this trimester incredibly depleted, of course you're not going to have the reserves and the energy to tolerate the night feedings and to tolerate a lot of that comes with having a baby. So end of day, my advice as a mom whose children are now teenagers, 16 and 17, and I think back on my time and going through that postpartum period, and I wish I knew as much as I knew now, I would have had a very different experience. (31:48) My advice both professionally, medically, and personally is plan for your postpartum period. Plan for that fourth trimester. Understand what the deficiencies are that you're walking in with. Understand your energy and harness it and master it and have a game plan from a physical standpoint, a mental standpoint, an emotional standpoint, an energetic standpoint, and build that community that's going to advocate for you as you transition into this really incredible phase of life. (32:22) I had a patient, I've got to tell this patient story real quickly, but you know, she was wanting to get pregnant again, but she was terrified because her first pregnancy literally wrecked her. She's like, I never want to do this again. This was the worst experience of my life. She felt awful. She said she looked awful. (32:40) She couldn't be the partner to her husband. She She was miserable. But they wanted to grow their family. So, I said, "Okay, let's work together. Let's see what's going on." And we worked together. And I told her first, please don't get pregnant for a year. Let's work together for a year to rebuild and restore your energy. And there are a lot of things that we found in that year. (32:59) She had a sluggish thyroid. She had low iron. She was deficient in terms of her gut health. She had a very leaky gut. She was losing nutrients rapidly even though she was trying to eat properly. So, we worked really hard to rebuild all of these systems. And she got pregnant again. And she like literally a month ago or two months ago had her second. (33:17) And her husband was like, "What changed? You you seem incredible. You're amazing." And her words to me were this. She was like, "This was so easy. I would do this again without thinking twice." So again, when we take a different approach, that holistic approach, we can have a different outcome. And we can have the energy to care for these kids, build a family while we build our career lives and everything else we want to do. (33:43) But it takes thought. It takes planning, not reactivity, but being proactive about your health, which ultimately benefits your children's health and the health of the whole family. All right, before you click away, don't forget to subscribe. It's free and it helps more people find Whole Plus. (34:01) And if you're already here, why stop now? Watch the next video right here on the screen. It's when you don't want to