Latest / Life After Birth by Her Health Room / Postpartum Recovery: Why Mothers Need More Than a Six-Week Check

Transcript

Postpartum Recovery: Why Mothers Need More Than a Six-Week Check · Life After Birth by Her Health Room

• 0:00
  We talk so much about preparing for birth, but very little about what comes after.
• 0:04
  The feeding, the bleeding, the exhaustion, the fatigue, the mental health struggles, and for some women, the grief after baby loss.
• 0:13
  In this episode, I'm joined by Dr.
• 0:15
  Julie Hammond, who is a founder of Mama, and author of upcoming book, Fourth Trimester, a GP, a mother who has gone through the postpartum period three times, to talk about what mothers actually need after birth and why we need to take action long before crisis hits.
• 0:32
  So stick around for this episode.
• 0:34
  We're gonna cover everything from pregnancy loss to the postpartum period and give you practical steps of how you can prepare for your postpartum period.
• 0:43
  Remi Mogekwu: So Julie, when we talk about the postnatal recovery, most people think about the six-week check or eight-week check that happens with the GP.
• 0:50
  Remi Mogekwu: But from your perspective as a GP, what do you think we're missing?
• 0:53
  Dr Julie Hammond: I think we're missing what happens in that period when you're waiting to be seen, and when you drop off being seen by your midwife or your health visitor and you're still waiting to see your GP, which often because of the timeframes is not until eight weeks or longer.
• 1:07
  Dr Julie Hammond: And we know that sometimes when people are waiting as well to see the GP for their postnatal check, they may not even get offered it as the mother.
• 1:12
  Dr Julie Hammond: They may just get offered either a telephone call or just get forgotten about altogether.
• 1:16
  Dr Julie Hammond: So again, it's very much a postcode lottery whether or not you get access to the service.
• 1:21
  Dr Julie Hammond: And I think it's all the things that happen after the eight-week check as well that you're still gonna have ongoing breastfeeding issues and weaning baby off the breast.
• 1:28
  Dr Julie Hammond: The complete, identity shift as well.
• 1:31
  Dr Julie Hammond: And on top of that, it's about getting ready to go back to work as well.
• 1:34
  Dr Julie Hammond: I really struggled with that transition of going back to work, still not being able to sleep during the nights and baby wasn't sleeping, and still breastfeeding, and it was j- it was just so much, and how it just changes your relationship as well.
• 1:45
  Dr Julie Hammond: There's so much that happens in that period that I wasn't even ready for in terms of physically as well.
• 1:50
  Dr Julie Hammond: My periods were all over the place.
• 1:51
  Dr Julie Hammond: My period didn't come back for about 16 months, during the postnatal period because I was breastfeeding.
• 1:56
  Dr Julie Hammond: But again, no one warned me of this, and I just thought about, well, how many other women, I mean, especially if they want to have babies quite close together, are not aware of the fact that if they're breastfeeding, this could impact their fertility?
• 2:05
  Dr Julie Hammond: So I just feel like so much information is not shared, which is why it propelled me into my journey to writing the book and to creating my mamAR all the other things that I do in the space.
• 2:16
  Remi Mogekwu: So then as a GP, what actually happens in the six-week check?
• 2:19
  Remi Mogekwu: So I've been the appointment on the side of a patient,
• 2:23
  Dr Julie Hammond: Mmhmm
• 2:23
  Remi Mogekwu: I often will drive the appointment because I know what I want from
• 2:26
  Dr Julie Hammond: Mm-hmm.
• 2:27
  Remi Mogekwu: But typically what happens in a six-week appointment check
• 2:31
  Dr Julie Hammond: So usually your doctor should review your pregnancy history.
• 2:34
  Dr Julie Hammond: So they should ask you a bit about what happened during the pregnancy.
• 2:37
  Dr Julie Hammond: Did you need any additional monitoring?
• 2:38
  Dr Julie Hammond: Were you diagnosed with any medical conditions?
• 2:40
  Dr Julie Hammond: So they can arrange the necessary follow-up investigations afterwards and even long term.
• 2:45
  Dr Julie Hammond: And then also they should ask you about how your delivery actually went.
• 2:49
  Dr Julie Hammond: Did you give birth vaginally?
• 2:51
  Dr Julie Hammond: Did you have a cesarean section?
• 2:52
  Dr Julie Hammond: Was it complicated by any infections at all?
• 2:56
  Dr Julie Hammond: They also should ask about your bleeding and whether or not your, what we call lochia, which is the initial bleeding you have after giving birth, has finished.
• 3:03
  Dr Julie Hammond: And also if you have had your first period, which some people do have quite quickly.
• 3:08
  Dr Julie Hammond: Usually they might explore how you're feeding your baby, whether you're choosing to bottle or breastfeed and if there's any issues there.
• 3:13
  Dr Julie Hammond: Although hopefully by then you should have seen maybe your health visitor or a breastfeeding consultant if you're really struggling.
• 3:19
  Dr Julie Hammond: And then they should maybe offer you, a assessment.
• 3:23
  Dr Julie Hammond: Well, in an ideal world, they should offer you assessment of your muscles.
• 3:27
  Dr Julie Hammond: So this is to look for any sort of diastasis recti as well to make sure that things are coming together as we would expect, and giving you some guidance on some pelvic floor exercises if needed.
• 3:36
  Dr Julie Hammond: Again, this is all ideal.
• 3:37
  Dr Julie Hammond: And they should also give you some information on wounds care as well as checking things like your mental health and touching on whether or not you want to start any contraception and, you know, your future, family planning needs if, if that applies to you of course.
• 3:50
  Dr Julie Hammond: So that's like the basics, just quickly in terms of what they should cover
• 3:56
  Remi Mogekwu: Basics.
• 3:57
  Remi Mogekwu: So how long would you, if you were designing the care, how long would you give that appointment?
• 4:01
  Remi Mogekwu: Because that's a lot to cover
• 4:02
  Dr Julie Hammond: It is a lot to cover.
• 4:03
  Dr Julie Hammond: Yes, it is.
• 4:04
  Dr Julie Hammond: I often find that whenever I'm doing these appointments, I overrun.
• 4:07
  Dr Julie Hammond: So I think ideally, a nice half an hour chunk just to focus on because again, otherwise it's just quite, you're always rushing through.
• 4:13
  Dr Julie Hammond: How can you talk about contraception?
• 4:15
  Dr Julie Hammond: Some women have never been on contraception before, and then to now have this discussion where you're giving them all these different options, and to do that all within 10 minutes, it's just almost impossible.
• 4:22
  Dr Julie Hammond: As well as you need to maybe look at their wound site to check if they're healing well, if, if they're having any concerns.
• 4:27
  Dr Julie Hammond: Something else that should be asked is when, you know, they should ask about any issues with, with your pelvic floors.
• 4:32
  Dr Julie Hammond: So are you experiencing any leakages when you're coughing or sneezing, are you passing urine?
• 4:36
  Dr Julie Hammond: Any loss of control of your bowels as well.
• 4:39
  Dr Julie Hammond: And if you're sexually active, they should be asking you whether or not you're having painful intercourse, because that is quite common afterwards, and there should be some tips that they can recommend or refer you to a pelvic floor specialist if needed.
• 4:50
  Remi Mogekwu: And I think even going back to your first answer about, you know, six weeks is great, but a lot of what actually women postnatally, and I recognize myself in what you were saying as well, is the sleepless nights, the going back to work, the breastfeeding and beyond that.
• 5:06
  Remi Mogekwu: The periods that come back or don't come back properly.
• 5:10
  Remi Mogekwu: You'll try contraception, and the contraception causes you to have spotting, irregular periods.
• 5:14
  Remi Mogekwu: There are so many touch points, I think, in the first 18 months after having a baby that should happen and don't happen, and often have to be driven by the woman.
• 5:26
  Remi Mogekwu: But obviously, you know, as an obstetrician, I would try and speak about contraception antenatally and even before they go home, and then the idea is that they can go into sort of GP care.
• 5:36
  Remi Mogekwu: But not everyone's gonna be lucky enough to get a GP like you.
• 5:40
  Remi Mogekwu: So how can they drive their own to make sure all those touch points are mentioned?
• 5:46
  Dr Julie Hammond: So I think sometimes if you feel like you had your postnatal check and that hasn't been enough for you, it's okay to ask for another appointment.
• 5:53
  Dr Julie Hammond: A lot of the times when we're asking women,"Oh yes, contraception," they're like,"I haven't even thought about having sex.
• 5:56
  Dr Julie Hammond: That's not even for the-- That's the last thing on my mind.
• 6:00
  Dr Julie Hammond: Why are you asking me about this right now?" So of course they're going to say no, they're not interested.
• 6:03
  Dr Julie Hammond: But maybe, you know, four months, six months down the line, they may b- they may want to come back and have that discussion again.
• 6:09
  Dr Julie Hammond: So I feel like, yes, we have that first appointment, but maybe subconsciously it will It shouldn't be up to us.
• 6:14
  Dr Julie Hammond: We really should be calling women back just to make sure that they're okay.
• 6:17
  Dr Julie Hammond: But there should be another opportunity to see your doctor again at six months when things have really settled down and you can start to see if you're having any of the ongoing issues.
• 6:26
  Dr Julie Hammond: So again, we often talk about, you know, baby blues, but things like postnatal depression.
• 6:30
  Dr Julie Hammond: Again, in that first few months you may just feel like, oh, it's exhaustion.
• 6:33
  Dr Julie Hammond: At the six months mark, I tend to find that that's when the symptoms are really more evident that, no, this is not normal, this is not transient.
• 6:40
  Dr Julie Hammond: This is when I may actually be more willing or understand that I may need some help.
• 6:44
  Dr Julie Hammond: But again, you don't really have that touch point to go back and see your GP, so a lot of women are just left to struggle with it on their own.
• 6:51
  Remi Mogekwu: Like obviously they are struggling, but also in that time they're raising a baby, right?
• 6:55
  Remi Mogekwu: Most women.
• 6:56
  Dr Julie Hammond: Yes.
• 6:56
  Remi Mogekwu: you're neglecting yourself really because you're trying to prioritize the
• 7:01
  Dr Julie Hammond: Mmhmm
• 7:01
  Remi Mogekwu: this child.
• 7:02
  Remi Mogekwu: And say you're on maternity leave, your partner's at work, you're at home, who wakes up at 8:00 o'clock on mat leave to book a GP appointment or fill out a triage form?
• 7:13
  Remi Mogekwu: So it's just so easy to forget yourself probably get a bit of re- breathing room 18 months later, and by
• 7:18
  Dr Julie Hammond: Mhm.
• 7:19
  Remi Mogekwu: like the damage would've been done.
• 7:21
  Remi Mogekwu: And I think we're just talking about people who have had a low risk
• 7:25
  Dr Julie Hammond: Mm-hmm.
• 7:26
  Remi Mogekwu: and gone through a normal delivery and not had a cesarean section or a
• 7:30
  Dr Julie Hammond: Mmhmm
• 7:30
  Remi Mogekwu: tear or high blood pressure.
• 7:32
  Remi Mogekwu: But for women like that, what, no real safety net for them.
• 7:39
  Remi Mogekwu: They still have to be proactive and come and see a GP.
• 7:43
  Remi Mogekwu: So what do you try and tell women that fall into that category?
• 7:47
  Dr Julie Hammond: So again, I try and remind women at the six-week check that this, you know, if you have any concerns, you can always come back.
• 7:52
  Dr Julie Hammond: And then even then, if there's any woman that who I've met who's had a history of gestational diabetes or preeclampsia, I do like to warn them that, you know, this condition doesn't just end because you've given birth.
• 8:02
  Dr Julie Hammond: It is something that increases your long-term risk of developing either diabetes if you had gestational diabetes or if you had hypertension in pregnancy or had preeclampsia in pregnancy, your lifelong risk of developing hypertension in life, yes, is increased.
• 8:15
  Dr Julie Hammond: So I like to warn w- women of this and just m- advise them, you know, at least have that yearly check-in with your doctor, or if you have a, a monitor at home, just make sure you're checking your blood pressure at home.
• 8:25
  Dr Julie Hammond: But ideally, go into the doctors and have that, you know, yearly blood test.
• 8:28
  Remi Mogekwu: Yeah.
• 8:29
  Remi Mogekwu: And I find that when I see women who've had it in their first pregnancy, and they come back with their second pregnancy, they've not had the checks.
• 8:35
  Remi Mogekwu: So then what you then find is that they come into pregnancy either with high blood pressure or with diabetes, and then that second pregnancy or third pregnancy is already starting at a disadvantage because they have these conditions to hand.
• 8:49
  Remi Mogekwu: So I think that, yeah, it's really important.
• 8:51
  Remi Mogekwu: And in an ideal world, I know we're both speaking in ideals,
• 8:54
  Dr Julie Hammond: Yeah
• 8:55
  Remi Mogekwu: all women would see a women's health GP, someone who is a bit more conversant about what to expect, what to discuss with them, to direct them to a physiotherapist or refer them on or put them even in group sessions, so they are getting the help they need.
• 9:10
  Remi Mogekwu: So personally for me, I'm in my third pregnancy, and I, you know, I, I never really did pelvic floor physio, which is really naughty of me.
• 9:16
  Remi Mogekwu: I never examined my tummy.
• 9:18
  Dr Julie Hammond: Mmhmm
• 9:19
  Remi Mogekwu: I just completely just had the babies and was like,"I'm young enough.
• 9:22
  Dr Julie Hammond: Mmhmm
• 9:23
  Remi Mogekwu: are fine." And so when I got pregnant, I was like,"Oh my gosh, I've got a really significant, diastasis recti" that I just didn't know was there.
• 9:31
  Remi Mogekwu: even as a doctor, I struggled to navigate the system.
• 9:34
  Remi Mogekwu: I wouldn't even know if the GP would refer me to a physio or if
• 9:37
  Dr Julie Hammond: Hmm
• 9:38
  Remi Mogekwu: to go to a physio privately.
• 9:39
  Remi Mogekwu: And it's obviously something that's now on my mind that I
• 9:41
  Dr Julie Hammond: Hmm
• 9:42
  Remi Mogekwu: take seriously after this baby's born.
• 9:45
  Remi Mogekwu: but I just, I just often really sympathize, with women who have to navigate the system that just doesn't really work.
• 9:53
  Remi Mogekwu: And so when you-- in terms of like pathways, I know it will be different for places.
• 10:00
  Remi Mogekwu: Do people live
• 10:00
  Dr Julie Hammond: Hmm
• 10:01
  Remi Mogekwu: in the UK?
• 10:02
  Remi Mogekwu: What pathways do you typically make use of to get people through to other allied healthcare professionals?
• 10:08
  Dr Julie Hammond: As a GP, I know that I can refer women directly to pelvic health physiotherapists.
• 10:12
  Remi Mogekwu: Okay
• 10:13
  Dr Julie Hammond: I also know that, again, depending on their needs, so if they've had any sort of complications in their pregnancy or have any pre-existing medical conditions, and they come to me for preconception advice, I am aware of services like the preconception clinic, which I do make use of in my area.
• 10:29
  Dr Julie Hammond: So even if it's not necessarily the local hospital, I do like to educate women and let them know that this is a service that's available.
• 10:34
  Dr Julie Hammond: You may have to travel a bit further, but this is something I'm happy to refer you to.
• 10:39
  Dr Julie Hammond: Again, I'm all about, you know, if you have the resources and you're able to go private, I also let women know that this is an option for you as well, that if you do have any additional needs, maybe you're not able to access the service as quickly as you need within the NHS, then you can definitely go privately as, as well.
• 10:54
  Dr Julie Hammond: And I, again, I always liaise with the health visitors, just to get some further advice if they have any recommendations,'cause I know that I don't know everything.
• 11:01
  Dr Julie Hammond: So, I'm always happy to do that.
• 11:03
  Dr Julie Hammond: And then finally, we have a, care coordinator in our practice.
• 11:06
  Dr Julie Hammond: So anything that I'm not aware of or any services in my area that I'm not too certain about, I will just contact them as well and see, just ask, you know,"Is there any pathways I can refer this lady to?" But another service as well is that the perinatal mental health services as well that I, I do refer quite a few women to that'cause I know that there's a a long waiting list for counseling.
• 11:23
  Dr Julie Hammond: But if I do feel like the need is more urgent, I'll also make use of that pathway
• 11:29
  Remi Mogekwu: Okay.
• 11:29
  Remi Mogekwu: And if there is a long waiting list for those,'cause I was gonna say that for perinatal mental health and for physio, oftentimes people are waiting a really long time to be seen.
• 11:37
  Remi Mogekwu: For the mental health aspect of it, if they are waiting for a long time, what's the, what's the safety net in between that you often will use?
• 11:45
  Remi Mogekwu: 'Cause again, these are people that by the time they deliver, I, I almost will never see them again until they're pregnant
• 11:51
  Dr Julie Hammond: Yes.
• 11:51
  Dr Julie Hammond: Yeah.
• 11:51
  Dr Julie Hammond: So I usually just say if anything is worsening.
• 11:55
  Dr Julie Hammond: So if you're finding that your mood is becoming progressively worse if you're finding that the anxiety is becoming unbearable,'cause again, we talk about postnatal depression, but postnatal depression and anxiety, they often coexist.
• 12:06
  Dr Julie Hammond: So if you find that
• 12:07
  Remi Mogekwu: Hmm.
• 12:08
  Dr Julie Hammond: those intrusive thoughts are taking over your day, you're not sleeping because of it, you're finding that you're not enjoying motherhood, you're struggling to bond with your baby, or you're having any dark thoughts about not wanting to, wanting to be here or to-- that you may harm yourself or your baby, then I say definitely go and see your GP again,'cause then that's how we can expedite your access to services if needed.
• 12:28
  Remi Mogekwu: And when we think about postpartum health, and obviously'cause you've just written a book on it,
• 12:32
  Dr Julie Hammond: Mmhmm
• 12:32
  Remi Mogekwu: talk about you often realize that actually it's not just the obstetrician or the GP or a sexual health physician, but it's a physiotherapist, it's a lactation consultant,
• 12:42
  Dr Julie Hammond: Mmhmm
• 12:42
  Remi Mogekwu: psychologist, a psychiatrist.
• 12:45
  Remi Mogekwu: even beyond that, there is the whole going back to work.
• 12:48
  Remi Mogekwu: Are you financially capable of, like, surviving a year without pay?
• 12:53
  Remi Mogekwu: Like, there are so many issues that affect women
• 12:56
  Dr Julie Hammond: Mm-hmm.
• 12:56
  Remi Mogekwu: that period of life, and on top of that, you're potentially, like, looking after a newborn on your own.
• 13:02
  Remi Mogekwu: Well, not on your own, but, you know, partners don't get as
• 13:05
  Dr Julie Hammond: Mmhmm
• 13:05
  Remi Mogekwu: so largely you're on your own, and then there's loneliness and all of that
• 13:10
  Dr Julie Hammond: Oh
• 13:10
  Remi Mogekwu: with
• 13:10
  Dr Julie Hammond: yeah.
• 13:11
  Dr Julie Hammond: I definitely suffer from that.
• 13:12
  Remi Mogekwu: endless.
• 13:14
  Dr Julie Hammond: It was with my fir- with my eldest.
• 13:15
  Dr Julie Hammond: We moved out of the area, so we're living in Rochester which is far away from my family at the time, and then in COVID and it, all the restrictions, and I was just Yeah, it was very isolating during that time, so I literally remember my husband leaving the house, shutting the door, and I just thought,"Oh my gosh, I'm just with the, me, myself, and the baby for the next 12 hours.
• 13:31
  Dr Julie Hammond: What am I going to do to keep myself sane?" Oh, yeah, those were really long days.
• 13:35
  Dr Julie Hammond: I'd go out for a walk, I'd come back again, and it'd be like, it's only 10:00, and I'm like,"Okay, I still got another 10 hours to do." So,
• 13:42
  Remi Mogekwu: did you find that you made friends in that time or not really?
• 13:45
  Dr Julie Hammond: I was really, really intentional about trying to go out and make friends.
• 13:49
  Dr Julie Hammond: So it did take a while.
• 13:50
  Dr Julie Hammond: I went to every single possible group there was.
• 13:52
  Dr Julie Hammond: I went to the library, I went to baby groups.
• 13:54
  Dr Julie Hammond: I tried different baby groups.
• 13:55
  Dr Julie Hammond: I enjoyed it, but obviously maybe not everyone there was my type of people, people that I meshed with quite well.
• 14:01
  Dr Julie Hammond: So then I had to go and navigate and find different groups, and eventually I did find my people, so that made it so much easier.
• 14:06
  Dr Julie Hammond: J- just like a group of mums who all g- all just got it, and we all are just like, n- I don't wanna say normal mothers, but we didn't put any, you know, false standards on each other.
• 14:14
  Dr Julie Hammond: We were just embracing motherhood in our auth- authentic selves.
• 14:18
  Dr Julie Hammond: So what- however that meant turning up, we were just completely just ourselves.
• 14:22
  Dr Julie Hammond: So I really felt like myself again in, in that time.
• 14:25
  Remi Mogekwu: How long did it take you to get to that place?
• 14:27
  Dr Julie Hammond: Ooh, I would say, so I s- I would say I started to get back to that place maybe around about seven to nine months, and then I went back to work, so then we all lost t- touch with each other.
• 14:37
  Dr Julie Hammond: 'Cause again, you make all these friends, but then everyone starts to go back to work after six nine months, and then we all lost touch again.
• 14:43
  Dr Julie Hammond: And then I went through another dip where I was just like, okay, going to work, coming home, and I was just, like, in survival mode because not sleeping, didn't have any time to, like, do anything for myself.
• 14:51
  Dr Julie Hammond: It was just literally baby, work, baby, work.
• 14:54
  Dr Julie Hammond: That was all that I w- that was my days for the next another, like, nine months before I eventually, I was like,"Okay, you need to focus on you now."
• 15:01
  Remi Mogekwu: So then that probably takes you what?
• 15:02
  Remi Mogekwu: To about 18 months or
• 15:03
  Dr Julie Hammond: Yeah.
• 15:04
  Remi Mogekwu: you had started focusing on
• 15:05
  Dr Julie Hammond: So for me again, I speak openly about my story.
• 15:08
  Dr Julie Hammond: So at the time I had obviously had birth trauma from my, how I gave birth.
• 15:12
  Dr Julie Hammond: I had postnatal depression anxiety, so I did try and manage it a lot on my own.
• 15:15
  Dr Julie Hammond: Did talking therapies, all the, did all the rest of it.
• 15:17
  Dr Julie Hammond: But ultimately, I think the thing that really helped me was actually saying that I needed help and seeing my GP and starting medications.
• 15:23
  Dr Julie Hammond: And I just felt like instantly that cloud was lifted.
• 15:27
  Dr Julie Hammond: I wasn't just constantly in a state of survival or exhaustion.
• 15:30
  Dr Julie Hammond: I was able to sleep well.
• 15:32
  Dr Julie Hammond: I was a- my anxiety was much better, and I felt like that really helped me in my recovery and then my ability to like find myself again and to think clearly.
• 15:40
  Dr Julie Hammond: 'Cause again, even though I was functioning, I didn't feel like I was really embracing my full self and thinking cl- I just, I was very much just in survival mode.
• 15:48
  Dr Julie Hammond: And then after that I was actually like,"No, let's take care of yourself.
• 15:50
  Dr Julie Hammond: Let's find out who Julie is again." Because I definitely had forgotten who, who I was in that period
• 15:56
  Remi Mogekwu: And what was the trigger for you at that point?
• 15:59
  Remi Mogekwu: What made you take, yeah, make, take that step?
• 16:02
  Dr Julie Hammond: I think, again, I always say this moment.
• 16:03
  Dr Julie Hammond: So it would be when I went on holiday with my family.
• 16:06
  Dr Julie Hammond: We went to the Caribbean and, you know, it was beautiful.
• 16:09
  Dr Julie Hammond: Everyone was dancing, drinking, the sun was shining, and I just felt so sad, and I felt like I wasn't really present or that I really enjoyed the moment, and I just thought,"I just can't c- go on living like this.
• 16:21
  Dr Julie Hammond: I can't be, like, in beautiful moments that I've dreamed of." I was like, a year ago if you told me this, this will be my life, I would be like,"Oh my gosh.
• 16:27
  Dr Julie Hammond: Thank God.
• 16:27
  Dr Julie Hammond: This is everything that I wanted." And I was in that moment, and I wasn't, you know, embracing.
• 16:31
  Dr Julie Hammond: I couldn't really feel all the emotions.
• 16:33
  Dr Julie Hammond: And I said,"You know what?
• 16:34
  Dr Julie Hammond: I need to go and seek help.
• 16:35
  Dr Julie Hammond: I can't keep on doing this." And then that was my trigger
• 16:38
  Remi Mogekwu: thank you so much for sharing.
• 16:39
  Remi Mogekwu: I think it's really and often when I talk about the postnatal period, I'm very careful to not, put my own experience on other people,'cause I
• 16:49
  Dr Julie Hammond: No, absolutely.
• 16:50
  Remi Mogekwu: really hard, time.
• 16:52
  Remi Mogekwu: I have such a soft spot for who have to go through the postpartum period,'cause it is hard, and I found it hard twice, and so much so that my husband was like,"We don't need any more babies.
• 17:03
  Remi Mogekwu: This is enough." Cause it affects your relationships, it affects everything.
• 17:07
  Remi Mogekwu: And for both pregnancies I've had, like, talking therapy, and
• 17:10
  Dr Julie Hammond: Mmhmm
• 17:10
  Remi Mogekwu: of them I probably didn't start it till about 18 months.
• 17:13
  Dr Julie Hammond: Mm.
• 17:14
  Remi Mogekwu: Because you kinda think, like,"If I just get through that next step, if I
• 17:17
  Dr Julie Hammond: Yes.
• 17:17
  Remi Mogekwu: that next
• 17:18
  Dr Julie Hammond: Yeah.
• 17:18
  Dr Julie Hammond: Yeah
• 17:18
  Remi Mogekwu: you're not getting better, and then you're like,"Well, actually, now I need help." And I never, I actually never went through the GP
• 17:24
  Dr Julie Hammond: yeah.
• 17:25
  Remi Mogekwu: and I
• 17:25
  Dr Julie Hammond: Yeah.
• 17:26
  Remi Mogekwu: it.
• 17:26
  Dr Julie Hammond: Yeah
• 17:27
  Remi Mogekwu: yeah, just hearing where that, that moment of and really called out to you,.
• 17:33
  Remi Mogekwu: and made you take that step, I think is really empowering, and I hope whoever is listening or watching this really resonates with that and takes a step of their own.
• 17:40
  Dr Julie Hammond: Absolutely
• 17:41
  Remi Mogekwu: But if it's all right, I'd like to cause although we're
• 17:44
  Dr Julie Hammond: Hmm
• 17:44
  Remi Mogekwu: about your postnatal when you had the baby and
• 17:48
  Dr Julie Hammond: Mmhmm
• 17:48
  Remi Mogekwu: at home, and you were
• 17:50
  Dr Julie Hammond: Mm-hmm.
• 17:50
  Remi Mogekwu: making friends that's not the only type of postpartum experience that
• 17:54
  Dr Julie Hammond: Mm-hmm.
• 17:55
  Dr Julie Hammond: Yes
• 17:56
  Remi Mogekwu: you shared with me that, you suffered from baby
• 17:58
  Dr Julie Hammond: Mmhmm
• 17:59
  Remi Mogekwu: so how was that postpartum period in comparison, and what support do you wish you had
• 18:03
  Dr Julie Hammond: yes.
• 18:04
  Dr Julie Hammond: I mean, again, I've, I'm a d- I'm a doctor.
• 18:06
  Dr Julie Hammond: I've, I've been on the wards.
• 18:07
  Dr Julie Hammond: I've cared for women who are going through pregnancy loss.
• 18:09
  Dr Julie Hammond: So I thought I really understood that experience.
• 18:12
  Dr Julie Hammond: I think I, I thought I understood, you know, what they're going through, and I had empathy.
• 18:16
  Dr Julie Hammond: And it wasn't until I went from my experience that I realized that how the system fai- fails to care for women after having a pregnancy loss.
• 18:24
  Dr Julie Hammond: So in particular in terms of my first pregnancy I had the loss around 31 weeks.
• 18:28
  Dr Julie Hammond: So again, I was still very much postpartum, had all the hormonal changes, gave birth vaginally.
• 18:32
  Dr Julie Hammond: So I went to my postnatal check.
• 18:34
  Dr Julie Hammond: My sister's a midwife.
• 18:35
  Dr Julie Hammond: She's like,"No, j- just go ahead." So I was like,"Should I go?
• 18:37
  Dr Julie Hammond: Like, is there any point?" She's like,"No, no, go, go to your appointment." But then when I arrived to that appointment, the GP there just looked at me like,"Why are you here?" And she, she, we just literally sat down like staring at each other for a few moments, and I was just like,"Okay, I'm here for this.
• 18:49
  Dr Julie Hammond: Do you wanna check this?
• 18:50
  Dr Julie Hammond: Do you..." I was almost like prompting her on what to do in her role, and it sh- it was like she just couldn't understand that, oh, why are you coming to postnatal check if you don't have a baby?
• 18:58
  Dr Julie Hammond: Like, like I didn't exist as a person.
• 19:01
  Dr Julie Hammond: And one of the big things after that was that, okay, you give birth, go home without your baby, but then there's no care for mother in that period of time.
• 19:09
  Dr Julie Hammond: You, you don't have, you don't have the health visitors, or at least in that area where I was at the moment.
• 19:13
  Dr Julie Hammond: I didn't have the health visitors coming out just to check on me, see how I was getting on.
• 19:16
  Dr Julie Hammond: It was literally you go home, and then you're just expected to go through postpartum by yourself with no support, which again is part of the reason why I thought this is this, this is, you know, awful.
• 19:27
  Dr Julie Hammond: We, I, you know, I took, I wanted to like try and change this care that's been offered to women.
• 19:30
  Dr Julie Hammond: So there's a lot of w- lot of motivation behind what I do at the moment.
• 19:34
  Dr Julie Hammond: And then even after then having my rainbow baby and going home with him, I, again, I just assumed that, okay, this is everything I wanted.
• 19:42
  Dr Julie Hammond: I'll go home.
• 19:42
  Dr Julie Hammond: Everything will be sorted.
• 19:43
  Dr Julie Hammond: But then I think I focused so much on getting through the pregnancy that I completely forgot, okay, I'm going to have a baby.
• 19:50
  Dr Julie Hammond: I'm gonna still be recovering myself afterwards.
• 19:53
  Dr Julie Hammond: And then that's where I found I was just wasn't prepared, and I was just struggling with, with all of it, not sleeping.
• 19:58
  Dr Julie Hammond: Again, I was like not sleeping during the pregnancy because I was so anxious.
• 20:01
  Dr Julie Hammond: And then to go home and to not be able to sleep because my baby wasn't, he went, he was born early.
• 20:06
  Dr Julie Hammond: He was in SCBU for a number of days.
• 20:08
  Dr Julie Hammond: So again, you get absolutely no sleep.
• 20:10
  Dr Julie Hammond: I was trying to breastfeed during that time, so I was trying to express.
• 20:13
  Dr Julie Hammond: I was just, I don't even know how I was functioning during that time, and I feel like that had a knock-on effect.
• 20:18
  Dr Julie Hammond: And it definitely impacted my, my, you know, my first experience postpartum with my eldest.
• 20:23
  Dr Julie Hammond: But then I, I say all of that because with my youngest now,'cause I went on to have a second rainbow baby, it's been a completely different experience.
• 20:31
  Dr Julie Hammond: I think maybe'cause I mentally I was aware and what we needed, and we had all the support mechanisms in place.
• 20:36
  Dr Julie Hammond: But I found that I, I haven't struggled the way that I did previously.
• 20:40
  Dr Julie Hammond: And I think, again, I have, I had amazing GP as well, who I went to, and then they really just helped to support me.
• 20:46
  Dr Julie Hammond: They even offered me counseling in case I did need it.
• 20:48
  Dr Julie Hammond: But I didn't have to reach out to them in this postpartum period.
• 20:51
  Dr Julie Hammond: But at least I knew the services And I think I felt a lot more confident on how to navigate it as well, which definitely helped
• 20:58
  Remi Mogekwu: Yeah.
• 20:58
  Remi Mogekwu: So which support mechanisms did you actually put in place?
• 20:59
  Remi Mogekwu: 'Cause I think that's really useful I've said it a couple of times, I'm having my third.
• 21:05
  Remi Mogekwu: I've found hard, and my sister looked at me and was like,"What preparations are you making this time?"
• 21:11
  Dr Julie Hammond: Mmhmm
• 21:12
  Remi Mogekwu: like, I haven't,
• 21:12
  Dr Julie Hammond: Yeah
• 21:13
  Remi Mogekwu: haven't really thought about it." Because you can't, predict how your body responds.
• 21:18
  Remi Mogekwu: You can't predict how your baby is.
• 21:20
  Dr Julie Hammond: Mm-hmm.
• 21:22
  Remi Mogekwu: and, you know, I'm an obstetrician, I'm also a Nigerian, I'm a Christian, and
• 21:26
  Dr Julie Hammond: Yes.
• 21:26
  Dr Julie Hammond: Yes.
• 21:26
  Remi Mogekwu: optimistic for a safe, happy delivery.
• 21:29
  Remi Mogekwu: But you don't know what your birth experience is gonna be like.
• 21:31
  Remi Mogekwu: So there are so many even in the third trimester,
• 21:36
  Dr Julie Hammond: Mmhmm
• 21:36
  Remi Mogekwu: as much as you want to Have a plan.
• 21:38
  Remi Mogekwu: This a period of life that you cannot really plan for.
• 21:41
  Remi Mogekwu: Like, even sharing your,
• 21:42
  Dr Julie Hammond: Yeah.
• 21:43
  Remi Mogekwu: with your first pregnancy and your second pregnancy.
• 21:46
  Remi Mogekwu: I know you recently wrote about the pain that you felt during the cesarean
• 21:49
  Dr Julie Hammond: Yes, I forgot to mention that as well.
• 21:52
  Dr Julie Hammond: Again, it's what I, I didn't prepare for all of that.
• 21:53
  Dr Julie Hammond: I had a vaginal delivery the first time, so I wasn't I just didn't think that...
• 21:57
  Dr Julie Hammond: I thought a cesarean section I can control what's going to happen.
• 22:00
  Dr Julie Hammond: Again, it ended up being an emergency, but I knew I was always gonna have a cesarean section with my second.
• 22:04
  Dr Julie Hammond: But then I just didn't, I, again, you read about statistics, but I just thought as a doctor, this is where it happened to me, how can I not be, have enough pain relief during the procedure?
• 22:12
  Dr Julie Hammond: And then even after I came out of it, I was like,"Is this what all women are going through?
• 22:15
  Dr Julie Hammond: Like, this is crazy.
• 22:16
  Dr Julie Hammond: How is it possible that this number of women are struggling?" And then I spoke to my friends.
• 22:21
  Dr Julie Hammond: They're like,"No, that's not normal." And I was just like,"Oh, okay." And again, it wasn't until my youngest when I gave birth again and had another cesarean, and I felt nothing.
• 22:28
  Dr Julie Hammond: I was like, Okay, that definitely wasn't a normal experience at all."
• 22:31
  Remi Mogekwu: Yeah
• 22:33
  Dr Julie Hammond: yeah, so you can't prepare.
• 22:35
  Dr Julie Hammond: It was so much.
• 22:36
  Dr Julie Hammond: Yes.
• 22:36
  Remi Mogekwu: But what did you prepare for the third?
• 22:38
  Dr Julie Hammond: So again, we were fortunate enough to be able to afford to move closer to London so we were closer to my family, so that definitely helped.
• 22:44
  Dr Julie Hammond: I had my mother-in-law she was, she's retired at the moment or semi-retired, so she was able to come in a couple days a, a week and just support me so I wasn't alone.
• 22:53
  Dr Julie Hammond: We hired a cleaner just to help clean the house.
• 22:55
  Dr Julie Hammond: At least that's one less thing for me to worry about.
• 22:58
  Dr Julie Hammond: Again, I was lucky enough to have another friend who lived really close to me who was in a postpartum as well.
• 23:02
  Dr Julie Hammond: So it's quite nice just to be able to like, whenever we felt like it, if we both of us woke up and we had energy that day, we'd just say,"Okay, let's meet up and let's go for a walk, and let's do something." So all of that I think definitely helped to just support me during that period.
• 23:14
  Dr Julie Hammond: So with my second, I was, you know, doing all the baby groups because I, I really wanted to have that company and I was really worried about being isolated and lonely.
• 23:22
  Dr Julie Hammond: And then this time around I didn't join any groups'cause I just felt confident that I had a good support system around me.
• 23:27
  Dr Julie Hammond: So even on the days I didn't do anything or didn't like go out to any baby groups, I just went to mom's house instead and stayed there and had support looking after my son.
• 23:35
  Remi Mogekwu: And I think as well, like, we shy away from, like, how beneficial having a cleaner is, or
• 23:41
  Dr Julie Hammond: Mmhmm
• 23:41
  Remi Mogekwu: food is, or, you know, just having people that you're familiar with.
• 23:45
  Remi Mogekwu: Like my, one of my biggest issue with all the baby groups is that it's great but you're often making friends with people that the only thing you have in common with is the fact that you just had a baby, and then you
• 23:55
  Dr Julie Hammond: Yeah.
• 23:56
  Dr Julie Hammond: Yeah.
• 23:57
  Dr Julie Hammond: Yeah
• 23:57
  Remi Mogekwu: So I found that even for both children I tried, but I would often still feel lonely within a
• 24:03
  Dr Julie Hammond: Mm
• 24:04
  Remi Mogekwu: they just were not
• 24:05
  Dr Julie Hammond: Yes.
• 24:06
  Dr Julie Hammond: Yeah.
• 24:07
  Dr Julie Hammond: So that, that's how I was with my first groups that I was going to, and I just like And then afterwards they all said,"Oh yeah, let's go for coffee then." I wouldn't be invited.
• 24:14
  Dr Julie Hammond: Not, maybe'cause I didn't look like them, can read between the lines.
• 24:19
  Remi Mogekwu: I think it's a really real thing though, because again, like being a doctor, you're
• 24:23
  Dr Julie Hammond: Mmhmm
• 24:24
  Remi Mogekwu: a minority in
• 24:25
  Dr Julie Hammond: Mmhmm
• 24:25
  Remi Mogekwu: That's not, it's not brand new.
• 24:27
  Remi Mogekwu: And then when you are able to buy a house, get a mortgage, you will often find that you're a minority in the, in the areas in which you can afford to live in.
• 24:35
  Remi Mogekwu: And then, you know, you're around people that you're not necessarily familiar with, and they're not familiar with you.
• 24:41
  Remi Mogekwu: now I'm like, I have
• 24:43
  Dr Julie Hammond: Mm
• 24:43
  Remi Mogekwu: that again."
• 24:44
  Dr Julie Hammond: I mean, you don't have to, but I did find that going out the house, getting dressed up and leaving the house helped to keep me a bit sane.
• 24:51
  Dr Julie Hammond: Just to know that I had, like, one thing, not to look forward to, but one task that I, I wanted to complete to say I had a successful day.
• 24:57
  Dr Julie Hammond: So that's what I was doing it for.
• 24:59
  Dr Julie Hammond: But then this time around I didn't feel like I needed, I needed, like, the routine as much.
• 25:03
  Dr Julie Hammond: I was like very much if I didn't do anything that day, that's absolutely fine.
• 25:06
  Dr Julie Hammond: But I think maybe the, the second time around I was, like, very much focused on having the perfect postpartum experience that I was doing all these things that I don't think were necessarily benefiting me during that time.
• 25:15
  Dr Julie Hammond: But I wanted to be the mom who took my child to the library, to this baby group, to swimming.
• 25:20
  Dr Julie Hammond: You know, what is a three-month-old doing swimming?
• 25:22
  Dr Julie Hammond: But I went every single week.
• 25:23
  Remi Mogekwu: and I've got a nine-year-old, and the stuff that I've been doing with her since she was, like,
• 25:28
  Dr Julie Hammond: Yeah
• 25:29
  Remi Mogekwu: old, and obviously I'm sure it all- it, it's all beneficial, but it just never stops.
• 25:34
  Remi Mogekwu: So in my head I'm like,"You might as well take that first year to do nothing and just do what you absolutely enjoy."
• 25:40
  Dr Julie Hammond: Yes.
• 25:40
  Dr Julie Hammond: Yes.
• 25:41
  Remi Mogekwu: to brunches, go for
• 25:42
  Dr Julie Hammond: Mmhmm
• 25:42
  Remi Mogekwu: don't I don't think they need sensory.
• 25:43
  Remi Mogekwu: I think they'll cope without it, personally.
• 25:45
  Dr Julie Hammond: my youngest didn't go to sensory and I think he's very well developed and advanced for his age, so
• 25:50
  Remi Mogekwu: And I think there's this element of doing postpartum or mat leave or
• 25:54
  Dr Julie Hammond: Mmhmm
• 25:55
  Remi Mogekwu: well.
• 25:56
  Dr Julie Hammond: That's it
• 25:57
  Remi Mogekwu: and it's an unnecessary pressure that
• 25:58
  Dr Julie Hammond: Mmhmm Yes.
• 26:00
  Remi Mogekwu: unnecessary.
• 26:01
  Dr Julie Hammond: Because I think I was struggling so much internally, I wanted to look outwardly to the world like I had it all together, like I was enjoying it, I was doing this, I was doing that.
• 26:09
  Dr Julie Hammond: 'Cause everyone's like,"Oh my gosh, you, you're always dressing up and you're going to all this activity." I was like,"Yeah." But I, I hated it.
• 26:14
  Dr Julie Hammond: Like, either I had anxiety leaving the house each day to go to.
• 26:17
  Dr Julie Hammond: And he would scream in the car the whole way there, and scream on the way back.
• 26:21
  Dr Julie Hammond: And I was like,"Why am I doing this?
• 26:22
  Dr Julie Hammond: Why am I putting myself through this?" But again, I wanted to have this image of just looking like I had it all together when, you know, things were falling apart.
• 26:30
  Remi Mogekwu: 'Cause you said you were on treatment or, like,
• 26:33
  Dr Julie Hammond: Right
• 26:33
  Remi Mogekwu: medication after your second.
• 26:36
  Remi Mogekwu: And were you then still needing the medication after your third or did you find that the things that you'd put in place were enough?
• 26:42
  Dr Julie Hammond: Yeah, so I did the medications for about six to eight months.
• 26:45
  Dr Julie Hammond: I can't remember exactly how long I was on it for.
• 26:47
  Dr Julie Hammond: And then I decided to come off it and just see how I did without it, and then I was okay, and then I ended up falling pregnant shortly after that.
• 26:55
  Dr Julie Hammond: And then I was always, I was always in the mindset that if I do need the help and I do need the medications, I'm not going to, this time round, I'm not going to suffer.
• 27:04
  Dr Julie Hammond: I wanna actually enjoy postpartum'cause I feel like it, you know, depression, anxiety stole so much from me during that pre- experience.
• 27:10
  Dr Julie Hammond: So I was like,"No, this time round I'm not gonna allow it to happen again." So my thresholds for going to get help has been extremely low, and I so far haven't needed it.
• 27:18
  Dr Julie Hammond: I mean, there were moments, especially when I first gave birth, I was like,"Oh my gosh, is it happening again?" But I think that was more so the baby blues, and I, I came out of it.
• 27:25
  Dr Julie Hammond: But there was a moment for that first, you know, month I was like,"Oh, you know, things are a bit shaky." But fortunately I was able to come out of it, and it wasn't like it was the second time round.
• 27:34
  Remi Mogekwu: And did you have perinatal mental health, like, follow-up or extended postnatal care or
• 27:40
  Dr Julie Hammond: So I had the support again with my second pregnancy.
• 27:43
  Dr Julie Hammond: So in the pregnancy as well as already having the counseling support, I was like I don't know how, like I'm not sleeping.
• 27:49
  Dr Julie Hammond: I need support.
• 27:49
  Dr Julie Hammond: So I was having the follow-up with them, seeing I had a psychiatrist who I was seeing, and again, I was on their books until two years.
• 27:56
  Dr Julie Hammond: This time round I did again mention that, you know, you know, what's the referral pathways?
• 28:00
  Dr Julie Hammond: 'Cause again, it was a, I was in a different area.
• 28:02
  Dr Julie Hammond: I was in Rochester at the time.
• 28:03
  Dr Julie Hammond: Now I'm in closer to London.
• 28:04
  Dr Julie Hammond: So I was like, okay, what are the referral pathways in my area?
• 28:07
  Dr Julie Hammond: And to be honest, I was really disappointed when I heard that it would be about a year's waiting list time if I needed help, if I needed counseling.
• 28:14
  Dr Julie Hammond: I was just like, so I'm not depressed yet, but should I put myself on a waiting list now just in case I do become depressed or
• 28:20
  Remi Mogekwu: Hmm.
• 28:21
  Dr Julie Hammond: It's crazy and this is what women are having to go through like that you have to almost future plan just in case.
• 28:26
  Dr Julie Hammond: Let me go and put myself on waiting list whilst I'm pregnant, and this is whilst I was pregnant.
• 28:29
  Dr Julie Hammond: I wasn't gonna get help until I was how many months postpartum.
• 28:32
  Dr Julie Hammond: Yeah, or go private.
• 28:33
  Remi Mogekwu: It's, it's a madness, and I think'cause I've sat in, well, I've run quite a few perinatal mental health antenatally, so for
• 28:40
  Dr Julie Hammond: Mmhmm
• 28:40
  Remi Mogekwu: people who've had a history of anxiety or depression or have it currently.
• 28:46
  Remi Mogekwu: And I will often say, like, r- self-refer for talking therapy in the pregnancy because you honestly don't know, and whilst you are pregnant,
• 28:53
  Dr Julie Hammond: Mm-hmm.
• 28:54
  Remi Mogekwu: give you a bump up, up
• 28:55
  Dr Julie Hammond: Mm-hmm.
• 28:57
  Dr Julie Hammond: Mm-hmm.
• 28:57
  Remi Mogekwu: because actually you can't, like I said, you cannot predict how you feel, what
• 29:01
  Dr Julie Hammond: Yeah.
• 29:01
  Remi Mogekwu: what,
• 29:02
  Dr Julie Hammond: Yes.
• 29:03
  Remi Mogekwu: looks like.
• 29:03
  Dr Julie Hammond: Mm-hmm.
• 29:04
  Remi Mogekwu: and I think as two doctors talking and we're like you c- you know, you can't predict.
• 29:09
  Remi Mogekwu: I've worked on the labor ward, I have
• 29:11
  Dr Julie Hammond: Mmhmm
• 29:12
  Remi Mogekwu: women through most outcomes, and even for myself, knowing the midwives, knowing the doctors that
• 29:19
  Dr Julie Hammond: Yeah
• 29:19
  Remi Mogekwu: be around, delivering in a unit that I feel completely comfortable in, still like,"I don't know."
• 29:26
  Dr Julie Hammond: Yeah
• 29:26
  Remi Mogekwu: Like, there's just so much that you cannot predict and that you can't work around.
• 29:31
  Remi Mogekwu: And then I say this as someone who's a Black woman, and I think if I, with all my privilege, and you with all your privilege, and our education and our knowing what's right cannot, plan
• 29:43
  Dr Julie Hammond: Mm-hmm.
• 29:43
  Remi Mogekwu: for a specific outcome, what more for women who look like us but don't have, any of the privileges that I've mentioned?
• 29:50
  Dr Julie Hammond: Mm-hmm.
• 29:50
  Remi Mogekwu: And I noticed that you do work that speaks to Black women, so type of thing do you recommend that they would do to navigate the space, both in pregnancy and after pregnancy?
• 30:01
  Dr Julie Hammond: So again, I think definitely just trying to be as educating and aware of what can happen in pregnancy as possible.
• 30:07
  Dr Julie Hammond: And knowing-- I know all the time we're talking about all, all the things that we increase risk of, and I'm not trying to say it to scare anyone or to scare monger.
• 30:14
  Dr Julie Hammond: But I think you-- again, just being aware that yes, we are increased risk of things like gestational d-diabetes, especially if you have a history of a family history of diabetes and pre-eclampsia, so that when you do go to your appointments, you can even ask like,"Oh, have you checked for this?""Oh, can you do my blood pressure?
• 30:26
  Dr Julie Hammond: Can you just check my urine?" That being proactive and knowing that you can ask for these services.
• 30:30
  Dr Julie Hammond: You can also, if you're not happy with your midwife or your consultant who's looking after you, you can always ask to see someone else for a second opinion as well.
• 30:40
  Dr Julie Hammond: Just knowing that and then knowing as well that if you if you're not feeling confident speaking up for yourself, you can always bring someone along to those appointments with you.
• 30:47
  Dr Julie Hammond: Because sometimes even myself, when they're giving lots of information, it's, it can be overwhelming to like really know what you're processing.
• 30:53
  Dr Julie Hammond: So having someone else there who's also, you know, on your side to advocate for you and also to take notes, that can also be very much be- beneficial.
• 30:59
  Dr Julie Hammond: And to write everything down.
• 31:01
  Dr Julie Hammond: Before go to your appointment, write down all your questions.
• 31:03
  Dr Julie Hammond: Make sure, being sure that you're well informed.
• 31:05
  Dr Julie Hammond: So ask-asking them, you know,"What will happen if I do not have this treatment that you recommended me?
• 31:10
  Dr Julie Hammond: Like, why are you recommend-recommending it to me?
• 31:12
  Dr Julie Hammond: What is it meant to do for me?
• 31:13
  Dr Julie Hammond: What's gonna happen if I don't?
• 31:14
  Dr Julie Hammond: What are the side effects?
• 31:15
  Dr Julie Hammond: And you know, what happens if we wait?
• 31:17
  Dr Julie Hammond: How long can we wait safely safe as possible without having intervention?" So I think, you know, just feeling empowered and knowing that you can ask for these these questions a-ahead of time.
• 31:26
  Dr Julie Hammond: And I think also even before getting pregnant, just to start planning for it.
• 31:30
  Dr Julie Hammond: I mean, again, I'm not sure people listening where they are on their journey.
• 31:34
  Dr Julie Hammond: But before getting pregnant, if you can, I think just being aware of any medical conditions that you may have.
• 31:39
  Dr Julie Hammond: So just go and do that blood test, go and check your blood pressure, have a scan if you're having heavier painful periods, so you know if you have conditions like fibroids endometriosis, adenomyosis, all of these things.
• 31:48
  Dr Julie Hammond: I think just being in as informed as we can be so that we can advocate for ourself effectively.
• 31:54
  Remi Mogekwu: Yeah, no, I think, I think you've hit the nail on the head.
• 31:56
  Remi Mogekwu: And I think that sometimes people enter the consultations and appreciate that, they probably enter it thinking that there is a power balance in the favor of the doctor or the
• 32:09
  Dr Julie Hammond: Mmhmm
• 32:10
  Remi Mogekwu: But I think you should enter it that you're either on the same level or actually you as the patient hold the power.
• 32:17
  Dr Julie Hammond: Yes
• 32:17
  Remi Mogekwu: Once you're a pregnancy, if you're planning, cause I know lots of people don't plan,
• 32:22
  Dr Julie Hammond: Yeah.
• 32:22
  Remi Mogekwu: if you are planning a pregnancy, taking stock of your health, when you go and see your midwife for
• 32:27
  Dr Julie Hammond: Mmhmm
• 32:27
  Remi Mogekwu: appointment, being like,"These are my conditions.
• 32:31
  Dr Julie Hammond: Mm-hmm.
• 32:33
  Dr Julie Hammond: Mm-hmm.
• 32:35
  Dr Julie Hammond: Mm-hmm.
• 32:35
  Remi Mogekwu: 'cause the person on the other side of it is also human.
• 32:38
  Remi Mogekwu: They might be tired, they might be, traumatized from the shift before.
• 32:42
  Remi Mogekwu: Like, there are so many ways in which your own details can get lost.
• 32:47
  Dr Julie Hammond: Mm-hmm.
• 32:47
  Remi Mogekwu: So I struggle with being anemic.
• 32:50
  Remi Mogekwu: At the booking appointment,"I know I'm anemic.
• 32:53
  Remi Mogekwu: Can you give me iron tablets?""Oh, no, no, no, we need to check." I was like,"I don't, I don't like taking iron tablets anyway, so whatever.
• 32:59
  Remi Mogekwu: So ch- do your checks."
• 33:01
  Dr Julie Hammond: Yes, I can.
• 33:01
  Dr Julie Hammond: Yes
• 33:01
  Remi Mogekwu: then I get a text three days later,"You need to go pick up iron tablets." I was just there.
• 33:05
  Remi Mogekwu: And you know, it's the type of thing that you can be like,"No, I'm literally here.
• 33:09
  Remi Mogekwu: Just give me the tablets."
• 33:10
  Dr Julie Hammond: Mm-hmm.
• 33:11
  Remi Mogekwu: And then I was like,"Well, can you just refer me to get an iron infusion?"
• 33:14
  Dr Julie Hammond: Mm-hmm.
• 33:15
  Remi Mogekwu: "No, no, no.
• 33:16
  Remi Mogekwu: We'll, we'll do it at your 28-week bloods." At the 28-week check, we're Having the same conversation, and it got to a point I was like,"You know what?
• 33:22
  Remi Mogekwu: I'm just gonna text a friend." And I was like,"Can you book me an iron
• 33:26
  Dr Julie Hammond: Yeah.
• 33:26
  Dr Julie Hammond: Yes
• 33:27
  Remi Mogekwu: 'Cause you're like, otherwise I'd get to 36 weeks, and then you guys would look at me and be like,"Oh, still anemic." I just think that, yeah, education has a place,
• 33:36
  Dr Julie Hammond: Mmhmm Mmhmm
• 33:38
  Remi Mogekwu: up, and the only way that you can do that effectively is actually knowing yourself.
• 33:42
  Dr Julie Hammond: Yes
• 33:42
  Remi Mogekwu: So you're obviously a very busy mother, and you have got life experience, lived experience, and clinical experience, and you're using that for good, which I think is really important.
• 33:54
  Remi Mogekwu: And I think sometimes when we've gone through things, we should think about giving back, and that's why I record
• 33:59
  Dr Julie Hammond: Hmm.
• 34:00
  Remi Mogekwu: YouTube, and that's why I'm passionate about pregnancy and the postpartum period.
• 34:03
  Remi Mogekwu: But you've got two things coming.
• 34:05
  Remi Mogekwu: You're building a company called MamAR,
• 34:07
  Dr Julie Hammond: Yes.
• 34:08
  Remi Mogekwu: you've got a book coming
• 34:09
  Dr Julie Hammond: Yes
• 34:09
  Remi Mogekwu: that talks about the fourth trimester.
• 34:11
  Remi Mogekwu: So tell us about the book.
• 34:14
  Remi Mogekwu: When is it out?
• 34:15
  Remi Mogekwu: What does it cover, and what can people look forward to with it?
• 34:18
  Dr Julie Hammond: Okay.
• 34:19
  Dr Julie Hammond: So the book is out on the 19th of November this year, and essentially I want it to be your encyclopedia covering all things related to postpartum recovery.
• 34:30
  Dr Julie Hammond: It's going to go tell my personal story, stories of my patients or family, all included.
• 34:34
  Dr Julie Hammond: So it's almost like a novel that you read through with storytelling involved, and then it will give you some practical advice on things to do that if you're going through it as well.
• 34:42
  Dr Julie Hammond: So we cover everything.
• 34:43
  Dr Julie Hammond: So we cover recovery from both vaginal and also cesarean section delivery, things that I wasn't even aware of before giving birth.
• 34:49
  Dr Julie Hammond: So things like, you know, the importance of things like scar massage after having a cesarean delivery, whereby we do that to prevent any adhesions.
• 34:56
  Dr Julie Hammond: Also helps to, to prevent any sort of keloid scar or hypertrophic scar formation.
• 35:01
  Dr Julie Hammond: Again, I wasn't aware about any of this, but these are things that I learnt.
• 35:04
  Dr Julie Hammond: The importance of things like pelvic floor exercise, having sex after giving birth.
• 35:08
  Dr Julie Hammond: It's not something we really talk about, but a lot of women don't enjoy sex after giving birth.
• 35:12
  Dr Julie Hammond: They find it painful.
• 35:13
  Dr Julie Hammond: They have vaginal dryness, all of these things.
• 35:15
  Dr Julie Hammond: I wanna empower people to take control back and to know that sex doesn't have to stop become, becoming pleasurable because you became a mother.
• 35:22
  Dr Julie Hammond: You can know, you can still have the best sex of your life even despite that.
• 35:26
  Dr Julie Hammond: So I talk about that as well.
• 35:27
  Dr Julie Hammond: I talk about postpartum anxiety and depression, of course, and even things like postpartum OCD, which again, I've just learnt so much in this, in this space and doing research and knowing that it can present in different ways.
• 35:38
  Dr Julie Hammond: I, I s- I write about postpartum intrusive thoughts, which again, is considered to be normal, but again, they can still feel quite scary when you're going through it and when you're especially when you don't expect that, that that's going to happen for you.
• 35:49
  Dr Julie Hammond: I talk about birth trauma as well, and also my unique experiences of having a child in Skaboom and how that can affect you postpartum, and also having your rainbow baby as well, that even though you bec- you go po- postpartum, you've had your baby, you can still continue to struggle.
• 36:05
  Dr Julie Hammond: And I talk about all these other fun things, you know, finding yourself again, friendships, all the rest of it in the book as well.
• 36:11
  Remi Mogekwu: No, that sounds great, and I think it sounds like you're covering everything.
• 36:15
  Remi Mogekwu: The way I like to think about women's health really, or all health, is the biopsychosocial model,
• 36:20
  Dr Julie Hammond: Mm-hmm.
• 36:21
  Dr Julie Hammond: Yes.
• 36:21
  Remi Mogekwu: The physical things
• 36:22
  Dr Julie Hammond: Yeah.
• 36:22
  Remi Mogekwu: wrong,
• 36:23
  Dr Julie Hammond: Yes.
• 36:23
  Remi Mogekwu: psychological things
• 36:24
  Dr Julie Hammond: Mmhmm
• 36:24
  Remi Mogekwu: but also the real social
• 36:26
  Dr Julie Hammond: Yes
• 36:26
  Remi Mogekwu: either it's internally or it's externally with friends.
• 36:30
  Remi Mogekwu: And like things like work and money,
• 36:32
  Dr Julie Hammond: Yeah.
• 36:32
  Remi Mogekwu: of those things change in
• 36:34
  Dr Julie Hammond: I love that.
• 36:35
  Dr Julie Hammond: I love...
• 36:35
  Dr Julie Hammond: Sorry, I also talk about culture as well, and how that affected my experience.
• 36:38
  Dr Julie Hammond: I have Nigerian parents, and some of the things they said were a bit outrageous.
• 36:44
  Dr Julie Hammond: And when you don't know any better, you're, you, you're like,"How can I fight?" You're like circumcision, all these different things.
• 36:49
  Dr Julie Hammond: I know they're touchy topics, so I won't talk too much in case people come and say,"No, you should definitely do this, or you shouldn't do this." But I had mixed emotions of, of feelings about it.
• 36:57
  Dr Julie Hammond: My husband is Caribbean.
• 36:58
  Dr Julie Hammond: I'm, I'm Nigerian.
• 36:59
  Dr Julie Hammond: So again, we had a lot of discussions in our household about what we're going to do with our two boys.
• 37:03
  Dr Julie Hammond: So all of these things can definitely play a role in how you, you're adjusting and how you relate to your partner as well.
• 37:10
  Dr Julie Hammond: So yes, you mentioned the social as- aspect, and we cover all of that.
• 37:13
  Dr Julie Hammond: Even going back to work, I speak of my struggles.
• 37:15
  Dr Julie Hammond: The fact that there was one day I was so tired that I, I don't even know how I got to work, but I was filling up my car with I think I had a diesel car, and I put petrol in my diesel car.
• 37:24
  Dr Julie Hammond: And I broke down on the motorway as a result because I, I don't know how.
• 37:29
  Dr Julie Hammond: And even when I was trying to put the nozzle in, it wasn't fitting, but I was like,"Oh my gosh, you're so tired, you've forgotten how to fill up the car." And it, I just didn't put two and two together until the car wasn't responding to me on the motorway.
• 37:38
  Dr Julie Hammond: I mean, I...
• 37:39
  Dr Julie Hammond: It was, it was dangerous.
• 37:40
  Dr Julie Hammond: I could, something, you know, could have happened to me on the motorway, thank goodness.
• 37:44
  Dr Julie Hammond: But it was at that moment, again, I was just like,"What is going on?
• 37:46
  Dr Julie Hammond: Like, you need to slow down.
• 37:47
  Dr Julie Hammond: You can't keep on going as you are before." Babies don't just slot into your life and you continue on.
• 37:52
  Dr Julie Hammond: You have to make adjustments for them, whether that's going less than full time, et cetera.
• 37:55
  Dr Julie Hammond: So all of these things I mention in the book.
• 37:57
  Remi Mogekwu: I think that's actually a really important point, and I think the effects of sleep deprivation on women when they're pregnant,
• 38:04
  Dr Julie Hammond: Yes.
• 38:05
  Remi Mogekwu: they have the
• 38:06
  Dr Julie Hammond: Mmhmm
• 38:06
  Remi Mogekwu: it's something that we really overlook.
• 38:08
  Remi Mogekwu: We know how much sleep is important.
• 38:11
  Dr Julie Hammond: Mmhmm
• 38:11
  Remi Mogekwu: much it's good for brain health.
• 38:13
  Remi Mogekwu: We know the effects of it longer
• 38:15
  Dr Julie Hammond: Hmm.
• 38:16
  Remi Mogekwu: we're just happy for who choose to have babies to continue to struggle without, and expect them to perform in the
• 38:25
  Dr Julie Hammond: Yes.
• 38:26
  Remi Mogekwu: and how dare you complain?
• 38:29
  Remi Mogekwu: How dare you?
• 38:29
  Remi Mogekwu: Because who sent you?
• 38:31
  Remi Mogekwu: And it's this wider picture that we're missing that,
• 38:34
  Dr Julie Hammond: Mmhmm
• 38:34
  Remi Mogekwu: we have kids, and actually that helps the population.
• 38:37
  Remi Mogekwu: It
• 38:37
  Dr Julie Hammond: Mmhmm Mmhmm Mmhmm
• 38:42
  Remi Mogekwu: but there is no support and even going back to work is a struggle for you as the person who's not sleeping all of these things But then it's how they treat you when you go back to work how your pay gets messed up how the paperwork is
• 38:55
  Dr Julie Hammond: Yeah
• 38:55
  Remi Mogekwu: how people have completely insensitive comments on either side Being pregnant going on mat leave coming back to work there's just no sensitivity around the fact that this person has gone through
• 39:07
  Dr Julie Hammond: Mmhmm
• 39:08
  Remi Mogekwu: that is lifechanging
• 39:09
  Dr Julie Hammond: yeah, it's not, not all places know about phased return or keeping in touch days.
• 39:13
  Dr Julie Hammond: And I remember going back to work and not having the best support, and being thrown into the deep end and, you know, going back to 10-minute appointments on your first day back at work and just being like,"I've been off for a year.
• 39:24
  Dr Julie Hammond: What's going on?" Yes, all of this happened.
• 39:26
  Dr Julie Hammond: And we forget that sleep deprivation is a form of torture.
• 39:30
  Dr Julie Hammond: When you're sleep deprived, it affects everything.
• 39:32
  Dr Julie Hammond: It affects your resilience, so it affects your mental health, you know, how much things affect you.
• 39:37
  Dr Julie Hammond: It affects your ability to concentrate.
• 39:38
  Dr Julie Hammond: I couldn't even remember, like, simple medications.
• 39:41
  Dr Julie Hammond: Like, I'm not a PN, I was like,"What...
• 39:42
  Dr Julie Hammond: The name of that medication that begins with A." I, these silly things and then the, you know, the patient look at me like I'm incompetent, but I'm like, my brain just isn't functioning as normal, and I don't know what to do.
• 39:51
  Dr Julie Hammond: And yeah, so it, it's been an adjustment and a learning period.
• 39:56
  Dr Julie Hammond: Definitely know it takes me at least 18 to 24 months for me to get back to myself again.
• 40:00
  Dr Julie Hammond: So I feel like I'm 22 months deep.
• 40:03
  Dr Julie Hammond: Maybe I'm getting there.
• 40:06
  Remi Mogekwu: I think that's a real realistic estimate I think it is
• 40:09
  Dr Julie Hammond: Mm-hmm.
• 40:11
  Dr Julie Hammond: Yeah
• 40:11
  Remi Mogekwu: for most people to be back to nor And for me like when I held the dinner so I had a dinner recently had 15 women in the
• 40:18
  Dr Julie Hammond: Yeah.
• 40:19
  Remi Mogekwu: early
• 40:19
  Dr Julie Hammond: Yeah
• 40:20
  Remi Mogekwu: And like there were people with threeyearolds fouryearolds fiveyearolds and they were like I've been able to leave the house people were close to tears And it's just it's actually really hard to function with all these things going on
• 40:35
  Dr Julie Hammond: Mmhmm
• 40:35
  Remi Mogekwu: are still let's not forget you are still raising a
• 40:38
  Dr Julie Hammond: Yeah
• 40:39
  Remi Mogekwu: that child in and of themselves is doing all these growing walking talking eating
• 40:47
  Dr Julie Hammond: my God.
• 40:47
  Dr Julie Hammond: Yeah
• 40:47
  Remi Mogekwu: that you're juggling on top of all the things that you are
• 40:51
  Dr Julie Hammond: Yes.
• 40:52
  Dr Julie Hammond: Absolutely
• 40:53
  Remi Mogekwu: how is mamAR gonna solve that issue
• 40:57
  Dr Julie Hammond: So it's a digital health platform which I've designed to help support parents from preconception through to the first five years of their child's life.
• 41:03
  Dr Julie Hammond: And essentially I want it to be the one-stop shop that you go to for if you're needing community or online community, if you're needing education if you need access to professional support, I want it to be the one place that you go to, to go and get a- access to all of this information.
• 41:17
  Dr Julie Hammond: 'Cause I certainly found that I needed some support.
• 41:19
  Dr Julie Hammond: So we mentioned about, you know, you're still navigating going back to yourself, going back to work and that juggle, but then what happens if you have a child who has some additional needs?
• 41:27
  Dr Julie Hammond: I mentioned my son had speech delay at the time we weren't sure if is it speech delay, is it autism?
• 41:32
  Dr Julie Hammond: So I had to go and navigate all these different services.
• 41:35
  Dr Julie Hammond: We know the waiting times for, you know, community pediatrician assess- assessment is up to two years in certain areas, and I think I've heard now it can be up to five years in certain areas now.
• 41:44
  Dr Julie Hammond: Yes, it's increased.
• 41:45
  Dr Julie Hammond: And I was just like,"Where do I go?" And I was like,"You know what?
• 41:47
  Dr Julie Hammond: I don't care, I wanna go private." And then even when I went online to, you know, I was googling, trying to find private providers, and a lot of people were fully booked.
• 41:54
  Dr Julie Hammond: And I, when I did find someone, I was like,"Can I trust them?
• 41:56
  Dr Julie Hammond: I, where, where's the reviews?" So I want this to be the one platform that you go to where you can actually be like,"Okay, I can see the reviews.
• 42:01
  Dr Julie Hammond: They're close to me.
• 42:02
  Dr Julie Hammond: They have availability." Just to make it a little bit less stressful.
• 42:05
  Dr Julie Hammond: 'Cause again, when you're trying to find out help for your child who's struggling or even help for yourself if you're going through fertility issues or issues in your pregnancy, I don't want it, it to be another barrier where you don't know who to go to or where to go to for help.
• 42:15
  Dr Julie Hammond: So this is why, this is why I created Mama
• 42:17
  Remi Mogekwu: Nice so is it a platform where they come for education but it also will highlight who they need to see to seek help from with recommendations so a doctor on the other end of it or a physiotherapist or
• 42:30
  Dr Julie Hammond: Yes.
• 42:31
  Remi Mogekwu: great so it really is a onestop shop
• 42:33
  Dr Julie Hammond: Yes, a one-stop shop.
• 42:34
  Dr Julie Hammond: So, and again, I want it to be very much independent providers who have their own businesses.
• 42:38
  Dr Julie Hammond: So it helps them to grow their business as well whilst they're on the platform if they're starting out.
• 42:41
  Dr Julie Hammond: We'll always check everyone, make sure that we're fully verified, they have the right checks, they're insured, they have their DBS checks.
• 42:47
  Dr Julie Hammond: So everyone needs to be, to have all of that to be on our platform.
• 42:51
  Dr Julie Hammond: But then once on the platform, it's, it's up to you who you choose to go to.
• 42:54
  Dr Julie Hammond: So we're not gonna push you towards anyone.
• 42:55
  Dr Julie Hammond: You can pick and choose.
• 42:56
  Dr Julie Hammond: If you meet someone and you don't necessarily get on with them or you don't like their approach to the care, you can find another provider on the website and you can leave a review as well
• 43:03
  Remi Mogekwu: So Is it out now or
• 43:05
  Dr Julie Hammond: So I am piloting at the moment.
• 43:07
  Dr Julie Hammond: So I'm, you know, anyone who's interested, please do sign up and give me feedback.
• 43:12
  Dr Julie Hammond: I'm happy to learn.
• 43:13
  Dr Julie Hammond: So we're developing the service user aspect in particular to make it a seamless experience.
• 43:18
  Dr Julie Hammond: So again, I'm trying to focus more so on the fertility aspect or preconception care.
• 43:23
  Dr Julie Hammond: So to give you access to all of that information that you may need for yourself to go and speak to your GP and advocate for yourself, as well as being able to access any support in that period of time as well, as well as, you know, creating tools to help you in pregnancy to remind you to check your blood pressure at home and, you know, and also monitor trends.
• 43:39
  Dr Julie Hammond: So if there's anything that's beginning to creep up, it'll just signpost you that,"Oh, no, this is looking like it's creeping up a little bit." Maybe just have a touch point with your midwife and just to empower you to, again, when you go and speak to a healthcare professional.
• 43:50
  Remi Mogekwu: and how have you found the founder process especially y you are busy You're a working GP you're a mum
• 43:56
  Dr Julie Hammond: Yes
• 43:57
  Remi Mogekwu: you've written a book how have you found the founder process
• 44:00
  Dr Julie Hammond: it's hard.
• 44:01
  Dr Julie Hammond: I mean, everyone wants to be able to say that,"Yes, I'm an entrepreneur and I got my business." But it's been a journey.
• 44:06
  Dr Julie Hammond: I've had many bumps on the roads.
• 44:08
  Dr Julie Hammond: There are moments where you have extreme highs when you're getting grant funding and, you know, you're getting accepted onto accelerators, and that's all fantastic.
• 44:14
  Dr Julie Hammond: But then there's also, you know, trying to raise money to expedite the next steps in terms of, you know, you know, bringing the platform fully live and, and trying to get users on it.
• 44:23
  Dr Julie Hammond: And I find that that part is, is the challenging part, especially since I've been pregnant.
• 44:28
  Dr Julie Hammond: So I found that that's been, that's been quite difficult.
• 44:30
  Dr Julie Hammond: So trying to fundraise when you're obviously pregnant or postpartum and maybe trying to keep that a secret it hasn't gone down, gone down quite as well as I'd like.
• 44:38
  Dr Julie Hammond: And I've decided maybe now to, like, bootstrap it more so.
• 44:42
  Dr Julie Hammond: So my co-founder is a software engineer, so we're able to almost do it all in-house for the time being.
• 44:48
  Dr Julie Hammond: So we're just, like, letting it grow o- organically and then seeing where it goes.
• 44:51
  Dr Julie Hammond: And then if the time comes where we do need the investor, then we can get an investor on board.
• 44:55
  Dr Julie Hammond: But I'm trying to create it so it's sustainable on its own without having any additional support
• 45:00
  Remi Mogekwu: so you'll send me the link and obviously if anyone wants to pilot it and give you some feedback it sounds really great I'm trying to think when I was on my first mat leave But know you'd come across apps like Peanut where you can
• 45:11
  Dr Julie Hammond: Yes.
• 45:12
  Dr Julie Hammond: Yeah
• 45:12
  Remi Mogekwu: people online but I've never really come across an app where you can take ownership of your own recovery and
• 45:18
  Dr Julie Hammond: Mmhmm
• 45:18
  Remi Mogekwu: help And even as I'm thinking now about going into my postpartum period I'm like I know I need to fix this diastasis recti I know I need to work on my pelvic floor I know and I may well need another another round of counseling Like all these things that I know from my previous
• 45:36
  Dr Julie Hammond: Mmhmm
• 45:37
  Remi Mogekwu: might come up again and it's nice to have a onestop shop as opposed to just rely on Google reviews potentially word of
• 45:45
  Dr Julie Hammond: Exactly
• 45:46
  Remi Mogekwu: and and sometimes you don't want even to talk about remember finding my first therapist because I posted it on Instagram I was like
• 45:52
  Dr Julie Hammond: Really?
• 45:53
  Remi Mogekwu: a thera Yeah I was like Looking for a therapist Who's got
• 45:56
  Dr Julie Hammond: Mm
• 45:56
  Remi Mogekwu: then someone sent me
• 45:58
  Dr Julie Hammond: Oh, amazing.
• 45:59
  Dr Julie Hammond: Yes
• 46:00
  Remi Mogekwu: And I was just like cause at it was at that point that I was just like this is madness
• 46:04
  Dr Julie Hammond: Mmhmm
• 46:04
  Remi Mogekwu: can't carry on like
• 46:06
  Dr Julie Hammond: Exactly, yes.
• 46:07
  Dr Julie Hammond: No, so I was gonna mention it, even with my son, again, in the Black community, if you start saying things like autism, everyone's like,"God forbid." And I just didn't want the stigma.
• 46:14
  Dr Julie Hammond: I didn't want him to be judged or be labeled.
• 46:15
  Dr Julie Hammond: So again, I felt like I was very much private with what I was going through.
• 46:18
  Dr Julie Hammond: I wasn't really speaking to many people about it, and I was trying to, you know, find help on my own.
• 46:23
  Dr Julie Hammond: So again, that was also an, a barrier to accessing services.
• 46:26
  Dr Julie Hammond: So this is why I wanted to create MamAR, so if it's something you want to keep private, you can also just be able to go and have this in your private online community or find the providers there as well
• 46:36
  Remi Mogekwu: I think it sounds great I think
• 46:38
  Dr Julie Hammond: Mmhmm
• 46:38
  Remi Mogekwu: entered into this pregnancy and
• 46:40
  Dr Julie Hammond: Mmhmm
• 46:41
  Remi Mogekwu: space roughly around the same
• 46:43
  Dr Julie Hammond: Mm-hmm.
• 46:43
  Remi Mogekwu: And I think the more I've come into the space the more I'm validated
• 46:48
  Dr Julie Hammond: Mmhmm Mmhmm
• 46:50
  Remi Mogekwu: wasn't a me problem it's an actual problem And I love that you added the essence of culture because when you are firstgeneration immigrant
• 47:00
  Dr Julie Hammond: Mm-hmm.
• 47:00
  Remi Mogekwu: like Nigerian I'm
• 47:01
  Dr Julie Hammond: Yeah.
• 47:02
  Remi Mogekwu: both both grandmas are Nigerian That comes with its own
• 47:05
  Dr Julie Hammond: Yeah.
• 47:06
  Dr Julie Hammond: Mm-hmm.
• 47:06
  Remi Mogekwu: and the overwhelm and yes you get help but help at what cost And sometimes it's the mental health I don't know damage I
• 47:16
  Dr Julie Hammond: Yeah.
• 47:17
  Dr Julie Hammond: Mm-hmm.
• 47:18
  Dr Julie Hammond: Mmhmm Mmhmm
• 47:21
  Remi Mogekwu: the expectations The an endless thing to navigate that
• 47:26
  Dr Julie Hammond: Mmhmm
• 47:27
  Remi Mogekwu: when you then go out into a baby group you can't relate right Because you actually have no one to talk about it
• 47:33
  Dr Julie Hammond: Yes, can no one understand?
• 47:34
  Remi Mogekwu: it with don't get
• 47:35
  Dr Julie Hammond: Yes.
• 47:36
  Remi Mogekwu: And so I yeah ul ultimately I stopped talking to a lot of people about the practices that we do
• 47:41
  Dr Julie Hammond: Mmhmm
• 47:42
  Remi Mogekwu: d I do think that there's a lot of benefit
• 47:44
  Dr Julie Hammond: Mm-hmm.
• 47:45
  Remi Mogekwu: in what we do culturally and I think that it's very easy when you're Western and evidencebased to shun a lot of practices that come out of Africa
• 47:56
  Dr Julie Hammond: Mmhmm
• 47:58
  Remi Mogekwu: but they happen for a reason and they w and they work
• 48:01
  Dr Julie Hammond: No, I agree.
• 48:01
  Dr Julie Hammond: I agree.
• 48:03
  Dr Julie Hammond: I agree.
• 48:03
  Dr Julie Hammond: So I talk about the, the positives and negatives, and I talk about maybe just adapting some practices.
• 48:07
  Dr Julie Hammond: Yes, you may do, like, so again, the naming ceremony, I was like, I came out of hospital the day before the day eight naming ceremony, and I was like,"There's no way I'm hosting people in the house." We did it virtually.
• 48:17
  Dr Julie Hammond: So again, I told people like virtual...
• 48:19
  Dr Julie Hammond: "What do you mean virtual naming ceremony?" But I was like,"You know, I don't care.
• 48:22
  Dr Julie Hammond: Either we do this or we don't do it at all." And it
• 48:24
  Remi Mogekwu: Yeah
• 48:25
  Dr Julie Hammond: and I was happy with it.
• 48:26
  Dr Julie Hammond: I think it was beautiful how it was.
• 48:28
  Dr Julie Hammond: But again, it's not
• 48:29
  Remi Mogekwu: it
• 48:29
  Dr Julie Hammond: typical.
• 48:29
  Remi Mogekwu: I've even got a video on my channel about belly binding So I
• 48:32
  Dr Julie Hammond: Oh, yes.
• 48:33
  Remi Mogekwu: me to do
• 48:34
  Dr Julie Hammond: Yes
• 48:35
  Remi Mogekwu: time and I was like Leave me alone
• 48:37
  Dr Julie Hammond: Mmhmm
• 48:37
  Remi Mogekwu: my head I'm like I care not if my tummy's flat or not after having a
• 48:42
  Dr Julie Hammond: Mmhmm Mm-hmm.
• 48:44
  Remi Mogekwu: But some people do and some of my friends had it
• 48:47
  Dr Julie Hammond: Mmhmm
• 48:48
  Remi Mogekwu: I still don't really know the benefits but I know that it's not particularly harmful
• 48:52
  Dr Julie Hammond: So many cultures do it.
• 48:54
  Dr Julie Hammond: Yes.
• 48:55
  Dr Julie Hammond: It's not only
• 48:56
  Remi Mogekwu: do it if you
• 48:56
  Dr Julie Hammond: Yeah, it's not only African, so many different cultures do it.
• 48:59
  Dr Julie Hammond: So,
• 49:00
  Remi Mogekwu: Yeah
• 49:00
  Dr Julie Hammond: I don't know if I did it after my fi- definitely with my youngest I did it, sort of.
• 49:05
  Dr Julie Hammond: When I couldn't be bothered to apply I did it.
• 49:07
  Dr Julie Hammond: So I don't know how much difference it made.
• 49:10
  Dr Julie Hammond: Maybe it's placebo.
• 49:11
  Remi Mogekwu: did you do it?
• 49:12
  Dr Julie Hammond: So I actually bought a-
• 49:14
  Remi Mogekwu: or b- you bought a belly binder?
• 49:15
  Dr Julie Hammond: a belly binder online.
• 49:17
  Dr Julie Hammond: I looked at one with lots of reviews, and I was like,"Okay, this looks okay." And as long as it was comfortable for me, then I, I used it.
• 49:23
  Remi Mogekwu: Cause I did the video, I was like,"Oh, should I do it this time?" And then I think I saw something in John Lewis that has,
• 49:29
  Dr Julie Hammond: See, John Lewis is doing it.
• 49:31
  Remi Mogekwu: binder
• 49:31
  Dr Julie Hammond: Yes.
• 49:32
  Dr Julie Hammond: And you know what?
• 49:32
  Dr Julie Hammond: Usually we shun our culture until it's accepted by Western culture, then we're like,"Oh, no, that's some..." So again, maybe I saw something like that, someone, you know, an Instagram influencer doing something like that.
• 49:43
  Dr Julie Hammond: Okay, you know what?
• 49:43
  Dr Julie Hammond: They're gonna do it, I should be doing it as well.
• 49:45
  Dr Julie Hammond: There's nothing wrong with binding our bellies.
• 49:47
  Dr Julie Hammond: Yeah
• 49:47
  Remi Mogekwu: And I think this is the problem, that we often will get told,
• 49:50
  Dr Julie Hammond: Hmm Hmm Mmhmm
• 49:51
  Remi Mogekwu: are you doing that?
• 49:51
  Remi Mogekwu: That's gross, that's disgusting, that's a waste of time." someone cottons onto it, reinvents it, and then sells it back to you, and then all of a sudden it's fashionable.
• 50:02
  Dr Julie Hammond: Yeah.
• 50:02
  Remi Mogekwu: Please,
• 50:03
  Dr Julie Hammond: Yeah.
• 50:03
  Remi Mogekwu: that.
• 50:03
  Dr Julie Hammond: Yeah.
• 50:04
  Remi Mogekwu: So just to wrap up, for the woman who is pregnant or planning for their postpartum period or someone who's newly postpartum
• 50:12
  Dr Julie Hammond: Mmhmm
• 50:13
  Remi Mogekwu: what parting words do you have for them?
• 50:15
  Dr Julie Hammond: I would say that it does get better.
• 50:19
  Dr Julie Hammond: I don't want to, sound all doom and gloom, but I would say even the darkest moments, they, it does get better, and everything is only for a season.
• 50:25
  Dr Julie Hammond: I think at the beginning when I had my, my eldest now, I was almost like,"Is this, this gonna be the rest of my life?
• 50:30
  Dr Julie Hammond: Am I just, am I just not going to ever sleep again?" Especially when I heard people saying,"Oh, yes, it's been seven years and I'm still waking up at night." I was like,"Is this gonna be my life forever?
• 50:38
  Dr Julie Hammond: Like, how can I function like this?" But it does get better, and if you do need to seek help, please don't delay it.
• 50:45
  Dr Julie Hammond: Ultimately it's just affecting you and it affects how your experience of that period, and you wanna look back and have any regrets.
• 50:51
  Dr Julie Hammond: So I think do whatever you need to do to, in order to be fully present as yourself with your baby.
• 50:56
  Dr Julie Hammond: So look after yourself as well.
• 50:58
  Remi Mogekwu: That's really nice and reassuring, and even as someone who's going through it again nice to hear.
• 51:04
  Remi Mogekwu: And I remember when I was telling a friend I'm really gonna try and get into the postpartum space and
• 51:08
  Dr Julie Hammond: Mmhmm
• 51:09
  Remi Mogekwu: it and really empower women".
• 51:10
  Remi Mogekwu: And they were like,"Oh, I don't think that's necessary because all you need to do is give it time.
• 51:15
  Remi Mogekwu: Time heals all things".
• 51:17
  Remi Mogekwu: Yeah, like time is,
• 51:19
  Dr Julie Hammond: Mmhmm
• 51:19
  Remi Mogekwu: to give it time.
• 51:20
  Remi Mogekwu: It's
• 51:20
  Dr Julie Hammond: Absolutely.
• 51:20
  Remi Mogekwu: quick
• 51:21
  Dr Julie Hammond: Yeah.
• 51:22
  Remi Mogekwu: to be proactive
• 51:23
  Dr Julie Hammond: Exactly.
• 51:23
  Dr Julie Hammond: Exactly
• 51:24
  Remi Mogekwu: so, so that you're not affecting your health lifelong.
• 51:27
  Remi Mogekwu: You're not,
• 51:28
  Dr Julie Hammond: I think
• 51:28
  Remi Mogekwu: know,'cause even the way you interact with your baby, like all of that is
• 51:32
  Dr Julie Hammond: Mmhmm
• 51:32
  Remi Mogekwu: being well.
• 51:33
  Dr Julie Hammond: Yes
• 51:33
  Remi Mogekwu: And there's an element I think of selfishness
• 51:37
  Dr Julie Hammond: Mm-hmm.
• 51:38
  Remi Mogekwu: that is needed in women after they've had babies.
• 51:40
  Remi Mogekwu: So'cause if you look after yourself, then your baby will be well, your relationship will be
• 51:45
  Dr Julie Hammond: Mmhmm Mmhmm Mmhmm
• 51:48
  Remi Mogekwu: there are so many benefits of making space for yourself in
• 51:52
  Dr Julie Hammond: Exactly.
• 51:52
  Remi Mogekwu: that
• 51:52
  Dr Julie Hammond: And you'll be more patient as well.
• 51:54
  Dr Julie Hammond: I found that, not that I was short, but everything just felt so much harder.
• 51:58
  Dr Julie Hammond: Like, just again, the thought of being with my baby the whole day, I was just like,"Oh my gosh, how am I going to survive this whole day?" It just felt so hard, like a monumental task.
• 52:06
  Dr Julie Hammond: I'm like just like But when I looked after myself, then I realized that actually I did have that capacity to, to I enjoyed spending the time and just going for a walk and not putting pressure on myself.
• 52:17
  Dr Julie Hammond: So yes, I do agree time does heal things, but also do seek the help if you do need it.
• 52:23
  Dr Julie Hammond: Don't, don't struggle.
• 52:24
  Dr Julie Hammond: You'll only regret it later
• 52:25
  Remi Mogekwu: Thank you so much for being on.
• 52:27
  Dr Julie Hammond: Thank you
• 52:28
  Remi Mogekwu: really forward to the book and the app, it sounds amazing and very much needed in the space.
• 52:33
  Remi Mogekwu: Thank you for being honest as well,
• 52:35
  Dr Julie Hammond: Mmhmm
• 52:37
  Remi Mogekwu: I think it was really important to hear the different experiences, but to hear the triggers.
• 52:42
  Dr Julie Hammond: Mm-hmm.
• 52:42
  Remi Mogekwu: yeah, and I really hope that whoever's watching really resonates with that and find you on social media,
• 52:47
  Dr Julie Hammond: Let's speak
• 52:48
  Remi Mogekwu: 'cause the work that you're doing is great.
• 52:50
  Dr Julie Hammond: Thank you
• 52:50
  Remi Mogekwu: Why don't you shout your social media platforms out, and then I'll also list them down below
• 52:54
  Dr Julie Hammond: So I am, I am drjulie_gp on Instagram.
• 52:59
  Dr Julie Hammond: On LinkedIn you can just search Dr.
• 53:01
  Dr Julie Hammond: Julie Hammond, you'll be able to find me.
• 53:03
  Dr Julie Hammond: My website is www.mamahealth.com, and the name of my book is'The Fourth Trimester: The Best Friend's Guide to Your Postpartum Body and Mind'.
• 53:14
  Dr Julie Hammond: And you can find it on Waterstones, Foyles, and also on Amazon as well
• 53:19
  Remi Mogekwu: Nice.
• 53:19
  Remi Mogekwu: Is it pre-order?
• 53:20
  Dr Julie Hammond: you can start to pre-order.
• 53:21
  Remi Mogekwu: Okay, so I'll put the link in down below, and I'll also get my copy'cause I'm your target audience.
• 53:26
  Remi Mogekwu: Thank you so much for being with us.