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Empowered Motherhood and the Fight for Maternal Health Equity with Dr. Eboni January | MaternalRx · Pharmacy Podcast Network

• 0:05
  Speaker 1: You are listening to the global network of podcasters dedicated
• 0:09
  Speaker 1: to the pharmacy profession. Welcome to the Pharmacy Podcast Network.
• 0:37
  Speaker 1: Welcome to the Maternal arn X podcast on the Pharmacy
• 0:40
  Speaker 1: Podcast Network, where pharmacist expertise meets interdisciplinary collaboration to overcome
• 0:46
  Speaker 1: today's devastating maternal health crisis. I'm Danielle Plumber, pharmacist and
• 0:50
  Speaker 1: antipartum doula, and am overjoyed today to introduce doctor Ebony January,
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  Speaker 1: affectionately known as doctor e J, an award winning Board
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  Speaker 1: certified OBGYN, best selling author, media contributor, and America's maternal
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  Speaker 1: and women's wellness expert. She has delivered more than eight
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  Speaker 1: thousand babies and is recognized nationally for her leadership and
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  Speaker 1: maternal safety, women's health, education, health equity, preventative care, and
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  Speaker 1: faith informed healing. She's founder of Empower Labs, Empowered Motherhood,
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  Speaker 1: Empower Mama, Private Summer and Fertile Faith Initiative, a comprehensive
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  Speaker 1: ecosystem of products, courses, clinical programs, and community partnerships that
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  Speaker 1: support women at every stage of life. I read about
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  Speaker 1: these statistics with doctor eg before I met her, and
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  Speaker 1: at a glands, Oh my goodness. Eight thousand deliveries, Board certified, Obgin,
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  Speaker 1: three best selling books, more than twenty national media features,
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  Speaker 1: over twenty five thousand followers on social media, and I'm
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  Speaker 1: sure quickly growing. Featured expert on health, hormones, pregnancy and
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  Speaker 1: preventative wellness. Founder of Women Centered Wellness Ventures with partnerships
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  Speaker 1: that cross a large spectrum of patient populations from churches, universities, hospitals,
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  Speaker 1: and corporations. Doctor EJ. Thank you so much for joining
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  Speaker 1: me today. Is there anything you would like to add?
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  Speaker 1: And following that, what an introduction, what experience and wealth
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  Speaker 1: of knowledge that you bring? Can you share a bit
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  Speaker 1: about your journey as an obstetrician guynecologist and what led
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  Speaker 1: you to focus so deeply on maternal health, equity and prevention.
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  Speaker 2: Yeah, yeah, so one, thank you for having me and
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  Speaker 2: thank you for that amazing introduction. I'm sure we'll get
• 2:38
  Speaker 2: into more you know about me, and I guess you know.
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  Speaker 2: The first thing is how I arrived at becoming an
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  Speaker 2: obgyn and then specifically in this space of advocating for patients.
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  Speaker 2: And so I started to get the idea that I
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  Speaker 2: wanted to be an obgyn when I was fourteen at
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  Speaker 2: that age, and I'll tell you why. Specifically, then my grandmother,
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  Speaker 2: who had given life to fourteen kids, her body was
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  Speaker 2: starting to deteriorate. She had multiple strokes, you know, she
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  Speaker 2: was in poor health, and I watched my aunts rotate
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  Speaker 2: and take care of her. At the same time, my
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  Speaker 2: step mom was pregnant with my youngest sister, Alyssa, And
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  Speaker 2: to see the body change, like it was like full circle, right.
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  Speaker 2: You know, I was young when my youngest siblings were around, right,
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  Speaker 2: so it was like really four of us that were
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  Speaker 2: all together, right, And then I had an older sister
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  Speaker 2: who was, you know, eight years older, who you know,
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  Speaker 2: she was young adult at this time, and then my
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  Speaker 2: youngest to know what life was like when she wasn't around,
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  Speaker 2: and now all of a sudden, there's this baby. And
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  Speaker 2: so to see the body change to deliver, to give life,
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  Speaker 2: but also to watch my grandmother's body, who had given
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  Speaker 2: life to so many beings, to see her deteriorate, and
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  Speaker 2: to watch the women in her life take care of her,
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  Speaker 2: it just really brought things full circle to me and
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  Speaker 2: had a huge impact on who I would become. At
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  Speaker 2: the age of fourteen, said that I wanted to be
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  Speaker 2: an obgyn, and I'll tell you why. You know, most
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  Speaker 2: people just think we deliver babies, but we don't just
• 4:07
  Speaker 2: deliver babies. We take care of the whole patient, We
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  Speaker 2: take care of chronic issues. We do a lot with
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  Speaker 2: regards to preventative health. And then they're surgery. Right, there's
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  Speaker 2: office procedures that were able to do, and then there
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  Speaker 2: are also surgeries that are not C sections that we
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  Speaker 2: do from a gynecological standpoint. So fast forward, I went
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  Speaker 2: into college and med school. Wanted to be an obgyn.
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  Speaker 2: And when I started practicing, I practiced for FQAC, a
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  Speaker 2: federally qualified health center where we dealt a lot with
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  Speaker 2: low income patients. Patients. When we talk about the social
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  Speaker 2: determinants of health, I knew what it was before it
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  Speaker 2: was even coined a phrase. And so I started to
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  Speaker 2: see women who knew nothing about their bodies, right, But
• 4:51
  Speaker 2: they knew a lot about being a mom, being a
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  Speaker 2: significant other, being you know, employee, or being you know,
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  Speaker 2: even an entrepreneur, but they didn't really know a lot
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  Speaker 2: about their bodies, and they didn't know a lot about
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  Speaker 2: preventive health whatsoever. So I started seeing a trend where
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  Speaker 2: I was having overweight women, young women, right, you know
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  Speaker 2: how it is like after you've had babies, you know,
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  Speaker 2: or as you get older, you gain weight. These were
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  Speaker 2: young women, some that hadn't even had babies yet they
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  Speaker 2: were had excess to weight. So I realized that in
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  Speaker 2: those moments that they didn't know what proper nutrition was.
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  Speaker 2: They didn't know what proper eating was. And you know,
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  Speaker 2: many times they were telling me that they only ate
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  Speaker 2: once a day. So I said, not eating is worse
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  Speaker 2: than overeating. And so I developed a text weight loss
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  Speaker 2: coaching program in response to my patient so that I
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  Speaker 2: can remind them to eat, workouts that they can do
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  Speaker 2: in the home, considering that they're busy, considering that they're
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  Speaker 2: everything to everyone, right, And so I started seeing not
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  Speaker 2: only were they overweight young, but they were managing so
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  Speaker 2: many things and their health took a back seat to
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  Speaker 2: everything else. So fast forward. Now I'm starting to deliver
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  Speaker 2: more babies, and I'm starting to see that women knew
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  Speaker 2: nothing about as it pertains to pregnancy, even if it
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  Speaker 2: was their second or third pregnancy, they didn't know. And
• 6:05
  Speaker 2: so I'm educating in the exam room. I'm drawing pictures
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  Speaker 2: and they're like oh, doctor January, can I have this
• 6:11
  Speaker 2: piece of paper that you draw on them? And I said,
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  Speaker 2: you know, of course, I have it up here, and
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  Speaker 2: I would point to my head like I have to pare.
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  Speaker 2: Of course you can have this. And so then I
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  Speaker 2: started doing more in the community. I started, you know,
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  Speaker 2: maybe speaking on on varying cancer, cervical cancer, I was
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  Speaker 2: on the radio. I ended up getting my own Fox
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  Speaker 2: two segment on my own podcast at CBS Radio that
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  Speaker 2: we called the Wellness Will. And so I realized that
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  Speaker 2: in order for me to best do my job as
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  Speaker 2: an obgi N, I had to heal them, and I
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  Speaker 2: had to educate, and I had to make sure that
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  Speaker 2: they knew that they were a part of the team.
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  Speaker 2: There's so many times that I had women that would
• 6:45
  Speaker 2: come in my office and they had been on the
• 6:47
  Speaker 2: same medication for ten years and they didn't know the
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  Speaker 2: name of it, and I said, that's crazy. They would
• 6:52
  Speaker 2: always reach for their purse to get the pill bottle out,
• 6:55
  Speaker 2: and I would put my hand over the purse and
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  Speaker 2: I said, let me tell you something. Let anyone give
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  Speaker 2: you a pill bottle and you don't know the name
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  Speaker 2: of it, or you don't know why you're taking it.
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  Speaker 2: This is just as much my responsibility as it is yours.
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  Speaker 2: I would tell them, I don't want you all complaining
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  Speaker 2: about doctors and nurses if you're not doing the job either.
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  Speaker 2: Don't get me wrong, I do my fair share of
• 7:15
  Speaker 2: complaints about us as well. But I'm telling you that
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  Speaker 2: this is a team sport. And so that's when I
• 7:22
  Speaker 2: started really taking a look at myself and the type
• 7:25
  Speaker 2: of doctor that I wanted to become. Right to say, Okay,
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  Speaker 2: I don't just want to push pills or my solutions.
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  Speaker 2: I need for us to think this thing through it.
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  Speaker 2: I need for you all to do your own homework
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  Speaker 2: and also keep track of your symptoms so that I
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  Speaker 2: can best serve you. But I want you all to
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  Speaker 2: do the work as well. That means eating right, that
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  Speaker 2: means going to the gym, That means knowing more about
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  Speaker 2: your health than you know about your favorite reality show star.
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  Speaker 2: This is how it talked to my patience, and they
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  Speaker 2: talk to you the same, right, very honest, and I
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  Speaker 2: love that like when you work as much as we do,
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  Speaker 2: they become your family. Of the conversation that you have
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  Speaker 2: to have with family, right, That's how I started really
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  Speaker 2: walking into the type of OBGYN and physician that I
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  Speaker 2: would be, and it was one that helped to prevent disease,
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  Speaker 2: reduce risk, but also educate and understand that my patients
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  Speaker 2: were part of the team. That's how I started advocating
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  Speaker 2: more for patients because I said, well, it's one thing
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  Speaker 2: for me to educate them, but it's another thing for
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  Speaker 2: me to also talk to other doctors so that they
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  Speaker 2: can understand what the patients are going through because we
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  Speaker 2: don't know what we don't know. You don't know if
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  Speaker 2: you're biased. Some bias is conscious and some is unconscious.
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  Speaker 2: That's when I started getting more into the advocacy space.
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  Speaker 1: So powerful you just shared so much. I don't even
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  Speaker 1: know where to begin with this your patients. I was
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  Speaker 1: here so lucky to have you and to have come
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  Speaker 1: across you. But it's interesting to hear your story how
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  Speaker 1: you had grown from the time you knew you wanted
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  Speaker 1: to be an OBGYN and then when you start working
• 8:55
  Speaker 1: with these patients. You said, I knew the type of
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  Speaker 1: doctor I wanted to grow in to, but it seems
• 9:01
  Speaker 1: like you already were at that point. The way you communicate,
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  Speaker 1: the way you share, the way you can relate to
• 9:08
  Speaker 1: who they are, their experiences, how they spend their time,
• 9:12
  Speaker 1: and then transition that to how can we empower them
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  Speaker 1: to take care of themselves. I heard you say online
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  Speaker 1: you make sure your patients are health literate and that
• 9:24
  Speaker 1: doctors are culturally competent. And you just gave examples to
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  Speaker 1: bridge that gap. So you're working on both the patient
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  Speaker 1: side and your community as a physician. You said, the
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  Speaker 1: rights and the risks are the most important things. Tell
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  Speaker 1: me about this best selling book you wrote, Empowered Motherhood.
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  Speaker 2: Once again, when we talk about social determinants of health,
• 9:48
  Speaker 2: I want to break that time down just for the
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  Speaker 2: people listening who don't know what that is. These are
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  Speaker 2: things that are in your environment that affects your health
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  Speaker 2: that are not necessarily the deliver of health care. If
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  Speaker 2: you can't get to the doctor, that is a social
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  Speaker 2: determinative of health transportation issue. If you can't eat the
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  Speaker 2: right food, this is social determinative of health. If you
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  Speaker 2: are not necessarily educated, just in general, this is a
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  Speaker 2: social determinative health. Health literacy, meaning your ability to understand
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  Speaker 2: what we say to you apply it is just as
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  Speaker 2: much of importance as any of those things. Right, I'm
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  Speaker 2: a fixer, Right, by everyone comes to me to fix things.
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  Speaker 2: Even in the family. I've unfortunately become a young matriarch
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  Speaker 2: due to passing up my mom, my aunt, and my
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  Speaker 2: grandmother in just a short period of time. But when
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  Speaker 2: you come to me, I'm a fixer, and if I
• 10:42
  Speaker 2: can't find something, and I know that you know that
• 10:45
  Speaker 2: something's wrong, then I have to be able to identify it,
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  Speaker 2: whether it's health or whether it is a financial issue
• 10:52
  Speaker 2: of mental health issue. What I started seeing when people
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  Speaker 2: were coming back to me after you know, I'm giving
• 10:57
  Speaker 2: them my best and things are not changing, I realized
• 11:01
  Speaker 2: is that maybe they didn't understand what I was saying
• 11:03
  Speaker 2: to them. So I had to break things down in
• 11:05
  Speaker 2: the simple format. As I was stating before that I'm
• 11:08
  Speaker 2: a visual learner, So I was drawing on the paper
• 11:10
  Speaker 2: that we pulled across the exam table. I was drawing
• 11:12
  Speaker 2: on those things. People were going home with these big
• 11:14
  Speaker 2: pieces of paper. You know, when I wrote the book
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  Speaker 2: in Power Motherhood, it was two reasons, not just because
• 11:20
  Speaker 2: they didn't understand health and what we were saying to them,
• 11:24
  Speaker 2: but also because even the educated woman doesn't necessarily feel
• 11:28
  Speaker 2: comfortable asking the doctor questions, right, So this was just
• 11:31
  Speaker 2: as much for the patient as it was the doctor,
• 11:33
  Speaker 2: because oftentimes we keep bumping our head not knowing why
• 11:37
  Speaker 2: the symptoms aren't improving or why the numbers aren't changing,
• 11:40
  Speaker 2: and it has a lot to do with what is
• 11:42
  Speaker 2: going on at home or their understanding of what we're
• 11:45
  Speaker 2: saying to them. Is to bridge the knowledge gap, because now,
• 11:48
  Speaker 2: as a doctor that's seeing forty patients in the exam room,
• 11:51
  Speaker 2: giving her a little bit of information or educating her
• 11:54
  Speaker 2: within two minutes doesn't seem so cumbersome because she has
• 11:57
  Speaker 2: a foundational understanding of what I'm saying to her. Understand
• 12:00
  Speaker 2: that in this book there are some big words, but
• 12:03
  Speaker 2: underneath those big words are the explanations, because when doctors
• 12:06
  Speaker 2: say these big words to you, you have to be
• 12:08
  Speaker 2: able to understand what they're saying so that when you
• 12:10
  Speaker 2: go home or when you go into an er or
• 12:13
  Speaker 2: ob triage and your doctor's not there and we ask
• 12:16
  Speaker 2: your medical history and you say, oh, no, it's the
• 12:19
  Speaker 2: pregnancy has been normal. But you've gotten the diagnosis of
• 12:22
  Speaker 2: preclaims here, but you didn't understand the word right. This
• 12:24
  Speaker 2: is what this book is for. It's for you to
• 12:27
  Speaker 2: be able to understand what we're saying to you to
• 12:29
  Speaker 2: bridge that knowledge gap so that doctors can educate within
• 12:32
  Speaker 2: a couple of minutes. You understand because you will already
• 12:35
  Speaker 2: read about it in this book. And so that's what
• 12:38
  Speaker 2: this book is for. There's pictures, I'd walk you through
• 12:40
  Speaker 2: the pre pregnancy safe medications, what it's safe to eat now.
• 12:44
  Speaker 2: And obviously this is not the end all, be all
• 12:46
  Speaker 2: because information changes and I don't know everyone's health history.
• 12:49
  Speaker 2: This is so that you can have an intelligent conversation
• 12:52
  Speaker 2: and inform conversation with your doctor that you can see
• 12:54
  Speaker 2: what a tolak is versus a v back and if
• 12:57
  Speaker 2: you don't know what that is, I'm going to challenge
• 12:59
  Speaker 2: you to get the book. You know, you should know
• 13:01
  Speaker 2: what these things are. You should know your risk, you
• 13:03
  Speaker 2: should know what the difference is between baby blues and
• 13:06
  Speaker 2: postpartum depression. That's what this book is for, is to
• 13:09
  Speaker 2: close that knowledge gap, to make you informed and also
• 13:12
  Speaker 2: so that you understand that you're a part of the team.
• 13:15
  Speaker 1: Incredible, it sounds like everybody needs to read this book.
• 13:18
  Speaker 1: One of my previous roles, I was working in the
• 13:20
  Speaker 1: space of preclamsia. What I found was so interesting when
• 13:24
  Speaker 1: I said the word preaclamsia, not to the health professionals,
• 13:28
  Speaker 1: but when my friend's family would ask me, what is
• 13:30
  Speaker 1: it that you're working on now, they had known it
• 13:32
  Speaker 1: under the name toxemia the older Yes, friends, right, doctor Jenry.
• 13:37
  Speaker 1: How would somebody purchase your book?
• 13:40
  Speaker 2: I'm going to answer that question, but I want to
• 13:41
  Speaker 2: go back to what you just said. You can get
• 13:43
  Speaker 2: my book on Amazon. Actually it's on Kindle as well,
• 13:48
  Speaker 2: and I'm also going to have a downloadable version of
• 13:51
  Speaker 2: it coming soon so that you can just go straight
• 13:53
  Speaker 2: to my website and get it. But I also have courses.
• 13:56
  Speaker 2: I have courses. I have a masterclass for labor implications.
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  Speaker 2: These are things that you should do before you get
• 14:03
  Speaker 2: to the labor room getting the book and knowledge. I
• 14:06
  Speaker 2: have downloadable guys for men for doulas on my website.
• 14:09
  Speaker 2: I heard that you said that you were your doula.
• 14:11
  Speaker 2: We need support persons to gain the knowledge so that
• 14:16
  Speaker 2: you can best support a pregnant woman. Because I'll tell
• 14:18
  Speaker 2: you this, sometimes pregnancy brain is a thing. You get
• 14:21
  Speaker 2: into the er or the labor room and you forget
• 14:24
  Speaker 2: certain things. But this is when that support person steps
• 14:27
  Speaker 2: up and says, hey, oh, by the way, she does
• 14:30
  Speaker 2: have pre acclaimsia. Oh. By the way, she has a
• 14:33
  Speaker 2: bleeding disorder, and that could prohibit her from getting an
• 14:36
  Speaker 2: epiduaal because if she gets one, then she may get
• 14:38
  Speaker 2: a hematoma and potentially be paralyzed. So this is where
• 14:41
  Speaker 2: the support person has to step up. When I talk
• 14:44
  Speaker 2: about a team approach, I'm talking about doula's, I'm talking
• 14:47
  Speaker 2: about dads, are significant others. I'm talking about you know,
• 14:50
  Speaker 2: family members that should have an understanding of what that
• 14:53
  Speaker 2: pregnant woman is going through in her medical background, her information,
• 14:57
  Speaker 2: so that you can deliver that information to us. And
• 15:00
  Speaker 2: we shouldn't be offended by that because I know that
• 15:03
  Speaker 2: pregnant women don't always remember right, and so I have
• 15:06
  Speaker 2: these guys, and I have courses and even I just
• 15:09
  Speaker 2: taught a course in Las Vegas, and they got handouts
• 15:11
  Speaker 2: places where they can keep track of their symptoms, their
• 15:13
  Speaker 2: blood pressure, their diabetes testing that if they have diabetes,
• 15:17
  Speaker 2: they get a handout to keep track of their sugars.
• 15:20
  Speaker 2: We need this information. This is data that helps to
• 15:22
  Speaker 2: treat individuals, but we need support persons to know that
• 15:25
  Speaker 2: information or at least have a general understanding. It's like
• 15:28
  Speaker 2: you said, every time I talk about pre clamcy. I
• 15:30
  Speaker 2: did a video on my Instagram about how it used
• 15:34
  Speaker 2: to be referred to as toxemia, and you just said that,
• 15:37
  Speaker 2: and I said, all the time, it used to be
• 15:39
  Speaker 2: called toxemia. And this is for like the older people
• 15:42
  Speaker 2: who have daughters and granddaughters who are having babies. I
• 15:45
  Speaker 2: just let them know it used to be called toxemia.
• 15:47
  Speaker 2: Now it's pre clamsia. And it was toxemia because it
• 15:50
  Speaker 2: effect that every organ system. You have headaches, spots in
• 15:53
  Speaker 2: your vision, you can have excess fluid, It affects your liver,
• 15:56
  Speaker 2: it affects your kidneys, it affects the baby. It literally
• 15:58
  Speaker 2: affects every organs system. And that's why I was called taxmia,
• 16:02
  Speaker 2: but now pre eclamsia because you can have seizures, pre
• 16:05
  Speaker 2: meaning before eclamsia meaning seizures. So it's important that you
• 16:09
  Speaker 2: gain this knowledge support persons, not just pregnant individuals. Get
• 16:13
  Speaker 2: it as a baby shower gift, but get it for
• 16:15
  Speaker 2: yourself as well to support the pregnant woman. And it's
• 16:17
  Speaker 2: available on Amazon.
• 16:19
  Speaker 1: Doctor Jennry, you took on quite a task. So when
• 16:23
  Speaker 1: we say we're a fixer, I'm a fixer. I'm a
• 16:25
  Speaker 1: visual learner. I think everyone that works in pharmacy, I'm
• 16:29
  Speaker 1: guessing most physicians are fixers as well. This is how
• 16:32
  Speaker 1: we're trained. What's the problem? How can I correct it?
• 16:35
  Speaker 1: But it's normally on a smaller scale. You're changing something
• 16:40
  Speaker 1: that has impact to improve healthcare for thousands, tens of thousands,
• 16:45
  Speaker 1: one hundred thousands, potentially worldwide, millions of women, and I
• 16:49
  Speaker 1: am so grateful. The statistics in the United States right
• 16:52
  Speaker 1: now are truly frightening around the world as well. So.
• 16:56
  Speaker 1: The United States has the highest maternal mortality rate among
• 17:00
  Speaker 1: developed nations, often ranking fifty fifth worldwide in some reports,
• 17:05
  Speaker 1: with up to twenty two deaths per one hundred thousand
• 17:09
  Speaker 1: live births. This is from the Commonwealth Fund study. Despite
• 17:12
  Speaker 1: high spending, we know what it costs for healthcare in
• 17:15
  Speaker 1: the United States, the US rate is more than double
• 17:18
  Speaker 1: that of most other high income countries, with over eighty
• 17:21
  Speaker 1: percent of these deaths considering preventable. You mentioned the work
• 17:25
  Speaker 1: you were doing to prevent maternal morbidities and mortalities. Norway
• 17:30
  Speaker 1: has zero. Norway has zero. Granted they are a small
• 17:35
  Speaker 1: country in a more homogeneous patient population. Zero in the
• 17:39
  Speaker 1: United States, we see that large racial disparities maternal and
• 17:42
  Speaker 1: infant hell outcomes persist. Pregnancy related mortality rates among Black
• 17:47
  Speaker 1: women are over three times higher than the rate for
• 17:51
  Speaker 1: white women. Black American, Indian, Alaska, Native, and Native Hawaiian
• 17:56
  Speaker 1: and Pacific Islander women have higher shares of pre birth,
• 18:00
  Speaker 1: low birth weight birth, and births for which they receive
• 18:04
  Speaker 1: late or no prenatal care compared to white women. Infants
• 18:07
  Speaker 1: born to Black specific Islanders Alaska Natives have marketly higher
• 18:12
  Speaker 1: mortality rates than those born to white people. And that
• 18:14
  Speaker 1: was from this KFF organization, very frightening statistics. You stepped
• 18:20
  Speaker 1: firsthand into this environment, saw what was happening, started with
• 18:25
  Speaker 1: who was in front of you, and said, I am
• 18:27
  Speaker 1: going to improve this. I'm going to make these change
• 18:29
  Speaker 1: and now you're doing this on a global level. Thank
• 18:33
  Speaker 1: you so much for this undertaking, because it's a big one.
• 18:37
  Speaker 1: It has to happen, and it takes people like you
• 18:40
  Speaker 1: to get this education one on one end at a
• 18:44
  Speaker 1: large scale to happen. From your perspective, what are the
• 18:47
  Speaker 1: most misunderstood drivers behind these outcomes?
• 18:51
  Speaker 2: A couple of things. It's so multifascinating. The first thing
• 18:55
  Speaker 2: is delays and care gaps in care and also understanding
• 19:02
  Speaker 2: the patients that you serve and knowing when you need
• 19:06
  Speaker 2: to release your ego and attitude with regards to your
• 19:09
  Speaker 2: position and say, hey, this is a human being. I
• 19:12
  Speaker 2: can be in this position one day as a patient,
• 19:15
  Speaker 2: no matter what I look like, and say, Okay, how
• 19:18
  Speaker 2: do I best become a better clinician? And I'm not
• 19:21
  Speaker 2: just talking about doctors. I'm talking about across the board.
• 19:24
  Speaker 2: How do I best become a better hospital leader and
• 19:28
  Speaker 2: improve my outcomes? How do I improve the systems? But I
• 19:31
  Speaker 2: said this on a previous podcast, is that you know
• 19:34
  Speaker 2: a lot of times we point the finger, right, and
• 19:37
  Speaker 2: if we're not pointing the finger and finding a solution
• 19:40
  Speaker 2: on the other side of pointing the finger as a solution,
• 19:42
  Speaker 2: then what are we doing. We're just pointing the finger.
• 19:44
  Speaker 2: But my grandmother used to say, when you point the finger,
• 19:46
  Speaker 2: the thumb points back at you. So it's everyone's responsibility.
• 19:50
  Speaker 2: So when you talk about delays and care, this is
• 19:53
  Speaker 2: a patient issue, right. I want the patients to know
• 19:56
  Speaker 2: the red flag symptoms and to act fast what to
• 19:58
  Speaker 2: go in for. Talk about this a lot in my book.
• 20:01
  Speaker 2: One of the top causes of mortality, your blood pressure issues,
• 20:05
  Speaker 2: cardiovascular issues. Monitor these at home. When you talk about advocacy,
• 20:10
  Speaker 2: use your voice and be unapologetic, but be respectful on
• 20:13
  Speaker 2: both sides. We need to be more respectful to each
• 20:16
  Speaker 2: other making statements like you know, I'm not feeling well.
• 20:18
  Speaker 2: I need to be evaluated. This is a change from
• 20:21
  Speaker 2: my baseline. But you got to know what your baseline is. Also,
• 20:24
  Speaker 2: build a support team. As you say to Danielle, you'r
• 20:27
  Speaker 2: a doula, but you don't necessarily just needed a doula.
• 20:30
  Speaker 2: You can have a partner or friend who is educated
• 20:32
  Speaker 2: of community health worker. I think everyone needs a pregnancy navigator,
• 20:36
  Speaker 2: and insurance companies need to start paying for these pregnancy
• 20:39
  Speaker 2: navigators to improve outcomes and also keep all of your appointments.
• 20:43
  Speaker 2: The other thing that I see is when women have
• 20:45
  Speaker 2: had multiple babies, they think, oh, this pregnancy is going
• 20:47
  Speaker 2: to be like the last one, and so they misappointments
• 20:50
  Speaker 2: or don't think that they need prenatal care. You absolutely do,
• 20:54
  Speaker 2: because one as you age and as you have more babies,
• 20:57
  Speaker 2: things like postpartum hemorrhage become an additional risk. So understand
• 21:01
  Speaker 2: your personal risks. High blood pressure diabetes, whether you're overweight,
• 21:05
  Speaker 2: if you have an autoimmune disease, if you have a
• 21:07
  Speaker 2: bleeding disorder. These are things that you need to know
• 21:10
  Speaker 2: about your personal history that are going to set you
• 21:13
  Speaker 2: up for success. Right and mental health because that's the
• 21:15
  Speaker 2: top cause of morbidity and mortality is mental health conditions.
• 21:19
  Speaker 2: If you have a pre exist in mental health condition it,
• 21:22
  Speaker 2: address it, get help now. Start planning for your postpartum
• 21:26
  Speaker 2: period right now, okay, And also advocate for better health,
• 21:30
  Speaker 2: better care. Interview these hospitals just like you interview anything else.
• 21:36
  Speaker 2: Know the patient advocate numbers be okay, asking for charge
• 21:39
  Speaker 2: nurses and as leaders on our side of things, we
• 21:43
  Speaker 2: need to know. We have to start using our voice
• 21:46
  Speaker 2: and also start improving our systems. Look at what hospitals
• 21:50
  Speaker 2: have good outcomes and start mirroring what they're doing. Make
• 21:54
  Speaker 2: things visible like patient advocacy number, charge numbers. Start also
• 21:59
  Speaker 2: evaluate the people who are delivering care. Just like we
• 22:02
  Speaker 2: used to have the secret shoppers, remember those, Start doing
• 22:05
  Speaker 2: secret shoppers to make sure that the training that you're
• 22:08
  Speaker 2: having your staff do that is being implemented. That's so
• 22:12
  Speaker 2: important that we have to do these things. And also
• 22:14
  Speaker 2: making health care easier for patients. That means we need
• 22:19
  Speaker 2: peer navigators. We need to educate them so that they
• 22:22
  Speaker 2: know your resources are here. Insurance carriers as well. Many
• 22:26
  Speaker 2: times patients don't know what resources are available to them.
• 22:28
  Speaker 2: They don't know how to make follow up appointments. And
• 22:30
  Speaker 2: this is where as systems we have to improve because
• 22:33
  Speaker 2: when you talk about gaps in care or delays and care,
• 22:36
  Speaker 2: a lot of times these are systems they don't know
• 22:38
  Speaker 2: how to call, or it's difficult to get through it
• 22:40
  Speaker 2: for mental health specialists, or get set up for a
• 22:43
  Speaker 2: postpartum visit to get their blood pressure check. These things
• 22:46
  Speaker 2: can be done before they leave the hospital. And I've
• 22:49
  Speaker 2: seen it done. You know, I'm licensed in sixteen states.
• 22:52
  Speaker 2: I practice in a lot of these states, and so
• 22:54
  Speaker 2: I see where things are being done right and I've
• 22:57
  Speaker 2: seen where things are not done so well. And so
• 23:00
  Speaker 2: we can make accessing healthcare a lot easier for our patients.
• 23:05
  Speaker 2: You just think about being sick, and now I have
• 23:07
  Speaker 2: to figure out how to make an appointment with this
• 23:09
  Speaker 2: person or that person. Oh they don't accept my assurance.
• 23:12
  Speaker 2: This person maybe accept my insurance, but if they do,
• 23:14
  Speaker 2: they don't have an appointment for three months. You get
• 23:16
  Speaker 2: what I'm saying.
• 23:18
  Speaker 1: I don't just get what you're saying. I am you
• 23:19
  Speaker 1: can't see me right now. I am being every single
• 23:22
  Speaker 1: one of those what you want to call them, pearls
• 23:24
  Speaker 1: BAC are so important as women. We don't hear these things.
• 23:29
  Speaker 1: Even in the healthcare profession. We don't hear these things.
• 23:31
  Speaker 1: Which is even though I'm a pharmacist why I got
• 23:34
  Speaker 1: the DULA certification. Insurances are now starting slowly to step
• 23:39
  Speaker 1: on board and rembse for dulas. A COG just changed
• 23:44
  Speaker 1: their guidelines recently to show you need to see your
• 23:48
  Speaker 1: obstetrician when is best for your body and when you
• 23:52
  Speaker 1: have access to get to that obstetrician, not necessarily on
• 23:56
  Speaker 1: the guidelines that were set many many decades ago. How
• 24:00
  Speaker 1: do we empower ourselves? I was going to ask you
• 24:03
  Speaker 1: already answered it. It's really incredible to say I have
• 24:07
  Speaker 1: this power. I should be interviewing the hospital like I've
• 24:11
  Speaker 1: never heard anybody say that the secret choper analogy is
• 24:15
  Speaker 1: just brilliant.
• 24:17
  Speaker 2: Absolutely, we have to You can take a tour of
• 24:19
  Speaker 2: the hospital, ladies, you can absolutely do that. You can
• 24:24
  Speaker 2: ask for these key numbers. Let's talk to people who
• 24:27
  Speaker 2: are not pregnant, because I'm sure that you'll have some
• 24:29
  Speaker 2: people listening to this who aren't pregnant. They are patient
• 24:32
  Speaker 2: advocates for just anyone. They're community health workers. Check in
• 24:35
  Speaker 2: with your insurance company, and then umbudsman, this is someone
• 24:39
  Speaker 2: who advocates for you on a higher level. Get their number.
• 24:42
  Speaker 2: Their numbers usually very accessible, and so just look it up.
• 24:46
  Speaker 2: And I think that that's so important. And then, as
• 24:48
  Speaker 2: like I said, as leaders, we have to make sure
• 24:51
  Speaker 2: that we're not offended when we say things like this,
• 24:54
  Speaker 2: because if we're worried about good outcomes, if that's the goal,
• 24:57
  Speaker 2: is a good outcome healthy patience, then we shouldn't be
• 25:00
  Speaker 2: offended when someone gives us a solution to the problem.
• 25:05
  Speaker 2: Thank you.
• 25:05
  Speaker 1: I've actually run into that when people have hired me
• 25:08
  Speaker 1: to advocate for them. I'll call the er. Sometimes you're
• 25:12
  Speaker 1: very excited to hear from me, and then other times
• 25:15
  Speaker 1: I'll just get that, don't tell me what I'm supposed
• 25:18
  Speaker 1: to be doing my patient, my specialty being hyperemesis crabagerum.
• 25:21
  Speaker 1: So I know if somebody is malnurished, I'll do something
• 25:24
  Speaker 1: like ask for a banana bag, because there is for
• 25:26
  Speaker 1: word of keys but when you have somebody taking care
• 25:29
  Speaker 1: of that patient in the er and I don't work
• 25:31
  Speaker 1: at that hospital, it can be it can go either way.
• 25:36
  Speaker 2: And I think that we have to switch up how
• 25:39
  Speaker 2: we speak to each other just in general our mindsets.
• 25:42
  Speaker 2: We are a team, right. I tell you how many
• 25:45
  Speaker 2: times I'm going to call internal medicine if I can't
• 25:47
  Speaker 2: control the blood pressure, if this headache is not going away,
• 25:50
  Speaker 2: I'm calling neurology. You know. I've even called down to
• 25:53
  Speaker 2: the er before and they're like or they've called me
• 25:56
  Speaker 2: and they're like, Okay, we have this patient. She has
• 25:58
  Speaker 2: this going on, asking questions to get more standing, and
• 26:01
  Speaker 2: I'm like, okay, Also she needs to see this person.
• 26:04
  Speaker 2: And they're like, oh, are you gonna come see her? No? No, no, no, no,
• 26:07
  Speaker 2: I'm coming to see her. She also needs this person,
• 26:09
  Speaker 2: because in my years of practice, I know that this
• 26:13
  Speaker 2: also may be an issue. Many times when women come in,
• 26:16
  Speaker 2: they just think everything is the uterus or the ovaries.
• 26:19
  Speaker 2: And I can't tell you countless times that I've diagnosed
• 26:21
  Speaker 2: kidney stones and women with pelvic pain and bleeding with
• 26:25
  Speaker 2: your nation and they just thought that it was coming
• 26:27
  Speaker 2: from the vagina. And that's not the case. So I
• 26:29
  Speaker 2: think that it's important for us all to change our
• 26:32
  Speaker 2: mindset surrounding working with one another, because I can't do
• 26:37
  Speaker 2: what you do, or maybe I could, but you know,
• 26:39
  Speaker 2: I need an extra set of hands. And then you
• 26:41
  Speaker 2: specialize in this. Maybe I don't see this every single day.
• 26:44
  Speaker 2: And it's the same thing with doula's and patience and
• 26:46
  Speaker 2: their significant others. You know, we have to change how
• 26:49
  Speaker 2: we interact with one another our mindset as well, because
• 26:53
  Speaker 2: if the goal is good outcomes, then we need to
• 26:55
  Speaker 2: put our egos aside.
• 26:57
  Speaker 1: Music to my ears, if that's I started this podcast
• 27:01
  Speaker 1: because pharmacists are often a forgotten entity in the healthcare
• 27:05
  Speaker 1: collaboration team, and these are the ones that your patients
• 27:09
  Speaker 1: when they're not seeing their specialists, they can always walk
• 27:13
  Speaker 1: into a pharmacy and ask for help. We're there at
• 27:16
  Speaker 1: the retail space, in the hospital space, in infusion centers,
• 27:20
  Speaker 1: and I'm hoping to close that gap so we can
• 27:23
  Speaker 1: work with professionals like yourself who are one on one
• 27:28
  Speaker 1: with those patients.
• 27:30
  Speaker 2: So absolutely, and then understand that pharmacists can also delay
• 27:34
  Speaker 2: care as well. I had this recently happened. I called
• 27:37
  Speaker 2: in a prescription for someone and they were worried about
• 27:40
  Speaker 2: like my office number when I gave them my cell number,
• 27:42
  Speaker 2: and then now this patient suffering because there's a delay there,
• 27:46
  Speaker 2: or maybe not understanding in your clinical training that one
• 27:50
  Speaker 2: particular medication was used for one particular disease, but their
• 27:55
  Speaker 2: medications that can be used for multiple things, but maybe
• 27:57
  Speaker 2: your experience didn't see it used in an other way
• 28:01
  Speaker 2: that happens as well.
• 28:03
  Speaker 1: This is a really important concept, and I'm glad you're
• 28:05
  Speaker 1: bringing this up because my training as a pharmacist is
• 28:08
  Speaker 1: very different than many others, and the retail workspace is
• 28:12
  Speaker 1: not the pharmacy space that I work in in a
• 28:15
  Speaker 1: very long time, and it's changed a lot. I don't
• 28:18
  Speaker 1: ever want to see that or hear that a pharmacists
• 28:20
  Speaker 1: delayed care. So I started as another reason I started
• 28:24
  Speaker 1: the podcast was to educate what can those retail pharmacists
• 28:28
  Speaker 1: do when you have thirty seconds per patient coming to
• 28:30
  Speaker 1: that counter. I like to recommend that patients choose which
• 28:34
  Speaker 1: pharmacy they go to, find the ones that can offer
• 28:38
  Speaker 1: you the time, get those questions that would remove that
• 28:42
  Speaker 1: barrier of delayed care that should never happen.
• 28:45
  Speaker 2: This just happened to me last week and the patient
• 28:49
  Speaker 2: didn't tell me three days go by it and I'm like,
• 28:51
  Speaker 2: did you get your prescription? They said that it wasn't there.
• 28:54
  Speaker 2: I'm like, I called and spoke with the pharmacist directly,
• 28:56
  Speaker 2: and then they called me to make sure that the
• 28:58
  Speaker 2: office number lined up, and I told them, look, I'm
• 29:00
  Speaker 2: licensed in multiple states. This patient needs this. And keep
• 29:03
  Speaker 2: in mind, this was a diabetic and I couldn't believe it.
• 29:06
  Speaker 2: And so that's another conversation for another day, but it
• 29:10
  Speaker 2: ties into the whole delays and care. I was busy
• 29:13
  Speaker 2: and I had to take a couple of calls from
• 29:16
  Speaker 2: the pharmacies and they still didn't do it. They still
• 29:18
  Speaker 2: didn't feel this prescription.
• 29:19
  Speaker 1: Look into that one for sure. But I know your
• 29:21
  Speaker 1: time is pressed. So that's anything I can do to
• 29:24
  Speaker 1: help you figure out what happened there. Retail pharmacists are
• 29:27
  Speaker 1: kind of flying blind. When they feel something, their license
• 29:30
  Speaker 1: is at risk and if they don't feel one hundred
• 29:32
  Speaker 1: percent comfortable. But that's where we need this education. Just
• 29:35
  Speaker 1: a few quick questions. What's one myth about pregnancy or
• 29:40
  Speaker 1: women's healthy you we'd love to retire.
• 29:42
  Speaker 2: That every pregnancy is the same. It is absolutely not
• 29:46
  Speaker 2: the same. I want women to know that. You know,
• 29:49
  Speaker 2: if you think that your second or third pregnancy is
• 29:53
  Speaker 2: going to be just like your first, that's not always
• 29:55
  Speaker 2: the case. And a lot of times women don't necessarily
• 29:58
  Speaker 2: come in for them reason or there's delays like oh,
• 30:02
  Speaker 2: you know, I'll be fine. You know this happened with
• 30:05
  Speaker 2: my last pregnancy, or my last pregnancy was normal, those
• 30:08
  Speaker 2: kind of things. I've seen a lot of poor outcomes
• 30:11
  Speaker 2: that way. When you think that every pregnancy is the.
• 30:13
  Speaker 1: Same, absolutely, What's one thing every woman should ask for
• 30:18
  Speaker 1: ob but doesn't.
• 30:20
  Speaker 2: What are my risks? You have to know what your
• 30:23
  Speaker 2: risks are. For example, if you've had this is your
• 30:26
  Speaker 2: third or four pregnancy, what are my risks because this
• 30:29
  Speaker 2: is my third or four pregnancy. If I have if
• 30:32
  Speaker 2: I'm a little overweight, what am I risks because I'm overweight?
• 30:36
  Speaker 2: If I want to see section, what are my risks? Like,
• 30:39
  Speaker 2: let's start prepping for what's to come, as opposed to
• 30:43
  Speaker 2: when it happens everyone's shocked or not necessarily prepared for it.
• 30:47
  Speaker 2: I think that that's one of the key things that
• 30:49
  Speaker 2: we should talk about, like what are my risks? And
• 30:52
  Speaker 2: we don't talk about it often.
• 30:54
  Speaker 1: I've never heard that question asked from a patient. Absolutely,
• 30:58
  Speaker 1: thank you for bringing that one to light as well.
• 31:01
  Speaker 1: And my last one for you, are there specific red flags,
• 31:04
  Speaker 1: either physical or emotional, that women should never ignore during
• 31:08
  Speaker 1: pregnancy here postpartum, even if they're told that's normal.
• 31:12
  Speaker 2: Sure, severe headaches and vision changes, chest pain and shortness
• 31:16
  Speaker 2: of breath, if you have sudden swelling in the face
• 31:19
  Speaker 2: and hand, specifically heavy bleeding. You know, postpartum hemorrhage is
• 31:23
  Speaker 2: the top cause of mortality and morbidity, decrease, feed of movement,
• 31:28
  Speaker 2: pain specific on this right side, right upper abdomen. Those
• 31:33
  Speaker 2: are signs that you definitely want to look out for.
• 31:36
  Speaker 2: And just feeling withdrawn postpartum filling withdrawn, you're not interested
• 31:40
  Speaker 2: in baby, you're not interested in you know, just doing
• 31:43
  Speaker 2: anything that's also be a sign of postpartum depression. And
• 31:47
  Speaker 2: so we don't want you to go down that path,
• 31:49
  Speaker 2: and so speak up and for the people around them,
• 31:52
  Speaker 2: if they're saying that they're okay, I need for you
• 31:54
  Speaker 2: to watch them a little bit closely if you know
• 31:57
  Speaker 2: they have any of those signs or symptoms as well.
• 32:00
  Speaker 1: You so quickly just responded to that question. Everything you
• 32:04
  Speaker 1: named is so so important. My other question for you
• 32:07
  Speaker 1: is what can we do as healthcare professionals differently to
• 32:10
  Speaker 1: support maternal wellness close those equity gaps within our own roles?
• 32:14
  Speaker 1: And I think you just answered all of that. Is
• 32:16
  Speaker 1: there anything else you'd like to add?
• 32:18
  Speaker 2: You know, the main thing is healthcare professionals. I want
• 32:21
  Speaker 2: to reiterate, if the outcome is wanting to be good,
• 32:26
  Speaker 2: then we have to put our egos aside and we
• 32:28
  Speaker 2: have to work together, not just as healthcare professionals, but
• 32:31
  Speaker 2: improving the system and also including our patient as a
• 32:35
  Speaker 2: part of the team.
• 32:37
  Speaker 1: So powerful. Thank you so much, doctor Ej. To connect
• 32:41
  Speaker 1: with you. What's the best way if people would like
• 32:43
  Speaker 1: to access your courses and learn more about what you do,
• 32:46
  Speaker 1: follow you on social media?
• 32:48
  Speaker 2: Sure you can go to. My website is doctor ej
• 32:51
  Speaker 2: dot com. That's d O C t O R ej
• 32:54
  Speaker 2: dot com. My email address is doctor EJ at doctor
• 32:58
  Speaker 2: eej dot com. That's d O C t O R
• 33:01
  Speaker 2: EJ at d O C t O R ej dot com.
• 33:04
  Speaker 2: And I'm pretty active on Instagram and Facebook. That's doctor Ebony.
• 33:09
  Speaker 2: January that's doctor spelled out Ebony with an I. In
• 33:12
  Speaker 2: January just like the month. And that's both on Instagram
• 33:16
  Speaker 2: and Facebook and then also on LinkedIn. Many people reach
• 33:18
  Speaker 2: out to me on LinkedIn as well, and it's just
• 33:20
  Speaker 2: doctor Abnue January.
• 33:22
  Speaker 1: Doctor January, thank you so much for taking time today
• 33:25
  Speaker 1: to speak to us. I know it's an emotional day
• 33:27
  Speaker 1: for you everyone. Thank you for listening to the Maternal
• 33:30
  Speaker 1: RX podcast. I am doctor Daniel Plumber, advocating for better
• 33:34
  Speaker 1: maternal outcomes through pharmacist led collaboration. AM eternally grateful to
• 33:38
  Speaker 1: doctor January for all the work she is doing, both
• 33:41
  Speaker 1: on a patient level and on a global scale, and
• 33:45
  Speaker 1: I think the best is yet to come.
• 33:47
  Speaker 2: Thank you so much, Thank you, thank you for having
• 33:49
  Speaker 2: me