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Navigating Pregnancy Advice With Confidence · Meaningful Medicine with Novant Health

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  Gina Kaye (Host): Meaningful Medicine is a Novant Health podcast bringing you
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  access to leading doctors who answer questions they wish you would ask.
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  From routine care to rare conditions, our physicians offer tips for
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  navigating medical decisions and building a healthier future.
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  I'm Gina Kaye.
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  And with me is Autumn Wendler, a certified nurse midwife.
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  And today, we are discussing midwifery.
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  Welcome, Autumn.
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  It's great to have you with us today.
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  Autumn Wendler, CNM: Thank you so much, Gina.
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  I'm so glad to be here and be able to share whatever knowledge
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  I can impart for everybody.
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  Host: Great.
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  We're excited to hear what you have to say.
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  So, let's start off.
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  There's a lot of pregnancy and women's health advice on social media.
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  How can patients tell the difference between evidence-based
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  information and misinformation?
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  Autumn Wendler, CNM: Yeah.
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  Well, that's a great question, because we are inundated with information
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  all the time, especially with social media platforms and TikTok.
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  And it's hard to navigate.
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  I mean, folks who are MDs, nurse practitioners, people in scientific
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  research, they spend entire courses being able to discern, what's quality
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  scientific research and what's not.
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  So, it can be even harder for folks who have not spent that
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  time studying that information.
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  The things I like to tell folks to navigate towards would be to look
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  at your professional organization.
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  So, is it coming from a professional organization?
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  So in our instance, when it comes to pregnancy care, that would be ACOG,
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  the American College of Obstetrics and Gynecology, ACNM, the American
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  College of Nurse-Midwifery, Women's Health Nurse Practitioner Organization,
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  the American Pregnancy Association.
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  Is it a government site?
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  Because government, they have to go through rigorous studies as well in
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  order to be published and endorsed.
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  So, something that's being published by the CDC, for instance, would
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  also be a reliable resource.
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  And then when it comes down to it, if sifting through it is really
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  difficult then talking to your care provider and having them kind of
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  break it down for you and explain.
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  And I also like to tell people, a lot of times if it sounds too good to be
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  true or too novel, it probably is.
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  So, making sure, if that research or that evidence has not been duplicated
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  somewhere else, there usually is a reason for that, and sometimes we have
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  to look at that with a more critical eye.
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  Host: Great.
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  What is one common pregnancy myth you hear regularly?
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  And then, what does the evidence actually tell us?
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  Autumn Wendler, CNM: Yeah.
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  So, one of the things we hear a lot, especially in the midwifery world,
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  because we do tend and trend towards more natural and holistic practices,
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  is that natural equals better.
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  And that's not always the case.
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  There are many things found in nature that are toxic.
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  Toxic to humans, toxic in pregnancy, for instance.
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  One of the things that comes up a lot, for instance, would be
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  THC or marijuana, for instance.
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  We'll see folks that use that in order to help manage early pregnancy
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  nausea or appetite, for instance.
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  And for them, some feel that it is superior because it is what they
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  consider to be natural and not an artificial pharmacologic, such as
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  medications that we prefer to use, like Phenergan, Diclegis, Zofran.
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  But what the research actually shows us is that we have actually shown harm
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  to the baby whenever marijuana has been used, whereas these medications, these
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  prescriptions have been rigorously studied to determine that they are safe to use.
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  But we are seeing research studies that show that there are
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  neurodevelopmental outcomes to babies that are born to mothers
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  who utilize marijuana in pregnancy.
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  Host: Let's talk a little bit about evidence-based care.
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  How has that changed the way midwives support patients during pregnancy,
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  labor, and delivery over the years?
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  Autumn Wendler, CNM: I feel like evidence-based care and
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  practice has really expanded the care that midwives can provide.
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  Meaning that it used to be that we could really only manage low-risk
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  patients because that is our specialty.
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  But we know people and their health statuses are getting more
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  complicated, but does that mean that those more complicated folks don't
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  deserve access to midwifery care?
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  And the answer is no.
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  I think that anybody who wants access to that care model deserves it.
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  But what evidence practice provides is it provides protocols, it provides
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  algorithms so that we can rely on those things, kind of help us check
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  those boxes to make sure that we are managing them medically in collaboration
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  with our MD, DO partners, of course.
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  But it really also helps us to continue to focus on the holistic and the whole person
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  aspect of the care versus getting kind of caught in the weeds of the medical aspects
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  as well, because we know that's important.
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  But what makes midwifery care so special is really being able to connect on
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  that more holistic interpersonal level.
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  Host: Many patients want to make the healthiest choices for
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  themselves and their babies.
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  What are the most important evidence-backed habits that
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  you recommend during pregnancy?
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  Autumn Wendler, CNM: So, I think this goes back to the roots of ensuring
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  that, I believe that all women of reproductive age—this is not just
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  me, but I definitely endorse this, that all women of reproductive age
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  should be on a prenatal vitamin.
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  There's really very low risks to it, but what research is showing us more and
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  more is that having that folic acid in your system three months before you ever
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  conceive is really beneficial to helping reduce the risk of neural tube defects.
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  What we see in the research is that about 50% of pregnancies are unplanned.
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  If we're already on a prenatal vitamin, that already sets us up for more success
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  with an early pregnancy, because a lot of times folks may not even find
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  out they're pregnant until they're already four, six, eight weeks along,
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  where a lot of those developmental milestones have already occurred.
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  In addition to that, I think that getting established with prenatal care
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  in that first trimester is also very pivotal because that really helps us
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  to be able to monitor and manage risk factors very early on, again, because
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  there's so much development that happens in that first trimester and we can
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  really kind of curate and cater your prenatal plan to you based on what
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  you're coming into the pregnancy with.
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  Host: Some expectant parents are overwhelmed by
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  conflicting recommendations.
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  How do you help patients make informed decisions when there
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  isn't a clear-cut answer?
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  Autumn Wendler, CNM: Yeah.
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  So, my big platform and the platform of midwifery in general
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  is empowering patients, right?
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  Empowering them with knowledge.
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  So really, we are going to discuss the pros and cons of each option and then
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  kind of talk about what their goals are.
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  Because sometimes what their goals are or what their background is can also inform
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  maybe what might be helpful in choosing them if we're at equal levels of options.
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  Host: Let's talk a little bit about your role specifically.
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  What role does a certified nurse midwife play in helping patients
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  understand the risks and benefits of different care options during
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  both pregnancy and childbirth?
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  Autumn Wendler, CNM: Yeah.
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  So again, I think that really goes back to making sure we lay out the facts in an
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  unbiased manner for each option available.
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  And making sure that, again, we bring in the person's goals, their backgrounds
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  to help them to make a decision that aligns with those, and ultimately
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  supporting what their decision is.
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  So, sometimes patients may make a decision that you may not
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  feel like is the right one.
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  But again, still elevating them and supporting them and knowing that
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  you provided them with the knowledge and now you're going to provide
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  them the best care and support in the safest manner that you can.
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  And knowing that you gave them the information, and ultimately what they
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  chose to do with it was up to them.
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  Host: And finally, if you could give every pregnant patient one piece of
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  evidence-based advice to help them have a healthier pregnancy and birth
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  experience, what would it be and why?
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  Autumn Wendler, CNM: So, I think my answer to that is probably boring,
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  because I think we all really want there to be that special, secret trick or
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  secret supplement or things that we, as healthcare professionals, are gatekeeping.
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  But what I truly, really feel like it goes down to is our, roots of
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  health and, when we lean into, nutrition and physical activity.
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  And we think if we are putting the best things in our body and taking care of
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  our body in the best way possible and moving our body and physically active,
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  that sets up the best building blocks so that we ourselves, as the pregnant patient
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  and our babies, can have the best start.
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  We already know that a lot of the pregnancy complications that occur.
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  Some of the root causes can be related to poor diet, not enough exercise.
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  Now, we cannot blame that entirely, so I don't want anybody to ever think
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  that because they developed, for instance, gestational diabetes or
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  preeclampsia, that was their fault.
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  Because by all means, those do happen spontaneously, and I've seen very, healthy
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  patients that are healthier than anybody, myself, anybody that I've seen, not that
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  I'm the standard of health by any means.
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  But I do think that if we can really set ourselves up for the most success if we
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  really get back to the basics of being very mindful of what we're putting into
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  our body, monitoring the weight gain.
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  Because, again, lots of pregnancy complications can kind of go back to that
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  Host: It's funny, it seems like we all just want that magic pill,
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  but sometimes it's just going back to the basics and doing the right
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  things for the right reasons, right?
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  Autumn Wendler, CNM: Exactly.
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  And I think we all have to be mindful of that.
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  Even us in healthcare, we sometimes have to take a step back and reel it in
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  and realize, okay, yes, we know that we want to be able to think that vitamin
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  D or magnesium is going to cure all ills, but like maybe I need to work on
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  my sleep hygiene and get better rest, and maybe I'll feel better and more
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  productive throughout the day, right?
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  So, it's something that I think we all can work on, but it's not sexy
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  and it's not exciting, but it is very helpful and very important.
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  Host: Fantastic advice.
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  Autumn, thank you very much for sharing your knowledge and your time.
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  It is very much appreciated.
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  Autumn Wendler, CNM: Thanks again for having me.
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  I appreciate it.
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  Host: Thank you for listening to the Novant Health Meaningful Medicine podcast.
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  To find a physician, visit novanthealth.org.
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  For more health and wellness information from our experts,
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  visit healthyheadlines.org.
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  Thanks for listening.