Postpartum Care: You Deserve Better!
Interview with naturopathic doctor Alicia Hart by Kate Drake
Today I spoke with Dr. Alicia Hart, ND and mother of three. Alicia graduated from NUNM and has a thriving practice located in Tigard, Oregon. Dr. Hart serves as a primary care physician and focuses on on women’s health and pediatrics. In today’s world there is a lot of talk about fertility and pregnancy health, but where I think the conversation stops short, is often at postpartum care. In this interview I was interested in hearing about Dr. Hart’s experiences working with postpartum mothers, how she’s helping them and what resources she has for soon to be mothers or mothers out there who are struggling and are seeking support and guidance. Here’s our conversation:
KD How long have you been in practice and how did you find yourself focusing on women’s care?
AH I’ve been in practice for a couple of years now and I got into this medicine because it’s what worked for me. I have a very conventional pre-med background, as I thought I was going to be a veterinarian. Long story short, I got into human medicine and then had a really horrible postpartum experience myself. And I thought, there has to be a better way than this. As it turns out, there is. There’s totally a better way than the way I did it. And so I’ve cobbled together the expertise of a few naturopathic midwives, some psychiatric nurse practitioners, and pelvic floor physical therapists to come up with this comprehensive plan to get women back to feeling like people after they have babies.
Common Postpartum Issues That Are Treatable:
- Incontinence after birth
- Lack of libido
- Mood disorders such as anxiety and OCD
- New food sensitivities
KD When seeing postpartum women, do you feel that there are often unmet needs mothers have? Or topics and issues that come up that aren’t talked about commonly prior to giving birth?
AH So many things!
KD Do you want to give me just two or three?
AH So I do a ton of postpartum pelvic floor rehab because uncontrolled peeing after having a baby does happen to a lot of people, but it’s not normal to continue to have an issue like that. And I help people get their libido back because they should want to have sex at some point, it’s healthy. I help with postpartum mood disorders, especially anxiety and OCD, which people don’t necessarily realize are more common than post partum depression. And then I often see moms who have a lot of food sensitivities come up and that’s usually more of a boundary issue. Meaning, for the past nine months, you’ve been sharing all of your food across the placenta, so your body keeps trying to do this, but there’s no longer a placenta anymore, so then it turns into a food allergy.
KD Interesting, I’ve never heard of that before.
AH Yeh, nobody talks about it, but it happens to a lot of people and I’m always putting people back together who have become sensitive to foods postpartum. Postpartum thyroiditis is my other big thing. I work with a lot of women’s thyroid health.
KD So the thyroid changes a lot postpartum? That’s pretty common?
AH Yep. It’s more common than people think.
Must Have Resources for Postpartum Mamas:
- Aviva Romm, MD Blog Posts. She’s an MD Gynecologist, herbalist, and midwife of 25 years
- Tami Kent, MSPT. She is the pioneer of the holistic pelvic care movement and has several worthwhile reads
- The Tummy Team. Specializing in Diastasis Recti problems and associated and associated issues, such as pelvic floor dysfunction
- Baby Blues Connection. Postpartum mood disorders support groups that are free of charge (for moms and dads), reading resources, workshops, local postpartum resource list (counseling, NDs, breastfeeding health, and more)
- Hike it Baby. Offering a unique way to help bridge the social isolation of being a mom with a newborn. Find a hiking group in your local area
- Post Partum International. Offering a wide variety of resources, covering topics such as: medication (for pregnancy and the lactation period), loss and grief, doulas, military family support, father support and more
- Alicia Hart, ND. Videos, blog post and webinars
KD What resources you would recommend to anyone who might read this article?
AH I have several blogs on on my website and a few in other places. I’m also working on putting together a webinar that people can sign up for. And then there’s Aviva Romm, her articles are excellent and she does much of the same work that I do. She’s an MD Gynecologist and herbalist. And then often I will refer over to Tami Kent (MSPT) because she is the person who started the holistic pelvic care movement that I’ve been trained in. I was trained by Tami and she’s written a few books that are great too. I also refer to The Tummy Team because diastasis impacts pelvic floor function and people don’t always know about diastasis recti. So there are a lot of resources. There’s also Baby Blues Connection, they’re good for postpartum mood disorders in Portland. Hike it Baby is good for helping bridge that social isolation and Post Partum International is another great resource for learning about postpartum anxiety and postpartum OCD, etc.
Postpartum Eating & Diet:
- Eat a real meal for yourself, not just your toddlers left overs. You need nutrients for yourself and your baby
- Conventional diets may not work while nursing, be sure to choose something that supports lactation
- Don’t focus solely on weight loss. Be sure to work with someone that can customize and optimize a meal plan for you that’s in your best interest
KD Do you do recommend specific diets or nutrition programs for postpartum moms to help them get back up and running?
AH Sometimes. A lot of the time I’m just getting them to eat food, because often they’re just eating whatever scraps that are left over from their toddler while they nurse their new baby. So just getting them to eat can be a significant challenge. I’m also a Health at Every Size provider so I try never to focus on just weight loss or anything like that. So, a lot of what I do is just optimizing it for them individually. I like Whole30 as a general diet, but people will lose their milk supply on it sometimes, so it kind of depends on the mom. Some people can’t nurse on Whole30.
Ease the Transition into Postpartum: Top 4 Things To Do While Pregnant
- Create a postpartum depression prevention plan: Have an idea of what you need to do to prevent postpartum mood disorder (some are preventable)
- Create a support team before your delivery date
- Make a pre-delivery IBCLD consult & ensure breastfeeding gets off on the right foot
- Make a plan to follow up with someone beyond the six week mark postpartum & avoid possible postpartum complications (which can happen anytime during the first year)
KD For moms who are pregnant, would you say there is planning that can be done prior to delivery to ensure a smoother transition to postpartum?
AH Oh for sure! They should absolutely have a postpartum depression prevention plan. I offer planning to make sure people have an idea of what they need to do to prevent postpartum mood disorders, because some of them are preventable. They should also be looking into having a support team set up before they deliver. It’s so much harder to reach out for help when you’re surrounded by a screaming person who doesn’t let you sleep. Getting a pre-delivery IBCLD consult can be really helpful and ensure that breastfeeding gets off on the right foot, depending on whether or not they’re planning on breastfeeding. And then, making sure that they have a plan to follow up with someone beyond six weeks. Because postpartum complications can happen anytime within the first year, so just not going back for care after the first six weeks isn’t really a great option.
KD Who would you recommend that they see? Their primary care doctor, perhaps, their midwife, or someone else?
AH It would depend on who they're seeing. I am primary care and I don’t do deliveries. But I know many primary care docs aren’t trained on lactation and they’re not trained on postpartum care so it’s really easy for women to fall through the cracks. The midwives don’t know how to manage the medical complications, like postpartum preeclampsia and the doctors don’t know how to manage the midwifery complications like the diastasis and pelvic floor. So, that’s one of the reasons I started this clinic, so that you don’t fall through the cracks as often.
KD It sounds like a really well rounded practice and are a great resource…
AH Thank you…
KD ...for anyone who is pregnant or has recently had a kid...Do you work with children as well, or just mamas?
AH I do, my clinic is about 50% pediatrics. I have three kids. I’m really good at pediatric rashes. What to do when they run full tilt into a desk and knock themselves out, not that that happened this week at my house.
KD No of course not.
AH How to glue children back together. I had a couple of people who jumped out of a high chair and had their chin split open, so I put them back together. Then I had a seven year old who broke her arm from falling down the stairs. So just really general primary care practice for pediatrics.
KD You said you had three children how old are they?
AH I have a five year old and two two year olds.
KD I bet they keep you very very busy.
AH Oh yes. I had an 80oz of coffee one day just to stay alive.
Postpartum Take Away: You Deserve Better
- You should feel like a normal person again after having a baby.
- Feeling normal is possible!
KD Thank you for your time today. Is there anything else you want to say to wrap up this conversation?
AH I really want women to know that they deserve better. That our culture does not take care of them the way that they should be. And that they should feel like a normal person again after baby.
KD And that is possible?
AH It’s totally possible!