Ep 253: The Fourth Trimester with Pediatrician Dr. Jess Daigle

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I love connecting you with other physicians who have a real heart and passion for caring for people and that’s exactly what you’re going to get in this episode with Dr. Jess.

Since she was 10 years old, Dr. Jess Daigle (@momandme_md) knew she wanted to be a pediatrician and neonatologist. Now a board-certified pediatrician and CEO of Mom & Me MD, a concierge practice that focuses on providing in-home care and support for moms and babies after a NICU stay, she has made that dream a reality and then some.

Dr Jess’s dedication to NICU care is rooted in her own challenging experiences with pregnancy and birth including a loss at 19 weeks and bedrest for 65 days followed by a preterm birth with her second pregnancy. Her passion and commitment for her work really shines through in this episode and you can’t help but listen to her and think “Man, I would love for her to be my doctor!”.

We have a great conversation about 5 areas to prepare for when you’re having a baby (mom, baby, relationships, household, and career) as well as the importance of advocating for oneself and asking questions.

In this Episode, You’ll Learn About:

  • How Dr. Jess’s personal experience shapes the kind of physician she is
  • Why she wishes she would’ve done things differently after pregnancy loss
  • What makes Mom & Me MD different from other postpartum care services
  • Which unique emotional struggles affect families with babies in critical care
  • What “fourth trimester” refers to and how this period can be more challenging for NICU parents
  • How to create a postpartum “9-1-1 Crew”
  • Why you should prepare for postpartum while you’re still pregnant

Links Mentioned in the Episode


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Transcript

Dr. Nicole (00:00): I love connecting you with other physicians who have a real heart and passion for caring for people, and that's exactly what you're going to get in this episode with Dr. Jess.

(00:15): Welcome to the All about pregnancy and birth podcast. If you're having a baby in the hospital, you are giving birth in a system that too often takes away power from women over what happens in their own bodies. I'm Dr. Nicole Calloway Rankins, a practicing board certified OBGYN, who's had the privilege of helping well over a thousand babies into this world. I've been a doctor for over 20 years and I'm here to help you take back your power, advocate for yourself, and have the beautiful pregnancy and birth that you deserve. This podcast is for educational purposes only, and it's not a substitute for medical advice. Check out the full disclaimer at drnicolerankins.com/disclaimer. Now let's get to it. Hello there. Welcome to another episode of the podcast. This is episode number 253. Whether this is your first time listening or you have been here before, I'm so glad you're spending some time with me today, Dr.

(01:10): Jessica Dayle. Dr. Jess is a board certified pediatrician who works as a neonatal and pediatric hospitalist. She's also the founder and CEO of Mom and me, md, a concierge medical practice in Atlanta, Georgia that provides local and home and virtual care services to NICU babies with the focus on education and support for their mothers and families to make the transition home from the NICU easier and less overwhelming. She also offers life coaching for NICU moms to help them balance life after the NICU and be the confident mom they want to be. Dr. Daigle is passionate about NICU families and postpartum care and believes moms and their babies should thrive on their NICU journey in and out of the unit. And what Dr. Daigle does is not only based on her deep commitment to her work, she actually knew she wanted to be a doctor and a neonatologist when she was 10 years old, but it's also based on her own difficult personal experience with birth.

(02:18): She lost her first baby after giving birth at 19 weeks. She went back to work too soon after that, her next pregnancy, she was on bed rest in the hospital for 65 days, from 22 weeks to 31 weeks when her son was born at 31 weeks and her daughter was also born a bit prematurely as well. Her passion and her commitment and just heart for her work really shines through and you can't help but listen to her and think, man, I would love to have her be my doctor. We have a great conversation about five key areas that are affected when a mom has a new baby, as well as lots of great advice that is specifically for parents of NICU babies. This is an episode you may want to bookmark for later on just in case.

(03:09): Now, let's get into a quick listener shout out before we begin to the episode. This is from SF Bay Mama and the title of the review that she left me an Apple podcast says, a must listen for expecting mamas. I love how Dr. Rankins breaks down the reality of birth and how I don't need to be fearful. I highly recommend this podcast and appreciate the chats with experts on the front lines of pregnancy. Well, thank you so much for that SFA, mama, I appreciate you taking the time to leave that lovely review, and I am so glad you found the podcast helpful. I would also like to shout out your review on the podcast, so head on over to Apple podcast, leave me a review and I will give you a shout out on a future episode. All right, let's get into the conversation with Dr. Jess. Thank you, Dr. Daigle for agreeing to come onto the podcast. I am so excited to chat with you today.

Dr. Daigle (04:12): Thank you. I'm so excited too. I've been a fan for a long time on LinkedIn and it's just so reassuring to see someone passionate to do the work they do on the OB side, especially given everything we've learned and training and all of that.

Dr. Nicole (04:26): Absolutely, absolutely. And same to you. I'm so excited to have you because your passion comes through in what you do, and we are going to listen and get some of that knowledge and passion today. Okay? Yes.

Dr. Daigle (04:37): Awesome.

Dr. Nicole (04:37): Yeah. So why don't you start off by telling us a bit about yourself and your work and your

Dr. Daigle (04:42): Family. Okay, so I'm Dr. Jess Daigle. I'm a board certified pediatrician. I live south of Atlanta. I'm originally from Louisiana, and so transplanted here for training. I did my residency with Morehouse Pediatric Residency, and then I did a year of neonatology fellowship before I resigned because right prior to that time, I actually had my own preterm son at 31 weeks I needed to be in the nicu. So I have him. And then I have a five-year-old daughter, so his name is Liam, and my daughter's name is Avery, and they are definitely the joy of my life. And I always laugh because I was one of those people that grew up saying, I did not want to have children. I was like, Nope, nope. I'm just going to take care of everybody else's children. So I knew early on I wanted to be a pediatrician from 10 years of age, so that wasn't my life plan for sure. But all the rest of it were surprises along the way, but I always say that it was good surprises. So I'm grateful. I'm definitely grateful and my life experiences has definitely informed the work that I do, and I think that's probably how it should be actually.

Dr. Nicole (05:48): Yeah, absolutely. Absolutely. So I like to be sure that really we're uplifting the voices of experts because there's much information out there, everybody and their mama's hopping on social media and saying things. So can you tell us a bit about exactly what your training, your pediatric training, what training you went through, and not even just pediatrics even before then the training you went through

Dr. Daigle (06:11): To be able to do what you do? So actually from the age of 10, I wanted to be what's called a neonatologist. So that's a subspecialty of pediatrics. So it's a pediatrician that does more extra training in taking care of sick infants, and they could be premature infants or term infants, but infants that's right after birth require intensive care. And so I had read this book called The Lone Dying of Baby Andrew, and by it was actually an autobiography, a family who had had a real preterm son, and it was kind of an ethical book because they were fighting for the right to just let him die in peace as opposed to all these heroics. And that was right around the time that surfactant was coming out. And for the listeners, surfactant is something our lungs make that allows us to breathe more easy. And so preterm infants don't start making that until roughly 28 weeks. So earlier than that, they struggle with their lungs functioning properly. And so this family just wanted their baby to die. They had kind of come to terms with what it meant, but that was around that time that was coming out. So us in medicine, we are about saving lives and doing no harm, which is arguably one of the things that intrigued me because about quality versus quantity of life. And even at a young age, my mom always said I was an old soul,

(07:24): But even at a young age, I was fascinated by that, what is the right thing? And so I did some research and it was this website called Neonatology on the Web, and actually this many years later, I just turned 40. So this many years later, 30 years later, that website is still around. Isn't that crazy? That

Dr. Nicole (07:40): Is crazy.

Dr. Daigle (07:41): But it tells you what to do. So it's like you got to go to school this many years, you go to college and then you go to medical school, it tells you what happens in medical school, and then it tells you about pediatrics residency, which is where we learn how to take care of children. And so I made it all the way through all those stages. And then I was applying for fellowship as well, and I got in. But like I mentioned earlier, prior to that, that's when I had my own son. So it shifted my life course in a way, which is often what can happen when you have kids. So my training is medical school, just like what you have to do is go to medical school, which is about four years or plus, depending on if you do a PhD or something else extra. And then you get into the residency of your choice, which is whatever type of specialty you want to do. So for me, that was pediatrics, and then the training to do neonatology is extra after that.

Dr. Nicole (08:32): Gotcha, gotcha. And we all have to maintain our certifications and things like that, all that. It's lifelong learning. It

Dr. Daigle (08:39): Is lifelong learning. It is. And it should be because so much has changes over time. And so sometimes I'm always intrigued when people are always trying to do things from years ago, and I'm like, we're supposed to be

Dr. Nicole (08:49): Improving. Exactly. Exactly. Exactly. So tell us about mom and me, md.

Dr. Daigle (08:54): What is that? So mom and me, this was my attempt to connect and support families outside of after they have the baby outside of the hospital. So when I was in training, when you're in training, you can have the choice to do things that are more clinic-based versus hospital based. And this is mostly for the listeners, but in the clinic. And a lot of parents probably will shake their head in agreement. It's often a rushed environment when you go to be seen, they try to give you 10 to 15 minutes to get your concerns in about your child. And I didn't ever really like that environment because a lot of times, depending on what was going on, it often took a good 30 to 40 minutes to really assist a family with their needs and concerns. And because of these repetitive short visits, a lot of times they were not really getting the comprehensive care they needed.

(09:49): And so then it just increased my frustration in theirs. And so I saw in the hospital the time that I felt I needed, I could take, if I needed to sit at the bedside and we need to go over what jaundice is and why it's happening. If I wanted to take those 20 to 25 minutes, it was on me at my leisure. And I enjoyed that because I knew I was effectively getting across what this family needed to know. And that mattered to me more than just the turnover of how many people I was seeing. And I understand that medicine is a business. So I find early on, I tell residents, you just have to decide what kind of person you want to be and who you want to help, and then that's how you're going to fit in where you fit in. Yeah, exactly.

(10:29): Exactly. So I started working in the hospital, and we'll get to my story about how I got there, but I started working on level two nicu, which I loved taking care of families. And again, I can spend that time educating them about, well, why is your baby being admitted to nicu? What do we want to happen? What needs to go on after that? But I found that I also wanted to follow them after. So it's trying to get that clinic environment without the constraints of the time, and I wasn't quite sure I could really do it. So I fought it for a little while, and then I started just Googling home health or follow up in the home, like that old scoop medicine, which is why I wanted to be a doctor. Anyway, I love the idea of going to someone's home and connecting with them in their space where they felt comfortable.

(11:15): And I found a neonatologist in Colorado that was doing it, and I was like, oh my God, somebody else has this great idea and I understands what's needed. So I connected with her and she told me about the business model. And so the term of mom and me is almost, since I'm a pediatrician at the time, it comes almost from the baby's perspective, the baby understanding the child, understanding that it's me and my mom, us together. It's important that diet is important and the mom has to do well as well as my mom does almost as well as I do. And so that informed the postpartum part of what I do because I can care about the child all day long, but if I don't know what's happening at the family level, at the mom level, the dad level, then we're really not being effective.

(12:02): And I was like, I always want to give effective care. So that's how mom and me came about. And initially I was going to just do just newborns and a new mamas, and then I think I kind of got a little nudged. Well, there are a lot of people that are focusing on new moms now, and a lot of things with postpartum, with doulas and things emerging, but not a lot of people pay attention to the post nicu follow-up timeframe. And so I was like, maybe I need to. And that was already my passion, but I was hiding from it. It was different. I'm like, well, nobody's doing in-home care for NICU babies. And I was like, well, I could. So I just started asking questions, and now I've worked with a few families and I love it. I love being that point person that's that extra level of knowledge and reassurance for the families because again, they're still going to the pediatrician appointments that may often feel rushed. And I've had some families say that, well, I needed just a little bit more time to talk about what's going on with my baby. That's how Mom and me came to be.

Dr. Nicole (13:03): Now, before we get into some of the practical tips of and advice, I like to do that maybe why don't you share with us what happened with your own NICU journey

Dr. Daigle (13:11): And your story? What was that? What happened for you? Yeah, so like I said, I was going on the path to becoming an neonatologist. So in some way, I was going to be taking care of dealing with preemie babies. In my intern year of pediatrics residency, I got pregnant, and then I ended up having a miscarriage right around 19 weeks. And that for me was my first reality into the work that I do and in a close near ride because I'm seeing new babies being born all the time, especially, I was doing a lot of NICU rotations before that, and even in my residency, I had made it heavy. It just threw me for a loop about what these parents are feeling, people are going through these experiences. And then it really opened my eyes to the fact that we don't talk about it. So when I was pregnant, as in residency, a lot of times you'll do multiple of the same rotations.

(14:05): So the first year you might do two ER rotations, and one might be at the beginning and the end of that year. So people who knew I was pregnant, then by the time I came around again, they were like, so where's the baby? And I had to be like, oh my God, and talk about it. So it's that retraumatizing, right? You're kind of trying to heal and then you're having to explain all over again what happened. And then it helped me to have a personal conversation with my OB because she didn't make it for that delivery. And I ended up delivering the baby by myself in the bed in the hospital. And so we had to have a talk about that because I didn't like the way some of that was handled, but I think it opened my eyes to how we as healthcare providers, doctors, whatever term people like to call themselves, how we sometimes can lack awareness around how we're moving the things we're seeing or not saying.

(15:06): And I found myself having to explain to my husband why we wasn't resuscitating this baby. And I felt like that was when she should have been stepping up to be like, Hey, let me talk to you about this. And I think her knowing that I was in medicine kind of made her hold back a little bit when I was the person that was grieving too, right? So helped me to understand it, even when people say if nurses or doctors come, yes, they may understand the medicine, but there's still people going through an experience. Absolutely. So still validating that, Hey, this is hard, this sucks. Or what do you need to explain to your spouse or partner so you don't have to? And so that made that awareness. So I went back right to work after four weeks. I don't think I gave myself probably enough time, and I think that's in medicine, we're so completely type A and let's get back on track.

(16:02): And so then I got pregnant towards end of my second year, in the middle of my second year going into third year. And because of that, I was considered high risk. So I was seeing a maternal fetal medicine doctor. I was doing progesterone shots. And so during the pregnancy though, the prior pregnancy when I had the miscarriage, she had said I was doing some cervical funnily, and I started having some early labor pains. And so she had told me to be on bed rest, but I was in my house and I was trying to do my best, but I don't know. And now I give myself a little grace about that. I think what was going to happen was going to happen if I just had laid down in my bed all day. I think I still would've had the same outcome because all I did was walk around my apartment.

(16:41): Absolutely. And then I went to get something to eat one night, and that's when I went into full on labor. But I still had that in my head like, oh, I should have probably done something different. So this time when she told me, you need to go on bedrest, I was like, well, please put me in the hospital. I feel like I'm going to, that's the best way I can do it, to make sure that I'm not tempted to run around or just do anything. So I was in the hospital for like 65 days, Jesus, 65 days, and I had my son at 31 weeks. So I went in at 22 weeks and had him at 31 weeks, and he was in the NICU for about five weeks. And did you just go into labor early? You just Yes, I did. Okay. And at around 24 weeks, she had given me the betamethasone shots, which for the listeners, that's helps to mature the lungs or the babies.

(17:32): And so then I got another dose at around 20 weeks. She was like, okay, I think if anything I was, this chances are up, which I knew that as a pediatric resident. And so I think my water broke around right at 29 and something weeks. And we were like, oh, no. But she put me antibiotics and she said, well, maybe it'll seal up and you'll do fine. So we just monitor vitals and things like that. And I made it all the way to third one. I made it additional two weeks after that. But that time I knew it was real because a couple of times I'd already gone back. They rush you over where you think you might be doing something, and they give you some fluids and probably some other meds that I wasn't paying attention to at the time. I know more of now about it than I did then.

(18:18): And then they would calm down. They'd be like, all right. But that third time I text her, I said, no lady. We are having this baby today. This is, I timed this. Gotcha, gotcha. So we had him and he actually did pretty good in the nicu. He got a dose of the surfactant that I mentioned earlier, and then he was on the vent that night. And then the next morning, by the next morning, by the time I got to see him, he was actually going on room air and he stayed off of oxygen that whole time. He just required treatment for jaundice on and off a little bit. But what's the term? The feeder grower, which for the listeners means when your babies just, all they have to do is feed and grow because they're too small to go home in the car seat. They don't weigh enough to sustain their temperature, things like that.

(19:00): So you ideally want them to be in a position to survive and thrive at home. But most parents, which is what informs a lot of the work I do now, you think, okay, once I get my baby home from the nicu, that's it. It's good. But the NICU journey keeps going. Yes, yes, it does. Yes, it keeps doing therapies and yes, yes. I mean, my first daughter was 32 weeks, so I totally, you keep going, the worries there, all of the things, all of it. All of it. And I don't regret it in the sense that I wouldn't have really been able to connect with my family's Now if it wasn't for that, because even as I wanted to do the work becoming a neonatologist, I would've only still understood the medicine. I would've not ever understood the emotional impact or the life impact of having a preemie without having my own.

(19:52): It's just some things you're not going to understand unless you experience it. Now that I want everybody experiencing to help people. But in truest form, when you've experienced something, can you really truly empathize with others? And so he had to go back on a feeding tube for a little bit. And then I was trying to still finish training. I had interviewed on bedrest to get into fellowship, and I got in and then I had to finish training late. So everything got shifted. And I don't think I made space for the fact that my life had changed. I was again, trying to just, lemme just try to get back on track instead of being like, you know what? Let me take whole space for this experience and see what is different, what are my current needs as opposed to what I thought whenever I was childless, because that's different. So that's kind of what has informed that part of my work and why also adding life coaching on for NICU moms, because that part of moving forward can be very difficult because some part of you still has to deal with the trauma of being in nicu. And I never thought that it was traumatic, actually, I think since I knew what to expect, but I needed to recognize the emotional impact more than I'd had at the

Dr. Nicole (21:05): Time. Yes, yes. Wow. So obviously you bring a wealth of experience to this, for sure. Yes. So with that being said, then, let's go ahead and get into some practical tips and advice. I know you mentioned there are five areas that are affected when mom has a new baby to think about. Let's talk about that. Some of those

Dr. Daigle (21:28): Areas. I love this, and this has come from me doing a postpartum planning workshop that I used to do because I think that one of the things I wanted, this was one of me wanting families to feel reassured that they are not different in the sense of there's nothing they're doing wrong if they're finding it challenging or hard when they have a baby. Because with social media brings a lot of good and bad good that you can see when people are being authentic about struggles and challenges. You're like, ha, see, I'm not alone. But then bad when everybody else is trying to fake it. Everything is great. And you're like, well, why am I struggling with this?

Dr. Nicole (22:07): It's

Dr. Daigle (22:07): Like, that's not true. Everybody's struggling with it. It's just not everybody telling the truth. So the five areas that are affected are first the mom, you've had a baby. I think people don't really realize how monumental that is. It's part of what I love, and I'm not really that jealous of you guys, but I'm grateful to you because you get the baby here. But I love watching you do it. I love being in the deliveries and seeing the baby come out. I hope. I imagine you probably feel the same way I do, but it's just so amazing to me every time. It never gets old for me to see it. I'm just like, man, all the things that had to go right from where their eyes are to where their nails are, that's crazy To me. It's really a miracle every time.

Dr. Nicole (22:51): Every time, every time.

Dr. Daigle (22:53): But you are doing this mom and you've done this and your body has changed. And I think that's where we are doing better. I see more people doing a better education with moms about what really is happening in their bodies. I think we just think, oh, we're pushing out a baby. No, no. It's not just anything. Okay.

Dr. Nicole (23:14): Right. Exactly. Exactly.

Dr. Daigle (23:15): This is like a movement.

Dr. Nicole (23:17): Yes.

Dr. Daigle (23:18): So your mind, your body, your emotions, all of you is changing in your person. And then now you have this baby who also is going through this fourth trimester experience who's also have to deal with a different environment and have to do things differently. They didn't have to eat to grow. They just lay there and swim around a little bit and play with a chord. And now they're like, wait, I got to suck and do all these things and people touching me and stethoscopes and everything. They probably don't know what's going on. And so they're also trying to deal with that. And then you're mentally thinking, I am responsible for this person. And you start thinking ahead to college. You're like, man, the baby's only one day old. Are you worried about college already? Right.

(24:02): But you do start having those thoughts. It's just insane, really. And so then your relationship, so relationship with yourself, your spouse, your baby, whoever. Everything has changed in regards to how you might feel about them, what you think. I didn't even really process what having a kid admit myself until after I had my own children and I was seeing kids for a living, it never mattered. I never thought about, well, what do I want to do? In some way I'd be like, I think when I have kids, I don't want to do this or I won't do that. We all say those things. Well never let 'em do this, but it's not true. Right. We fall short too. We fall short.

Dr. Nicole (24:41): Absolutely.

Dr. Daigle (24:43): Absolutely. So your relationships are changing and then because then the dad or your partner, it's also like, wait a minute, I have means still or things, and then your household, I tell people nothing changes just because you have a baby and everything changes. It is like your bills still do. You still have laundry, you still have to worry about what you're going to eat. And then if you have other kids who going to pick them up, who's taking care of them so you can focus on this baby? And then lastly, your career or even if you want to stay at home, what does that look like? Or if you're going from a career to now you want to stay at home. And so that's like every facet of your life that you're managing every day. Those things change are impacted when you have a baby. And so when I used to do the workshop, I used to just have people just sit with that and think, well, what would be ideal? Because the thing is, even when you plan, we know that plans don't go as planned sometimes, but I think you still should be aware. Absolutely. Ideally, I would want this person could help me with this. And I used to tell families to develop what's called a 9 1 1 crew. This, your folks are people that you're going to call for X, Y, and Z.

(25:54): If they can call on you, don't think you can call. I need somebody if this is happening, if this is happening. At least just have those three or four people in mind because you're going to need something at some point. And if you've thought about it at least a little bit ahead of time, you don't have to be in that panic mode. Well, who can help me with my kids? Oh, my friend said she was going to be in town. She grabbed the kids from me from school for a few weeks. That automatically can de-stress you. Absolutely. Absolutely. Those are the areas that's changing. And I think if we let people know, Hey, expect this, then they can say, okay, just like when you're going on the trip, if you expect that there could be raid, you're going to get an umbrella. You're going to have the things you need. So it's just more making it a norm that things are changing instead of you're doing something wrong. And that's why things are changing.

Dr. Nicole (26:37): And it's also important to think about these things while you're still pregnant because once the baby comes and everything is hitting you all over the place,

Dr. Daigle (26:49): You need

Dr. Nicole (26:50): Autopilot. Yes, yes. And we focus so much on which is important. Yes, you need to focus on your childbirth education, and yes, you want to get your nursery together, people, folks doing these gender reveal parties and all of those things, that's fun. But you got to start during your pregnancy thinking about what's going to happen after, because that's the long haul.

Dr. Daigle (27:12): It sure is. That's a forever. That's why I tell people now, when I counsel these moms, if I see 'em ahead of time, I'm like, don't be asking for all these baby clothes at your baby showers. Tell 'em you need stuff for you. Yes. Because the baby, a pack of white onesies and some socks, they're going to be all right.

Dr. Nicole (27:26): They don't care what you, they

Dr. Daigle (27:28): Don't. They don't. They don't. I had stuff. People gave me stuff that I had to give away. People gave me stuff when my child was going to be 24 months. So I've been like, I hope in two years I'd be able to provide for her.

Dr. Nicole (27:39): Right.

Dr. Daigle (27:42): I could have used that money for a meal or something,

Dr. Nicole (27:44): Right? Yes, yes, yes. You just have to think practically about the things that are going to be serving.

Dr. Daigle (27:51): Yeah, I think it's just making it normal too, because the baby showers and the general fields, we made that a thing. So now we need to make mothering parties and things to support the mama thing, start our own new trends, and that becomes the norm.

Dr. Nicole (28:04): Absolutely. I love it. I love it. I love it. So let's talk about what things do you want to say? What pieces of advice, two or three pieces of advice specifically for parents that have NICU babies?

Dr. Daigle (28:16): Yes. So I'm actually doing this funny. I'm doing a masterclass tomorrow on five things to do or know if you should find your baby admitted to the nicu. And it's because a lot of people, for a lot of people, it is a surprise their baby ending up in the neo intensive care unit. If there's something going on in the pregnancy early enough, a lot of times they're being told like, Hey, you're going to need to go deliver at this specific place because they're going to need this specific surgery or things like that. And so those families end up a lot of times being introduced into what is a NICU early on. But for most people, they're like going on in their MER life and some event happens where they're delivering early or the term baby is not breathing or doing something. And so what I would say for families who end up in the NICU is one, just grappling with the fact that you did your best because for 99% of the people, if you had some foresight that to do X, Y, Z, you won't end up there.

(29:12): I think most people would take that chance. Okay, so you're telling me if I do this, I won't have a baby in the nicu. But we know that's not possible for a lot of times. So let that try to work on letting that guilt go. And then the second thing is rallying friends and family to support you, or in a way, choosing a point person that could be that sounding board for even communicating with the doctors and getting information, especially right away. Because most of the moms who end up having a baby that's going to nicu, they themselves are requiring some type of further care as well. They're on mag because of preeclampsia or they're having to go to the ICU themselves. They needed something or lost too much blood or just different things then that being connected to their baby, it's often someone else has seen the baby, the grandma or their dad.

(30:02): So really empowering them to be like, Hey, please get the information, communicate with the nurses and doctors about why the baby is there and what are the next steps and feel empowered to do so. I'm really, really big on empowering families to advocate for themselves when it comes to communicating with the healthcare team. You should not need to be afraid to talk to anybody about anything regarding your baby. Now there's a way to do it, and we don't have to be aggressive and frustrated, but I've learned to read into even that aggression as fear. And so that's why I even say for healthcare providers to take a step back and look at it through the lens of this is a family who we do this every day. This is most of the time their first experience and encounter. When we went to work, we knew the chance of us dealing with the preterm baby or a sick mom or whatever.

(30:52): They didn't know that that was going to be what happened when they woke up that morning. Exactly. So thinking about that, but really one, knowing that you can advocate for yourself, you have a right to understand what's going on with your baby, why are they being admitted? Ask these questions clearly, why are they being admitted? What is the next step? What do you have to do and what do you foresee as far as when they'll be able to go home? I'm trying to think what else. Other than that, the guilt just, oh, I think really important is get a notebook or something that you can write and keep track of things too, because a lot of information is coming at you. And I like to, I don't mind repeating. I tell people we're going to probably have the same conversation over the next week about three or four times, and I'm okay with that. I plan for that because they're only going to retain about probably five to 10% of what you said. And the first thing is they just want to know is they may, okay. And then after that, when they could come home and then you got to fill in all the middle, right,

(31:48): Wait, let's go down. But I don't let that frustrate me. I understand. They just want to know everything's going to be okay. Sure. And so just that's my tips automatically for the families at this time.

Dr. Nicole (32:01): Yeah, I love that. I love that. So

Dr. Daigle (32:05): As

Dr. Nicole (32:05): We wrap up, what would you say is the most frustrating part of your work?

Dr. Daigle (32:10): I think it's for me and frustrating. I guess if I were to say frustrating instead of what's sad for me, I guess what's frustrating is sometimes just seeing that there can be a lag in communication with families between the healthcare team and families. I think that's for me, I think I'm sometimes frustrated just in medicine how we need to do better in terms of being aware of our families and their situations and that the work we're doing, how important it is, how we make such an impact. They're going to remember us for a long time associated with such a huge event in their life.

(32:51): When they think about the birth of their baby or the sadness or the death of the thing, your face and your name is always going to be remembered along with that experience. And so just taking that in I think is important. So that it frustrates me that I don't think a lot of people really think about it that way. So that's probably the most frustrating thing other than just I would be okay with seeing just healthy babies being born all day. So obviously I don't want anyone to be sick. So that's the second frustrating thing for me too.

Dr. Nicole (33:20): Yeah. And you mentioned sad. What's the saddest part of

Dr. Daigle (33:24): Your, I think it is sad seeing death and seeing families deal with hurt and pain. That doesn't ever get old for me in the sense of even now when kids die or babies die, I cry. And I don't want to lose that because I've just accepted that. That's just part of the journey for myself, and I make a room for that. And I think it is helped me to stay not getting burned out actually, because I'm authentic in my feelings about the fact that sometimes it does suck. And sometimes I even want to lower why. And just right along with my families, I have questions too. Absolutely. We don't like when we don't have the answer or we can't fix anything. And I think if families know that we feel that same frustration, it bridges that gap. It bonds us together. Yeah,

Dr. Nicole (34:15): Absolutely. Then what's the most rewarding part of your work?

Dr. Daigle (34:19): Seeing all the babies and connecting with families? I love connecting with people. I think it's just at the heart of what makes us human and what makes this life worth it. Since you got to deal with all the bs, excuse

Dr. Nicole (34:33): My French. Yeah, no,

Dr. Daigle (34:36): If we going to have to deal with it, at least we ain't alone. And at least we have people that are rallying with us and loving with us and crying with us and all of it. I think you need people for all of it. And so I love seeing a family feel blessed and reassured that I was a part of their life. I feel the same way. I feel blessed to be a part of their journey too, even if it's hard. I had one of our respiratory therapists, I was at one of her deliveries, and her baby ended up passing. And that was so hard because this is a person I've worked alongside for six years. We were going to deliveries together, and after everything, she still came to me and said, Dr. Daigle, if I had to have somebody there, I would've rather been you. And I would remember thinking, wow. For her to tell me that in the hardest moment of her life, she was glad that I was the person there. That just changed me all the way around. And so I just love, I get that joyful feeling every time I'm interacting a baby and not just babies. I still cut up with the big kids too, especially those toddlers that like the cut up. So I just think it just helps the kid and me to stay alive too. So I love that. Definitely.

Dr. Nicole (35:49): Definitely. So then what is your favorite piece of advice that you would give to expect a mom

Dr. Daigle (35:53): Or expecting families? I think the one piece I would say is just know that you are not alone. And because sometimes the journey can feel lonely, and that's at every stage when you are pregnant, when your baby is one, when your kid is 10, you're always going to be going through changes as a parent. And there's always something more to learn. That's why I always tell my family, even as a pediatrician, I have learned so much as a mom doctor that I didn't have the perspective of when I didn't have kids. And so I still had to go through all of the changes. Is it time to feed my baby more? Do they want to see that the breast, is that the cue?

(36:36): It didn't matter that I knew more, that I had learned more. I still had to go through an experience as well. And so you're not alone in that regard. And so take pride in that just like everybody else has figured it out, you're going to figure out what works for you too, and it's going to take some failing forward or winning and learning to say you're not going to lose it. You're learning. You either win or you learn. So being a parent is a lifelong journey and process. And I think if they just enter it with that, you know what? I'm learning myself and my baby, I expect things to change and I'm going to roll with it. If they can be flexible, I think the people who are more flexible in the way that they approach it, I think they end up faring battle mentally instead of putting these restrictions on ourselves, which makes you feel like you're always failing. Now there are some hard nos and things. Yeah, your child shouldn't be swinging from the ceiling thing. Things like that. Maybe let do it one time. One time

Dr. Daigle (37:36): Just to say, you know what? They survived that. Look at that. Don't let it be on repeat. But anybody who's being honest as a pair would tell you they didn't have that thing. They're like, oh, thank, but the grace and God, they made it. They made it.

Dr. Nicole (37:50): Yeah, absolutely. Absolutely. Absolutely. So where can people find you and connect with you if they're interested in working with you or learning more about what you do?

Dr. Daigle (37:59): So I'm actually on all platforms. So on LinkedIn, I'm under just Daigle md. And then also the same thing on Facebook. But then on Instagram, I'm on Mom and me, md. Then I have a link there that links to services. I do the in-home concierge care for newborns and NICU families here in Atlanta. So that's actually where I come to the home and we'll see the baby and take care of them for what we call the fourth trimester, which almost doesn't quite apply. Sometimes the NICU babies, they have an extended fourth trimester, so now I say fourth trimester beyond for those families, babies, some NICU babies might come home right away and then some it is going to take two or three months or so just there for those families as they need. And then also I do life coaching for NICU moms who are trying to get back on track in their lives after having a NICU baby and build confidence as a mom that they know they can be.

Dr. Nicole (38:56): Okay. Awesome. Well, thank you so much for coming onto the podcast. Thank you. Like I said, your energy and your passion for your work just shines through. I love, and I know folks are going to be like, how can I work with her? She's just so delightful.

Dr. Daigle (39:09): Yes. I love it. I love it. I love my families and I have fun and it's just like this all the time. And the only other frustrating thing I would say is medical records and EMR Charlie.

Dr. Nicole (39:20): Yeah. That stuff.

Dr. Daigle (39:22): If I can just talk to families all day and we just talk it, I do that all day.

Dr. Nicole (39:26): Yes, absolutely.

Dr. Daigle (39:28): Absolutely. Well, thank you so much again, and I love the work that you do, and I love your new way of thinking about labor and delivery, and it was so refreshing for me to see that because sometimes you're in there and you're like, can this be done a better way? And when I started hearing you talking, I'm like, see, I'm not the only one that think things could be done a that way. There you go.

Dr. Nicole (39:49): There you go. I love it. Well, thank you so much.

(39:58): Wasn't that a great episode? I really enjoyed chatting with Dr. Jess and hearing about her journey and her experience and her commitment to her work. After every episode when I have a guest on, I do something called Dr. Nicole's notes where I talk about my top takeaways from the conversation. Here are my Dr. Nicole's notes from my conversation with Dr. Jess. Number one, her passion for her work really shines through. And I know for a fact that there are many of us out there who approach care like this, where we are truly and honestly committed to service and appreciate the privilege of what it is that we do. You just have to sometimes do some work to find them. So if you don't feel like you have a doctor or a pediatrician, an ob, GYNA midwife, whoever is taking care of you, who really feels committed to you and taking care of you, then look for someone who is better suited for you, someone who makes you feel seen, who makes you feel heard, who makes you feel valued, because you are absolutely, positively worth it.

(41:10): All right. Next thing is give yourself some grace. None of us are perfect, and sometimes despite doing all the things right, some things will just happen that are beyond our control. Dr. Daigle felt some guilt over being on bedrest, and then she started having contractions. And when she went to get something to eat and wondered, could that have impacted what happened? Probably didn't. But it's hard sometimes to look back on things and wonder, could we have done something different? Just give yourself some grace. You are doing the best that you can and you are doing a great job. Sometimes things are just difficult. Sometimes life unfortunately is just hard. So keep your head up, know that you are doing great, know that you are doing wonderful, and give yourself some grace. And then the last thing I want to say is be sure to prepare for postpartum while you are still pregnant.

(42:10): This is not something that we talk about nearly enough, and it's definitely not something that you're going to get a lot from your OBGYN. We focus a lot on pregnancy care, prenatal care, and the birth, but not a lot on what happens postpartum. And really postpartum is the long haul when things really, really, really get started and cranking up with life and the changes. So think about things like your household, like your finances, like your relationships while you're still pregnant. And that third trimester is a good time to do that. And it doesn't have to be overwhelming. It doesn't have to take up tons of time. Sometimes it can feel like, oh my God, I got to do this, I got to do that. I got to do all of the things. But just give some thought to the things that she discussed in the episode.

(42:53): Preparation is key to help you manage any of those life circumstances that pop up. And having a new baby is a huge new life circumstance. So just taking a bit of time to think about those things that are going to come up after you have a baby and setting yourself up for success in the postpartum period is really, really important. And a little bit of time can go a long way to help. Speaking of preparation, I would love for you to come and take my birth plan class, make a birth plan the right way to help you get prepared to have the beautiful birth experience that you deserve. The class is totally free, and I'm doing it live at the end of the month on April, I want to say 30th it is. You can head to my website at drnicolerankins.com/birth plan in order to sign up for that class.

(43:42): Registration will open on April 15th, and the class is again on April 30th. This is a great opportunity to connect with me live, to connect with other pregnant folks. So do check that out. It's drnicolerankins.com/birthplan. I cannot wait to see you there. So there you have it. Please share this podcast with a friend and go ahead and remember to head over to Apple Podcast and leave me that review and Apple Podcast. I'd love to hear what you think about this show, and I love to do shout outs and say thank you for all of the kind words that you say about, all about pregnancy and birth. So that's it for this episode. Do come on back next week and remember that you deserve a beautiful pregnancy and birth.