A Holistic Approach to Infertility and The Black Maternal Health Crisis with Physical Therapist Dr. Yeni Abraham

Dr. Jessica Drummond** ((00:00:03)) – – Hi and welcome to the Integrative Women’s Health Podcast. I’m your host, Doctor Jessica Drummond, and I am so thrilled to have you here as we dive into today’s episode. As always, innovating and integrating in the world of women’s health. And just as a reminder, the content in this podcast episode is no substitute for medical advice, diagnosis, or treatment from your medical or licensed health care team. While myself and many of my guests are licensed healthcare professionals, we are not your licensed healthcare professionals, so you want to get advice on your unique circumstances. Diagnostic recommendations treatment recommendations from your home medical team. Enjoy the episode. Let’s innovate and integrate together. Welcome back to the Integrative Women’s Health Podcast. I’m Doctor Jessica Drummond, and today I’m going to be introducing you to my dear friend Doctor Yeni Abraham, who has one of the most innovative practices in pelvic rehab and integrative medicine in the fertility space that I’ve ever heard of. She’s really done an amazing job of integrating manual and visceral therapies with a more holistic and mindful and listening medicine, and we’re going to get into some of the deep stories around what inspired her to do this work, the black maternal health crisis and what we can do, what we can do to help mitigate this very serious crisis as women’s health and wellness professionals and inspire you to maybe create this kind of practice in your community, it is sorely needed and the need is going to be accelerating, is accelerating now and is will be continuing to accelerate as we’re in this challenging world of reproductive medicine.

Dr. Jessica Drummond** ((00:02:11)) – – All right. Enjoy. Welcome back, everyone, to the Integrative Women’s Health Podcast. I’m your host, Doctor Jessica Drummond, and I’m here today with Doctor Yeni Abraham. And I’m so excited to introduce you to her. We met almost six months ago in Georgia at the Pelvic Con conference, which we were both speaking there, and she really gave an innovative talk, as we’re always looking for on this podcast in our community. And today we’re going to dive deep into the story behind her professional journey, what she’s doing to innovate the field of fertility education and pelvic rehab, and how we can help all of us, as women’s and public health clinicians, do everything we can to improve the really severe black maternal health crisis that’s going on within our health system. So welcome, doctor Yeni, and I would love to hear a bit of your story. What brought you here?

Dr. Yeni Abraham** ((00:03:24)) – – Well, thank you so much for having me. And yeah, I can’t believe it was that long ago that we met. It seems like it was a little bit longer ago.

Dr. Yeni Abraham** ((00:03:31)) – – I don’t know what it was, but. Yeah. So I am so happy to just chat a bit about, you know, my journey. I think when I tell this story, I told it in different kind of from different perspectives. But I think the perspective that speaks to be more recently is just leaning into how my personal and professional lives collided, because sometimes as clinicians, we don’t necessarily start the work and then find ourselves personally dealing with the same challenges. Sometimes it’s the reverse. I find that a lot of clinicians are inspired by their own journeys and then get into the work, but I’d say that for me, you know, I came out of physical therapy school pretty certain that I wanted to be a pelvic floor therapist. And so from day one, my first job was in pelvic floor therapy. And I saw all genders, multiple different ages. And I got a whole gamut of it. And, you know, after a couple of months and, you know, I would have these coincidental situations where I’d have patients who would return back to me and say, you know, my period was a lot better last month, or, you know, I felt like I slept a lot better.

Dr. Yeni Abraham** ((00:04:29)) – – And I’m like, what? You know, and if you’ve ever worked in outpatient orthopedic physical therapy settings, you hear your typical, yeah, you know, my knees moving better. I’m running better. I mean, balance is better, but you don’t always hear somebody tell you that their period was better, right? So of course that was a bit of an anomaly for me. And it created a sense of curiosity. I think I use the word curiosity quite a bit now when I explain my story, because that’s literally what I led with is curiosity. I never claim to be an expert in anything really, especially early on in my career. I didn’t know, you know, I barely knew when joint was from the other early on. Right. But I led with that curiosity. And just because that curiosity created opportunities for me to start taking different courses that would actually place what were accidental manual skills into a frame of reference for me. And so I’ll backtrack and say this. You know, I was reflecting the other day and I was thinking, you know, where did I get my manual, my confidence in my manual skills from, like, where did this start? And it started.

Dr. Yeni Abraham** ((00:05:32)) – – I had an amazing advisor and instructor when I was in physical therapy school, Doctor John Winslow, who gave me an incredible confidence in my manual skills. He taught me how to trust my hands. He taught me how to trust my instincts, and I’m so happy that I learned that level of advanced skills so early on, because it carried me along. Right. And so, like I said, I started at first was just why are my patients periods getting better? Taking visceral courses to establish the why and then realizing that, well, if I could fix their periods, then surely there must be a way to also manage ovulation, right? And then started having a couple of patients, typically with PCOS, who would have fibroids, who would come see me, who maybe had like insidious like groin pain, you know, just interesting MSK injuries. And we were able to create systems and techniques that I was able to implement on them. And we were achieving positive pregnancy results. And so there’s a much longer version of this story.

Dr. Yeni Abraham** ((00:06:32)) – – But I like to highlight this because at this point I started also going through my own fertility journey. It was kind of when art imitated life, like I was a person that was obviously making all these interesting findings, and at that time I wasn’t talking a ton about it. I think only a handful of my colleagues really knew the work I was doing in my office. I mean, I think at the time I maybe had just connected with Nicole and she was like, oh my God, you got to teach people what you’re doing. And I was like, teach people. I just figured out what I’m doing, right. But just to cut the long story short, you know, having my personal infertility journey did a weakened sense of purpose in all of this work and created just a. Augusto and not just doing the manual skills, but also learning the wellness component, the nutrition component, the hormonal component, and really treating people holistically, literally the whole body approach.

Dr. Jessica Drummond** ((00:07:26)) – – So yeah, you know, that really mirrors a very similar experience that I had where I was sort of optimizing my hormonal health and then my pelvic pain patients.

Dr. Jessica Drummond** ((00:07:37)) – – I thought, well, if we can truly improve hormonal health with nutrition and mindfulness and all of the, you know, supplements, why couldn’t we improve pelvic pain? Because there’s such a hormonal component. So I think that’s really what we want to be doing as a profession and innovating by catching a thread and then seeing people. You know, I had a patient who was like, oh my gosh, I stopped eating gluten and dairy and I didn’t have to have a hysterectomy. Obviously, that wasn’t the whole story. It’s not that simple for most people, but I’m sure you’ve seen those cases where it’s like, oh, I, you know, improved the facial flow in this certain part of the abdominal pelvic region and suddenly, oh, we’re getting circulation and lymph flow and nervous system connection. And now this person can get pregnant. So I think we’re just starting as even with an integrative and functional medicine, to truly understand how important that flow of fascia and lymph and really superficial nerves and capillaries, how that’s truly a part of the neuro immune system.

Dr. Jessica Drummond** ((00:08:56)) – – I’ve been talking to other people, and I’ve got more and more of a heavy caseload of complex chronic illness with a lot of like viral reactivation and endometriosis and chronic pain. And I think we’re now seeing this connection between mind body medicine used to be very separate in the sense of you were meditating or you were exercising.

Dr. Yeni Abraham** ((00:09:21)) – – Yeah. Or you use holistic medicine versus conventional medicine. Yeah, absolutely. It’s definitely I think people are starting to realize that it is a healthy balance of both. Absolutely.

Dr. Jessica Drummond** ((00:09:32)) – – Well, and I think even more than that, the connection space physiologically is in that sort of facial lymph, superficial capillaries, nerves, space that people that are well trained, not even I don’t know if well-trained is even the right word trained as part of it. But as you said, to have that trust in their hands, they almost have the ability to listen with their hands.

Dr. Yeni Abraham** ((00:10:00)) – – Yeah, exactly. And of course, you know, Jean Perel, who’s like the master of visceral manipulation, you know, that’s the technique that he teaches local listening.

Dr. Yeni Abraham** ((00:10:09)) – – It’s an intuitive way of passively testing and appreciating value the skin beneath the dermal layers. And of course, these are manual skills that we’re referring to. And again, I think what I’ve learned to appreciate over the years is how some people’s natural tendencies as providers is going to lead them to learn these skills a lot easier. Right? Because if you’re already pretty intuitive as a provider, if you’re not married to the research and you’re willing to take risks, you’re going to find that you’re going to make a lot of impact in the fertility world. Right? But if you’re always looking to check off boxes, I mean, someone who is dealing with unexplained infertility, it’s not in the same kind of theory squared box as someone who had an ACL reconstruction, right? It doesn’t mean that there’s not nuances to that reconstruction, but there’s a bit more predictability when we see challenges arise.

Dr. Jessica Drummond** ((00:11:01)) – – Well, and the reality is we also have more research on things like sports injuries so we can develop protocols, whereas what you’re doing is innovating the protocols of fertility, which it’s not to say that anyone, you know, there’s not a one size fits all protocol for anything, but I think what you’ve created here around fertility and manual therapy is the, I don’t know, 1980 version of the maybe even later than that.

Dr. Jessica Drummond** ((00:11:32)) – – Like if I think about when I graduated from school, like in 1999, even we didn’t have as clear of an ACL recovery structure as we do now. So, you know, so what you’re creating is really that. So let’s talk about that a little bit like in the experience that you have now and some of the feedback you’ve gotten from your patients and your own experience with infertility and then pregnancy, let’s say we’re in that early stage of framework that we would eventually be able to test. What does that look like for you?

Dr. Yeni Abraham** ((00:12:02)) – – Yeah. So if I understand your question correctly, we’re kind of looking at all right. So if we have a particular diagnostic issue, PCOS or Endo that potentially is impacting fertility outcomes. Like, what are the sequencing that we’re doing? Right? And the funny thing is, Jessica, I have learned the more I try to sequence it, the less it needs to be sequenced.

Dr. Jessica Drummond** ((00:12:23)) – – Good, good.

Dr. Yeni Abraham** ((00:12:24)) – – Cause I’m telling you, reproductive health is the wild, wild west. You cannot protocol this.

Dr. Yeni Abraham** ((00:12:31)) – – You must be willing to create it. And I think a lot of providers struggle, especially people who are. I’m teaching a cohort providers right now who are getting certified. And a lot of the initial learning is unlearning systems that told you you have to do things one way, because you’re going to meet ten patients on your caseload. At the same time, you all have PCOS and they’re all going to be uniquely different and they’re all going to have infertility. So how do you approach this right? And why is it that when you did something on this patient, it worked right away, and then you do the same thing on another patient, and you’re still feeling like you don’t know what the heck is going on. It’s because like you said, we are complex beings, right? We have hormonal receptors and response patterns in our body. We have genetic findings. I mean, if you want to be wowed and you ever want, you know, some quote unquote light reading, be sure to pay attention to all the genealogy and genetic work that’s happening right now, because we’re constantly learning more about.

Dr. Yeni Abraham** ((00:13:25)) – – Even the other day, I was looking at some work that, you know, they had looked at some archaeologists, had dug up some old bones. And I mean, we’re talking about like thousands of years old, and we’re able to pick up so much information about some diseases that even existed back then that we haven’t had a lot of conclusions about. So things are always changing, right? And who knows, maybe 20 years from now, my thought pattern around this is going to be different, but I just don’t think it is safe enough. And it is wise enough to teach people a protocol when you are approaching reproductive care.

Dr. Jessica Drummond** ((00:13:56)) – – Yeah. Well, and I also think that in doing work with hormonal regulation and nervous system regulation is what I’ve been doing for 17 years now. Eventually you’re able to sort of come up with an order of operations, if you will. And I think that’s the closest I’ve ever come.

Dr. Yeni Abraham** ((00:14:16)) – – And that sounds about right. Yeah. You kind of know what areas you want to hit, right? And you kind of know, okay, for the most part, this should work for you.

Dr. Yeni Abraham** ((00:14:24)) – – But I always leave things to chance. There’s a likelihood that I’m going to give this person all this education, and they’re going to get all this feedback, and then they’re still going to come away and say, nothing changed, right? Those things do happen. Right? But I think as far as when it comes to especially individuals who are on early on in their careers or not, I say early on who are looking to refine certain skill sets around reproductive care. I don’t like to teach a protocol, right. I think that it does more harm than good because when people don’t fit in the box, there’s a ton of frustration and providers are, let me tell you right now, like I tell all my students, you are not there to fix your patients. You there’s no such thing, right? Because fixing saying that you’re fixing a problem or fixing them and saying that they’re broken. Right. And that’s not fair. So I think we have to give people the benefit of the doubt that there might be some dysfunction there.

Dr. Yeni Abraham** ((00:15:15)) – – Yes, there can be some impairments. There are things that definitely need to be corrected or dysregulation that’s common, you know, in the work we do, but we don’t come in guns blazing with a cape on and say, hey, you know, abracadabra, let me fix you.

Dr. Jessica Drummond** ((00:15:29)) – – Yeah, absolutely. So are you doing in your manual work? Is it full body? Is it because I’m thinking kind of cranial vagus nerve, pelvic floor. You know, spine feet. Like, what are you looking for first with a client?

Dr. Yeni Abraham** ((00:15:48)) – – So great. I’m happy you phrased it that way, because I’m not looking.

Dr. Jessica Drummond** ((00:15:52)) – – You’re listening.

Dr. Yeni Abraham** ((00:15:54)) – – I’m listening. Exactly. I’m there to receive the information that is present. And so, of course, the zone of operation is typically in the abdominal pelvic space. That’s where I hope to get enough information. So I know where to go. Right. And typically my assessment of the abdominal pelvic region, whether it be internal with pelvic floor findings or I’m looking to do my visceral skills there and do some local listening, what I’m looking to do is just say, okay, where does it seem like we should go? Right? If there are old scars and if there’s adhesions, okay, then of course we’re probably going to do a ton of facial work as well.

Dr. Yeni Abraham** ((00:16:30)) – – And I’m going to be, you know, of course, if there’s like neuromuscular problems, I might have, you know, them doing some PNF movements, you know, bringing those things back up. If there’s a lot of hormonal migraines or trauma involved, we’re going to do some cranial sacral work. We’re going to do some vagal nerve work as well. And this is one thing I tell even my patients is like, I go where your body tells you, right? I go where I feel led. And of course, if they feel and I’ve never had a patient that’s had issues with this, but I always lend them to some level of descriptive explanation, because I want them to feel affirmed and the things that they’re feeling right. Like if I’m going there and I feel an essential amount of discomfort or someone has an emotional letdown, you know, the. We’re going to come and talk about it, and we’re going to say, why is it that potentially happened? Or what were you feeling when that happened? Then I’m also going to let them know that, hey, your body is telling us is calling attention to this area.

Dr. Yeni Abraham** ((00:17:23)) – – And that is awesome, right? So creating a lot of safe space so that we can get the work done.

Dr. Jessica Drummond** ((00:17:28)) – – And a lot of communication it sounds like.

Dr. Yeni Abraham** ((00:17:31)) – – Absolutely. And the communication is ongoing. Right. It starts the first day, you know, building that level of trust and making sure that I’m not here to fix you. I’m here to walk alongside of you and help you and guide you along the way. But ultimately, I want what you want out of this. Right? So even just lending those kind of words, which is something that I think a lot of people as clinicians that they struggle with, is the language, you know, we talk a lot about like clinical buy in and patients, not really, you know, feeling like they’re valued. I’m like it goes back to the the way that you approach it. Right? I have a lot of patients that don’t look like me. They don’t come from my background who I’m able to build some credible trust with. And that doesn’t necessarily mean I have the hottest personality on the block, but it just means that on a professional standpoint, I understand that in order for me to lend my skills and do the work appropriately, I have to be willing to meet people where they’re at.

Dr. Jessica Drummond** ((00:18:25)) – – Yeah. What about physically? So a lot of what we teach with our clients is our students who are professionals is you’re always kind of neuro regulating with the client you’re with. So do you have your students do anything themselves? Because sometimes almost that’s once they learn how to do it. That’s almost easier than explaining what you’re doing to just co regulate.

Dr. Yeni Abraham** ((00:18:50)) – – Yeah. So when I teach I am big about starting with you. Of course I’m going to unpack your why. Why are you even here if you’re here just because you got some infertility issues and you want to get fixed, this is probably not the best place for you, right? But if you are here and you’re genuinely have a burden for this population, right? Or you’re seeing a lot of it and you feel very misplaced, great. Let’s lead with that discomfort. I think a lot of people, and this is always so exciting because of course a lot of Pts and OTS or ortho or neuro is, you know, a lot of us are used to being in spaces where we are the best, the expert on top.

Dr. Yeni Abraham** ((00:19:30)) – – We know all the answers. Boom, boom. I can give it to you right away. Right? And I think what is so great is being able to lead people to navigate in areas where they are not comfortable. I don’t even know what that means. Can you explain that? Thank you for asking. Let’s dig into that. I’m happy that you don’t know what that means, and I’m happy that you didn’t just nod your head and act like, you know, because your patient’s going to mention that she has such and such disorder next week, and I don’t want you to fake it. I want you to be genuine. Right. So I think that has a lot to it. I mean, even sometimes it’s even granular. Like I don’t talk down to patients like my body language. Like I’ll tell a patient if I’m happy to be standing up. And then they go to transition and sit down somewhere and we’re talking. I’m like, hold on a second, let me get on your level.

Dr. Yeni Abraham** ((00:20:15)) – – Right. So I even prefer if they’re like sitting on the table where I’m sitting on the chair or we’re sitting face to face because teaching things like that are so I mean, what is the study say? It’s like 80 or 75% of language.

Dr. Jessica Drummond** ((00:20:27)) – – Is your body language is your.

Dr. Yeni Abraham** ((00:20:29)) – – Body language. Right. So that’s where it starts is infertility. Reproductive problems is literally some of the deepest work in the human experience. Next to grief right. Next to loss. Right.

Dr. Jessica Drummond** ((00:20:43)) – – And involved in, you know, includes grief and loss.

Dr. Yeni Abraham** ((00:20:47)) – – Yeah, exactly. It is. So you cannot go in without that level of empathy. And I also think it’s important to that you’re not taking that on. Right. So it’s like a sense of there’s a delicate balance. There is. You know, I have and I admittedly would say that no matter how long I’ve been doing this, I do have some people that keep you up at night that, you know, I’ll wake up from out of sleep and I’m like, oh, God, you know, I gotta go look this up real quick because there’s always going to be that 1 or 2 people that just like you are just a puzzle and I gotta figure out how to help you.

Dr. Yeni Abraham** ((00:21:20)) – – But yeah, but I think it’s important that as much as you are empathizing in your present, in the work, that you also have healthy patterns to just gently just associate for the sake of, because if not, you will not have longevity in this work.

Dr. Jessica Drummond** ((00:21:35)) – – Yeah, absolutely. So why did you decide instead of just doing this? I don’t know what your job was before triggered, but I would love to know why you chose to open a practice, because that’s a whole different skill set. And many of our students in our community are entrepreneurs or budding or aspiring entrepreneurs. So of course, this is work you could take to any women’s health clinic or gynecologic practice. Why did you decide to open your own space?

Dr. Yeni Abraham** ((00:22:04)) – – Well, I think it’s kind of obvious. Nobody even was like, what? Fertility? What you’re going to do and what I don’t. Is that, you know, I took a good break from outpatient care, and I work in the acute space, and it was kind of a life hack at the time.

Dr. Yeni Abraham** ((00:22:20)) – – It was one helping me have a bit work life balance gave me the space to take the courses I wanted to take, but it provided me to having access to an amazing interdisciplinary team. I had all of these amazing doctors at my disposal, and I was constantly grabbing them in the hallway, meeting up for, you know, I’d have lunch with them and it privy me to learn a lot about the value of interdisciplinary medicine and, you know, and insight to help patients. But I knew very clearly that in order to do this work well, I would have to be willing to build that environment because there was nothing around it. And I live in North Texas. It’s super conservative here. People are pretty cut and dry about what they’re doing. I mean, obviously things are starting to change post-pandemic, but I started my practice pre-pandemic, so at the time, it didn’t feel like there was going to really be a natural way for me to establish what I thought led to do in the context of what was present.

Dr. Jessica Drummond** ((00:23:17)) – – Right. Okay. So you really felt like how you wanted to work was a driver. And also and we’re always talking about this, like creating the kind of business that serves your clients in the way they need to be served. And obviously this kind of work requires slowness, patient space, not, you know, three patients at a time or even 30 minutes back to back.

Dr. Yeni Abraham** ((00:23:41)) – – Exactly like there’s not. I mean, and even now, because obviously I’m teaching more now, I’m not treating every day like before. But even now, just like the things that go into it, the fact that I do have to correspond a bit more with these kind of patients, there’s a lot of things that I have to do emailing them, having phone calls, advocacy, conversations, education, virtual consult. It integrates a lot more than your traditional practice setting.

Dr. Jessica Drummond** ((00:24:07)) – – Yeah. That’s amazing. So what would be your biggest kind of, I don’t know, inspiration or recommendation to someone who’s thinking, you know, who’s really interested and as you said, almost feels like a calling for the work of fertility because it is such a sacred space, truly, and a space that has so much complexity, including shame and hope and family.

Dr. Jessica Drummond** ((00:24:36)) – – And, you know, there’s so much complexity. And, you know, they don’t live in North Texas, so they can’t come work for you. So what would be your inspiration for someone who might be interested in that field? What would be your next steps?

Dr. Yeni Abraham** ((00:24:51)) – – Yeah, so I get at least a handful of DMs asking me this question every week. So pretty.

Dr. Jessica Drummond** ((00:24:56)) – – Where do you start answering it?

Dr. Yeni Abraham** ((00:24:58)) – – And I always tell people, just start. Just take the class, you know, just jump right in. I think a lot of times it’s especially about let’s also do this like, you know, rehab professionals, we always want to like, you know, read more articles or take a webinar or just jump right in. You would be surprised how much of this will complement the practice that you already have, right. Or the practice that you already do. You’re seeing the patients already. I guarantee you like 90% of them have some level of endocrine disruption.

Dr. Jessica Drummond** ((00:25:28)) – – Yes, yes.

Dr. Jessica Drummond** ((00:25:29)) – – Yes, especially post-pandemic.

Dr. Yeni Abraham** ((00:25:32)) – – Everybody has metabolic disorders, thyroid problems. I guarantee you everyone has these hormonal problems. So if anything, you’re going to be able to lend more to the patients that you already see. Right. But I’m big on just jumping right in. Like I don’t think there’s a ton of value in just questioning it. When you feel led, when you feel that and that’s just go right in.

Dr. Jessica Drummond** ((00:25:53)) – – Yeah. Love that. So let’s change gears a bit. I think, you know, your practice is so focused. It’s so niche focused on fertility but also pelvic pain, perinatal health, postpartum health. And we have one of the worst black maternal health crises in the world in this country. And generally, you know, maternal death rate is the worst among all industrial nations, I believe. And for black maternal health, it’s anywhere from 3 to 12 times as bad. So being in that space, do you have any thoughts for how those of us who also, you know, work with pregnant women who are black, who are of color, who have less access to care? What are some of the things we need to be doing to improve this situation?

Dr. Yeni Abraham** ((00:26:50)) – – Yeah, I’m happy that we get to include this in our conversation today.

Dr. Yeni Abraham** ((00:26:54)) – – I am not going to enter this thinking that everyone knows the facts and everyone understands the nuances involved. So I’m just going to try to speak from like a higher level and really break it down here. So prior to the pandemic, I think it was in the black community. I can say that there were general conversations around. Years. Going to the hospital. Fears. Interacting with the medical system. Not feeling heard. We’ve had some stories and some incidents, even pre-pandemic. You know, we’re left without care postpartum or we’re not listened to. And unfortunately, that led to the loss of a life of the mother or the baby or sometimes both. Right. So there’s a general issue that has been going on. And by the way, that is not a race problem. That is a systemic racism problem. Right. So that’s a higher, higher complexity, right. That’s integrated in medical bias from insurance payouts, reimbursements providers. You see prenatal care. It’s a very complex system. But where we are, I think where the major problem is right now or the major symptom I say right now is the endpoint, is that are we safely seeing mothers to the other side? Right.

Dr. Yeni Abraham** ((00:28:05)) – – And the honest truth is, and I can even speak for myself when I had my son, is that even though I’m a provider, the fear of somebody likely going to get this wrong, not because they’re not good at their job, or they don’t know the numbers or they don’t know what to do, is that they are in a society, and they were raised in such a way that will not necessarily privy them to pay attention to me. Right. I’ll give you an example. I have a phenomenal OBGYN, and when I has a lot of complexities, I had my fertility journey, had a lot of issues getting pregnant. So along the way, unfortunately I did have infant loss. I had a couple of miscarriages, so my OB was 100% like she knew my history. So about a week before I had my son, I was starting to experience some borderline PTSD due to the infant loss that I had, and she kind of looked me in the face and she said, I don’t know if your body is going to be able to work through having this vaginal delivery.

Dr. Yeni Abraham** ((00:29:02)) – – Do you trust me to have a C-section? And I said, heck yeah, I trust you. I feel it’s right. I think this is the best decision for me. So I had a scheduled C-section, but a couple of days before I went into labor on my own, and this happened to be the only day that my OB was not on call.

Dr. Jessica Drummond** ((00:29:18)) – – Oh no. Yes I’m getting.

Dr. Yeni Abraham** ((00:29:20)) – – Of course I’m dilating. We have a family history of progressive labor. We progressed pretty quick in my family. I mean, it’s happening fast. I’m dilating. He’s coming and I’m in the hospital room and the coverage OB comes in and she’s like, well, you know, you’re progressing fine. We’re just going to give you some photos and like no questions being asked. And she just was like, yeah, I think you’re going to be okay. And I was just like, oh God, girl. What? I’m in a lot of pain right now. I don’t think this is the best decision for me.

Dr. Yeni Abraham** ((00:29:47)) – – So I’m here. There’s a nurse in the corner seeing my husband and I as I contact as this OB was barely even looking at me, and I scan over because I’m feeling a lot of pain at this point and I’m like, well, I don’t know if this is going to be the best decision. But I also felt that for what they were telling me, I was too far to then have a C-section. So I’m getting somewhere here because I think this is an important just example. So all of a sudden I see this nurse, she’s on her phone, Jessica, and she’s.

Dr. Jessica Drummond** ((00:30:20)) – – Like, oh.

Dr. Yeni Abraham** ((00:30:20)) – – And all of a sudden I hear, like the person on the phone get her on the phone right now. She called my OB on her cell phone, my OB gets on the phone, I’m putting on my jacket right now, and I’m coming to us when we’re doing this dissection. Do you trust me? And I said, yes, of course I trust you. Do you trust me to make the best decision for you? I said absolutely, you know me.

Dr. Yeni Abraham** ((00:30:40)) – – I’ve been she’s been my OB since I was in college. So I was like, you know, me. Cool. So of course we have the C-section. After the C-section, extended, time was spent because I bled out. I had secondary postpartum hemorrhage, which happened after I had the last infant loss, and my body just picked up where it left off with the trauma right after that. Of course, I unfortunately was not ambulatory for the first 24 hours postpartum because of the complications and the amount of blood loss I get. All these nurses come in and oh my God, thank God your doctor came when she did. It would have just been a bloodbath if it was a vaginally. How many people go through that? Right. Great example. I think if your provider hearing this, I’m sure I want you to think deeper about the scenario. I don’t want you to think on face value. Like, oh, good thing her OB got involved. She sounds like she has a good OB. That could be you.

Dr. Yeni Abraham** ((00:31:32)) – – You could be the person that even the nurse that gets on the phone because she doesn’t know me from a camera or.

Dr. Jessica Drummond** ((00:31:42)) – – She doesn’t.

Dr. Yeni Abraham** ((00:31:43)) – – Know me. I’ve never met the lady in her life. She was a guardian angel, God bless her. Right. But that could be you. You could be the person that says something about this is off. But this is a black woman in a predominantly white hospital who have had several challenges. Having children is potentially, you know, ready to have her first live birth. How can I insert myself in this situation to make sure that she is safe, that she feels heard and she feels advocated for? And I think that. The three prong piece is. What is missing in our health care system is that a lot of black women do not feel safe, they do not feel heard, and they do not feel advocated for.

Dr. Jessica Drummond** ((00:32:23)) – – Yeah. And I think what’s amazing about that story is that having had children myself, you know, when I first worked in this field, I didn’t have children.

Dr. Jessica Drummond** ((00:32:33)) – – So there is some insight from just having that experience of giving birth. But even if you haven’t, one of the things that’s important to know is that as educated or as strong or as fit as you might be in your regular life, when you’re having a baby, you’re in a very vulnerable situation. And same thing. I very well trusted my OB. There were some things that like, if you would ask me the clinical data, I would have been like, don’t know, I don’t want you to do that. We’re like, whatever, ten centimeters dilated. I have no.

Dr. Jessica Drummond** ((00:33:11)) – – Epidural. I’m like, I’m experiencing high levels of pain.

Dr. Yeni Abraham** ((00:33:15)) – – I don’t know where I’m in space. The science is not coming to me right now.

Dr. Jessica Drummond** ((00:33:21)) – – You have to have that person that you trust, because you can’t actually advocate for yourself very well in that very effectively, because you simply don’t know what you’re doing. You’re just kind of like flowing with it. And that’s in sort of the best case scenario, you know, in my situation.

Dr. Jessica Drummond** ((00:33:41)) – – And so what I would say is that as a provider, because the other thing is that many women die not exactly in childbirth, but in postpartum. So even rehab professionals, even perinatal massage therapists, even postpartum doulas, even postpartum fitness instructors and health coaches have a role here. And this is where I think all of our training in nervous system regulation and intuitive medicine, and in just observational skills and listening skills are the key, because that nurse just felt as you said something was wrong, she didn’t really know, and you didn’t really know. You couldn’t have predicted that you were going to bleed out in the middle of that circumstance. And so let’s say you had had the vaginal birth and then it was an emergency. A lot of times what happens is that’s the point where no one listens, where everyone’s kind of like, oh, it’s going to be fine. I think it’s going to be okay when if you just take faster action when you like, take action on that, or, you know, if you’re in a postpartum rehab setting or you’re in a fitness class and someone’s blood pressure’s a little high and they’re feeling a little off, we don’t wait and think, oh, you know, she’s strong enough to do this.

Dr. Jessica Drummond** ((00:35:08)) – – She’s a fit person. You’re in a very vulnerable situation physically and emotionally, especially if you’ve also had histories of miscarriage and infant loss and infertility. That gets wrapped up in all of this, too.

Dr. Yeni Abraham** ((00:35:24)) – – And I love that you lended, you know, just to the imagery of vulnerability, because that’s really a big piece of this. But what I found, too, is that a lot of what we see postpartum could have been discussed prenatally. And, you know, I’ve had many patients who come to me who I just noticed certain things about their health. And your blood pressure has just been all over the place your whole pregnancy. There’s a condition called preeclampsia. I’m not saying you have it, but I just want you to be aware of that. Something that sometimes people are prone to when they have high blood pressure. Big, big lifesaver for a lot of women, right? These are the signs to pay attention to. Even asking a question. Are you going to have health at home when they become so who’s there just beyond you and hubby or beyond you and your partner? Right? Because we need a third eye in that room.

Dr. Yeni Abraham** ((00:36:10)) – – Who’s going to be looking out for you, right. So I think that’s really important. Of course, doulas play a big role, but I do see that even postpartum doulas sometimes don’t have a lot of leverage. So I think, like you said, rightfully so. As rehab providers, we’re typically the people that see them first. I have been I can’t tell you how many times I have picked up postpartum depression or postpartum anxiety. And unfortunately, I’ve had even a recent case of postpartum psychosis, right, in black women. You know, they’re coming to see me because they trust Doctor Yeni and they know that she’s going to keep it real. And I’m like, something’s off about you. Is your mom here? Can she take the baby? Because I need you to go get some help. I’m going to have you go to the E.R. right now. Right? And she’s like, oh, yeah, no, it’s too much of like, trust me, I don’t. Something like that saying that something about it, sure enough, you know.

Dr. Yeni Abraham** ((00:36:55)) – – So I think it’s about being able to sometimes be the voice for the voiceless. And it’s not to say someone doesn’t have a voice, but in the midst of such an ability that extends six, eight weeks postpartum, we still have to learn how to advocate.

Dr. Jessica Drummond** ((00:37:09)) – – Yeah. And I think that’s so important that you emphasize that the vulnerable. Ability doesn’t end. The moment you like are not in 12 out of ten labor pain like you know, in a way it’s worse six weeks later because you haven’t slept that whole time. So I think that’s really the key, is that women who appear because, you know, when they come to the doctor’s appointments, right? Or the clinician appointment, they sometimes try to get dressed. They, you.

Dr. Jessica Drummond** ((00:37:39)) – – Know.

Dr. Yeni Abraham** ((00:37:40)) – – Hair looks clean, looks like they had a shower, you know, like maybe they have a little lip gloss on. They look really good. Like, oh my gosh, you look great.

Dr. Jessica Drummond** ((00:37:49)) – – Yes. And that’s where we have to not let our guard down as professionals, as listeners, as advocates.

Dr. Jessica Drummond** ((00:37:58)) – – And I think training your intuition by training your hands is one way to strengthen that skill set. And if you’re in health coaching, another way to strengthen that skill set is training your listening, your mindful listening training, your neural attunement, so that especially when we see, you know, in health coaching and in PT and rehab and these kinds of professions, you know, the gynecologist is going to see the person at the hospital. And then six weeks later and then basically that’s it, unless they reach out. And so we have that relationship building that you talked about in the beginning that helps to attune when things are more normal for that client and when they’re a little bit off. And I think it’s another thing is to start adding, you know, perinatal early prenatally, postpartum, basic things like blood pressure, hydration, like pain, bleeding. You know, don’t just dismiss some of those things out of hand.

Dr. Yeni Abraham** ((00:39:04)) – – Obviously, there’s a pretty easy to use objective tools out there that we can, you know, build into our paperwork.

Dr. Yeni Abraham** ((00:39:12)) – – I mean, all of my patients get a survey every I think they get it every two months, you know. So I’m getting an update on, you know, their anxiety and their depression. And we’re talking about it. I’m like, hey, I noticed there your sport drop. Let’s lean into that. What’s going on with you? But I think something that I also want to mention is just like also just that post-pandemic change to in black maternal health, because we did see that a lot of women, black women especially left traditional forms of medicine and went to midwifery support, doula support and are looking to do more home births or births and, and births and, you know, conversation that I had a lot with a lot of my colleagues, especially a lot of women of color who are providers. A lot of the conversations I’ve had is, okay, are we still screening these women for their high risk? Right. Because sometimes they’re not aware that they’re high risk, because unfortunately, when you are a black woman birthing in America, you’re high risk.

Dr. Yeni Abraham** ((00:40:06)) – – That’s the honest truth, right? And then add the age and then, you know, some of the complexities of co-morbidities, right? So I’m saying, are we still having that conversation? Are we screening them appropriately, making sure that this person is even safe to have a home birth right, or safe enough to have a birth at the birthing center? Right. And so I think sometimes it’s tough when especially I think it was probably around 2021, was when I found that I would have patients that were damn near have like mental breakdowns in my office. When I say, I think you need to go see an MFM because I think you’re 38, this is your first kid. You’ve had some weird nights, and I’m not feeling comfortable with the fact that all you’re seeing is a midwife. You know, not saying your midwife isn’t great, but not all states have the same regulations for midwives, right? So there’s some states that midwives are trained differently than others. And there can be a lot of inconsistencies in the care that they’re delivering.

Dr. Yeni Abraham** ((00:41:00)) – – So in Texas though, out of all the states we have this the worst black maternal outcomes out of the United States.

Dr. Jessica Drummond** ((00:41:07)) – – That’s terrible. I mean, it’s awful.

Dr. Yeni Abraham** ((00:41:10)) – – It’s the wild, wild West out here, literally. And it puts a incredible burden on allied health professionals, on birth providers to know more, to do more. You know?

Dr. Jessica Drummond** ((00:41:22)) – – Well, and unfortunately, that’s probably going to get worse because we’re now in a situation where we saw that recent case in Texas where, you know, essentially they’re telling women who need abortion care to wait in the parking lot until they’re septic and then they can treat them. This, to me, is so problematic, not just because of those acute cases, which apparently are there’s something on the order, you know, that was in the news. There was a lot of talk about this, but I’ve heard the the data is roughly 90,000 cases in that state since Roe v Wade was overturned. So in the state of Texas, 90,000 similar cases. And then the other problem, though, is that gynecologists are not.

Dr. Jessica Drummond** ((00:42:12)) – – Coming to Texas to train.

Dr. Jessica Drummond** ((00:42:14)) – – Yeah, but can you blame them, though?

Dr. Jessica Drummond** ((00:42:16)) – – No, no, no, I mean, I certainly.

Dr. Jessica Drummond** ((00:42:18)) – – Yeah, I.

Dr. Yeni Abraham** ((00:42:19)) – – Cannot blame them. And that’s where I mean, I’m not seeing of course, in the state of Texas we do have great providers, but.

Dr. Jessica Drummond** ((00:42:26)) – – Oh for sure. Yeah.

Dr. Yeni Abraham** ((00:42:27)) – – I think in the coming decades, if we do not see a change in the legal side, you’re going to see less and less high quality providers who want to practice you. Right, because the limitations are much.

Dr. Jessica Drummond** ((00:42:38)) – – Well, it’s.

Dr. Jessica Drummond** ((00:42:39)) – – Dangerous for them. Really.

Dr. Jessica Drummond** ((00:42:41)) – – Yeah.

Dr. Yeni Abraham** ((00:42:41)) – – And of course, if you have a patient that has a trisomy, you know, genetic disorder and they’re carrying a child and they’re looking to get a early enough abortion and they’re not able to do that. You know, this is just messy, right? So I think it’s interesting that you brought this up because a lot of times people don’t think about the whole abortion conversation in the context of, of maternal health, fertility.

Dr. Yeni Abraham** ((00:43:05)) – – Right. But it’s all reproductive care. It’s all the same thing, right? It all falls under because you and I, maybe because of the kind of work that we do, we do see the anomalies and the inconsistencies in care. So I’m like, they do exist, guys. It’s not always just somebody got knocked up and they want to make this decision. Right. It’s usually severe medical decisions being made. Right. Or and if people don’t have the options than we do see more and mortality unfortunately.

Dr. Jessica Drummond** ((00:43:32)) – – Absolutely. And if you lose you know high risk gynecologist people who are trained surgically in high risk gynecology. And I agree with you completely. I gave birth actually to both of my daughters in the state of Texas. I worked for off and on for about a decade at the Women’s Hospital of Texas in Houston and Houston.

Dr. Jessica Drummond** ((00:43:53)) – – Yeah, you.

Dr. Jessica Drummond** ((00:43:53)) – – Know, great maternal care. We delivered, on average, one baby an hour the whole time.

Dr. Jessica Drummond** ((00:43:58)) – – I worked there, I believe it, I’m pretty.

Dr. Yeni Abraham** ((00:44:00)) – – Sure it’s still the.

Dr. Jessica Drummond** ((00:44:01)) – – Same. Yeah.

Dr. Jessica Drummond** ((00:44:02)) – – So we saw everything. You know, I worked with women in labor and delivery and postpartum and outpatient and, you know, had both my daughters there and had a miscarriage there. And so I’ve experienced that among wonderful providers in the state of Texas. And I also know midwives because I used to, you know, send patients back and forth to midwives, some of which were very skilled. And so I think, as you’re saying, the gamut of professionals, there are great professionals in Texas and in all states. And when you create an environment not just in Texas, but in other states that have these issues, Tennessee is another one. You know, it becomes difficult because then what you’re saying is already the pandemic sort of drove more black women to seek care from midwifery and home birthing, which for certain people, that’s a really good option. But we are now missing some data points. We’re also potentially missing some women getting the high risk care that they might need.

Dr. Jessica Drummond** ((00:45:08)) – – And so I think as a profession, we need to be really thinking about that level of complexity because we’re talking to professionals now. We’re not just talking about, you know, the ideal situation.

Dr. Yeni Abraham** ((00:45:23)) – – Oh yeah, because there’s nothing ideal about this. Even the environment we’re practicing is not ideal. Right. I will say this is that I think that the solution to the black internal crisis in the United States is going to be multifaceted. There are going to have to be a lot of legal decisions made to even give healthcare providers the environment to practice good medicine. That’s the honest truth. We know that nurses are overworked. We know that oftentimes hospitals and providers are underpaid. So we’re aware that those systemic issues are also contributing to this as well. But what we can say is that conversations like this, at least, will start to sow better seeds of societal mindsets, right? And restrictive thinking patterns, right. Then there’s also the conversation about, even in education, educating providers early on when they’re in med school, when they’re in midwifery school to school, and, and learning about racial bias early on so that that is woven as you’re learning about physiology and anatomy that is woven into your education.

Dr. Yeni Abraham** ((00:46:26)) – – And we’re seeing things the way they’re supposed to be seen. Right? Because the honest truth is, and I can share the sentiment with a lot of providers, is that most providers of color, especially black providers, do not have the bandwidth to educate their colleagues. Right? So a lot of the educating really needs to be self started and needs to be done in forums like this, because it is so exhaustive to have to be the person receiving the insult and also, you know, being able to communicate the solution.

Dr. Jessica Drummond** ((00:46:55)) – – Right. It’s ultimately not your responsibility to create the solutions. And I think that’s where, as you said, integrating it within our initial training is so important because so much of this bias is just subconscious. It’s part. Part of the training, I mean, part of growing up in a racist society. I think many people are even unaware of their own racial bias because it’s just there. It just exists. And so we have to actively learn and, you know, be aware.

Dr. Jessica Drummond** ((00:47:29)) – – So if you are in a circumstance where you’re working with a woman of color who is pregnant, almost go the extra mile of looking for you may not be aware of your own level of racial bias. It may be very difficult to even uncover that. So try to at some level overcompensate. Be even more focused. Be just mindful. Like you said, just build it into your paperwork. Blood pressure, mental health screens, you know, empowerment of communication to maybe her partner or her doula, people who will be in the room to give them that green light. You know, sometimes if a health care provider says, like, hey, you know, if you feel something’s off, just keep bothering them until they listen to you, because she’s not going to be able to do that in a vulnerable situation.

Dr. Yeni Abraham** ((00:48:19)) – – And sometimes being that provider, that also kind of helps patients feel safe enough to make the right decision. You know, I’ll quickly share this story. I had a patient who had a cesarean delivery for her first child, and it did not.

Dr. Yeni Abraham** ((00:48:32)) – – That’s not what you wanted. She wanted a home birth. She hired a whole team midwife, had a doula and everything. And so by the time she was coming to see me, it was postpartum, her first child. So of course, after assessing the situation, you know, she said she was fine with the C-section. She was okay. That had to happen. She can labor for days. The first thing I thought to myself was like, you are not the right candidate for this. You should have probably been under the care of an ob gyn, and you need to be in a hospital just because of the way her progression was during labor. So I had a conversation with her. I said, here are some names. So look at these providers. I’m going to give you the autonomy. Of course, do whatever decision you want, but I firmly believe so. Thankfully she did. She is pregnant again. We have an awesome experience with an ob gyn. Very firm, very awesome.

Dr. Yeni Abraham** ((00:49:18)) – – She comes to me the third time with a third kiddo. We’ve been together a while and she’s like, I’m pregnant again. I’m not doing any. What do you think we should doing? So we should do exactly what we did last time. I think we did really well. This pregnancy was unfortunately a lot more challenging for her. And of course, there were, you know, some mental health disturbances. We worked through all of that. But one of the things I remember she was about maybe 37.5 weeks, she came to see me and I was like, and her blood pressure was in the one 60s to the NE or two days before it was in 180. It was all over the place. And I looked at her and I said, I think we need to have this baby. And she goes, well, my doctor is saying maybe I should wait another week and a half. And she said, I really think you should have this baby. So I get on the phone and I call the doctor’s office and I say, this is she’s in my office of taking her blood pressure.

Dr. Yeni Abraham** ((00:50:06)) – – I don’t love the way she’s feeling, and I know her, and I genuinely feel that she needs to come in and get induced. It’s the nurse practitioner. So she’s like, hold on one minute and she comes back and she’s like, okay. The doctor says she should come in. And I looked at my patient. She was crying. She was very emotional. I said, you got this. I said, I have a strong feeling you’re gonna have this baby tomorrow. So it’s gonna be a long night. So go stop by and get you some French fries or something.

Dr. Jessica Drummond** ((00:50:31)) – – Right?

Dr. Yeni Abraham** ((00:50:34)) – – We live in Texas, so get you some Whataburger, right?

Dr. Jessica Drummond** ((00:50:36)) – – Right.

Dr. Yeni Abraham** ((00:50:37)) – – You know you love because you’re going to have a long night ahead of you. Because I have a strong feeling you’re gonna have this baby tomorrow. And sure enough, she texted me, I did it. I can’t believe I got my second V back. It went well again. All you had to do was lean in and trust that in seeing a lot of us are, you know, even if we’re not moms, you know, we have that feminine energy, that feminine grace in us, that instinct where we know, like when something’s off, that intuition that tells us a little bit inside of us that, something about this isn’t right.

Dr. Jessica Drummond** ((00:51:07)) – – Yeah. I love that story, you know, and the one other thing I’d like to emphasize from that is you have done the work of building these relationships with your clients, but also with the local physicians, nurse practitioners, midwives. You know, people used to ask me all the time when I was at Women’s Hospital, I used to call the doctors all the time because, you know, we worked with them. We were very connected. You know, one of them delivered a couple of my own babies. I fixed her shoulder like there was a whole thing.

Dr. Jessica Drummond** ((00:51:37)) – – Yeah.

Dr. Jessica Drummond** ((00:51:38)) – – And I do think that relationship building takes away some of, you know, the other structural problem that we have in hospitals, which is that kind of structural hierarchy where people feel, you know, intimidated to call a doctor, to call an OB nurse, to call a midwife. And I think having that confidence to develop the relationships is a part of your advocacy for your most vulnerable clients and patients. So as soon as you can start developing those relationships, just meet these doctors, you know.

Dr. Jessica Drummond** ((00:52:11)) – – Just meet them. They’re all normal humans.

Dr. Jessica Drummond** ((00:52:14)) – – And we are. They have the same.

Dr. Yeni Abraham** ((00:52:16)) – – They probably are fighting with your toddlers the same way you are. They’re sleep deprived the way you are. I mean, it’s just like we’re all human. I love that you said that. It does take time to build a relationships. It does take time to build that reputation of integrity in your community. But it’s so worth it. It makes your job so much easier when you can be direct and you can advocate for your patients because the provider actually knows you, or at least have heard of you and can feel like, okay, I think this person knows what she’s talking about.

Dr. Jessica Drummond** ((00:52:43)) – – Yeah. And I think when you build your practice, you know, we kind of just circle back to end this at the beginning where we started. If this is a professional passion for you, a calling, just something you’re super interested in and curious about and you want to create that space in your community. If you think of this as a long term commitment to your community, to the perinatal and women struggling with fertility in your community and building those relationships, meeting the people you need to meet in your community, you’ll ultimately, you know, have the opportunity to create the kind of practice that you’ve created.

Dr. Jessica Drummond** ((00:53:21)) – – And I would imagine it’s very rewarding.

Dr. Yeni Abraham** ((00:53:25)) – – Oh yeah, absolutely. It is very rewarding. And it definitely keeps you going, especially on the days when being a business owner gets hard. And of course, there’s all that stuff to it. But I definitely think even conversations like this just makes you really reflect on how much of just a privilege it is for us to be in this space and get to walk with people in the most vulnerable times of their lives. So yeah.

Dr. Jessica Drummond** ((00:53:46)) – – Absolutely. Well, thank you so, so much for spending so much time with us today and share with us how our professionals can find you if they’re interested in doing more of your training.

Dr. Yeni Abraham** ((00:53:59)) – – Yeah. So for all professionals, I recommend that you check out Turgut Academy. Com we’re also on social media, but the real people know that all the love goes into the newsletters and the mailing list, so feel free to just contact us at Triggered academy.com and got a great team that helps me out over there to communicate. So if you ever have questions about the courses, we’ve got master classes, we’ve got a certification we’re running right now.

Dr. Yeni Abraham** ((00:54:22)) – – I’d love to pour into you and help build that side of your practice up. And fertility and gynecological care sounds interesting to you.

Dr. Jessica Drummond** ((00:54:28)) – – Yes. Excellent. Well, thank you so, so much. I’m so glad to just hang out with you a little bit more today.

Dr. Jessica Drummond** ((00:54:34)) – – And so good to see you again. See you soon in Atlanta. Yeah. We’ll do it again. Perfect. All right. Thank you.

Dr. Jessica Drummond** ((00:54:47)) – – Wow, that was an inspiring conversation with Doctor Yeni. I’m really blown away by the state of black maternal health care in this country, and maternal health care in general in this country, and I’m really saddened by the fact that in these places and spaces which, you know, are accelerating throughout the United States, where reproductive medicine is, the complexity of it is no longer in the hands of the providers. It’s more in the hands of the lawmakers. And as you’re seeing, this is having disastrous consequences in especially vulnerable regions such as where Doctor Yeni is living. And I really think my key takeaways here is in the situation that we’re currently in.

Dr. Jessica Drummond** ((00:55:36)) – – Hopefully it will continue to improve, but if it stays the same or gets worse or even as it’s improving as women’s and pelvic health providers, we have a really important role to use our skillful, mindful listening to use our intuition to use our nervous system code regulation. And we could literally be life saving by building relationships within our community and building deep, longer term relationships with our clients. So if you’re working in the sacred space of fertility and perinatal and postpartum medicine, I really want to emphasize that you working on your skill set of health coaching and manual medicine through our training, through Doctor Yeni’s training or anything else, just the practice of it. It could be life saving in the relatively dangerous environment that we’re currently in. So keep developing those skills, keep deepening your relationships in your community, and keep trusting your instincts because your patients need you to be their advocates. All right. I’ll see you next time. Thanks for joining me today. Thank you so much for joining me today for this episode of the Integrative Women’s Health Podcast.

Dr. Jessica Drummond** ((00:56:56)) – – Please share this episode with a colleague and if you loved it, hit that subscribe or follow button on your favorite podcast streaming service so that we can do even more to make this podcast better for you and your clients. Let’s innovate and integrate in the world of women’s health.