About a month ago, I asked you all on Instagram what you wanted to hear next on the pod and far and away the winner was: things I’d do differently in pregnancy and postpartum… and boy do I HAVE SOME THOUGHTS.
Before we get into it, a small disclaimer about the title. Things I’d do differently is a little misleading because it doesn’t account for the sheer magnitude of what becoming a mother entails. It’s so indescribable, so earth shattering, so unlike anything else I’ve ever done, that it’s almost laughable to be like… ok, here’s the list, here’s what I’d change. As the iconic midwife (and one of the wisest women I’ve met) Pam England said to me during our Birth Story Listening session: you went through a massive initiation - and the thing about an initiation is you can only get the wisdom by going through the experience.
So in the spirit of no longer being a person who regularly criticizes and beats myself up for being a human - this isn’t a regret list... or a, here’s what I did wrong. It’s more of a reflection - an honest accounting of what I’ve gleaned by the actual living through it, and a few things I’d hold lightly the next time around.
And there will be a next time…. and soon! Brian and I are planning to start trying to conceive again at the end of this summer, so that’s the lens I made this episode through. I’m in this rare window where it’s all close enough to feel and far enough to see, and I’m gathering up all of my insights and preparations before I walk through that doorway again. Some of what I share is hyper-specific and practical (the lab work, the supplements, the things I genuinely wish I had done that could have eased my experience in some way). Some is more philosophical (the illusion of control I gripped so tightly, the information traps I fell into, the surrendering I had to do). All of it is, as always, only my experience - and I can only speak for myself, duh :)
If I could wave a magic wand and give one gift to my pregnant self, or to a first-time mom, it would be grace. The most amount of grace that a heart could possibly give to another. Because we always think of the newborn as the precious, brand new being who needs all the protection - but in many ways, I believe a first-time mom is equally that, too. She is so worthy of gentleness, support, and the unjudged space to be a beginner at the most life-altering thing she will ever do.
So please, as always, take what resonates and leave the rest.
In this episode, we get into:
* Preconception: the baseline lab work I wish I’d run, the supplements I’d start months ahead, and why all of this is “do what you can and hold it lightly”
* The miscarriage that humbled me, and the hypervigilance that came after
* The information addiction of our modern times- falling down the algorithmic rabbit hole and how it cost me my own intuition
* What I missed in pregnancy - undiagnosed gestational diabetes and severe iron deficiency (cool, fun, etc) and how I’d go about preventing that next time
* The mental health challenges I didn’t get help for, and really wish I had
* The home birth that failed and traumatized me, the C-section I never expected to have, and what I’d actually think about going into a first birth if I could do it all over
* The hospital experience - what to advocate for (and what to politely decline)
* Postpartum support, or how Brian and I tried to do way too much alone
* Why The First 40 Days template didn’t quite work for me - and what I’d eat and do instead
* The truth about exclusive breastfeeding that nobody really tells you
* The digital monitoring & surveillance trap, and what it did to my OCD
* Letting go of who I thought I was supposed to be as a mother - and meeting the actual child, the actual partner, the actual self I had become
If I haven’t said it enough times in the episode itself, I’ll say it once more here - none of this is a mistake, all of it was the path. The whole point of an initiation is that it changes you, and to say I’m changed is an understatement.
Resources are at the bottom, organized by season - preconception through postpartum. As always, I’m not your doctor, this is just what I would do (and am doing). Please work with a practitioner you trust to figure out what’s right for your body.
If it’s something you’re interested in, I’m thinking maybe I’ll do a follow-up to this one… “Things I’m grateful I did do…” because there were so many things I got right too, and they deserve their own episode.
As always, thank you so much for listening. Hope it helps you on your path, whatever it looks like.
xo, Kacie
RESOURCES
At the bottom of every episode I share the resources I trust most for the topic at hand. This list is by no means exhaustive - there’s a whole world of pregnancy and postpartum support out there - but these are the ones I personally use, have used, or wish I had only used. I’ll add to this over time, so save the link.
Books I’d Actually Recommend
I read way too many books in my pregnancy and ended up more anxious, not less. If I could go back, I’d just study these three.
Birthing From Within by Pam England: This book - and Pam herself - changed my life. It’s not really a birth book in the traditional sense. It’s a deeply spiritual, deeply human exploration of what it means to give birth and become a mother, drawing on rites of passage and indigenous wisdom. If you read one book during pregnancy, make it this one.
Transformed by Birth by Britta Bushnell: Britta speaks to the truth that birth is not something you can plan or control, and that the most important preparation is preparing yourself to meet whatever shows up. I would love to have her on the podcast someday. Pair this with Pam and Erica’s books and you genuinely don’t need anything else.
Nurture by Erica Chidi: My dear friend Erica’s book is a beautiful, practical guide to pregnancy, birth, and the early postpartum days. Warm, knowledgeable, accessible, and not extreme. The third book on the shelf.
Honorable Mention for Fertility - It Starts With the Egg by Rebecca Fett: If you’re in a preconception window and have the luxury of time, this is the book on improving egg (and sperm!) quality. Especially helpful if you’re trying after 35, working through unexplained infertility, or recovering from a miscarriage.
Preconception Lab Work & Testing
Function Health: My number one recommendation for any woman thinking about getting pregnant. Function tests over 160 biomarkers - vitamin D, full thyroid panel including antibodies, iron and ferritin, ANA for autoimmunity, the works. Way more comprehensive than what most doctors will run at your annual physical, and the dashboard makes it actually useful. Use code KACIE when you sign up and you’ll get $25 off— it’s $365 for the year, which is nothing compared to running this kind of work with a functional medicine doctor. I’ll be a member for life.
Whether you spring for a Function membership or not, I recommend asking your doctor for baseline testing for the following:
* HbA1C (3 month average of your blood sugar, ideally your number is under 5.3)
* Fasting insulin (ideally between 2-5)
* Fasting glucose (ideally below 90, 80-85 optimal)
* Vitamin D (between 60-90)
* Full Iron Panel including Ferritin (Ferritin are your iron stores, and you want them above 70!)
* Full Thyroid Panel including Antibodies (you’ll want to get medicated if you have hashimotos)
Hormone Panel (FSH, AMH, Estrogen, Progesterone): Worth getting hormone work done with a doctor who knows how to interpret it, especially if you’re over 35, have a history of irregular cycles, or have miscarried. Progesterone is particularly important - we need a big surge of it to establish and maintain implantation in the first trimester. A lot of women with recurrent miscarriages benefit from progesterone supplementation in the first trimester/during implantation. This is best tracked by the Inito (below) or a DUTCH test.
Inito Monitor: An at-home urine based fertility monitor that tracks your hormones across your cycle, gives you an accurate conception window, confirms ovulation, and shows whether your progesterone is climbing high enough in your luteal phase. Way more accurate for hormone trends than a one-time blood draw, since hormone levels shift dramatically depending on where you are in your cycle.
DUTCH Plus Test: The gold standard urine and saliva hormone test in functional medicine. If you want the deepest possible look at your sex hormones, cortisol patterns, and how you’re metabolizing estrogen, this is it. Order through a functional medicine practitioner.
Preconception & Pregnancy Supplements
A note before this list: please do not freak out and feel you need to take all of these. People conceive children all over the world in all kinds of circumstances and you do not need to be a perfect specimen to grow a baby. These are the levers you can pull if you have the time, resources, and inclination. Hold it all lightly.
High-Quality Prenatal: My favorites are Needed, Seeking Health and Fullwell. Most prenatals are missing or underdosed on key nutrients. Ideally start three months before you start trying - it takes about 90 days for an egg to fully mature, and during that window you can meaningfully impact egg quality. I personally am using Seeking Health MF this time around.
Fish Oil / Omegas: DHA in particular is critical for fetal brain development. I love Rosita Real Foods Cod Liver Oil, Fullwell Omega. Most prenatals don’t include enough, so you’ll want to take this separately.
CoQ10 : One of the most well-studied supplements for improving both egg and sperm quality. Therapeutic dose for fertility is 400mg daily. Talk to your doctor, but if you have a partner trying with you, get him on this too, great for sperm health.
N-Acetylcysteine (NAC): Great for supporting hormone metabolism, antioxidant capacity, egg quality, and fertility. I take it most days.
NAD Precursors: Mitochondrial health is foundational to egg quality, especially as we age. Anything that supports NAD production is going to help. TruNiagen is a great one.
Choline - Most prenatals don’t have enough choline and our needs increase significantly in pregnancy - here’s a great article by the one and only Lily Nichols RD about just how important it is to consume enough. Women should be consuming 930mg of choline DAILY in pregnancy for optimal brain and neural development. Make sure you check your prenatal - some don’t contain any at all, so you may need 2 pills instead of one (especially if you’re allergic to eggs, like me!)
Adapt Naturals Bio-Avail Organ Complex: Hands down the best way I know to build iron stores before pregnancy. I cannot stress how important it is to go into pregnancy with strong iron stores - see the postpartum section below for what happens if you don’t :/ Use code KACIE for a discount!
Iron Supplement - Important thing to note is that most of the really high quality prenatals DO NOT contain iron (Needed, Fullwell, Seeking Health ) — their iron supplements are sold separately so that you can customize, but make sure you don’t skip this. All the more reason you DO need to track your hemoglobin, iron AND ferritin levels throughout pregnancy and increase your dosage as you go — I repeat, don’t skip this. Needed has this really convenient iron dosing guide. I also love grass fed organ meat supplements, but they are high in copper, so you should test once or twice just to make sure your copper isn’t getting too high (or outweighing your zinc levels- zinc should be slightly higher). Eat lots of red meat and get that iron up!
Pregnancy: What I Wish I Had Done
Just Take the Stupid Glucose Test: Yes, it’s gross. Yes, it’s full of unnatural stuff and an amount of sugar no human would consume in one sitting. I refused it. I thought I was too good at balancing my blood sugar to ever get gestational diabetes and I got caught up in all the politics of it. I was wrong. If I could go back, I would take the standard glucose tolerance test (or the FRESH test, a more “natural” version) AND wear a continuous glucose monitor (the Stelo paired with the Nutrisense app) for my second and third trimester. Gestational diabetes can be silent and the consequences for both you and the baby are real (Khalil was 8.5 lbs and I am 5’2... not cool). Trust me, if even this nutritionist can get it…. it happens to the best of us!
Track Your Iron Throughout Pregnancy: My ferritin started borderline high (over 100) and tanked to 13 by my third trimester. Nobody caught it until my energy totally cratered, and I think it had something to do with my mysterious gestational diabetes appearance. I had to get multiple iron infusions in my third trimester and I instantly felt better. Going into postpartum anemic is a major risk factor for postpartum depression. Get your iron and ferritin checked at least once each trimester, and supplement aggressively if it’s dropping, or consider getting an Iron IV (work with a doctor on this.) Look for bioavailable forms with vitamin C for absorption - and don’t consume iron rich foods with dairy, it will block the absorption.
Vet Your Birth Team Hard: Ask the specific questions. What labs do you run and when? What’s your protocol if X happens? How do you handle disagreement about my preferences? Don’t be afraid to change teams if it’s not working. This is one place I really wish I had been more discerning and listened to my intuition when I didn’t like how certain things were progressing. Listen to your red flags, they’re telling you something.
Mentally Prepare for The Possibilities: A dear therapist friend told me near the end of my pregnancy: spend a little time really sitting with the possibility you might have a C-section. I didn’t listen to her and I should have. Birth is not controllable, and a birth plan is more of a birth wish. Of course it’s important to stay positive, hope for the best and not spin out into negativity and fear. But I do recommend spending some inward, honest time with the reality that your birth might not go the way you want, that breastfeeding might have challenges, that recovery might be longer and harder than you imagined. Doing this in a sober, realistic way is not catastrophizing, it’s making peace with the uncertain nature of this process.
Move Your Body: I was so afraid of miscarrying again that I barely worked out my whole pregnancy. Looking back I can see I lost too much muscle mass and I think that was a piece of the blood sugar puzzle for me, too. Find a good prenatal trainer or program you trust and keep moving. (See the postpartum section for one I love.)
Birth & Hospital
Pam England’s Birth Story Listening: If you have a traumatic birth, or a birth that just doesn’t sit right with you, please please please book a session with Pam. Birth Story Listening is a specific therapeutic modality she developed and it is one of the most healing things I have ever done. She still does the sessions herself, if you email her. I came out of mine able to see the gifts in my birth, which felt impossible to me beforehand.
Pack a Real Hospital Bag: Again, I didn’t think I was going to have a C-Section, so my “hospital bag” was packed almost like a joke, and I found myself woefully underprepared. Bring your actual pillow and a breastfeeding pillow like the My Brest Friend. Bring food and drinks you love and want to eat. Bring electrolytes and magnesium for the postpartum constipation that is one hundred percent coming for you.
Skin to Skin, Constantly: The single best thing you can do in those first hours and days is keep the baby on you and at the breast. This stimulates milk production, prevents jaundice (the more colostrum they get, the more they poop out the meconium), regulates baby’s temperature, and starts your breastfeeding journey on the strongest possible footing. The hospital staff will want to take the baby to do measurements and tests and then wrap them up in a tight swaddle afterwards and pop them back in the bassinet. Most of those things can wait or be done in your room with the baby on you. You are allowed to advocate for that!
Postpartum: Lactation & Breastfeeding
Kimmy Mills at Milky Way Mamas: If you are in Los Angeles, RUN to book Kimmy Mills. She is hands down the best lactation consultant and I love her. I met with her once before birth, had her come to the hospital the day after I gave birth, and then she came to my house regularly for the first few months. She is a heaven-sent angel and I want her to adopt me. Even if you have hospital lactation support (and you should use it), having one consistent person who knows you and your baby through the whole journey is the difference. This was probably the single best decision I made. She also takes insurance!
Find a Local LC if You’re Outside LA: Look for someone IBCLC certified, ideally with a private practice so you get continuity rather than a different person every visit. Ask other moms in your area for referrals.
The Truth Nobody Says About Breastfeeding: Exclusive breastfeeding is essentially a full-time job. It requires constant caloric intake, frequent stimulation every couple hours, and is genuinely incompatible with a lot of things about modern adult life (going back to work, baby starting to sleep through the night, your period returning, getting sick). If you’re able to do that, amazing! But if your supply drops or you end up supplementing with formula, you didn’t fail. Khalil is a thriving, robust toddler with a great microbiome and we used formula in his second half of his first year. It’s okay. Do what’s best for you and your family, you don’t have to drive yourself insane trying to exclusively breastfeed if it’s harming your mental health.
Postpartum: Body Recovery
Labwork: Please have your OBGYN run this set of labs on you at 3 and 6 months postpartum: Vitamin D, Iron (Including ferritin), and a full thyroid panel including antibodies. This should be mandatory but sadly, it is not and I can’t tell you how many women become anemic or get an autoimmune disease and no one catches it, and it makes their postpartum and recovery so much harder. You may need to advocate for this, but please do it.
The Sculpt Society: The best online program I’ve found for safely rebuilding your core postpartum. There are specific prenatal and postpartum programs and the progressions are genuinely smart. I’ll be doing this through my next pregnancy. You can start with gentle breathing-based core work in the very early weeks and their core recovery program is designed to actually restore your deep pelvic floor function. You can’t just go back to the gym and start ripping situps and planks, that kind of pressure can actually exacerbate the dreaded diastasis recti. Instead you need a structured program that will help you rebuild your deep core.
Bodily Belly Band: A good belly band in the first weeks postpartum makes a huge difference for organ support and the yucky “everything is hanging out” feeling. Bodily makes the best ones I’ve found — other ones are too constrictive.
Walking Pad: I am 100000% buying one for next time. Sitting on the couch all night watching The Sopranos in pregnancy and postpartum was, in retrospect, not great for my blood sugar or recovery (or my mental health?). A walking pad in the TV room means I can keep moving while still resting and watching shows.
Bone Broth, Stews, Steaks, Roast Chickens, Soups, Cooked Vegetables: This is what I would actually eat next time, instead of trying to force myself through bowls of ayurvedic porridge in 105 degree LA summer. Postpartum nutrition needs to be calorie-dense, protein-rich, mineral-rich, and most importantly appealing to you. The food doesn’t work if you don’t want to eat it. A salmon and goat milk stew might be nutrient dense on paper, but if you can’t get it down without gagging, maybe reconsider the approach! It should be something other people can easily heat up for you.
Postpartum: Mental Health
CBT and ERP for Postpartum OCD/Anxiety: If you have a history of OCD or anxiety, find a therapist who does Cognitive Behavioral Therapy and Exposure & Response Prevention before you give birth, not after. Postpartum is when these things flare hardest. The intrusive thoughts about your baby dying or accidentally hurting them are extremely common and there are real evidence-based tools to manage them. You don’t have to suffer through it.
Consider Medication: If you are struggling, talk to a perinatal psychiatrist about whether a postpartum-friendly SSRI is right for you. There is no virtue in white-knuckling your way through postpartum mental illness and if my anxiety is as bad as it was last time, I’ll definitely consider it.
Get Off the Phone Monitor: Having the Nanit camera and the breathing wear data on my phone made my OCD ten times worse. The constant checking didn’t make me feel safer in the long run — instead it made me more obsessed. We switched to a regular standalone monitor. Your phone doesn’t need to be a portal to your sleeping baby at all hours. Detaching helped my mental health immensely.
Postpartum: Support & Community
Doula Support, Both Birth and Postpartum: Worth every penny. A postpartum doula doing a couple of overnights for the first six weeks was one of the best gifts we gave ourselves, and I wish I’d gotten daytime help too, since we didn’t have family in town.
Ask for More Help Than You Think You Need: I tried to do too much alone and it was too much. Even imperfect help is better than no help. Family, friends, hired help — all of it. Set boundaries about what you need (and what you don’t), but accept the freaking help!!!
Baby Sleep
Eileen Henry, Gentle Sleep Training: I swore I would never sleep train. I changed my mind around 7 months when nobody in our house was getting any rest and Brian and I were fighting like we never, ever have from sheer sleep deprivation induced rage??? Khalil didn’t wan to sleep in his crib but he hated cosleeping (and honestly, so did I!) Eileen does a beautifully gentle, attachment-based approach and our experience with her was transformative. Khalil now loves his crib and has a great relationship with sleep and while I do think it’s partly his personalty, it’s definitely also because of the sleep training we did. She also has a great book you can read. Not saying this is for everyone, only you can know that, but it was 100% the right thing for our family.
If there are specific resources you’re looking for that aren’t here, send me a note — I’ll add them as I go.
xo
Kacie
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