The Whole Pineapple

Among the "industrialized" nations, the United States fares worst in terms of maternal mortality. That means more birthing people die in childbirth in the US than in any other industrialized nation.

In fact, in 2017, US rates of death from childbirth actually went UP. And for Black people giving birth, the risk of death is even higher.

Why are pregnancy and childbirth so much more dangerous in the US than in so much of the world, and why is it even more dangerous for people of color?

Dr. Jasmine Johnson is a physician and assistant professor of Obstetrics and Gynecology in the Division of Maternal-Fetal Medicine at Indian University School of Medicine. She is a fierce advocate for improving equity in obstetrics and gynecology and health care as a whole.

In this episode, Ruby and Anne talk with Dr. Johnson about the historical and continuing disparities in health care and how we might understand and solve them.

Have a listen, then find Dr. Johnson on her blog, The Mrs. The Mommy. The MD: http://www.mrsmommymd.com/. You can find out more about Ruby and Anne at The Whole Pineapple Podcast: https://thewholepineapple.com/.

For a very long time, scientists and fertility experts believed overweight or obese bodies had a harder time getting or staying pregnant.

Lots of would-be parents went on strict diets or adopted difficult life-style changes in the hopes of achieving and maintaining a healthy pregnancy. And many fertility clinics wouldn't perform IVF until the potential parent's BMI dropped below a specific threshold.

Was it worth it?

Maybe not, say Ruby and Anne. Large-scale, randomized studies seem to show no particular benefit in dropping X% of your body weight.

In this short snack, our experts take a look at some new studies and sum up for us what this new information appears to indicate.

You're going to want to hear this. And if you know someone else who could benefit, we ask that you please share.

References:

https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/practice-guidelines/for-non-members/obesity_and_reproduction.pdf

https://www.fertstert.org/article/S0015-0282(22)00271-0/pdf

https://www.fertstert.org/article/S0015-0282(22)00379-X/pdf

You thought you were done talking with your teen or pre-teen about reproduction. You had the birds/bees talk — or some version thereof — but now your kid is experiencing pelvic pain, and it's time for Awkward Conversation Two-Point-Oh.

But it doesn't have to be. Fortunately there are experts like Dr. Angela Hernandez, Pediatric and Adolescent Gynecologist at Seattle Children's Hospital.

For past generations, getting a proper diagnosis for pelvic pain could take half a dozen doctors and a decade OR MORE, if the diagnosis came at all. Getting a diagnosis — and management plan — ASAP is definitely worth a potentially uncomfortable talk!

This episode could be a great place to start. Ruby, Anne, and Dr. Angela tackle the tough topic head on. If you or your child are having pelvic pain issues, be sure to listen to this snack and the full episode and check out these resources:

The Center for Young Women's Health: https://youngwomenshealth.org/gynecology-index/#a-gyn-guides-E

The Journal of Pediatric and Adolescent Gynecology: https://www.jpagonline.org/article/S1083-3188(19)30365-1/fulltext

Or check out the Adolescent Medicine department at Seattle Children's at 206-987-2028.

Periods can be a pain, disrupting your plans, pimpling your face, and REALLY messing with your moods.

But if they're causing a lot of actual pelvic pain, or if the pain is persistent and not only cyclical, that may indicate a problem that's more than "normal" cramps.

Müllerian anomalies and endometriosis are common causes for pelvic pain, but because people with uteruses are told that pain is "normal," it can take years to get a proper diagnosis and treatment. Yeah.... no.

Fortunately, getting the right diagnosis for pelvic pain can mean finding solutions to help with the pain and heavy bleeding. Solutions now may also help preserve fertility in the future.

In this episode Ruby and Anne are talking with Dr. Angela Hernandez, Pediatric and Adolescent Gynecologist at Seattle Children's Hospital, about pelvic pain, why it happens, what we can do about it, and how far someone who says "suck it up, it's normal," can shove it.

Are you or someone you know concerned about pelvic pain? Learn more from the resources below:

The Center for Young Women's Health: https://youngwomenshealth.org/gynecology-index/#a-gyn-guides-E

The Journal of Pediatric and Adolescent Gynecology: https://www.jpagonline.org/article/S1083-3188(19)30365-1/fulltext

Or check out the Adolescent Medicine department at Seattle Children's at 206-987-2028.

More about Dr. Angela Hernandez: Dr. Angela Hernandez is a Pediatric and Adolescent Gynecologist at Seattle Children's Hospital. She completed OB/GYN residency at Baylor College of Medicine and PAG fellowship at Texas Children's Hospital in Houston, Texas. Her clinical interests include Mullerian anomalies, multi-disciplinary care, complex contraception and chronic pelvic pain in adolescents. When she is not at work, she enjoys going to Orange Theory fitness classes and exploring the PNW with her partner, James, their two dogs, and their foster child.

We've talked a lot of the science of sex recently, so on today's snack, we welcome back friend of the pod, Jamie Mammenga, to bring some awareness around the emotional and pyschological side of sex.

Jamie and Anne sit down to talk about distinguishing love making from baby making, how to maintain a strong relationship when sex becomes stressful, and how to communicate your needs with yourself and your partner. And then, Jamie leads us on a meditation that will leave you relaxed, refreshed, and ready for the day.

Family building is complicated no matter who you are. But for queer and trans families, there are some unique hurdles. So what can you do to make sure your family feels protected?

On today's short snack, we welcome back Lara Hayden (she/they), MSW LICSW, to talk about some of the legal specifics of LGBTQIA+ family building. What legal issues should LGBTQIA+ folks think about when beginning a family building journey? What resources are out there? What are the options and protections around sperm donations? Even though legal issues often make us think about worst case scenarios, for Lara, the goal is to be prepared, not scared!

Mentioned in this episode:

National Center for Lesbian Rights

More about Lara:

Lara Hayden (she/they) is a long time Puget Sound resident and a licensed independent clinical social worker. Lara works with LGBTQIA+ folks looking to grow their families, providing 1:1 education and care coordination, support groups, and second parent adoption home study reports. In addition to work with queer and trans families, Lara has worked for over a decade providing clinical care and program management in community health, including pediatric gender-affirming care, adolescent medicine, chronic illness case management, HIV case management, and student health programs. Lara also offers clinical supervision, consultation, and training to other professionals looking to learn to better support LGBTQIA+ families.

Find Lara at Courageous Constellations.

According to a recent Gallup poll, over 20% of Gen Z identifies as LGBTQIA+, so there are millions of reasons why Lara Hayden (she/they), MSW LICSW is working to raise the bar for LGBTQIA+ medical and fertility care.

Lara is a licensed independent clinical social worker who's passionate about working with LGBTQIA+ folks looking to grow their families. In their conversation, Lara, Ruby, and Anne discuss the importance of harm reduction and investing in health equity work, knowing that it benefits all patients. They talk about the range of experiences people have surrounding gender affirming hormones and fertility, and how we can preserve queer and trans joy in the family building process. And they have notes for navigating sperm banks, good questions for LGBTQIA+ folks to ask a potential fertility clinic, how fertility clinics can be safer and more inclusive, how fertility journeys can be more comfortable, and how to see through the rainbow washing. Don't miss these critical insights!

More about Lara:

Lara Hayden (she/they) is a long time Puget Sound resident and a licensed independent clinical social worker. Lara works with LGBTQIA+ folks looking to grow their families, providing 1:1 education and care coordination, support groups, and second parent adoption home study reports. In addition to work with queer and trans families, Lara has worked for over a decade providing clinical care and program management in community health, including pediatric gender-affirming care, adolescent medicine, chronic illness case management, HIV case management, and student health programs. Lara also offers clinical supervision, consultation, and training to other professionals looking to learn to better support LGBTQIA+ families.

Find Lara at Courageous Constellations.

Mentioned in this episode:

Maia Midwifery and Fertility

Queer Conception: The Complete Fertility Guide for Queer and Trans Parents-to-be

Cue the candles and oysters. Let's talk about sex… Part 2!

You had questions, we have answers. On today's short snack, we're responding to your queries about sex. Like, are aphrodisiacs real? Is there such thing as a sexual "peak"? And can you control the sex of your baby at conception? Tune in for all that and more.

And to continue down the nutrition rabbit hole, check out Ruby's favorite website, nutritionfacts.org

Jaimie Kelton, co-host of the queer families podcast, If These Ovaries Could Talk, is back! On this short snack episode, Jaimie, Ruby, and Anne are talking about what it's like to be out as an LGBTQIA+ family.

Jaimie has some great anecdotes and a lot of insight about undoing internalized homophobia, modeling pride for your kids, and grappling with being a non-biological parent. How to be a queer family out in the world? It boils down to love, of course.

Happy Pride!

Mentions:

Jeffrey Marsh

Auntie Uncle Drag Queen Hero

Oh-varies, do we have a special treat for you! On this episode, Ruby and Anne talk with Jaimie Kelton, who is the co-host of the famed show, If These Ovaries Could Talk, the queer families podcast. The podcast has been written up in Forbes Magazine, was a Webby Award honoree, and has a celebrity-studded following (like Amy Schumer…no big deal).

When she went through her own fertility journey, Jaimie looked around and couldn't find stories like hers – of queer people building families, facing roadblocks, and experiencing the joys of parenthood. So she started If These Ovaries Could Talk to fill the gap.

In today's conversation, Ruby, Anne, and Jaimie dig into the nuances of queer parenting and fertility journeys – from trips to the clinic, to donor siblings, to decisions about where to get sperm, to insurance coverage biases. It's informative, honest, and funny, all rolled together.

In addition to podcasting, Jaimie is an actor, singer, dancer, wife, and lesbian mom to two kids.

Happy Pride, all!!