Healthcare Rooted in Community with Guest Dr. Michelle Stephens

Tina: Hey everyone, I'm Tina

Serena: And I'm Serena, and we are the Mental Health Mamas.

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Tina: Welcome to No Need to Explain. We are so glad you're here.

Serena: First, as always, a quick disclaimer.

Tina: We come to not as mental health professionals or experts in the field, but rather as parents with lived experience who are on a mission to normalize the conversation around mental health.

Serena: If you or someone you love is experiencing a mental health crisis, please seek professional support. You'll find a variety of resources in our show notes and on our website, noneedtoexplainpodcast.com.

Tina: Serena and I are huge fans of integrated comprehensive healthcare. We love it, but, and this is a really big but, it can be really hard to find, especially when it comes to care, as it relates to mothers and children, right?

Serena: Right. Yes, as we've found with mental health, connective with a supportive community can be an extra challenge. I guess thinking about the, you know, the family as a whole or even the individual as a whole.

Tina: Exactly. Yeah, that whole whole body health thing. So today we have a guest who has helped to create just this kind of community. We love this. Dr. Michelle Stephens is a co-founder and chief nursing officer of Oath Care. Oath Care is a new model for healthcare rooted in community to improve the health of all families. She is helping to bring supportive, connective healthcare to, you know, into this new era that we hope is more common. Michelle, welcome to the podcast.

Michelle: Thank you. Great to be with you two today.

Serena: So before we launch too far into Oath and the Oath app, let's start by having you tell a little bit of your story and how you came to do what you do.

Michelle: Sure. I've been a pediatric clinician my entire career. And I was inspired to go into pediatrics when I was seven because my brother was diagnosed with a congenital heart defect and passed away. So I got to work at the same hospital where the surgeon that developed the repair for my brother's defect was in residence. And this was my first job as a nurse. I worked on a pediatric ICU and I got to take care of a lot of patients like my brother. And while having this full circle experience, I also witnessed the tremendous amount of stress that parents and children undergo while in the ICU. And this actually made me reflect on my own experience as a child around my brother's death and how that created a whole host of stressful experiences growing up, but then also just realizing how ill-equipped I was as a medical professional and as a culture and society to really not only help parents and children survive the ICU, but thrive after the ICU. And so I took a deep dive in this phenomenon and understood that there's this concept of adverse childhood experiences or ACEs. And I think that this is a concept that you all are very familiar with and address regularly.

Serena: Yes.

Michelle: But it is, thank goodness.

Tina: Well, so I'll just shout out. We do have a few podcasts on it, so look it up. We do, yeah, we've had some great guests, so.

Michelle: Yeah, yes, so good. Because this is such an under, I would say, broadcasted thing and it's so important. I mean, seven out of the top 10 chronic illnesses we face today in the United States, all have at least correlations and roots to the early childhood experience we experience. And so I really am on a mission to understand this and try to prevent these Adverse Childhood Experiences and thought best to do so in primary care. So became a pediatric nurse practitioner and really wanted to implement ways of reducing adverse childhood experiences and stress. But kept coming up against care recommendations and protocols that weren?t rooted in maternal and child research, really finding limited ways within the healthcare system that I was working with in to actually deploy these strategies and protocols. And honestly, just found myself not really being able to understand child's health as it's happening. I mean, like everything is so retrospective, it's generic, it's one to one, it's transactional. I have very limited time, seven minutes with each family. And so, oh gosh, and all that I'm really measuring and tracking in a kid is their height and head circumference.

And so all of these barriers really had me think about the impact that I wanted to make and how I could make it more broadly. And so around this time, I was actually experiencing and embarking on my own motherhood journey, which was not, I would say, typical, although some of my experiences are very typical. So I did end up having two spontaneous abortions, otherwise known as miscarriages, which I think is an important statement to make this day and age. I only had six weeks total between my two kids, leave from FMLA, family medical leave act, not paid maternity leave, which thankfully I live in a dual-income household, but this experience really messed with my thoughts of value and identity, worth, and severely rushed my transition into motherhood. And I suffered undiagnosed postpartum depression with my second child and survived a suicide attempt, which is something that I never thought would have happened or even dreamed of doing otherwise, but knowing what I know now, it's a physical, chemical, biological change that my body goes through. When pregnant and postpartum. And to have this, I think, medical, clinical scientific experience, I really was unable to take the hat off from motherhood and really look at myself objectively and say, no, this is this is postpartum depression.

And so from that personal experience and professional experiences that I've had, I really became on fire for combining maternal and child research into the clinical setting and pursued a PhD in early childhood stress physiology and got connected with the foremost researchers in early childhood stress at UCSF. I left that PhD program really understanding one foundational thing. And that's the single most well understood antidote to early childhood stress is for adults to form intimate relationships with children. And children need positive, consistent caregivers in their life to help buffer the experiences of stress. And that can be done best when parents show up to these children really working through acknowledging their responses to stress and having managed them be able to then show up fully for the child to help buffer them. And so in that, I have created both In Oath Care to be able to really be able to empower parents give them the tools, supportive care and resources to be able to understand their own reactivity and buffer their own stress in a communal environment so that they can show up to their children and help buffer their experiences of stress all to really improve health outcomes for themselves and the future generation.

Tina: Yeah, so we'll get into that a little bit more. I wanna circle back and say we're so sorry about your brother and it does seem as though many of us have journeys that are pain to purpose, right? So I also want, you mentioned that when you miscarried, and maybe you weren't referring to this, but not all too common. And I think it is very common, right? I think we don't talk about it enough. Serena, did we not have an episode about that back.

Serena: We did, yes.

Tina: Yeah, it's an October last year, I think. Yes, yeah. How common it really is and how many people feel very alone, like it's just happened to them. And then you talked about the seven minutes of visits, which is we won't go on about that, but I can't even imagine the pressure of doing that. You know, I've only clearly experienced that through one lens. But I'm grateful that you have created this thing that really does think about the whole person. I think it was Bruce Perry and Oprah's book, What Happened to You? That book, Bruce Perry says essentially that what's changed in the world is, that families do not have?our world is so different now that we don't have the support that we used to have. So yes, perhaps the world is getting more traumatic and we are asking parents to do so much more with so little support, right?

Michelle: That's right.

Tina: Yeah, so let's dive in and talk more about oath and this integrated supported supportive healthcare model. So it's digital and you go from there.

Michelle: Yes, so oath is a digital high touch community of fellow parents embedded with an extensive panel of trusted experts and facilitators to deeply support the experience of pregnancy, postpartum, and beyond. And what we're really up to here is addressing the fact that to Bruce Perry's point who is actually my mentor's mentor. So that we literally don't have that village, that the rich that is so foundational to humanity and that as we have evolved, the village has not. And it has quite literally dissipated. And parental mental burden is at an all time high. And disproportionately so we definitely see maternal mental health at its all time highest in terms of postpartum, depression, anxiety, even peripartum, anxiety, psychosis. These are all things and we don't even know the numbers on fathers and partners experiencing mental health issues as well. It's just because it's so overlooked. But to the point of the village, we are wanting to create an experience of healthcare and support that is continuous. That starts when you are even trying to conceive and follows you throughout the experience that you don't have these silos in care where you're seeing your OB and then your OB doesn't really talk to your pediatrician. And then none of what is happening during your pregnancy is informing your child and their life.

And so we know from a scientific perspective that is so heavily informed and involved. But we quite literally do not connect those experiences. And so Oath is the place where that can be a continuous experience that your care is personalized. It's not generic that you're not receiving so much generic content out there. There's so much information overload. We are able to distill that and be able to present it in a way that is relational. That even our experts first meet with vulnerability around their own personal experience. And then hopefully allowing you to be able to be more vulnerable and honest about what's happening with you and be able to distill the content that you're reading and understanding in a way that feels very friendly to you and personal. And that yeah, the care is not transactional that it's not just the provider speaking down and to the individual, but that it's relational and that it's centered around the parent and that you can imagine the experts and the facilitators are coming alongside the parent and walking with them in the experience. And that we're technological that we're not antiquated care that you're not on the phone waiting for hours or in a waiting room waiting for hours or getting your results faxed to you or needing them to come through mail or on paper, but we are quite literally at your fingertips and a beautiful seamless experience that is through an app that feels connective and warm and inviting and not sterile and cold and with bright lights and you're quite literally naked.

And so these are the things that we're wanting to build when we say village. And then the other thing that we address is on the other side, which is that the care that we receive is not from providers who are burned out or facilitators that are emotionally not able to really be present. And so our experts and facilitators are really able to give the care that they so have wanted to give and would have led them into this profession and to begin with, but the unfortunate system has just tied their hands in ways that they are just not satisfied with. And so we give them a way to really provide the care that they've always wanted to provide and get support from a multidisciplinary care team that informs their care in a much more broad wide way, opens up their lens and gives them this refreshing and newness to their care that is so welcomed for them and is so energizing.

Serena: So I love all of this.

Tina: We're speechless. This is amazing.

Serena: Yeah. Well, one of the things I wanted to say is this idea that, so Tina and I talk about the idea that when our kids struggle or maybe we could even take it to, you know, when they're when they're sick or, you know, or we're seeing maybe developmental delays, things like that, you know, children are treated and there are resources for the children, but the parents are often left feeling like, yeah, what about me? Right? So I love that your approach is, again, that whole, you know, family that you're supporting the caregivers as well. That's huge.

Michelle: Yes, parent health is child health.

Serena: Right. Yes. Thank you for that. Yes. Yeah. So as we said, this is an app. So no matter where you live, you can connect with others from various ages and stages of development, from pregnancy, postpartum, toddlerhood, and early childhood. So tell us what this kind of looks like. How does it work? And maybe, you know, you can share some of the power of these connective communities.

Michelle: Yes. So when you enter the Oath app, there are a few onboarding questions to really understand your stage of parenthood and even be able to give you the choice of topics and clinicians and services that you really need at this time. And then you are a part of as many communities, actually, as you'd like, not just the one that you are currently in. Because we understand the experience of parenthood is something that can also be beneficial to give back to and serve. So you might want to be in a community that you have already been through so that you can lend advice and knowledge to folks that are kind of coming up the ranks to share your experience with what has worked for you and, you know, what even hasn't worked for you. And then maybe you want to be a part of the community that you're in now so that you can really glean all of those learnings and information. And then maybe even want to be a part of the community that's a little bit farther ahead so you kind of can see what is coming through and be prepared and be able to predict what you'll need and prepare for that. So we are not prescriptive with communities. They are very fluid and able to be interacted with, however you like. But what you are going to experience is what we call the magic moment. And the magic moment is when you are met with a high touch care that allows you to feel seen and heard. And that is met with empathetic responses from whether it be other members, facilitators or experts that even share their own experience around the issue or topic that's being discussed. And they meet you with data. And data can come not just through the evidence, the guidelines from the American Academy of Pediatrics or the American College of Obstetrics, but really the tried and true anecdotal wisdom that been there done that. I can tell you what can work for you now to even carry you through until you see a clinician or go to that office visit. But really, when we mean data, we really mean things that you can do that feel really supportive and aligned with your values and your resources.

Tina: That's awesome. And I've been on your website. And it's amazing. So yes, I would invite people to go there. So let's shift a little bit from Oath to your Mamahood. And I'm curious, like many of us, you have a complicated life, talk a little bit about the complication of being a healthcare provider and a human at the same time. And I can imagine it is not easy for you, right?

Michelle: Yes, Tina. I often talk about this as like really like maybe a multiple personality. Like I wear a mom hat. And then I literally take that mom hat off and I wear my clinician or scientist hat. I can pretend that one doesn't inform the other, but it's almost like an intentional act on my part to be present to what is most of service in that moment. And so I think I alluded to this, but I can most profoundly say that these hats have been not of service when I was in the early postpartum period where I just needed support in both buckets and didn't want to really admit that. I didn't want to say that like, I guess being postpartum I was fully in Mom mode and not really wanting to say that I was depressed that as a clinician. I called it, I didn't want to say that I needed help that I clearly had the signs of postpartum depression, but I called my anger, marital problems that have existed since the beginning of time and I called my sadness just mourning not being able to work as I usually work and think as I usually think and have my own time as I usually do. And my fear around just the future and being able to really show up as my full authentic self. And so I really got them convoluted and I think it's important to understand that this is my in-process struggle that even though I intentionally wear a hat that I have to understand and know that my whole self informs the moment and yeah, that's something that I'm still realizing and understanding to this day. And I have people in my life and have learned to be more vulnerable with my communities so that I realize that it's just not all up to me and it doesn't have to just come from me and myself but I get to know myself through others and through the community that I have created.

Serena: So how do you support your own well-being in the midst of all of this switching hats and being a mom and a healthcare provider?

Michelle: Yes, so important to take care of self and I have realized that over time. One of the most transformative things that I have pursued is being a part of a leadership forum and mind you, we are all called to be leaders and so this isn?t for a select few or this is an inclusive for everyone environment. And this forum is called the Conscious Leadership Group. It's quite literally a practice, a place where I can learn and live life more authentically and I can't emphasize enough how life changing this has been to quite literally understand my ego and what unconsciously drives me. And so if I can see those patterns and those scripts that are my default, I then have a choice, a choice then to how to respond to those defaults and that feels so much more empowering and energizing to be able to live life at choice rather than at the effect of. And then I get to feel that life is happening through me, not to me and really has helped me overcome a lot of my victim mentality scripts that have just been so much a part of my life. And so that's something that I get to do daily.

So I am in a Slack group, a Slack channel that I communicate with my forum mates. I meditate daily to be able to get more in touch with what is here now. And we meet up in person, which is also part of the importance of community and building relationship. And so that forum is something I do for myself and it is transformational. The other thing I do is that I choose to wake up at 5am every morning and I start my morning with prayer and meditation and then I work out. Movement is so important to my life. It has been a part of my life since I can remember. Specifically playing sports. But I get to work out. I have been an avid cross-fitter for most of my adult life, recently transitioned more into bodybuilding. But with that, I get to do my work out and I'm back by 7.15am in time for my kids to wake up and to really start the rhythm of my day. I think the last thing that I do to take care of myself is to keep myself in rhythms with the things that mean the most to me, which means that I have date nights weekly with my husband. I go away at a cadence with my husband with my family and friends and with myself. And going away with myself is actually something that I just started doing within the last few years. But oh my goodness has it been so good. So so good. I get to eat alone by myself. I'm completely by myself or just sleep and do all of these things that I just haven't realized haven't been done alone. And what power and learning comes from that experience?

Tina: Yeah, and you know, I'm hearing you say that and I'm thinking of many times in my life when there was a lot of guilt for me surrounding. I mean, even taking a business trip with my husband, there was guilt around that and I love the freedom. I love your words. You get to, you choose to. And I love that you say that life is happening through you. Not to you. I really love that. I will be adopting that language. So so people can get more of your vibe and know more about you. Tell our listeners how they might connect with you and learn more about the Oath app.

Michelle: Yes. I'm so glad you asked. My whole life's mission is to really have folks know me deeply and in that deep knowing that there is appreciation and love there. So please connect with me. Reach out to me by email. You can email me at michelle@oathcare.com. You can check out more about oath at oathcare.com. And you can download the oath app and use us completely free at this time on the Apple App Store or Google Play.

Serena: Love it. So is there before we bring the episode to a close? I'm wondering if there's anything we haven't asked you that you want to make sure you put out there to the world.

Michelle: Yes. I want to make sure I emphasize that we are not meant to live this life alone. Yet our country continually pushes us to live highly individualistic lives. And this is a lie that we've bought. The truth is humans are hard-wired for connection. And Oath is not just building care and supportive experience for parenthood, but we are building a new model of health care that is rooted in community because we believe that you can actually improve health outcomes more radically than we are doing now because we can actually move the needle on the most serious of chronic illnesses when we provide care and support that is not just with one person at a time or one body part at a time, but literally in this many-to-many model of care.

Tina: Oh, my gosh. That is?amen sister! That's what we're talking about seriously. Oh, Michelle, you are so smart and so delightful and we are so lucky that we got connected with you. So thanks for joining us today and sharing yourself, some parts of yourself that we're glad you were vulnerable about and all the wonderful things you are doing to turn your pain into purpose and make better health care for moms and children.

Michelle: Thank you, Tina and Serena. It has been such a privilege to be with you today. I truly enjoyed my time.

Serena: Thank you, Michelle. And so podcast friends, we are as always grateful for all of you listening and supporting us. We know you have so many choices out there, trying to get your attention and we just appreciate that you've chosen to spend some time with us today. You can help us out by visiting Apple Podcast. Leave us a review while you're there. Subscribe and please share our podcast with others and you will find more content on our website, noneedtoexplainpodcast.com.

Tina: And this is your gentle reminder to take good care of yourself while you are also taking care of your people.

Serena: Thanks for listening.

Tina: Bye.

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