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In this podcast episode, we are tackling the topic of the mental health needs in motherhood. The pregnancy and postpartum periods can be filled with times of beauty, love, wonder, and awe….AND fear, anxiety, anger, loneliness, loss of identity, confusion, and many more challenging emotions and feelings.
However, the latter feelings are often discarded or ignored leaving many pregnant women and new mothers feeling more afraid and alone than ever before. Amanda Hall, MScOT and owner of Willow Family OT in Ontario, Canada works with women, families, and children to ensure they get the support they need to thrive during these transformative periods of their lives.
In this podcast interview, we cover a lot of really important topics that will improve maternal mental health for you, your patients, or loved ones.
This is a really wonderful conversation that covers a lot of topics near and dear to our hearts. We believe that if we want healthier and happier societies, we need to have happier and healthier moms. And part of that is through proper maternal mental health services and support.
If you are struggling with difficult thoughts or emotions…or are concerned about a loved one. You do not have to go through this alone.
Please reach out to us or Amanda and we will ensure you get the help and support you need.
Amanda Hall MScOT is a registered Occupational Therapist in Ontario, Canada and owner of Willow Family Wellness Occupational Therapy Services Inc. She is also certified in perinatal mental health through Postpartum Support International, a certified yoga teacher, nature based therapist and a recognized provider with the Ontario Autism Program.
Over her last 12+ years of clinical experience, she has worked in hospital, clinic and community settings. Her experiences cover both physical and mental health approaches which she gives great value to when working from a mind-body connection point-of-view.
Following the birth of her own two babies, she developed a passion for working with and helping women as they transition into their motherhood journey from a physical, mental, spiritual and social health perspective. She loves spending time in nature and find great benefit to bringing a natural element to her client interactions when possible. She holds a term adjunct teaching position in the OT program with Queen’s University where she coordinates fieldwork experiences and teaches in the mental health course.
00:00 Dr. Ginger Garner Hi everyone. I’m excited to be back with you again today with a fantastic guest who is very unique in her background and we are working to make it less unique because we want more of this in the world and that’s Amanda Hall. She is an OT working with the perinatal population.
So you might be surprised to know OTs work with perinatal health and what’s more they work in mental health. Yes, they do. I’m emphatically shaking my head yes if you’re not watching the video. Yes, they do. So I want to take just a moment to welcome Amanda, welcome to the program and also tell you guys a little bit about her.
All right, so Amanda is a registered OT. She is actually in Ontario, Canada, our friendly neighbor to the north. She owns Willow Family Wellness Occupational Therapy Services. She’s certified in mental perinatal mental health through Postpartum Support International. She’s a certified yoga teacher, nature-based therapist and a recognized provider with the Ontario Autism Program, which is close to my heart. I’m a mom, a boy mom of three and one of my kids is on the spectrum. So that’s important work right there.
She has over 12 years of experience clinically in the hospital and community settings covering both physical and mental health as OTs well do. So if you’re not familiar with how they do that, then this is definitely going to be the podcast for you to listen to because OTs I think have just a long time background and strong foundations in looking at a mind body point of view and something that physical therapy can learn from because we just weren’t taught to do that.
But OTs are the kind of original mind body therapist, I think. So speaking a little bit about Amanda’s personal experience after the birth of her two babies, that’s when the passion was born. She really birthed three things, two babies and a bunch of passion for helping women as they transition into their motherhood journey.
And I get tangled up on those words because there’s a lot like in my heart and my head when I say motherhood journey, being a mom of three, it’s just, I can’t wait to get into that discussion with you. But it’s biopsychosocial, it’s physical, mental, spiritual, it’s everything.
But speaking about you personally, about Amanda personally, she loves spending time in nature, finding great benefit from bringing that natural element to client interactions. And she also adjunct teaches, because she has spare time here, in the OT program at Queens University. And then she coordinates field work experiences and teaching in the mental health course, which is fantastic.
I am a huge advocate for anyone in this mental health space as a PT or OT, because it’s not something that we skipped, but we also didn’t have classes and courses in it either. Kind of like nutrition’s important, but nobody talked about it. And they don’t teach it in medical school either. So let’s talk about it today. Tell me how you fell into such an incredible blend of expertise and services.
03:35 Amanda Hall: Yeah. Well, first of all, thanks for such a nice opening there. It’s certainly my passion in maternal health and mental health and physical health. And so it really came about when I recognized that we really are lacking services where I am. And we really needed to bring in awareness. And it really spoke to the piece about OT that I love is the advocacy piece and bringing awareness to what women are really going through every day. And we have really poor rates, unfortunately, around our country of screening for postpartum mood disorder.
When I do some of my education that I’ve done since being a student in the program officially, I really was looking at how is pain manifested in the body. And very often we have this mental health component that comes along with that. And when we speak with a lot of women who are going through a challenging time, there is this physical pain that also is in conjunction with it. And that really spoke to me. And a lot of these experiences that I’ve had with my clients, my own experiences have really shaped where I am right now.
It’s hard breaking into the medical world with these kinds of concepts though at times, which is challenging.
05:07 Dr. Ginger Garner Yeah, it is. Can you take a moment? I know we could spend the entire time talking about the challenges, but if you could just take a snippet of that to give our listeners a feel for what are some of the pushbacks? Because really what we’re talking about is getting moms the help they need and mental health and otherwise.
But what are some of the things that you realized weren’t okay and some of the pushback that you got so that moms can be on the up and up of what are my rights? What should I expect? What do I have a right to ask for, kind of thing?
05:34 Amanda Hall Absolutely. So right back when I first started this journey in 2019, one of the moms that I worked with had just been discharged from having a cesarean birth and she had no idea how to get out of bed, how to get up off the toilet, how to use, sorry, I should back up. She had a walker that she had to use for short-term because of some other complications.
So she had no idea how she was going to use a walker, heal from this major abdominal surgery and care for her baby. And she was discharged with all of these unknowns. And so here she is now at home three weeks postpartum and has no idea who she is anymore, lost complete identity with herself, is in a really down state, not in a great state mentally. And yet her healthcare providers are telling her it’s just the baby blues, you’ll get over it. It’s okay.
06:40 Dr. Ginger Garner That’s so terrible. It’s worth a pause because I know that many of our listeners are going to say, oh, that’s me. I felt that too. And instead of actually being ushered into say, oh, this isn’t your fault, you’re actually blamed for it. Like, oh, this is your fault. You’re in this situation. So you’ll just spring out of it magically somehow.
And it’s also worth talking about that in the United States, in Canada, what is the situation of paid leave? Because we have different burdens in the US and Canada. So how does that look? Because not everyone is employed by a system that’s going to provide leave in the US. And even when they do, it’s just minimal, it’s nominal, and it’s usually without pay too. So describe to the listener a little bit about that, not to get too far off topic, but with the leave situation in Canada.
07:39 Amanda Hall So we are very fortunate in Canada. While our healthcare system is certainly not perfect by any means, but we are very fortunate to have paid leave. So right now, employers are required to hold a person’s job up to 18 months postpartum. And you can be off on leave, paid leave for 18 months. For the first 12 months, or six months, I believe it is actually you get a lot of employers will provide a top up is what we call it.
So for example, I was with a big hospital organization, and I was able to get topped up on my maternity leave to 85% of my income for the first six months off. And that makes a big difference.
08:25 Dr. Ginger Garner: Yeah. So what if someone self employed? What if they have their own business is does that still apply to them?
08:30 Amanda Hall: Yes, you just don’t get that additional top up. So you get 55% of your of your income typically for the previous year from the government. And then that does go down after the first six months. And then it will be a smaller amount that you would get because you still get the same chunk of money, whether you go 12 months or 18 months. It’s just spread out over 18 months. But the nice thing is, is that employers are required to hold your job for 18 months if you choose to be off that that length of time.
09:00 Dr. Ginger Garner: Right. And so I think that as we talk about the impact of mental health, one of the things that I want to bring up is that a lot of women will sit in shame and self blame. And what what I want them to realize, and I think that you know, this is you probably agree with me about this is that you we we want to help lift women out of that self blame and shame game, because how can you thrive in an environment, which don’t doesn’t give you the resources to actually even heal?
09:33 Amanda Hall: Right. Exactly. Yeah, that is just it. And it is really looking at society’s expectations for new moms. You know, there’s a reason why we don’t tell people or feel comfortable telling people we’re even pregnant for the first three months. Because goodness gracious, if you have a miscarriage, and then you’ve got to talk about something really uncomfortable, and nobody wants to hear about your miscarriage. Right. It’s that’s the rhetoric that we’re being told that that in itself needs to change.
And yeah, we just have a lot of work in society to do. I think whether we’re in Canada or the US, I think that there’s a lot of work around the world, especially to support women as we go through these challenges that we have no control over them. And yet we’re we’re being stigmatized and shunned for some of these experiences, which it doesn’t make sense. You know, and it’s not just around childbirth, it’s around anything that women experience. Really.
10:35 Dr. Ginger Garner: Absolutely. Whether it is going through a hysterectomy, which is a major abdominal surgery, and then getting no care. There’s no standard of care for post-op abdominal surgery, which could actually then cross, you know, it crosses genders. Men aren’t getting that care, either. No one is getting that care that they need. So I just want to really drive home the message to the listener that if you’re suffering from some of these situations, regardless of gender at this point, that the standards of care that should be nurturing you back towards thriving again, are not even really in place yet.
We just don’t have the standards of care. And so that’s really it’s why I was excited to talk to you today, because you and other people like you doing similar work are trying to create and forge standards of care where there aren’t any. And so I want to know how the, for you, how did that, the occupational therapy as your profession, and you as a mom with obvious, you have your own perinatal health concerns and mental health, how did all that kind of converge to get you where you are now and the work you’re doing?
11:55 Amanda Hall Oh, that’s a great question. I was working rehab in a rehab hospital for a number of years and recognizing that I just hadn’t found my niche as an OT at that point, I knew that I was working under certain parameters being in a publicly funded hospital. There were things that I could and could not do. And so I ended up just quitting my job with no, nothing else to go to.
I was very fortunate to be in a position where my husband was gainfully employed, and I was able to do that. And it was one of the scariest things I’ve ever done, but one of the most amazing things at the same time, looking back on it, it took a lot of courage to be able to say, you know what, this isn’t feeding my soul right now, and I need a change. That’s when I really did some soul searching. And I stayed home with my daughter at that point, and then became pregnant with my son and decided to just stay home with him and just figure out who I am as a person. If I’m not resonating with my OT identity at that point, who am I? Right.
And so going into a postpartum phase where I also was experiencing postpartum mood disorder, anxiety, intrusive thoughts, you name it, I feel as though I had the gamut full of it. And being a mental health provider as well, feeling like I should know these signs, and I should know these symptoms. And yet I was in denial. And it was probably 10 months before I got diagnosed with a postpartum mood and anxiety disorder.
And I don’t want other moms to have to wait that long. Right. And it doesn’t matter whether you are a mental health provider or whether you are an architect. We all are going to be experiencing these experiences in different ways, but very often our mood is going to be impacted whether we expect it to or not. Right. And I think my biggest point of awakening for me was I could open up my own business. I can do this.
And having the faith that I am able to provide a service through my own experience and have my own experiences as I was healing, drive my passion to help others and advocate for others and know that I could really use my OT skills to provide a service that was something very unique in our area. And so that’s really how the two collided when I realized I just needed to go out on my own and do my own thing and be responsible for my own career as opposed to working with a hospital, which is nothing wrong with that.
If it’s for that person, to each their own. But for me, it just, it wasn’t serving my needs any longer.
14:48 Dr. Ginger Garner Yeah. It wasn’t, it wasn’t, um, where, you know, it wasn’t, I always use music analogies. It wasn’t resonating.
14:56 Amanda Hall: Yes, exactly. It certainly wasn’t. And I also, uh, am certified in nature-based therapy. And so that’s, um, you know, challenging to bring into a hospital setting. And I was really feeling a calling to incorporate some of that into the work that I do as well. And so actually this morning I just had a mom who was going through a hard time. We just sat in the forest this morning and chatted through some of the things that she’s experiencing and putting a plan together for some support. And we just had a mindful moment in the forest listening to the birds and the squirrels that were running around and the wind and the leaves. And it was a very healing place to be this morning for both of us, I think.
15:38 Dr. Ginger Garner: Yeah. I think that I just want to call out, um, you know, and you sharing your story to go back to the beginning of what you’re talking about, you know, you’re sharing your story as courageous and brave and, um, kind of the, what we all hope for when we’re going through something really hard. We hope that we can take it and, um, cause it’s easy for us to do the other thing, which is to go, why me? Why is this happening to me?
16:10 Amanda Hall: And there was probably a bit of that though, too.
16:12 Dr. Ginger Garner: We all start there and it’s, and it’s okay to like, I’m just like wallow. If, you know, if you can’t see what I’m doing, cause you’re not watching the video, I’m just kind of like wallowing in the mud. And that’s part of the process too, is to kind of grieve a little bit. Like this isn’t what I thought it was going to be. But then to be able to, and hearing your story to say, and hear that shift and that evolution of, well, because there’s something better, there’s something better that I can do that for many of us, it’s not, um, it’s not going to make any more money, for example, like, so it’s not money driving us.
You end up, and I think people don’t understand this about when you say, well, I quit my job. Oh, but you have a husband that works. So that’s fine. Actually, not when you have a kid, not when you have a second kid, not when you have, you’re raising the next generation and it is expensive to raise the next generation. And, you know, in the United States, we get absolutely zero help to do that. So in choosing to start a family, you’re choosing to help fund Medicare one day with the birth of those children who will take care of other people who may or may not have children.
And so it’s a big undertaking. And I think that, um, it’s probably easy for a bitter society to say, oh, it’s, well, it’s easy for her to say that she did that because she had A, B or C. Yeah. But when you don’t have the basic support and you come home and you realize, gosh, maybe I have postpartum mood issues because of the lack of support and culture and society. And if we had that, we would have lower levels, but until we change awareness, until we reach more people, which is what I’m hoping this podcast is going to do until we reach more people to say, ‘Hey, don’t, don’t beat yourself up. Don’t blame yourself. Um, you, you didn’t choose to, you know, drop into this, this state’ of what some people call, oh, they just feel sorry for themselves.
They got themselves, they chose to have a family. So therefore they need to, they need to buck up actually not so much. Um, the system is what needs to buck up and support our people, our citizens, no matter what country they belong to. And if we had that, um, it’s kind of like what’s good for mom. Like if mom is happy, everybody’s happy, kind of thing.
18:35 Amanda Hall: Oh, completely. Well, and we, so my, I also do some work in child development and I lecture on infant mental health, right?
18:42 Dr. Ginger Garner Amazing. What a, what a hand in hand thing to do is to support the families who are having, you know, we increasingly, and we could talk about this all day. I’m sure neurodivergent experiences in our families, that is a whole level of stress that then you have one kid who may be neurodivergent, and diverse and wonderful and lovely, but our system is also not set up to accept those children and the way they learn and the way they experience the world. So that makes me take a big, you know, exhale for all those people. I’m one of them as a, you know, as an autism mom to say, wow, we can do so much better. Which brings me to what you do at Willow family OT, which you can check out at the.com: WillowfamilyOT.com.
Tell me what you’re doing to move the needle. Like we’ve clearly outlined the problem and probably got people fired up listening to it. I get fired up. I get, I get appropriately angry because moms shouldn’t be blamed. Uh, families shouldn’t be blamed when they just don’t have good support. So what, what have you been doing? What are you busy doing moving the needle about?
19:52 Amanda Hall Oh my goodness. So a lot of education. Uh, so we are providing education for employers on, uh, you know, return to work plans for moms from maternity leave. What is that support that moms might need as they come back, especially, um, you know, being a very fortunate and privileged mother to have 12 months off with my baby. I can’t imagine going back after three weeks, three months.
20:18 Dr. Ginger Garner: I was 5 days. 5 days with my first. I was crying…
20:24 Amanda Hall Oh my goodness. My heart just, my heart breaks for that because there’s so much in our research that shows that those mom and baby bonds for those first, that first little while is so crucial. And it’s, it’s such a protective measure for mom’s mental health to be able to have her baby by her side, not be separated because of employment reasons. Right.
That aside, even after a year or so going back into the workforce can be really challenging for so many moms. And we always talk about separation anxiety with children, but we don’t talk about separation anxiety with moms. It really is. And how many times can moms relate to dropping their baby off at daycare and they ball the entire way to work because this is the first time they’re away from their child.
And now they need to go to work and expected to fulfill the same demands at the same timeframe that they were a year ago or pre baby, which even if it’s not a year ago, even if it’s five days, goodness gracious. But if it’s a shorter amount of time, your body has changed, your brain has changed, your identity has changed. You are a whole new person inside and out.
And so the expectations of just picking up where you left off after having a baby is not realistic. Right. And so we’re really trying to provide some education to employers and parents to be able to advocate for themselves of, you know, maybe we need a graduated return to work following pregnancy and postpartum. And that even includes women who have experienced the miscarriage. We’re seeing so many individuals that are losing pregnancies or young infants and are still expected to just jump right back into work where they left off as if nothing happened.
22:16 Dr. Ginger Garner: Like the experience just gets swept under the rug. As if it was nothing.
22:19 Amanda Hall: Absolutely. Yeah. Yeah, absolutely. And so that’s an aspect. Another piece of what I’m doing is ensuring that women know that they’re able to request a screen for postpartum mood disorder and that it doesn’t need to happen in the postpartum period. So what many women in my area are told is that there’s no need to really screen for postpartum mood disorders while you’re pregnant because it’s just so in flux anyways.
That’s really not best practices according to PSI, the Postpartum Support International. They’ve got this lovely document on their website that shows what best practices are for postpartum screening. And it well, perinatal screening is what we should be calling it really. And so using the Edinburgh Postnatal Depression Screen is best practices right now for this. And it is free open source online. So I encourage anybody who’s curious to go and check it out. It is something that you can do yourself.
Where I have had some roadblocks that have been quite challenging is that healthcare providers in our medicalized system don’t want to do this because they say you can’t diagnose postpartum mood and anxiety disorders during pregnancy. Or you can’t diagnose postpartum mood and anxiety disorders within three months of postpartum because it’s just the hormones during pregnancy or it’s just the fluctuation of baby blues. And so let’s not even screen because it’s just not worth the while because we can’t diagnose anyways.
So I turn that around and I say my question to you is why do we need a diagnosis? If this screen can tell us that there is a mother who’s struggling, and it allows open conversation to say to that mom, I really do care about how you’re experiencing things right now, let’s just do this together and see what comes out of it. And then we can move on from there to figure out what domain in the screening shows true that you could really use some extra supports right now.
24:19 Dr. Ginger Garner Absolutely
24:20 Amanda Hall: That is what we need to use screening tools for, not as a diagnostic tool.
24:25 Dr. Ginger Garner Yeah, I fully agree because we are such a diagnosis seeking system in the biomedical, you know, allopathic system of healthcare where it’s almost rabid diagnosis seeking. Like, if I can’t find a diagnosis, it doesn’t exist instead of saying, but the problem still exists, and it’s not being addressed. And moms and kids and families are being harmed for it. It serves no one to skip over screening.
I’m wondering if there’s another because I have heard this multiple times. And, you know, I was aware of it as a pelvic PT, and screening myself and making sure I was trying my best to do self care because I was self employed and was forced to go back way too early.
Is that moms are afraid to be screened because they’re feeling like social services is looking over their shoulders just looking for a reason to come into the home and take their kids.
25:26 Amanda Hall Absolutely. That is one of the biggest things that I hear about. Because if a mom gets screened, and it shows that they’re not coping, or they’re struggling, or they’re having these intrusive thoughts, then all of a sudden, they’re a bad mom. And all of a sudden, somebody’s going to drop in their house and take their kids away. Right.
And that’s a very real anxiety that many, many moms feel. And that is such a shame. That really does break my heart that that is the reason why people are so reluctant to seek support and to seek help. I don’t know the best way around it. Unfortunately, that’s one of these systemic issues that we’re faced with that hopefully just with more education, and understanding that it’s nothing that the mom has done. It’s not warranting to take their children away. It doesn’t mean that she’s a bad mother. And it means that she just needs a little extra support. And you know what, who doesn’t during that time of life, right?
26:27 Dr. Ginger Garner I often think about this in a way of because it after having one, two, three kids and the the burden and the expense just continues to increase. And there’s very little sensitivity or compassion, for the most part to it. People are like, buck up, buttercup.
26:46 Amanda Hall: Because we chose this, right?
26:49 Dr. Ginger Garner We chose it so buck up, buttercup. And I often think about it this way. If if there’s a very real threat, I even found myself on a postpartum inventory, because the only person that would screen for it is the pediatrician in the United States. Really? ACOG in the United States. And it could have changed. But when I was teaching perinatal classes, it wasn’t recommended. [Wow.]
Actually provide the inventory, your PCP is not taking it. The only person that was going to take it is the pediatrician. Now, how likely is a mom to just check I’m severely incapacitated by feelings that I’m having at the pediatrician’s office when you’re right there?
27:25 Amanda Hall: They’re not going to.
27:27 Dr. Ginger Garner They’re not going to. They’re not going to. And I found myself in the same situation. Years later, my oldest, you know, they’re in high school now. But I think about it this way, because I also have a child on the spectrum. I know how if we think back to how children were treated that didn’t assimilate and didn’t learn well, and these issues weren’t identified in them in the 50s in the 60s, right? Right. And then we went through a period of time of ostracizing them, pulling them out of classrooms, sending them to, you know, special classrooms where they weren’t integrated.
It’s kind of how we’re treating mothers now of them living under that threat of getting pulled or their kids getting pulled or them being ostracized. I’m hoping that we’re not that far off of just being through in the school system where my oldest when he was in eighth grade, went through that period of transition where things were getting better all the time for him.
Yes, because of that integration, that compassion, that understanding that de-stigmatization of having any kind of diagnosis at all. And so it’s not pie in the sky, I think, to think that hopefully, you know, I said, think twice in a row, hopefully, feel like we can go in that direction of how we are inclusive towards those children now, they are integrated into the they are integrated into the classroom and you’re seeing improvements across the spectrum, literally across the spectrum in them, that can we think of mental health in the perinatal population that way, you know, instead of exercising and finger pointing and bullying? Can we be compassionate? Can we understand? Can we integrate systems that will actually – why can’t a therapist come into the home? Why don’t we have home care the way other countries do?
29:24 Amanda Hall Right? Yes, absolutely.
29:26 Dr. Ginger Garner Because I don’t know if you guys have mental health, you know, in the home or not, but we don’t.
29:30 Amanda Hall.We do a little bit. But I would say it’s certainly more focused on physical health. And so most often the times when a community therapist would be going into see somebody significantly post-op from a c-section, or from other complications at birth. And those are the times that we see the OTs and PTs going into the home. Otherwise, it’s not happening, right? And the onus is really on that mom to reach out for the help.
And my hope is that with more education, more advocacy, we’re able to actually say, look, you’ve got your six well-baby visits that are going to happen for your child. And these three, let’s start there, are specifically for you. And we’re going to follow you. And we’re going to ask, hey, how is the bleeding after pregnancy, or after your delivery? How is your mental health? How is your nutrition? How is your physical ability and stamina?
And all of the support system from, you know, there’s so many different aspects that are just not asked. And we are in a place where moms are and women are really expected to reach out for that support. We also can’t forget all the support partners.
Gender aside, if somebody is supporting this person going through a recent birth, then there’s a mental health component to that as well. We know that fathers specifically, which is where the research is that one in 10 specifically are experiencing some sort of mood adjustments or changes postpartum. We don’t recognize that in our society either. And so that’s, you know, that’s where my practice is a very family focused practice where we look at the family as a unit.
We don’t look at them as siloed individuals living alongside each other. We are looking at them as an integrated unit, which I think is so important for higher quality care. And unfortunately, when we get into some of our publicly funded supports that we have in healthcare, the way how funding is allocated, we’re not able to look at each person more so than just that person, right? We can’t look at the walls that they hold.
31:47 Dr. Ginger Garner That’s true. That’s so true in the United States too, in the insurance based system. Right. You can’t even look at another joint. I mean, you’re like stuck looking at one single thing. You cannot treat the entire person, much less the entire, you know, like family system, which is necessary to truly ensure safety all the way through the process of healing.
32:10 Amanda Hall Absolutely. A perfect example is just last week, I was meeting with a new client. This child was six years old, recently diagnosed with ADHD and autism, having a really, really hard time at school. And as I’m talking to mom, she starts to get upset. And we’re talking about the experiences of her child. And she just said, you know what, my whole childhood finally makes sense through the eyes of my son, because I’m realizing I have these challenges too, but nobody’s ever talked to me about them.
And my whole childhood now makes so much sense why everything was so hard for me. And that just was like, oh, right in my heart. So that’s where we transitioned our work from her child. He came and played in the forest, but we started working with mom, and we started doing some, creating a sensory profile with mom. We created an understanding of what her executive functioning was like. Where does she require some of these supports? Because she is not able to support her child in the way that she wants to, because she’s not feeling supported.
33:25 Dr. Ginger Garner Yeah. Explain executive functioning to the listener, because as an autism mom, I’m like, yep, I totally feel that, and I’m shaking my head, but that might be the first time they’ve ever heard that word.
33:36 Amanda Hall Of course. Yeah. So executive functioning is really our system that, our cognitive systems to be able to plan and organize time efficiently, being able to follow directions, being able to problem solve, really all of these pieces of, okay, I need to get from A to B, how am I going to get there? And what do I need to bring with me in order to do that? That’s all your executive function pieces that make that happen successfully.
And so with a lot of individuals that have a diagnosis of ADHD, or even just experiences that are aligned with ADHD, I’m not just at a diagnosis. These are the areas where they’re struggling in. So these are the kiddos that are looking like they’re not paying attention in the classroom. These are the moms that might just need to check out and scroll their phone because they’re feeling overwhelmed, because they, everything is just harder.
Everything for somebody who might have ADHD and an associated executive function disorder, think of it as it takes them twice as many steps as it would for us without an executive functioning disorder to do a complete task. So making dinner is much more complex than what it would be for somebody who doesn’t have an executive functioning disorder.
34:53 Dr. Ginger Garner Yeah, I often think about it in terms of, which I think is why doing small tasks, like scaffolded tasks, like Legos, the way the book in the Lego is, here’s your first piece. Yes, I love those kits. And it can be very reorganizing, I think, maybe even therapeutic, because all my kids actually did Legos. But I think about executive functioning like that. It’s like a really good Legos book to help you scaffold your life, not just putting a rocket engine together or something, or The Hobbit or something like that.
So you might be listening and going, oh gosh, I have difficulty scaffolding my own day or goals, or maybe it could be five year goals, not just how you’re going to complete your day. It could be a kid’s school project or a project at work that feels really overwhelming and it gets, it agitates you and maybe you lash out at other people and you just don’t understand why. So it’s encouraging to me to say, oh, if you’re feeling that, that could be a reason to go seek someone like yourself or someone else who can help identify that and then de-stigmatize it for you.
You’re not stupid, you’re not incapable, you’re smart, you’re intelligent, you’re fully capable of doing this. Your brain just works differently. And it’s society’s fault for not understanding the way brains work. We have so much to understand and discover about our brains. And so I never want someone to think because they have any kind of diagnosis at all, ASD, ADHD, anything at all, mental health wise, anxiety, depression, that it’s somehow – you’re just a weak person. That’s just not true at all.
36:58 Amanda Hall Yeah, absolutely. And you know, when we think about the terminology neurodivergent. Divergent is synonymous with something negative or something bad or not normal, right? So my hope is that we can at times get away from that word divergent because what are they diverging from? You know, what is the standard that they’re divergent from and really move into more of that neurodiversity?
And when I was speaking to somebody around the concept of neurodiversity, they were saying, you know, aren’t we all just different? Wouldn’t that apply to everybody? Yes. You know what? Yeah, actually, it could.
37:34 Dr. Ginger Garner Here’s the umbrella of neurodiversity. And then there’s the we’re all under here somewhere. And I caught myself doing that earlier is to say, you know, divergent isn’t synonymous with diversity. You know, in my mind, because I don’t think of it as a stigma, they are kind of synonymous, but not to the general, not to most people, they think divergent is like some kind of horror movie or something.
Really it isn’t. You know, we can think of it as, as diversity. But yeah, I think of it as an umbrella and all the little raindrops, beautiful little raindrops coming off of it. We all fit under there somewhere. We just don’t understand enough about the brain to be able to meet everybody where they are yet.
38:15 Amanda Hall Exactly. Absolutely. And so flipping that back into some of the work I’ve done is working with moms, understanding why sensory births work, why bringing in components of, you know, that tap into our sensory needs. Why those are really important and some of the work I do with doulas is really looking at how can we support the birth process for folks that might feel a little bit more on the neurodiverse scale.
So, you know, we know that there’s fonts that are more friendly for folks that identify as being neurodiverse. So if you’re giving some written information, make sure it’s in something like Arial that is widely accepted across differences, like learning disabilities and different things like that.
Giving information not just verbally, but also on paper, providing resources, links to resources that are videos for, you know, tapping into all of those people who have different learning styles.
39:21 Dr. Ginger Garner Yeah. So my thing is why can’t we apply all this to the birth process and recovery process as well and make it more inclusive? And can you spend just like a time? I know we don’t have a ton of time for it. We could just talk all afternoon about it, but the whole sensory motor integration piece and the sensory piece is so important. And I don’t think, this would be my wish for creating safety for everybody in healthcare, but particularly for women and girls and people who identify as female because there’s so much discrimination and stigmatization of what we go through.
I wish that we all graduated from high school with basic body knowledge, knowledge of sensory motor integration, that kind of thing. So I think most people may not get how critical that sensory piece is. Can you spend just a little bit more time with in regards to the birth process, how that looks, if we’re being sensitive, if we’re really plugging in, which describes your work with Doulas, which I absolutely love too.
40:27 Amanda Hall I love Doulas. So, I mean, this is, again, I could talk about this for hours because this is a complex topic, but it’s also something that I’m so passionate about and is near and dear to my heart for sure. One of the things is that we are all sensory beings. Every single one of us. We have our five senses, our five core senses, but then we also have the three other senses of our vestibular system, our proprioceptive system, so movement and balance.
And then we’ve also got our interoceptive system, which are all those internal signals that our body is telling us, which when somebody has any type of neurodiversity, interoception is one of those senses that can be really misunderstood and misguided, lacking interpretation.
When we are going through the birthing process, there is so much happening in our body that we can’t understand, necessarily, all of the signs that our body is telling us from a sensory perspective. So knowing that it is probably one of the most overwhelming sensory experiences we may ever experience in addition to knowing that we have a lack of control, and that in itself might increase our sense of overwhelm and sensory overload, increasing us to becoming more dysregulated, increasing our risk of becoming more anxious and more stressed.
So in an ideal world, if we all had a really lovely understanding of how our sensory motor experience worked, we would hopefully be able to be much more self-regulated and much more aware of how our body is reacting to different signals. How can we interpret and know the proper response or behavior that your body needs in that moment when it comes to interoception mostly?
So you know, with interoception, if you need to go to the bathroom. You understand that you get a sensation in your pelvic region telling you that you might need to go to the bathroom, your bladder is full. But maybe you don’t interpret that signal as that’s what it is. Maybe you’re like, oh yeah, I feel kind of weird in my belly, but I’m not too sure why, and then you have a urinary accident.
This is very common for people who have this disconnect between their brain and body and interpreting their interoceptive system. And so if we’re able to recognise what that signal is, give it a name and a meaning, and then attach a behavior to it, then we’re able to really regulate ourselves in a much greater way.
So if we have this understanding of our body prior to going into labor and delivery, imagine how we might be feeling like we’re a bit more in control of our body because we can respond in a better way. This is where doulas come in in such a beautiful way because I’ve been sharing a lot of this information and education with doulas that are in our area here who are supporting women through these deliveries to be able to understand what their body is needing.
So we do a lot of education pre-birth to prepare for that. How many women do we know that they feel comfortable to put in a pair of noise-cancelling earbuds during labour? Not many, but if you are being distracted from being able to self-regulate and be calm in the moments of delivery because there’s a lot of beeping and noises coming from the background that are really triggering your nervous system into a fight or flight response because it’s an overstimulation, then let’s do something because we can’t get rid of the beeping, so let’s do something with us to try and mitigate that overwhelm.
44:16 Dr. Ginger Garner Yeah, and the message here is that having this knowledge that everyone perceives sensory input differently, everyone perceives input differently and has different sensations and actions, the motor parts of what help us move, that’s going to be different also. We have to acknowledge, and I think this is a really important thing to stop people from beating themselves up, stop women from beating themselves up, giving themselves a hard time and feeling such shame and guilt is think about how birth has been set up in the US.
It has been set up in the US and Canada and in other places with no knowledge, no sensitivity whatsoever to someone’s sensory motor perception.
45:02 Amanda Hall No, not at all.
45:05 Dr. Ginger Garner: None, but you think about nature and the piece that you work with in nature is so interesting to me because if you think about nature and I use this a lot when I’m doing birth prep training, kind of pre-training with my patients and clients is think about an animal in the woods. What do they need in order for birth to progress and for them to be able to give birth safely?
They actually need quiet, they don’t need any of that sensory input, they have to focus and yet we’re expected to for birth to progress with all of these inputs that are foreign to us and that’s saying they’re able to handle that. What if they come in with birth trauma, what if they come in with PTSD? So if you are able to realize our systems aren’t currently set up to be sensitive to your actual needs as a person, then you can be more self-compassionate and realize oh it isn’t me, it’s the system.
And then the other thing that you mentioned that was really important and I want to bring in a little nerdy science here is that when you look at women, this is specifically to women because I teach continuing education on trauma-informed practice.
46:29 Amanda Hall: Yes, I do too.
46:39 Dr. Ginger Garner: Yes, kindred spirits. [I love it.] When you look at who responds best when you have complex PTSD, that kind of treatment resistant, what people, what clinicians or researchers would throw into the bin of hard to treat, tough to treat, complex to treat, the two things that move the needle the most for them is improving exactly what you were saying.
Interoception, how do we feel? And proprioception, where am I in space and how is my body moving? Absolutely. And that’s why mind-body medicine is so amazing. It’s why OT and PT can be so effective in this population and you may not have ever thought about that before, you know, listening to this but now you do, you know, now you can realize how many empowering possibilities there are to seek out a perinatal OT or a PT in your area and see what kind of work they’re doing or reach directly out to Amanda at willowfamilyot.com, because I’m sure like many practices, my practice is the same, we will field those emails, we will answer your questions, we will spend a little bit of time on a free consult trying to point you in the right direction.
Whether or not you come to see us is not the point, it’s empowering each person to know what their rights and options are so they can get the care they deserve.
48:01 Amanda Hall: Oh, that’s very well put. Yes, I agree 100%.
48:07 Dr. Ginger Garner Yeah, yeah. I absolutely love the work that you’re doing. I would, I want, I’m going to have a couple of rapid fire questions I always end with because they’re always inspiring to me to see kind of what are you reading? What are you listening to? Like what’s moving you these days? So, yes, is there like a book or a song that’s kind of like, you know, that you’re currently reading or a song that you’re going to lately?
48:32 Amanda Hall So it’s, I wish it was maybe more interesting because it’s, I find this fascinating. This is a book I’ve just picked up and of course it’s right beside me because I don’t go far without it but this is the one I’ve got right now and it’s Canadian birth stories and anthology and it’s Oh, it is just a combination of amazing birth stories and that is what I’m reading right now. actually just been published by our dual support foundation here in Kingston.
48:59 Dr. Ginger Garner Oh wow. I would have like, I’d need a whole case of tissues. I can’t watch a birth. I can’t hear a birth story. I can’t read a birth story without actually just completely melting because every single one is sacred.
49:14 Amanda Hall Absolutely. It is. Yes, this has been a very special read so I highly recommend it and it supports this non-profit Doula support foundation in town. Wonderful. Not that I meant to plug them in any way.
49:24 Dr. Ginger Garner: Can they find that at a particular website or anywhere?
49:30 Amanda Hall You can get it off of Amazon.
49:32 Dr. Ginger Garner:Okay, anywhere you buy your books, lots of people buy them off Amazon. Go check it out. Is there a fail safe chill pill that you have like your go-to? I need to chill. This is what I do.
49:42 Amanda Hall Yes, I go because I have a forest therapy space on my farm. I’m very thankful to live on a farm just north of Kingston in Ontario and so I go out to my forest therapy space and I actually do hammock therapy with my clients so I give myself a little bit of hammock therapy.
49:52 Dr. Ginger Garner I’m going to have to come all the way up to Ontario.
49:59 Amanda Hall Please do. Yes. So I just go and I chill in the forest in my hammock and I just relax for a little bit and that is my go-to.
50:08 Dr. Ginger Garner That sounds divine.
50:11 Amanda Hall I recommend everybody to have a hammock in their house, in their backyard. We have multiples all around my home so yeah it’s a little something to be said for it.
50:17 Dr. Ginger Garner: Nervous system centering cocoon.
50:22 Amanda Hall Oh, it’s incredible. Yeah. I have one in my basement even for those days when I don’t want to go to the forest.
50:30 Dr. Ginger Garner: That’s really good imagery you know because we think about trauma posturing, closing, in on ourselves but also it can be very comforting to feel that sense of kind of pressure through the joints, that rocking and swinging motion for the vagus nerve so if you’ve not tried it, go check it out. [Absolutely.]
Amanda, thank you so much for this time. You have shed so much wisdom on this. We’re going to have tons of bullet points for you guys. We’ll put her contact info in the show notes. Definitely reach out to her. Check out her work. Check out the Birth Stories book.
Thank you, Amanda.
51:07 Amanda Hall: Thank you so much for having me.
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