Dr. JoAnn Yanez, AANMC Executive Director, joins KCAA’s NBC LA affiliate On the Brink to discuss healthy pregnancy and naturopathic medicine, healthcare disparities, infant loss and personal stories.
Full Transcript of Interview Below.
Topics Include:
- Healthy Pregnancies and Naturopathic Care
- Healthcare equity
- Infant loss
- Personal Story
Erin Brinker:
Welcome back. I’m Erin Brinker.
Todd Brinker:
And I’m Todd Brinker.
Erin Brinker:
And we are On The Brink, the morning show on KCAA AM 1050, FM 106.5 and FM 102.3. And I’m super excited to welcome back to the show Dr. JoAnn Yanez. She is the executive director for the Association of Accredited Naturopathic Medical Colleges. And she joins us once a month to talk about health and naturopathic medicine-related issues. Dr. Yanez, welcome back to the show.
Dr. JoAnn Yanez:
Thank you so much for having me. Good morning.
Erin Brinker:
Good morning. So one of the hardest things that a family has to deal with, probably the hardest thing a family has to deal with, is the loss of a child and the loss of an infant via miscarriage. We watched Christy Teigen struggle with the loss of her child, she miscarried a child. It is overwhelming, and it hurts every bit as much as a child that has been delivered. I’ve had friends who have gone through that and it’s just extraordinarily painful. And infants sometimes inexplicably die. Call it SIDS or call it whatever. And October is, I think, it’s an international remembrance month for the loss of infants. You all are dealing with that subject this month in your podcast?
Dr. JoAnn Yanez:
Yes, we are. We try to support patients throughout the life cycle. And one of the areas many MDs focus in is fertility and healthy pregnancies. And if you are working in the world of fertility and pregnancy, invariably pregnancy loss is going to be part of the equation. And so it’s something that I am dedicated to bringing more awareness about. I think it’s something that people don’t talk about.
Dr. JoAnn Yanez:
In my fertility journey, I went through miscarriages, and it is very interesting that folks really don’t… After I had mine, I talked to family members and friends and, “Oh, I miscarried three times before I got pregnant,” or… There was so much discussion around that after the fact, but it was only through me initiating that conversation that things started to come out with my own loved ones that I’d known for many, many years. And so I think it’s interesting for us in a society that holds backs some things that are very personal.
Dr. JoAnn Yanez:
And I think also it’s very much been in the news, the racial and ethnic disparities that are very apparent in our medical system. 42.4%, 42.4 deaths per 100,000 live births for black, non-Hispanic women. That is well over the 13 deaths per 100 births for white, non-Hispanic women. I think it’s very… The numbers are also very striking for Native American and Alaska’s Native women in our country. And so it’s very striking. And I think that it shines a light on… Right now, we’re talking so much about racial equity, equity based on gender, just equity in general. And the disparities that we see in healthcare and healthcare delivery are very evident with the data.
Dr. JoAnn Yanez:
And so I think that as a naturopathic doctor, our profession is committed to equity across all of our patient populations and making sure that our patients have access to the care they need to have safe and healthy pregnancies. But when you see that ethnicity data, it just makes me as a doctor ask why.
Erin Brinker:
It’s horrifying.
Dr. JoAnn Yanez:
Why is this existing? I have a very good friend of our family, African American physician who went through… She died on the table delivering her child.
Todd Brinker:
Oh my.
Dr. JoAnn Yanez:
… and was revived.
Erin Brinker:
Oh, wow.
Dr. JoAnn Yanez:
And her husband is a physician. And the only reason that… An ER physician at that. The only reason she is alive, we all feel, is because he saw the markers going south and started raising the alarm flags saying, “This isn’t right. Something’s going wrong. You all need to get in here now. She’s crashing.” And turned out she was hemorrhaging and nobody caught it. But the long and the short of it is… African-American family. Had he not been there to advocate for his wife, she and very much well the baby could have both died. And as it is, her recovery was many, many months to come back from that.
Dr. JoAnn Yanez:
So I hear stories like this and it just makes me really scratch my head. And it’s not a slam on doctors or nursing staff or anything. It’s just as an industry, we need to do better. We shouldn’t have a developed country that has some of the most expensive healthcare and the outcomes that we have with pregnancy and delivery. And so it tells me we need to do better.
Dr. JoAnn Yanez:
And one of the ways that naturopathic doctors help in the system, and we’ve talked about this before, is preconception. It’s starting with young children and families and creating healthy habits that will hopefully impact fertility later on for both females and males.
Dr. JoAnn Yanez:
And I think there’s a little bit of gender bias that goes on when we talk about fertility and kind of putting the onus on the female. And it can be both sides to that equation. It can be egg quality, sperm quality, uterine issues, hormonal issues, et cetera. So there are so many pieces of the puzzle there when you’re thinking about fertility in a couple.
Dr. JoAnn Yanez:
And from the naturopathic perspective, we look at everything. As you know, we look at stress, we look at mind, body issues. We look at… There’s strong data around things like hypertension and diabetes and a chronic heart disease, which is all on the rise in younger populations as well and having an impact on fertility. So the more we can impact those things early on, the more we can get hormones regulated, weight balanced, stress under control, the better outcomes we’re likely to see.
Erin Brinker:
So I’m horrified that these two highly educated people were not… I don’t want to say not treated better, but not treated better. I mean, it’s… Are we so quick to dismiss people when they have an issue or just assume things are fine? And I know that being female going in and getting medical care, there have been many times where a doctor just essentially, not literally, but essentially, figuratively, pats me on the head and says, “You’re fine.” And I find out later that something very serious is happening and it’s very frustrating.
Dr. JoAnn Yanez:
[crosstalk 00:08:00] It is. And Erin, it’s hard for me not to get frustrated on this topic as well and triggered myself. In my own birth with my son, my water broke at 9:00 AM the day before my due date. No surprise, not a big shocker. So I called up the office and I told them. And the woman on the phone began to tell me, “Oh, no. You must be mistaken.” And I said no.
Erin Brinker:
Wait. What?
Dr. JoAnn Yanez:
Yeah. Yeah. And so in my own birth story, I was basically… And nobody from the office followed up with me for the entire full day. It was always in my plan to labor at home for as long as I could. And so I stayed home that whole day. My husband, I called my husband. I told him it’s probably go time soon. And he asked if he should come home. I said, “No, I’m okay right now. Hang out, do your thing. And I’m kind of good by myself.”
Dr. JoAnn Yanez:
And so he came home from work and we both kind of realized nobody called all day. And so at that point, we started to get worried. I’m like, “Wait a second. Okay. We should probably have gotten a phone call at least.” And so we went into the hospital that evening and the triage nurse, again, didn’t believe that my water broke or that I was in labor.
Dr. JoAnn Yanez:
And what she said to me is, “Well, you’re too calm.” And I said, “What do you expect?” I started to get a little triggered. I’m like, “Because I’m a Hispanic female, did you expect me to just be like [Spanish 00:09:38] Oh my god. Oh my god.” What were you expecting me to do? And I was like, “What were you expecting? I’m just reporting my symptoms.”
Dr. JoAnn Yanez:
And then I get up on the floor and the midwife and the doctor greet me. And again, third time. “Well, maybe it was just a heavy discharge. Maybe you weren’t… Your water didn’t break.” And I said, “Go get a piece of litmus paper.” And that’s when doctor in me kicked in. I was like, “It’s really quick. Amniotic fluid is alkaline, and the normal pH is acidic.” So I said really quick and easy way to finish this conversation is to go get a piece of litmus paper. And immediately her tune changed. She brought the surgeon in. She said, “We need to go and get you in for a C-section.” And I said, “Hold on a second. So-
Erin Brinker:
You went from ignoring me to I need emergency C-section? Come on.
Dr. JoAnn Yanez:
Yeah. Yeah. So my own experience, the experience I’ve seen with friends of mine, you kind of need a doctor in the room to advocate for yourself. It can really turn very quickly. And so, for me, just seeing my own experience and… We need to do better at listening. We need to do better at believing women and listening to them and listening to what they’re saying. And so I know I don’t normally make these talks that we have personal, but I really… Just with you talking and it kind of compelled me to go there.
Erin Brinker:
Yeah, no. Absolutely.
Dr. JoAnn Yanez:
I hope you don’t mind, but I think it’s so important to share these stories, for women to talk and to share their experiences and to be open and honest about it. Because if we don’t open up this discussion, it’s not going to get better.
Erin Brinker:
No.
Dr. JoAnn Yanez:
So for me, I think I’ve always been committed to personal honesty. And I think that it’s just so important that we start having these conversations. We have more of them. We hold people accountable to provide good care and equal care and really just step up our game.
Dr. JoAnn Yanez:
But I love the… When I talk to my naturopathic colleagues who work in L&D, who work with pregnancy and with infants, I just love to see the holistic approach they take. They’re listening. They’re really focused in on what the person needs, what the family needs, what’s best for them to get them to optimal health. And that can include supplements, that can include acupuncture, that can include stress reduction and nutrition and all of the above. But it’s really holistic view to birth and delivery and child rearing.
Erin Brinker:
So I’m still processing how badly you were treated or how poorly you were treated.
Todd Brinker:
That’s awful.
Erin Brinker:
That is absolutely awful. And especially… And at no point, did anybody just maybe think maybe we should do a pelvic exam?
Dr. JoAnn Yanez:
No.
Erin Brinker:
I mean, if for no other reason, you were at term and something’s happening, obviously. So nobody wanted to do a pelvic exam?
Dr. JoAnn Yanez:
Yeah, no-
Todd Brinker:
Sounds like that’s sort of the first line of response, because my wife, when she delivered our first child, the exact same thing. The doctor said, “Well, I don’t think you’re really in labor, but if you want to come in, come on in.” And so we waited a while and then we decided to go in, but I was timing contractions. And he was trying to say, “No, no. I think it’s probably false labor.” But it just seems to be their knee-jerk reaction. “Nah, you’re not having a baby. You’ve only been carrying it for nine months.”
Erin Brinker:
Wow. Yeah.
Todd Brinker:
Isn’t that weird?
Erin Brinker:
It is. It is. It is. It’s awful actually.
Todd Brinker:
Three examples of the first reaction.
Dr. JoAnn Yanez:
And Todd, I recognize my privilege. One of the first things is when we got to the hospital and my husband started to see things, he got his… His best friend’s wife is an OB, and he got her on the phone. And I recognize our privilege. Not many people have that on speed dial, where they have somebody that they can call. And so I recognize the privilege that I had and that my friends had that are likely alive today because her husband’s an emergency room doctor and knew how to read the machine.
Todd Brinker:
Yeah. Well, there’s certainly, like you said, certainly a privilege and advantage there. I will say, to the credit of the doctors, we were living in Pennsylvania at the time. They had a great medical system. We had a great doctor. Soon as we got there, he brought her back and did an exam and said, “Okay, yeah. You’re dilated. This is happening.” And checked her in. And we got great care.
Erin Brinker:
Wow.
Dr. JoAnn Yanez:
And it’s no means a slam on doctors. I’m married to a doctor. I have many lovely doctors in my life. But I think overall, that dismissiveness, and Erin, you talked about the patting on the head. I think it’s so important to be open in dialogue and partners in a relationship with a patient. And the paternalistic I’m above you, you have to do what I say relationship often has problems in it, because you can miss stuff.
Erin Brinker:
So this is such an important conversation. And like I said, you all are having a webinar on this topic, correct? At the AANMC?
Dr. JoAnn Yanez:
We have webinars every month. We host webinars on fertility and depression. And we have one coming up on seasonal affective disorder and staying healthy in the wintertime. So just hope people can come to all of our events. They’re free and monthly and available for the public.
Erin Brinker:
And that’s at aanmc.org, correct?
Dr. JoAnn Yanez:
Yes, ma’am.
Erin Brinker:
So it is always a treat. I wish we had more time because this is such an important topic. Thank you so much for joining us today.
Dr. JoAnn Yanez:
Thank you, folks. And have a good day.
Erin Brinker:
Thank you. You too-
