Start Smart: Fertility - Pregnancy - Hormone Health

Why HG Isn't In Your Head: An ER Doctor on the Biology of Severe Pregnancy Nausea

Episode Description In this episode of Smart Start, Kristin Williams sits down with Dr. Rick Pescatore, emergency physician, founder of BellyMD, former Chief Physician for the Delaware Division of Public Health, and editor-in-chief of Emergency Medicine News. Together they unpack one of the most overlooked conditions in women's healthcare: hyperemesis gravidarum (HG). Dr. Pescatore shares what he sees at the bedside, why so many HG patients arrive at the ER blaming themselves, and why thiamine (vitamin B1) deficiency has become what he calls one of the largest in-our-face public health crises of his career. The conversation moves from acute ER protocols to preconception planning, the limits of genetic studies, the gut-brain axis, and what truly specialized outpatient HG care should look like. What You'll Learn * Why HG is a biological condition, not a failure of resilience, and how decades of treating women's health as a "hardware problem" have left patients behind * How often Dr. Pescatore actually sees HG in the ER (hint: it's not once every five years) * The ACOG stepwise treatment protocol and where it falls short * Why thiamine deficiency is dramatically underrecognized, and why up to a third of pregnant patients presenting to the ER with nausea and vomiting meet criteria for Wernicke's * The difference between thiamine mononitrate and benfotiamine, and why Dr. Pescatore recommends the lipid-soluble form for preconception and pregnancy * Everyday thiamine blockers most women don't know about: coffee tannins, sushi, GLP-1 medications, and alcohol * How to think about MTHFR, GDF-15, and the recent wave of HG genetic research with appropriate skepticism * Why women who have had HG once are more likely to have it again, and what to do about it before the next pregnancy * The case for specialized outpatient HG care over repeat ER visits, PICC lines, and Zofran pumps * A preview of BellyMD's upcoming phenome app for disorders of gut-brain interaction Key Quotes * "We've approached medicine for decades as a hardware problem. If we don't see a problem, there must not be a problem. We're finally starting to shift that narrative." * "About one third of women with nausea and vomiting who present to the emergency department in pregnancy have thiamine levels so low as to qualify for a Wernicke's diagnosis." * "If you have suffered hyperemesis gravidarum, you have suffered an injury to your brain-gut axis. We've normalized this for so long, but it is not normal." Chapter Markers * 00:00 — Welcome and introductions * 01:07 — The Instagram post that started it all: Wernicke's in the ER * 02:03 — How HG patients actually present, and the emotional weight they carry * 04:01 — Inside the ER treatment protocol for HG * 05:28 — How Materna keeps patients out of the ER with proactive IV care * 07:17 — What happens after discharge: outpatient supplementation and prevention * 09:23 — Preconception planning and the case for benfotiamine * 11:08 — Surprising thiamine blockers: coffee, sushi, GLP-1s, alcohol * 12:46 — MTHFR, evidence-based medicine, and why population-level data fails individual patients * 14:48 — GDF-15, the new HG genetic studies, and why to pump the brakes * 17:19 — Preparing for a second pregnancy after HG * 20:01 — Designing the ideal specialized HG outpatient center * 21:25 — Why Dr. Pescatore became a "big B1 guy" and the science of proton tunneling * 23:20 — Thiamine deficiency in children and a new randomized trial on pediatric bedwetting * 24:43 — A first look at BellyMD's upcoming phenome app About the Guest Dr. Rick Pescatore is an emergency physician, founder of BellyMD (focused on disorders of gut-brain interaction), former Chief Physician for the Delaware Division of Public Health, former White House task force advisor, and editor-in-chief of Emergency Medicine News. Follow him on Instagram for ongoing education on thiamine, HG, and gut-brain health. About Materna Health Materna Health is a boutique functional fertility and OB/GYN practice in the West Village, NYC, closing the gap in women's healthcare with same-day access, IV hydration and vitamin replacement protocols for HG, and continuity of care that keeps patients out of the emergency room. Visit maternahealthcare.com · 130 7th Ave South, New York, NY · 917.382.0336 · hello@maternahealthcare.com [hello@maternahealthcare.com]

Rethinking Fertility & Early Pregnancy Care with Dr. Julie Von

Summary In this episode of Smart Start, host Kristin Williams speaks with Dr. Julie Vaughn about the complexities of women's health and fertility. They discuss the importance of early pregnancy care, the role of nutrition and anemia in fertility, the impact of trauma, and the benefits of acupuncture and alternative medicine. Dr. Vaughn emphasizes the need for self-care and resourcing, the significance of preconception care, and the importance of reframing fertility challenges. The conversation highlights the need for a holistic approach to women's health and fertility. Takeaways Women's health is complex and multifaceted. Trauma can significantly impact fertility and wellbeing. Anemia is a common issue that can delay conception. Acupuncture can help regulate the body and support fertility. Self-care should be viewed as resourcing, not indulgence. Preconception care is essential for better outcomes. Chronic anemia can affect thyroid function. Finding personal pillars of support is crucial for health. Women often carry the burden of fertility planning. Reframing challenges in fertility can lead to empowerment. Sound bites "We have complex hormonal cycles." "Traumas can impact our wellbeing." "Acupuncture is very regulating." Chapters 00:00 Introduction to Dr. Julie Vaughn 02:14 The Complexity of Women's Health 05:01 Preconception Care and Self-Advocacy 09:10 Understanding Optimal Health Before Pregnancy 11:00 The Impact of Anemia on Fertility 14:12 Nutrition and Its Role in Conception 17:29 The Emotional Aspects of Fertility 19:59 The Journey to Expansion in Fertility 23:18 Collaborating with Healthcare Practitioners 24:57 The Role of Acupuncture in Preventative Care 28:33 Practical Changes for Supporting Fertility 33:52 Understanding Your Body Before Pregnancy About Dr. Julie Von Dr. Julie Von is a Manhattan-based holistic physician specializing in fertility, reproductive health, and integrative women's care. Her path into medicine began unusually early, apprenticing with healers, shamans, and physicians across multiple healing traditions before formal medical training. She went on to become one of the youngest practitioners in the United States to study Chinese medicine and continued her education in China, earning a doctoral degree from the Shanghai University of Traditional Chinese Medicine. Dr. Von also holds a degree from the American College of Traditional Medicine in San Francisco, grounding her work in both classical Eastern medicine and modern clinical practice. For over a decade, Dr. Von has worked with patients in New York City, collaborating alongside some of the most advanced and well-known names in fertility medicine. Her clinical approach integrates rigorous medical training with earth-based and intuitive traditions, allowing her to address fertility through physiology, environment, emotional health, and energetic balance. Her work is known for bridging science and tradition in a way that is both deeply personalized and clinically thoughtful. Learn more at drjulievon.com About Materna Healthcare Materna Healthcare is a first-of-its-kind medical practice dedicated to early pregnancy and preconception care. From fertility planning through the earliest stages of pregnancy, Materna provides expert, compassionate, same-day care designed to keep women out of the emergency room and deeply supported during a critical window of health. Learn more at www.maternahealthcare.com [http://www.maternahealthcare.com] Materna Healthcare on Social Media Instagram: @materna_health_ TikTok: @maternahealthcare LinkedIn: Materna Healthcare We'd love to hear from you. Have a question, a story, or something you'd like us to cover? Reach out anytime — we're listening.

The Mythology of Birth: A Conversation with Dr. Britta Bushnell

In this enlightening conversation, Dr. Britta Bushnell shares her insights on the transformative journey of parenthood, emphasizing the importance of mythology and psychology in understanding childbirth. She discusses the illusion of control that many expectant parents face, the significance of childbirth as a rite of passage, and the dynamics of family roles as new parents navigate their identities. Dr. Bushnell also highlights the critical role of partners during the birth and postpartum periods, advocating for the practice of receiving help and the power of storytelling in reframing birth experiences for healing and resilience. "Stories are how we remember." "Partners need to embody 'bank' energy." "Practicing receiving help is crucial." Chapters 00:00 Introduction to Dr. Britta Bushnell 02:58 The Illusion of Control in Parenthood 05:41 The Intersection of Mythology, Psychology, and Childbirth 11:52 Childbirth as a Rite of Passage 17:33 The Transformative Family Wheel 29:23 Partner Support During Birth and Postpartum 44:50 Reframing Birth Stories for Healing Keywords birth, parenthood, transformation, mythology, psychology, childbirth education, rites of passage, family dynamics, partner support, healing About Britta Bushnell Britta Bushnell, PhD, is a childbirth educator, birth advocate, and author known for her work on the neurobiology of birth and the mind–body connection in labor. She holds a doctorate in Mythological Studies with an emphasis in Depth Psychology, and she brings a unique, research-informed perspective to understanding how physiology, environment, and emotional safety influence birth outcomes. Britta is the author of Transformed by Birth, a widely respected book that explores how birth experiences shape women neurologically and psychologically. Her work bridges neuroscience, psychology, and childbirth education, helping parents and providers better understand how to support labor in ways that promote safety, confidence, and optimal outcomes. Through teaching, writing, and speaking, Britta Bushnell continues to challenge fear-based narratives around birth and advocates for care models that honor the intelligence of the birthing body and brain. https://brittabushnell.com/ [https://brittabushnell.com/] About Materna Healthcare: Materna Healthcare is a first-of-its-kind medical practice dedicated to early pregnancy care. From preconception through the earliest stages of pregnancy, we provide expert, compassionate, same-day care designed to keep women out of the emergency room and connected to the support they need. Learn more at www.maternahealthcare.com or reach out at hello@maternahealthcare.com [hello@maternahealthcare.co] Materna Healthcare on Social Media 📍 Instagram: @materna_health_ 🎵 TikTok: @maternahealthcare 💼 LinkedIn: Materna Healthcare We'd love to hear from you! Have a question, a story, or something you'd like us to cover? Reach out anytime, we're listening. We'd love to hear from you!

Iron Deficiency: A Silent Global Epidemic with Dr Michael Auerbach

In this episode, Dr. Michael Auerbach, a renowned hematologist and oncologist, discusses his extensive experience with intravenous iron therapy, debunking myths about its dangers and highlighting its efficacy. He shares insights on the importance of iron in pregnancy, the challenges of iron deficiency, and the need for updated guidelines in obstetrics. Dr. Auerbach also emphasizes the significance of proper iron supplementation and the impact of iron deficiency on global health. Takeaways * Intravenous iron therapy is safe and effective, debunking myths of its dangers. * Iron deficiency is a top global health issue, affecting over 3 billion people. * Proper iron supplementation is crucial, especially in pregnancy, to prevent developmental issues. * Dr. Auerbach has pioneered studies in iron therapy for various conditions, including pregnancy and chemotherapy-induced anemia. * Iron deficiency is often overlooked in obstetrics, with many women undiagnosed due to outdated guidelines. * The American College of Obstetrics and Gynecology has yet to adopt international guidelines for iron deficiency screening. * Oral iron supplements can be ineffective and even harmful in certain conditions like inflammatory bowel disease. * Dr. Auerbach advocates for universal iron screening and intravenous iron therapy for iron-deficient women. * Iron deficiency can lead to significant health issues, including fatigue, postpartum depression, and developmental delays in children. * Updated guidelines and awareness are needed to address iron deficiency effectively. Sound Bites * Intravenous iron is safe and effective. * Iron deficiency affects over 3 billion people. * Proper iron supplementation is crucial. * Iron therapy in pregnancy prevents issues. * Outdated guidelines overlook iron deficiency. * ACOG needs to update iron guidelines. * Oral iron can be harmful in some cases. * Universal iron screening is essential. * Iron deficiency leads to health issues. * Awareness is key to addressing iron deficiency. Chapters * 00:00:00 Introduction and Background * 00:00:00 Intravenous Iron Therapy * 00:00:00 Iron Deficiency in Pregnancy * 00:00:00 Challenges in Iron Supplementation * 00:00:01 Global Impact and Guidelines Michael Auerbach, MD, FACP, is a board-certified hematologist and oncologist and an internationally recognized authority on iron deficiency anemia, including its management in pregnancy. A Clinical Professor of Medicine at Georgetown University, he serves on the American Society of Hematology Guidelines Committee and has authored more than 220 peer-reviewed publications, including multiple UpToDate chapters on iron deficiency. Dr. Auerbach is a pioneer in intravenous iron therapy, leading landmark educational sessions and the first U.S. prospective study of IV iron in pregnancy. For more information on Dr. Michael Auerbach you can find information at https://ccbdmd.com/physician/michael-auerbach-md-facp/ [https://ccbdmd.com/physician/michael-auerbach-md-facp/] https://ccbdmd.com/physician/michael-auerbach-md-facp/ About Materna Healthcare: Materna Healthcare is a first-of-its-kind medical practice dedicated to early pregnancy care. From preconception through the earliest stages of pregnancy, we provide expert, compassionate, same-day care designed to keep women out of the emergency room and connected to the support they need. Learn more at www.maternahealthcare.com or reach out at hello@maternahealthcare.com [hello@maternahealthcare.com]. Follow us on instagram @materna_health [https://www.instagram.com/materna_health_] Materna Healthcare Social Media * Instagram: https://www.instagram.com/materna_health_ [https://www.instagram.com/materna_health_] * TikTok: https://www.tiktok.com/@maternahealth [https://www.tiktok.com/@maternahealth] * LinkedIn: https://www.linkedin.com/company/maternahealthcare [https://www.linkedin.com/company/maternahealthcare] We'd love to hear from you!

Navigating Genetic Testing for Preconception & Early Pregnancy with Ushta Davar Canteenwalla

In this episode of Pregnant-ish, host Kristen Williams speaks with genetic counselor Ushta Davar Canteenwalla about the complexities of genetic testing during pregnancy. They discuss the importance of genetic counseling, the different types of genetic tests available, and the emotional and ethical considerations surrounding these tests. Ushta emphasizes the need for accessible genetic counseling and the benefits of preconception testing to help parents prepare for potential complications. The conversation highlights the advancements in prenatal genetic testing and the importance of informed decision-making for expecting parents. * Genetic counseling is essential for informed decision-making during pregnancy. * Many OBs do not work with genetic counselors, leading to gaps in information. * Preconception genetic testing can provide valuable insights for future parents. * Emotional support is crucial when navigating genetic testing results. * NIPT is a non-invasive test with high detection rates but has limitations. * Amniocentesis provides definitive answers but comes with risks. * Advancements in genetic testing technology are rapidly evolving. * Expecting parents should approach genetic testing with a positive mindset. * Understanding family history can guide additional testing needs. * Genetic counseling should feel like a supportive conversation, not a clinical obligation. About Ushta: Ushta is a board-certified genetic counselor with over 20 years of experience guiding individuals and families through their genetic health. In 2018, she founded FiND Genetics, a telemedicine consulting practice dedicated to making genetics more clear, accessible, and empowering. Her work spans reproductive, adult, and general genetics, as well as clinical operations, education, and mentorship. Previously, she led a collaborative fetal care center at Columbia University Medical Center and directed the national genetic counseling team at CooperGenomics. For more information on Ushta Davar Canteenwalla and Find Genetics you can find information at https://www.findgenetics.com/. [https://www.findgenetics.com/] Join the priority list for her upcoming Prenatal Testing with Confidence workshop series: self-paced learning experience with ongoing live support from me to help you understand genetic testing in pregnancy. Sign up here [https://ushta-davar-canteenwalla.mykajabi.com/prenatal-testing-with-confidence-priority-interest-list]. And Follow Ushta on Instagram @findgenetics [https://www.instagram.com/findgenetics/] About Materna Healthcare: Materna Healthcare is a first-of-its-kind medical practice dedicated to early pregnancy care. From preconception through the earliest stages of pregnancy, we provide expert, compassionate, same-day care designed to keep women out of the emergency room and connected to the support they need. Learn more at www.maternahealthcare.com or reach out at hello@maternahealthcare.com [hello@maternahealthcare.com]. Follow us on instagram @materna_health [https://www.instagram.com/materna_health_] Materna Healthcare Social Media * Instagram: https://www.instagram.com/materna_health_ [https://www.instagram.com/materna_health_] * TikTok: https://www.tiktok.com/@maternahealth [https://www.tiktok.com/@maternahealth] * LinkedIn: https://www.linkedin.com/company/maternahealthcare [https://www.linkedin.com/company/maternahealthcare] We'd love to hear from you!