Co-host Nipunie Rajapakse M.D. talks through the “biggest adventure of my life” — she’s pregnant! She’s joined by co-host Angela Mattke, M.D. — and special guest Jay Homme, M.D., pediatrician at Mayo Clinic and father of six children. Tune in for a wide-ranging discussion of pregnancy in an age of social media and pandemic, with topics including: * When, and how, to announce your news? How can we be sensitive to others who’ve struggled with infertility? * What to expect when we’re older and expecting? Dr. Nipunie is 37, her partner Thomas is 40. * How do we maintain mindfulness and stay in the moment? * What are good ways to keep partners involved in the pregnancy journey? * How do we stay active and preserve “date nights?”
Dr. Angela Mattke:
Welcome to the Mayo Clinic Mom's podcast. We're having candid conversations and answering difficult questions about pregnancy, raising kids, and everything mom-related. I'm Dr. Angela Mattke, and I'm a mom of two and a pediatrician at Mayo Clinic Children's Center in Rochester, Minnesota. And my co-host is Dr. Nipunie Rajapakse, who's a pediatric infectious disease doctor also at Mayo Clinic and is also pregnant. So congratulations, Nipunie, you are pregnant. How are you feeling?
Dr. Nipunie Rajapakse:
Thanks, Angie. I'm feeling pretty good. We're super excited and excited at all the new new adventures that are ahead. So yeah, really excited to go through this.
Dr. Angela Mattke:
Absolutely. And adventures that are ahead are absolutely the best way to put it because literally it is the biggest adventure of my life, you know, from having kids to, you know, every single different stage of their lives. And every day is something different and every day is really fun. And there's different challenges I think with all the different stages as well. So I'm going to bring on our special guest for this episode who is the perfect person to help us go through all of these questions today? I wanna introduce Dr. Jay Homme, who is a pediatrician and adolescent medicine physician at Mayo Clinic Children's Center. So Dr Homme is also an extremely experienced father. So Dr. Homme, thank you for joining us today. Can you give us a little bit about your background? And how many kids do you have?
Dr. Jay Homme:
Well, thanks for having me. My wife Becky and I are the proud parents of six children: five biologic and our youngest is adopted. And we've been married for over 26 years and I've found that we've had successes and we've had some challenges and some failures and sometimes failures teach you a lot of things and you don't do those things again. But it really is a parenting, honestly, going from none to one is just a huge change. And after that you just sort of add 'em on.
Dr. Angela Mattke:
Yeah, that's what everyone tells me. You know, I only have two and I going from one to none, but I thought going from one to two was like even harder. But then everyone says after you've got two, it's like, no big deal. What was that like, was that true for you?
Dr. Jay Homme:
Well, you have to go from man to man to zone defense. But other than that, you know, each of them is an individual. You gotta take 'em that way, but, you know you get used to having one and then you add another one and one of the big things like, well, how will I possibly have enough love for two? And it's like, there it is. You know? And then you just, after you kind of get used to that, then here we go.
Dr. Angela Mattke:
Yeah. Your heart just gets bigger and bigger. There's always room for more, right?
Dr. Jay Homme:
There's always room.
Dr. Angela Mattke:
Yeah, absolutely. So you've probably had a lot of experience with, I mean, going back to even like your first child finding out that you guys were expecting, there can be a lot of like excitement in wanting to tell people, but then like worries and fears about like, what if I tell them too soon? What if something happens to the baby or worrying about what other people's responses might be to your pregnancy? Was that, tell us a little bit about kind of what you went through during that experience. And then I wanna hear about Nipunie's thoughts and her journey from that is.
Dr. Jay Homme:
Yeah. I think the decision of when and how to tell is really individualized and a lot of it just stems from your own sort of personality and the way you like to interact. In some ways I'm just sort of an open book, you know, I'll just tell you anything that's happening whenever, but my wife is a little bit more introverted, a little more reserved. But this was something she was really looking forward to. So, she was excited to tell others. And we, in our initial time, we were very, I felt young and dumb I call ourself, but there is some, some benefit to that, cuz we just didn't worry about a lot of things. We just felt mostly excited as the years went on and we knew more things, there are things about, oh we should we worry about this or that, but telling is very individualized. Some people wanna keep it private for a while because of the concern about, well, if I tell you I'm pregnant and then something happens to the pregnancy. Now I have to tell you, I don't want to go through it. That's really hard. That's real people have dealt with that. Others are just so excited. Like they pee on the stick and they call someone and say, there's two lines, you know? And, I think it's okay. You just need to decide for your self, what works for you. Now I've had times where people come up and say, I need to tell you something. I'm pregnant. And I always respond the same way. That's awesome. And in my head sometimes like, yeah that was pretty obvious several months ago, but I'm glad you're telling me now.
Dr. Angela Mattke:
So yeah. What about you Nipunie? I mean, did you guys start telling people right away? Did you wait, what are the thoughts that went through your head?
Dr. Nipunie Rajapakse:
Yeah, so we were obviously super excited when we got the positive test, but I was also cognizant of a few things. So when we're starting on this journey kind of later in life, so I'm 37 years old. My partner Thomas is turning 40 later this year. And so I knew with that comes kind of a higher risk of certain complications, for example, miscarriages or early pregnancy loss. And so we did end up waiting until we had kind of passed that 12 week point. I know Thomas told one of his good friends and his sister I think the day or the day after we found out. So it was nice to be able to kind of talk with them about the experience kind of early on. But for most others we waited until after we got past that 12 week point. The other thing that kind of waited heavily on me was I obviously have had a lot of friends and colleagues who have had trouble either conceiving or have struggled with recurrent pregnancy losses or were going through complic pregnancies even around the time that we became pregnant. And so I wanted to be kind of sensitive to those experiences and how we announced it. And so we obviously, there's lots of different ways to, to make an announcement and different things will work for different people. But we chose to kind of tell people, obviously in the pandemic also added some additional challenges and that most of it had to be done virtually. And so we didn't go kind of down the, the big social media reveal or anything like that. And tried to kind of have one-on-one conversations, mostly virtually to let our families know. Both of our families are outside of Rochester as well. So that added some additional kind of complications, but we were really happy to share the news with them.
Dr. Jay Homme:
I was fortunate. Social media didn't exist when, you know, we were dealing with this and I'm still pretty much a, you know, social media is not really my thing, but it really is this idea that, that our business is everybody's business. And it's not. This is about you. And this is about how you want to experience this really neat transition in your life and the life of you and your partner. And you know, it's, it should be on your terms, not other people's.
Dr. Nipunie Rajapakse:
Yeah. I feel like even after the baby is born, there's probably, especially at work cuz through zoom meetings and everything I have, there's limited people that you're seeing in person still. And I feel like even after the baby is born, there's probably gonna be people that are like, oh, I didn't even know she was pregnant. They'll find out in due time.
Dr. Angela Mattke:
Absolutely.
Dr. Jay Homme:
I think most people wanna be happy with you, but once in a while you feel that sort of judgment. You know, I think our fourth child, I think my wife's grandmother was kinda like, what are you doing? I mean, we're like, we're just having more children cuz we want to, but again, it's about what's right for us and what we were wanting to do. And you know, you have to tune, tune down some others sometimes,
Dr. Angela Mattke:
No focus on you and your, and your family and your journey. So I love, I love that. Let's talk about the journey actually with pregnancy and focusing on enjoying it because there's so much. You know, Jay just talked about like social media, right? As soon as you start talking or searching online about pregnancy or babies, right. It's gonna be directing a lot of stuff marketed at you. And then you start worrying about all the things you need and then, and then you start worrying about likewhat's gonna happen to your baby and your future and your life and stuff like that. So Jay, you know, you've been through this so many times, like how do you still stay mindful and in the moment and really just enjoying the journey and the pregnancy, because that's an incredible experience.
Dr. Jay Homme:
Well, some of it just, again, comes down to your personality style. I'm the planner. I like to know what's gonna happen when it's gonna happen, how it's gonna happen and then like to see a plan come through. But there's only so many things you can plan. Okay. One of the nice things about most pregnancy is it's gonna take about nine months and then that baby's gonna show up. So we've got some time. So just kind of dial it back a little bit and say, what's important right now. Sometimes it's just getting through that. Oh man, you know, my wife just feels crummy. She's tired. How can I be helpful right now instead of, you know, what kind of car seat do we need and what kind of crib and all that? Those things are fun too. But like what is the thing that's up in front of us right now? And then having a mind of where we're going. So there's some of that just being in the moment and mindful, but also finding things to celebrate, but being real about what the not fun parts of this is.
Dr. Angela Mattke:
So Nipunie, do you feel like it's been hard to kind of stay you know, mindful in the moment of the pregnancy and taking, you know, some of those moments to really just reflect on it or or has that been an easy thing for you?
Dr. Nipunie Rajapakse:
Yeah, I think it's definitely been, been a struggle. Obviously there's a lot going on now in the world and work wise, things have been really busy. And so in some parts of the pregnancy seem to have just flown by so quickly. We're 31 weeks now. And thinking back, I almost like, feel like some weeks, I didn't even realize were going by. So yeah, that has been a bit of a challenge, but we have been trying to be as mindful as we can and try and enjoy some of the moments, especially things like ultrasounds and making sure that we're going to visits together and sharing these experiences together. That has definitely been, been really nice. It's been hard not having family here and not being able to share some of these moments with them as well. We, for example, decided not to do a baby shower because of the pandemic. And so some of those experiences we haven't had a chance to, to enjoy, but we found other ways to, to kind of share the, share the news and celebrate with them as well.
Dr. Angela Mattke:
You know, you mentioned like getting Thomas involved and coming to visits and coming to the ultrasound and stuff. Jay, you have obviously been in an incredibly involved father and parent and husband throughout your journeys. What are some other ways that partners can stay involved and feel like, you know, they're part of this journey. I know that, you know, their body isn't physically changing and they're not growing the baby, but they're definitely a really important part of it. And and I think most partners wanna have that role.
Dr. Jay Homme:
Yeah. I think one of the ways to think about it is how can we be helpful? How can we be supportive with the goal of continuing to stay together, walking together rather than feeling like we're kind of starting to separate in paths? Like you're doing your thing and I'm doing my thing. You know, I appreciate you saying I'm an engaged father. I hope so, but I have missed lots of parts of my wife's pregnancies, lots of parts of my kids' lives because of work and other responsibilities. But thankfully, you know, some of my kids have told me that dad might not be around a lot, but he still seems engaged just like he knows what's going on and we can count on him. If you have that option, you have that opportunity, that person to, to be walking this journey with somebody else, just find ways to stay engaged with each other. And it's very individualized for partner relationships. You know, one thing that my wife might appreciate, somebody else might say, I don't want that or need that. She told me things like you never went and bought me ice cream when I was craving ice cream. Like, well, you craved ice cream when you weren't pregnant. And you know, like, I guess I didn't recognize the difference. So communication is real important too. Yeah. Like just things like what, how, what, how can I be serving you right now? You know, and also recognizing that there's a loss through this as well. Some of the things when you're used to a partner that maybe wants to be active and going do things is not feeling well and just wants to sit on the couch and that's what they need. And you're like, well, what about me? It's hard not to turn focus and say, what about me? Communication can be really helpful in that case.
Dr. Angela Mattke:
Are you thinking about getting pregnant or maybe you're a current mom to be,? Or you're like myself and you're in the midst of raising kids and you're looking for practical evidence-based advice from Mayo Clinic experts? Mayo Clinic Press has got you covered. We have a series of four books starting from Fertility and Conception to Guide to a Healthy Pregnancy, Guide to Your Baby's First Years. And the last book in this series, the one I was the medical editor of, Guide to Raising a Healthy Child. You can find these amazing books from Mayo Clinic Press, wherever books are sold or on the Mayo Clinic Press website.
Dr. Angela Mattke:
I remember you talking to me in residency because I've always been like a fitness exerciser and that kind of went away. And I remember you being like, you gotta do that. You have to take the time for yourself so that you're taking care of yourself physically and emotionally, but like that's really hard to do. So like, do you have any advice for Nipunie of just, how do you take those 10 minutes to do whatever that self care is for yourself?
Dr. Jay Homme:
I think some of it just think about, what's motivating you to do it. There are things that you enjoy, things that you want, but oftentimes we let a feeling of guilt. Like if I'm doing this for myself, then I'm not doing this for my child or for my partner. But then think about if you go long enough, not doing those things, how do you feel and how, how available are you to your child or how available are you to your partner? We all get a pretty good sense when someone we care about is not feeling happy and not feeling well. And that's not the time you wanna go up and say, Hey, let's why don't, let's focus on me here? You know? It's just a more natural exchange when our tank is more full. We have more that we can give away. Now we all have to be clear, like there are times where you, there is sacrifice. There is like, maybe I don't get to go for the hour long bike ride. Maybe it's gonna be 20 minutes, but it needs to be 20 minutes and not never.
Dr. Angela Mattke:
So Nipunie, I know you've been so busy during the pandemic you know, with our hospital census being really high. Your hospital service, taking care of really sick kids has been super intense. Where have you found the moments to still do some self care for yourself?
Dr. Nipunie Rajapakse:
Yeah, it's definitely something that we've had to be quite intentional about because with how busy work has been, there's definitely no shortage of work. And I could probably work for all of my waking hours at this point. And so I've tried to be intentional, especially around the time when I get home from work to try and enjoy that time with Thomas to try and make a meal together and sit down and, and eat together and at least catch up on what's gone on during the day. And then any opportunities that we've had on weekends off to try and get outside, especially enjoy some from fresh air and some nature and work in as much exercise as, as we can. That's been a bit of a struggle as I've gotten further and further into the pregnancy, but trying to stay active as well. And so those are, so some of the things we've we've been doing and also trying to enjoy some things that I know will be harder with a newborn and baby, like enjoying a meal out once in a while so that we, we can have some nice uninterrupted time. Cause I know things like that will be a little bit harder to come by once the baby's here.
Dr. Angela Mattke:
Well, I wanna move on to our last topic. Probably from the moment that you found out you were pregnant, you started to envision what your baby's life would be like. And you started to have hopes and dreams for their future and maybe some worries and fears as well because that's normal, that's part of being human. I wanna hear kind of your thoughts on this and I wanna hear Jay's thoughts on this as well. Because sometimes those hopes and dreams are, you know, they don't end up being necessarily what we thought they were gonna be and they change over time.
Dr. Nipunie Rajapakse:
Yeah. That's a great question. And so obviously, yeah, as soon as we found out, you kind of start thinking about this entire life that's ahead of your child coming up and there's very little, you know, in those initial days, aside from those two lines on the pregnancy test. And so I think initially my focus was very much more kind of short term concerns or worries about is the baby going to be healthy? I know I'm older going into this. I know there's kind of higher risk associated. What does this mean? Kind of in the, the short term, but as we've gone through and now had some of the testing and the ultrasounds and things seem to be going well, your mind definitely shifts to kind of more long term things. What is she gonna be like? How is she, I think Thomas and I have pretty different personalities. So kind of mix of the two of us? Is she going to end up being like and I think we, as all parents just kind of want, want the best and wanna do everything right. And to try and set her up for a healthy and successful life. And so there's so many unknowns. I think being in pediatrics, we also see some of the, the complications and difficulties that children and families can have. And so those certainly weigh on you as well, and thinking about kind of all the, all the great things, but also some of the, the complications that can arise has been, been a bit of a challenge in trying to stay positive, but also be realistic about the different pathways things could go down has been kind of where my thoughts have been been at so far.
Dr. Jay Homme:
I think that's really a great approach and it's just natural to really have sort of all these goals or dreams or visions, but it's just being kind of willing to deal with what is the reality. You know, that baby is born and hopefully handed directly to you. Some people have different situations where there might be a medical issue, medical complication, maybe the baby needs to spend some time in the neonatal intensive care unit. Just remembering what that baby needs most is you, they need you. And however that comes and however it turns out that is one of the best predictors of children doing well long term is that they just have, have caregivers that love them and meet their needs. Their needs. Wants are a whole different thing and as they go through different stages of life, but what do they really need? And at first it's really simple. They need you, they need you to care for them. They need you to feed them. They need you to change them. And then it'll get a little more complicated in time. You'll be driving them to this and that. And then you'll be, they'll be driving them here and there, but just take each stage as it comes. As we all have had the privilege of working with so many families with children with various healthcare needs, and I'm always so heartened to see what parents are willing to do and what they will do for their children, no matter what the situation is. And we just all get to be part of that.
Dr. Angela Mattke:
Well, thank you both so much for joining us today and our introductory episode of our podcast pregnancy series. We hope that everyone will join us for our next podcast as we go into a little bit more of the medical stuff. Your early pregnancy. We'll start talking about genetic testing. Should you get it? When should you get it? And what does it mean? We'll go on to talk about kind of, how do you take care of yourself in pregnancy and what are some potential complications that could happen and some testing that you might be needing during your pregnancy. Thanks everyone for joining today. Make sure you don't miss any of our upcoming episodes by subscribing and following along on either Apple Podcasts or Spotify. If you enjoyed this episode and you want other moms out there to hear this valuable information, make sure that you leave a review wherever you listen. Thanks for joining us. We'll see you next time.