“We all have a struggle. We all have a challenge. You’re not going to get from birth to the grave without dealing with a hardship. And we all share that.” In this episode of the WWN podcast, Dr. Erika Brandenstein talks with Kate about creating welcoming and supportive local spaces for women of all ages to receive medical care, working with mothers struggling with addiction, and what drew her to become an obstetrician-gynecologist practicing in Wayne County. Enjoy!
Transcript
Erika Brandenstein: I am Dr. Erika Brandenstein, and I’m director of Reid Health’s maternal treatment program for mothers struggling with addiction.
Kate Jetmore: From Civic Spark Media and the Western Wayne News in Wayne County Indiana, I’m Kate Jetmore. As a native of Richmond, Indiana, I’m excited to be sitting down with some of our neighbors, and listening to the stories that define our community. My guest today is Dr. Erika Brandenstein, a patient-focused obstetrician-gynecologist at Reid Health, with many years of dedication to patient education and quality care. Dr. Brandenstein builds rapport with her patients to foster a trusting and effective care environment. She’s passionate about helping women achieve their health goals, including the management of chronic health conditions and substance abuse.
Welcome, Dr. Brandenstein. Thanks so much for joining me on the show today.
Erika Brandenstein: Thank you, happy to be here.
Kate Jetmore: I’d love to start by learning a little more about you, where you’re from, and how you ended up settling in Richmond?
Erika Brandenstein: So I am from South Bend, Indiana, which is about three and a half hours north of where Richmond is. So I have some family in the area, it’s not too far from home. I never wanted to venture too far from home. And this was just where God happened to lead me. I felt like the community and the hospital were a perfect fit for me, and I’ve been here ever since. I came in 2011, right out of training, and I’ve been here ever since.
Kate Jetmore: And do you plan on being here for a while? Does it look like you’ll be here for the foreseeable future?
Erika Brandenstein: Oh, yes, I’m not going anywhere. I will be here until I retire. I have to put two kids through college, so that’s going to be a while from now.
Kate Jetmore: Excellent, excellent. Well, how did you choose to study medicine, or did you choose to study medicine? Would you call it a choice or a calling?
Erika Brandenstein: I would definitely say that it was a calling. I entered college thinking that I was going to be a chiropractor. And then I did a summer program at the Yale New Haven Hospital in Connecticut, where they let students watch surgeries. And so not thinking that I was going to go to medical school at all, I wanted to see the surgery, and I did. And I saw someone’s heart beating in their chest, and I saw someone’s lungs inflating and deflating, and I was immediately sold, immediately sold on becoming a physician at that point.
Kate Jetmore: Wow.
Erika Brandenstein: And then it was in medical school where I developed my passion for women’s health, and decided that I wanted to pursue being an OB/GYN.
Kate Jetmore: And was that a surprise to you that ended up being your specialty, the thing that you were really drawn to?
Erika Brandenstein: Yes, it was a surprise because, initially, it was like the one thing that I said that I would never do. I wanted predictable shift work. I was thinking I was going to do emergency medicine. And then I really just loved the rotation when I did it, and I knew that I wouldn’t be happy doing anything else.
Kate Jetmore: Wow. And has it ended up being what you thought it would be?
Erika Brandenstein: Oh, absolutely. It’s ended up being better than I thought it would be.
Kate Jetmore: That’s amazing. So can you share with us a moment in that rotation when you had your OB/GYN rotation, and your heart was touched by what you were experiencing, or witnessing, in the same way that you saw someone’s heart beating in their chest or their lungs inflating?
Erika Brandenstein: Yeah. Definitely I think, for me, and for most med students, the first time you get to deliver a baby is always extremely memorable. And, also, during medical school, I learned that I loved surgery, so I like operating. And then I also was able to just appreciate that you really get to know your patients. When you have a baby or you have surgery, those are some of the most important, significant moments of your life. And it’s a privilege to me to have the opportunity to be able to share that with people. So I just felt like being an OB/GYN was the perfect balance of medicine, where you continuity of care with your patients, and where you can also take care of them surgically too. And if I’m going to get called in the middle of the night, I would rather be delivering a baby than taking out someone’s appendix. So it just ended up being perfect.
Kate Jetmore: Oh, that’s wonderful, that’s wonderful. You’ve obviously been out of school for a long time now, so I don’t know how in touch you are with what’s happening currently in med school. But whether it’s what you’re aware of now, or what you remember from your medical training, I’m curious, what’s changing in med school training when it comes to respecting and fostering women’s health?
Erika Brandenstein: Well, I would say one thing that’s really changed is there are more women. So, initially, it was very male focused. And I think part of the reason why women women’s voices weren’t as heard before was because it was basically male dominated. The profession was male dominated, and medical research, very much male dominated. And there’s been a really big shift in that. So, now, I think it was just over half of physicians now are females.
Kate Jetmore: Wow.
Erika Brandenstein: And since I’ve been in medical school, a lot more of medical research and medications have been focused on diagnosing and treating women specifically. So that’s one thing that I’ve definitely noticed a change in.
Kate Jetmore: Interesting. Well, I first came into contact with you last year, when you spoke at the opening of the 50 Over 50 photography exhibit at Reid Hospital. And as you know, that project was focused on empowering older women through photography and audio. And I’m just curious why it was important to you to speak at that opening? And what message you were hoping to put across to the people who were there that evening?
Erika Brandenstein: Well, truly, I just think women of all ages are beautiful. We live in a society where aging is viewed as something negative, or where we’re trying to reverse the signs of aging. But, really, I think that there’s something just beautiful and glorious about getting older. More beautiful on the inside as well, just because your life experiences shape who you are as a person, and that continues throughout your lifetime. And so I think every woman needs to be acknowledged. Every woman needs to feel beautiful. Every woman needs to feel significant, even if you’re in your older years, even if you’re retired, even if you stay at home, even if you’re a full-time nana, like my mom is.
Kate Jetmore: Actually, that was going to be one of my questions was, are your comments coming from what you observe in your own mom, or your aunties, or other women in your life? Or is it observing yourself as you age?
Erika Brandenstein: I would say mostly inspired by my own mother. She’s just an incredible, amazing, beautiful woman. She is my main support person, helps me with my children. I always say that she’s like Mary Poppins, just because I feel like she’s Superwoman. She can do anything. She’s like magic. And just seeing her selflessness and her strength has been such a huge inspiration to me. When I see her, all I see is beauty.
Kate Jetmore: Oh, I love hearing that. Well, when it comes to older women in Wayne County in general, that would include your mom and all the other older women in Wayne County, what resources would you like to see be available to those women?
Erika Brandenstein: Well, in general, I would say what I’ve found in the community is a lot of women feel that once they are past childbearing age that their healthcare changes. They don’t need to see the gynecologist anymore. They’re not having babies anymore. And I think, in general, there’s just a lack of education. Sometimes, I’ll run into women in the community, and they’ll ask me what type of doctor I am. And when I say OB/GYN, if they’re postmenopausal, they’ll immediately say, “Oh, well, I’ll never see you.” And I’m like, “No, you need to take steps to maintain your wellness, to maintain good health throughout the course of your life. It doesn’t stop after having babies.”
Also, I think that, oftentimes, what I’ve noticed with women is, we focus so much on our families and on our children, and if you’re married, relationships. And then their health gets put to the side. So, oftentimes, chronic health conditions don’t even get diagnosed or treated until later in life when the kids are in school, or off to college, or where they actually have a time to slow down. And even that transition, I would say, is difficult because, oftentimes, women are dealing with older aging parents that they’re taking care of too. And so it’s easy to get your own health put to the back burner, or to think that maybe you don’t need to see the gynecologist, but the truth is that you do.
Kate Jetmore: Mm-hmm, mm-hmm. And what about resources that already exist in Wayne County, but maybe people aren’t even aware of them. Are there any that you’re aware of that maybe you can share with our listeners?
Erika Brandenstein: Well, definitely, of course, I’m a part of the Reid OB/GYN practice, and we are very diverse in what we’re able to offer women through our practice. If you want to see a nurse practitioner instead of a physician, you can do that. That can be a different experience. If you want to deliver with a nurse midwife instead of a regular OB/GYN, we have two excellent nurse midwives. Oftentimes, people say that they want a very natural, hands-off, unmedicated experience, which you can get with a doctor. But our schedules are much busier, our appointment times are much shorter. We have less time at the bedside than a nurse midwife would. And so if that’s something that you’re looking for, I don’t know if people need to know that that’s something that’s available for them as well. And then, of course, the work that I do with women at the treatment program.
Kate Jetmore: Mm-hmm. Well, I want to talk about the treatment program. Maybe this is the perfect time to make that shift. It’s no secret that the opioid epidemic has hit our county hard. What are you seeing in your practice, when it comes to mothers who are struggling with addiction?
Erika Brandenstein: Well, one thing that I’ve been seeing, and that I’ve been seeing actually for many years, was women coming in to have their babies, a lack of prenatal care, and then leaving their babies in the hospital. One of the reasons why I’m so passionate about our maternal treatment program was, I actually had the opportunity to just sit at the bedside with these women and talk to them. “What’s your story? What is your goal? What do you really want for your life? If you could have what you wanted, what would you want?” And they are the same as any other mom. They want to parent their child. They want to take their baby home. They want to be a successful parent. But addiction was the obstacle standing in the way. So a lot of them even felt hopeless, like, “I have to leave the hospital and use. What other option do I have?”
And that’s part of what we wanted to accomplish with the maternal treatment program, the Nest, which stands for Nurturing, Empowering, Sustaining, and Thriving. And, basically, what it does is, it gives women the resources to enter recovery. It’s not just about prenatal care or taking a medicine. A lot of the women need socioeconomic support. There’s almost always an underlying mental health condition that needs to be addressed. And with Reid partnering with Meridian, we’re able to actually give women the resources that they need, help support for their family, parenting, all the support that they need. And they can actually bring their children with them to the Nest, which offers them a resource of not having to get child care while they’re getting the care that they need. And it also gives them an incentive, encouragement, like, “You’re a mom, this is where you belong, and we’re going to help you stay sober so that you can be a mom.”
Kate Jetmore: So is a community of moms taking shape through this program, the Nest?
Erika Brandenstein: Absolutely, 100%. We’re definitely like a family at the Nest. It feels like family because you get really close to those people. You’re going through something very personal when you’re fighting addiction. And what I’ve found is, my patients, who entered the program years ago and were successful, are now helping to support the newer moms that are coming in, dealing with the same thing. It’s one thing for me to sit down as a physician and treat a patient, but seeing someone that’s actually been in your shoes, I think, is highly effective. And just giving women hope that there’s another option, that they can achieve their goals to be good mothers.
Kate Jetmore: And how are those women helping? Are they there as volunteers?
Erika Brandenstein: They’re there as patients. So, basically, we take women in during the pregnancy. Sometimes, they join immediately after the pregnancy, but they can continue being patients at the Nest after that. So I see patients during the pregnancy and for the first six weeks after pregnancy, and then they get ongoing medical care and treatment for as long as they want to stay with us.
Kate Jetmore: Wow.
Erika Brandenstein: So they’re coming in, and they’re still getting counseling. Sometimes, they’re still getting medication, they’re still attending group. And then their presence there enriches the environment for new moms coming in that need that.
Kate Jetmore: Yeah. And what about the children who are born to mothers who are struggling with addiction? Are those babies born addicted?
Erika Brandenstein: Oftentimes, yes, they can have some symptoms. It actually depends on the drug that the mother was using. But just in general, babies can have withdrawal symptoms. And usually that just looks like agitation, poor feeding. And there are ways, but we’ve also learned ways, things that we can do to help mothers to take care of babies who are withdrawing too, like encouraging lack of separation between mom and baby, putting the baby skin to skin, breastfeeding. All of those things can actually help women deal with their babies’ withdrawal symptoms, and they help babies to make that transition.
Kate Jetmore: What about those of us who aren’t there? Those of us who aren’t on staff at Reid, participating in this program, but we are people who live in Wayne County who care about the women and the children that you’re describing. How can we better support our neighbors, especially, as I say, these women and children who are in the throes of addiction?
Erika Brandenstein: I think the one of the biggest obstacles to women actually getting help and treatment, besides just having hope that they could do it, is just judgment. So a lot of people will look at a woman who’s using drugs during pregnancy and judge her very harshly. “How can you do that to your baby?” I’ve honestly had patients that didn’t want to in to doctor appointments, and didn’t want to come to the hospital to deliver, because they were afraid they’re going to be judged harshly. And they’re dealing with addiction, they’re dealing with an illness, and a lot of people don’t see it that way. So a lot of negative judgment goes towards these women, and I think it’s an obstacle to them getting help.
I think just knowing that if you know someone that’s struggling with addiction, that they’re a mom, just like anybody else. See them as a mom, and somebody that needs help,, just like we all need help. And oftentimes, I’ll tell my patients, “Nobody gets through life unscathed. We all have a struggle. We all have a challenge. You’re not going to get from birth to the grave without dealing with a hardship. And we all share that.” And I think that just realizing that these women aren’t that different from anyone else, and not putting those judgments on them, and then just educating people on the fact that the Nest is available, is really helpful. Our police department; and Meridian through social services; and DCS, the Department of Child Protective Services, all refer patients to us. They do. Sometimes, it comes through our office. Sometimes, it comes through them just coming in and having a baby. And I think that just them knowing that somebody’s on their side, and that they’re not being harshly judged, is very helpful.
Kate Jetmore: Mm-hmm. Dr. Brandenstein, I see from your bio that you describe yourself as being dedicated to comprehensive well-woman care from the teenage years through the menopausal years. Talk a bit about the difference between caring for a healthy female body and care that’s required because of illness?
Erika Brandenstein: Okay. So a lot of what an OB/GYN does is called preventative health. So when you come in for, we call it a well-woman exam, you generally will get a head-to-toe physical exam. And we’ll address all the things that you need to do to keep yourself healthy, in addition to getting tests to make sure that you’re healthy. So I examine, I do a thyroid exam, I do a breast exam, I do a pelvic exam. We get Pap smears, which is a screening test for cervical cancer. We order mammograms in women who are age 40 or above. We recommend colonoscopies in women who are 45 or above. When women get 65 or above, we want to get X-rays to make sure your bone density is normal, that way you don’t fall and break a hip later in life. And so it’s mostly health. So well-women care is about prevention mostly, and also early diagnosis and treatment of an illness.
But we also deal with all, I would say, usually the majority of what I do is actually dealing with illness that’s affecting women. One thing that I commonly deal with is chronic pelvic pain. And I think for a lot of years the mentality was, “Oh, you have painful periods.” Or, “Oh, you have pelvic pain, you’re a woman, that’s your life, deal with it.” And that’s not actually the case. A lot of times, there are illnesses associated with chronic pelvic pain that can be diagnosed and treated, like endometriosis, super common. Even today, I’ve seen multiple patients that were dealing with that. There are medications, there are treatments, there are therapies that can be done to help women so that they don’t just have to suck it up and suffer. And then I treat other chronic health conditions as well.
One thing to think about is menopause. So a lot of people just say menopause is natural, and it’s something that you just go through, and that is that. But the truth of the matter is different women experience menopause differently. And some women really struggle with the hot flashes, and night sweats, and skin and hair changes, and insomnia that can go with that. And that’s not normal. That’s not something that you should just deal with. That’s not normal to have to suffer like that. And so just treating women in the perimenopause and menopausal years, I think is really important too. Just recognizing that what we experience as women isn’t necessarily all normal. And that if we’re having a problem or an issue, it is something that you want to address with your doctor.
Kate Jetmore: Mm-hmm. We need to start wrapping up, but I’d love to hear you talk for just a moment about why female health is important in the context of society, or maybe on a more local level in the context of Wayne County?
Erika Brandenstein: Okay. Well, I think that there are a lot of benefits to empowering women, and to hearing women voices. I think that, like I said, a lot of times, women, we’re taking care of families, taking care of kids. There are a lot of working women, taking care of aging patients. And I do see a lot of women put their health to the back burner, and that aren’t proactive about preventative health or about addressing health concerns. And I just think that women of all ages should be empowered to take care of themselves so that they can be happy, live their best lives, and then be able to go on and take care of everyone else.
Kate Jetmore: Right, the oxygen mask, right?
Erika Brandenstein: Mm-hmm, yes, exactly.
Kate Jetmore: Put the oxygen mask on first, and then you can help those around you.
Erika Brandenstein: Yes.
Kate Jetmore: Well, Dr. Brandenstein, I want to thank you so much for joining me on this show today. It’s really been a pleasure getting to know more about you and about your work. And I want to wish you and your family all the best.
Erika Brandenstein: Thank you. I enjoyed being on your show.