The Human Delivery System: An Interview with Beverly Hills OB/GYN Suzanne Gilberg-Lenz, MD

Dr. Suzanne Gilberg-Lenz is involved in women's empowerment and public education, and appears frequently as an expert in women's and integrative health on TV, online and in print. Dr. Suzanne completed her undergraduate education at Wesleyan University and post-baccalaureate pre-medical studies at Mills College. She earned her medical degree in 1996 from the University Of Southern California School Of Medicine, completed her residency in obstetrics and gynecology at Cedars Sinai Medical Center and has been in private practice of obstetrics and gynecology in Beverly Hills, CA since 2000. After many years of a personal yoga and meditation practice, she completed her Clinical Ayurvedic Specialist degree at California College of Ayurveda in 2010 and was board certified in Integrative and Holistic medicine in 2008.

What surprises you most about the work that you do?

Dr. Suzanne: EVERYTHING! I am constantly humbled, reminded of my own requirements for patience. That is a practice- One never gets it perfectly right, and that love really does heal, because it makes us more compassionate and unconditional, less judgmental and more open to a variety of tools. It doesn't mean we eschew evidence or science, but rather we wrap it in a human delivery system. I am also frequently surprised at how powerful my advice and words are. Everything counts and we never know what is affecting other people, so we must be mindful of what we put out there.

You are an OBGYN in a high profile community and practice in Los Angeles; does that present unique challenges for you?

Dr. Suzanne: It actually provides unique opportunities. My patients are highly educated and discerning and not as homogeneous class-wise as people imagine "Beverly Hills" attracts. People who come to our practice are sophisticated and empowered enough to expect the best care possible. They seek and welcome partnership and dialogue but also accept that I have expertise that they do not. They are experts about their own experience of their bodies; I have nearly 20 years of medical experience and training. That is the perfect combination for enlightened high quality healthcare. Before I was completely "out" about my interests, training and participation in integrative and holistic medicine and mind-body practices, I was very concerned about being judged negatively by my community--more my peers and colleagues, not my patients. But that was merely part of my process of learning to own my skills, talents and journey.

What is your top advice to pregnant women approaching birth?

Dr. Suzanne: Know what you know and what you don't know. Seek advice and counsel of trusted, knowledgeable sources. Don't use or respond to fear as the basis for educating. Trust your gut instincts but be open to hearing things and information that maybe don't fit into your fantasy of best case scenario. Trust yourself and your team. Get more than one opinion if necessary. Don't assume conventional medical providers and institutions are not in support of your journey or not open to your wishes. How do you integrate screening for mental health into your practice? Dr. Suzanne: I try to ask explicit questions about personal and family history of mood disorders, abuse and substance abuse. At this point, I am very lucky to have a practice where the majority of my pregnant patients are not new to me. In other words, I have known many of them for a while prior to their conceiving -- that helps a lot. I also use my instincts and when I encounter anxiety about body changes, the birth and control in general, I see these as red flags to open a dialogue. Anyone whom I suspect may be at risk for a postpartum mood disorder are seen by me at 2-3 weeks postpartum and not the standard 6 weeks.

What are the difficulties you experience in screening in pregnancy and postpartum?

Dr. Suzanne: Some people resist discussing matters that they themselves haven't already recognized or addressed and I am not a trained psychotherapist, but people are mostly open to the discussion and appreciate that I am interested and have a ready arsenal or referrals who are experienced and trained. Honestly, time is the biggest constraint -- but I'm a bit notorious for running late and this is one of the reasons why: I strive to be present for every patient encounter- some require more time and attention than others.

What do you think the difficulties for women are in communicating mental health needs to practitioners?

Dr. Suzanne: Shame, guilt, and fear, confusion lack of support or understanding that help is available. If we don't ask, we may not ever know -- most patients won't reveal unless asked directly. Some patients' family members don't get it and that can be a barrier. The Supermom Syndrome and unrealistic expectations of doing it all themselves can also be barriers.

If a woman does not feel her mental health concerns, or symptoms were addressed by her OBGYN, what should she do?

Dr. Suzanne: There are so many great resources online today-- Postpartum Support International, the social media platforms, etc. I'd go there and get local resources -- maybe anonymity helps some people to approach the topic too.

Do you see a lot of postpartum depression or anxiety in your practice?

Dr. Suzanne: Of course I don't document stats but I'd say it runs at about 10-15% -- that is a wild guess BTW! What is really interesting is that I have a number of patients who had a postpartum mood disorder in first pregnancy and we anticipated the second time with a plan and prevented a recurrence -- that is really satisfying to me and also indicates that if we can recognize the risk, we can mitigate the occurrence -- just like any other medical issue. If someone has an elevated GLUCOLA challenge (standard gestational diabetes screening tool), the GET Diagnostic testing and then dietary counseling to prevent the untoward effects of untreated carbohydrate intolerance and insulin resistance. We wouldn't think of ignoring that!

What would your top advice be for a woman who thinks she may be experiencing postpartum depression or anxiety?

Dr. Suzanne: Don't be afraid to say it out loud to someone who can help -- ask for help -- if you don't get it at first ask again -- talk to your provider, your partner, your friends -- treatment is available and it works. Parenthood requires humility and surrender, not the façade of perfection.

Thank you, Dr. Suzanne for sharing your advice with Giving Birth With Confidence!

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Website: www.thedrsuzanne.com

Twitter: @askdrsuzanne

Facebook: https://www.facebook.com/pages/Dr-Suzanne-Gilberg-lenz/

A special thanks to article transcriber, Miles Moon Karraa.