Ep.21/ Disparities of Fibroids and The Effects On Fertility Outcomes of BIPOC Women with Candace Robertson-James
Ep.21/ Disparities of Fibroids and The Effects On Fertility Outcomes of BIPOC Women with Candace Robertson-James
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Note: This transcription has been created with a help of an AI thus errors and mistranscriptions may be present.
[00:00:00] Hello? Maternal Health 911? What's your emergency?
Dr. Jill Baker: Hi, I'm Dr. Joe Baker. I'm a wife, a mother, a community health scholar, an executive director, and a fertility coach. More than 12 years ago, I was on my own infertility journey. Since then I've made it my personal mission to help anyone who is on their own journey. to become a parent as well as shed light on infertility and maternal health experiences of BIPOC women and couples.
Now let's begin this week's episode of Maternal Health 9 1 1.
Greetings Maternal Health 9 1 1 family. It is your illustrious [00:01:00] host, Dr. Jo Baker, who is super excited to be with you all today. On this show, we are going to talk about fibroids.
I want to talk to you all a little bit about a couple of stats before we get into the show and my discussion with my very special guests. So for those of you who don't know fibroids are muscular tumors that grow in the wall of the uterus or the womb. They often appear during the years that women are usually trying to get pregnant and give birth.
And fibroids disproportionately affect black women. So on today's show, I'm going to talk to my long time, very special friend, Dr. Candace Robertson James about her experience with having fibroids and the steps that her and her husband had to [00:02:00] take in order to get pregnant. Candace and I, for those of you who don't know, go way, way back gosh, what, I think over 20 years, longer than that, but definitely at least, close to 20 years Candace?
Yeah, close to 20 years. We called ourselves, we were in the first cohort of our doctor of public health program at Drexel. And so we called ourselves the guinea pigs. So our cohort, that's what we call ourselves. And we still call ourselves that, although we've all graduated and now are doing these amazing and big things.
And we were still the little guinea pigs. And even what's even crazier is that I'm also very dear friends with her husband Dr. George James, and we've all known each other. Oh my gosh, before we all had kids. So that should give you some perspective and what our lives were like. We had a life before [00:03:00] these kids came.
And then, we got our education and had these amazing careers and partners and we all are very big with our families. And I remember when you all were on our last, my last show we talked a little bit, I remember, Candace, in the beginning about you having fibroids and I was like wait a minute, I said, you never told me that.
And I said, okay, I'm gonna remember that. And that was like two years ago. And I said to her, I need for you, we have to talk about it together. And she promised that we would. And so we are here today and we're going to walk through this journey with her today. But before we get into that, I want to share her bio.
And so everyone knows all the amazing things that you do and all the multiple hats that you wear. So for my audience Dr. Candace James Robertson, her ultimate [00:04:00] goal is to serve passionately. Promote endearing change and to leave a lasting impression that will inspire action. She is the founder of the Rouch Lab, a faith inspired space that aims to engage, empower, and equip individuals and families to recreate and re imagine themselves as they pursue purpose.
She and her, very free time, authored a children's book in 2019 entitled Reflections of Me to promote a positive self concept in girls of color based on her research with Black women. And as part of the ROUCH Lab, she launched the ROM Mom Squad, a virtual discussion group for moms of color in 2021.
And this group aims to provide a safe space for moms to share experiences, [00:05:00] receive support, and gain encouragement. Dr. Robertson James held her first Mother Dora event in May of 2023, which aimed to promote intergenerational approaches to health and wellness. Dr. Robertson James is an assistant professor, the director of the bachelor and master of public health programs and the chair of the department of urban public health and nutrition at LaSalle University.
She has taught numerous Public health courses led and evaluated community participatory research initiatives involving multiple sectors, such as health community school and faith and promoting health in diverse and underserved communities for over 12 years. She received her bachelor of science in biology from Villanova university, her master of public health from MCP Hahnemann university.
And her doctor of public health from Drexel university school of [00:06:00] public health. So without further ado Dr. Candace Robertson, James, welcome to maternal health nine one one. And I, I was reading your bio the other day and I was like, okay, I didn't know that you were the chair. Now you didn't tell me that.
Okay,
Candace Robertson-James: you have more time. Yeah, really exactly. Who needs to sleep these days, really?
Dr. Jill Baker: And mother of two. Okay. So one of the things that I wanted to ask you before we get into this specific journey of yours, your fibroids journey, from all the different hats that you wear and from also your own kind of.
Personal experience, why do you think that BIPOC women and couples are, suffering from infertility, more than their, their white counterpart? [00:07:00]
Candace Robertson-James: Yeah I think there's so many reasons, but a lot of it, I think, does have to do with our experiences of inequality and racism and discrimination.
Lifetimes and generationally. And so I think all of those things compound for preconception health to influence how we're able to enter into a pregnancy journey things like fibroids and other things that we might assist in all kinds of things that really impact us and ability to carry and to continue.
So I think a lot of it does, Let's go back to and how we've embodied our history as a people.
Dr. Jill Baker: No, I love that answer. That's a real and a very authentic answer. So when you go back to that time in your life, when you found out you had fibroids, [00:08:00] how did you find out? So walk us through like where you were and how old you were.
Yeah. And how did you find this out?
Candace Robertson-James: Yeah. So I had just gotten married. I think actually I was before getting married. I went to the gynecologist and she said, Oh, you have a few five breaks. So I said, okay, no big deal in my mind. Something that I knew my aunt, my grandmother, it wasn't like, Oh, wow.
So I'm like, okay, I'm not like overly surprised. Most of the women in my family, I just remember growing up talking about fibroids and at that point I didn't really think too much about it because they just talked about it like just, having fibroids and okay. So there
Dr. Jill Baker: was you, so there was a family history you were aware of.
Candace Robertson-James: Definitely was aware of, had heard of them before. And so she said, okay, you have them. And then fast forward a little bit.[00:09:00]
And then I go to the gynecologist. I guess she does everything. I think I go to get an ultrasound of the fibroids, and at that point, she calls me. And when a writer calls you, it's never good news. Yeah, they don't just call
Dr. Jill Baker: you. They
Candace Robertson-James: don't just pick up the phone and call. Exactly.
Exactly. I just want to say congratulations. No, not at all. At that point, as soon as I saw the number come up on my phone of course, my heart sinks, because I'm like what's wrong? Something is wrong. And so she tells me that my fibroids have doubled in size in, of course, a very short period.
So Now she's concerned and she's okay, stop the birth control. Stop like saying I need you to come in and, we need to see what's going on because now they're so large that we need to like, take them out.
Dr. Jill Baker: So they [00:10:00] doubled in size and then they were just larger.
Candace Robertson-James: Significantly larger. And so they went from this like benign, not problematic thing to Oh no, you have to have these removed. You can't. And so at that point, I remember, again, we had just gotten married and we had this, we were going to wait a few years thing going on.
And so we're like, Oh, wait for three years to get pregnant. So right. I go in and she's it's going to be like a major three eight weeks. It's like the traditional kind of thing. And remove the fibroids. And so I'm like, I'm out for eight weeks. Is there, there's nothing else that can be done.
And so she's nothing else that I like, that's what. And so I just remember like [00:11:00] feeling so overwhelmed. Oh my gosh. What is what I don't want to have this massive surgery here. I am thinking I'm a healthy. I don't, I've never had any health complications. So I'm like, how did I go from healthy person to all of a sudden I need like this major, yeah.
So I remember just being confused and on some level, my provider was, I was a black woman. So I was like just trusting her. And I was like I felt like I didn't have, I'm like, okay, I trust her. She. She's a black woman. This is good, but I still something in me was like, I don't want to have this.
I need to address other options. And so I remember,
Dr. Jill Baker: so let me ask you with this particular OB that was a black, did you, was this your regular OB? So did you have a long term relationship with this
Candace Robertson-James: doctor? Yes. So this was regular. Yes. So I definitely went to her. So that's why I felt even more [00:12:00] compelled at first.
I just take what she was saying and say okay, and I have to have this major surgery, then I should just go and have this major surgery. But I just kept on feeling uncomfortable with that. So when I went to speak with someone, I, I had, I was working at that point and drug school, college of medicine.
So I had a lot of positions too. I was connected to and we were in the
Dr. Jill Baker: same building.
Candace Robertson-James: Yeah, everything. So I talked to my supervisor, my boss at that time, you always want to get a second opinion, like not saying that is wrong or she's wrong or anything, but you need to get a second opinion and One, actually her niece, and one of the clinicians who was in her residency, who I actually was connected to, she was going, it's I think she was just either finishing or going to OB GYN, and so I said, let me just reach out to her, get her thoughts, and she just confirmed, and she helped me, and she's no, you get at least two second opinions, at least two.
She's your insurance [00:13:00] usually will pay for the consultation, just look. Okay. She gave me the 411 call these people, say this. It will it will happen. And so I said, Oh, okay. And so she gave me the names of two clinicians. One in particular, she's this person is awesome. Like I, I did a rotation with them.
Like I just saw how he handled this patient and you want someone in these things thousands of times he uses robotics, he can be less invasive. So I went to see both of them. The one was cool, but then the other one that she would just highly recommend it. I just. The door, like he was amazing. So yeah, so you were like,
Dr. Jill Baker: this is the one that I will see to get the second opinion from.
Okay, so before we move on to the next thing. So one of the things is that we know that not all women with fibroids have symptoms. So did you have any symptoms, anything at
Candace Robertson-James: all? Any, I will [00:14:00] say for how I would say traditionally, no, I really didn't have symptoms and especially for how large mine were.
I didn't have any of the like excessive bleeding, anything like that. I think the only thing I did feel was a little bit of pressure and, pressure a little bit. But I was like but that was, it was very mild, very I wouldn't probably have even paid any attention of sorts, very subtle nothing like I didn't have a lot of the pain excessive bleeding or things of that nature.
Wow. Wow. With that, but definitely Oh, as time progressed, could definitely feel like the pressure, more like pressure if I can explain it. Okay.
Dr. Jill Baker: So just pressure, no excessive bleeding, no other kind of pain. No,
Candace Robertson-James: nothing. No, not really. Not really.
Dr. Jill Baker: Wow. Wow. And yet still the, and then they doubled really quickly.[00:15:00]
Yeah.
Candace Robertson-James: In time. Quickly. In time, which made them go from just Oh, we'll just watch them. You don't bother them. They don't bother you. It's time to bother them. You can't. You can't.
Dr. Jill Baker: Okay. So another question that I wanted to ask you, so we know how, a bit of how you were feeling at this time.
So you and George had just gotten married. So what was this communication like between the two of you? How was he feeling? Yeah, what was going on for your, your marriage with this, you finding out you have these fibroids that now have to be
Candace Robertson-James: removed. Yeah, definitely, changed our conversations to this whole like, Oh, we're just going to hang out and wait for a few years and then try to get pregnant to I was really, have real conversations of what are all the potential outcomes of these surgeries?
What does this mean? If I can't get pregnant, [00:16:00] what does this mean for our, what's going to be our timeframe? Do we need to accelerate that timeframe? We can now have a whole host of conversations and be on the same page. And, again, I have been just super blessed that he was super supportive and what do we need to do?
Whatever we need to do this is what we're going to do. And we'll just figure it out and, we might have to let go of some of our initial plans as far as our time frame, but, Yes. We're going to be in this together to figure it out. Yeah, so
Dr. Jill Baker: George was supportive and You all were able to come to a place of, okay, if we need to have some more flexibility about what our family planning is going to be, then that's what kind of, yeah, we will do.
So the next thing I wanted to ask you, so after you got that, second opinion, what, so what were then [00:17:00] the options, the final options that were presented to you at that point?
Candace Robertson-James: Of course we had to go through a whole series of testing, and so the second clinician, the clinician I decided to go with said that he could remove them properly with the robot, through the robotics.
Whoa. It should be a much less invasive surgery I still need to wait. Of course, until our body was killed before I'm trying to conceive but that. I was gonna the physical impact of the surgery, I would not be out eight weeks. I would be out a couple days. aNd
Dr. Jill Baker: Eight weeks, two days.
Yeah. That's a big difference.
Candace Robertson-James: Tremendous, tremendous. So I was like, okay, let's, let's move forward. Let's do it.
Dr. Jill Baker: So then you decide to [00:18:00] get this laparoscopic surgery,
Candace Robertson-James: then I decided to get the laparoscopic surgery. And so I had six fibroids. And so from the surgery, initially he was able to get five of them, but there was a six of hiding in the back and he couldn't get it at that point because we could have, but he said that took a little bit longer because the And because I was already like under much longer than they wanted it or thought initially.
Six one was where it was going to be more difficult. But they would, stop at that point. They got the five to get the six. And so a little bit, this part is oddly enough where I started to get like a little bit more overwhelming because in my mind, I'm like, okay, I'm going to have this.
I'll heal for this time, and then we can start to conceive, but now, or try to conceive, but now, it was, at least five removes, I was going to have to wait till my body healed, and then have another [00:19:00] surgery, and then wait till my body healed, and then.
And so that was yeah, that definitely was like, okay, now I have to, wait again for this now, six months to be removed and I just remember going back and forth for the checkups and being like, okay. How am I held down? He's no, sorry, you can't, you can't it's not safe.
It's not safe. It's not safe. And he was really cool. I just really appreciate him from day one saying it's not safe for you to try to get pregnant with these in you. And then throughout the process, he's no, your body has to heal. Your body has to heal. It's not safe. So just like that patience.
But it was, I remember it was hard. I would, every appointment, I was like, Today's gonna be the day he's gonna say, you're ready. He'd be like, No, you're not ready yet. No, not today. Not today. Not today at all. And I was like, okay, Today's gonna be the day. Nope, not today. And I remember when he [00:20:00] finally said the day okay, you look, everything's ready.
And I was like, I've been waiting for this day. Kind
Dr. Jill Baker: of us
Candace Robertson-James: graduating from school. Yes, exactly. Exactly.
Dr. Jill Baker: It's the same. It's the same feeling, but it's the. I don't know. I always feel like there's a lot of kind of similarities. Although, people's infertility, fertility experiences are different especially for women of color.
But I always feel like I know that there are these kind of moments of like highs and lows, like you're literally on a roller coaster. Did you feel like that? Is that how you felt with this process?
Candace Robertson-James: Absolutely. I'm going to go from the high of, we're going to do all this stuff. You have your own, idea on your mind, how to get, any issues.
And then you're like, when you're a
Dr. Jill Baker: Public
Candace Robertson-James: health, this is what we, you do. This is what we do. [00:21:00] I, and then to wait, what, this is like a thing, like this is something could happen. I could, really struggle with infertility. I said, maybe not. But all this could, the surgery could damage something.
I like just all these ifs to your vision that you have in one call, one diagnosis, one setting could just change overnight. So you have the low of all the what ifs of what if, and then of course being just married oh my gosh, what if my husband is not supportive?
He's no, I want two children. I don't know. Like all of the what ifs that you're constantly you know, dealing with and grappling with and then throughout the journey it's such a long, at least at that time it felt like so long of a journey to now be. Then, I'll get the second opinion.
There's a lot of waiting. waIt. There's a lot of waiting.
Dr. Jill Baker: So what, did you have any like coping for yourself or the, during this process and for the waiting part and [00:22:00] the, the, yeah, the emotional rollercoaster that, that it
Candace Robertson-James: is. Yeah, you're right. I think for me, it was definitely just a blessing that my husband was so supportive.
He was just like there every step of the way. He, was there for the surgeries. He was like there, for me to navigate. Everything and just, I think, to stay patient with the process, hey we're gonna get through this no matter what we have to do we're gonna figure it out and also, meeting people along the way who were having
schools to commiserate with and see how this is not just me learning, like you said infertility can be such an invisible struggle sometimes and, you grow up and maybe you haven't heard of anyone. At that point when I was Being told these things. I'm like, I don't, no one ever told me I didn't know, and my own situations and, going through all the what ifs, talking to other friends.
People who are like, [00:23:00] I'm having trouble, I'm having trouble. Alright, this is the issue. Yeah, I call it
Dr. Jill Baker: The infertility me too, although I can't say me, I'm in that context, but I feel you're the one like, Hey, I'm suffering from infertility.
Then you think you're alone. And then you tell someone, they're like, Oh, I went through, I had infertility struggles too.
Candace Robertson-James: It's so all of that was happening, talking, sharing I just, knowing that we're going to be in this together, I think was just right off
Dr. Jill Baker: for sure. Yes.
That partner support is key. And as I said, and then finding other people who are going through similar struggles that can be a community for you while you're, going through this very challenging experience. Don't Okay. So one thing I want to ask you again, ask you in, in thinking about this [00:24:00] particular experience, but now even, where we are in this country now and BIPOC women still, and couples still really suffering from infertility the most.
sO what do you think are the main reasons, and this is with, all the hats that you wear where do you think some of the main reasons that Black women are suffering more from infertility and all the disparities that it comes with versus, our white counterparts?
Candace Robertson-James: Yeah, I think it's definitely complicated, and I think honestly, because So many women are suffering from infertility and, seeing experiences, things like fibroids, which can obviously greatly influence infertility and outcomes.
First and foremost, we need to be committed to doing much more research to really understand those differences because I think the differences are well documented, but we have room for [00:25:00] growth and really understanding. Those differences and I think their root is in really our lived experiences and how those lived experiences differ between the two, most important for Black women of color and white women, largely at the population level and so I think when we think about these very difficult experiences, especially generationally, and how our bodies I know there's been a lot of research looking at the stress response and how our body increased rates of certain hormones, how we deal with all the stresses that we really chronic stress and really not just chronic, but toxic levels of stress.
Yes. All those toxic levels of stress over time, and again, even generationally can begin to influence things like fibroids and things like other things that could increase and vulnerability. For not just infertility, but poor health outcomes as well. And so I think that we really have to begin to look at these things.
And I find it as a science geek, [00:26:00] it's so interesting not to stress.
The stress hormones that we Are you
Dr. Jill Baker: still a science ge No, you're not still a s What? No. Oh, no. Yes, you
Candace Robertson-James: can be. Now you're not playing. No, it is, but thinking about We wouldn't do what we do
Dr. Jill Baker: if we weren't
Candace Robertson-James: health geeks. We weren't. We are. And
Dr. Jill Baker: you're absolutely right because it's the re We have to do more research too.
There has to be more research done to, to get another kind of set of answers more and more holistic answers about and population level answers about infertility.
Candace Robertson-James: I think we really do, because I think, we are past the documentation of it. We really need to understand.
What the etiology is, what some of the root causes are, so that we can have assistance and help people really, do that sort of [00:27:00] preventative prevention lens that we so like to focus on, but we don't really have some, we don't really have great answers now really at all. And so I think. The first step is really like understanding how all these things influence our bodies and make us vulnerable to these things, but then even going beyond that research is to say are where we are now undo some of those effects that are carrying.
I think that's where the millions are because generationally like we are easy to like undo and yes we know some of the lifestyle things but I think it's more. I think it's bigger than that. And so I think like how do we really begin.
I think there's right holistic, like you said, I think from a building to our mental health trauma from therapy to the physical things, but also at the population level, like what we need to be able to live more healthily.
Dr. Jill Baker: Especially before, if you can [00:28:00] before you get pregnant.
Candace Robertson-James: Absolutely. I think that's so important.
So important. Thinking about our children and our adolescent health and our child health, like it all ties together. We can't just wait till we're all ready to get pregnant by then. Yeah, we have
Dr. Jill Baker: to, this might be too late sometime.
Candace Robertson-James: Absolutely. Absolutely.
Dr. Jill Baker: So I wanted to get back to, so you got the laparoscopic surgery to remove your fibroid.
So then, did you, so what happened in terms of your timeline with getting pregnant? So then, what was that like?
Candace Robertson-James: Yeah, so I had the first surgery, then waited, had the second surgery, and was on that rollercoaster going back and forth, hoping every visit, and then finally, when he said you could die, I was like oh, okay.[00:29:00]
This is real now. And again, that up and down that rollercoaster of being excited that wow, like I'm finally here. I've been so stressed and impatient and like hopeful and disappointed, for these several months. And now, all the emotions, all of the emotions like that disappointment that I had every single point when he said, Nope, not yet.
And then having to Oh, okay. I'm here. I can try to conceive. And then I'm like what if I don't, again, trying to manage the what ifs, yes. You're almost afraid to try. Cause you're like, okay, at least there was some safety in the fact that someone was telling me not to try and don't do this.
And now like a new set of vulnerabilities to say, oh, okay, now you're ready to try. And they're like, Oh, that's the
Dr. Jill Baker: word is vulnerability. You're right. You're right. It's probably one of the, I would say, yeah, I never even thought about it with that word, but that's [00:30:00] exactly what it is to say. Okay. If this is a no, or if this outcome is, this is not happening and I pick myself up and do this again in order to try to start my
Candace Robertson-James: family.
And so I we tried for a little bit and then I'm pregnant, so I was super excited, of course, super happy. Super nervous. Okay.
Dr. Jill Baker: So how fast? Oh, I want to know.
Candace Robertson-James: Pretty fast. I feel like. Dang! Because I feel like my husband was like, okay. He was gonna, he was looking forward to the trying process. He was like, all right, we are ready to get trying.
And I remember being like, oh, I was trying to try some more.
Dr. Jill Baker: I can see George being very excited about that.
Candace Robertson-James: Yes. He was like, yes. Dr. George James. We get to try. Yeah, Jordan,
Dr. Jill Baker: He's such [00:31:00] a, he wanted the kids thing was a big thing. Big thing for him. Not that it wasn't for you, but it was a big
Candace Robertson-James: thing for him.
Absolutely. Absolutely. Absolutely. It was great. Just like you said, having a partner where you can be on this. I always say that is so important. Because you change that you change the whole story, and I got pregnant but so I got pregnant. I'm excited. I'm elated.
I'm nervous. And then, of course, why wouldn't you be? And then I go ultrasound. They're like, okay, five, whatever it goes to your ultrasound. So then I go to the ultrasound. Yeah. Technician walks out the room. I'll be right back. And so I'm like, oh no, this is, oh no, this is not good.
Come back. What do you mean you'll back? What? And so then somebody, then the doctor comes in and he looking and they're like, okay. So then they explain that there's some like unusual measurements. So you know, they're doing like [00:32:00] increments of, the different things that they do.
And so then they're like, there's an unusual measurement like at the back of the neck or something of that nature. So they're like okay, could be nothing because maybe take different times to develop. So it could be nothing, or it could be down syndrome. It could be like lots of other things.
So we would recommend that you get a counselor. So I was like, what? So
Dr. Jill Baker: you went from the fibroids, all the work to remove your fibroids, waiting to find out if you could physically start having intercourse in order to get pregnant after the fibroids. And now you're told you got pregnant pretty quickly and that there may be something wrong with the baby.
Hello, Maternal Health 911 listeners. If you are enjoying this [00:33:00] episode, and if you happen to be going through infertility, or you know someone who might be and who needs support, I want to announce to all of you That I am offering fertility and infertility coaching services, and I have a very limited amount of spots.
But for those of you who are interested, please visit my website, www. drjoelbaker. com, or you can email me at drjoelbaker at gmail. com. about your interests and we can figure out a time to book a consult call. Would love to hear and help in any way that I can.
Candace Robertson-James: So what
Dr. Jill Baker: is going on for you, your feelings and George?
Candace Robertson-James: Overwhelmed. Yeah. If I said [00:34:00] that I didn't really consider the infertility part or the fibroids being an issue, I'd be bitter there being, problems like after conceiving, so I'm like, Oh my God, and we are in this time pressure because they're like you need to see the genetic counselor because What different tests that we would need to do maybe and your like window for a different test are going to be closing soon.
Oh, make this decision. So I'm like, okay let's go to see the genetic counselor. In my mind, this is where I think expectation management was a little bit off because in my mind, Yeah, I was gonna really be able to help you make this decision. But when I The genetic counselor, that's not actually, what they really do.
And so I remember just leaving their age, just sitting there like in a blur. Like [00:35:00] I, I could not even, I was just like, what are you talking about? So they, they, their husband's there, I'm there. They go through all this, the history first, and then they take you through the measurements and what was the abnormal measurement?
And yeah, family history risk, that you did. And then they just list like a long list of possible abdominal percent risk of this. And it's at the such percent risk. It's very
Dr. Jill Baker: overwhelming. It's very overwhelming.
Candace Robertson-James: Or, and then after 20 minutes of all the possible things, and then at the very last thing it's or it could be nothing.
And I'm part, and I'm like I what, Hey, this did not help me. This did not help me make a decision. Like what? And so I was going to have the amniocentesis. So they were going to take okay, I was
Dr. Jill Baker: going to ask you,
Candace Robertson-James: okay. So I need. like that day. So I remember walking out and being [00:36:00] like, I need to consider like, when you go, it's going to be like that.
So if you're going to go, you need to like, go downstairs immediately. And see, I think they scheduled on the same day or something. I remember like standing in the hallway after walking out the genetic thing. I don't know what just happened and and I'm like, it could cause miscarriage, it could cause this, and I'm like, Yes.
At that point, just completely overwhelmed. I don't know what to do. I don't know what to do. And I don't know. And then if we find out there's something wrong, is that gonna what does that information get us? Do we want to know? Do we not want to know? How does that help us?
How does that not help us? Are we going to do something differently?
Dr. Jill Baker: So a lot of things you have to try to figure out in a very short amount of time, which under normal circumstances, you want to have some time to think about all of these options.
Candace Robertson-James: Absolutely. Absolutely. Literally. I remember we're like, okay, we're both academics, so we pull out a pros and cons [00:37:00] list. So we're like, okay, I don't know. We're going to make a pros and cons list because I don't know how bad the decision
Dr. Jill Baker: is a very research efficient strategy to figure out what decision is going to be
Candace Robertson-James: made. Yeah and that's what we did.
We're like, okay. And now something is wrong. Are we going to, are we going to do something different? Then we had that conversation and we're like, decided that we weren't. So then we're like, what do we want to know? And then we're like, yes, that we did. Because we're like, Hey, if mentally, like how your mental health is going to be rest of these months.
So first, my husband is like, very keen and it's can you handle knowing? If you've already decided you're not going to do anything different can you mentally and emotionally handle that? So that was like we had to have, but why do you want to know if you're not going to do anything different, why do you want it?
And so then we decided our lives are like, we would want to be in a. Getting support to like understanding how our lives were would change and like what [00:38:00] we would need so that way we could I guess be more prepared. So that's where we land. Okay Yeah, this one was very concerning I think he tried to really check me out okay If is this going to be a problem, like we want We need to talk about this and so we went through that whole process.
We had it. Oh goodness Yes. Yes. And you're on pins and needles until they, they call you back. And in the meantime, it's crazy because with insurance, it covers some things, but not other cover. Like some of the, whatever they call the basics, but then they're like, Oh, but it also could be all these other things covered by insurance.
And they're like, this one is like 5, 000. This one is 2, 500. This one. And I was like, okay, yeah, I don't have the resources to like, for you to write everything. Like you said, rollercoaster the whole time, so they test and they're like we can, it's not basic battery of tests that they run.
It's not that, but they're always [00:39:00] cautious to show you, but it could be other things that we didn't taste test for. Again, you're like, Hey, it's not that I'm high on the high. That's great. But the low, like it could still be something else that we did.
Dr. Jill Baker: Exactly.
Candace Robertson-James: I felt like that's what they were saying.
Don't get too happy
Dr. Jill Baker: because. Yeah, those genetic counts that we have to do that with twins that's probably one of the scariest appointments. Yeah. Yeah. And it's overwhelmed. It's just, these are some very important decisions that you have to make about. Being a parent, what do you, what information do you want to know?
Do you want to wait until after the baby comes? It's a
Candace Robertson-James: lot. It's a lot. Yeah. And it's so individual. Like I had, friends who are in a similar position and maybe like it's so individualized, like it's no right or wrong. It's what literally is best for you and you figure that out. And no judgment.
And no judgment. Yeah. And no [00:40:00] judgment. And I appreciate my husband being able to say can you handle this? That was the right thing to ask. And that's why it's a big question, because sometimes we want to know things that we can't really handle. we Don't know, like, why do we really want to know this?
And can we handle knowing this? Yes. And so it's so interesting. So I was on pins and needles, always happy, but I think for the shoe to drop, like waiting for like the bad news to come. And the rest of the journey everything seems to be going okay.
But then I went into labor early, my water broke early. And because of that, I had to have a C section, which I already knew. The multiple robot is much less invasive, but they make multiple. And so because of that, then there is, of course. scar tissue in multiple places where there's potentially with the scar tissue, thinner and thicker tissue.
And so the risk of any one of those incisions throughout the [00:41:00] laboring process, they're like that's bad. Bad. We don't that's not a, that's not a thing. Okay.
Dr. Jill Baker: So the decision was made that you were going to have a a plan, a Schedule C
Candace Robertson-James: section? Schedule C section. But then, so I knew I OB at that point was really great to note, to say so this is the risk, this is why, and this is why you need to have a C section.
I understood that. Okay. It explains it all really well. Okay. So then they also explain so that if something happens where your water breaks, you need to get to the hospital ASAP. Right away. Do not want you laboring again, it's not even, it's the laboring that could rupture one of those incisions.
Yes, bad for both you and baby like that and there are no certain things we want to rupture that turn this into like life or death situations and so if You get to the hospital immediately, so that was programmed in my brain. I love that
Dr. Jill Baker: they were [00:42:00] on the ball.
Candace Robertson-James: Yes. So I appreciate that because yeah, actually what happened, my water broke in the middle of the night.
One night I was like, Oh, and my husband was so hilarious. I have to tell this story because he was so funny, like three o'clock in the morning. So I'm like hey, I'm like, tapping him babe, I think my He's okay, just go get another one. And I was like It's like just go get another one back and I was like And then i'm like babe my what he's like oh, okay.
I'm, sorry He like jumps up, but I joke we always joke to this day. Oh Go get another
Dr. Jill Baker: one in a
Candace Robertson-James: break get another one Yeah, it was hilarious. But yeah, so we, of course, I called the doc and they're like, [00:43:00] come over here immediately. Come right now. Right now. And I knew, we knew the drill. We were prepared.
So we, they prepped me as soon as I got there. That baby was out quickly about, there are three. Morning, like 6 30. Yeah, they did not. What? Actually, not fast. I would have broke at 3 30 because I woke up at 3 30 in the morning. Okay. It was not far from us. It's probably like 10 minutes from us, it's a little just had to get up, get dressed, get my stuff, which already had a bag, get there.
Of course you did. So they did not take any time.
Dr. Jill Baker: Yeah. And so then, so when the baby came, then what
Candace Robertson-James: was the outcome of the baby? You're nervous. Of course. No, she's healthy. She's healthy. And so I was like, okay, this is great. I'm excited. And then it was so funny because they, of course I'm excited. Feeling all the ups and downs of having a [00:44:00] newborn now.
Completely surprising. Oh,
Dr. Jill Baker: is that what we're calling it? Ups and downs of a
Candace Robertson-James: newborn?
Dr. Jill Baker: How about,
Candace Robertson-James: This whole life changing, completely like it's human that I'm responsible for. Now you have a life that, Oh, you have to take care of this life. And you had no idea what sleep deprivation was before. I worked like a newborn. I was sleep deprived. I don't even, I didn't even know what sleep deprivation was.
One of my life when I haven't slept at all for several months. And I did all that. And then I remember getting like a letter or a call or something saying that she had G6PD deficiency. And originally, like, when I first heard that, I was like, No! I knew something was wrong, and then, I wound up like talking to one of the doctors in the psychology. And I was like, Oh! Okay. Okay. And then, but it also, like just the trauma of it all and how [00:45:00] I still was waiting for bad news, I still was like in the back of my mind, like waiting for something, to happen because I was on edge and primed.
So it really just signified and triggered to myself although like on the surface, you're happy and you're like, okay, like it all worked out and they're still like. Waiting for some bad news. And so I think at that moment, it's really trying to deal with my own process, and trying to release all of that, because that kind of experience in the, that instant I need to know, it's okay, I'm still dealing, I'm still carrying this even though she was born, and we're, like, on the other side, it's still with me, and I'm still carrying it.
And how do I, still Even just the process that I went, excuse me, that I went through, even though it was a happy ending. Like, how do I still deal with that journey?
Dr. Jill Baker: No, I know what that feels like because after the twins born, they had, Gavin had to get tested for something like some iron deficiency or something.
And I was [00:46:00] freaked out. It was like, Oh my gosh, please. God, after all of this, please do not let these babies have something. Yeah. Yeah. So he had to get, we had to take him to CHOP, and then he had to get a blood test. I don't remember if both of them had to get, I don't remember, I just remember they had said that Gavin might have it, but then after he got the test, the results came back, they said he didn't have it.
But I was just like, why? Did we not go through enough to ask these
Candace Robertson-James: babies? Absolutely. Please! nO.
Dr. Jill Baker: And now that baby is How old now?
Candace Robertson-James: Oh, just turned 13! She's an official teenager. I don't know what. I can't. I can't. I'm like, I just stare at her everyday. I don't understand how you got here. I know.
Dr. Jill Baker: She has her [00:47:00] own business.
Candace Robertson-James: She sure does. She's like a whole.
Dr. Jill Baker: And she's just a beautiful, just warm daughter. Cause you guys are her parents.
Respectful. So just beautiful. Just so beautiful. Okay. So for, I love that. I never heard that whole story before. We never even in all of this, we never even talked about it.
Candace Robertson-James: But
Dr. Jill Baker: That's, that goes to show you though, that. You can know people for a very long time, but you still may, and especially with sisters, you still may not know what they went through to have their children.
That's so true. And we need to like, share our experiences
Candace Robertson-James: more. [00:48:00] We do, because I think that's one of the things that is that when you're in the experience, you feel like no
one's there. Oh, there we go. Oh yeah, I was just saying, at times, we can know we can feel so isolated and feel like, oh, no one else around us is experiencing these things, like we're all alone. No one else, but the reality is. That we just haven't perhaps shared right? And there, there are people around us and we dunno, we don't have to feel as isolated or we did share more.
So I love that you're right. Like we can know people for a long time and dare I say, there could even be people in our family that we dunno that I know and
Dr. Jill Baker: more [00:49:00] than likely there are people in our family because. Like you said, like we were talking about, if your family member doesn't, at least you knew that there were fibroids, but you didn't, but how it impacts you is still different, right?
But some people don't even know their history from their mom, mother, their grandmother, and oftentimes so many of these health issues and experiences are passed down.
Candace Robertson-James: And I had, I
Dr. Jill Baker: just had a conversation with my aunt who's 74 and she went through years of infertility. And she said, but we didn't have a word for it. And I was like, She was like, nobody called it that, but you knew what it was. Yeah. Oh my goodness. And I was like, but we're not doing that much better.
Candace Robertson-James: Yes, you're right. That's so true. So true. So
Dr. Jill Baker: true. But hopefully, all the, us, talking, sharing our [00:50:00] lived experiences, I think, and sharing with other women. Hopefully, when our girls, and our sons, when they have kids. If they decide, I never told you, I never say have
Candace Robertson-James: kids
Dr. Jill Baker: show a decision if you don't, I understand why no judgment, but if you hopefully maybe for their generation, their experiences might be a little bit different.
Maybe I, that's what I hope,
Candace Robertson-James: I hope. Absolutely. I hope so, too, because it's something that we do talking about more especially because even if people make those choices, they might be making them at different ages. And I think that was the thing that was, although I heard them because a lot of the women, especially again, at that time, my grandmother, certainly she had us when she was young.
And so when she was like early twenties, so it was different, I was 30, it was different. And so You [00:51:00] know, it didn't impact their pregnancies as much because a lot of them had already had their children. They're like, hey, what? You know whatever You
Dr. Jill Baker: can't get pregnant what
Candace Robertson-James: do you mean that wasn't even a question for them because they were like I'm done. Better
Dr. Jill Baker: put some tussin
Candace Robertson-James: on you or something. Yeah, exactly. Exactly, I think those conversations are so important. Especially as our world changes. We, maybe understand the complications.
Even though I knew it wasn't my period, I didn't, I did not connect the dots to pregnancy, because those stories were because, by the time fibroids became an issue for those women, they were already, they had already had them.
Dr. Jill Baker: That's right. That's right. And that's the difference.
That's a great point. So if you could go back in time to Candace at that age, just finding out you have fibroids. And the [00:52:00] whole experience after that with starting your family, you and George, is there anything you would change?
Candace Robertson-James: That's a fantastic question. I think, largely there are not things that I would change.
I think a couple of things, like I think that one of the most stressful experiences was definitely that kinetic counselor. So I think having a certain information or just would have known better what to expect I just, I think, and I just had very high expectations of what I thought was supposed to happen in that encounter and what happened, and it just really stressed me out, and it gave me almost too much information and so now I was really equipped with a million reasons to worry.
Before I had a couple of reasons to worry, and now I was really well educated on a lot of reasons. Great. And I think that I would have a better expectation of what do I really want to get from this conversation and this [00:53:00] interaction? I think that, that would be something that I would change and did change because I had a similar thing happen with my second child.
And they said, do you want to see a genetic counselor? I was like, nope. I don't match. We're going
Dr. Jill Baker: to skip that part.
Candace Robertson-James: We're going to, we're going to skip that. Skip that. Yeah.
Dr. Jill Baker: That's the things you learn after you have won.
Candace Robertson-James: And that's no shade on genetic counselors. It was really mean.
Dr. Jill Baker: Their jobs are very important.
They really are. So we can't take that away, especially when you have a high risk pregnancy. No doubt. No doubt. But it's the timing. Yeah. It's very hard to It's very hard to manage that.
Candace Robertson-James: Yeah, it really is. It really is. Absolutely.
Dr. Jill Baker: So genetic counselors, maybe y'all could be a little warm and fuzzy.
I don't know. Yeah. We [00:54:00] know what we do, how we do it. Just giving y'all a little bit of advice. That's all.
Candace Robertson-James: Okay. It was hard. It was hard. I'm so traumatized. I still can see myself staring at the sky all the time. What just happened? I don't, I feel like I'm a fairly educated person. I understand biology. I know. What did she, is she speaking English? It's almost yeah.
Dr. Jill Baker: When you get a car, and they give you all these options, and you're like, I don't want all these,
Candace Robertson-James: and how much, and it ain't, I don't want, I didn't even know, this is too much information, and I don't want that, I need to terrorize I was like, I don't have to just be concerned about these three things, let me tell you, you could be concerned about,
Dr. Jill Baker: there's 91, 91 things, there are
Candace Robertson-James: 91 things you could be scared of now, thank you.
Dr. Jill Baker: So for anybody that might have to do that, yeah, yes, we were giving you a little bit of warning. [00:55:00] Yeah. Okay. Oh, gosh, I love it. So what would you want people to know about fibroids and especially BIPOC women?
Candace Robertson-James: I want people to know that they could have fibroids, even if they think they're healthy, even if they think they do all the things they are maybe not.
They eat healthy, whatever the situation you feel like, not me I want people to know that you too can have fibroids and may likely have fibroids. And I also want you to know to ask those questions to get checked because, Is because I had just happened to have that initial check where she was measuring some and then had to follow up.
That is where she knew that they had grown so quickly much so quickly. And if I hadn't been having that regular care for her to say, wait, something is awry here. We need to stop the birth control obviously was feeding the and I think [00:56:00] that being knowledgeable about how things like birth control impacts fibroid growth.
Understanding and knowledgeable about all these things I think are so important for asking questions, getting your routine checked, making sure you know what's in your body, and even if you're not, you don't bother them, they don't, please make sure they're still not bothering you, and make sure that you are doing what's best for yourself.
Oh, I love that. I
Dr. Jill Baker: love that answer. Okay, so my last question, and this is the question that I ask all of my guests. Why do you think maternal health is an emergency in this country?
Candace Robertson-James: Oh, goodness. Yes, it is. It is an emergency. Yeah, not
Dr. Jill Baker: needs a question.
Candace Robertson-James: Yes, that is. You asked all the good hard questions. I think that I think that one thing that I [00:57:00] often think about that it's an emergency because we don't think it is, we think we're so arrived.
We think we're on the other side. We think like when we think about health issues in this country, we're going to think about heart disease and diabetes. We're not necessarily thinking about. That we're in a crisis that we're increasing our rates of maternal mortality and not decreasing for one of the most Absolute countries in the world with all the resources all the health care all the things that we have We should not at all have the outcomes the maternal health outcomes that we have and that we're facing And so it is a crisis.
It is emergency like people We need to be sounding the alarm that we are actually increasing in our rates of maternal mortality, and unfortunately, black women are experiencing the brunt of that, and that is hideous and we need to do differently, we need to be taking women seriously when they show up at the ER, when they show up at the doctor, we need to listen, we need to advocate, and we need to do both so that we need to have providers who are better trained to listen and to understand Diversity of symptoms and how people [00:58:00] express symptoms and then we have as we have to prepare communities to advocate for themselves so that if you go to hospital one or provider one and they're not listening to you, you go to hospital two and provider two because there are a million.
Right around and don't just take yes, just don't take like it's nothing. Just don't take that because you know your body more than anybody. And so if you know something's wrong, something probably is wrong. It's an emergency and we need to be sound. Oh,
Dr. Jill Baker: sister. I love that. Y'all heard what Dr.
Robinson James said, she said, ring the alarm. Oh gosh, because I've had a lot of people ask me. Why do I have this show Maternal Health 9 1 1 and not 4 1 1? And I'm like, because it's an emergency. Exactly what you said, Kim, because it's not getting as much attention as it should.
Period.
Candace Robertson-James: I love what you're doing.
Dr. Jill Baker: So [00:59:00] we got to be the ones to change it. We know it's going to be, BIPOC women are going to, Black women of color, we're going to be the ones to change it. In every way possible, every way possible. So thank you, sister, so much for this awesome episode.
Dr. Candace Robertson James, thank you for joining me and sharing such important information about actions that can be taken to reduce infertility and maternal health disparities in this country. Please let our listeners know how they can find you and connect with you on social media.
Candace Robertson-James: Thank you so much for having me today.
It's been a blast. I'm so excited to be here. I'm on Facebook. I'm at reflections of me book one that's reflections plural of me book one and on Instagram. I'm at the RUAC lab. R U A C H L [01:00:00] A V. And I'd love to check it out.
Dr. Jill Baker: And we'll make sure to have your book should we have an Amazon link or something of your book?
So it can be in the description, on the notes, so people can buy it.
We want to make sure people know about the book and can support it. So thank you, sister. Thank you so much.
Thank you for listening to this episode of Maternal Health 9 1 1. Please follow the show on Instagram, Facebook, and Twitter. Feel free to DM me with your questions and thoughts or to share your infertility, fertility, and maternal health story. For more information on this podcast and your host, Visit www.
doctorjoebaker. com listening to the show on Apple podcast. Please rate and review it. It really helps the show and the feedback is welcome.[01:01:00]
IIn this inspiring episode of, our host engages in a heartfelt conversation with the incredible Dr. Candace Robertson-James. Join us as Dr. Robertson-James shares her personal journey, navigating the challenges of living with fibroids and the transformative steps she took to realize her dream of starting a family.
Our special guest opens up about her experiences, shedding light on the impact fibroids had on her life and fertility. Dr. Robertson-James discusses the emotional and physical toll of dealing with fibroids, providing a candid look at the hurdles she faced.
As we delve into the steps she took to overcome these challenges, listeners will gain valuable insights into the resilience of the human spirit. Dr. Robertson-James shares the empowering story of how she navigated the complexities of fertility treatments, highlighting the importance of advocacy, self-care, and perseverance on the path to parenthood.
Join us for an episode filled with hope, resilience, and practical advice for those facing similar challenges. Whether you are on your own fertility journey or seeking to support someone you care about, this conversation with Dr. Candace Robertson-James is sure to inspire and uplift.
Guest Bio:
Dr. Candace Robertson-James’ ultimate goal is to serve passionately, promote endearing change and to leave a lasting impression that will inspire action. She is the founder of the Ruach Lab, a faith inspired space that aims to engage, empower, and equip individuals and families to recreate and reimagine themselves as they pursue purpose. She authored a children’s book in 2019, entitled Reflections of Me, to promote a positive self-concept in girls of color based on her research with Black women. As part of the Ruach Lab, she launched the ROM Mom Squad, a virtual discussion group for moms of color in 2021. The group aims to provide a safe space for moms to share experiences, receive support and gain encouragement. Dr. Robertson-James held her first mother daughter event in May of 2023 which aimed to promote intergenerational approaches to health and wellness.
Candace Robertson-James, DrPH is an assistant professor, director of the Bachelor and Master of Public Health Programs and Chair of the Department of Urban Public Health and Nutrition at LaSalle University. She has taught numerous public health courses, led and evaluated community participatory research initiatives involving multiple sectors (health, community, school, faith, etc.) promoting health in diverse and underserved communities for over 10 years. She received her Bachelor of Science in biology from Villanova University, her Master of Public Health from MCP Hahnemann University and her Doctor of Public Health from Drexel University School of Public Health
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