Ep.2/ Interview with Dr. Samantha Butts Part 1
from 0 babies to twins and knowing that you are not alone, sister!
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Note: This transcription has been created with a help of an AI thus errors and mistranscription may be present.
[00:00:00] Dr. Jill Baker: , maternal Health 9 1 1. What's your emergency?[00:00:06] Dr. Jill Baker: 1, 2, 3, 4.
[00:00:12] Dr. Jill Baker: Hi, I'm Dr. Jill Baker. I'm a wife, a mother, a community health scholar and 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. To become a parent, as well as shed light on infertility and maternal health experiences of bipo women and couples.
[00:00:40] Dr. Jill Baker: Now let's begin this week's episode of Maternal Health 9 1 1.
[00:00:51] Dr. Jill Baker: Everyone. Without further ado, you are in a very wonderful place today to be listening to my talk today with one of my favorite, favorite doctors in the whole world, Dr. Samantha Butts, who I had the benefit of her being my and my husband's infertility doctor. I don't even wanna think about what my life would be without her, but we're gonna talk about all those things and why is she so special and is so for many, many reason.
[00:01:21] Dr. Jill Baker: Dr. Samantha Butts, MD M S C E is a professor of Obstetrics and gynecology and chief of the division of Reproductive Endocrinology and Infertility at Penn State Health and Penn State College of Medicine. . In this role, she oversees an academic practice that offers a broad array of clinical services and conducts innovative clinical research.
[00:01:50] Dr. Jill Baker: After graduating from Harvard Medical School, she completed her residency in obstetricians and gynecology, her fellowship in reproductive endocrinology and infertility. And she also received a Master's in Clinical Epidemiology from the University of Pennsylvania. Dr. Butt specializes in treating individuals and couples who require fertility treatments in order to achieve pregnancy, and has extensive experience in providing the full spectrum of state-of-the-art treatments to meet the needs of people who are single.
[00:02:29] Dr. Jill Baker: Coupled L G B T Q and those whose complex medical histories impact their reproductive health. Dr. Butts also has expertise in treating conditions such as premature ovarian failure, surgical menopause, endometriosis, polycystic ovarian syndrome, and uterine fibroid. As an experienced educator, Dr. Butts devotes significant effort to the oversight and hands-on training of residents and students and conducts research to understand how to best train leaders in medicine, which is so critical.
[00:03:08] Dr. Jill Baker: Dr. Butts is also a reproductive epidemiologist and has dedicated her research career to study. The impact of nutritional and environmental factors on fertility factors associated with reproductive changes as women age and the impact of race on reproductive functioning and access to care. So without further ado, maternal health 9 1 1.
[00:03:34] Dr. Jill Baker: Let's welcome Dr. Samantha, but woo-hoo.
[00:03:38] Dr. Samantha Butts: Good morning. Thank you, Dr. Baker. It's an be here.
[00:03:41] Dr. Jill Baker: So we're going to have two parts to our discussion, just so the audience knows. And the first part of our discussion I thought we would just kind of start off with just talking a little bit more on the personal side about our time together.
[00:04:00] Dr. Jill Baker: and me being your patient and prior to this episode, everyone will be able to kind of listen to kind of a more detailed journey about exactly what we went through.
[00:04:12] Dr. Jill Baker: But I would say overall I think by the time. , me and Gamal maybe got to you. I know it was 2010. I was in my post-doctoral program at Penn and I think at that point we had been going through a year of just trying to get pregnant and just have unprotected intercourse and. a year of having not having a baby.
[00:04:42] Dr. Jill Baker: And I'm pretty sure I was 31 at the time, and I have to say I was in disbelief, you know? I was just like, how can this be that we can't get pregnant? I never thought that, like with everything else in my. . And, and I'm sure you know, you hear this a lot and probably particularly from women of color and you're, you're checking the boxes like Michelle Obama coined so perfectly in becoming, getting your education, trying to figure out your career, getting that job established, career established, check, check, check, finding a partner, check, check, check.
[00:05:29] Dr. Jill Baker: Does his partner wanna have kids? Maybe get a house check. So then when you think it's time to just, okay, let's just go ahead and try to have this baby. Oh no the baby isn't coming and so you're just left with this despair and hopelessness. So I don't know if, if that's kind of a common.
[00:05:51] Dr. Jill Baker: Theme that you experience with your patients.
[00:05:54] Dr. Samantha Butts: It is Jillian, and I like what you said, it, it's so resonated with me. You said disbelief, right? Because I think there is still not the level of awareness that there should be generally, and we can talk about how this may differ in populations according to race, ethnicity, socioeconomic status, but people really.
[00:06:18] Dr. Samantha Butts: Think that fertility is much more straightforward than it is. My perspective is quite different. I think it's all very, very hard shocked that anybody ever gets pregnant easily. But that's my kinda warped, uh, perspective based on what I do for a living. and so when that's the case, I think maybe some of the denial.
[00:06:43] Dr. Samantha Butts: Perhaps can contribute to some people delaying care because they're saying it's hard to accept that I have to medicalize pathologize something that should seem so natural. Why do I have to get a diagnosis? This doesn't make any sense. And so I think that you're feeling is incredibly.
[00:07:05] Dr. Samantha Butts: Universal
[00:07:05] Dr. Jill Baker: and the more women I talk to because of my own experience. And I know I've shared this with you, so I'm starting a fertility coaching practice for women of color with recognizing the need that , the emotional support is lacking in these, you know, instances and experiences.
[00:07:25] Dr. Jill Baker: I didn't have a, a group of women I was talking to or you know, or a group. Fortunately I was in Gaal, we were in therapy at the time, thank goodness. Because it was also one of the hardest times in our 22 year relationship. And I know that there are a lot of couples who don't even make it through infertility for a number of reasons.
[00:07:56] Dr. Jill Baker: Not being on the same page about what to do once you kind of get your diagnosis and then are presented with options and then the cost and then whether insurance can cover certain things and whether. , you have to take out a loan. And so there are just so many reasons of why couples, don't also don't make it.
[00:08:18] Dr. Jill Baker: That kind of just sparked in me that, okay, I wanna be able to provide like any kind of support that I can to, to other couples of. going through this ex, this experience, because it, it's so needed and it's still, it's still needed today. Yes.
[00:08:35] Dr. Jill Baker: I know.
[00:08:36] Dr. Samantha Butts: I agree. I think a lot of this, there's the clinical side, the science, but there's also the social networks and the agency, right? Where do agency doesn't just pop up in your life, you know, agency I think is something that is learned and you have to learn how to navigate these.
[00:08:56] Dr. Samantha Butts: These clinical scenarios. I find even people who are highly experienced in medicine have difficulty navigating this because it's very new. These are critical, critical elements for success
[00:09:09] Dr. Jill Baker: and very different from any other kind of medical experience because even as a woman, when you go, may go to the ob gyn every.
[00:09:18] Dr. Jill Baker: It's not the same. Isn't that the same process as when you are going to infertility and then having to do the testing and,
[00:09:29] Dr. Samantha Butts: and it's a lot,
[00:09:30] Dr. Jill Baker: it's, it's all, it's a lot.
[00:09:31] Dr. Samantha Butts: It's a lot of, it's a lot of data now, from my, my perspective is somebody who really enjoys data. I have to understand that maybe my patients receive data differently than I do.
[00:09:42] Dr. Samantha Butts: So, you know, I try meet people where they are. Right. There's the clinical facts and then there's the per individual before you. Right. And that's not to say you give certain people different levels of care. It's that you tailor the care for. Where they're at. One of my favorite questions to ask couples is how do you envision yourself in terms of your approach to moving forward in this?
[00:10:07] Dr. Samantha Butts: Do you wanna take sort of an incredibly gradual approach? Do you wanna dive into the deep end, into the ocean? Do you wanna do something in the middle? Because I'm gonna tell you what all the options are, but it helps me to know. Where you're at makes no sense for me to push an option that you will never receive.
[00:10:25] Dr. Jill Baker: Oh my gosh.
[00:10:25] Dr. Samantha Butts: That you, that you'll never, that's never that, that is not aligned with what you're able to do, what you will ever want to do. And at a certain point, to the extent that we push those things, in some instances, it's maybe a little insensitive.
[00:10:40] Dr. Jill Baker: Right? Yeah. Ab, so two things that you said. One, Agency, gosh, 200%. I talk to people about that all the time, particularly when it comes to, and that's just another consistent theme that I hear when I talk to, women and couples and, people struggling to get pregnant. And then people, navigating once they are pregnant and trying to ensure that they're having positive experiences during pregnancy.
[00:11:10] Dr. Jill Baker: and that they come home alive and that they don't die a few weeks after they come home. Cuz now being into this world and now have people in my, in my network and people who have been on the show and people who have supported me, come and share their experiences of them losing their, their wives and their partners.
[00:11:31] Dr. Jill Baker: and losing their children and this just reality of that. All of these things when we're trying to get pregnant, then when we are pregnant, that for black women and women of color, it is life or death.
[00:11:47] Dr. Samantha Butts: Yes. Yeah. And, and, and what are the best ways to sort of assert that agency? Right, because I, I feel like there are ways to. Advocate for yourself, get your questions answered, understand what's happening to you, and still maintain good relationships with the care team that you are working with. It's all possible. It's not necessarily intuitive and I think that that's an incredibly important thing for us to think about and, and talk.
[00:12:21] Dr. Jill Baker: and I can vouch for that when you were our doctor, you know, I remember I think we did the first round of tests. And I had to do the hs. Oh gosh. I know you
[00:12:32] Dr. Samantha Butts: don't wanna . I'm sure like even saying it out loud is, it's still true.
[00:12:37] Dr. Jill Baker: Taking you back too, it was so painful.
[00:12:40] Dr. Jill Baker: Oh, it was so painful. Yeah. Um, and how
[00:12:42] Dr. Samantha Butts: many years ago was that? Joan 13. Still have a very fresh memory Yes. Of how difficult that was. Yes. And not that we're discouraging people from doing
[00:12:51] Dr. Jill Baker: No, no.
[00:12:52] Dr. Samantha Butts: Just the kinda tests that they need to do. But I, I think it is important.
[00:12:57] Dr. Samantha Butts: Knowing how challenging some of this journey can be, that we really shepherd our patients through this and walk beside them and, and understand and, and are saying, I'm sympathetic to the fact that that HSG was terrible. Oh, terrible. But you know what? It gets us a whole lot of information that I'm going to use to help you now
[00:13:17] Dr. Samantha Butts: and support you
[00:13:17] Dr. Jill Baker: now, Dr. Butt. So I have to tell you two things. One, going through that experience myself, you know, remembering. Being a public health doctor and staying on top of the literature, staying, I'm like, okay, has the testing changed? No. Have a friend and a close sister who was a guest on the my other show and talking to her in a pre-chat with her experience in trying to get pregnant, while she was married and trying to have a second pregnancy after having a teenager and not being able to get.
[00:13:52] Dr. Jill Baker: She went to an infertility clinic in Chicago. They told her right away because she was slightly overweight, not even that much. They told her automatically, well, you are going to have to do I v F. They never tested her, she never did the diagnostic testing. So when I said, well, did you do the, you know, the procedure with the dye and she didn't know what it was.
[00:14:22] Dr. Jill Baker: And so she never got an accurate diagnosis. And this clinic she ended up doing two rounds of I V F. The clinic took her money, it was $10,000 per cycle. She had to take out a loan, she never got pregnant. Her and her husband ended up separating. She goes to her regular OB, B G Y N, like a year later and.
[00:14:47] Dr. Jill Baker: GYN confirmed that she had so many fibroids, there was no way she would've been able to get pregnant without intervention with the fire. So she had five, it was fibroids.
[00:14:59] Dr. Samantha Butts: It's part of agency is also learning to trust your gut. Yeah. Sometimes and I think.
[00:15:09] Dr. Samantha Butts: There's no reason nobody's feelings are going to be hurt if you get a second opinion. Right? Why not? Like we, you know, this is very accepted in the oncology world. Patients get multiple opinions and they try to get the opinion that obviously is competent data driven and evidence-based.
[00:15:30] Dr. Samantha Butts: Sometimes it's a matter of finding that team. You feel comfortable with and resonates with you, right? I tell patients, not uncommonly, this is my assessment. This is my synthesis of the data. My opinion is not the only one in this clinic, in this city or in this state. And if what I'm saying to you doesn't resonate, I fully support you getting a second opinion.
[00:15:56] Dr. Jill Baker: I love that
[00:15:56] Dr. Samantha Butts: because I don't want anybody feeling like my way. Dogma. It certainly is not. And sometimes people need to hear things more than once, or maybe a different clinic has a different approach and a view. And I know that's ask, that's a big ass too, because just to get appointments is hard and going from place to place.
[00:16:16] Dr. Samantha Butts: But guess what we have now telehealth. And I still do quite a bit of telehealth and, and my hope is that telehealth is tr hopefully leveling the playing field as pertains to access to care, especially with respect
[00:16:29] Dr. Jill Baker: to what we do. I love. , and let me give a shout out to that's Dr. Vanessa Goodar, who went on to, now she is just an advocate for this work as well and has her doctorate in self-care and working, her mission is to help black women really understand the importance of self-care and having that experience then led her to say
[00:16:50] Dr. Jill Baker: I'm going to be an advocate now. So it's like those of us who've had these experiences are now the ones who are like, okay, so we're gonna be a warrior in this work. because it does become so personal.
[00:17:04] Dr. Samantha Butts: And it's a beautiful example of paying it forward or paying it back. Yeah. Or however you wanna
[00:17:08] Dr. Samantha Butts: Yeah.
[00:17:09] Dr. Samantha Butts: Envision that.
[00:17:09] Dr. Jill Baker: But I remember, you know, when we got our, you know, kind of testing. . And you said to us, well, you know, there are several options that you all have and it's not the worst, um, . And then you can kind of take it slowly or, be more aggressive. And I'm sure I know that I was the one like, oh no, like, let's be more aggressive because
[00:17:35] Dr. Jill Baker: let's get to this baby as fast as possible. Yeah. That's my personality. .
[00:17:41] Dr. Samantha Butts: I also temper that counseling with this, which is, I'm not the kind of doctor who's gonna say, we're gonna take a tempered approach and I'm gonna let you do that for a year and a half, right? Mm-hmm. , Nope. No. I mean there's, there has to be approaches, but with.
[00:17:59] Dr. Samantha Butts: Checkins monitoring surveillance. So if you've done this three or four times and it hasn't worked, then I think maybe we need to think about, is there more testing to do? Do we need to pivot and course correct? And where your head's at now, because the way you envision this prior to having done anything, maybe one thing, but after having done something three to four times and not being successful, you may say, okay, deep into the ocean time.
[00:18:22] Dr. Samantha Butts: Right. Uh, some of this is just. People have to find their own way and find their path themselves, right, with our supervision, guidance
[00:18:33] Dr. Jill Baker: and support. So, I don't know if you're, you remember this, but, Gamal really. let you know because he just our personalities are so different. I'm more, you know, assertive.
[00:18:44] Dr. Jill Baker: He's more laid back, . Mm-hmm. , which he still is. And you know, baby B Gavin is still, that always was that, and he's still that way but he really, and I, I tell people this, like he really let me decide. What course of action we're going to take. And not that he was just like passive, but he was like, whatever decisions we make about whatever treatment you decide to do, it's going to affect you because you are the one who's gonna have to take the medicine, right?
[00:19:18] Dr. Jill Baker: Do the insemination ultimately get pregnant. And so I remember we decided, you gave us the options of. , you guys can do, you know insemination and we can try that first. And if that doesn't work, then you can try, the clate with the insemination, and I think we might have did the insemination once, and then it didn't, there was no baby.
[00:19:41] Dr. Jill Baker: And then I was like, you know what, let's just bring on the medicine at that point, .
[00:19:45] Dr. Samantha Butts: You know, Jillian, what you're saying is an example of just that there for many, many people. There is not just one option. For a lot of patients that we see, there are a number of options, and as I said, so long as those treatments are being supervised and we're checking in regularly, you know, we can. Take that type of approach, shared decision making, but you just, it showed that you did something once you, you decided that that was enough of that. And now let's move on to
[00:20:18] Dr. Samantha Butts: option B.
[00:20:18] Dr. Jill Baker: And so went onlo. Woohoo. Oh my gosh. Awful, awful, awful. Worst medication I've ever had to take in my life. So what happened as a result of that
[00:20:31] Dr. Jill Baker: I had no control of my emotions. Just would be in work meetings and cry for no reason. Now, you may not know the, and the audience may not know. I am a, I, I'm a crier. I, I, movies cry, TV show, cry. I'm a crier. Not at work though. I'm not a person unless it's really bad or someone passed away or something. I do not cry at work.
[00:20:56] Dr. Jill Baker: Clemen had me crying at work. Went out to lunch with some of my friends. Bawling, crying, Joe, what is that? I said, I'm on Covid right now. I'm trying to get, we can't get pregnant with a baby. So then told my, you know, some of my sister friends and then one of my sister friends said, girl, I went through the same thing last year with one of my, me and my husband.
[00:21:19] Dr. Jill Baker: What? Wow. First friend, first sister, to tell, to tell. She went through the same thing. Never had anyone say we went through infertility to have a baby.
[00:21:34] Dr. Samantha Butts: And so why do you think that is?
[00:21:37] Dr. Jill Baker: Stigma. I know among our community that there's still. Feeling or belief that especially for women of color, especially for black women, also because in mainstream culture, we're still kind of hypersexualized.
[00:21:55] Dr. Jill Baker: So it's like you can't, you can't have a baby. You can't get pregnant. And I think for black men it's the hyper sexuality and people believing black men, all black men have multiple babies with multiple wo, which is not true at all. And so put those together.
[00:22:13] Dr. Jill Baker: And so we, we still have black couples and couples of color, like, not saying that they can't have a baby. Yeah, it's tough. And I,
[00:22:23] Dr. Samantha Butts: It takes a long time to debunk these myths. And sadly, a lot of this incredibly pervasive stuff is holding people back from being able to share what they're doing, receive support, or get the help that they need medically.
[00:22:45] Dr. Samantha Butts: it's one of the most upsetting parts,
[00:22:46] Dr. Samantha Butts: right, of all of this, because,
[00:22:48] Dr. Jill Baker: I mean, the reality is age-wise, definitely by the time you're 30 the clock is kind of ticking at that, at that point. I tell people that I. I wouldn't have changed the process and the experience of what we went through to have to have our first set of children. But I, if I had to change anything, I would've started earlier trying to have children like 20, at least 27, 28, something like.
[00:23:24] Dr. Samantha Butts: One of the things, Jillian, that I, I talk to patients about and then I, and then I also give lectures about, is this concept of the reproductive life plan.
[00:23:33] Dr. Samantha Butts: Right? And, I say to people, do you have a reproductive life plan? And some people are very robust about that. And some people look at me like I have two heads. And so this is something in medicine that we should. Engaging with patients on, right. I think some people walk on eggshells.
[00:23:51] Dr. Samantha Butts: They're a little bit uncomfortable, but we shouldn't, make assumptions about what people want to do. We should be the arbiters of understanding women's fertility and reproductive potential so they can have kids when they want to. And Thinking about helping them prevent pregnancy when they don't want to become pregnant.
[00:24:11] Dr. Samantha Butts: Pregnant and talk about contraception and all these things. But it can't be just one or the other. It's gotta be this is a life course approach to thinking about this and maybe you say, yes, I wanna have children, but not now. So can we talk about what that looks like in the form of fertility preservation?
[00:24:29] Dr. Samantha Butts: And this is something that has come up in. The coverage of reproductive health disparities for women of color, which is that a lot of women of color feel like they go to their doctor and it's just like, okay, I'm refilling your birth control pill now because we gotta focus on preventing pregnancy.
[00:24:48] Dr. Samantha Butts: Right. Oh, hold on like that. Can we have maybe a, a more in-depth, robust conversation about what may be some of the things that put me at risk for not becoming pregnant when I wanna, can we talk about that? Can we talk about the fact that like, I had a diagnosis of endometriosis last year. Does that mean you just keep refilling my birth control pill and don't have a conversation with me about the fact that women who have endometriosis may be at risk for infertility and they shouldn't be counseled the same as everybody else, right?
[00:25:19] Dr. Samantha Butts: When they're thinking about that, right? These are the kind of things that we have to. Have better
[00:25:26] Dr. Samantha Butts: conversations around. Right. And, and I've, you know, had many conversations with, of, of women who've had endometriosis, pcos and who are just like, yeah, my doctor didn't, did not tell me that. Me continuing to take like 15 different types of birth control was then going to affect my ability to have a baby.
[00:25:46] Dr. Samantha Butts: But they just kept, like you said, refilling. Prescriptions and yeah. So there was just one part of the conversation, but not what are the potential infertility outcomes that could come from a result of that.
Following Jill’s Journey in Episode 1, the next 2 episodes will be a peak at the other end of the story as she interviews her Doctor, Dr. Samantha Butts.
They encountered the whole experience - the good, the bad, the ugly and the joys of it all in the end!
They also answered what should a couple look for when they are seeking an infertility specialist and how they worked successfully with Dr. Butts.
And most importantly, this two-part episode is to enforce the message that you are not alone, sister!
About Our Guest:
Samantha Butts, MD MSCE is a Professor of Obstetrics and Gynecology and Chief of the Division of Reproductive Endocrinology and Infertility at Penn State Health and Penn State College of Medicine. In this role, she oversees an academic practice that offers a broad array of clinical services and conducts innovative clinical research. After graduating from Harvard Medical School, she competed her residency in Obstetrics and Gynecology, her fellowship in Reproductive Endocrinology and Infertility, and a Masters in Clinical Epidemiology and the University of Pennsylvania.
Dr. Butts specializes in treating individuals and couples who require fertility treatments in order to achieve pregnancy and has extensive experience in providing the full spectrum of state-of-the art treatments to meet the needs of people who are single, coupled, LGBTQ, and those whose complex medical histories impact their reproductive health. Dr. Butts also has expertise in treating conditions such as amenorrhea, premature ovarian failure, surgical menopause, endometriosis, polycystic ovary syndrome, and uterine fibroids. As an experienced educator, Dr. Butts devotes significant effort to the oversight and hands-on training of residents and students and conducts research to understand how to best train learners in medicine. Dr. Butts is also a reproductive epidemiologist and has dedicated her research career to studying the impact of nutritional and environmental factors on fertility, factors associated with reproductive changes as women age, and the impact of race on reproductive functioning and access to care.
Dr. Jill’s Fertility Story
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