Sorry, I Missed This: Oh, Baby! It’s an ADHD pregnancy!

ADHD can impact pregnancy in a number of ways: Higher rate of postpartum depression, hormone surges that affect the brain’s functioning, increased demands on our executive function, and so much more. 

Our guest this week, Dusty Chipura, is an ADHD and pregnancy expert, ADHD coach, and doula in training. Dusty takes us through pregnancy with ADHD, what you might expect, and what conversations are important to have with your support network ahead of welcoming a baby. 

We love hearing from our listeners. Email us at sorryimissedthis@understood.org.

Related resources

• A guide to hormones and ADHD

• ADHD and pregnancy workbook by Alix Bacon and Dusty Chipura

• Dusty’s website, vancouveradhdcoaching.com

Timestamps

(01:27) Some ways ADHD affects pregnancy

(02:25) How did Dusty become an expert in ADHD and pregnancy?

(04:21) First trimester/early pregnancy and ADHD

(05:57) Sensory sensitivities and pregnancy

(08:44) Second trimester

(13:23) What conversations should we be having with our support system during this time?

(17:20) Third trimester

(20:04) What happens after the baby is born?

(22:33) ADHD and the postpartum period

(25:55) Best practices and tools

(28:41) Dusty’s top tips

(30:35) Dealing with parental guilt

(31:59) Where you can find Dusty

Episode transcript

Cate: Hi, everybody, and welcome back to "Sorry, I Missed This," the show where we talk about all things ADHD, relationships, communication, and intimacy. It's me, your host, Cate Osborn. Today on the show, we are talking about ADHD and pregnancy with Dusty Chipura, who is one of the leading experts in this very, very niche world of expertise.

One of the most ironic things about the work that I do as a sex educator who focuses on ADHD and neurodivergency is that I'm an expert in the bedroom, right? I know a lot about sex. I know a lot about intimacy. I know a lot of like, interesting positions and things to try. I know a lot about the science behind arousal and orgasm. But what I don't know a lot about is what happens after the bedroom sometimes, which is, of course, pregnancy.

The joke that I always say is that I'm the person that you want to talk to if you want to talk about what goes on in the bedroom. And then our guest today, Dusty Chipura, is there for anything that might happen after. She is an ADHD coach, she is a midwife, she is a doula, and she is incredibly knowledgeable on all things pregnancy and ADHD. She's one of my really good friends as well, so I'm super excited. Let's take a listen to my conversation with Dusty.

Hello, Dusty.

Dusty: Hi.

Cate: Thanks for being on my podcast.

Dusty: You're welcome.

(01:27) Some ways ADHD affects pregnancy

Cate: Quick question for you, just real quick before we start, how does ADHD affect pregnancy? Go.

Dusty: So many ways. We know that there is a higher incidence of preterm labor, NICU admission, C-sections, and preeclampsia for ADHD-impacted birthers. But the interesting thing is that risk is present regardless of whether or not the person took or takes stimulant medication and regardless of whether or not the person even knew they had ADHD at the time of their pregnancy, we don't know why, but we know that there are some different pregnancy outcomes.

Not to mention, many people still will be advised to go off their medications or may choose, so that's going have a big impact on their family functioning. So, how we get through pregnancy is going to matter because stress during pregnancy can have an outcome. And then in the postpartum period, how we transition into being parents, keeping track of things, managing that increased demand on our executive function, really kind of everything.

Cate: Honestly, I'm not going to lie to you, that was more than I thought. I thought you were just going be like: a lot of stuff. And then that was more than I thought.

(02:25) How did Dusty become an expert in ADHD and pregnancy?

Dusty, before we get into this topic, which is a very large, very broad topic, I just want to know, how did you come to be an expert in this? What made you want to explore this specific juncture of ADHD and pregnancy?

Dusty: Well, when I was pregnant, I started Googling "ADHD in pregnancy" so that I could get some help. And there was like a desert wasteland on the Internet, of all places, just nothing. And so, I wanted to create those resources because it turns out that it's a whole thing. And not for everybody, right? I just want to say some people will be totally fine during their pregnancy because we know that there's a link between estrogen and dopamine.

So, for some people, pregnancy is actually going to be easier than everyday life. But everybody's ADHD flavor is different. So, certainly, for me, there was a lot of differences from the experiences that my other pregnant friends were having.

Cate: I have this sneaking suspicion that I know the answer to this question, but I love your take on it. Why do you think there is such an absence of research and education about ADHD and its impact on pregnancy?

Dusty: For the same reason that we are only now learning about the impacts of ADHD on the menstrual cycle, on menopause, right? And like you said, you know what I'm going to say, but we started with our standard sort of like white man, white boy as our research subject, and women are the deviation from that, right?

So, there's a lot of assumptions about what the ADC experience is. You know, we assume that that's going to apply to women the same as men, broadly speaking. And so there's these whole areas of people's lived experiences vis a vis pregnancy that people without uteruses might not even think about or consider.

Cate: Yeah, menopause is another one that I'm really excited to explore on the podcast because your girl's going through it early because I lost an ovary. So, I get like early fun menopause and it's like wild because there's like nothing. I'm just like, I don't, what is happening? I don't know what's going on. It's been a wild journey this year.

Dusty: Yeah. I don't think I've ever heard someone say the words excited and menopause in the same sentence before.

(04:21) First trimester/early pregnancy and ADHD

Cate: What I would like, if it's OK with you, Dusty, I would love to sort of take us through a pregnancy. Not like how are babies made. I'm with you on that one. But the sort of process of OK, so as my body is changing, as my hormones are changing, what things are going to be happening with my ADHD and what red flags do I need to look out for, what are things that I might want to know to communicate with a partner?

So, how soon into a pregnancy are you going to start experiencing perhaps effects with your ADHD?

Dusty: If there's a glazed look in my eyes it's because suddenly, like the whole galaxy flashed in front of my face there, because, how much time do you have?

Cate: It's OK. I also like to ask giant questions and then just go: go, have fun.

Dusty: OK, so we could talk all about pre-conception and fertility and pregnancy planning with ADHD, which is a whole thing, but we won't get into that. But let's just say that I once forgot to take my birth control pills for two weeks and then forgot that it had been two weeks because what is time? And now I have a six-year-old. So, that's all we'll say on that.

But so, like, I think right away you're going to start feeling the effects because in early pregnancy, even within days of becoming pregnant, often you have some symptoms, right? You're more tired than usual. You may have nausea, you may have like breast tenderness. And so, if you're someone like me who's a very hyperactive ADHDer, or it can be a huge about-face to suddenly be like fallen asleep all the time, like, so that loss of energy can really impact us hugely.

Like nausea, again. So, it's already so hard to eat with ADHD, but having food aversion, sensory sensitivities, so not being able to start paying attention to some of those early signs and symptoms of pregnancy. So, those are kind of, going to kind of be your early things because at that point you're so baseline.

(05:57) Sensory sensitivities and pregnancy

Cate: I want to talk about that a little bit more, though, too, the sensory sensitivity. Because I feel like that's something that doesn't get highlighted a lot, where sometimes your sensory sensitivities are with things that are going on in your own body.

Dusty: Yeah. So, there's a great book by Alexis Quinn, I think it's called "Autistic and Expecting," and she's speaking only to the autistic experience. But she mentions that the sensation of the baby moving in your uterus might be like a bit disarming or alarming for some autistic folks versus like we always have that idea of like: Oh the baby's moving, right? But what does it mean for your identity as a parent if every time you feel this baby move, it like makes your skin crawl and you're like, ugh, right?

Cate: Yeah.

Dusty: So, yeah, sensory differences. But even just if we're talking strictly about ADHD, right? We know that with ADHD, we have an inability to regulate our attention. So, if I can't stop paying attention to how painful my nipples are, that's going to impact my productivity throughout the day, right? Well, there's a lot of things that for me in pregnancy were very surprising, like your blood volume doubles. So, by the end of your pregnancy, you have twice the amount of blood that you had in your body at the beginning of your pregnancy.

And so, you get a lot of nosebleeds. There's pregnancy, rhinitis, pregnancy, stuffiness, toothaches. I had constant tooth sensitivity and pain and toothaches, and I couldn't stop paying attention to the sensation of my molars being, like, really nervy. So, there's all kinds of pregnancy things anyway that are uncomfortable. But when you don't have the ability to like, regulate your attention away from those things, they can be extremely challenging to manage.

Cate: It's also interesting to me to hear you talk about stuff like, "Oh the baby is moving" and that difference of how one might experience that. And so, do you think that there's, I don't want to say like a stigma, but there's messaging that we hear about pregnancy that, you know, it's like there's a magical time and it's like, wonderful. But that's not the experience for every person, right?

Dusty: Yeah, I think that's especially salient for people with ADHD. Often when you're pregnant, you do get that messaging like, "Oh, like don't compare yourself to the perfect yoga moms." Like, yeah, we hear that. But the problem with ADHD is we look at something and we make like a flash judgment and we go, "Oh that must be the way that everyone's doing it." It's like, we don't take time to notice that like, OK, people are saying they're doing one thing, but if I really look and see what's happening, there's more be on the surface.

And so, I think that can apply a lot in pregnancy or rather in early parenthood. And then on top of that, you've got a person who's like pretty much always used to doing it wrong already. Like we have this very sort of built-in sense of like, I'm probably screwing this up. With any parent, ADHD-impacted or not, you get a lot of those like internalized ideas like, "Oh I'm not doing is good enough."

And there's lots of like mom guilt and parental guilt. But then if you add the ADHD guilt on top of that, and then you add on top of that, like the perfectionism of like, "Well, doing it right means doing everything right" is definitely a thing.

(08:44) Second trimester

Cate: What about the second trimester?

Dusty: Yeah. So, even sort of transitioning from first to second, all of a sudden there's all these new rules and things that you have to remember. Taking prenatal vitamins, new appointments, foods that you're not supposed to eat.

Cate: Can I ask you, I know I just interrupted you so hard, but I happen to know this. So, I'm a person who, like honestly, I don't know a lot about pregnancy. And so, how do you learn that stuff?

Dusty: Well, that's the thing that's shocking to me. Is like, here's the thing, right? A lot of people don't know anything about pregnancy until it's like suddenly happening to them.

Cate: Yeah.

Dusty: And there's just this assumption that you're going to be able to, like, change your habits and behaviors. And so, if you have ADHD and you struggle to change behaviors and maybe your schedule's too busy or you're not the most organized of ADHDers, don't know where you're at in your ADHD journey, all of a sudden, like you've got all these appointments to keep track of and you're supposed to like not take baths that are too hot and like not eat this food and like do more of this. And, you know, like it can be really overwhelming.

Cate: How do you learn all of this? Like, how do you know when you're supposed to start taking your prenatal vitamins or like, how do you learn that hot baths are bad? I've never heard that in my life.

Dusty: Some people don't, unfortunately. We hope that you have a good primary care provider. And I found personally that my OB was not very forthright with telling me a lot of things. And I think her approach was like, "Sometimes we don't want to worry pregnant people." Like there's so many things that can go wrong in pregnancy, but unless there's a reason to think that something's going wrong, I think a lot of care providers don't want to upset or stress or worry people.

But I find that for my ADHD-impacted clients is the opposite. It's the absence of that information that they find really disturbing. So, I mean, there's like books, you know, like a lot of people have heard of, like "What to Expect When You're Expecting." And then at a certain point, you could take a prenatal class and some people do and some people don't.

But that's like way, usually you're not taking that prenatal class till close to the time of your birth. So, the whole pregnancy, you kind of have to educate yourself if you don't have a care provider who's very forthright with information.

Cate: Yeah. Well, and I'm guessing that those books "How to Expect When You're Expecting" they don't include a section about "And if you have ADHD, here are some other things that you might want to know."

Dusty: Yeah, exactly. I mean, the information is quite well-organized. So, I think the thing that's missing is the like how. OK, you know, you're supposed to take a prenatal vitamin every day. How? And like, how much should you panic if you think you took it twice or if you haven't taken it in a week or you forgot that it existed? Like, how severe is that? Is that important at all? You know, there's a lot of questions.

And people go one of two ways with it, right? Either they get overwhelmed and they shut down or they like go into hyperdrive. And now they're reading like every pregnancy book and they're taking in way too much information and they're like getting themselves all in a tizzy about doing every single thing right.

Cate: While also trying to handle a drastic schedule change and lifestyle change, which you were talking about. That was in the second trimester. So sorry, I interrupted you.

Dusty: No, that's OK.

Cate: Second trimester. Back on the bus.

Dusty: Yeah. Yeah. So, that's it, right? There's all these things you're supposed to be doing. We tend to say that the second trimester is like the honeymoon trimester. Pregnant people tend to feel their best, their estrogen is rising, but their baby bump is still small and cute. They don't have a lot of the physical discomforts that we see in, like, late pregnancy.

And so, again, for a person with ADHD, I think that trimester is all about managing the expectations, right? So, people may be really, really excited. They might be trying to do everything at once. I provided doula services for someone who was having a wedding and renovating their house during their pregnancy, right? So, like, there might be a lot of things that you want to do and it might be hard for you to figure out what's the priority.

It's really important not to do too much, even though you're feeling good because you can still put yourself into a state that's not good for the baby. So, I think it's just about that self-management in the second trimester and people may be getting their energy back, but they may not. Some people have nausea all the way through pregnancy. Some people have tiredness. And this is the point at which you might be becoming aware of a particular pregnancy complication.

So, there's a lot of adaptation and I think a lot of expectations. So, often with clients in that trimester, I'm helping them sort of like pace themselves, not do too much too fast, but also like not get avoidant and not do anything. And you're still usually like working your full-time job, but maybe you may be doing it with no meds, depending on what you and your health care provider have decided.

And that conversation is changing a lot. Actually, there were just guidelines released in 2024, this year, the first guidelines on the use of ADHD medication in pregnancy. Up till now, we had no guidelines and it was totally like one doctor to another would do different things. But many people were advised to just quit their meds, cold turkey.

So, up until this point, most people have been like just white-knuckling it through work and life. If you have other children, whatever your responsibilities are, you're still expected to participate in all those responsibilities. But with no medication and with whatever, you know, nausea, fatigue, or physical symptoms you are dealing with.

(13:23) What conversations should we be having with our support system during this time?

Cate: So, if we're contextualizing this in a conversation about communication and relationships, what are the things that we want to be communicating with our partners or our support systems as we sort of navigate through the second trimester? Or are there like particular like, you know, "Make sure you talk about this specific thing" that you have advice on?

Dusty: Yeah. So, interestingly enough, a study showed that ADHD-impacted birthers were at a greater risk for less family and partner support. They were more likely to be isolated in the postpartum period, right? We know that people with ADHD are at a higher risk of like domestic violence and things like that. So, sometimes, unfortunately, because of ADHD, we find ourselves in life circumstances where we don't have a good support system.

So, that's really kind of like a conversation on its own is like, who is your support system? Getting comfortable, asking for help, getting comfortable setting boundaries. This is a time where I often encourage people to learn about boundaries and start studying them because I think people are more willing to accept your boundaries when you're pregnant. Like if you say "No" or "I'm tired," people are more thoughtful of you. You might be more comfortable because it's not for you. Now you're doing it on behalf of the baby.

Setting limits for yourself and others. It's a good time to practice, right? But certainly, I think, like, there needs to be conversations. If you have a primary partner in the pregnancy, like about what their role is, what the expectations are, and just like revisiting that early and often because your needs are going to keep changing and if it's your first pregnancy like, you also don't know what to expect.

I think that if, you know, your finances allow, having a doula can be a really important support person for you during pregnancy and that's, of course not always possible. But there are like doulas who are training. You can even just have a friend, a sibling. And if you don't know anyone, starting to build some community and some networks and connections amongst other like pregnant people in your community, because they're going to be in the same life circumstances as you, but you definitely, you need support.

Cate: And also, just very quickly, for our listeners who might not be familiar, can you talk a little bit about what is a doula, what that job is, and what that entails?

Dusty: Yeah. So, a doula is like a birth coach. They're not replacing your health care provider or your midwife. They're not replacing your partner. They're there to support you and your partner in the birth process. So, it's somebody who brings a lot of knowledge about what to expect during labor. And you can have a labor doula or a postpartum doula or someone who does both. So, they're going to bring you a lot of information about what to expect in the hospital, what to expect during labor, what to expect in the postpartum period.

They can help you make some decisions about like what you might like or not like, what your preferences are because, this doesn't always seem obvious, but you do have a lot of choice and control over how your labor happens. And depending where you're giving birth, you may be very empowered or you may be very disempowered. Not all sort of birth settings are made equal.

And so, if you happen to be giving birth somewhere where people are rushing you or they're not really listening to your preferences or they're kind of scaring you, freaking you out or treating you like a patient who's ill versus somebody who's having like a momentous occasion in their life, a doula is your advocate. They kind of know the ins and outs of how these things happen and they can ask for more time. They can help you advocate for yourself, they can help you make decisions.

And they're also there supporting your partner, too, right? So, again, they don't want to interfere in this, like, magical moment between you and your partner. They might be like getting your partner coffee. Like if your partner's freaking out, like helping them manage their own self, tagging it with them, even just, like, going to pump the meter with change.

And then if they're doing postpartum work for you, they're going to be coming checking in on you postpartum. Keeping an eye out for any postpartum warning signs of mental health issues. They could even just be doing something as simple as holding the baby while you go shower, helping you kind of like manage or navigate expectations on yourself, managing your postpartum body.

Because whether you have a C-section or vaginal birth like you may need some aftercare. And so, helping make sure you're on top of that. And even just keeping you company. New parenthood can be quite isolating. So, they're sort of doing a range of things that all just sums up to like caring for you and coaching you and helping you to do what you're trying to do in a way that feels good and not like scary and traumatic.

(17:20) Third trimester

Cate: And then we move on to the tri-trimester. So, what is the third trimester looking like for us?

Dusty: Yeah. So, I mean, either you were really stoked and you got everything done way too early and now you're bored or you left everything to the last minute and now you're like panic-organizing your nursery and all that stuff, and you're starting to have more of those, like, physiological issues. So, again, those sensory sensitivities are coming up.

One thing I didn't mention in the second trimester, but that is present all throughout pregnancy is that emotional dysregulation on steroids, right? During my pregnancy, I once cried to a Nickelback song and then I cried to an Ed Sheeran song. It was that Galway Girl. Is that Ed Sheeran? I don't know. But it came on and I was like "I love the Celtic fiddle so much." Like, I wept while driving and I was like, "The fiddle," right?

Like, there's this trope of like, pregnant people being overly emotional. But when we combine that with rejection sensitivity and emotional dysregulation, so we're, we're also expending extra energy managing mood issues, right? We might still be working. And so, there's more of those physical complaints like you might be having lots of pain, like what's called false labor or Braxton Hicks contractions.

Often at this stage, people are struggling to sleep. They have to pee all the time. They can't breathe too much because the uterus is like pushing up into their diaphragm. They might be struggling to get in and out of bed at night, finding comfortable positions to sleep. We see insomnia being really common, so that's obviously going to impact your ADHD as well, right?

And then there's towards the end of pregnancy, there's more and more appointments. You get to a point where you're having an appointment a week. So, there's a lot of appointments to keep track of and then labor is coming up, right? So, there might be a lot of fears and or confusion or distraction around labor. And when you hit the end of pregnancy, it's really boring. You're just waiting for the baby to come. And it's like time just like stand still. And we don't do well with boredom.

So, often in the third trimester, we're managing those sensory sensitivities, continuing to manage expectations and boundaries because we may be having like more family or people in our lives trying to influence what the postpartum period's going to look like, you know, or labor. So, managing those demands and then just like making sure that you're organized, right? Baby doesn't always come right at 40 weeks.

Sometimes baby comes 2 or 3 weeks early. And so, I had one client who it was her second pregnancy and the first pregnancy, she didn't have her hospital bag packed. And so, we talked about her packing the hospital bag for several weeks in a row. She just wasn't getting it done. So, finally, we started texting each other every day and every day I said, "Pack one thing" and by breaking it down, she got the hospital bag packed on time. And sure enough, we became like an unexpected time, but this time she was ready.

And again, like, if you've never given birth, you don't necessarily know what's going to happen when you get to the hospital. So, one of the things that I do is I walk people through like what it's going to be like when they give birth. If this then that this might happen, this might happen, and like, here's how to prepare for all those things.

(20:04) What happens after the baby is born?

Cate:OK, so what happens after? So, you had a baby. It's there. The baby has arrived. What happens next? I mean, an entire life happens next, which is very exciting. But in the immediate future.

Dusty: Well, for most of us, and by that I mean sort of like cis white women. We all just, you know, get a little bit of care in the hospital and then we'll go home. So, what I mean is, like, if you're an indigenous woman in Canada, that experience can look a lot different. We, at least here in Canada, we're not doing great with supporting new indigenous mothers. There's a lot of traumatic things that are happening that are terrible. So, that really needs to change. Canada, get your stuff together. Little side rant.

Cate: No, it's OK. I mean, I think it's important to talk about because the same thing happens here in America. Like BIPOC women are drastically affected by like maternal death rates and like that kind of stuff because like, the care is not equitable. And I think that's really important to name, especially if you also have the additional issue of ADHD.

Dusty: Oh yeah.

Cate: Because so many people in those communities are already going undiagnosed or undermedicated and that kind of stuff. And so, like there is a real issue.

Dusty: Well, that's it. And then missing your appointments means something different. Having a messy home means something different. Being perceived as aggressive or blunt means something different. So, what your post-birth and even birth experience is going to look like absolutely matters when it comes to your class and your race. But anyway, for many people, what it's going to look like is you're in the hospital, the nurses are helping you learn about breastfeeding or chestfeeding, body feeding, if you will.

You're going to do your recovery. So, if you've had a C-section, you're off in the hospital for a couple of days. If you've given birth vaginally, you might go home even the same day. And again, all of this is talking about what happens in the hospital. Some people give birth at birth centers. Some people give birth at home. But a lot of people give birth in a hospital. So, you're taking your baby home, often like they'll give you some pamphlets and some paperwork and some information about what to expect in the first few days.

And then you just figure it out. Deep end of the pool, right? Keep that sucker alive, man, and do it without sleeping. Because a newborn has to eat every 2 to 3 hours around the clock and you're experiencing a big estrogen crash. It might be great. Like, I don't want to scare anybody because, like, you might be in sort of that honeymoon period where you're like, "Oh my God, I've been waiting for this baby. And here it is. And it's so cute."

And like my baby was very easy in the postpartum period. I had no problems with latching. I had no problems with milk supply. My baby slept a lot. So, the postpartum period was quite unremarkable for me. But if you're struggling with body feeding, if you have any pregnancy complications, you know, it could look like a lot to manage.

(22:33) ADHD and the postpartum period

Cate: What about ADHD and postpartum depression? Do we see higher rates?

Dusty: Yes.

Cate: Yes. That's a straight answer?

Dusty: Yes.

Cate: Yeah. And so, what do we do about that? Like, what are we communicating? What are we looking out for in our partner? Like, can you talk a little bit about that?

Dusty: I think, again, like having those conversations in advance is good. I found a resource buried deep, deep in a 180-page postpartum guide, and it was essentially like a contract between a postpartum person and their partner saying like, "Here are the signs that I'm not OK and I authorize you to take action on my behalf, even if I'm resisting, right? Even if I don't want to get help. If I'm exhibiting these signs, like get me help, you know, don't listen to my nose, but, like, include me as much as you can."

Sometimes it does get to that point. And postpartum depression is the most common thing, followed by postpartum anxiety, followed by more rare is postpartum psychosis. And we do see high rates of postpartum depression. And I'm just guessing here, but I think it probably does have a lot to do with that big estrogen crash, right? Because if estrogen is linked to dopamine, then you're experiencing more executive dysfunction.

You've been experiencing a relatively better amount of executive function throughout pregnancy, and then all of a sudden that's all taken away. Plus you're not sleeping. So, again, I don't want to scare anyone. Sometimes the postpartum period is great because you just you love your baby and your baby's cute and their head smells good and you're just sleeping a lot. And like, newborn babies often are quite easy because they sleep like 16 hours a day.

And, like, it's just one of those things where people's experiences are going to diverge, like really wildly. So, we just want to make sure that going into postpartum people are not alone, that they have a good support system. Like often people want to come over and visit the baby, right? And so, again, the continuation of those good boundaries, right? Because it can be exhausting having all those social visits, especially if they don't really serve you.

Like if you feel like your house needs to be clean or you're going to be expected to serve these guests like tea and coffee. If people come over, they need to be like sweeping the floor, making food for you, like they need to be cleaning or they need to be feeding you one of those two things. And like babies' needs change almost constantly. So, there's a really interesting aspect of the postpartum period where you have to track everything.

The way that we know that babies are doing well is we track how many wet and poopy diapers they make in a day. And so, when I was in my postpartum period, the public health nurse called me a couple of days after I gave birth and she said, "How many wet and poopy diapers that she had?" And I'm like, "I don't know. But like, you know, enough." And she's like, "Well, what do you mean you don't know?" I'm like, "I don't know." She's like, "Well, was it more than this? Was it more than that?"

And I'm like, "Lady, I have ADHD. I don't even know what day it is." And she was really concerned and all I knew, I knew that everything was on track, but I didn't have a number. And so, I like to warn clients in advance that, you know, they need a tracking system. And then there's stuff like if you are formula feeding your baby, there's rules for safe preparation and storage of formula that have to be followed very stringently because baby's immune system is not good.

And you also have to manage your own body, right? If your body feeding you literally to manage your breasts. And so, you have to keep track of like which side did the baby feed from? So, I would walk around with a Post-it note and I would just, like stick it on one side of my chest or the other. And I would just, like, flip it to the other side.

But yeah, so like just managing all the things for your newborn, it changes quite a lot. The worst thing about, the worst thing about children...

Cate: The worst thing about children.

Dusty: Especially when they're little, is like as soon as you lock in like one thing, like you've finally got their sleep schedule figured out, then it will change as soon as you've nailed it, it like switches. It's a practice in constant frustration for like five straight years.

(25:55) Best practices and tools

Cate: Are there any resources or ways of being that you can recommend? Like, do you have best practice advice for folks who might be getting a little nervous?

Dusty: Yeah, so there's lots of free apps and you could like try them out in advance to see if you like any of them in terms of the tracking. But if you forget to use an app because it exists in your phone or not anywhere else, there's nothing wrong with just like a fun sticker chart on your wall, like, you know, to keep track of what diapers and feeds and these kinds of things. The La Leche League is a really important resource for body feeding.

Body feeding isn't always easy. We have this idea that it should just happen, but it's actually more common to have some issues at first, and it's really important that we don't let that low frustration tolerance and emotional dysregulation get the better of us. If you have pain like where the baby's feeding, like in the areola or the nipple, that is wrong. This should not be happening.

If baby is falling asleep too quickly at the breast or just like seems really unsatisfied, is not gaining weight, these are all signs that something's not quite working about it. And so, then we want to just as early as we can, investigate how is the latch? Do you need any support? Can you get a specialist in there to just, like, give you some advice? Can you watch some YouTube videos on it?

Because like, once you know how to do it, once you figure it out is great, But like, it's not this, like, natural thing, like, "Oh just my body knew what to do." No, it's like the weirdest thing. Continuing on with strong boundaries, with people who want to drop in on you, with people who want your time, with people who want to make demands of you, with people who stress you out. That's really, really important.

Continuing to set and manage expectations with your partner, right? So, we want to make sure that our partners, especially if they are cis males, are showing up and like picking up their end in terms of like helping with not just like cleaning and household management, but I find that sometimes cis male partners they feel like a bit more shy of like assuming baby care because it's like, OK, you birthed this thing. There's like sort of this like natural connection.

And I think it's really important that fathers be empowered to care for infants, change diapers, do all that stuff as early as possible, not only because they want to, but because the longer it goes on, they're not doing as much of that. The earlier it sets that double standard of women doing more work. What I love to see is dads being able to independently care for infants without having to go to the other parent, be like, "Oh what do I do about this? What do I do about that?"

You know what? The person who birthed that baby also didn't know those things. They read some books. They figured it out, however, they figured it out. And if they can figure it out, you can figure it out the same way. Because also, like the hormones from pregnancy last for about six months. Like there's not just like you squeeze the thing out and like, you know, you go right back to normal. You've got a hormonal soup going on for about six months.

So, you're continuing to struggle, I think, with like a lot of emotional dysregulation and like mood issues. And it's going to take time for you to get back to your baseline. So, you continue to need a higher level of support, not only from your primary partner, but like from your community.

(28:41) Dusty's top tips

Cate: Dusty, this is been an absolutely fascinating conversation, and I could talk to you for 100,000 hours about all the little nuances, but so thank you for giving us such a gorgeous, entertaining, fascinating overview of such a big, huge topic. As we leave our listeners today, do you have like top three, top five, "make sure you do this" best practices, tips, tricks, pro tips, anything like that?

Dusty: Just really quickly, I want to say like, again, I don't want to paint this like horror story. I think that like having ADHD is a boon for certain aspects of early parenting. Like you're often used to being sleep-deprived. You're good in a crisis, right? The novelty of a new child can be very focusing. Pregnancy and ADHD doesn't have to be this thing that's like, "Oh no, this is going to be terrible." I just want to make sure that every person with ADHD goes into it understanding what to look out for so that they can have a great pregnancy.

So, my top 3 to 5 things are, number one, take the reason to work on your boundaries. If not for yourself, it's easy when you have a baby to learn to start setting boundaries, you're going to benefit from that for the rest of your life. Set boundaries. Number two, ask for help early and often. Don't be a hero. Number three, advocate for yourself. Ask for all the information upfront. Number four, don't be perfectionistic.

Babies survive under all kinds of very inhospitable and inopportune circumstances. Your baby is going to be fine. Even if you forgot to feed at once or you didn't take prenatal vitamins for three weeks, or you bumped its head gently on the cupboard door. They're like, babies will survive. Don't fret too much and like enjoy it.

Cate: So, one more bonus question, Dusty.

Dusty: If it's "How hard can you bump your baby's head on the cupboard door?" I don't know the answer, but I've given Melody some pretty good swats and she's reading at a third-grade reading level, so.

Cate: My mom straight-up dropped me down the stairs on accident. She, like, tripped over a baby gate — she still tells the story — she's just straight up dropped me down the stairs one time and I'm like, I was fine.

(30:35) Dealing with parental guilt

I know that for a lot of people who are parents, there is such guilt and a shame ascribed to things like, "Oh my gosh, I forgot to feed the baby." I don't know, just something happens. "I forgot to change the diaper."

How do we as ADHDers, how do we let go of that guilt? How do we let go of that shame? What is a healthy way of making sure that our baby is safe and healthy and taken care of? But also, like, sometimes we forget stuff.

Dusty: Yeah. Yeah. So, like two things on the topic of how do we make sure our baby is safe and healthy and taken care of. Know your areas of relative weakness that could cause harm and compensate for them, right? So, if you really are highly distractible to the point where you might not notice your kid running out in a parking lot, be aware of that and have a plan. Keep your kid on a leash if that's what you need, right?

Or like, if you're, you know, if you know your areas of weakness where that may really have a real impact and get some help to manage that. But on the other hand, this is why you need a neurodivergent community, right? You cannot just have a bunch of friends who are parents who are all neurotypical. That's a stupid idea. Don't do that.

You need other friends who are neurodivergent, who are also parents. And preferably you need some who are older than you who can go, "Oh yeah, no, I totally did that. This one time I blah, blah blah blah, blah." You need those experiences to be normalized so that you can, like, calm down and chill out a little.

(31:59) Where you can find Dusty

Cate: All right. Dusty Chipura, thank you so much for being here today. Tell the people where they can find you.

Dusty: The Internet.

Cate: Do you have a website, Dusty?

Dusty: Yes. My website is VancouverADHDcoaching.com and I'm on Twitter and I'm on TikTok and I'm on Instagram and I'm on Facebook. I couldn't tell you the handles off the top of my head. But if you just Google Dusty Chipura you will find me.

Cate: Great.

Dusty: Oh, and I'm the new co-host of "Translating ADHD" podcast.

Cate: Give a 30-second pitch about your podcast.

Dusty: I don't know that much about it. They just asked me... No, I'm just kidding. It used to be Cam Gott and Asher Collins. It's like a really long-running ADHD podcast, which is great. And Cam has gone on to do other things because he's so cool and badass and now I'm the Cam.

Cate: Congratulations. That's fantastic. We will put the resources and stuff that Dusty mentioned in the show notes.

Dusty: Oh my God, I'm so dumb. I didn't even tell you guys that I made a bunch of resources.

Cate: Well, OK. Tell us about the resources, Dusty.

Dusty: Were you trying to get me to self-promote?

Cate: I was. I was trying to get you to promote yourself.

Dusty: And so... I didn't. That... right over my head.

Cate: It's OK. Social cues.

Dusty: So, the best resource, really, I think if you have concerns about all of these things is "The Pregnancy and ADHD Journal" that I co-wrote with Alix Bacon, which I also turned into a notion template. So, if you're more techie, you can get the notion template version. If you're less techie, you can download the journal, which is unfortunately at this point still a digital journal. So. You have to like go to a Kinko's to print it. But we'll get it made in print at some point soon.

And we're also working on "The Postpartum Journal," which should be out like very soon, like by the end of this year.

Cate: That's fantastic. Congratulations.

Dusty: Thank you.

Cate: Thank you for listening. Anything mentioned in the episode will be linked in the show notes with more resources. Have a question, comment, burning story you'd like to share? Email me at sorryimissedthis@understood.org.

This show is brought to you by Understood.org. Understood is a nonprofit organization dedicated to empowering people with learning and thinking differences like ADHD and dyslexia. Learn more at Understood.org.

"Sorry, I Missed This" is produced and edited by Jessamine Molli and Margie DeSantis. Our theme music was written by Justin D. Wright, who also mixes the show. Ilana Millner is our supervising producer. Briana Berry is our production director. Neil Drumming is our editorial director. For Understood.org, our executive directors are Laura Key, Scott Cocchiere, and Seth Melnick. I'm your host, Cate Osborn. Thank you so much for listening.

There's like dogs fighting outside of my apartment right now. I don't quite know what to do about that.