95 | Creating a Welcoming Environment

Annie: Well, Hey there Leah.

Leah: Hey there, Annie. How are you?

Annie: I'm all right. It is. It's spring in New York City, which means today it's 65 degrees, but then we also might have another, one more freeze before things get nice and stay nice, but I'll take it. Sometimes we get a little teaser today, like, hey, it's coming.

Leah: It's coming. We've definitely had such weird weather this year in Houston, like we had literal snow storms, like straight up blizzard action snow in South Houston. I'm like, what is happening where I'm like, tromping around in like four or five inches of snow. I don't even know, but now we're definitely turning spring here too, but we've had some cooler mornings, which has kind of been nice because I just know the crazy, like, summer heat trap that I will live in for six months is on its way. So I'm taking every opportunity and just relishing, like, I'm freezing and it's fine. Where I'm like, your body's probably more climatized to being super cold.

Annie: Yes, it is. I am Northeast through and through, well, Mid Atlantic, but I've lived in the Northeast longer than I lived there at this point in my life, which is, which is weird. Well, today we're going to, right now it feels like. New York City is creating a welcoming environment for me as a human being, but we want to talk about how what we do to create a welcoming environment for our clients, all the kind of what that means to us, all the little things that we do and think about when we are beginning work and seeing these families. So Leah, what, what does it mean to you to create a welcoming environment for these families and their babies?

Leah: I think it's always top of my mind. I want them, I know this is like for oftentimes they're just in a high stress state, no matter what, because they're having difficulties feeding their baby and they just had, had a baby oftentimes and they're like, their bodies are going through so much. So I know that. Their experience with me can be like, I just take it really seriously, like very lifelong effects because they're in this high emotional state. So that means it's going to stick with them, whatever experience they have with me. So I take it pretty seriously and really try to like be very conscientious of How I'm interacting with them from just like my behavior and my trying to build some rapport and, and help their nervous system come down a little bit, even how I breathe, you know, I, I remember learning somewhere, you know, like your breath kind of red can regulate the room.
And I always think about that. And then. And then even just like the physical environment, like, what is my space putting out energy wise? Like, is it chaotic or is it like super duper clinical? And it's kind of unnerving. Cause you're like, Oh my gosh, this is a clinical space. Or is it, you know, something that is welcoming, but clean and organized? You know, I do think a lot about it, but, but having this conversation is kind of bringing all those thoughts. To the forefront of my mind of like, I don't necessarily like think, think about it super hard, but it's like all these years of people bringing different aspects of that to my attention have made me just like way more aware of it than I think I ever was like when first starting out, you know, but how about for you? Like, what is, what does that mean for you?

Annie: Yeah, I think like for me, it means a lot of it is like me being the welcoming environment, first and foremost, like I think about for home visits, it's like, Yes, they're welcoming me into their space, but I'm not their guest. It's almost like I need them to feel comfortable in their own space with me there. Like I'm the host in some ways. So I think a lot about like, when I go, like, for example, a lot of my home visits were in apartment buildings. And so they're buzzing me in and then I'm coming up, the stairs are coming up in the elevator. So they know that I'm coming up, but I also still have to knock on their door. And so I'm like, when I knock on their door and they open it, I want them to see me smiling and like being warm and not like looking at my phone, which is like something you have to remember. So I use that time, time to like in the elevator, it's fine. But like if I do a home visit in a third or fourth floor walk up and especially during the height of COVID when I definitely had a compromised respiratory for a long time, like I couldn't breathe. And so I would get even going up to the second floor, I was out of breath and winded. And so when you were talking about my breathing, it was like, I was like, I don't want the first thing they say to me is I'm sorry we live on the fourth floor or the second floor. So I would be like, just take it slow and try to hide the fact that I'm breathing hard. Or just to be like, make sure I speak even while I'm breathing hard. So they know I'm fine. Like, which is a really weird thing to have to do with like, I'm not fine actually, like I'm, I'm, I can't breathe, but that's not your problem. And I chose to come here. And so that, that was like one thing that came to mind with home visits. I feel like it would be different. Because, like, what is it like for, like, you're driving up and pulling into somebody's driveway? Like, what is that like?

Leah: I don't, well, it's funny because I'm, like, I'm very conscientious, like, where I'm parking, and then in case they're, like, looking out the window, I try to, like, I'm not sitting in my car for a while, like, putzing around, doing things, you know, I try to be prompt about like once I pull up in front of their house, I'm getting out. I'm getting my things to the door. So if I am running a few minutes early or need to do something in my car before I get in, I'll always stop like a block or so away. And like if I needed to get my hair pulled back or like do something, put chapstick on or whatever, take another bite of my snack. I try not to do that in front of the house. Cause I know for me, like once I see somebody's car in front of my house, I'm like, okay, they're coming in. And then if they don't, I'm like, okay, well, what are they doing out there? Like, why are they coming in? You know, I've had people like repair people or whatever. And then it, like. Revs up my anxiety because I'm like, what are they doing? What's the problem? Why are they coming in? Do they think they're at the wrong house? Like what could be happening? You know, so it's, it's these little small things that I guess after you do things for so long, I just get a sense. I'm constantly like trying to put myself and other people's experience and like, okay, how can I make this feel as easy breezy, like no big deal that I'm here for you, like, I don't want them to be considering. Any part for me, you know, I want them to just be able to focus on themselves and their needs and know that I'm here to provide this care and service for them and not for them the other way around to like, let me do something for you. It's so funny how it's like, as we're talking about this, I'm like, there's so many things that I guess I do, but I don't even realize like I'm doing them for these specific reasons, you know, but it was really interesting, like. Getting our own clinical space made. So this is so crazy. When we first worked at the pediatric clinic, like this was 10, 11 years ago. So working in a pediatric clinic for this purpose was not commonplace, you know, and at the time they didn't really have a designated space for us. But one of the practice doctors had a larger office with a couch and they were like, Hey, we'll let you guys use this space. But it was, you know, like an office space. And then the other side of the room was like a nice couch and seating area. So we like to use that space. You know, the vibes were like, you're in an office. And so it was really so wonderful when they transitioned us. All the doctors, they have another section, like all the doctors gave up their offices so that they could build a space out for us, which was just amazing. And they, like, wanted to make it a very, like, comfortable, homey feel to it. And one of the things they did instead of, like, just painting regular walls in a solid color, they had these, like, really beautiful little murals painted on the wall, which we get so many comments about, you know? They're like, oh, this is so nice and welcoming, and they're just very, like, One's like a scene of birds and trees and one's like the sun and they're very uplifting and welcoming. So instead of having that like really clinical feel that we first originally had, like it was such a nice, like, even for my nervous system, it feels very like, it almost feels like I'm still in a home visit sometimes, you know, cause they, you know, have some nice pictures on the wall that feel more homey than clinical and they have. It's really cute. Down the whole hall, they have pictures of the doctors as babies. Isn't that funny? Which I thought was so cute. Like, such a sweet idea. So all the doctors down our hall, like, their baby pictures are all the things that are in our hall, which is so fun. And it makes you feel like you're in, like, somebody's house with their baby pictures on the wall, you know? So these little, like, touches we get. So many of our clients mention, like, Oh, this space feels so nice, feels like home. And, although we still have to have, like, the pleather couches that we can wipe down, and things like that, that are still,like, a little clinical, you know. For the most part, it has, like, these little tiny touches of, like, you're not just, like, in a doctor's office. It's a clinical office space, you know, like you're kind of in a more comfortable space where you can be relaxed and not feel, you know, as uncomfortable, especially with this very intimate thing and feeling maybe more exposed because of the situation. It's like, maybe we can help them feel a little bit more comfortable. How about you when you like to set up your space? Did you have much control? Like, that's my first thing, like, what did you have control over changing? Because I know before, like, we didn't. We didn't have much control. We were kind of at their mercy. And then also, like, what did you choose or did you think through some of those aspects?

Annie: Yeah, so when I first started my sublet, I didn't have any control. I was subletting from a home birth midwifery practice. So they were, they asked me, like, what do you need in the room? And I was like, I need, you know, I need a place that they can sit, put their feet up and I need a cabinet to store my supplies in, but they did all of the decor and all of that. So the way my office is inside a wellness studio called earth and sky healing arts, they do massage acupuncture. They have somebody that does therapeutic breast massage. They do an abdominal wrap. They do prenatal postpartum reflexology herbal stuff. They do. These themes, like they do it all, cupping, they're amazing. I've been going there for 15 years and I always was like, I wish I could be here. So they used to have, they are in the back and then they had to have a hallway that has some therapists that rent rooms by the day or whatever. And then there's a physical therapist practice across the hall, and she's actually going to be our deeper dive guest in June talking about movement with families is my P.T. Dr. Sherry and she has like her and a pelvic floor therapist, and then her practice also has someone that does private Pilates for postpartum anyway, so it's all very holistic. But what it used to be was a family physician practice there. So she had most of the room, like the earth and sky had half the rooms and the family practice had most of it. And then like, there was like one or two therapists, their family practice moved out earth and sky took over the whole thing. And my office is what used to be the receptionist area for the family practice. So my, it is an interior room, but it has two windows. Oh, nice. So it's like right in the front. So people walk in and there's the waiting area, which is like really nice with like plants and hardwood floor and there's a water cooler and cups and like just all those like nice like there's a, Oh, there's a bookshelf that has like take one lending library, bring just bring it back at your next appointment and it's all like holistic stuff and stuff for families. So it's really, it's really great. That way, but my office is right there. So the first thing that I had to do was put curtains on the windows because can't have people looking in. So it's nice. I get some light into the room, so I don't feel like I'm sitting in a windowless room all day. And sometimes I'll even open it while I'm eating my lunch just to get some natural light in for me, but so they come in. I have like a sign on the door and then I bought a door hanger that says session in progress. Do not disturb because I have had people open the door because they think it is like a reception. Or they're just like postpartum or like the UPS will stand right in front of my door and yell UPS because the reception, there is a receptionist is just all the way in the back for earth and sky. So I'm like, okay, don't come in. That's the number one way I create a welcoming environment, right?

Leah: Like I'm not going to get barged in on in the middle.

Annie:So when they come into my office, so now I, we reversed it and now the midwives sublet for me and I'm in the space now. We're in there six days a week. And then I redecorated it. I made it a little more, a little more decor on the wall. But really like we designed it like you were saying to feel like a living room. And I've had people say like this feels like a living room. Like it's a nice comfy couch and it's not clinical and doesn't feel like you're there to have an exam. It feels like you're there to hang out and get help. So that visual, like it's so important. It's a, it's also very, doesn't have a lot of stuff out. It's also a small room. If it was a bigger room, I probably would like have. A bookshelf or something like I don't mind a little not clutter, but well clearly But I I have my bookshelves behind me anybody when you come to deeper dives and i'm sitting in front of my giant wall of books But it's such a small room that like you don't want it to feel like it's like closing in on people So so we do keep it pretty clean, but I have snacks out I offer I have a bowl of candy and I have like a tray that has like Pine bars and luna bars and the little like fruit leather and stuff like that to give out to people.

Leah: At our birth center location, they have a whole snack bar like nourishment center that has like, you know, water, you know, thing. And then it has like, where you can make tea or coffee and ice machine. And then a whole array of little snacks and different teas and things. And I think that like really says two things. One, like we honor your body and, and like comforts, but also like, Hey, this is also important, like nourish yourself. Like, don't forget about this part of it. Even during the space and time that you're here, like we still. Find this to be important enough that we set this whole space aside for you. And I really like in our birth center location, the room is a flex room. And so it has, it's used for lots of different things, which is kind of fun because there's like a big, super cushy. Like lay down table that they use for like when they're doing their non stress test and everything, but it's actually like worked out great because it's basically like a bed, you know, it kind of is the cushioniness of a bed and we have, they have like lots of pillows and different, you know, things like that, that feel kind of homey, even though it's used for lots of different things. I love having that because I can like, let's do some really comfy laid back. I can put pillows under your knees and on your back and get you really laid. And we can get all different angles and I feel like it's cheating a little bit because I'm like in every other space I don't have enough room to have a whole table that it elevates and, and it also reclines and everything, which is just like a really sweet space. I love it. I love, like, different aspects of each space. And then, the birth center was so great because they put up a whole bunch of, like, very inclusive feeding pictures, which I just love. Like, literally, any way that a body could be, look. And then anyway that you could feed a baby and they're like these beautiful hand drawings and they're just all over all the walls. And I just, they did that on their own. They're like, you're going to use this space for infant feeding stuff. So we're going to just make sure that all bodies are included and all ways of feeding your baby are included. And I just love that because it's a really neat space. And I love to just, I'll sit there and just stare. Because it's like collages of like all different. Bodies and all different baby situations and baby feeding situations, , and so it's really cool. So it's, it's really neat to be in these different spaces, but appreciate the different ways that I can use that space to help people feel comfortable and then, you know, hopefully bring my own. You know, building rapport and smiling and being welcoming to, like, enhance whatever that, like, just physical environment can offer. And I also, like, really try to read the room, you know? Like, I try to really notice, like, is the parent kind of sitting awkwardly on the surface that they're on. Or did they lean into it and kind of like, Oh, thanks. And if they haven't, I'm like, Hey, would this seat be more comfortable? Or do you want me to put this pillow behind your back before you've even started anything to do with feeding? I just noticed, like, what is their body saying to me? Like from the get go, and maybe it's that I just need to. Not jump into clinical and build a bit more rapport so I can see their shoulders go down and see them sit back in the chair or like, no, they're physically just whatever reason this chair isn't working for their body or this cushion or the couch or whatever they're on, you know, and I always try to start with that because I'm like, I can get their body that somatic experience to be like, then I'm like, okay, we're going to be able to have so much more positivity come out of the session, no matter how the outcomes are, then if they're like, You know, tense and, and on edge, you know, and I sometimes like takes longer, it takes longer. This is why I'm always running over on my visits.

Annie: Definitely. I feel the same way. Like they, sometimes they come in and they are so just, they're anxious and they're nervous and they're stiff. And like, just like, can I take your coat? Let me hang up your coat for you. Just like, do you have water? I'm here to take care of you like you, I am paying attention to you. I have the lighting in my office bothers me. It's something I still haven't quite figured out. So it's got like, so it's a, it's a small space, but the ceilings are super high. It's like they're, they're extremely high and the walls are painted white, which is what I wanted. We have one wall behind the couch. It's like an accent wall and it's got this kind of nice, like modeled. Textured paint in a nice, like, like kind of a color, so that's fine, but you wouldn't want that on all four walls, but the rest are white, and it's so bright in there with the overhead light on, so I have, like, next to my desk, I have a standing lamp that has, like, a pretty shade, but it's not enough, it's like, that's not enough light. Like, it doesn't create the, like, I can't just have that light.

Leah: I'm also like with my old eyes and like, I can't see anything. I can't see anything.

Annie: So I bought these, like, I got, I got these wall sconces that work with magnetic, like press lights, but they're not bright enough either. Like, so my, I, my dream was like, I have the wall sconces and my floor lamp and I don't have to use the overhead light. It's all filled with light. But the room is also so small. I can't have a table like there's no room for a table lamp. Like that would be too much. They have to be on the wall. We can't wire in because I can't afford that And like, I'm a sublet letter of a renter, like the, not like they, we own this building or earth and sky owns this building. Somebody else does. It's just like too much. But the good thing is I keep it nice and bright. And sometimes I'm like, I'm just like, it's so bright and I'm sitting in this monotone room all day. When I have those three and four month distractible babies come in there. It is magical when I turn off the overhead light for them And I'll be like, you know what? Let me just let me put on the mood lighting and I turn off the overhead light and it's a little dim and a lot of times babies are like I can relax now. Not all of them. I have like, you know, there's some that are just like, I don't care what you do. I don't know. Like, get me out of here. But it's always funny to me to see that, like that just turning off the play in that space and kind of demonstrating how just lighting can have an impact on the baby's like alertness and curiosity and everything.

Leah: That's so nice that you have the different lighting options. You were talking about windows. One of the things they did in the pediatric space, which I so appreciate is they put like from Amazon, you know, like some frosting, like a peel and stick frosting. So the whole window is frosted, so we get to leave the windows all the way open, you know, which is super nice, because the light, you know, is nice and bright, it feels like that natural light that's uplifting and not so, like, clinical lighting, although there still is overhead light, it just doesn't, you know, when you have it countered by the natural light, sometimes it doesn't feel.

Annie: Yeah, we have Roman shades in there, but they're white, and they're, so they let a lot of, I have like on that because I live in an apartment, so I have a lot of familiarity with needing to have light come through, but not people seeing you all the time. That’s a great another great tool to do that if you don't want to do like the peel and stick is to get a tension rod with just a sheer curtain that goes behind your decorative curtains and that's what we have. That's what we use in our bedrooms so that we can have the windows open but not noisy neighbors. Everybody's watching us. I mean it's like light is so important and it makes, it does make a difference. Like having good lighting can really set a nice mood. And maybe I just, I need to work a little harder on these scones because they're really pretty and I want it to work. But the lights themselves are just not bright enough. They don't have enough, like enough, they don't fill in over there on that slide. So I don't know. But that's a work in progress.

Leah: I mean, it's kind of like your second little home. I know yesterday we were out and about, and I, in our pediatric space, we don't have any plants. There's lots of plants in the home birth space. And I was like, I found this like the sweetest little mushroom. A planter thing, and I was like, I wonder if I could put like a little plant in our little pediatric room space just to bring a little, like, little bit more hominess in there. I had dreams of that, so I bought the little planter, so we'll see. It feels fun, because like, whenever I'm out and about, always in the back of my head, I have like, I'm always on the lookout for little touches that might enhance the space and just make it more comfortable. That's inviting and hopefully makes the people's experience of their time with us, like even more positive, you know, it's just like bringing in all these different aspects, not just like how clinically smart we are, but so much more than that. Right. It's like, definitely so, so much more than that. I mean, the clinical smartness is. It's imperative, but it's, it's the whole package and it's always a work in progress for me.

Annie: I was listening to another podcast, everything iconic with Danny Pellegrino, which is basically a housewives recap podcast, but it's hilarious. He's so funny. He went off on this tangent on the episode I was listening to yesterday about one of the housewives going to get a mammogram and how he thinks that all doctors should have candy. Like he's like, we didn't normalize grownups getting candy when they go do things that they don't want to do, like get their mammogram. He was like, and ladies get your mammogram. You gotta get your mammogram. He kept saying that and it was making me laugh so hard because I have this bowl of saltwater taffy that is the candy that I keep because I love the beach. And it does, like, make people a little bit delighted, but I'm like, there's candy in here, and some of them are like, that just makes me happy, that, like, candy,

Leah: Yeah, how can you not just be a little, like, less on edge if you just know there's a, it's a bowl of candy waiting for you.

Annie: So, and it's like, it's not like I'm making them eat the candy. So, like, from, you know, like, from a health perspective, yes, it's candy, but you know what? In a life perspective, it's candy.

Leah: And it gets a message to us, you know, it's like our brains know that that's like, not to be on edge and in defense when a ball of candy is present. Exactly.

Annie: This is a safe space for you not to feel like you have to be a perfect human being.

Leah: Exactly, exactly. I love it. This is such a fun conversation. You brought so many thoughts to my mind. I like even now I'm like, Hmm, there's [00:27:00] some little changes. I want to play even more with the lighting like you're talking about. I love it. So I'm looking forward to continuing to work on my space and hopefully just that whole package going learning and also cultivating beautiful, comfortable spaces.

Annie: I love it. Well, it was great talking about all of this and I also have some things I need to, I want to think about doing based on what we were talking about and also just being excited that it is a space that I can play in and have fun. And I have got good feedback from families that they feel comfortable there and that's the most important thing, whatever it looks like they feel good, that's all that matters.
So we have a bunch of great deeper dives coming up this spring and summer. I mentioned the deeper dive into movement. We've got a case study on triplet. Lisa Marasco is coming in to talk with us about low supply for a deeper dive. And we're going to be bringing some very targeted questions for her because, you know, she does written books and does trainings about this. But I know specifically about implementation and private practice. This is what I want to talk to her about. Just like what, what do we do? We're in the thick of it. We're in the weeds with it. So I'm excited for those. So you can sign up for a monthly subscription and cancel any time, but you get access to our archive of deeper dives going back to 2020. When you do subscribe and we've had some bangers over the years,

Leah: So good. They're so good. I mean, if you get that, that is like the jackpot being able to get all the back episodes of the deeper dive. They're just so good. We've had so many amazing people come and talk to us and just share like, Oh, it's just wonderful that time that we have one on one with them. I know. I love it.

Annie: So, you know, it's always, the recordings are there. Whenever people come live, it's always so fun to interact with you guys. So thank you so much for listening and we'll catch you next time.

Leah: Bye.