By Dr. Denise Montagnino, DO, MPH, OB-GYN
There is a moment I have come to recognize in almost every first appointment. I start with something simple, how are you feeling? or how are things going?, and she pauses. She searches my face. She’s deciding whether it’s safe to answer. I let her decide. I sit with the silence, sometimes for a few beats, awkward beats, and I let it fill the room. I let her search her memory, her emotions, whatever she needs to search. I’m not rushing her. I’m not filling the space to make myself more comfortable. I’m waiting for her. And most of the time, there are tears. Not always right away. Sometimes it takes a little longer. But eventually, in that exam room, something opens. And when it does, I’ve come to understand that what I’m often witnessing is the first time she has let herself feel anything, really feel it, in many, many years.
I am an Obstetrician-Gynecologist at The Next Door Recovery. What I am here to do is bridge women back to a safe medical home. The women I care for, pregnant, postpartum, women who haven’t had routine gyn care in years, often arrive with a complicated history with medicine. Not because they didn’t need care, but because somewhere along the way, the care and the woman stopped connecting. Too many have sat across from a practitioner and felt unseen before the appointment even started. The rushed visit. The unanswered question. The sense that the room wasn’t quite built for her story. So they stopped coming. They delayed prenatal visits, skipped follow-ups, said nothing about pain they were carrying because they didn’t believe the space was safe enough to say it out loud.
My job is to tear down those walls. To get to the heart of the matter. That looks different for every woman. For one, it meant giving the first appointment the time it actually required, her history, her pregnancy, her fears, what she hoped for. That is not inefficiency. That is medicine. She hadn’t seen a doctor in years. Not once during a pregnancy that was nearly over. For another, it meant recognizing that what looked like apathy, maybe even defiance, was postpartum depression sitting just below the surface, pressed under the weight of new motherhood and new sobriety arriving at the same time. That wasn’t separate from her recovery. It was her recovery.
Both pregnancy and the postpartum period demand careful attention. A pregnant woman is navigating a body she no longer fully recognizes, and emotions that shift before she has words for them. Then the baby arrives, and everything shifts again, hormones drop, sleep disappears, and feelings that have been pushed down for years come up all at once. This is not the time to pull back. It is the time to move closer.
My hope is that after our time together, she can walk back into the medical world differently, knowing she was heard. Knowing she matters.
Looking for help? Contact The Next Door Recovery below:
615.243.1650 (Confidential talk/text)
At The Next Door Recovery, we walk with her through every step, season, contraction, and celebration—from heartbreak to healing, from fear to freedom, all the way to new life.