Transcript: Sense by Meg Faure – Season 7 Finale
Meg Faure: Welcome back mums and dads. This is Sense by Meg Faure and this is our very last episode of Season 7. I’m really excited because in this episode we are joined by Dr. Kat, who is a very well-known doctor in South Africa. She’s kind of one of our best-loved doctor influencers in the parenting space and so I’m really, really delighted to have her. Welcome, Dr. Kat.
Dr. Katlego Lekalakala: Hi Meg, thank you so much. It’s been such a long time since we last spoke. I’m excited to be here.
Meg Faure: It absolutely has. In fact, the last time we connected, you had just given birth—or she was a little bit older than that—to your firstborn, your little girl who is absolutely exquisite. At the time you started the Clueless Mums events in South Africa, and so you and I had really connected around that time. It has been a while. How old is your firstborn now?
Dr. Katlego Lekalakala: She’s four, so she’s going to turn five in May next year. She reminds us every single day. She’s so excited about that age.
Meg Faure: So precious, too sweet. That means that you and I probably spoke about three years ago, which is absolutely unbelievable. But I think for our audience it would be really awesome if you could introduce yourself—a little bit about yourself as a doctor, a mom, and of course the brilliant mind behind Clueless Mums.
Dr. Katlego Lekalakala: Okay, so as you said, I am from South Africa. For those who are South African, I need to just take them into my actual world. So, I’m from Pretoria, the Jacaranda City, and I feel like that really colors my identity because it makes me present myself in the world in a very authentic way, a very confident way. I really wear my Pretorian heritage as a badge of honor.
I studied medicine at the University of Pretoria and I completed my studies around 2019. I practiced medicine for quite a little bit of time. I finished practicing medicine in community service and then I decided that I would go into Public Health, which actually is the basis for why I started something like Clueless Mums.
You know, the same mindset that I use in the work that I do is the same kind of mindset that I use in Clueless Mums. I believe that health education and healthcare need to be accessible to everybody. People need to have an opportunity to advocate for themselves and also advocate for their children, and the best way to do so is to provide them with that information.
So right now, I lead a communications campaign. It’s teen-focused and it’s in support of something that’s just been adopted in South Africa now, Meg, which is the national strategy to accelerate action in children and teens. So my work is greatly in support of that and it’s also basically guided by the priorities of the strategy. I work with teens helping them understand their identity and how it forms part of their well-being. As you know, the WHO said that identity is a huge part of adolescent well-being. So that’s what I do on my day-to-day.
I’m a mom, I’m a wife—I just got married. I got married in April, but I’ve been with my partner for seven years. And yes, we’re expecting our second one and I guess that’s why I’m here today. So we always meet when I have a new bundle of joy in the family. But yeah, so that’s who I am and this is the brains behind Clueless Mums.
Meg Faure: Excellent. Oh, well it’s lovely to hear your journey and I love the work you’re doing with adolescents. I think it’s just such an important stage of life. I guess we all also do have our callings; mine very much has always been around new moms and babies, and of course, being called to actually work with teen moms is just so, so important around their identity. So that’s really incredible.
Of course, we’re touching on this because you’re pregnant again. I saw your beautiful baby shower and I’ve been watching your pictures. When I reached out to you and I said, “Could we please chat just before you give birth?” you said, “Absolutely. I’m going to be having a C-section because I have gestational diabetes.” And so we decided to speak literally the week before you give birth. So, you are giving birth in four days’ time! I’d love to hear a little bit about the journey and how different this pregnancy has been to your first pregnancy.
Dr. Katlego Lekalakala: Yeah, so definitely very different. I learned about this pregnancy very early on, and that’s just because I decided after giving birth to my first child that I’ll take my woman’s health very seriously. So I was very well aware of my body. As soon as I missed my period, I knew that I was pregnant.
Then six weeks came in, and we all know that six weeks is when the hormones really start to rise. So then I got the nausea, and it was all-day nausea. It was all-day nausea up until week 15. It was horrendous. I did not experience that with my first child. I experienced nausea here and there, but not to this scale.
And also the fatigue. I don’t know if [it’s] because when I was pregnant with Nia I was working as a medical doctor—I was working as an intern—that I didn’t have the opportunity to actually appreciate how tired I was. Now that I work predominantly from home and my job is a little less labor-intensive than being a medical doctor, I’m able to appreciate how tired I am. I also don’t know if it’s because of age. I mean, I gave birth to my first child when I was 26; I’m now 31. But the fatigue is out of this world. I had never experienced it.
First trimester was actually quite intense on me. I was an insomniac, very insomniac, and I was having a lot of bad dreams. A lot of cravings, I won’t lie! That was the one thing that really got to me. And with this pregnancy, I’ve experienced more UTIs than I experienced with my first child, which is completely different. So I had a lot more health challenges in this pregnancy in terms of needing medication. I also had the worst flu. I had the flu for two weeks just a week ago that I’ve just recovered from.
And then with Nia specifically, it felt a little bit more traumatic. So this pregnancy doesn’t feel traumatic. With Nia, it felt traumatic because we learned at around 13 weeks that I have a short cervix. We opted not to do a surgical cerclage at that time because I went for a second opinion and it was decided that I’d do conservative treatment. And then close to 24 weeks, I started funneling. So my cervix started opening up and then I had to go for an emergency cerclage.
So that experience was really not great on my mental health. It caused me a lot of anxiety. So with this pregnancy, we already knew prior that I have this issue that we need to sort out. So that was already planned. I could go into the surgery already with the understanding that this is something that needs to happen. And it was prophylactic instead of emergency. So different type of energy and different type of atmosphere in terms of dealing with this.
And I’ve also changed gynaes. I didn’t change gynaes because of any reason, but working with a new gynae… I actually worked under him. I don’t know why, but it seems like it’s more comfortable. It’s the most interesting thing. I feel like we collaborate a lot more. So I feel very involved and very in control of my pregnancy.
But yeah, so that’s some of the differences. And then the gestational diabetes. So with Nia, I was treated very conservatively. So my doctor felt that because I was very close in terms of the test… because she felt that the results were very close to what is considered a diagnosis or the criteria for the diagnosis, she still treated me as a gestational diabetic. However, when I compared my results now to then, these results were so clear that I had gestational diabetes.
So with Nia’s pregnancy, I didn’t really take it that seriously. It didn’t really affect my life because I didn’t even really stick to what the doctor was suggesting. I just used diet and sometimes I had to cheat on my diet. So this time around, it snapped me into this weird reality and I was just like, “I do not want to lose my child,” because my results were so bad. It was just so clear that I have gestational diabetes.
Meg Faure: And can I… I mean just for the audience and for myself as well, gestational diabetes—what can go wrong with gestational diabetes in terms of mom and the baby? What are the negative repercussions potentially?
Dr. Katlego Lekalakala: Okay, so for the mom, it’s the same type of complications that a diabetic can face. So you can have hypertension, but in pregnancy, it can lead to eclampsia or pre-eclampsia. You can have a stroke. You can struggle with cardiovascular complications. So that’s just the mom.
With the child, the unfortunate part is they can become macrosomic, so they become bigger. So the sugar makes them quite big and if your plans are to have a natural birth, the child can suffer an injury called shoulder dystocia, which is a dislocation of the shoulder, and that can be really horrible with a newborn.
Another thing is you can have more of the amniotic fluid; we call that polyhydramnios. And then also another thing is you can have a stillbirth. So that’s the reason why they induce gestational diabetics by 38 weeks. They want the child out because they don’t really understand the reason why the child just dies, and you just don’t want to go through that.
And then also when they’re born, because they’re so used to these high levels of sugar, when they don’t get that high level of sugar—because now everything comes back in balance, your breast milk will definitely not have that much sugar—they start to experience lows. So they have hypoglycemia, and hypoglycemia is very dangerous. It can lead to seizures. It can lead to a coma. However, they will manage that well. And then later on in life, the child is more at risk of also developing diabetes. So it’s very important to manage it and to manage it quite quickly.
Meg Faure: That is just so interesting. And what actually… do they know what causes it? Is it genetically driven? Is it diet? Is it lifestyle? Is it just a random thing? Do they know?
Dr. Katlego Lekalakala: No, it’s the placenta. It’s the hormones in your placenta. However, I have this theory—and I want to sit actually with a physician and endocrinologist about this—I have a suspicion that I have insulin resistance and that put me at risk. Because I was telling people… when I look at my lifestyle compared to when I was with Nia and now, I did worsen in terms of how I was eating. I had the insulin resistance skin tags, the hyperpigmentation, the central obesity—that’s your waist circumference being quite large no matter what you do.
And how I would get rid of those symptoms was through exercise and diet. And that’s normally what you see in insulin resistance. And my doctor… because I had a physician with Nia because we discovered that I had fatty liver disease when I was pregnant with Nia. He had actually said to me, “I don’t think you’re a diabetic. I don’t even think you’re a pre-diabetic. I think you struggle with insulin resistance and I’d really love for us to investigate that.” And I never investigated it.
And funny enough, just the other week because I was sorting through our documents, I found the blood form that he had requested and all the tests that he was requesting were to diagnose if I have insulin resistance. So I’m not saying insulin resistance puts you at risk of gestational diabetes. I can’t confirm that, but I had a sneaky suspicion that I was going to have gestational diabetes and it was confirmed.
I do… My mother also is someone that is diabetic and she’s insulin-dependent. However, they do always say that it is caused by the placenta. You could be the healthiest person. You could be working out. You could do everything correct. You could live your life the best way possible and still develop gestational diabetes. And you could also be obese and not develop gestational diabetes.
Meg Faure: Just so interesting. Really, really interesting. So it hasn’t been a straightforward pregnancy, but it has been a more predictable pregnancy, which is really interesting because you’d normally put the unpredictability and the tricky pregnancy in the same camp. But actually, you’ve had deep fatigue, you’ve had the nausea, you’ve had gestational diabetes, but you’re managing everything this time and it’s a little bit more predictable for you, which is really super.
And of course, the most predictable thing is that you are going to be giving birth on Monday… on Sunday. And I guess one of the questions that I would love to ask you is, you mentioned that you’re being induced. Are you going to be going for a natural delivery or a caesarean section?
Dr. Katlego Lekalakala: No, I’m not being induced. So if you choose natural, you’d be induced. I’ve decided to have a caesarean, but it’s because also I had a caesarean with my first child. I had an elective caesarean with my first child. So I prefer to go for another caesarean. I could have gone for a trial of labor after caesarean section, but I’ve decided not to do that.
Meg Faure: Yeah, absolutely. Absolutely. So I guess just before we leave the gestational diabetes side of things, you know there will be moms who are pregnant and are battling with gestational diabetes. What is the best way to manage it? Is it predominantly managed through lifestyle?
Dr. Katlego Lekalakala: It’s diet, definitely. You must see the medication as a helper. And if you are able to avoid going on medication, I would suggest [it] completely. You know, I see in the Western world they really discuss a lot of the differences in terms of how you’d manage. So whether you’d go for insulin or you’d go for Metformin, which is what I’m on. And I see in the Western world they normally push more for insulin because it doesn’t cross the placenta. Metformin can cross the placenta. So those kinds of anxieties you don’t want to actually deal with.
So I would say really do your hardest to trial with diet. I didn’t have that opportunity and I didn’t have that option. I actually should have gone fully insulin because my levels were so bad when they tested me when I did the OGTT test. But the best way is definitely making sure that you’re having more greens, a lot of protein—lots and lots of protein—making sure that you are taking your sugar. So don’t miss out on doing the six-point profile or, if you are able to afford it, to do the continuous glucose monitoring and making sure you’re aware of what triggers the spikes and so forth.
And then also being kind to yourself. It’s very, very important because this journey is so harrowing. So you know Meg, you say that it’s predictable, but I thought because things would be more predictable that I’d have less anxiety and less depressive episodes if I can put it as such. But I’ve actually found myself really struggling with the reality. So yes, expecting it, but having the reality dawn on me has been quite tough and sometimes that really affects my mood, and because my mood is affected I become an emotional eater.
So that’s why I say actually really working on your mood and having people to team up with you. So in your family, your partner needs to team up with you. You shouldn’t feel isolated in this journey. You guys must all have the same type of meals, you know. They must also get involved in understanding what you’re going through. My child knows. She knows. She says, “Mommy, Mommy, now you need to test your sugar. Mommy, you don’t eat this because too much sugar.”
Having that understanding and that collaboration with my family really helps. And then also you need to be more physically active. Unfortunately for me, because of my cerclage, I wasn’t as physically active as someone else would be. Yeah, because you don’t want to put pressure on the cerclage. But yes, definitely having like a walk really helps and you can treat yourself from time to time. As I said, the emotional part of it, the psychological part of it is also something that you need to take into consideration.
Meg Faure: Yeah, you know it’s so interesting that you mentioned that because it’s something that people don’t talk about and that’s antenatal depression and anxiety. And you know, I think you kind of go into this pregnancy, you’re going through the motions and are expected to be so excited, particularly if you’ve ever lost a baby before. This was a very wanted baby. People think, “Oh, you must just be feeling fabulous, you know, you must be embracing this, you must be so happy.”
But actually, it’s very interesting, Dr. Kat. We did a survey just about a month and a half ago. We sent out a survey to thousands of mums and we got over 450 responses on that particular survey. The survey was specifically sent to mums in their third trimester of pregnancy and it was a request to fill in the Edinburgh Postnatal Depression Scale (EPDS), which you’ll know about. And it’s a global screening tool… for other mums who don’t know, it’s a global assessment tool that’s used to screen for postnatal depression, but it can be used for antenatal depression as well, for depression in pregnancy.
And when we talk about depression, mums, you know we often put this in the same camp as anxiety and depression when we’re talking about perinatal mood because it goes hand in hand. It’s not that you’re necessarily feeling sad and depressed; it can also be that you’re feeling anxious and distressed.
And so we sent this survey out to thousands of mums, over 450 filled it out, and you won’t believe the numbers. Over 65 percent of mums were coding over a score of 12, which means that they’re at risk or at serious risk of depressive episodes. And that was not a number we were expecting. The previous numbers that have looked at populations postnatally in South Africa—and actually globally—can sit somewhere around 20 percent. So 65 percent is a number that is very, very high.
Of course, we did a little bit of unpacking around it and there were some reasons. When we sent the email out we actually asked a leading question, we said “Are you feeling anxious?” so the cohort who filled it in were already mums who were probably feeling anxious. But the point is that anxiety and depression in pregnancy is very prevalent. You know, whether you have a situation of a physiological reason behind it or whether or not you’re just feeling anxious and depressed or very ambivalent about your pregnancy, it leads to a whole array of feelings. And I think people don’t recognize it enough; they don’t talk about it.
Dr. Katlego Lekalakala: Yeah, they don’t recognize it because they don’t want to recognize it, right? Because everybody has kind of marked pregnancy as a state of… it’s a blessing, it should be a great time. However, we’re not aware of the amount of physiological changes a body has to go through, which already puts strain [on you], and physiological changes can lead to psychological changes as well.
I mean, these hormones are doing their absolute worst in your body. Your body is really under attack. I mean, people even liken pregnancy to having cancer and that’s the truth of it.
Meg Faure: Yeah, well it’s a huge shift. But it also puts your life at risk.
Dr. Katlego Lekalakala: It does put your life at risk. But because you know you have this blessing at the end of it, people are not really aware of that or don’t want to appreciate that. And I even spoke about this in my podcast when I was speaking about the first trimester—that you need to understand that when a pregnant woman tells you that they are struggling, it’s not because they’re looking for attention. It’s because it is the truth. And there are physiological changes that have been described in literature that can actually support why they feel this way.
But it’s terrible that we always constantly have to qualify—especially as women, right, especially also with women’s health in a broader sense—why we always have to qualify why we are struggling. But also bringing a life into the world is not an easy task. It comes with so much responsibility and sometimes you might think that you’re ready for it, but when the reality of it actually comes true, you might struggle with the idea and the concept of “Am I going to become a mother?”
And I love that you speak about parents that have gone through a loss and now are going into a phase where they have the miracle baby or the rainbow baby. You know, I have a WhatsApp group under the Clueless Mums umbrella for pregnancy loss support and I engage with these women from time to time, periodically. I’m more led by them just so that I don’t trigger them.
And when we were going through Pregnancy Loss Awareness Month, we had a lot of conversations and they were just talking about how the one thing that they resent is when family members or people close to them keep telling them like, “Oh, don’t worry, you can just have another child,” or “Oh, at least you’re blessed enough to have another child.” And for them, that loss is not like “I lost a pair of shoes.” I lost a part of me and it will always be a part of me. And even when I carry someone else, I’m still carrying that burden or that grief with me. And in actual fact, it makes them more anxious because then they feel like their body will fail them again. And they struggle a lot with guilt and feeling as though they are the reason why this happened to them.
Meg Faure: Yeah, yeah. No absolutely. Gosh, it’s a myriad of emotions that we deal with. And you know, I think one of the things that we also know about antenatal depression and anxiety is that it can code for mood disorders or mood imbalances after the pregnancy. So is this something that you kind of are alerted to and are just going to be watching yourself? How are you preparing yourself going forward for the next stage when your little one arrives?
Dr. Katlego Lekalakala: Yeah, so I am thinking about it quite a lot because I struggled with anxiety after having my daughter and I didn’t realize it at first. I had a panic attack when I got home with her. I really struggled through that. So what I’m trying to do right now is to make sure that I have all the supportive measures in place. And that’s by making sure that I have enough people around me. I really know how to ask for help, but making sure that I actually will be asking for help.
I will be having a discussion with my husband actually. Funny enough—and I’m glad that you spoke about this—because I saw a TikTok the other day of a woman who was not aware that this was happening to her. And it was fortunate that somebody then realized that this is happening to her. So I’m going to make my husband aware of it because it’s so easy for you to misread the situation and just say, “Oh, it’s just fatigue,” or “It’s just postpartum,” or “Oh, it’s baby blues.”
However, I think that it’s very necessary that I would need to get help obviously urgently if it is happening because that’s the problem—the window of help is quite short in postpartum. Right? It’s not like people who live with chronic depression. With postpartum, it happens in such a short space of time but it can escalate in such a short space of time. And if people around you are not acutely aware of that, if they are not sensitive to that, then you can be missed. So that’s the conversation I need to have with him.
And yeah, but make… you know, also believe in God. I’m not saying God cures everything, though, definitely not. But I’m just praying to Him that, you know, “Please, I’m begging you, don’t let me go through that.” But yeah, I definitely know I’m at risk like just like every other person.
Meg Faure: Yeah. Oh, well you know, thank you for this conversation. It has been such a candid conversation around the challenges that you’ve experienced. And you know, I have faith and one of the best parts about having faith is that there’s an inexplicable peace that God does bring to us and it’s not a logical one. And yeah, I’ll just… I’ll be praying that that peace comes over you over the next week as your little one enters the world. It’s going to be a very precious thing to meet this life on Sunday.
I’ll be thinking about you and watching Instagram to see the birth of this little one. This particular episode will fly when your baby is about a week old because it will be in about a week and a half’s time. And I would love to touch base again, Dr. Kat. If you’re feeling up for it in the next couple of weeks, I’ll reach out on WhatsApp and we can definitely have another conversation because I think this honesty in a non-dramatic way is just such a tonic for moms who are going through the same thing because it’s such a common feeling. So thank you for sharing so candidly.
Dr. Katlego Lekalakala: Thanks, Megan. Thank you for always being one of my biggest supports. I mean, I will never forget really entering my postpartum phase and everything that you’ve created… you’ve put your heart into really supporting me through that time. I mean the BabySense app—can’t wait to get it back on! You know, it really supported me and it’s things like that that you might take for granted but they really do a lot. And I’m so excited. I can’t wait. I will definitely be meeting with you again.
Meg Faure: That’s lovely. Thanks so much, Dr. Kat. And I know moms are going to want to know where to get hold of you. Can you just tell us your Instagram handle or where’s the best place where people can follow your journey now?
Dr. Katlego Lekalakala: You’re going to have to write it down because it’s going to be tough for them, but it’s Dr. K Serikani—which is S-E-L-I-K-A-N-E—and then once you follow me you’ll see all my profiles on my page.
Meg Faure: That’s wonderful. Thank you so much, Dr. Kat, and good luck for Sunday.
Dr. Katlego Lekalakala: Thank you.
Meg Faure: Have a good one. Bye.
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