**This episode is sponsored by The Lactation Network, the largest network of accredited breastfeeding experts in the country. Visit tln.care/AAPB to learn more and schedule your own insurance-covered consultation today!

Dr. Rebecca Dekker is back! You may remember Dr. Rebecca from way, way back in episode 18. Since then, my work and hers have both grown tremendously. If you enjoy what I’m doing here I think you would also enjoy the resources she provides through her organization, Evidence Based Birth.

Today’s conversation is all about the topic she has dedicated so much of her work to: birthing positions. A majority of US births are supine, or on the back. This is what we always see in tv and movies but it’s actually not the ideal, or more importantly, ONLY way to give birth. There isn’t a perfect or best labor position. Instead, what really matters is that you have the freedom and support to move your body and find what works best for you.

In this Episode, You’ll Learn About:

• What the classifications are for birthing positions
• What does research show about which positions people opt for if given the choice
• Why most people in the US give birth on their backs
• What makes lithotomy/stirrup birth dangerous
• What evidence says about birth positions with and without an epidural
• How birth seats are used
• How medical culture affects birth outcomes

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The umbilical cord is truly your baby’s lifeline. It provides a pathway for the exchange of nutrients, oxygen, and waste. After birth the cord is cut and the fetal circulation ends, leaving behind a small stump. And when that stump falls away it makes the belly button, a permanent reminder of the physical connection between you and your baby.

In this episode you’re going to learn about what potential problems can happen with the umbilical cord including those diagnosed during pregnancy (marginal cord insertion, velamentous cord insertion, vasa previa, 2 vessel cord), and those that can occur during birth (cord compression, cord prolapse, nuchal cord, cord knots). Now, even though I go over a lot of cord-related issues in this episode, the chances of a true emergency are unlikely. I want you to be informed and aware of the potential risks but mostly I want you to come away from this episode feeling amazed and appreciative of what your body can do.

In this Episode, You’ll Learn About:

• What the umbilical cord delivers to your baby and how it works
• Which cord-related issues can be diagnosed during routine ultrasound exams
• What cord complications can happen during the course of labor
• What delayed cord clamping is and what the benefits are
• What umbilical cord blood banking means
• What the types of cord blood banking are and which might be right for you
• How different cultures around the world commemorate the umbilical cord

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Full website notes: drnicolerankins.com/episode209

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When Candace learned how dangerous it is to be Black and give birth in the US, she started looking for solutions. Using her skills as a professional data scientist, she determined that she would be safest opting for an unmedicated birth at a birthing center.

There, the staff was patient, respectful and communicative. But at 39 weeks, after days of prodromal labor, a hospital transfer was necessary. That’s when her whole experience took a dark turn. 

About 20% of all birth center births will result in a hospital transfer. The most common reason for transfer is pain management. If we do a little back of the napkin math, that means that Candace’s story is incredibly common. That’s just unacceptable. We can and should do better and this episode shows how the simplest efforts can make big impacts.

In this Episode, You’ll Learn About:

• Which four factors Candace determined improve outcomes for Black parents
• What respectful medical care looks like
• How Candace discussed racial healthcare disparities with her care team
• Why she decided to switch doctors mid-delivery
• What convinced Candace it was time for a c-section
• How she managed the emotional pain and trauma she felt in the wake of her birth

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Society has always been so judgmental of what mothers “should” wear during pregnancy. But celebrities like Rihanna and Beyoncé are showing off their baby bellies and still looking sexy, proving maternity doesn’t have to mean sacrificing style.

Personal stylist Anetra Byrd is here for a fun episode about what to wear while your body goes through changes. If you saw the pictures from my women’s empowerment talk with Tracee Ellis Ross, you know how talented Anetra is. She styled me for that event and made me feel confident and true to myself. You deserve to look good during pregnancy, whatever that might look like to you, and Anetra has a lot of great advice on how to be chic and stay comfortable.

In this Episode, You’ll Learn About:

• What a personal stylist does
• How Anetra helps clients express themselves authentically
• Why you need support from both your bra and your loved ones 
• What some key pieces are that look cute and aren’t restrictive
• Why you might consider a stylist for a maternity shoot
• Why you may need several sets of clothes throughout your pregnancy and after baby’s arrival
• What a capsule wardrobe is and how it could help simplify your life postpartum

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Full website notes: drnicolerankins.com/episode207

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We’re doing a better job of talking about miscarriage but we don’t necessarily talk a lot about ectopic pregnancy loss. As I explain in the episode, an ectopic pregnancy happens when a fertilized egg implants outside of the uterus, usually in the fallopian tube. If that happens, it can be life-threatening and requires medical attention.

The emotional impact of an ectopic pregnancy can be the same as a miscarriage. Feelings of sadness, grief, and loss are common. Plus, it’s normal to experience anxiety and fear around your own health as well as what’s going to happen in future pregnancies.

The good news is that most often, an ectopic pregnancy will not affect your fertility. Listen to this episode to learn what warning signs to look out for and how to get the treatment you need. After you’ve received proper care, you should be able to go on to have a healthy baby.

In this Episode, You’ll Learn About:

• What ectopic pregnancy is and what causes it
• How common it is to experience
• Whether you can do anything to prevent it
• How doctors can tell the difference between an ectopic and normal pregnancy
• Which treatment option is right for you

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It’s a good thing Chelsea is a lawyer because she had to defend herself all through labor. She did a lot of research and was incredibly prepared for her birth. However, when she asked informed questions her doctors were impatient and annoyed instead of giving her the attention she needed. After her water broke, a doctor literally didn't believe her until she saw the ultrasound to prove it.

As a Black woman, Chelsea’s biggest fear was dying in childbirth. The way her doctors dismissed her concerns is exactly why it is so dangerous to be Black in the maternal healthcare system. Despite being mistreated and nothing going according to plan, she has now gone through counseling and is feeling proud of her birth.

In this Episode, You’ll Learn About:

-How she prepared for her birth

-What made her favorite doctor so special

-How she managed several days of contractions at home

-How some of her doctors were dismissive of her concerns

-How long she labored without pain medication before being induced

-What her attitude was towards pain

-How she felt rushed into her c-section by her doctor

-What ultimately convinced Chelsea to opt for a cesarean

-Why it’s important to think about alternatives to your preferred birth

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What happens with your newborn in the hospital and at that first doctor's visit after you go home? No really, what happens? Because as an OB/GYN I don’t know. Once mom and baby are separate, the pediatrician takes over! Lol.

Today’s guest, Dr. Obidi, is here to fill us in on all of that. He is a board certified pediatrician and the CEO of Newborn Prep Academy, an online newborn preparation course. There is a lot of great advice in this episode for how to get the most out of your visits with your baby’s doctor. I love, love, love his “confident moms mindset” approach and I know you will too!

In this Episode, You’ll Learn About:

• When you should start looking for a pediatrician
• Which tests are done in the hospital for baby and why
• What are some of the most common postnatal tests and treatments
• What some of the intervention options are for treating infant health concerns
• Why you shouldn’t panic if your baby loses weight in the first few days
• When you should bring your baby to the pediatrician
• How pediatricians screen for postpartum depression

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Full website notes: drnicolerankins.com/episode204

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This episode covers a very difficult subject but it’s important for EVERYONE to hear. Pregnancy-related deaths are on the rise in the U.S. and Black women/birthing people are dying at more than twice the rate of their white counterparts. As the richest country in the world, we have the resources to do better and it’s honestly embarrassing.

Because it’s Black Maternal Health Week (April 11-17), I wanted to focus on racial inequities in care. When controlling for other factors, it comes down to systemic racism. I know race can be hard to talk about but things aren’t going to get better unless we do. We can specifically address disparities that affect Black folks AND we can acknowledge other problems at the same time. It’s not an either/or.

Resolving healthcare inequality starts with listening so please really listen. If you feel moved to help, there’s a lot you can do. What you say, how you vote, and where you put your money makes a difference. Listen till the end and check the website notes linked below for how you can!

In this Episode, You’ll Learn About:

• What the differences are between “maternal mortality” and “pregnancy-related death”
• How common maternal death is in the United States
• Which factors contribute to pregnancy-related death
• How risk factors vary by demographic
• What you can do to help reduce maternal disparities
• What “implicit bias” means and how we all have room to grow
• What my top 10 tips are for keeping yourself safe during pregnancy

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Full website notes: drnicolerankins.com/episode203

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You’ll definitely want a box of Kleenex for this episode but spoiler: Charlotte’s baby is doing just fine! A very low risk pregnancy became high-risk almost overnight when an irregular scan revealed a heart problem. This very rare condition meant her baby would be born with a partially-formed sternum and an exposed heart.

Eventually she delivered her daughter via c-section but before that she had to decide whether to proceed with the pregnancy at all. Termination was a viable option and she discussed it with her husband. However, it didn’t feel right. Charlotte is an ardent supporter of a woman’s right to choose and when it came time to make a decision about the path of her own pregnancy, she chose to continue. She has some really wise words for anyone going through the unpredictable parts of pregnancy so you are definitely going to learn something by listening to this powerful episode.

In this Episode, You’ll Learn About:

• Why childbirth education is important even for someone who works in maternal and children’s health like Charlotte
• How her care changed after the defect was discovered
• Why she had to make a very quick decision about the best course of action for the pregnancy
• What life circumstances made it possible for her to choose to continue her pregnancy
• What congenital conditions affected her baby and what they mean (even I had to look some of it up!)
• How a therapist and a doula helped Charlotte with her mental wellness
• Why you should make a birth plan even if you aren’t getting the birth you wanted
• What it means to consider “quality of life”

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Full website notes:https://drnicolerankins.com/episode202/

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Aren’t twins so fascinating? Today we have Dr. Nathan (Nate) Fox here to tell us all about them! He’s a maternal fetal medicine specialist, also known as a high-risk pregnancy doctor or a perinatologist, which is an OB/GYN that works with more complex pregnancies. 

The truth is a lot of doctors don’t have much training or experience with twins and as a result, you might not get the level of care you need or have all the birth options open to you. You want doctors on your team who know which screenings/tests to do, how often you should be seen, and what your nutrition should be like (it’s different for twins). You also want doctors who feel confident offering vaginal birth instead of just going straight to cesarean, which happens more than it should. Whether you are pregnant with twins or just want to learn more about twins, this episode is a must listen.

In this Episode, You’ll Learn About:

-What it means to be a maternal fetal medicine specialist

-How common it is to have twins

-What some of the risk factors are for having twins

-What distinguishes different kinds of twins from each other

-How the prenatal care for single babies and twins differ

-What the models of care are for twins

-Why you should consider seeing a specialist

-How a high-risk doctor works with other perinatal care providers

-What additional risks come with twin pregnancy

-How perinatologists approach (the almost inevitable) early term twin birth

-How much more important Dr. Fox says weight gain is in twin vs. singleton pregnancy

 

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Sorry, the first file was initially cut off. Here's the full episode. Enjoy!

__________________

Wow! Can you believe it’s been 200 episodes?! Thank you, thank you, thank you for being on this journey with me. If you had asked me a few years ago if I thought I was going to be a podcaster, I probably would’ve said “What’s a podcast?”

I never could’ve imagined having this opportunity to help and serve so many people beyond what I do at the bedside. Whether I realized it or not, I was guided along a path here. Thanks to God, the “Universe,” or whatever it may be, I wound up in the right place to do the most good. Everything fell into place and I’m so grateful to have what I never knew I wanted.

In this Episode, You’ll Learn About:

-How my medical school epiphany struck me

-What aspects of medicine I was specifically drawn to

-How I wrestled with parting from a career in academia

-Why it’s important to remember that you can get what you want and not be happy

-How the universe lined up some coincidences that set me on my way to becoming an OB/GYN hospitalist

-What a twisty-turny path it was to go from a health coaching side-hustle to this podcast

-How this show has changed my life

-What’s next…

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Full website notes: drnicolerankins.com/episode200

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Wow! Can you believe it’s been 200 episodes?! Thank you, thank you, thank you for being on this journey with me. If you had asked me a few years ago if I thought I was going to be a podcaster, I probably would’ve said “What’s a podcast?”

I never could’ve imagined having this opportunity to help and serve so many people beyond what I do at the bedside. Whether I realized it or not, I was guided along a path here. Thanks to God, the “Universe,” or whatever it may be, I wound up in the right place to do the most good. Everything fell into place and I’m so grateful to have what I never knew I wanted.

In this Episode, You’ll Learn About:

-How my medical school epiphany struck me

-What aspects of medicine I was specifically drawn to

-How I wrestled with parting from a career in academia

-Why it’s important to remember that you can get what you want and not be happy

-How the universe lined up some coincidences that set me on my way to becoming an OB/GYN hospitalist

-What a twisty-turny path it was to go from a health coaching side-hustle to this podcast

-How this show has changed my life

-What’s next…

--

Full website notes: drnicolerankins.com/episode200

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I am particularly delighted with Haley’s birth story! She was just about as prepared as you can be. Not only did she do childbirth education (including taking my birth prep course!) but she prepared physically. Before she and her husband even started trying she was taking vitamins, minding her physical fitness, and getting tests at the doctor.

In this episode we literally laugh and cry. Her birth was relatively straight-forward. What makes this story so special is the joy you can hear in Haley’s voice when she talks about her birth experience and meeting her baby. Tune in for an interview that will remind you what makes birth beautiful.

In this Episode, You’ll Learn About:

-Why I call Haley “textbook” prepared

-How knowledge made her feel empowered in her decisions

-How she and her provider came to a compromise over induction

-How she was able to instinctively tell when labor was starting

-What her husband did to support her every step of the way

-What her nurse did to advocate for Haley’s needs

-Why her sister encouraged her to go to the ER four days after giving birth

-How pelvic floor therapy helped her postpartum

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Full website notes: drnicolerankins.com/episode199

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So today we’re talking about how to get ready for the hospital, specifically what to pack. Packing your hospital bag can feel stressful and getting ready in advance will give you one less thing to worry about when the time comes.

Of course there’s more you can do to prepare for your trip than just packing. I also offer some helpful logistical tips to make navigating your labor and birth easier. As an OB/GYN I’ve seen a lot of what works and what doesn’t and I’d love to share some of that knowledge with you today!

 

In this Episode, You’ll Learn About:

-What it means to “pre-register” with the hospital and how it can make your birth easier

-Why it’s a good idea to visit the hospital and find labor and delivery ahead of time

-What “GBS” refers to and why your GBS status is important

-What to bring for while you’re in labor

-What to bring for after your baby is born

-What to bring for going home

-What not to bring

-What your partner should bring

-Why it doesn't matter what you look like "down there"

 

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Full website notes: drnicolerankins.com/episode198

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Continuing on the topic of mental health, this week’s episode is an interview with the CEO and founder of Canopie, Anne Wanlund. Canopie is an app that works in tandem with top perinatal mental health experts to give parents access to clinically-effective therapies. Their mission is to make mental wellness support universal and a standard part of pregnancy and postpartum care.

I appreciate the preventative approach of Anne’s work. It helps bridge the gap between those who need care and the services that can help them. Her own experience inspired her to create a solution: something streamlined, easy to use, and affordable - she’s even working to make it FREE!

I want you to know that I am not being compensated for this episode. I think Canopie is doing great work and I just love to bring you all information about tools that may be helpful in your pregnancy, birth and postpartum journey.

In this Episode, You’ll Learn About:

-How prevalent perinatal issues are

-How screening tools are deficient

-What the financial and societal impacts are of maternal mental health issues

-What types of preventions are shown to be effective

-What the Canopie app is and who it works for

-How shame and stigma stop some people from seeking mental health care

-What research has been done to evaluate the effectiveness of the app

-How Canopie interfaces with traditional mental health services

 

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Full website notes: drnicolerankins.com/episode197

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This week's episode is a rebroadcast because my husband Falcon and I are taking a much needed trip togther with just the two of us. And in the spirit of he and I taking some time together, I chose an episode that you and your partner can listen to together! I interview David Arrell, author of Welcome to Fathrhood: The Modern Man's Guide to Pregnancy, Childirth, and Fatherhood. Grab your partner so you both can take a listen and soak up all the goodness in this episode. I know you are going to enjoy it and find it really helpful!

 

In this Episode, You’ll Learn About:

-How to be a supportive and attentive teammate through pregnancy, birth, and postpartum

-Why it’s important to look at parenthood as “teamwork,” as opposed to “women’s work”

-How to handle people who challenge a more progressive approach to fatherhood / being a stay at home dad

-What inspired David to write his book

-How to use code words to ask for or offer support during pregnancy

-What kinds of obstacles are being created by covid

-Why hiring a doula can be helpful for both partners during birth

 

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Full website notes: drnicolerankins.com/episode101

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In this episode we have Marielis sharing her experience with postpartum psychosis. I usually don’t do two birth stories in a row but in light of the Lindsay Clancy case I thought it was important to release this one today. If you haven’t heard about it yet, Lindsay Clancy strangled her three children and is now a paraplegic as a result of a suicide attempt. It is suspected that this was due to postpartum psychosis.

Postpartum psychosis is relatively rare, occurring in only 1 to 2 births out of 1,000. And homicidal behavior is uncommon among those with the diagnosis. Psychosis is a disturbance in an individual's perception of reality which can manifest in the form of delusions and hallucinations among other symptoms.

This is what Marielis experienced after giving birth. Once she realized something was wrong, she did everything right: listened to her intuition, communicated that she felt off, sought help early, and followed through on her medication and therapy plan. Today she is doing well and wants to spread awareness in hopes of preventing future tragedies.

In this Episode, You’ll Learn About:

-What psychosis felt like for Marielis

-What the early signs were that something was wrong

-How her condition made her feel about her baby

-Why being a woman of color made her hesitant to seek care

-How her family supported her during her mental health crisis

-How Marielis’s psychosis was treated

-What risk factors increase the likelihood of postpartum psychosis

-When postpartum psychosis presents after birth

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Full website notes: drnicolerankins.com/episode196

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This is a delightful birth story episode from a fellow physician! Claudia is an orthopedic sports surgeon, currently stationed with the Air Force in Anchorage, Alaska. She gave birth at the same military facility where she works and loved her experience. Even though she went into pregnancy at a (barely) advanced maternal age and with pre-existing borderline hypertension, she was still able to have the vaginal birth she wanted.

Being in the “at risk” category doesn’t necessarily predict how your birth will go. A different hospital might have pushed for a c-section instead of waiting for interventions to work. Induction can be long!! Hers was Tuesday to Thursday. You have to be patient with the process and fortunately her care team was.

I love how one of the doctors in the practice asked if she had birth wishes. This is how it should be done. Fortunately Claudia came prepared with a birth plan she’d made the right way (using The Birth Preparation Course) and went over it with her team before she went into labor. If she hadn’t done that she may not have gotten the outcome she did.

This story goes so many places and I know you’re going to learn a lot from Claudia's experience.

 

In this Episode, You’ll Learn About:

-How Claudia and her partner got pregnant without any treatment right after visiting an infertility specialist

-How her experience as a physician influenced her expectations of birth

-How she felt about giving birth in the military overall

-Why she and her care team opted for induction

-Which pain management option she liked and which one she hated

-When and why her team decided to implement different interventions to move her labor along

-How she felt when her doctor said they needed to consider a c-section after she’d been trying for vaginal for so long

-How well she recovered after a 3rd degree tear by immediately requesting pelvic floor physical therapy

-How her baby’s latching issues were resolved

-What she wished she’d have known about the postpartum “baby blues”

 

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Full website notes: drnicolerankins.com/episode195

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Today’s guest, Liesel Teen, BSN, RN, is a labor and delivery nurse and the founder of Mommy Labor Nurse. I have been wanting to have a labor and delivery nurse on for a long time because I know how important they are to the birth experience. We obviously have quite a bit of overlap in what we do but I never want to come in front of you like I’m the only one with information to help you through your pregnancy and birth.

Now of course I offer fantastic information but it’s great to have more than one trusted source. We come from different backgrounds, different experiences, and we bring that to our work. It can also be reassuring to hear the same thing from multiple experts. Different people present information in different ways and you may just find that one educator’s style works for you better than another.

In this Episode, You’ll Learn About:

-What exactly does a labor and delivery (L&D) nurse do during labor and birth

-What are some misconceptions about L&D nurses

-How L&D nurses work with doulas, doctors, and midwives

-What should you expect from your L&D nurse

-What you should do if you are not happy with your L&D nurse

-What are some tricks and tips that Liesel has learned from her career

 

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Full website notes: drnicolerankins.com/episode194

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I cannot believe I graduated from medical school in 2002! Looking back at my career, a lot of wild things have happened. On this podcast I get to bring you expert advice, education on important topics, and all kinds of birth stories. But for this episode, I thought I’d do something a little more lighthearted and share 10 interesting things from my two-decade career.

I will be talking about some of the difficult things that happen in my specialty, as well. Some of these stories are going to be a little bit gruesome - I give a warning in the episode before going into anything graphic so you can skip ahead. Overall you are going to enjoy it and hopefully you find these stories funny or relatable.

In this Episode, You’ll Learn About:

-What makes it impossible for the hospital to prepare your epidural before you arrive

-Why all kinds of reactions to the arrival of your baby are ok

-Why certain items absolutely should not be inserted into a vagina!

-Why you should think about how your actions affect can others in a public space

-How even I, after 20 years in practice, am not able to predict how quickly a birth might progress

-Why faster is not necessarily better when it comes to labor

-Why we need to monitor placenta previa so carefully

-How we medical providers could be more sensitive to our patients feelings

-What a notarized birth plan is and what it means (or honestly doesn’t mean)

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Full website notes: drnicolerankins.com/episode193

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