Ep97: 15 Things You Need to Know Before Giving Birth

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This week I wanted to revisit my oldest and most downloaded episodes, 9 Things You Need to Know Before Giving Birth, to give it a little update. I have learned so much professionally and personally over the last two years of podcasting, so I wanted to share six more things that you should know and provide a bit more detail on the advice I shared before.

I am more insistent than ever before that every birthing person and their support partners should invest in comprehensive childbirth education. A lot of the advice in this episode boils down to that, including what you should know about making a birth plan, what to expect from your physicians and nurses, and how to advocate for yourself and the care you want.

I also share what I have learned about giving birth in the hospital as I have heard more stories over the life of this podcast. I want all of you to have a beautiful birth and a safe, healthy postpartum transition into parenthood, so be sure to take in this information and continue your childbirth education in a way that works well for you!

In this Episode, You’ll Learn About:

  • Why there is no right or wrong way to give birth and what that means for your birth planning
  • Why you should advocate for things like delayed cord clamping and immediate skin-to-skin during your labor and birth
  • What kind of care you should expect & advocate for from your labor nurse and your delivery doctor
  • How a doula can help you have a better birth experience and how to find one
  • Why nothing should happen during your birth without your explicit, informed consent
  • What you need to know about giving birth in the hospital
  • When to start preparing yourself mentally & emotionally for postpartum life and having a new baby

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I want this podcast to be more than a one sided conversation. Join me on Instagram where we can connect outside of the show! Through my posts, videos, and stories, you'll get even more helpful tips to ensure you have a beautiful pregnancy and birth. You can find me on Instagram @drnicolerankins. I'll see you there!

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Ep 97: 15 Things You Need to Know Before Giving Birth

Nicole: It is 2021. And we are kicking off this new year with 15 things you must know before you give birth.

Speaker 2: Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Calloway Rankins, a board certified OB GYN who's been in practice for nearly 15 years. I've had the privilege of helping over 1000 babies into this world, and I'm here to help you be calm, confident, and empowered to have a beautiful pregnancy and birth. Quick note, this podcast is for educational purposes only and is not a substitute for medical advice. Check out the full disclaimer at drnicolerankins.com/disclaimer. Now let's get to it.

Nicole: Hello. Hello. Welcome to another episode of the podcast. This is episode number 97 and as always, I'm so grateful to have you here with me today. So it is finally 2021 and I am so looking forward to this year and it being better than the last. 2020 was something else. And I am excited to start this year with renewed vigor and hope and just excitement for what's to come. So in today's episode, I decided to revisit the very first episode of the podcast and update it. Now, why did I decide to revisit this episode? Well, I've had a tremendous amount of personal and professional growth since that first episode aired just about two years ago on January 8th, 2019. And over these two years of podcasting, and the feedback I get from you all, and emails, and DMS, and Facebook posts, and Instagram comments and all those good, great things, I've come to appreciate that there are some additional really critical things that you need to know if you're having a baby that I didn't include in that first episode. And I just felt like the two year mark and a new year coming in, also closing in on a hundred episodes for the podcast was just a great time to emphasize those things revisit and update that episode. So here we are. So what I'm going to do is go over those original nine things that were in the first episode with some additional insight, and then I'm going to add a few more for a total of 15 things you need to know before you give birth. So before we get into the episode, let me do a listener shout out from mountain mite. And the title of the review says interesting, relevant and helpful information. And the review says hands down, my favorite pregnancy and birth podcast, I listened to it on daily walks throughout my pregnancy.

Nicole: I loved how Dr. Rankins covered key topics related to pregnancy and birth. And candidly discussed various scenarios. This podcast empowered me to select the right medical provider, navigate a 50 hour labor without unnecessary interventions and successfully prepare for the postpartum period. I highly recommend taking her Birth Preparation Course as well. Well, thank you. Thank you. Thank you for that really, really lovely review. I so, so, so appreciate you taking the time to leave me those kind words. What you described is exactly what I do, what I do, which is empower pregnant people to have a beautiful pregnancy and birth. And I'm super excited about the things I'm doing in 2021 and going forward in 21 to serve you even better. So with that being said, let's get into those 15 things that you need to know before you give birth. All right, number one, there is no right way to give birth.

Nicole: Everybody is going to have an opinion about how you should give birth. Some people, and by some people that could be friends that could be family members, that could be something that you see on social media, but some people will tell you that you should definitely have a natural birth or an unmedicated birth. Like why in the world would you not try and have an unmedicated birth? Some people will tell you that you should absolutely get an epidural. I don't understand why you wouldn't get an epidural. Just go ahead and get an epidural. And a lot of those decisions or comments revolve around pain management. Sometimes it also revolves around the choice where you decide to give birth or who you decide to have as your care provider. Like some people may have strong feelings about having a physician versus a midwife or giving birth in a birth center versus a hospital.

Nicole: And the truth is only you can decide what will work best for you during your pregnancy and birth and whatever you decide is okay. So if you don't want to use medication to manage pain, cool, if you want an epidural, as soon as you hit the door, that's fine too. If you want a Cesarean birth, if you don't want to labor, that is okay too. I'll be honest. That one took me a little bit longer to come around to. It just always felt a little bit, I don't know, interesting to me that someone would choose a surgery over vaginal birth, but the reality is if that's what you want, then you should have access to it. And you are capable of making that informed decision for your self. There are different approaches to birth. There's no right way. There's no wrong way. You have to do what works best for you.

Nicole: So as long as you're making an informed decision, you've done your research. You've checked things out. You've asked the questions. And also you're in a situation where you and your baby are healthy, then do you. Also be sure that you do not judge other women who make different decisions than you. We're each autonomous individuals. And we can make choices for ourselves and we need to support each other and not judge people for doing something different. Okay? Number two, labor is intense. Okay? Most women will experience labor as painful, and you probably will too. Now some laboring people like to call it different things like surges or waves to try to disassociate it from the perception of pain and contractions. But the honest truth is that most birthing people will experience contractions as pain, but here's the thing. It's a different type of pain. And that can be hard for people to wrap their heads around because typically pain means that something is wrong.

Nicole: Like when our body sends out pain signals, it typically does so because it's trying to tell you, hey, something's not right here. I cut something. I broke something, something's going on. But in the case of contractions, pain is not only a normal thing. It is a necessary thing in order to give birth. So this pain is different. It's awesome. Different in that it's predictable. It comes and goes at pretty predictable intervals. Once labor gets going, the cause of this pain is actually a joyous occasion, the birth of your baby. And there's an end to it, which is also a joyous occasion, the birth of your baby. So when you think about labor pain in this different way, that it's a different type of pain, it's not a normal type of pain, that can make it easier for you to manage. When you know that it's time limited, that it's related to a good thing, that is necessary and needed to have a vaginal birth.

Nicole: When you can have that mindset, it can help you deal with it better. It's also really important for the people who are supporting you to understand this as well. I've seen this happen many, many times that support persons can feel challenged, or it can be very difficult for them to watch their loved one go through that type of pain, the pain of labor. It can be jarring, I should say for them to see, to see their wife, their partner going through that. So it's also important for your support person to understand that this pain is normal. Now the good news is that there are lots of options to manage pain. There are medication free techniques, there's IV pain medication, there's nitrous oxide, there's epidurals. And I have a great guide that can help you. It covers all the options, the side effects, risk and benefits of each.

Nicole: You can grab that free guide at drnicolerankins.com/labor. All right, number three, your doctor is important, but so is your labor nurse. Listen, okay. Let me tell you, there is nothing on this earth quite like a great labor nurse. They are a critical part of helping you have that beautiful birth. Labor is a several hour process. And a lot of people are surprised to realize that your doctor is really not there with you for most of it. Your doctor pops in at various intervals every few hours or so and checks in on you. They're not there with you the whole time. They may not even be in the hospital the whole time. But the labor nurse, her job is to be with you during your labor. She keeps a close eye on, you keeps a close eye on your baby, make sure everything is progressing smoothly.

Nicole: She may be the one who checks you during your labor to see what progress you're making, update your doctor about any concerns. Your labor nurse is going to be in your room frequently every 15- 20 minutes or so. She'll help you with pain management techniques, moving around, getting in the shower if need be. She's also going to be the one who's there with you when you start pushing. And finally she gets you through the not so sexy parts, like cleaning up poop or blood or vomit and all of those things. She'll also get you started with breastfeeding and she can also be a buffer against an intervention heavy doctor. For example, I knew some nurses at a hospital that I used to work at. One of the doctors, he since retired, used to do a episiotomies a lot. So the nurses would wait until the very last second to call him for delivery.

Nicole: So he didn't have an opportunity to do an episiotomy. So nurses can be buffers against those type of things. I mean, ideally of course, that does scenario doesn't have to happen. We should not be doing episiotomies unnecessarily, but they can help in those situations to be that sort of buffer. So yes, your doctor is an important part of your baby's birth, but your nurse is a very, very important part as well. All right, number four, your doctor should wait to clamp the cord. We should be doing delayed cord clamping. I think this is gaining pretty universal acceptance at, I think there may be some still older doctors who don't necessarily do it, but delayed cord clamping should be pretty routine. It's the practice of waiting to cut the cord for at least 30 to 60 seconds. It can be done at the time of a vaginal birth or a C-section.

Nicole: And as long as your baby looks vigorous, whether they are pre-term or full term, then we should do delayed cord clamping. It's recommended by ACOG, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics. And of course the American College of Nurse Midwives. And there lots of benefits to it. It can increase hemoglobin. That's the part of our blood that carries oxygen. It improves iron stores for preterm babies. It decreases the need for blood transfusion, decreases the risk of bleeding in the brain. Um, it's just a really great practice overall. There is a slightly increased risk of jaundice with delayed cord clamping, but that jaundice tends to be very minor and resolved quickly. So delayed cord clamping should be routine. All right, number five. Another thing that should be routine is skin to skin contact as soon as possible between you and your baby.

Nicole: So skin to skin contact is when your baby is placed directly on your chest belly down. Nothing, no bra, no gown between you and the baby, like literal skin to skin. And it should happen as soon as possible after birth meaning the baby comes out of your vagina and can come straight up onto your chest. Now for some people that can be a little bit like, okay, there's this squiggly wiggly bloody fluidy baby. So we can definitely like put the baby on a blanket and just dry the blanket or dry the baby off a little bit and then put the baby on your chest, you know, within a couple minutes after birth, but everything that needs to be done for your baby can be done in your chest. We can drop the baby off, cover the baby with a blanket, put a hat on the baby if need be and do everything right there on the chest.

Nicole: The baby does not need to be whisked away to a warmer if the baby looks vigorous and healthy. And the benefits of skin to skin contact is babies will transition better to being on the outside, they have more stable breathing, temperature, it can help with breastfeeding. Um, it can promote bonding between you and your baby. So great things from skin to skin contact. Now, if you have a C-section or if your baby needs to be assessed, they come out and they look like they are in distress. Then skin to skin contact may be delayed a bit and that's okay. Just start as soon as you can, within the first hour after birth. The research shows that if it happens within the first hour after birth, that's sufficient. Now, if for some reason you can't do skin to skin contact because you are tired or, you know, you're having a C-section, then your partner can also do it too.

Nicole: So it doesn't necessarily have to be you. And then speaking of C-section, some hospitals will offer immediate skin to skin contact, even at the time of a C-section there's a specially designed drape that can be used during the C-section to facilitate that immediate skin to skin contact. That's not a very common thing. I will say that I see that you can do that, or the hospitals have that option, but it is possible. So you can ask, but it is possible that very shortly after birth and a C-section that the baby can be brought to you. So it shouldn't be very long that you can start skin to skin contact in the operating room. I will say it can be a little bit awkward doing it in the OR because you're laying on the table. So the positioning can be a little bit weird, but you can certainly give it a try.

Nicole: All right, number six, your doctor may not be there for your delivery. It's really increasingly common that the doctor who delivers your baby is not the doctor you were seeing for prenatal care. More often, it's the on-call doctor from the practice. So there's a group of doctors, five or six doctors, they rotate who's on call and whatever doctor happens to be on call is going to be the one who does your delivery. Now, in some instances, some doctors still try to deliver all of their own patients as best they can. But I would say that that's probably not the norm. And I could also be a doctor like me. I'm an OB hospitalist and every hospital's program is set up a little bit differently, but in my hospital's program, the hospital has taken over taking care of everyone on labor and delivery in the evening and on the weekends.

Nicole: So it's a high chance at the hospital where I work. The hospitals actually in the area where I work, they're all run very similarly that if you give birth in the evening or on the weekends, it's going to be by a hospitalist. And there are a lot of reasons for this shift in care. A big one is safety. Doctors cannot work day after day and then be up night after night and provide safe care. And it also helps doctors to have some predictability to their schedules and improves that work life balance. When they're not on call, then they can spend time doing things with their family and friends. And I will say that most women still have a great experience, even if it's not their regular doctor at the delivery. So I don't think that this has had a big, negative impact on birth. And actually in the case of hospitalists, there's some data and evidence that hospitalists have improved things like Cesarean rates.

Nicole: The Cesarean rates tend to be lower at hospitals that have hospitalists because there's no rush to get birth done. Um, and outcomes are better. If you have some concerns about who's going to be there for your birth, then definitely ask ahead of time. There's some opportunity potentially during your prenatal care to meet all the potential doctors who could be there for your delivery. All right. Number seven, giving birth is very much so normal, but it is also very much so unpredictable. Now the vast majority of births, normal, healthy, uncomplicated, but we cannot plan how things go. Birth is very unpredictable. Your baby is the one who is most in control of what happens. And they do not communicate that with you, your doctor or anybody else. So although birth normally goes well, it's not necessarily because we had control over planning it that way. All right.

Nicole: It's just that things happen to line up and go the way that we want. And now that happens most of the time, but again, we don't have control over that. Now. Some people misinterpret that to mean that because birth is so unpredictable, then you shouldn't have a birth plan. You shouldn't have any birth wishes for how you want your birth to go. And that is ridiculous. Like having a baby is a very, very special event. So of course you can have wishes or you should have wishes if you want to about how you would like your birth experience to go. A lot of times people say, you know, you should just be happy that you have a healthy baby and that you're healthy. And of course that's good. Like every birthing person wants to be healthy and wants their baby to be healthy after the experience.

Nicole: But it is perfectly reasonable, normal to want more, to want to be respected, to want to have a certain environment in your room, to want to have certain people there to want to have a vaginal birth. All of those things are normal and reasonable. So don't let anyone tell you any different. Now it's important that you do take some time to educate yourself. So your wishes for your birth are really well-informed based on your unique circumstances for your pregnancy. Now I have a free online class. I can help you with that on how to make a birth plan. It covers some really important questions you want to ask, how to get your doctors and nurses to pay attention, what to include. You can sign up for that class at drnicolerankins.com/birth-plan. Now, it is important to understand that because birth is unpredictable, you have to remain flexible during the process of birth.

Nicole: So yes, you have wishes about how you like things to go, but you can't be particularly attached to any specific outcome because it's really unpredictable what will happen. And again, although the most likely outcome is that you and your baby are healthy and well, the journey to that happy ending isn't always what you expect. And that journey may take some twists and turns along the way. Being flexible about that process will leave you feeling comfortable, will leave you feeling at peace, whatever your journey is. When people are not satisfied about their birth experience, it's most often because they thought it should go a certain way. And it didn't. They weren't prepared for the possibility that things could go different than what they expect. So being flexible, being open to following the journey and the process is really important to feeling good about your experience and having that beautiful birth.

Nicole: Okay. Number eight, consider getting a doula. Doulas provide physical and emotional support during labor and the postpartum period. Now, to be clear, most doulas do not have medical training, but research studies show that having a doula can do things like shorten your labor. It can decrease your need for pain medication and can increase your chances for having a vaginal delivery. So what you want to do is, again, although they don't have medical training, they do have training. So you choose one who's had formal training. You want to choose a doula who doesn't push her own agenda. So you don't want to choose someone who's like, I only support people who have an unmedicated birth. You want to have someone who supports your wishes, whether you want a medicated, whether you have an epidural, whether you have a cesarean. You also want to make sure you have a doula who doesn't try to replace your partner.

Nicole: Okay. They should really be there to support both of you during your labor and birth. So in these times with COVID even doulas are doing virtual support. Um, so just ask your questions, interview ahead of time to make sure you have someone who fits for you. You can get recommendations from friends, family members, your doctor or hospital may have some recommendations. You can also go to doulamatch.net and look for doulas in your area. See their training, see their rates, all of that. Good, great stuff. I have a podcast episode about doulas it's episode number nine. It's where I interview Kesha Graham. She is the doula who manages my Facebook community groups. So I'm definitely check that episode out. If you want to know more about doulas. All right, we are just over halfway there. Okay. So number nine is consider taking a look at your placenta.

Nicole: This is my inner nerdy self coming out. I think the placenta is so fascinating. The placenta is a unique organ, and that you can have a placenta, this organ that's in your body, and it can not be genetically related to you, but your body won't reject it. So what I mean by that, like, if you have a kidney transplant, for instance, then the kidney transplant has to be similar to you genetically, and you have to take medicine so your immune system won't try to fight off this new kidney in order for it to work. Like your body will see this new kidney and reject it otherwise. However, the placenta can be like any genetic material from any person at all. Like, this is how a person can carry a pregnancy that is from a donor egg and donor sperm. And it still happens just fine.

Nicole: Like the body doesn't recognize the placenta as being foreign, even though it's an organ that's in the body that is foreign. I don't know. I just find that particularly fascinating. So it's also your baby's lifeline. It provides the nutrients your baby needs, it filters waste. It's just a miraculous organ. So I in the last few years have started offering to show the placenta to anyone who sees it. Lots of people take me up on that offer. Some people are amazed. Some people are grossed out. Um, you can see the sack that the baby lives in. You can see the umbilical cord. You can see the fleshy part, some people even take pictures of it. So consider taking a look at the placenta. It's one of those things that you only get to see once or twice in a lifetime. So, um, just consider taking a look.

Nicole: Cause again, it's really a fascinating organ. Now you may have heard some folks talk about placenta encapsulation, which is the practice of ingesting the placenta. After it's been steamed, dehydrated, ground, it gets placed into pills. There's no evidence that it helps, no scientific evidence. There's anecdotal evidence. I actually have a bonus lesson in the Birth Preparation Course all about that. But short story is there's no evidence that it helps. There's no scientific evidence that it is harmful either. Okay, number 10. And this is really important. It should probably be like number one or two, but nothing. And I repeat nothing, should happen during your birth without your consent. That means before a vaginal exam, an episiotomy, before breaking your water, there needs to be a discussion about the benefits, the risks, the alternatives, and your provider needs to receive your explicit explicit consent before proceeding.

Nicole: Now it's true that in rare emergency circumstances, we don't have time for detailed consent, but that is rare. The vast majority of the time, there should be informed consent. You should always have choices. You should always have power over what happens to you and your body during your birth. This is something that I say I'm ashamed to say. I didn't realize until later in my career now I would never like do at an episiotomy or break someone's water without their consent or a C-section or anything without their consent. But it hadn't occurred to me until the last few years to ask explicitly before doing a vaginal exam. We're certainly trained to just go in and say, hey, I'm here to do a vaginal exam, put your ankles together, let your legs flop out. I mean, if you've had an exam, you kind of know how the discussion goes and it's not that I was ever mean or forceful or anything like that about it.

Nicole: I feel like I've always been pretty pleasant, like introducing and connecting with people. But asking that explicit, is it okay before I do this? It's just not a culture or part of the culture of obstetrics in the U S. So again, nothing should happen during your birth without your consent. Okay. Number 11, this is another big one, if your doctor or your labor nurse is not meeting your needs, then find another one. I cannot tell you how many times I've seen people stick with a doctor who does not work for them. Okay? Because the truth is there are some not so good doctors out there. However, there are some really great doctors out there. So there's really no reason that you need to stick with a provider who does not work for you. Don't be concerned about hurting feelings. Is it going to be difficult?

Nicole: All of those things, because the most important thing at the end of the day is you and your pregnancy and how you are cared for. Like that doctor is going to continue going on, doing what they need to do or doing what they're doing with their work. But you are the one who is affected. So if you're not having a good experience, then find another one. You may have to look a little bit and you may have to change one or two times. The sooner you can change if someone is not meeting your needs, the better. A common scenario I see is that someone was taking care of them outside of pregnancy, like for GYN care and their during pregnancy, things are different. That is not an uncommon thing that happens. So, and then people feel funny because that doctor has been caring for them.

Nicole: But then now during pregnancy is different. Still don't be afraid to change, and you can really do it any time. I have a couple of podcast episodes. I have one with Kristin Pascucci from Birth Monopoly. She changed midwives, I want to say at like 41 weeks. Like at the very end. I did another podcast episode with, um, I want to say it was with a birth with Tavia Redburn, the birth photographer who I had on. And she fired somebody like mid labor. So I don't suggest if you can do that, if you can avoid that rather than avoid that. So it's changed the sooner you can, the better. So you have time to find someone, but don't stick with the provider who is not meeting your needs. It is not too late to change. Also during labor, if your nurse isn't meeting your needs, do not be afraid to ask for a, another labor nurse.

Nicole: All right. Number 12. Okay. If you are giving birth in a hospital in the US, you are giving birth in a system that was not designed to support you. Now, I'm not saying this to be like, I don't know, alarmist or dramatic. I'm saying it because it's the reality. The foundation of maternity care in the US is a patriarchal system where women didn't have control over what happens in their own bodies. So there were things like Twilight sleep. There were high episiotomy rates, high rates of forceps births, those five o'clock C-sections in order to go home. Now we have definitely made progress. And there are many people who are working hard to ensure that women are well cared for and centered in their birth experience, but we haven't completely moved away from those days when women were just expected to do what the doctor said.

Nicole: For example, we still use words like allow, like we don't allow you to eat or drink in labor, or we don't allow you to not have an IV during your labor. Using the word allow implies that we are the ones who have the control over what happens to you during your labor and birth. And that's not how it should be. It should be a shared decision making process where you rea given information, and then you're able to make decisions. And we talk through things. It should not be that we control what happens to you during your birth. So that leads me into number 13, which is really important. And that is you must do childbirth education. Okay? Because of what I just said, I didn't used to be so insistent about this, that I felt like everyone needed to do some childbirth education, but the longer that I had been podcasting, the longer that I had been on social media and I get stories and hear feedback from women, the more I know that good childbirth education is really imperative.

Nicole: This is how you can be an empowered participant in your birth. This is how you're able to navigate and find those good places that we know exist in the system. The good places, the good doctors that can support you in your vision for your birth. Now, child birth education of course, is not going to like, you're not going to turn into an obstetrician, right? But it will allow you to have those informed conversations, speak intelligently and understand what's going on. It's also important that your partner whoever's with you go through some childbirth education so they can be there to support you as well. I think this is even more important where in our current time support people or who is being permitted in the birth room is limited. This is also important for communities that have been marginalized by our system like black women, women of color.

Nicole: It's really important that you have good solid childbirth education so that you are able to intelligently advocate for yourself during your pregnancy and birth. Super, super important. Now, of course, obviously I have a great option for childbirth education. If you've listened to the podcast enough, you've heard me talk about it many, many times the Birth Preparation Course, my online childbirth education course that ensures you are calm, confident, and empowered to have a beautiful birth. But I'm not arrogant enough, of course, to think that it is perfect for everyone. So you have to do your research and find something that works for you. But the important thing is to not skip it, that childbirth education is really, really important. Okay. Number 14, what is also important is being intentional about preparing yourself mentally and emotionally during your pregnancy and birth. And this is actually not just important for your pregnancy and birth.

Nicole: This is also important for you as a new parent and taking care of this tiny human being. And it's actually important for your own growth, growth and development as a person and as a human being. Now, one of the things I teach in the Birth Preparation Course is using meditation as a way to help get you in the right mental space. Also using affirmations. I talk about things like self messaging, where you send messages to yourself in little ways in order to help yourself mentally and emotionally, that may be prayer for some people to get in the mental or emotional space, maybe journaling. You really have to find what works for you, but just be intentional about paying attention to that mental, that emotional, maybe spiritual piece for you that is also very important for your pregnancy and birth and your life. Okay. The last one, and this is one I've kind of struggled with.

Nicole: Number 15 is you need to start preparing for the postpartum period during your pregnancy. Now, the reason that I've struggled with this is because, you know, as a hospitalist, 99% of what I do is deliver babies. So I don't see people in the postpartum period anymore. It's been a while since I've been in the office. And even when I was in the office, the way traditional obstetrics is practice is that we don't see people until six weeks postpartum. We see them for that one six week postpartum check. And then it's like, okay, after that, I'll see you in a year. That's the way that our system is set up. Someone has likened it to, I've heard this example before of like the baby is a piece of candy and a beautiful wrapper. And the woman is the wrapper. And then once the wrapper comes off and the candy comes out, then the rappers just kind of discarded.

Nicole: Like that's how we treat women in the postpartum period, but we need to spend more time preparing people for the postpartum period. And I'm not necessarily talking about for how to care for a baby. I mean, that's important too. Don't get me wrong. Like some newborn basics and things like that. But I think those things tend to come. Babies are very forgiving. They really just need like food and a bassinet and like a onesie, like it's not in diapers, you know, things like that. I can honestly say that you kind of figured those things out, what I'm talking about and let me back up. I don't want to be dismissive. Yes. Taking a newborn class, getting those things, figuring out how to take care of your baby is important. But what I'm really talking about is the emotional and physical postpartum journey that you as the birthing person, you as a woman can expect over the first year or so after you have a baby. Having a baby changes you in so many ways, and it can be very jarring for some folks to have a baby and then be completely unprepared for that roller coaster of the postpartum period.

Nicole: And I'm not saying it's bad. I'm saying that it's, it can be a lot. There's a lot of joy. There can be some sadness. There can be some difficulties. And this is more than just like postpartum depression. This is about how relationships might change, um, work, all of those things. So it can feel a bit overwhelming, but honestly it doesn't have to be, and you don't need to learn everything while you're still pregnant. Okay. But in the third trimester, start thinking about things and planning for things in that post partum period. I had a perinatal psychologist on Dr. Alyssa Berlin in episode 51 of the podcast. And she talks about how she thinks people should start preparing for the postpartum period around 28 weeks or so. And I believe she has a course. It was going to go online. I'm not sure if it's online now about preparing, uh, the birthing person and her partner for the postpartum period. Also had Dr. Christine Sterling on who's an OB GYN. And she talks a lot about the postpartum period. She was on episode 73 of the podcast. And I initially, or I recently rather, came across a Instagram account called postpartum dot push. That is an OB GYN and a midwife. And they focus on all things postpartum related to mom and baby. So those are some good resources you can check out. It doesn't have to be overwhelming or a lot, but just really in awareness. I think the biggest piece is understanding the range of things that you can expect in the postpartum period. And knowing that those ups and downs may be calming and then knowing what your resources are, or having some resources available to get help, if you need it, like having the lactation consultant on speed dial, knowing to go to your doctor if you're having some trouble with postpartum depression, knowing to reach out to your pediatrician and how to reach out to your pediatrician and that it's okay to reach out to your pediatrician if you're having some trouble understanding, that it's not always rainbows and unicorns, sometimes it's hard. Sometimes it's stressful having a new baby and all of that is normal. So I think just kind of following those accounts, looking at those things can be very, very helpful. Okay. So those are the 15 things you need to know before giving birth, just to recap. Number one, there's no right way to give birth. Number two, labor is intense. Number three, your doctor is important, but so is your labor nurse. Number four, your doctor should wait to clamp the umbilical cord. Number five, there should be skin to skin contact as soon as possible between you and your baby after birth. Ideally within the first hour after birth. Number six, your doctor may not be there for your delivery. Number seven, giving birth is normal, but also very unpredictable. Number eight, consider getting a doula. Number nine, consider taking a look at your placenta.

Nicole: Number 10, nothing should happen during your birth without your consent. Number 11, if your doctor or nurse is not meeting your needs, then find another one. Number 12, if you are giving birth in the US hospital, you're giving birth in a system that was not designed to support you. Number 13, you must do childbirth education. Number 14, be intentional about preparing yourself mentally and emotionally for pregnancy and birth. And then number 15, you need to start preparing for the postpartum period while you're still pregnant. Okay. So there you have it. Be sure to subscribe to the podcast in Apple Podcast or wherever you listen to podcasts. And if you feel so inclined, I would love it. If you leave an honest review on Apple Podcast, I do shout outs from those reviews that helps other women to find the show and it helps the show to grow. Also come connect with me over on Instagram @drnicolerankins. I'm having a ball on Instagram these days with connecting with folks and comments and DMS. Um, I do live videos, they're a Q and A sessions where I answer questions. So come connected with me over on Instagram. I'm @drnicolerankins there. So that is it for this episode. Do come on back next week. And until then, I wish you a beautiful pregnancy and birth.

Speaker 2: Thanks so much for listening to this episode of the All About Pregnancy & Birth podcast, head to my website, drnicolerankins.com to get even more great information, including free downloadable resources on how to manage pain in labor and warning signs to look out for after birth. You'll also find information on my free online class, on How To Make A Birth Plan That Works as well as everything you need to know about my signature online childbirth education class, the Birth Preparation Course. Again, that's drnicolerankins.com and I will see you next week.