Dr. Nicole Rankins, OB-GYN and host of the “All About Pregnancy” podcast speaks with Dr. Fox about her approach to creating relationships with her patients, her pregnancy and birth classes, and her podcast.
“All About Pregnancy & Birth” – with fellow podcaster Dr. Nicole Rankins
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Dr. Fox: Welcome to today’s episode of “Healthful Woman,” a podcast designed to explore topics in women’s health at all stages of life. I’m your host, Dr. Nathan Fox, an ob-gyn and maternal-fetal medicine specialist practicing in New York City. At “Healthful Woman,” I speak with leaders in the field to help you learn more about women’s health, pregnancy, and wellness. Dr. Nicole Rankins, welcome to the podcast. How are you doing today?
Dr. Rankins: I’m good. Thank you so much for having me. I’m excited to chat.
Dr. Fox: Yeah. Me too. Couple of podcasters just chatting away. Beautiful stuff.
Dr. Rankins: Yes.
Dr. Fox: So, you are the host of the “All About Pregnancy & Birth Podcast,” as well as other achievements and endeavors that you do, but we’ll talk about that. I guess we got connected originally through my association with Element, the prenatal vitamin. And I was on your podcast in that capacity. And then, you know, I don’t really actually listen to a lot of podcasts, interestingly, and then I sort of found yours and started to listen. I was like, wow, this is really good. We’re like separated at birth, the two of us, which is cool. So, I thought we would do, like, a home and away thing where, you know, you’re gonna come on my podcast, and I’ll come on yours, and we will let each other’s listeners get to know who the other one is. And I think it’d be pretty cool. So, thank you.
Dr. Rankins: Yeah. Absolutely. Yeah, because I think a lot of times I hear people say that they think that I am rare in terms of the way that I practice and approach medicine. And I like to tell people I’m not rare, there are those of us that are out there. I don’t think, you know, we may not be as well known, and maybe there aren’t as many of us that are definitely wanna, you know, reach out and connect my audience with more people who practice similarly, and have similar beliefs, so…
Dr. Fox: That’s great. Good stuff. So, you’re an ob-gyn, you’re a wife, you’re a mom, you’re a podcast host, you’re a course creator. You’re everywhere. You’re ubiquitous. How did you get into that?
Dr. Rankins: Yeah, so I actually started out in academics. I thought for sure I was going to be a clinician-researcher. After I did my residency at Duke, I went up down the street, did a research fellowship at UNC Chapel Hill, got an MPH, 100% thought I was gonna be an academic, and then I got into academics and realized that it was not the right fit for me. So, I was actually there for seven years, and research just was not working. And it wasn’t until my chairman at the time kind of mentioned that it was suggested that maybe I should be fired.
Dr. Fox: It was suggested. Hey.
Dr. Rankins: Yeah. That I realized okay, that, you know, I got angry and said, well, you’re not gonna fire me. I’ll quit. And as things happened, I was going to my own gynecologist appointment. And it’s like, long story short, or short very long, I was going to my own gynecologist appointment. She said, hey, at the hospital we have this opening for a hospitalist physician. Just, you know, she just happened to talk about it. And I looked into it, and then we didn’t wanna move. My husband was, like, we’re not moving, you know, you’ve gotta figure out something here if you’re getting a new job. And I started as a hospitalist, and I love being a hospitalist, love being just focusing on a OB. I love it more than I ever thought I would.
However, I was missing some ability to connect with people in a different way. And I also always, in the back of my mind, knew that people were looking for information online, and in different places, but we as OBS weren’t present in the places where people were looking for information. So, I initially started a blog, and then that transformed into a podcast because the blog was too hard to write and keep up with, and I’m a avid podcast listener. So, I said, hey, let me see what it’s like to start a podcast. And then now here we are.
Dr. Fox: Wow. So, I have to ask you, going back to the beginning of that story, so you went from Duke to North Carolina, so, what’s the deal? You’re a blue devil or a tar heel?
Dr. Rankins: I’m a blue devil.
Dr. Fox: You’re a blue devil.
Dr. Rankins: Through and through
Dr. Fox: Through and through. Okay.
Dr. Rankins: Yeah. Through and through. I had the best experience. Not that I had a bad experience in Chapel Hill, but I had a great experience in residency. I still have a group of friends from residency, like, we meet up every couple of years. They’re those, so I am a blue devil.
Dr. Fox: Yes. I have no skin in the game with Duke, North Carolina. However, I’ve always been torn in my life because I’m a big Michael Jordan fan because I’m from Chicago. So, that would put me North Carolina. But also in my formative years was like ’91, ’92 Duke, you know, Grant Hill, Christian Laettner. So I’m kind of [inaudible 00:04:48]. So, I guess if I moved to North Carolina, everyone would hate me. So, I don’t know. And so, how’d you get into medicine originally?
Dr. Rankins: Yeah, so initially, my undergraduate degrees are actually in mathematics and mechanical engineering. And in the process of starting my engineering degree, this is gonna sound crazy, but I swear it happened. I was in the dorm, and I was like in the bathroom standing at the sink and looked at the mirror, and I saw myself wearing a white coat. And that moment planted the seed that maybe you should be doing something different. And I just started looking into medicine at medical school and was just became very clear that that was the path that I wanted to go on. And, you know, so I did all the things, went to medical school, and even in medical school, you know, life is the fear of events that happened. I didn’t even think I was gonna be focused on OB. As a matter of fact, I wanted to be a GYN oncologist, like, 1000%.
Dr. Fox: So, you’re a gunner. All right.
Dr. Rankins: I am, I say I’m definitely a smart cookie, a high fever kind of girl. Yeah, for sure.
Dr. Fox: Was anyone in your family in medicine, or were you the first one?
Dr. Rankins: Yeah, that’s a great question. So, no, I’m the first one. My dad did not finish college. He was a hardworking manager at UPS that didn’t graduate from college but like outstanding work ethic. So, like, if you’re on time, then you’re late kind of guy. My mother taught math for 50 years.
Dr. Fox: Wow.
Dr. Rankins: Yeah. And my sister, I have a sister who’s an assistant principal. Everybody else in my family’s in education. Both my sisters in education, [inaudible 00:06:30] cousins in education. So, I’m a little bit of the eyeball.
Dr. Fox: So, you’re basically the one that they all ask their medical questions to?
Dr. Rankins: Yes. They ask me the medical questions, and their conversations around like, education stuff and the lingo. I’m like, I don’t understand any of this, so…
Dr. Fox: Wow. Yeah, it’s interesting. So, I have a lot of doctors in my family, and it was almost the opposite of what you had. It was sort of assumed, and not really assumed, like, in a bad way, that I would go into medicine. I just always thought I would. And I almost had a stand in the mirror and like make sure, like, do I really wanna do this? You know, because it was like the opposite from you, but it worked out great. So, at least in my family though, the questions, the free medical advice gets spread amongst multiple people. So, I’m not the only one.
Dr. Rankins: You are not the only one. Exactly.
Dr. Fox: So, what did shift you from GYN oncology to OB-GYN?
Dr. Rankins: Yeah, so I knew I wanted to do something with my hands. Like, I always like to operate. So, that’s why I kinda was drawn towards GYN oncology, but it just became, as I got through residency, it was like, hmm, this isn’t quite the right thing for me. I think I’m gonna go into general OB-GYN to do, you know, clinician research route. Like, I just thought I was gonna [inaudible 00:07:43]. I was gonna be an academic, and honestly, the hospitalist part just focusing on OB kind of fell into my lap. But I was never quite satisfied being in the office. I always found it overwhelming in some ways. I felt like I was just a Pap smear factory.
Like, I didn’t have the opportunity to spend time with patients, and I was always behind, and I didn’t have control over my schedule. So, that part clinically didn’t feel great either. So, definitely, as a hospitalist there are some pluses and minuses that I love what I do, do lots of stuff with my hands, obviously, with deliveries and whatnot. So, it is absolutely the best fit for me.
Dr. Fox: Yeah. But I could see what you’re saying that the hospitalist gives you sort of that action so to speak. And you’re always, you know, doing a lot, and you’re busy, and you’re working with your hands, but on the other hand, like you said, when you’re hospitalist, it’s just people come in labor, you deliver them or not delivering them. And then they leave almost like an emergency room doctor for a labor floor. So, I mean, you’re obviously very personable and, you know, you’re a talker, and you explain things, and you like to teach. So, I guess what you’re doing now is sort of how you connect with patients from, like, a more long-term perspective than just the ones you deliver.
Dr. Rankins: One hundred percent. Yeah. So, what I do outside of the bedside allows me to connect with lots more people, and support them during their journey and experience in a way that I can’t do for everyone at the bedside. So, it’s not quite like having that continuity of seeing the same patient over and over again. But I certainly get messages of people saying things like, you know, I followed you my whole pregnancy, even I heard your voice in my head while I was going into labor. That kind of thing. So, it’s so rewarding. It’s like been one of the greatest joys of my life really.
Dr. Fox: How did you actually start? Like, how did you make that, you know, jump-in-the-pool decision to do this? Like, let’s say to do the podcast.
Dr. Rankins: Yeah. So, I found that I don’t do very well with, like, a lot of idle time. I initially, and I get like my story’s kinda all over the place, but I actually started off thinking I was gonna do health coaching. So, health coaching is like a way to help people change healthy habits. And that was one thing that I thought was missing in the office. Like, we tell people to lose weight, but we don’t actually tell them how to do it. So, I actually went back to Duke and got trained as an integrative health coach and that gave me a perspective of, like, approaching health from a more holistic way. But it was actually really hard to put that in practice. And again, it still wasn’t quite the right fit. So, I found the marriage of, like, my OB world and then doing a podcast, which is what I love, and doing it that way.
But the thing that just made me, like, pick the leap and jump, it’s easier for me to say, like, I couldn’t not do it when those voices are in my head to say, this is nothing you need to do. I just go forth and just try it. I was, like, in the worst case, it’ll be a disaster and I can stop. But I never wanna look back on my life and say that I didn’t do something, and wonder what would’ve happened. I’d much rather say I did it and I failed, you know, or it worked out, so yeah.
Dr. Fox: And did you have anyone or any podcasts that you sort of modeled it after? Did you just come up with your format on your own?
Dr. Rankins: Yeah, so I just came up with a format on my own. I learned a lot from, I don’t know if you know Pat Flynn, I dunno how I even got into this podcasting stage. You know, you Google how to start a podcast, and he had this guide that kinda walked you through how to think about starting a podcast. And as you know, actually doing a podcast is not terribly hard. The consistency part and keeping it up, it’s a hard part, but starting is not terribly hard. But I knew from the beginning, I just thought through as, like, I wanna talk about birth stories just because I know people like to hear about those. I knew I wanted to talk about topics [inaudible 00:11:49] at my core, I’m kind of nosy I should say.
Dr. Fox: Tell me more about that.
Dr. Rankins: I just wanna know more about different things. Like, I like to learn about different things and different people’s perspectives about things. I wanna interview people about what they do, and their things as well. So that’s how I came up with part Growthing between birth stories and me talking about topics, and then interviewing people about all kinds of interesting things.
Dr. Fox: And did doing the podcast and getting busier with it, and more successful with it, did it affect your clinical practice in one way or another?
Dr. Rankins: I think it has made me a better clinician for sure in the sense that, it’s not just a birth story, we so much get into, like, we do this a lot, and I don’t wanna say routine, but in some ways, you know, the newness of it wears off. But I realize that for every single person having a baby, this is a new experience for them. It’s something that they haven’t done before. So, just helping me remember that when I go to the encounter I think really helped me to listen, slow down, answer people’s questions a bit better. Clinically, I haven’t backed down to my clinical practice yet. I do hope to, plus I had done a little bit in my hospital as practice. But it definitely has made me a better clinician for sure.
Dr. Fox: And your colleagues and maybe your community, do they all know that you do this? Do they sort of, you know, follow you? Do they like poke fun at you from time to time about things? Or, you know, how does that work?
Dr. Rankins: Right. Yeah. Interestingly, even though I’m on social media and I talk on a podcast, I am actually [inaudible 00:13:33] introvert. So I would much rather talk in front of like a thousand people where I don’t have to do a lot of one-on-one interactions than like be at a group in front of 10 people. Like, I’m not, like, a social butterfly kind of a person, so I never mentioned that I had a whole other separate thing going on. And it wasn’t until it started, like, getting more popular, and then people came to me, and was like, wait a minute, you’re on Instagram, you got like 10,000, 50,000. You know, why haven’t you told us about any of this?
And it’s just not my nature to really talk about it, but more and more people do know, I’ve been starting to segments on my local news channel, so people do see me. And occasionally I have patients come in more frequently that know me either from my podcast or social media. Some are quite surprised like, oh, you’re actually at Richmond. Like, I had no idea that especially were at the same city that I was in, because I don’t talk about it. But, yeah, it’s definitely starting to be more, more well-known and lots of my colleagues refer patients to my information as well.
Dr. Fox: Oh, that’s great. That’s pretty cool. So, let’s talk about the podcast. We’ll start there. So what kind of topics do you cover, or guests do you have, you know, sort of what is your, I don’t know so much format, but sort of like, what’s your overarching, maybe your outline, your goals, or something like that?
Dr. Rankins: Yeah. So for the birth stories, I like to include lots of different type of birth stories to give a comprehensive approach, or comprehensive view of birth. So, we’ll have anyone from completely unmedicated birth, came in, had a delivery very easily. To the other extreme. I’ve had people come on and share their experience with stillbirths. So, the whole gamut. Epidural, no epidural, primary C-section, elective C-section, all of the things to help people see all of the possible things that can happen. So, those are the birth stories. And so, it’s some good, some not good in terms of the experience or, yes, I’m a little bit selfish in the sense that I will also interview people that I want to know more about.
So, for instance, if I wanted to know about birth photography because people do it. So, I had a birth photographer come on. One of the most popular episodes of the guest has actually been getting your dog and your baby to get along after you have a new dog. So, that was an interesting thing to talk about. I’ve had someone come on and talk about nutrition or supplements, I’ve talked about obesity, I’ve talked about preterm labor, all kinds of things for the episode with you, with Element that was just bringing information to people about something that they may not know about.
So, I also have guests on who I think are talking about things that are interesting, and people may wanna know more about. I’ve had acupuncture, someone an acupuncturist on, a chiropractor on, a prenatal chiropractor. And I’m very honest and straightforward that like, hey, I don’t know how I feel about this whole chiropractor thing, but let’s talk about it. So, it’s really about me learning and sharing that information with others.
Dr. Fox: It’s so interesting that that’s sort of what you landed on. Again, we’ve never met, and I didn’t know about your podcast before we started ours. Actually, I don’t even know which one started. When did your podcast start?
Dr. Rankins: Early 2020.
Dr. Fox: Like, right when COVID hit, give or take?
Dr. Rankins: Just about. Yeah.
Dr. Fox: So, we started the exact same time. This is also a crazy coincidence. And we landed in the same place because like literally we did the same thing. We had birth stories, and we had topics, and things I do know about, things I don’t know about, you know, guests that I knew, guests that I didn’t know. So interesting. Wow. How about that? Go figure. Do you have any podcasts that were maybe not well received or controversial ones? Or like people, you know, were emailing you, like, what are you doing?
Dr. Rankins: Oh, yeah. I actually redid it a second time, but the first podcast episode that I did on obesity and pregnancy was really like negative. Like, I’ve talked a lot about some of the difficulties and challenges, and some people were like, you know, I felt really bad after I listened to it. I don’t think I did a good enough job of balancing like the realities of obesity and pregnancy with trying to make the best of the situation. So, that one probably sticks out as one that I missed the mark with that. And when I re-recorded it, I think it came across a lot better.
Dr. Fox: What would you say is something you really learned from being a podcaster or doing these podcasts? Either in life or in medicine?
Dr. Rankins: Yeah. To some degree you have to have a, I don’t wanna say thick skin, but you really need to be open. You need to be willing to admit when you got something wrong or when you need to improve. I really think people respond to that. I don’t think people wanna see someone who’s perfect or, you know, like social media glamorous or whatever. I have found that people really appreciate my honest perspective. And when I admit that I have done things wrong, or I have grown as a physician, but I really am trying to do better, people gimme some grace for that.
Like, for instance, I completely used to roll my eyes at birth plans, like, and say that that was like, you know, your express ticket for the OR is a birth plan. Nonsense, and then now I’ve, like, come full circle and actually have a class on how to help people write a birth plan in a more effective way. So, I think people appreciate that honesty and my willingness to say that I’ve done things wrong, and I want to do things better.
Dr. Fox: Yeah. I mean, we’re only perfect on Instagram. That’s what we’ve learned. Everyone’s perfect on Instagram.
Dr. Rankins: Yeah. Exactly.
Dr. Fox: And you scratch the surface a little bit. No. I think that’s it’s really true. And it’s interesting. Do you share personal details about your life on your podcast? Like, would your listeners know, you know, the names your kids or you know, your husband or, you know, things like that?
Dr. Rankins: Yeah. I don’t share the names of my children. I do share the name of my hus…my husband’s name is Falcon, so that’s kinda easy to remember, Falcon like the bird. I occasionally share pictures of her children on Instagram. Not a lot because they don’t like to be on social media. And I respect that. I do definitely talk about my birth experience with my first because that most certainly has influenced what I do, and my work as an obstetrician.
Dr. Fox: In what way?
Dr. Rankins: Yeah. So, she had duodenal atresia. I was a complete nutcase during my first pregnancy. Like, I was ultra-sounding myself in the beginning. I was, like, just nervous and anxious…
Dr. Fox: And you were already an OG-GYN at the time?
Dr. Rankins: Already an ob-gyn. I had just finished residency.
Dr. Fox: Yes. See, I had the advantage of being an idiot because I was a medical student, so I knew nothing which is better.
Dr. Rankins: Okay. Okay. Sweet. Yes, it really is. It really is. So, I was certainly like less anxious. I was like, okay, calm down, relax, take a deep breath, go to an ultrasound appointment. And that’s when she gets diagnosed with the duodenal atresia which, you know, is a rare thing that happens with them. Of course, and they’re like, well, it’s gonna be okay. You know, most of these babies are born full term. They get surgery right after they’re born, they’re in the hospital for a few days, and then they go home, and they’re fun. You know, the surgeon was like really optimistic. So, I was like, okay, you know, good. Okay. I feel better. I feel better. And then I went into labor at 32 weeks. It subsequently delivered via C-section because her heart rate was just dropping like crazy.
Dr. Fox: You’re such the typical OB-GYN, you know. All right. There’s an abnormality in ultrasound, I have preterm labor, and I am having C-section. That’s our joke. If you’re in medicine, or you’re an OB-GYN like you’re screwed. That’s it. You know, it’s all happening to you
Dr. Rankins: On top of that, my epidural was not affected. So, when they did the Allis clamp test and the C-section, I felt it. And they went ahead and started because of her heart rate. Yeah. And it was traumatic, honestly, to be honest with you. And then next thing I knew, I was like, you know, feeling out of it, I was, like, [inaudible 00:21:59] I was like, oh, you just gave me some happy drugs. And then I was like, [inaudible 00:22:04]. But that first part was really challenging. I actually doubted myself in my experience and like, was I being dramatic? Was I just being a drama queen? And then it’s when I had my second C-section, and that was a whole nother experience.
I was like, oh, this is what it’s like you don’t feel any, like, I was not crazy. The first time I was actually feeling anything [SP]. [inaudible 00:22:30] my daughter spent a month in the NICU. That was trying times. I cried every day while she was there, and she’s 16 now doing extremely well. But those [inaudible 00:22:40] were challenging.
Dr. Fox: Yeah. No, that is hard. And I think just for our listeners, when we talk about unmedicated birth, we’re usually talking about a vaginal birth, not so much a C-section on Medicaid C-section. That’s not really a thing in the past couple of 100 years we sort of have avoided that. Wow.
Dr. Rankins: Exactly.
Dr. Fox: Wow. So, obviously, that will inform a lot of what you’re doing, and the advice you’re giving, and the thoughts you have about childbirth and pregnancy, and anxiety, and everything.
Dr. Rankins: The hard stop for me in a C-section, if a patient is saying she’s hurting still, I’m like, we gotta fix it. Because I quite know what it feels like. And then I’ve certainly related to, I don’t like talk a lot about it unless it feels like it’s a natural place to talk about it. About how hard it is to have a preterm baby who’s in the NICU, and how difficult that can be. And just offer some hope that on the other side thing you never forget that it gets better.
Dr. Fox: That’s great. And so, let’s talk about your birth plan class. So, you were a doubter at first in the birth plans, as I guess many obstetricians are. Well, what was it that that turned you around to it, and how do you use sort of that original doubt in helping people plan a birth plan?
Dr. Rankins: Yeah, so the first thing I say, the class is titled Make a Birth Plan and all that. The first thing I say in the class is that we can’t actually plan birth. None of us can, you know, doctors can’t. Doctors [inaudible 00:24:04] induce you. But none of us have control. The baby has control. They don’t really tell us when they plan to come out. So, I reframe it and, of course, you should have wishes about how your birth should go, but we can’t plan it within any certainty. And really the key is understanding that the hospital where you’re giving birth, and your doctor, or your practice are on the same page about the things that you want for your birth. And that’s a conversation that you need to have in the prenatal appointment.
Handing this piece of paper to someone when you go into labor is entirely too late. You’re in the hospital, you’re gonna be there at that point. So, you really wanna know going into it that you have the support for the birth that you wanna have. And it just opens up a conversation, you know, to make sure that everybody’s on the same page.
Dr. Fox: Yeah. I mean we did a podcast on birth plans specifically. And really the conclusion that we had was really that the idea of a birth plans really it’s, you know, have a conversation with your doctor or your midwife, whoever it is. Like, you guys should be in speaking terms, you know. Whether it’s written on paper, or not written on paper, whether you number it or don’t number it, get online, don’t get online. Ultimately it’s, hey, this is what my thoughts were, this is what, you know, I was hoping for. What do you think? And then the answer is either gonna be, I’m 100% on board, or that is unsafe, and here’s why. Or I’d love to offer this, but I just can’t because my hospital doesn’t have that. What do we do? And if you have someone who you’re working with that’s taking care of you, who you trust, then it’ll be easy because you just have a conversation, you figure it out. But if you don’t trust that person, handing them like a list of demands is gonna make it worse not better.
Dr. Rankins: Absolutely. I emphasize that doctors are humans also, and you wanna try to approach the relationship from, like, we’re working together collaboratively, and not demanding. You know, think about someone comes up to you and, like, this is what betters you, and this is how I better go. Like, that doesn’t set a good tone for the relationship, and that trusting piece, as you mentioned is so, so important. So, really the piece of paper, it’s the least important part of the birth plan. It’s really that process of making sure that you guys have a good trusting working relationship together.
Dr. Fox: Yeah. I was gonna actually ask you sort of in a related note as a hospitalist, right? You pretty much have almost never met the people before they show up in labor, unless you happen to have seen them, you know, in triage or something a week before or something like that. How do you develop a relationship, or a trusting relationship with somebody in such a short amount of time? Because it really can be, you might be with ’em in 12 hours, it might be very intense or intimate, and they might show up with the birth plan that they went over with somebody else. Like, how do you do that as a hospitalist?
Dr. Rankins: Yeah, that’s a great question, [inaudible 00:26:53]. When I started as a hospitalist, I very quickly realized that so much of what we do is people relations. Yes, the clinical piece is important, but so is the people relations because you have to establish that trust very quickly. So, it’s really just basic sayings about showing an interest in that person, and the things that are important to them. So, I tend to sit down, you know, ask the history, introduce myself, all of those things. But then I also ask, are there some things that you want for your birth that you would like us to know about? And that usually opens any discussion for birth plan, or anything that they wanted.
I’m very careful about asking permission before doing anything like vaginal exams, I always say, is it okay before we do this? I explain the rationale of things very clearly is people think that that takes a lot of extra [inaudible 00:27:46]. It doesn’t. You can establish things pretty quickly by just showing that you are really interested in this person, and them having their best experience.
Dr. Fox: Yeah. Listen, I think it’s true. It’s not an issue of time, it’s just an issue of taking the time to do it. I mean, you can do it while you’re putting your gloves on. Like, we’re not talking about like 10 minutes conversation. No. It’s like, you know, its 20 seconds or 10 seconds. In the hospital that you’re covering, are there students and residents and whatnot?
Dr. Rankins: No, actually they’re not. Yeah. So we don’t have students and residents in our Hospital.
Dr. Fox: So I mean, when they come in, it’s you. It’s you and the nurses taking care of them?
Dr. Rankins: Mm-hmm. Yes. Yep.
Dr. Fox: Okay. So, that’s all the more so you’re gonna have to develop a relationship with them. You’re not just sort of supervising the other people. You’re in there. Okay.
Dr. Rankins: It’s me. Yeah. And we have a unique situation where the practices in our hospitals, this doesn’t always happen, but all of the practices sign out their patients to the hospitalist. So, we’re like an extension of the [inaudible 00:28:47] practices in the area. We don’t just take care of “unassigned patients,” patients who don’t have a doctor. We take care of everyone.
Dr. Fox: Right. Meaning that is the plan in the prenatal care, like, hey, we’re gonna take care of you in the office. When you going into labor, one of these six people, or whatever it is the number, is gonna be delivering you. And we know them, we trust them, we’ve worked with them, and we have that all set up.
Dr. Rankins: Exactly. Yeah.
Dr. Fox: Excellent. All right. So, let’s talk about your online childbirth class. You do a lot. So, what’s going on there?
Dr. Rankins: Yeah, so I’ve made this childbirth education class, and that was a labor of love. It probably took me eight months to record this thing, right? And record this thing took a lot longer than I anticipated, but I really did it from the perspective of like, I wanna provide information that’s evidence-based. That’s from my perspective as a physician, and specifically about hospital birth. So, that’s what I talk about in the class. But it covers more than just like, what’s happening in your body during labor and delivery, you know, labor and birth.
It’s like postpartum issues that can come up, emergencies that can come up. I talk a lot about actually mindset because that’s a really big piece of labor. How you go into the process, your mindset and your support, having the right support lined up. I’m a fan of doulas because research shows that having someone like a doula improves experiences. So, I believe research. So, really, I just cover that whole gamut in the class. It was truly a labor of love, but I absolutely love it. And we’re at about 1,500 folks who’ve gone through the class, so I’m really proud of it.
Dr. Fox: And so, what happens? People sign up, and it’s just it’s an online, like, lecture series sort of?
Dr. Rankins: Yeah, it’s online. All of it’s recorded. People love it because they could do it… Well, first off, during the pandemic, for a lot of people it was the only option, right?
Dr. Fox: Yeah.
Dr. Rankins: There were no in-person childbirth education classes. So, it really took off during the pandemic. It certainly started to slow down a bit because more people are going back to in-person classes. And now what I’m really definitely attracting are people who feel like still online and being able to do it when it’s convenient for them. And people really love the ability to do it with their partner because they have a hard time, like, dragging their partner to a, like, in-person class. But they will sit down and do an online class at home. And then I have a Facebook group to provide, like, support additional, like, more live support where I do Q&As and things like that.
Dr. Fox: Wow. What do you do…?
Dr. Rankins: And people get lifetime access to it, [inaudible 00:31:16] they have it.
Dr. Fox: Lifetime?
Dr. Rankins: Mm-hmm. Yes.
Dr. Fox: Wow. All right. You know, someone’s gonna have a long birthing career, sign up with you when they’re young, and go all the way through to their ninth kid.
Dr. Rankins: I recently had someone who sent me pictures of all three of her children that she’s had since she…
Dr. Fox: That’s awesome.
Dr. Rankins: Since she bought the course.
Dr. Fox: That’s cool. What do you do about like either listeners or followers who have a really different approach from you? Do they just, like, self-select out, or do you try to be like, as, you know, wide or as broad as humanly possible? Or do you just, you know, stay in your lane and hope people join?
Dr. Rankins: I tell people this is my lane. This is how I approach things. If you like it, come on. If you don’t, there’s lots of other people elsewhere. Like, for instance, I have a lot of people who, not a lot, but a good number who will ask me about birth centers or home births. And I think those are safe options for people who are low risk, and you have to have backup available. I actually reached out to home births [inaudible 00:32:17] in my community just to be a place to transfer, you know, before it gets to be a train wreck kind of thing. But that’s not my lane. Like, I just can’t tell you what happens in a home birth or a birth center. I can tell you what happens in the hospital and birth there. So, that is my lane. And so, I’m very clear on that.
Dr. Fox: Yeah, I mean, similar, you know, I’ve never been at a home birth, but a lot of my listeners were curious about it. So, you know, we did several podcasts on it, but basically it was just me asking questions. Right. And, you know, talking about it a little bit, I mean, I have a working knowledge of it, obviously, but it is interesting and I don’t know, some people get really like, offended that you wanna stay in your lane, but, you know, like, listen, what do we do? Like, I don’t know anything about home birth. Like, I can’t tell you about it in that sense. But I guess they just stop listening is my guess. I don’t know. We try to be as inclusive as possible, but sometimes it’s just, like you said, if it’s not the right place to be, it’s not the right place to be. And that’s fine. That’s cool.
Dr. Rankins: Yeah. And honestly, some people, I don’t wanna like, speak negatively, but some people wanna stay. Like there are some, I’m a big supporter of midwives, big supporter of doulas, I work with midwives, I work with doulas. But there are some people in that community who want to stay in a space of arguing and fighting amongst, you know, like the hospital system is horrible. It’s just horrible. There’s no way that a doctor can be acting supportive, and they wanna hold on to that. And I’ve come to the conclusion that I can’t change people’s… Like, I can’t make it my goal to change people’s minds. I can present my information. If you find it useful, great. I love to work with different types of people, great. But I’m not going to be able to reach everyone. There’re gonna be some people who don’t like me. And that’s just the reality of it.
Dr. Fox: Yeah, no, I hear you. I was listening to someone, one of my guests has a podcast, and on her podcast there was someone talking about homebirths and midwives, and that person was sort of, as you were describing, like very combative, you know, like how awful hospitals are, and how awful doctors are and, you know, all the things they do. And It’s like, oh, whatever, you know, I listened, okay. And I just sort of wrote the podcast person an email said, you know, it was kind of pretty biased and not really factually true [00:34:39]. She said, why don’t you come on, and I’ll have you guys, you know, debate each other. I’m like, no chance. I’m like, I’m out.
I’m like, I have no interest in that. I’m not trying to convince her to think like me or, you know, whatever. It’s just, I don’t know, it was odd. But, yeah, I agree. I’m not interested in that. Just you do your thing, and I don’t know, people who follow, they just, you know, they’re gonna like it, or they’re gonna listen to it, or learn something from it. And that’s it, it’s not worth the fighting, that’s for sure.
Dr. Rankins: And far more, I dunno what your experience has been, but most people actually still want to hear from us as physicians, and actually appreciate our expertise and opinions. They just want us to, like, also respect them as individuals, and like, help them come to choices, and not just, like, tell people what to do. I still think people really value our expertise.
Dr. Fox: Yeah, I agree 100%. My father always told me this because he’s older, so he’s got all this experience. He gets to, you know, speak as the wise man. And he told me that, you know, when he would see patients, he’s a neurologist, he’d said when he would go around, you know, on rounds and see the patients and there was, you know, him and, you know, four residents, and two fellows, and 12 medical students, and six nurses, and three social workers, this, that, and he said you’d go in the room. He said the patients always wanted to know what he thought, like whether it mattered, didn’t matter to them, whether they, you know, it was gonna affect their care or whether it was the thing that was gonna change.
He said, they always wanna know what I thought. And he said, and I could tell you that I’m probably the least helpful person to that patient. You know, the nurses do much more for her. The social workers do a ton more than I’m gonna do. He said, but for whatever reason, people really care what the doctor thinks. And I think that’s true, but on the flip side, there’s a great responsibility with that for doctors to not be condescending, and not be my way or the highway type of thing.
It’s all right. This is my knowledge, this is my information, I’m gonna help you with that. But just that’s it, like without an attitude, and hopefully, that’s how doctors all are, but everyone’s had experiences with doctors, or any professional who’s not like that, and it can really turn people off. I was actually gonna ask that exact question, you know, since you’re basically in authority now, because everyone’s listening to you, does that scare you or worry you about all this responsibility you have that you say something and, you know, millions of people are now gonna hear it and listen to it and follow it?
Dr. Rankins: Oh, my God, of course. Yes, of course. Yeah. It’s, like, what if I say the wrong thing? What if I… Yeah. That, I think that’s a natural response. I think I have to be prepared that, and I’m seeing this more and more, and more people disagree, more people have comments, you know, so yes, absolutely. And I just have to keep telling myself, you know, I’m doing the best that I know how to do. I can course correct if need be, but yes, absolutely. It certainly is theory, but there’s a certain amount of both in this, and in the best side of checking egos and realizing that the ultimate goal is to be of service to the people that we’re really privileged to take care of.
So, it can be frustrating if someone isn’t listening to what you’re saying in a sense, but I’ve come to realize the best I can do is I have my knowledge, I have my expertise, I will share that freely, and I will share it openly, and as honestly as I can, and detach myself from if this person listens to me or not. I have shown up in the best way that I can. But that’s the best that any of us can do.
Dr. Fox: I love it. What a delight talking to you. I really enjoyed this. It’s great spending time with you, and I love what you’re doing, and I love how you’re doing it, and your voice is so soothing. It’s just great.
Dr. Rankins: Funny that you say this. People say that to me, and I would never have thought that before, but thank you. I appreciate it.
Dr. Fox: Yeah, you just have a great way about you. How do my listeners find you? Where can we find you?
Dr. Rankins: Yeah, my website is dr.nicolerankins.com. I’m on Instagram at Dr. Nicole Rankins. I’m everywhere. Dr. Nicole Rankins. The Instagram is my biggest platform, and my podcast is called “All About Pregnancy & Birth.”
Dr. Fox: Awesome. Thank you so much for coming on the podcast, and spending time with us. I really do appreciate it, and keep doing what you’re doing. It’s awesome.
Dr. Rankins: Thank you. And I look forward to having you on my show again soon for the [inaudible 00:39:06] episode as well.
Dr. Fox: Awesome. Thank you. Thank you for listening to the “Healthful Woman Podcast.” To learn more about our podcast, please visit our website at www.healthfulwoman.com. That’s H-E-A-L-T-H-F-U-L-W-O-M-A-N.com. If you have any questions about this podcast, or any other topic you would like us to address, please feel free to email us firstname.lastname@example.org. Have a great day.
The information discussed in Healthful Woman is intended for educational uses only. It does not replace medical care from your physician. Healthful Woman is meant to expand your knowledge of women’s health, and does not replace ongoing care from your regular physician or gynecologist. We encourage you to speak with your doctor about specific diagnoses and treatment options for an effective treatment plan.