Ep. 304 – Preparing for an Empowered Birth with Dr. Nicole Rankins

April 29, 2024

Listen Now:

Shanna and Laura talk to Dr. Nicole Rankins about what pregnant people can do to create an effective birth plan. Dr. Nicole is a board-certified, practicing OBGYN and the host of the podcast “All About Pregnancy & Birth,” and she is the creator of online courses “The Birth Preparation Course” and “Make a Birth Plan the Right Way” to teach pregnant people how to feel comfortable and empowered to have the birth they deserve. Also, Shanna reports on her spring cleaning plan for her kids, and Laura talks about taking a spring break trip to the Palm Springs area. Finally, they share their BFPs and BFNs for the week. Shanna’s kids are 5 and 8 years old, and Laura’s kids are 5 years old and 3 years old.


Visit https://drnicolerankins.com/ for more information on Dr. Nicole Rankins and her online birth plan and childbirth education classes.


Follow Dr. Nicole Rankins on Instagram.


Topics discussed in this episode:

-Surviving spring break with young kids

-Spring cleaning

-Encouraging kids to clean their rooms

-Taking a vacation with young kids

-How to make a good birth plan

-When in pregnancy to create a birth plan

-Doing a drop-off playdate

-Taking photos underwater


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Check out some of our favorite things: Books. Gifts for babies and kids. Registry items.

Big Fat Positive: A Pregnancy and Parenting Journey podcast is hosted by Laura Birek and Shanna Micko and produced by Laura Birek, Shanna Micko and Steve Yager.

Big Fat Positive: A Pregnancy and Parenting Journey is produced by Laura Birek, Shanna Micko and Steve Yager.

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Episode Transcript


Laura: Welcome to Big Fat Positive with Shanna and Laura. This week, we have our weekly check ins. We have our special segment, an interview with Dr. Nicole Rankins, a practicing OBGYN who tells us why most people are making their birth plans wrong, and we close with our BFPs of BFNs for the week. Let’s get started.


Laura: Hi, everyone. Welcome to the show. This is episode 304. Hi, Shanna. Hello. Tell me, tell me, what were you up to this week?

Shanna: Oh, just been trying to keep my head above water.

Laura: Are your walls clean yet?

Shanna: The walls and ceilings are clean from birdgate 2024. I had to take a magic eraser, stand on a chair, and scrub bird feather soot marks all off my ceiling. So that was fun.

Laura: I bet it was fun for the first two, and then it got old.

Shanna: Oh, it got so old. And I’m short, so I really had to reach up high and stand on my tippy toes and all of that.

Laura: Too funny.

Shanna: But that’s behind us. This week, we rolled right into spring break.

Laura: That’s right.

Shanna: Which means no school for my beautiful children, who I love very much.

Laura: Disclaimer.

Shanna: Was it that obvious? I do. I love them so much. I didn’t take any time off for spring break, and I’m regretting that now. But I didn’t because I’d been sick for a couple weeks and I was missing a lot of work for being sick and I was behind. And I just sometimes get this mentality that I can do it all.

Shanna: You know, I work from home. My kids are home. I’ll just do all of it, and I underestimate how overwhelming it is to constantly be multitasking, trying to focus on a task or a meeting and being asked for snacks or whatever. So I’m a little bit overwhelmed.

Laura: Yeah. I feel like it’s an impossible situation, though, because if you took vacation days, personal days, PTO, if you will, in the parlance of corporate America, for every time your kids had a break or a random Tuesday off or whatever it is, you’d have no more PTO. It’d be gone.

Shanna: Yes. That’s very difficult to do. And I was feeling very jealous of a lot of people in the moms groups online and the neighborhood groups talking about like, hey, what are activities I can take my kids out to do? Some moms are like, on Monday, I’m going to this museum. On Tuesday, I’m taking the kids to the beach and blah blah blah. And I’m just like, I can’t do any of that because I need to work. So I had to find something for these kids to do. Much to their chagrin, I decided that that would be the week that they would do spring cleaning on their bedrooms.

Laura: Oh, what all young children love, a cleaning day.

Shanna: Oh, yes. A cleaning week is how I framed it.

Laura: Oh, yes. Excuse me. A whole week. That’s dedicated. I’d love to see how Auggie would react to that. Auggie, I’ve got great plans. We’re gonna spend all week cleaning.

Shanna: Their rooms have been driving me nuts lately because they’re so cluttered with stuff. I mean, you’ve seen pictures and videos of how many stuffed animals Cece has. Right?

Shanna: That’s just the beginning. There’s tons of books and toys and things they’ve outgrown, and I really wanted them to clear it out. So I tried my darndest to make it seem like a fun activity. I got our huge whiteboard and I broke down spring cleaning into lots of very small, achievable steps and wrote them out.

Laura: Okay. I will say that this is something I could get behind because if someone gave me a full week free of any other responsibilities and told me that there was going to be a structured schedule for how I can declutter and clean my house, I would be in seventh heaven because I know I need it so bad. So maybe what I need to do is just copy this structure that you came up with. So, tell me, what was on this whiteboard?

Shanna: Okay. Well, first of all, I don’t know if you’re familiar with the Bluey episode where they do a chuck out.

Laura: I don’t. My kids have started watching more Bluey, but that’s not one that I recognize.

Shanna: Okay. So what we might call a purge or throwing things away, they call a chuck out. And the girls, Bluey and Bingo, have to chuck out a bunch of their toys. And, of course, they’re like, no. Don’t chuck it out. So I was like, girls, we’re gonna do a chuck out. So one thing on the list was a book chuck out, meaning books that they don’t read anymore that we are passing on to other people. We’re getting them out of our house.

Shanna: Another thing on the list was stuffed animal chuck out. They could either give stuffed animals away or put them in the garage for vacation, which is just me putting them in a big contractor bag and saving them for another time. Washing the windows, washing the bedding, vacuuming the floors. Like, all of these are individual little check boxes that they could do. And I explained that doing a spring cleaning is a big job. They didn’t have to do it all in one day. Could do a little bit every day, and I would help.

Shanna: And for everything they checked off, they would earn a pom-pom for their pom-pom jar. Laura, it worked.

Laura: They were excited. Excited to clean?

Shanna: Yes. They were excited to get through this list. Cece more than Elle, I have to say. Cece was pretty excited to do this whole system.

Laura: Now do you think she was motivated by the pom-pom situation or do you think she just really wanted to get her stuffies in order?

Shanna: Probably the pom-poms, to be honest with you. The kid likes a reward.

Laura: Okay. So did this completely transform the week? Did this keep them out of your hair while you did Zoom meetings all day?

Shanna: Oh, no. No. This, I discovered quickly, was a mother attended activity. They could not do this on their own.

Laura: And before anyone writes in and is like, where was Steve? It’s like Steve works in the office almost all week now. Right?

Shanna: Yes. Yes. Four days a week.  So I had to hold up every single stuffed animal and say, do you wanna donate it or do you wanna send it on vacation? You are limited to 10 stuffies for your room. 10. Laura, we put away probably a 100 stuffies on vacation in the garage. A bunch to give away, and they couldn’t choose 10.

Shanna: So I was like, fine. You can take 20. So we narrowed it down to 20 each, and that was a huge accomplishment.

Laura: Wow. That’s amazing.

Shanna: I know. I know. But all in all, we got through a lot of activities. We washed the bedding. We vacuumed. Vacuumed. We did a lot of things, even washed curtains.

Laura: Washed curtains. My god.

Shanna: I know. I was very proud of myself, but I lost steam by about Wednesday. I was like, I don’t know if I care that much if their rooms are spring cleaned or not. And we let it fall by the wayside as we do a lot of things. But it was it was good while it lasted.

Laura: You know, this is something I actually worry about is that I’m not teaching the boys cleaning skills. I think I’ve talked about it on the show. In general, but also just basic cleaning skills, like you said, like vacuuming, wiping down the counters, that sort of thing. So maybe I need to start introducing the stuff earlier, sooner than later, because I do not want them to be bad partners to their partners in the future, and I want them to I’m not a clean freak, but I do order and I do like not having bugs in the house. So, yeah, this is inspiring me to maybe not do a full week, but maybe just little somethings here and there.

Shanna: Yes. As a mom, it’s hard to transition from just doing everything for your kids because it’s easier, it’s quicker to kind of helping them learn to do those skills themselves. Even now they will eat on the couch and leave little wrappers and everything. And I’m like, oh, come on, girls. Like, clean up your trash. And I try to encourage them, but it’s so much easier for me to just go and pick up all the trash myself. So I’m trying to push myself beyond that and really get those skills into their minds too.

Laura: Well, this is good. I like this. And I’m sure their rooms are cleaner than my boys’ rooms, even though you ran out of steam on Wednesday.

Shanna: I don’t know. Maybe. But, yeah, that’s it for me. What about you? How was your spring break?

Laura: We were also on spring break, as you know. Auggie, bless his school. I really love his school. It’s such a wonderful environment, but they chose to have the Friday before and the Monday after spring break also as administrative days. So he’s getting many days off in a row. Sebastian just had the normal week off, so that’s a little easier, but I have to say we had a pretty fun week or at least the second half of the week.

Laura: The first half of the week was pretty normal. We were doing the same thing you were doing, basically, just trying to balance all the work we had to do with the kids being home. I didn’t set them up with special camps or anything because I did not get my ass around to planning that sort of thing.

Laura: But what did happen was my mom actually was very proactive about spring break. And four months ago, she just said to me, well, we need to figure out what to do for your spring break. And I was like, we? It’s January. I don’t wanna think about spring break right now. But thankfully, she did wanna think about spring break. She ended up planning a trip for us on the back end of our spring break for four nights, out to the desert, out to La Quinta, out past Palm Springs.

Shanna: That’s amazing.

Laura: Yeah. And I’m really appreciative because she really splurged on this trip. Like, for a while, we were trying to find an Airbnb and trying to go budget and all this stuff. And at some point, it was just it was getting so complicated and she wanted my brother and my sister-in-law to fly in and it was just the planning was just it was taking up way too much time. Like, she had roped me in at that point and I was just like, there’s too many options. I cannot figure this out. And then finally, I was just like, you know what? Last year, we used a fellow mom who’s a travel agent to book our trip.

Laura: Should we try to do that again this year? And my mom was oh, yes, please. So we reached out to Haley Paige at two Nights Inn. A plug for her because she’s so fantastic. And she ended up booking the whole thing for us. It was so great. She managed to get us rooms that were adjacent to each other, even when my brother came in for just two nights of the four and we went out to the desert to a resort out in the desert and it was honestly so fun.

Shanna: That’s amazing. Were there pools and slides and all that good stuff?

Laura: So at this particular resort, there were 40 pools.

Shanna: Did you say 40, 40?

Laura: Yeah. So it is not the type of place that has slides into pools big giant resort pools. What it had was all these bungalows, and within all the bungalows, there was a courtyard with a pool. So every little set of buildings had their own pool and hot tub. So you could go to the big main pool, which we did one day, and it was kinda chaotic, but the kids loved it. Or you could just go to the little pool that was right behind your casita is what they called your hotel room. It’s just a hotel room, but the casita pool.

Laura: And it was so nice to just be able to waddle out and go into your own pool where there were no other people most of the time. I will say it did rain two of the days, but did that stop my children from wanting to go in the pool, Shanna?

Shanna: No. No.

Laura: No. No. No. No. No. No. No. So we basically spent the whole time in the pools. If we weren’t in the pools, we were at their arcade that they had.

Shanna: What is this magical wonderland? Where is this?

Laura: It’s a very bougie resort called La Quinta Resort. Not to be confused with La Quinta Inn, which isn’t particularly bougie, but it’s called the La Quinta Resort, and I’m let me tell you, it wouldn’t even be in reach for me and Corey. It’s a fancy resort. We got a good deal with Haley and stuff, but my mom paid good money to go to this resort, and you can tell. Like, it’s one of those things where you’re like, I’m used to going to you know, mid-level hotels, lots of Airbnbs, that sort of timeshares, that sort of thing, And then you go to a resort resort, and you’re like, oh, this is fancy. Like, this is how the other half lives.

Laura: So, I do wanna say that if I were listening to a podcast and the host was going on and on about their fancy trip from La Quinta Resort, I would probably shut it off. So I want you to know I am fully aware of the privilege and obnoxiousness of this, but it’s all because grandma Susan is super, super generous. So anyway, listeners, I apologize. I will stop talking about how fancy it is, but I will say that one thing about a fancy resort is that you still have to sleep in the same room with your children.

Shanna: How did that go?

Laura: The first night especially was really rough, I think, because they were so excited to be there. Auggie fell asleep pretty easily, but Sebastian, oh my god. So this arrangement that we decided to go with was we got two queen beds.

Laura: And last time, the LEGOLAND trip, we realized okay, we’re not gonna be able to get them to sleep in the same bed together. We will just divide and conquer. So I was gonna sleep with Sebastian and Auggie was gonna sleep with Corey, And Sebastian is just rolling around and having fun. That child did not go to bed till 10 o’clock, Shanna.

Shanna: Oh, my word. Did he sleep in nice and late the next morning for you?

Laura: Cute. You’re so cute. No. I think he woke up at 4:30 and then 6. I finally ended up nursing him at 4:30, which I don’t usually do that sort of thing anymore, but I was just like, go to please go to sleep. And he was waking everyone up. You know? Oh my gosh. I will say he did get a little better subsequent nights, but he would do this really kind of adorable thing that wasn’t quite so adorable at two in the morning.

Laura: But still, it’s like the cutest way to get woken up if you have to get woken up, or he would just wake up and go, mama. I’d be like, what? What? Yeah. Mama, I love you. And then he’d fall back asleep.

Shanna: Aw. He’s probably dreaming about you.

Laura: You are forgiven for waking me up in the middle of the night. But he did this a lot. It was every two hours. Mama. Mama. Mama, I love you.

Shanna: Aw. It was probably exciting for him to sleep in the same bed with you.

Laura: Yeah. It probably was. This is the reason we don’t ever bed share. Like, I tried it with Auggie before too, and they are too excited to be in bed with us. So it doesn’t work. But I will say that this trip made me realize that they are getting easier to travel with than they used to be. Like, we just had to bring less gear this time. You know, they’re both sleeping in beds, so we didn’t have to bring a bed or anything like that.

Laura: We packed up the scooters instead of having to pack up a stroller and all this extra stuff. So in that respect, they are getting easier to travel with, and Corey and I both mentioned oh, we can see the light at the end of the tunnel. You know? Like, we can see how they’re gonna start being a little bit easier to travel with. So, I mean, maybe we’d even attempt a plane flight somewhere. We’re talking about maybe going and visiting my brother in Denver. So Yeah. Yeah.

Laura: But all in all, despite the disturbed sleep, it was very fun. And I’ll talk a little bit more about it in our final segment, but I do think that we should move on to our special segment now.

Shanna: I think we should.


Shanna: We are back, and this week we have an interview with Dr. Nicole Rankins. She’s a board certified practicing OBGYN wife, mom, and podcast host. She hosts the “All About Pregnancy and Birth” podcast, which is a wonderful podcast full of so much helpful information for pregnant people. She also has an online birth plan and childbirth education classes. She is a wealth of knowledge and we have her here today to talk to us about creating your own birth plan. We’re so happy to have you here, Dr. Nicole. Welcome to our show.

Dr. Nicole Rankins: Well, thank you so much for having me. I am excited to be here.

Shanna: Yay. Alright. If you could just start us off by telling us a little bit about yourself and how you became so passionate about birth plans.

Dr. Nicole Rankins: Yeah. So as you mentioned, I’m a practicing board certified OBGYN. I have been at this for 20 years. Hard to believe. Had the privilege of helping probably close to 2,000 babies be born, which is really wonderful. I totally love what I do. And the reason that I got into this online space and social media space is because I noticed that lots of people are going to social media.

Dr. Nicole Rankins: That’s where they get information. Nobody reads those pamphlets and things that we hand out. Everybody throws those away. We know you do.

Laura: True. Guilty.

Dr. Nicole Rankins: So it’s like, I wanna meet people where they are, which was online. So I initially started a blog, and it was too hard to keep up. It’s challenging. But I love podcast, and I listened to Serial, I don’t know if you ever listened to Serial…

Laura: Oh, yeah.

Dr. Nicole Rankins: Which is one of the best podcasts ever made. And I kinda went down the rabbit hole of how do you start a podcast? And as you know, it’s actually not that challenging to start a podcast. The hard part is keeping it up.

Laura: Yes.

Dr. Nicole Rankins: But starting is not that is not that challenging. So I started doing information in that way, and then I just started seeing people in my day to day bedside life of just not being educated about birth and not having great information from a place of really centering them and their needs and their desires and their experience. And so I just wanted to be a source of good evidence based information to help people have that beautiful birth experience that they deserve.

Shanna: Oh, I love that. I wish I had had more guidance on having a birth plan, especially during my first pregnancy. I feel like I was like, I don’t know what’s happening. And I went to a class at the hospital and just everything felt very chaotic.

Dr. Nicole Rankins: Absolutely. Absolutely. And so many people think that a birth plan, and I guess we’ll get into this, is you Google birth plan and you fill out one of those templates and you bring it with you to the hospital, and that absolutely doesn’t work. So we can talk about why it doesn’t.

Laura: That actually brings us to our next question. We do have questions written down. I think our listeners may wonder, do you guys just interview, or do you have questions written down. Shanna and I like to do our research, and we usually have questions written down and then also come up with questions on the fly. This is one of those happy moments where the next question we have written down is a perfect question for what you just said.

Dr. Nicole Rankins: Look at that.

Laura: You say I know. Right? You say that the way most people make birth plans is wrong. Why is that? What are people doing wrong? Which is literally just what we were talking about. So please tell us.

Dr. Nicole Rankins: So people go to Google, you print out a template, you print out that form, you fill it out, and you’re like, I am doing my birth plan. You take it with you to the hospital, and here’s what could happen. You could hand that piece of paper with all of the things that you want, or sometimes it’s like a 5-page thing, which I can tell you nobody’s gonna read. But you give that piece of paper to folks, and then they put it in the corner. Or they don’t read it, or they look at it, and they say, yeah. We don’t do any of that stuff. So then you’re stuck. You’re in labor.

Dr. Nicole Rankins: You’re at the hospital. You’re setting yourself up, not in a good way because you’re starting off like, wait a minute. I thought that if I put my stuff on paper, if I thought if I did this birth plan, this was gonna help me. You need to know well before you get to the hospital whether or not the hospital and the doctor actually support what’s in the birth plan. That template, that form is the very last piece, and it’s actually the least important piece. The most important part of a birth plan is a conversation.

Shanna: Okay. So I’m assuming it’s a conversation with your OBGYN. So what is a good point in pregnancy to start bringing this up with your doctor and thinking about it?

Dr. Nicole Rankins: Definitely, once you get into the 3rd trimester, you want to start thinking about making your birth plan. The 3rd trimester is around 28 weeks or so because it’s gonna be asking questions, and it may take a couple of visits. This is something that you wanna do under more low-key circumstances. You’re not asking in between contractions kinda thing.

Laura: Right.

Dr. Nicole Rankins: You’re able to sit down and go through and have this discussion. And I teach it in a way so it’s not adversarial. Like, sometimes you see people going in, and they demand things, and that never sets up a good tone for the birth experience. A lot of this is also about setting the tone for the birth and how to have that conversation within a system that we know too often takes away power from women over what happens in their bodies. It’s kinda patriarchal. So I teach some of the psychology of how to manage and navigate that. So it’s questions that you wanna ask during your prenatal visits.

Laura: And you mentioned how this patriarchal system can get in the way of people having the birth that they want. My question is so we’re talking about talking to your doctor about this, but how would women of color or other marginalized pregnant people approach creating a birth plan differently? Like, would you recommend doing it differently if you’re at a higher risk due to your identity or your race?

Dr. Nicole Rankins: Yeah. I think in that instance, you definitely want to make sure that the person, your doctor, the hospital that people see you as human. I know that sounds crazy that someone would not see you as human. But sometimes we forget when we’re doctors and we’re going through and we’re just doing the things and things like implicit bias, that kinda thing. You need to say listen. I’m scared because I see the statistics that as a black woman, I have three times the chance of dying compared to a white woman. So I’m just scared, and I want to do everything that I can to be prepared and have a good experience for my birth. And that’s the same thing I still tell everyone to say because everyone can be scared.

Dr. Nicole Rankins: Fear doesn’t have a monopoly or whatever. You know, it doesn’t belong to one person, but you definitely wanna be upfront and make that human connection. We are humans on the other side. And when we make that human connection, it helps us to slow down and say, you know what? Yes. I get it. You’re scared. And if they don’t see that, and if they don’t understand how to best support you, then you need to find someone else who can.

Shanna: Absolutely. What are a few examples of things that might come up when talking about a birth plan? Like, what specifically are we talking about here? Because when I think of birth plans, I think, okay. I wanna go in and have a vaginal birth. But what other types of items are on this list?

Dr. Nicole Rankins: Yeah. So here are the things that are gonna be a little bit surprising, the questions that I teach that that you should ask. And my birth line class is a bit longer, and it’s totally free, and people can go grab that. But some of the questions I want you to ask are, how often do your patients who are having their first baby have a c-section? So you want to know an idea of what their c-section rate is. Some people may not know that number right off the bat. But if they are like, why are you asking that or giving you some pushback, then that’s a red flag. I had someone ask their doctor how often do people have their having their first baby have a c-section that were under his care, and he said 80%. That’s a lot.

Dr. Nicole Rankins: And I was like, I’m sorry. Did you say he actually said 80%. And she was like, yes. If you want a vaginal birth, do not go see this man. He’s gonna do a c-section. So Yeah. You can’t guarantee that people will give an honest answer.

Dr. Nicole Rankins: But if you don’t ask and you have no clue, then you never would have known. So you wanna know how they feel about c-sections. You wanna hear some language of, no. We try for a vaginal birth because we want folks to have a vaginal birth. And you wanna do questions that start with how or, how you know, that force people to give more of a response. You don’t wanna say, is your c-section rate low? Because, of course, the person is probably gonna say yes.

Dr. Nicole Rankins: So you want them to force a conversation. So that’s why I say, how you know, what is your c-section rate, or how often do people having and specifically first baby, because those are things that we track. Those are things that the hospital track. First baby, how many have a c-section? You can ask, what are your thoughts about labor induction? That’s another good question to ask because more and more people are kind of pushing almost labor induction. I don’t know if you’ve chatted about that before in labor induction. So you just wanna give a sense for where people stand and if they are in line with the things that you want. So if they say after you ask, what are your thoughts about labor induction? Well, I recommend everyone get induced at 39 weeks.

Dr. Nicole Rankins: And if that’s not something that you wanna do, then you need to be prepared for that. You need to be prepared to advocate. You know what? I think I wanna go and wait and go into labor on my own and only be induced unless this is medically necessary. You don’t want that sprung on you suddenly at 39 weeks. Okay. It’s time to schedule your induction, which certainly can happen. Another great question to ask, and I’ll just leave it at three because I don’t because I could talk forever y’all.

Dr. Nicole Rankins: Y’all have to cut me off because I would talk forever. The last question, it was one of the questions that I teach, is what are your thoughts about doulas? So we know that research shows that doulas provide their the physical and emotional support they provide can shorten your labor, decrease your need for pain medication, increase your chances for having a vaginal birth. So I don’t support doulas just because it’s the in thing to do. I support it because research shows that it improves outcomes, and your doctor should too. So if you get some pushback that says, I don’t understand why you need a doula. Again, not a good sign.

Dr. Nicole Rankins: You don’t want that type of person who isn’t following evidence-based recommendations. You don’t want that type of person on your team, or you want to know so that you can be prepared to really advocate for yourself and educate yourself when you go into your birth experience. Preparation and education are key.

Laura: Do you have any tips for people who they hear this and they think, okay. So I’ve asked my provider a bunch of these questions. I don’t love their answers, but my insurance or my location prohibits me from switching at this point. How can a person advocate for themselves when they maybe don’t have a good match with their provider?

Dr. Nicole Rankins: Yeah. That’s a great question. That’s when you really need to invest in some quality childbirth education. Everyone should do that anyway, but it’s really gonna be important for you to be educated, and you need to have a second person who is ready and able to advocate for you on your behalf if need be. Now that second person could be your partner. It could be your sister. It could be a friend. It could be a doula, of course.

Dr. Nicole Rankins: But you definitely want to have someone there who can speak up, raise their hand, and say, hey. This is something different than what we talked about or what you wanted to do. So you have to be prepared and ready to advocate for yourself. Now, of course, I wish that that could guarantee things 100%. Unfortunately, it does not. But all you can do is what you can do, and being prepared and having that advocate with you is so important.

Shanna: So true. It’s really hard to speak up for yourself sometimes, especially when you’re in the face of the authority of the doctors and people who you feel like know more than you. So that’s super important.

Laura: It’s also nice to hear that someone else other than your partner might be the person who should be advocating for you because I don’t know about our listeners, but my husband, Corey, was pretty freaked out during my births. Right? Like, he was it was all new for him. He was about to meet his sons. I don’t think he was in this headspace to be my perfect patient advocate, you know? So being prepared with someone else who might be able to do that for you is amazing.

Dr. Nicole Rankins: Absolutely. Yeah. For sure.

Shanna: Okay. So I’m thinking about my birth experience. You know, it was a little chaotic. I kind of had an idea of what I was going for, but I got to the hospital and things went awry. Like, my water broke, so I guess I was on a timeline. They induced me. I was having some complications. What do you say to someone who’s in that situation, who has a plan, things go differently? At what point do we need to be flexible with what we’ve prepared?

Dr. Nicole Rankins: Yes. So I’d have to back up and say, the truth is, actually, when people’s water breaks, there should not be a timeline.

Shanna: Wait. They told me 24 hours.

Dr. Nicole Rankins: That’s a lie. Oh. That’s not true. I’m sorry. It’s there’s no clock. We we in our hospital, we’ve had people who had their water their water’s been broken for three days. And we just as long as the baby looks healthy, we just keep chugging along until labor kicks in. Most people, eventually, it’ll kick in.

Dr. Nicole Rankins: So there is no there is no clock, for when your water breaks. But as far as how things go awry. So what I say is and what is true is that the only predictable thing about birth is that it’s unpredictable.

Laura: Uh-huh.

Dr. Nicole Rankins: None of us can plan birth. I can’t plan birth. Your doctor can’t plan birth. You can’t plan birth. Doctors think that we can plan birth. We don’t. The only person who plans birth is the baby, and they do not tell us what they plan to do. So we have to be ready to go with the flow of the process.

Dr. Nicole Rankins: It’s almost certain that things aren’t gonna go exactly as you anticipate. And the way for anything in life to be prepared for something that you don’t know exactly how it can go is to be prepared for possibilities. If you’re going on a you know, you’re running a marathon or you’re going on a hike, for instance, you’re gonna have your water just in case. You’re gonna have your first aid kit just in case you fall down. Prepare yourself with education. And, no, you can’t be an MD like me. You’re not gonna know all of the things, but you can certainly be well prepared to deal with some of those twists and turns.

Dr. Nicole Rankins: Oh, what happens if they ask me about Pitocin? Oh, should I be able to move around in labor if I want to? What questions should I ask if they’re talking about a c-section? There are a few tools you can get in your tool bag to help you.

Shanna: That’s great advice. Great advice.

Dr. Nicole Rankins: And I will say the last thing that when I see people who are unhappy with their birth experience, it’s not necessarily because it didn’t go the way that they anticipated. It’s because they weren’t prepared for the possibility that it couldn’t go the way that they wanted. So when you’re prepared for the possibility and the twist and turns, then you tend to be okay with your birth experience because you were ready for it, and you had some, agency to make decisions in the process.

Laura:  You know, I was listening to your episode. I think it’s where you give a little preview of your birth course. And I was really struck by how first of all, how much information was in just that episode. You’re like, this is a little preview. And it’s like, oh my gosh. This is more education than I got probably throughout my first two trimesters, in 30 minutes.

Laura: But, also, there was something you said in there where you said, your labor room is your room. Like, you are renting this room. You and your insurance company are paying for the space. You are allowed to make it the way you want. First of all, that blew my mind. I was like, it was my space? You know, I get to do with it what I want. But it was an example for me of how incredibly crucial information like that is for pregnant people because no one’s telling us this stuff except for you, apparently.

Laura: And I was just really impressed with that little snippet of your birth course that I listened to. And I was wondering if you could tell us a little bit more about exactly what’s in that course for people to find.

Dr. Nicole Rankins: Yeah. Well, thank you so much for bringing it up. I just this is hard work for me. I just it’s my heart, soul, and passion to be of service to people who are having a baby. And, really, it starts with it’s a structured, organized program. So it starts with the very first lesson is mindset because so much about your birth is your mindset and how you go into it and how you approach it. So I talk about things like doing meditation, gratitude practices, affirmations to help you get in the right mindset. It’s the same thing that elite athletes do, business people do when they’re preparing for something big.

Dr. Nicole Rankins: So we start off with that and then thinking through the things that you want for your birth. And then we just lay out a program of, getting support. So I chat about doulas in the course, chat about your partner being able to support you. That’s the first part. And then the second module is all of the details of labor and birth, exactly what’s happening in your body with contractions, with your cervix opening, all of those things. And then, also, specifically, how labor and birth happens in the hospital. So what you can expect when you get to the door, how you may start in a triage area then go to another area, how frequently you have cervical exams, things like, do you need monitoring continuous monitoring versus being off the monitor, movement, strategies for pain management, both medication free and with medication, how often you see the nurse, how often you see the doctor, a lot of people don’t realize. You may see your doctor at the beginning of your labor and at the end of your labor, and that’s it.

Dr. Nicole Rankins:  It’s usually the nurse who’s there in in between. So it’s really focused on hospital birth. That’s my lane. That’s what I know, so that’s what I teach.

Dr. Nicole Rankins: And then some things about the possible things that may come up. So c-section, episiotomy, forceps, vacuum, infection, things that happen in that regard. And then the final module’s on postpartum, so how to get ready for the postpartum period. Because we really should start talking about preparing for postpartum while you’re still pregnant so that you can set yourself up for success. And then, of course, how to make a work plan so that’s in there too.

Shanna: Wow. This is exactly what I needed eight years ago. So much of my experience was showing up to the hospital at four AM. I was just like, where am I going? Why? What is who are you? Listeners, if you’re pregnant, get this course. This sounds absolutely amazing.

Dr. Nicole Rankins: Oh, thank you. Thank you. I think it’s amazing. And I should say, I think at this point, I’ve had, two, maybe 2,000 students go through it. And they say it’s amazing too.

Laura: So good. And Shanna and I were just talking about this in a few episodes ago where we were talking about how we had basically no education on what to expect postpartum. Both of us had c-sections with our first baby, Shanna because of complications, and mine because mine was breech. And we don’t remember really getting any instructions about what how to do wound care or what to avoid. Shanna tells this harrowing story about, what was it three days postpartum where you got on the floor at a lactation class and couldn’t stand up afterwards.

Shanna: Oh, yeah. It was horrible. Yeah. I was I was winging it for sure.

Laura: So I love that you focus on everything from not just pregnancy and the birth, but, actually, what happens when you go home. That’s amazing.

Dr. Nicole Rankins: Yeah. Yeah. Because, unfortunately, I’ve heard it described before, and I don’t know who it was that said it that pregnancy is like a piece of candy. Like, you’re the pregnant woman is the wrapper, and the baby is the candy. And once the candy is out of the wrapper, the poor wrapper just gets discarded. And we just don’t take care of folks postpartum like we should, even though we know that the best thing for a healthy baby is a healthy parent, healthy mom.

Dr. Nicole Rankins: But, you know, our society, the US society, that’s a whole another conversation. Doesn’t necessarily value moms and parents the way we should.

Laura: Yeah. We’re definitely have a lot of work to do there. Doctor Nicole, I am so glad that we at least have you to help fill a little bit of this gap that we have in our US health care system. I’m so glad you figured out how to do a podcast because you have so much great info on your podcast. You’ve got birth stories. You’ve got little 10-minute episodes where you just talk about one little topic. You’ve got your birth course stuff. It’s just amazing.

Laura: So, I mean, honestly, you’re our BFP today.  But we do have a question to ask you, which is the same question we ask all of our guests, which is, do you have a BFP for us?

Dr. Nicole Rankins: I do. So this is crazy. And it’s not gonna sound big. Well, it’s big,.Our 16 year old daughter this week or next week is going to Spain for a school trip, which is a big deal because this is my little preemie.

Dr. Nicole Rankins: She was born eight weeks early. She had a rare intestinal malformation called duodenal atresia. It happens in one in 10,000 pregnancies where her intestines weren’t connected. She had to have surgery three days after birth. She spent a month in the NICU. And to think now that that little tiny baby who used to literally fit between my elbow and my wrist, she was that less little, Is now about to go on a school field trip across the world is just like, oh I’m just so grateful that she’s healthy and happy and has all of these wonderful experiences, in her life now.

Shanna: Oh, I love that so much. What a journey. And that is a big fat positive. That is big for sure.

Dr. Nicole Rankins: Yes. Yes. Yes. And now we have college coming up, and I don’t understand how that happens so fast. Wait till y’all are in that situation, and you’re like, what happened? Why am I looking at college? Like, I’m so hot to hot. It comes up on you so fast. I know everyone says it, but it really does.

Laura: Oh, my word. I believe it. But that’s so cool that she gets to go to Spain. I feel like trips like that when you’re that age are so formative and so important. I hope she has an absolute blast.

Dr. Nicole Rankins: Yeah. Definite core memory for sure.

Shanna: Yeah. Yes.

Laura: Oh before we go on, is there anything you wanted to talk about? We’re gonna ask you where we can find you and your course and everything. But is there anything you’d like to talk about that we didn’t ask about?

Dr. Nicole Rankins: The only thing I would say is that please remember and know that you deserve to be centered in your birth experience.  Know that you have that power. Believe that you have that power and get comfortable exercising it. I think, especially for women, sometimes we don’t you know, we have to find our voices and learn how to use our voices, and pregnancy is a great time for you to start to know that you have power. You deserve to be centered in your experience, and don’t accept anything less than that.

Shanna: What a wonderful message. Thank you. And thank you so much, Doctor Nicole, for being here with us today. We’ve loved talking to you. I honestly wish that you were my OBGYN. Maybe I’ll get pregnant again and then go out to your side of the country.

Shanna: So let’s wrap up. Can you tell everyone where they can find you and your course and your podcast? Because I want our listeners to go and find you as well.

Dr. Nicole Rankins: Well, thank you so much. I am everywhere at @drnicolerankins. My website is drnicolerankins.com. My podcast is called All About Pregnancy and Birth. The website is where you can find all the information about my course, and my favorite social media platform is Instagram. I’m on Instagram at @drnicolerankins as well.

Shanna: Alright. Well, listeners, go find Doctor Nicole. And, Doctor Nicole, you have a wonderful day. Thank you for chatting with us. And, Laura, I think it’s time for us to move on to our BFPs and BFNs.

Laura: I think you’re right.


Laura: Okay. We close every episode with a big fat positive or a big fat negative from the week. And, Shanna, you’re up first. Do you have a BFP or a BFN?

Shanna: I have a BFP.

Laura: Yay.

Shanna: Yay. So this week, Cece had her first ever drop off play date.

Laura: What? That’s so interesting. I wanna hear all about it because I have so many questions and I don’t know when it starts. I don’t know how you even negotiate it, so please tell me everything.

Shanna: Yeah. It’s a big deal. And I actually haven’t even done it with Elle yet. Just it kinda hasn’t really come up yet. But this week, I got a text message from Cece’s best friend’s mom, and she was like, hey, on the first day of spring break, does Cece wanna come over? And you can just drop her off and get some work done or something. And I was like, what?

Laura: Oh, cool.

Shanna: I was like, oh, Steve might be a hurdle on this one. You know because I think it’s a bit of unknown dropping your kid off at someone else’s house, unless it’s a family member or a super duper close friend. And these are more of new friends to us. Right? She’s just started TK with this girl a few months ago. But I’ve met the parents couple times. I went over there for a birthday party.

Shanna: Like, everything is gonna be alright. So we talked about it, and I was like, I think we should just go for it. Like, let’s give it a try. It’s gonna be great.

Laura: Okay. So here’s a question. What did CeCe think of it? Like, when you told her you weren’t gonna be there.

Shanna: “Oh my god. Yes!!”

Laura: That’s what she said.

Shanna: That’s what she said, Laura.

Laura: But isn’t she super clingy with you guys most of the time?

Shanna: She is, but she loves this girl, her best friend, and loves her parents. Like, she knows the parents on a first name basis. She talks about how pretty their names are and how nice they are. And they have two claw machines in their house because they just bought them to have a side business.

Laura: That’s amazing. Of course, she wanted to go over.

Shanna: Yes. They were there at the birthday party, and they run them out at birthday parties and stuff. You know? But when, the little girl has her friends over, it’s a free for all. They can just play for free and you just go until you win. And Cece is so determined and focused with this kind of stuff. She came home with, I swear 18 little rubber duckies and little prizes and stuff while the other kids had three or four. So she just loves it. So she was not hesitant whatsoever to do this. So that made me feel better too.

Laura: Oh, for sure.

Shanna: So Monday came. I drove and dropped her off, and it actually was a little group play date. So it was her four little best friends were all there. And I was just like, woman, you are a  saint. Like, what are you doing? I’m like, I wish I could return the favor this week, but I’m working and everything. And we got to the door, and the mom was like, oh, does Elle wanna come too? And Elle got big eyes. I was like, no. No. No. No. No. It’s okay. It’s okay. I’m not gonna overload you. So I did not let Elle go. I let Cece go and have fun with her little friends.

Laura: You know what? It’s good to to let Cece have her own time with her friends. I feel like I’m already noticing this with Sebastian is that he’s kind of the add on for most of the hangouts. You know? Like, we’ll do play dates, and it’s like, oh, we’ll bring Sebastian along, and it’s like Auggie’s friend, but Sebastian’s just along for the ride. So I think it’s nice that you let Cece have her own time.

Shanna: Yes. Yes. Definitely. And when the mom had messaged me about everything in the planning, she was like, okay. How about drop off at 10, and I’ll get them pizza, and you can pick up at 2. And I was like, oh my gosh. four hours. Like, I don’t know. That’s so long for her to be away, and I don’t know. Laura, after an hour or two of having her occupied at someone else’s house, and I was focused on work, and Elle was, whatever, watching TV, I was so focused. I was like, we’ll go four hours. No big deal. And it came very fast. And I picked her up, and it was such a success.

Laura: Oh, that’s so great. Yeah. This is inspiring me to be more open to the idea with Auggie. Like, it’s definitely one of those things where one of his friends from TK, also, we got invited over for a play date, and I remember being I don’t know if this is supposed to be a drop off or not. I remember I think I even sent you a screenshot of our convo, and I was like, is this a drop off? And you’re like, you’re gonna have to ask. But it wasn’t. And I was like, that’s good because I don’t think I’m there yet with at least not with not with that friend because we had never been over to their house before too. But, yeah, with people you know really well.

Shanna: Yeah. I think that has a lot to do with it.

Laura: Yeah. That’s awesome. Oh, it’s like a whole new world.

Shanna: So that was an exciting new adventure for us. That’s my BFP. Nice. What do you got for us?

Laura: Well, I also have a BFP. Okay. There were a lot of BFPs this week, obviously, because it was such a nice little vacation we took at the end of the week. But, specifically, my BFP this week is the fact that iPhones are apparently waterproof.

Shanna: What?

Laura: Okay. So I knew this in theory. Right? Like, I knew that iPhones had a certain waterproofing rating and that you could get them wet. And I had never tried it because I actually have trauma associated with this. When the very first iPhone came out. I just got in a brand new job. And I was gonna treat myself to this brand new iPhone that everyone’s talking about the very first version. And two weeks later, I ended up washing it in the washing machine and it was dead.

Laura: And I was devastated. Right? I mean and remember, the first iPhones, it was like a thing. It was very exciting to get an iPhone. Anyway, so I’ve always been very cautious about water and my devices. Also, I should say, in college, I went spilled a whole glass of water on my laptop and had to get an entirely new motherboard, and it was expensive. And so to me, electronics and water do not mix.

Shanna: Sure.

Laura: But I kept seeing videos on TikTok and stuff of people submerging their phones to get videos underwater. And the videos would just they would just have it above water and then they dunk it. And I was like, that cannot be a real thing. Right? That cannot be a real thing. But we were in the pool all week this week, and Auggie has been getting so good at swimming. Like, that is really the BFP behind the BFP, which is he is getting so good at swimming. He’s not completely independent yet, but he can swim a long distance all by himself. And then if he gets in danger, he just flips himself on his back and floats.

Laura: It’s like this really cool safety thing that he learned. And so he kept being like, mama, watch this. Mama, watch this. And then I had this glimmer remembering all these iPhone videos. And I was like, wait, our iPhones are waterproof. Right? And my brother and Corey were both like, yeah. And I was like, I gotta Google this.

Laura: And I Googled it. And my iPhone, which is the iPhone 14 Pro wait. No. Is it the Pro Max or Pro? I don’t know. One of those, an iPhone 14 model. It has a rating of IP Cece 8, whatever that means, under IEC standard, which apparently means that it can go down to six meters for up to 30 minutes.

Shanna: What?

Laura: I know. six meters is a lot.

Shanna: That is so deep. This would have completely changed the video footage I got in Hawaii in the swimming pools.

Laura: Right? So I was you know what? This is scary, but I’m gonna try it because if it can go six meters, I can confidently bring it into this four-foot shallow end. And even if I drop it, it’ll be okay. But I was you know, I had a death grip on it and I decided I was just gonna flip it upside down and just put the camera lens in. But, Shanna, it worked so well. I’m gonna send you one of the videos I took. Now the only downside of this is you can see my finger in the corner of this because I was so afraid of dropping it that I think I was covering up a little bit of one of the lenses. But,

Shanna: Okay. Let’s see here. Wow. The quality is really good too. So here’s Auggie on the side of the pool. He ducks under and you put the camera underwater and he’s swimming towards you. His face is so clear. I cannot believe how good the quality is.

Laura: I know. Me neither. So I got a bunch of videos before I started checking out and being like, I don’t know. I’m worried that this is gonna be a problem. But, yeah. So I would definitely do your own research. Make sure your model is waterproof, but we’re heading into the summer, at least in the northern hemisphere. And if you’re in the pool and you wanna get some videos and pictures of your kids in the pool, this is an option.

Shanna: That’s so exciting. I love this tip. Thanks for sharing.

Laura: Yeah. But you know what? That is it for me, and I think that’s it for our show.

Shanna: I think it is. Listeners, don’t forget to check out Dr. Nicole Rankins on Instagram, TikTok, her website, and listen to her podcast All About Pregnancy and Birth. And if you have any questions or feedback or thoughts on this week’s episode or anything else in life, reach out. We’d love to hear from you. Laura, where can everyone find us?

Laura: We are on TikTok, Instagram, and Facebook at bfbpodcast. We have a website, bigbatpositivespodcast.com. If you wanna send us an email, you can always throw a voice memo in there. We love those. Just send it to contact at bigfatpositivepodcast.com. And finally, if you wanna get some exclusive content from me and Shanna and join the coolest group of people on the Internet, just search Facebook for Big Fat Positive Community. It’s a private group, so you have to request to join, and you gotta answer those two membership questions so we know you’re not a robot. But if you are not a robot, you’ll get added to the group right away and you can join in on those amazing conversations we’re having in there.

Shanna: Our show is produced by Laura Birek, Shanna Micko, and Steve Yager. Thanks so much for listening everyone. Have a big thought positive week. Bye.

Laura: Bye.