Humanizing Hospital Birth: Insights from an OBGYN with Dr. Nicole Rankins

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Nicole Calloway Rankins, MD, MPH is a board-certified OB/GYN and hospital-based hospitalist who focuses on providing evidence-based support for families to have empowered hospital births. She is the host of the Birth With Power podcast—formerly All About Pregnancy & Birth. Dr. Rankins also teaches an online Birth Preparation Course. She shares her story of her own c-section with inadequate anesthesia and the challenges of supporting her own child in the neonatal intensive care unit (NICU).

Find Dr. Rankins’ free guides and other resources at her website. She can also be found on Instagram @drnicolerankins .

00:16:45 - The pros and cons of hospitalist medicine. You get reeeeally good at building trust and making decisions quickly. Feeling safe is different from people doing things to you to “keep” you safe. Naming fears can be powerful as the patient. Having hard conversations around birth preferences ideally happens long before your labor begins.

00:26:44 - Dr. Rankins shares how the experience of a mother dying in her care and how the memory will forever stay with her as a reminder that this work isn’t always joyful. And occasionally “bad outcomes” take place without any way to prevent them. How can we optimize the experience for a mother who experiences a stillbirth or similar outcome?

00:35:40 - Dr. Rankins shares her experience with a child in the NICU for duodenal atresia and experiencing a c-section with a malfunctioning epidural. Fathers are often left out of the conversations through difficult hospital experiences.

00:42:15 - Physicians aren’t necessarily taught to humanize birth. Sometimes humanizing childbirth starts with remembering that we ourselves, as practitioners, are human, and this can be as easy as taking a breath! Nathan shares a story of a baby born without a trachea who is made comfortable to die shortly after birth and the challenge of being present with death.

00:50:00 - Advice for families that transfer from home to the hospital and don’t prefer any interventions whatsoever. Dr. Rankins visits local birth centers so that birthworkers in the community are familiar with her and her practice. You have the right to decline any intervention as long as you’re informed about the risks, benefits, and implications of all options on the table. Dr. Nicole weighs in on Vitamin K, Rhogam, and other common interventions offered throughout prenatal care and childbirth. We must avoid imposing our value system on that of others.

00:58:10 - We can’t advocate for autonomy in reproductive rights but not for a woman to give birth on her own terms. You either believe in autonomy or you don’t. How do you respond if a woman says “I’d rather die than have a c-section”? What is coercive language. In counseling around repeat c-sections, OBGYNs often neglect to describe the challenges of emergency c-section after multiple abdominal surgeries due to scar tissue

01:06:45 - Dr. Rankins’ thoughts on continuous fetal monitoring versus intermittent auscultation and lack of validation of this technology

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