Sarah Lavonne: Hi, I'm Sarah Lavonne, and I'm so glad you're here. Here at Bundle Birth, we believe that your life has the potential to make a deep, meaningful impact on the world around you. You, as a nurse, have the ability to add value to every person and patient you touch. We want to inspire you with the resources, education, and stories to support you to live your absolute best life, both in and outside of work, but don't expect perfection over here. We're just here to have some conversations about anything birth, work, and life, trying to add some happy to your hour as we all grow together. By nurses, for nurses, this is Happy Hour with Bundle Birth Nurses.

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Sarah: This treat for today, I just realized you are our first OB on the pod. [chuckles]

Dr. Jennifer Lincoln: I feel like I need to put that on my CV now. [chuckles]

Sarah: You might. [chuckles] We'll put you on ours. [laughs] That has not been intentional. That has just been how the wind has blown. We're very organic with how we plan this podcast. As we have built our business and been on social, there's been some names. There's been some voices in the space that feel like colleagues, to be honest. It's almost like there's this microcosm of social media, birth influencer people that know each other, that sometimes do know each other, and then we interact in various ways.

I'm so excited to have this conversation with you today, Dr. Lincoln, and talk about the book that you have been working on that is no small feat. As a fun, little teaser, those of you going to MOVE, she's given us some copies to give away at MOVE, so you'll get signed copies at MOVE, potentially. I'm excited to have this conversation specifically surrounding medical misinformation and social media. We'll see where the wind blows with that. Before we do that, will you just tell us who you are on the day-to-day and how people might actually recognize you in listening to your voice?

Dr. Lincoln: Yes. I'm so excited to be here. I do have that moment sometimes where I'm like, "Wouldn't it be so fun if we all just worked in one hospital together? We might not get worked on, though. I don't know. Maybe we would get so much work because it would be so fun. It would be like a party. Everyone would want to come have their baby with us.

Sarah: We talk about this all the time.

Dr. Lincoln: We can dream.

Sarah: Like all the time, where we can dream of the hand-picked people and how amazing that would be someday.

Dr. Lincoln: I know. I know. Yes, someday, and then maybe it could be a reality show. It'd be so fun. I'm Jen. I'm Jen Lincoln. I'm board-certified OB/GYN. I work clinically. I still do the thing. I'm an OB hospitalist, which means I'm labor and delivery based in the hospital only doing all the things that an OB hospitalist is, which is caring for patients who come in who don't have a doctor or midwife or had to be transferred, helping our high-risk OB/GYNs, being there for the midwives and the other doctors, simulations, emergencies, all the stuff that people like us love.

It gets our pulse up, and we enjoy it. The average person would probably think it's a nightmare because no two days are the same. I still do that. I am also the president of my national organization that represents us, the Society of OB/GYN Hospitalists. I do always put out the disclaimer. I'm here today in my personal capacity, not on behalf of my job or any org. All the lawyers are happy now. I'm also a mom to two boys. I'm married to a pediatrician.

I do the social media thing. I've been creating content, not just about what I eat for breakfast on my private account, but professionally since I think about 2018 now. I have always loved to break stuff down that's super complicated into very simple terms. I started out doing a lot of reproductive health content because I grew up going to Catholic schools, which meant really no sex education that was actually useful. It was before the internet existed. I went to college so unprepared.

All of this to say, the original content I created, I was trying to communicate to somebody like me, who was 16, 17, or 18, and scared, and scrolling through and seeing a lot of really interesting information or misinformation. I wanted to be a good, useful source. Then I wrote my first book during COVID called Let's Talk About Down There, which was really like TikToks, a lot of stuff about periods, birth control, all that kind of stuff. Then my most recent book is now just about labor and delivery. It comes out in the end of March. I am super excited about that.

Sarah: Yay.

Dr. Lincoln: I think that's all the stuff I do. Yes, I love to read. I'm a Virgo. Yes, that's me. [laughs]

Sarah: Fascinating. Your journey on social media, how has that been for you?

Dr. Lincoln: Oh, my God. It's been a wild ride. Again, I really started in 2018, wanting to put out some good stuff, and also wanting to connect with other doctor moms because it felt like this interesting community, where not everybody got what we were going through professionally, personally. It was really fun to create this little microcosm of people you feel that you know, and you're not so alone.

I started on Instagram with my professional content, and I jumped to TikTok before the pandemic. I'm a proud pre-pandemic TikToker, but I had previously said, "I'm never going on there. That app is for children and teenagers." Other people were like, "Well, Jen, that's your whole audience are young people who have questions." I remember I posted my first TikTok, and it got flagged. It got removed, I think, because I said the word "sex" or "vagina." How dare I?

Then I was like, "Well, I know how this stuff worked." I was like, "Well, I'm just going to post it again." Somehow it got through, which tells you just how great the censors are. We could talk about that all day. I went to bed, and I woke up, and it had a million views. I went, "We have something here." Continue to create, continue to really grow there, and then the pandemic hit. I feel like it's very different now in terms of what people use social media for, who's there.

I would say my journey there is that I never had any real expectations. So many times, I create content just because I'm interested in it, or I see that there's a need. It's allowed me to meet people like you and just open up my world. I got to go to the White House and meet Anthony Fauci and get my COVID booster. I got to go speak and testify at the United Nations in Geneva. It has just opened up a whole world, and it's led to my writing career.

At times, people say, "Do you think it's a good thing or a bad thing that we have social media, specifically when it comes to women's health?" It depends on my mood that day because some days, I'm like, "It's great. The teenager like me who never knew what a problem period is can now get help." Then other days, I'm like, "It sucks." It's just it's scaring people, and it's wrong. The wrong people go viral. I have a feeling I'm not the only one who feels that way because it's a journey. [laughs]

Sarah: It is that mixed boat, right? I'm a doomscroller. Are you kidding? I love a late-night TikTok, whatever. I get on these kicks, and my algorithm hits all sorts of different things that I find really fun at times. What you can find on TikTok or the tutorial, people, that's how they're searching for their information.

Dr. Lincoln: Right. They're not using Google. They're using TikTok.

Sarah: No, they're using TikTok.

Dr. Lincoln: Which is terrifying/maybe amazing because then you can-- Yes, I know, but then there's me who's like, "What cream do I need for my under-eye bags?" I go to TikTok. [laughs]

Sarah: Yes, same. Same. We're doing a bedazzling station at MOVE at their registration so they can bedazzle things.

Dr. Lincoln: I want to make sure you're bedazzling and not vajazzling because that's the same.

Sarah: We're not vajazzling, although you never know what could happen at these retreats. It can get wild. It could. [chuckles] These nurses are real creative with what they--

Dr. Lincoln: Oh, I believe it.

Sarah: You give them a rhinestone, and you never know where it'll end up.

Dr. Lincoln: Yes, you never know where it's going to end up.

[laughter]

Sarah: That trend is from TikTok. I got on the thing where I'm like, "Well, now, I have to bedazzle something, so let's just turn it into a little activity they can do at registration." Even all of that is just so fun. I want to be very clear that I agree that there's so much good. There's so much being able to check out, and then also getting the information that you need. I'll even speak for myself. Social media is why we're here, why we exist, and not so much on TikTok. I did not make that transition. I was very overwhelmed when TikTok happened.

Dr. Lincoln: Yes, because you're a smarter person than I am.

Sarah: I don't know. There's a lot of parts of me where I'm just like, "Man, we missed that boat."

Dr. Lincoln: It's garbage now. The algorithm, it's just-- yes. Instagram still is where it's at for your audience.

Sarah: Okay, thank you for that.

Dr. Lincoln: You're a smarter person. Yes, you're smarter for being there. Trust me. [laughs]

Sarah: Well, with TikTok, it's the video piece that, for me, I'm running a whole business. Social media is everything gets pushed on social before I can get to it. It's this constant battle of putting out content that's helpful, but I'm also a perfectionist, so it's hard for me to just, like, "Blah." On stories, that's fine. Those I know can turn into TikToks, but we haven't gotten into that. Thank you for telling me that, because there's a piece of me that's always been like, "Man, I really miss the boat."

Dr. Lincoln: No, you're good. [laughs]

Sarah: With that, there's all this good, and then there's lots of good information. I actually started on YouTube. That was where I started on social back in the day, meaning still. We have a YouTube video being posted right now for family's side. Really, it was nurses that took over for us on social. I relate to some of that, but I'm also not a full-time content creator. We have classes and all of that other stuff that come along with it.

Now, mind you, with that, there's also the darker side of social media that, actually, and why I'm so excited to have this conversation, and I think you're the perfect person for it, is that in my DMs/on Instagram, when I pull people and I'm like, "Okay, what's the issue with this," or, "What are you experiencing here," or, "What gets in the way of you providing the care that you want," or, "What's the most frustrating part of your job?" Those are more generic questions, but it trickles in with stuff where you wouldn't even expect.

It is the frustration with medical misinformation on social and what nurses are experiencing, especially. You can speak from the doctor's side that families come in, and they're educated, and they've done their research, and then you start to push a little more because what the messaging that does come in is a little wonky, a little concerning, a little like, "Wait a second. Wait. That's almost there, but not," or they're really afraid about certain things.

Now, nurses are having to manage expectations, manage patient education that doesn't come across as combative or defensive, and that's really awkward when a family comes in very strong about something, and you're like, "Oh, okay, let's help you reorient." That has become another layer onto our job. Thanks to social media. Talk to me about medical misinformation, what you know, what you've experienced, and then we'll talk about how we combat it, and what do we do about it?

Dr. Lincoln: Yes, so this will be a six-hour TED Talk series.

Sarah: Right.

[laughter]

Sarah: Seriously, though, it could be like a whole pod itself.

Dr. Lincoln: Well, honestly, it'd be a great course for you to offer. I don't know if you do already, but how do you meet your patients who've already felt that they've gone through the education? How do you dismantle misinformation in a way that meets patients where they're at? It could be a really good course. Just add that to your to-do list.

Sarah: It's not going to be a six-hour course, but it will be touched on at MOVE, because the entire theme of MOVE is centering the patient experience and how to exercise the creative art of nursing. It's managing those weird dynamics and the stuff that's harder to teach on. It's coming, so thank you for influencing my prep for it.

Dr. Lincoln: After the bedazzling, you're going to do--

Sarah: After the bedazzling, we'll go bedazzle to medical misinformation.

Dr. Lincoln: Yes, love it. Such an easy transition.

Sarah: Seriously.

Dr. Lincoln: This is something I'm really passionate about. Any time that I give talks to medical students or departments, and this is a huge thing I talk about, which is medical misinformation. In our space, the women's health space, labor and delivery, it's huge for many reasons. A huge reason. First, let's step back and realize that we created this. We own this, and this is our fault.

By "we," I mean our fields as a whole, in that we have not historically had a great track record of listening to patients, centering them, not mocking them when they come in with a birth plan. You go even further back historically, experimenting on patients for treatment. When I say "we," please don't get mad at me, but understand patients come in already feeling on the defensive. We just have to know that and know that that's on us.

Sucks to be us, but also, how wonderful is it because we can then change their perspective and then change that narrative. I lead with that to say, when I say to med students or to nurses, and I'm giving these talks, that when a patient comes in and you're getting that vibe, you're like, "Oh, this is something--" I know they've googled this, or they've looked on TikTok, or they're saying they don't want something or whatever.

You're like, "Huh, I wonder." I think it's really great to say to your patients, and I do this, and I'm like, "So what did you see when you looked this up on TikTok before you come in?" I love that smile. They look at their friend, and they're like, "Oh, my God. She knows. That's what I did," and then we laugh, and I'm like, "Yes, I'm not stupid. I look on there too for whatever. Tell me what you've seen."

Let's just cut to the chase and be like, "What is it you saw?" Sometimes they'll pull out the thing, and they'll show me. I'll be like, "Let me tell you why they're 90% there, but they're 10% not. Let's talk about this person, too." They're not an expert. I'm not saying that we can't. You don't have to be a doctor or whatever. If you're talking about skipping a treatment or declining something or whatever, we need to talk about the whole thing.

Here's how this person lacks this nuance. It is okay to feel frustrated that somebody is out there and is spewing something "ridonculous" about vaccines or birth or epidurals or Tylenol or whatever. I get it. You can feel annoyed, but you can also be like, "Oh, my gosh. I so understand. That's why you feel this way." It's making the organic connection with your patients. They still may not do the thing that you wish that they did. If you see them as a person, you might affect that change. You might change how they approach it next time.

You might be the reason they look to a different source in the future. I want to really speak to the nurses here because I say it to my colleagues, too, that we have to understand that, at the end of the day, we don't have to agree with every choice our patient makes. At the end of the day, you're going to go home after your shift. You're going to hug your family. Your life is going to go on. Don't take it so personally if somebody doesn't choose something or doesn't listen to you, because we have to respect bodily autonomy.

This is really important. I feel like we lose the plot, especially people like myself, who are very much about being pro-choice. You have the right to decide if you're going to be pregnant. Well, guess what? You have the right to decide how you birth, too. Even though I might not think you're the best candidate for a home birth, or I really wish you would do this, but you're declining this, I respect your autonomy. I see you as a person. I think that's really important. Taking out the personal investment in it, which I know can be hard. It can be hard sometimes. [laughs]

Sarah: Twofold here. I'm going to come back to that. When you're explaining them pulling out the TikTok and being like, "Let's talk about it," and then you breaking it down and saying, "Okay, here's 90% true. Here's 10% where I want to supplement," I like that of, like, "Can I come in and speak into that for your specific scenario?" That takes a lot of time. It also takes you actually knowing your stuff to be able to speak to and critically think your way through the TikToks. One, do you suggest that people are on TikTok/Instagram, knowing what's going on? Is that important? Two, how do you combat the objection of, "I just don't have time for that"?

Dr. Lincoln: Yes. Okay, I totally understand if you don't have time to be creating content or spending five hours on your phone every day. In fact, I love that for you so much. Again, when I give these talks and when I talk to people, when I say, "I don't think everybody has to be a content creator to move the needle when it comes to these things. I really think that you knowing what people consume, it's like research." It's like really knowing what your patients are seeing. I don't think it means that you should feel that you have to create a million accounts and follow a whole bunch of things.

It's great to have a pulse. Maybe that's another great thing to do is create a digest or something. In your sixth job or in my sixth series of things that are going around, and maybe that already exists, but I do think it's important. I think that a little investment in that time can really save you a lot of time at work. When it comes to talking about these things with your patients, I think it actually takes less time than you think because when you sit down, you make that eye contact. You have that conversation. It might actually only take three or four minutes, but it's going to save you time on the backend, I think.

It's just like when I talk to my learners or people when we're doing simulations, when we do the emergency C-section simulation or the shoulder dystocia, and I say, "When you stop and look and explain something to the patient, it takes 16 seconds to say, 'Hi, I'm Dr. Jen. I'm coming in because there's a shoulder dystocia. Your baby's stuck. I'm going to ask you to do some things. This might not be comfortable. I'm going to tell you all about it afterwards, okay?'" Boom, we're there, as opposed to, "100 people came into my room, and I don't know what the F happened." It actually takes very little time.

I would want to push back on that it takes so much time because I think it actually takes less time if you get that trust of your patients during that admission checklist, or if you do a TeamBirth huddle, which I don't know if you've ever covered TeamBirth. Oh, my God, you should. It's a fantastic way to communicate with your patients and get everybody on the same page. I think it's worth it. I think our patients really need us to know what they're experiencing in real time because that's also the life they're going to go back to. They're going to be using the same TikTok for looking like, "How do I know my baby's getting enough," or, "Is this normal?" You can really set them up for success with just the tiniest little spiel, I would say.

Sarah: Or even just that awareness that when there's a subtle reference, I'm picturing being in a room with a patient and them saying some word that you're like, "I've seen it. I know what they're referencing," the rapport that that builds and the brownie points you get with your patient. Even if you never have to talk about the TikTok, it's like--

Dr. Lincoln: "Okay, I see you."

Sarah: It's like the kids where they're 6, 7, and you're 10, 11. [laughs]

Dr. Lincoln: My God. Why? I ask him, "What is it?" He's like, "You just don't know, Mom. You're just not cool enough." I'm like, "Yes, totally." You're right. Let's say you have a patient who comes in, and she's like, "I do not want to push on my back." Something I say is, "Yes, I bet you've seen a lot of videos or things where people are like, 'I was forced to push on my back,' right?" She's like, "Oh, my God, you know."

I'm like, "You know what? I love that you've been looking into that. You can push in whatever position you want to. However, if we try something here and we find out that you being on your back this way is working, let's give it a go. I'm here for you." What she's hearing you say is, "You're not going to force me to do things I don't want to." That is going to, lightyears, put you ahead, and so many other things, too.

It's not that you're coercing people. It's just that you're building that trust, and you're like, "She gets it." Now, I don't have to be on the defense for everything, which is huge. So many people come into labor and delivery on the defense because they have heard the stories, because they're not stupid. They know the maternal mortality and morbidity rates. They know. We have to help them feel safe in a place they might not feel safe in.

Sarah: I love the "call the elephant into the room." Rather than you're speaking this undercover language where you're trying to address it while they're talking from this other place, just say, "Oh, yes, I saw that, too. Did you see that one?" Then all of a sudden, now, it opens it up for conversation, versus you having to be sneaky. I speak Spanish. My Spanish-speaking clients, especially if they spoke English as a patient, but their family was speaking Spanish, they're having this whole long thing.

Oftentimes, I would hear the misinformation from particularly the mom a lot of times. I'd note it. I'd clock it, but I didn't want to put anyone down, so then I'd have to subtly and very strategically weave those little tips into my conversation. That's just a lot of work, rather than saying, "I saw it. How did that make you feel?" or all of the things you said, or, "Let's talk about it, because I want to make sure that you feel comfortable here, and that we're doing something that supports you in your choices," and blah, blah, blah.

Dr. Lincoln: Exactly. Exactly, yes.

Sarah: I love that. Going back to, you mentioned, and this was a subtlety that I want to go there about personalizing their choices. Because even with what they choose to consume, of course, do I want them to take the Bundle Birth class? Do I feel like if you do that, you'll be ready? Of course. They may not have. Likely, they didn't, right? Instead, they chose TikTok instead.

I may have my own biases about that. I may say, "Well, but," blah, blah, blah. That's just an example to use here. You talked about personalizing their choices. I want to push into that more of, how have you figured out how to separate the two? Because what I see a lot, what I've experienced myself, and the work that I've had to do is that separation, and yet so much of medical, we get all hot about, "Oh, they don't want this," or, "They declined this."

We go to the nurse's station. We all talk about it, like, "Did you hear that, blah, blah, blah, blah, about their choices?" One of the phrases we use is, "We don't know why, but I'm sure they have a good reason for it." It's that idea of reeling it back and saying, "They have their whole life history that they're bringing into this room that I'm not entitled to." What's been your journey on making that separation? Tell me about that first, and then I have a follow-up.

Dr. Lincoln: No, I think that's such a good question. I think it changes. I think that those of us who are newer, who maybe just got out of nursing school, who are still in training, it is really hard to, I think, grasp or understand why somebody isn't doing the thing that you know has the best evidence. I say that because when I was a resident in my first two years out in practice, I was that way because, I even say this in my book, that I believed home birth was the place where safe birth goes to die because I had only seen the train wrecks that came in, or I had only seen what happens when you don't do whatever.

Those stick with you. I had only known one way. I think the longer you practice, so I've been out for over a decade now, which makes me feel old, but also I feel like a little bit wiser, you realize that there's multiple ways to do things. I think that comfort just comes with time. If you are a newer nurse and you're really annoyed that your patient doesn't want continuous monitoring, and maybe she's got something that would make her a candidate for intermittent monitoring, and you go out to the stage, and you're like, "Oh, my God. Does she even care about her baby? Why is she doing this?"

She's doing it because she saw The New York Times article that said that, but she didn't understand maybe the nuance that that didn't really apply to her. Whatever. The point is that she has her reasons. You can go out and be really annoyed and angry and go home and be like [grunts], or you can just be like, "That's her choice." I think it comes with the comfort that you know that you did your part. You educated. You connected. You documented. I'm not here to pretend that medical legal stuff doesn't exist.

I think that is really a lot of fear for big people, especially my people. OB/GYNs were the number one sued specialty. You got 18 years to do it, which was super fun. There's just a part of me that's like, "I know I made a good connection with the patient. I said everything I could. I documented it." I don't know. Just at the end of the day, I'm not going to lose sleep because my life does go on, whether or not something happened.

I think that it's not that I don't care. It's not that I'm tuned out, but it's just that I realize that I can't change the world and fix everything, or not everybody's going to listen to me, and it's going to be okay. Actually, 9.9 times out of 10, it actually is okay anyway. I think you grow that experience. I really would encourage people, nurses especially, who are with the patient at the bedside so much more than I am.

You, I get. You are invested. You were there. You're there with the family. You're listening, but it is a job, and you are going to go home. I really would encourage you to understand that what patients choose is not a personal reflection of you. Maybe my perspective is different, too. I'm in Portland, Oregon. Like I said, I'm married to a pediatrician. We are in an environment where vaccines are something that people decline more often than not when it comes to newborn things.

Maybe it's just my environment is different, where I'm like, "Yes, I hear you. Here's whatever. At the end of the day, what can I do?" Because if I got frustrated every single time somebody didn't do something how I would do it, I would be hypertensive. I wouldn't be able to do my job well, and I wouldn't be a nice person to be around. I think you just have to realize, like, this isn't about you. It really isn't your story, and you can't control everything. The sooner you realize that, you're going to be so much happier at your job. [chuckles]

Sarah: Well, it reminds me of the phrase, "We create our own suffering." It's just like the patient has a choice how to see their labor. It's one contraction at a time, and all these things that we also have a choice, an autonomy over how we approach our job and how much suffering we create for ourselves and how much emotional load we take on, which really is what it is.

Dr. Lincoln: Yes. You can still be a very caring person and show up for your patients and understand that that patient who declined that vitamin K, it's not a personal failure of you. You don't need to carry that because, you know what? That's her decision, not yours. Again, it's probably going to be okay. If you just got so frustrated about something, especially in health care, you're not going to last long at all. [chuckles]

Sarah: So true. I'm listening to you talk about not taking it personal, what the patient does. You're an OB. Oftentimes, if I'm totally candid-- and actually, let me go back to that. Oftentimes, for us on our job, one of the most frustrating things that we have to manage is the provider. I'm listening to you talk, and I'm like, "Oh, yes. Oh, yes, so aligned, so with you. Yes, this is everything that we live for, we stand for, that's integrated into everything we do. We're just, yes." I can hear nurses listening to you and going, "Oh, if only all the OBs functioned like you on my unit." Why do you think that is? Why do you think that is?

Dr. Lincoln: Yes. Well, I know. That makes me angry, and it also makes me realize how lucky I am to work with the people I work with because there's always that one person or two.

Sarah: Of course.

Dr. Lincoln: My colleagues, I love them. When I work with people, this is just how our unit works, but then I hear the stories because those same nurses DM me. They're like, "Well, that's not how it is at my hospital. My OB/GYN would never suggest this." I know that's true. I also briefly practiced after residency on the East Coast, and it was different. If anybody's listening from there, my nurse buddy's like, "Oh, my God. I love you so much."

Some of the docs, it was just a different way how to communicate. I'm not stupid. I think it's a huge problem with our field. When I wrote my book, The Birth Book, I started out writing a book because I wanted to help patients. I wanted them to know, "These are the questions you can ask. These are the things you can be prepared for." As I dove into the research, and there's 40-something pages of references, I started to get really angry because I realized some of the ways I was trained. What I was told was evidence-based.

I was like, "Whoa, this is not new information." I'm talking about things like eating and labor, intermittent monitoring, blah, blah, blah. Then I realized I was writing this book as much for my colleagues because it's on us. We need to practice in a way that is not defensive all the time, that centers them, and that really owns. Some of the things we've been doing have not been evidence-based or have caused harm.

To answer your question, yes, there are a good handful of us who would want to fight me in a bar if I said some of the things I said about these decisions or, "Well, that's easy for you. You haven't been sued," or blah, blah, blah. The point is, is that let's own where we are, which is that we do have some of the worst rates of maternal morbidity and mortality. We have patients that don't trust us. We have patients who are dying more than they should be, or who are choosing home births, who are not safe candidates because of people like us.

Do you want to be complicit in that and continue it? Do you think it's working well, or do you want to do something about it? Part of that means that sometimes we have to change how we practice, including how we communicate. That might feel uncomfortable, but we have to do it. If you actively now know that information and choose not to do that, that says a lot about you. Now, I'm getting really upset. Part of it is that, yes, it is us holding ourselves accountable. All of medicine, we don't.

I could talk about that all day. This sometimes starts not from a punitive way, but we need to set standards for how we communicate. There needs to be standards of respect and how doctors and nurses treat each other. There needs to be a way that people feel that they can say things and not be penalized for it. I'm talking about nurses saying, "Hey, this doc wants to do this," or whatever. We need to have those expectations. Again, I will put a huge call-out for TeamBirth, which is this way of communicating.

Actually, if you haven't had them on your podcast, you totally should. It's this idea that you check in with your patients, and the nurse and the doctors are there. It just changes the culture on a unit. I feel for the units where this isn't the culture. The nurse is afraid to call the doctor because they're going to get yelled at. Hospitals are also accountable, because if you're continuing to allow people to practice who are yelling, who are throwing instruments, who are doing crazy things, then that's on them.

They need to take a stand, too. I think we all just need to do better about holding ourselves accountable and what we're going to take or what we're not going to take because, at the end of the day, it's not about us. It's about the patient, and it's about outcomes. I have a lot of feelings about that, too, but I don't understand. Why do you go into this field, or why do you go into medicine if you can't talk to people and be nice? I don't get it. [chuckles]

Sarah: Well, it's the hierarchy, too, because I've worked in units, both types of units. The unit I started in, I was literally called a C-word.

Dr. Lincoln: No.

Sarah: Oh, yes, by a physician. I said something to my manager. I didn't write it up in an official report. She goes, "Oh, it's just how he is. It's just how he is. He's always been like that."

Dr. Lincoln: No, no, no, that's ridiculous. I couldn't even--

Sarah: I can't even imagine saying that word out loud, to be honest. Even thinking some of the worst people that I can think of that I might want to use that word for. That's an example of the unit that I came from, where there was a "my way or the highway" from how they talk to the patient, but also how they talk to the nurse. It was just so disempowering and so morally injuring along the way. I think for us to--

Dr. Lincoln: It's a power thing.

Sarah: It is. It is.

Dr. Lincoln: If it's the manager, if there's a department chair, if they're allowing that to happen, then they are a huge part of the problem, but then I get it. You're like, "Where do I go? Who do I talk to? How do I get this out there?" I'm hoping that is changing because these are the stories that are getting out on social media. As much as you hate to see it, I love to see that these stories are now no longer just being carried with you, but they're being shown. Then people can say, "Hey, that's not okay." Some of these people are not keeping their jobs or being held accountable. I think that's appropriate.

Sarah: Yes, I agree. Do you have any tips for nurses in working with providers/a perspective that would be helpful for us to understand?

Dr. Lincoln: Yes. I think my biggest tip is that to always be curious and to communicate. You might hear something in the room, and you're like, "What did I just say?" I think that it's great to ask questions. You should feel that you can because that's part of the job. Medicine is a team sport. I also think that there's ways to do these things because I work with great nurses, but I'm thinking back to residency, where sometimes the nurse would call me out in front of the patient and be like, "You want to do what?" I'd be like, "I've been here for 10 minutes."

Again, you're so right. I shouldn't, but we can chat outside the room because not everybody is always trying to do something harmful, or, like, "Yes, you should feel that you can have conversations, make suggestions, be curious." You can do it in a way that's going to maybe get you more likely to where you want to be, right? You can catch more flies with honey than with vinegar. I think that's how you say it, right? Not about the bees, it's the-- Anyway.

Sarah: Yes, yes.

Dr. Lincoln: You know what I'm saying. I would say that. At my institution, we have language where we know when we as doctors hear a phrase, we're like-- so if a nurse comes up to me and says, "I have concerns about this. I'm uncomfortable. This is a safety issue. It's how we escalate." As soon as I hear that, I go, "Oh, yes, I have to stop." I'm like, "The records crash." Not every hospital may have that.

That's something you can advocate for, because not every doctor has taught great communication or comes from the unit where they could talk like that, which is unacceptable. I would say, "Feel that you can talk to your providers, but do it in a way where you're not calling them out at the nursing station." You're engaging in the same way you'd want to get talked to or have a conversation with. If you feel that you're not getting somewhere, I want you to go up the chain.

Not in a way where you're like, "Well, F them. I'm going to get them fired." I'm seeing this. I'm worried about this. I feel that when they talk to the patients, they do this. I'm not talking about explicit things that are horrible, of course, but come at it from a way that, like, "How do we get them on our page?" I also think that with every group, I'm not encouraging gossiping here, but with every group, I bet you can think of that one doctor. You're like, "Oh, I can talk to her, or I can talk to him, but this other one, I can't."

Maybe going to them and saying, "Hey, I've noticed this about this provider. I'm not trying to gossip about them, but how do I get them to stop doing this?" Sometimes, let's move because then that doctor can then figure out a way to talk about it in a way that's not confrontational, taking you into account. I've done that where, as a group, I'm like, "Hey, guys, just as a heads-up, let's remember," da, da, da, da, da. That can be really empowering, too. I hope those suggestions are helpful.

Sarah: Definitely. I love your first comment about being curious. It's all like, we don't understand each other's vantage point. First of all, don't pretend like you do because you won't, unless you're going to go back to medical school, and vice versa. I remember we were sitting in a meeting, and we were talking about doctors, and I was like, "I have so many questions. I wonder about this, and I wonder about that," and then we realized the ACOG convention was happening. Literally, I was like, "I think we need to go." I left that night to go to ACOG.

Dr. Lincoln: Oh, my God.

Sarah: I went to ACOG this last year.

Dr. Lincoln: I love it. [laughs]

Sarah: Then we were like, "Let's just go explore," and so we did. I walked away being like, "Phew." My whole brain being like, "Wait." Even my takeaways of not being an OB and not wanting to be an OB, but also just being like, "We have to understand each other better if we're ever going to work together better." One of the biggest a-ha's was like, "You're managing way more than labor and delivery, which seems so silly."

I know this, but it hit that I was like, "Our whole world is OB." If we're labor and delivery nurses, maybe LDRP, but we're labor and delivery. That is my vantage point. That is what I know. That's what I'm obsessed with. That's like, I'm so narrow on that. You're navigating so many more dynamics and a spectrum of women's health. Even that, I just was like, "Oh, it's not their whole world." [laughs]

Dr. Lincoln: Yes. It goes both ways. I bet people who are listening have experienced this, where you're like, "Oh, my God. She wants to start pushing with this patient, but she can't feel anything or whatever. Why are we not laboring down anymore?" All of a sudden, now, they want to push immediately. That might be really annoying to you. If you stop and ask and be like, "Hey, Doc, just curious. I thought laboring down might be good," and then I might respond and be like, "I know why you think that."

There's actually newer data that shows that it doesn't decrease these risks and actually increases some risks. Here's what I'm thinking, "But what is your concern?" "Oh, it's that she really can't feel." "Cool. Why don't we turn down the epidural a bit? In 20 minutes, let's go. Does that sound good for you?" That's how it goes. If you're listening to this and you're like, "That's never going to happen. Those conversations never happen," those are my conversations every day.

That should be the expectation for how we communicate. Don't ever feel that you can't ask why because, like you said, I don't know what's going on in your world. When I say, "Why haven't you given these antibiotics yet?" what I'm going to say is, "Are they happening?" You're like, "Yes. Actually, it's not in the Pyxis, and it takes 20 minutes. I'm doing my best to get past these instead." I'm like, "She's so lazy, and she's passive-aggressive," and blah, blah, blah.

Just come at it from a, like, "I don't know what you know. Our worlds are different," which is why in the perfect world departments, we're having these conversations. We're having these interactions at safety huddles or meetings. If you don't have them or you don't have this, it doesn't hurt to start it. It just starts with one person saying, "I'm curious about this. Can you give me a two-minute spiel on why you do X, Y, or Z?"

Sarah: That sounds like teamwork. Imagine.

Dr. Lincoln: It's the shit you learn in kindergarten. I don't know if I want to curse on this. Literally, it goes back to the rules of kindergarten. If we just went back to that, so many problems in the world, not just our units, would go away.

Sarah: Amen. It is so refreshing to hear you talk, to be honest. I'm even just thinking how cathartic for nurses who are coming from the challenging units. I know you. You're in my DMs. I send you so much love and so much stamina and so much therapy to make it through because it is so hard. To hear an OB like you talking this way is just like, "Oh, thank God it exists out there, and there's hope for the future."

Dr. Lincoln: There are so many. There are so many like this. I think it's changing because I think that we're seeing on social media, like, this is how it can be, or this is how it shouldn't be. What's great is, now, patients are like, "No, I'm not going to go to this person who talks to me like I'm garbage, or my way or the highway." For the nurses who work at those places, like you said, I feel for them.

I want you to know, it is also-- Oh, I don't want to add more stress, but it's also your job to call out when things are not going right and not being complicit in a system or a unit that is harming patients, not just physically, but psychologically. I know that's easy for me to say. If you feel that you're in a place, whether it's based on your years of experience or your position in the hierarchy of, "You've been there. You have this position. You're a charge nurse," or something like that, please know that your patients deserve. They deserve better. I'm not trying to pretend that maternity care is great right now, but we need to do better. Until we all do, then we keep perpetuating these things. You have a right to work in a place where you don't want to kill everybody. [chuckles] Not the patients, the doctors. Let me be clear.

Sarah: Well, they may not be able to work with you in person, but they can take a piece of you with them with this new book. Can you tell us about what we can expect from your book?

Dr. Lincoln: If you preorder now, I will send a snippet of my hair. No, I'm kidding.

[laughter]

Sarah: Maybe a fingernail. [laughs]

Dr. Lincoln: Yes, so please, please follow along. I'm @drjenniferlincoln on all the socials. I have a Substack specific to birth. If you're a birth junkie, that comes out once a week. I have to write it tonight this week, so I'm going to get on it. My book, The Birth Book: An OB-GYN's Guide to Demystifying Labor and Delivery, it comes out March 24th, but you can preorder it now. If you preorder it, there's a special place in heaven for you because that makes a huge difference to publishers.

It tells them, "Hey, people want to read this, so we should support her more." If you want to, you can do that. Like I said, it's only focusing on labor and delivery. It's the first book written by an OB/GYN focusing on this. A lot of the books out there. There's lots of great stuff out there, but there's nothing just about the part where the baby comes out. If you work in this, you know so many people come in knowing the size of their baby every week, but have no clue what's happening when the baby comes out.

Not because they're not trying, but because our visits are way too short. I wanted to address that. It's written in easy-to-understand language. There's illustrations of things like a Jada and a Bakri balloon and decelerations and an FSC. You can actually look at it and be like, "Oh, I can show my patient what this actually is." Oh, and there's checklists, what to ask, things to think about. I did include my very own birth preferences because I know there's a lot out there. I'm sure you've got many episodes on birth plans and preferences. I think they're a great tool for communication, but some of them, whoo, are a bit much.

Some of them don't think about even the little things. It's like, "I want to talk about a blood transfusion, or I want to talk about some of these things." I put together what I think is a really good version. It's fully referenced, so you don't have to take my word for it. Like I said, I wrote it for patients, but I wrote it for those of us doing this work, too, because I want you to feel like this is how it can be, this is how it should be, and here's how we get there. You can order it from anywhere. Of course, I highly recommend your independent bookstore, but it is on all the big platforms, too. Once the book is published, all that stuff will be on my website, too.

Sarah: I love it. Well, this is one of the ways that we combat medical misinformation is that we know what sources to recommend, and that we also know what and how to talk to patients in plain language about the medical stuff and making complex things much easier to understand. One, I'm so excited to read your book. I'm also so excited to learn from you as far as how to connect with our patients in a way that they can understand and really be able to address those things.

The other plug I'm just going to make as you're talking, I'm like, for all of us out there, as a small business owner myself and as an entrepreneur, this idea of supporting creators and supporting people that you align with, it is how they survive. It is how they keep doing what they're doing. If you love this type of information and we want more of this more reliable information out there, we need to support those businesses.

I don't know if you're considered a business or not, but your work in that way to help them to be able to keep doing that. That, for me, I don't know that I got until I had a small business myself, where I'm like, literally, your badge buddy order is helping me support my staff so that they have medical insurance. You know what I mean? Stuff like that. Like you said, telling your publisher, "This is how you keep getting to create content."

Dr. Lincoln: Right, right.

Sarah: If you love and those people that you do love that you align with, everything you've said today, I'm like, "Yes." What can we keep doing together? We are so in the same lane and on the same mission, and that we are a team on social as authors, as content creators, as MOVE Learning Retreat people, or class makers, or whatever, that we're in the same world. If we want to keep making change, we have to support each other in that. One of the ways of doing that would be purchasing your book. Other ways that are cheaper are even just to follow a like. All of that really matters for all of us out there.

Dr. Lincoln: No, you're so right. Here's a fun, little secret to share. I can't tell you the number of times that I get reached out to from very shady companies that want to use my name, or they want me to develop something like a supplement. A lot of times, it's supplements because that's a huge trillion-dollar industry. There was one company specifically that was like, "We can help you make six figures a year."

Now, if you have no ethics, and unfortunately, there are a lot, I don't want to say a lot, there are some, even physician people out there who are doing just that. That's why, because it is so lucrative. You know what's not lucrative? Having ethics and morals and having a small business. [chuckles] Like you said, every time you buy a badge buddy, it's also an act of resistance against a healthcare system that I feel sometimes you just feel like you're failing, or you feel like you can't make any change. You don't always have to go to a protest.

Do that, too, but support the people who are doing the work to take care of our patients. I think I totally align with that. I think that I'm so excited to see so many people who are doing these things. When I go to work, and my patients are like, "What should I do?" I was like, "Oh, there's this Bundle Birth Nurses, and then there's this Count the Kicks app, and then there's this," duh, duh, duh, duh, "and I know these people, and I make no money from it, but here's why you should support them." They love it because they're like, "I just want to know, who do I trust?"

Sarah: We have that authoritative voice. We need to own and be responsible for the voices that we intake, and how we go through all of the information out there to find sources that really are trustworthy, that are going to continue to push the dial forward and not roll us back.

Dr. Lincoln: Right. Exactly.

Sarah: Thank you for being here. I don't know about you, but that felt like a breath of fresh air. I'm so grateful to you, Dr. Lincoln, for being here and for sharing your wisdom with this audience. If you loved that conversation and especially the one surrounding talking to providers and you're saying, "I need more skills for how to communicate with my providers, how to approach awkward or clinical situations in a way that actually gets through, versus feels awkward and uncomfortable," and maybe you just shy away from it altogether, even though you know that for the sake of the patient that you shouldn't.

I invite you to our Care Framework class. It's a $30, two-hour workshop that's happening on March 4th, 2026. It will be recorded, but you will get less CEs for those that don't attend live because there will be a breakout component where we're going to practice. We're going to have a conversation. I'm literally going to be sitting on the screen workshopping this stuff with you as we continue to push into the conversation surrounding how to communicate with our team, specifically those providers.

I have pulled in research from crucial conversations, from trauma-informed care, from centering the patient, and some healthcare management stuff, and other communication experts to put it into this synthesized way called the Care Framework. Join us for that class. If you're listening to this after when the class is live, there may be a recording. There may be future dates.

Then, for those of you coming to our MOVE Learning Retreat, this class is included with your ticket. Please mark your calendars, March 4th, 2026, and join us for this conversation because this is laying the groundwork for everything that we're going to do at MOVE and the conversations that we're going to build off of, and I will be referencing the Care Framework.

If you can't attend live, the recording will be in your account, so you'll make sure and watch that before you come to MOVE. Then we're going to expedite your learning. We're going to expedite your growth. We're going to have these conversations that are awkward. We're going to give you actionable tools to help support you in your practice so that you can thrive, so that you can survive in an environment where you feel down-regulated in your nervous system. You're outside of your norm. You can find that joy, that color, infuse that color into your life as we center the patient together. More information is down below.

Thanks for spending your time with us during this episode of Happy Hour with Bundle Birth Nurses. If you like what you heard, it helps us both if you subscribe, rate, leave a raving review, and share this episode with a friend. If you want more from us, head to bundlebirthnurses.com. Subscribe to our monthly newsletter, or follow us on Instagram. Now, it's your turn to take what you learned today. Apply it to your life.

The next time that you're at the bedside with a patient and you sense that there might be some sort of social media that they've consumed influencing the conversation around that, call it into the room, connect about it, and then continue to contribute your brilliant nursing education to the situation and see how it goes. Once you do so, let me know how it went, either on Instagram DMs or even just send us an email. We'll see you next time.