TRANSCRIPT EPISODE 12 – All About Pregnancy & Birth With Dr. Nicole C. Rankins

Transcript episode #12: HOw to choose a pediatrician with dr. phil boucher

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00:00                                You are going to need a pediatrician for your baby very soon after they're born. So listen in to learn how to choose a pediatrician that works for you and your family.

00:16                                Welcome the to the All About Pregnancy and Birth podcast. I'm Dr. Nicole Calloway Rankins a board certified Ob Gyn physician and certified integrative health coach. Every week I break down topics, share birth stories or interview experts to help you have your very best pregnancy. Quick note, the information is for educational purposes only and is not a substitute for medical advice. See the full disclaimer at www.ncrcoaching.com/disclaimer.

00:44                                Nicole: Hey there. Welcome to another episode of the podcast. I am so glad that you are here with me. This is a really fun episode for me today. I'm talking to my friend, Dr. Phil Boucher. Phil is a pediatrician, a father and husband from Lincoln, Nebraska. Phil and I got to know each other because we both have online courses. Phil's course is called Mighty Sleepers and it's an evidence based program to help your baby sleep through the night. It's a great program. I'll link to it in the show notes and of course my online course is The Birth Preparation Course, which is an online childbirth education class that ensures you are knowledgeable, prepared, confident and empowered going into your birth. I'll link to that in the show notes as well. Now, I invited Phil on the show to talk about the ever so important task of choosing a pediatrician for your baby. He gives some outstanding advice so I know that you will find this episode really useful.

01:46                                Nicole: Now before we get started, I want you to do me a favor. I love to know who's listening to the podcast, so I would really appreciate it if you take a screenshot of your podcast player and post it in your Instagram story, be sure to tag me so I see it. I'm @ Doctor Nicole Rankins and I would love to repost it in my own Instagram story. Now, speaking of WHO's listening to the podcast, let me give a quick listener shout out to Tadpohl. That's T. A. D. P. O. H. L. I like that. She left me a review in iTunes and it said, "Finally an ob who gets it. Refreshing and informative and easy to listen to. Love it. I am a birth and postpartum Doula that will be suggesting this podcast to their clients. Keep it up." Thank you so much for those kind words and for sharing me with other folks. I really truly appreciate it and I will definitely keep this podcast up. All right, so why don't we go ahead and get to the interview with my friend Dr Phil Bouchr.

03:01                                Nicole: Well, hey Phil, thank you so much for agreeing to be on the podcast.

03:06                                Phil: Thank you. I'm so excited to be here. I loved following along and learning all about moms and the Ob side of it.

03:14                                Nicole: Yeah, absolutely. Absolutely. So the purpose of today's episode is to help my listeners with the very important task of choosing a pediatrician and I thought we would start by having you just tell us a little bit about yourself and your work and your family.

03:33                                Phil: I am a pediatrician in Nebraska. I grew up here where I'm working, I'm back in my hometown. My wife is from a nearby city as well. She's just from up the road. So we both wanted to stay in Nebraska and that's where we ended up and are grateful for that. We have four young children and actually, at the time of this recording are expecting number five in about four or five weeks from now.

03:58                                Nicole: Wow.

03:58                                Phil: Yeah. And I am in private practice. I've got a great group that I'm a part of and love getting to see parents in the office and talk with them in advance before delivery, even about what to expect. That's just the highlight of my day is getting to see new parents that have just gone through the whole delivery birth process and then they've got this bundle of joy that they get to look at.

04:25                                Nicole: Awesome. Awesome. You know, I've never been to Nebraska. I don't think I've ever, I'm like, have I ever been to the Midwest other than like Chicago? I don't think I've ever been to Nebraska. Is it very cold there right now?

04:38                                Phil: It is freezing cold. I have a space heater in my office that I had to turn off so that I could record this without the background noise, but it is cold. And you know, Nebraska's new slogan this year that they just came out with and everyone's been talking about is "Nebraska. It's not for everyone." And that's the slogan because there's really, I mean it's flat. There's no mountains. It's very hard to do any sort of outdoor hobbies. There's no beach. But the people are just unbeatable. And the football is okay sometimes.

05:08                                Nicole: There you get, there you go. All right, so getting back to choosing a pediatrician. So when should a family start thinking about choosing their pediatrician?

05:19                                Phil: I think it's a good conversation to have, in the first, late, first trimester, early second trimester. I mean, I don't think you have to be, you know, have them picked out before you're even conceived or anything like that. But I think that once you are approaching that time where you're thinking about what hospital are you going to deliver at or the specifics of your birth plan, then that's the time to make sure that you have a pediatrician lined up as well.

05:43                                Nicole: Right. You know what, I honestly would've thought it would've been a little bit later. I don't even think I personally thought about a pediatrician that early in my pregnancy. So you're thinking like second trimester is perfectly fine?

05:55                                Phil: Yeah, I think that's a great time to do it because, for some pediatricians their practices are kind of full and so if you wait until you're about due, then you might find that they're not actually accepting patients right now and then you're kind of like trying to find somebody or weasel your way in or something like that. So if you're proactive and ahead of the curve a little bit, I think that you can't go wrong with being on the ball for that.

06:20                                Nicole: That makes a lot of sense. A lot of sense. So you're in your late first trimester, second trimester. So just walk us through what a woman should do around that time or a family I should say, about how they should go about choosing a pediatrician. Walk us through those steps.

06:38                                Phil: Most of the way that people come to us I think is through asking friends and through Facebook recommendations, who's a good pediatrician, you know. So I would first have people ask the friends that they trust who they see and then kind of use that as a starting point to say, okay, they recommended Dr. So-and-so and other doctors names. And from there you can start to look at their specifics. Are they near your home? Are their hours convenient? And you know, are they available when you would like them to be? Can you tell, you know, what their personality is like or if they have any special areas of interest. Those are the things that once you have a short list, then you can kind of whittle it down from there to what fits you personally.

07:24                                Nicole: Okay. So I can definitely speak from personal experience of having two children. You do not want a pediatrician that's like on the other side of town if you can help it. Right when you have a sick kid you want to be able to get in quickly and make sure that person has availability. So for sure where they're located and their hours are crucial.

07:44                                Phil: I agree. Availability is really important. And location availability is important too. We have families, we kind of live, our practice is on one side of town and we have families that come, you know, 30, 40 even 60 minutes to our practice. And I really, well I feel both honored that they came in, came out, drove all that way just to see little old me. But also it's difficult for them because there's such a commute and such a time to get to your doctor's office. So if you have the ability to see somebody that's close by, I think that's helpful for sure. And then, you know, not just location availability but hours availability to finding somebody that works with your schedule. Some pediatricians have weekend hours, some have evening hours to accommodate schedules. And both of those, you know, finding what works for your family and what works best will be the most benefit because then you can see them when you need them. What we always find or what we really get frustrated with is when patients feel like they have to go to the urgent care or theE R where they don't know your child, they don't know children as comfortable as we are with them, so they do extra tests, they order extra medications and things like that where if we can get them in our office, then we know that we can provide really high quality value to them. But if, if your doctor isn't available when you need them to be, then it's hard to to make those things work together.

09:09                                Nicole: Yeah, weekend hours and late evening hours can be very handy. Not even, not necessarily for like routine appointments but for sick appointments for sure.

09:18                                Phil: Yes, definitely. That's what we use, our weekends are just for sick visits. And we were just having a discussion recently about how popular those are and how people get a little bit upset when they can't get it on the weekend because they really, I mean that's when kids get sick in the middle of the night and on the weekend. They never get sick on your Tuesday that you have off when it's the perfect time to take them to the doctor.

09:38                                Nicole: Oh, of course. Of course. So you've, you've talked to some friends, you've gotten some recommendations, maybe you've narrowed it down to like three choices. What are your thoughts on prenatal consults with the pediatrician?

09:51                                Phil: I think that prenatal consults are a great opportunity to get to meet the, your potential pediatrician and make sure that your personalities Mesh. Make sure that if you have any specific concerns that you're able to address those with your doctor. If there's something special in your pregnancy that you want them to know about so that when baby arrives, they're cued into that. That's the perfect time to share that sort of information. And also just to, to get the sense of their approach. We have pediatricians that are more comfortable with allowing things to play their course. And then we have pediatricians that are more comfortable with getting labs and imaging and ordering additional testing. So finding out what the right person is for you, and I definitely am not the right fit for every parent and every family, but I get the opportunity to talk with them and see, you know, are we a good fit?

10:43                                Nicole: Yeah. So in terms of figuring out that good fit, are there any questions that you recommend that can help parents give a really good idea whether or not that person is a good fit for them? If you had to pick three questions, do you have three questions you could recommend?

10:58                                Phil: I think the, the first question that I would pick would be asking your potential pediatrician what their overall philosophy is in regards to pediatric care. I see plenty of different physicians practice in different ways. And so there's a lot of variation within normal acceptable standards of care in terms of testing that's done, in terms of letting things run their course. I think that parents and families relate differently and some parents really want full court press. If my child is sick, I want every test done. I need that reassurance. And being able to talk to your pediatrician and say, I have really high anxiety. I need to make sure that when I have a concern that we're taking it to the nth degree because I want to make sure that we're not missing anything. I don't care about the cost. I don't care about you know, over use of medications.

11:51                                Phil: I just want to make sure that whatever we can to do as addressed.

11:56                                Nicole: And that's a really great point. I want to say real quickly that that's the same thing I tell them. I'm going to ask about their ob doctor if their philosophies match. Are you somebody who's okay with like a low intervention birth and you know, not intervening unless needed or, or are you on the spectrum of intervene and pitocin and IVs and all the technologies and all that kind of stuff. So this is a great instance of where, you know, philosophy is a really big, asking about philosophy is a great question to help see if you're a match.

12:27                                Phil: Yes, definitely. I think that, I mean I think that's the biggest thing because most of the time, I mean the, the actual medicine is going to be quite similar from doctor to doctor. It's, it's everything that goes along with that decision making and how that goes and then, you know, intervention or allowing things to run their course. Those are the areas where things can differ a little bit where both are right. And some parents prefer one and some parents prefer the other.

12:53                                Nicole: Yeah. So, besides philosophy, what are the questions do you think finding out what their availability is like?

12:59                                Phil: I think parents these days are very keen on convenience and wanting to be able to get in when they need to get in and making sure that that's something that their office or that they have the same expectations that the office does in terms of being able to get in quickly for sick visits, well visits and wellcare and, and when those will be scheduled, making sure that you're a match in terms of schedules so that you can make the most of your visits and you don't feel like you have to seek alternative care places because you can never get in or the times never work.

13:32                                Nicole: Okay. Okay. Good. Anything else or are those the main things?

13:36                                Phil: I think, I think those are the main things. I guess if I'm trying to break it down to other broad questions, you know, finding out what their offices stance is on some of the different parenting things that come up, especially on Facebook, you know, vaccines, vaccine schedules is a big one. Antibiotic use is another one. I always proactive at my prenatal consults telling parents, you know, our vaccine policy or the majority of our patients in our office are fully vaccinated on the normal, you know, recommended schedule and I try and limit antibiotic use, sometimes to a fault the amount of time that I hem and haw over do we actually have to use an antibiotic? And so being able to make sure that you're on the same page with your pediatrician in those regards and not just, you know, is the pediatrician going to let me do what I want.

14:29                                Phil: But how does a pediatrician handle other patients in the practice who might be refusing to get vaccines? You know, is that going to impact my child because they're in the same waiting room with a patient that could have some unusual illness that is vaccine preventable? I think that's something that I hear from parents quite often is not, you know, can I do whatever I want with my vaccines? Will he let me do that? But can you reassure me that everyone else in the office is on the same page with the importance of vaccination? I hear that a lot more than people that want to do things different.

15:03                                Nicole: That is interesting. I would not have predicted that to be honest with you. That's a very interesting point and an important consideration for sure. I will have to say like my husband and I, we were, were we 100% support vaccines, but we kind of fell into that category of altering the schedule a little bit. Neither one of our girls got the Hep B vaccine in the hospital just because we felt like, they can get it later and they're so tiny and our neonatologist cause our first one was a preemie and the second then the pediatrician was like, oh yeah, that's fine. We often do it at the, I guess one month visit and you know, and then, we just didn't like how at some visits you may get like ,kids may get like four vaccines, I just felt like a lot to us. So we tended to spread them out a little bit. But it's interesting that you say that that's not what you seem to get the most of.

15:55                                Phil: Yeah, it's refreshing for me actually because I was kind of anticipating the other side where a lot of parents were seeing what they could get away with and not get kicked out of the practice basically. But that hasn't been the case at all. Most people in this part of the country, they just want to make sure that everybody's on the same page and there's no surprises in the waiting room or at Target or you know, that they're going to run into some vaccine preventable disease that could have been avoided.

16:18                                Nicole: Gotcha, Gotcha. Okay. So now if you've chosen, you've done the prenatal consult, you've decided like, this is a great fit for me. Will that pediatrician automatically see the baby in the hospital after the baby's born because once, mom, it just to say guys, once mom and baby are separated, baby has a whole nother doctor.

16:39                                Phil: Yeah, it varies. So, um, in our practice, we do go to the hospital and see our own babies. So you know, I get phone calls or text messages at 6:00 AM saying you've got a new baby and it's kind of a surprise and, and then I go see them in the hospital or if I don't have any babies then I just, you know, sip on my coffee and get a little bit slower start to the morning. But some practices do see their own babies in the hospital and then some use either a service or a hospitalist group that rounds on the babies in the hospital and then you meet your pediatrician when you go home and come in for that first office visit. I will say that I really like getting to see my patients in the hospital and it's really that time when they're at, the parents are at their most tired, but they're at their most joyful because they've got this new little bundle of joy that they want to show off. And so it's a time for me to get to bond with them. And if I'm on vacation or it's a weekend or something and I don't get to meet them in the hospital, it takes a little bit more to get to know the parents because you miss that kind of critical time period where you see everything. You're, you're there in the thick of it and you see their laundry on the ground. You know, just the way it is when you're, after you're delivering more important things are in your mind and so.

17:52                                Nicole: Yeah. Yeah. Now, how soon will you see the baby after they're discharged home?

17:57                                Phil: I typically have parents come in either the day after they go home from the hospital or the day after that. The biggest things that we want to watch for are making sure they're not losing too much weight because all babies lose weight once they are born. They are at their birth weight. They lose about eight to 11% of their birth weight before milk comes in and they start to gain weight. And so we just like to make sure that as they go home and they're waiting for their milk to come in, that we're not getting too low in our weight that we need to do need to do something. So for the majority that means I just have them come in the next day. It's also a chance, you know, especially first time parents, they go home and they don't even know what the questions are. And so having them come back the next day is helpful for me to answer all the questions that they never thought about because they've never had a baby at home before. And then in the hospital, the nurse took care of these things and they didn't even know there were things they had to take care of. So they come up with great questions for us to discuss at those visits.

18:54                                Nicole: Okay. And then speaking of, you know, you talked about the milk coming in and that kind of thing. Do you have any type of lactation support in your office or is that an expectation that women should look for? What do you think about that?

19:07                                Phil: I think you know when you're in that prenatal period. That's something that I would make sure and have a handle on in advance, because I think for a lot of women that breastfeeding is more difficult than it's made out to be because there's a lot to figure out in those first days when you're super tired and you don't have any milk for baby. And so being intentional about thinking, okay, if we have problems or want some extra help with nursing, here's where we can turn is a really helpful thing to plan in advance. Now we do have a physician actually in our office who just does breastfeeding medicine, so she gets to see babies and moms and it's a lot of first time moms or repeat moms that want some extra help with getting nursing off to the best start and it's such a value to our patients because they're able to get both visits done in one because they don't need to come see me as the pediatrician and then see her as the pediatrician and work on breastfeeding.

19:59                                Phil: They can just see her and then I'll see them once she has given her them her blessing that yes, nursing is going well, keep going.

20:05                                Nicole: Okay, okay.

20:06                                Phil: Some, some offices don't have that. And so there are lactation people in our town that can provide those services too, for, you know, you go see your pediatrician, you get checked out by them and then you see lactation as needed as well. So those are services that are available. And I've even seen some like tele health sort of lactation services, which I think it could, that could be a way to do it if you had a good scale. And the ability to help mom with latch especially, but I'm not sure where that will go. But in general, I think it's good to have that available if you need it. And, and I tell moms too, when you're in the hospital, really just bother the lactation consultants that are in the hospital because they are there for you. Ask all the questions. Even if things are going well, ask you know what do I do if he can't do this or what if, what do I do if this isn't working or what's another hold that I can try? I tell parents to really annoy the lactation people with all of the questions that you can think of so that when you go home and one doesn't, one thing or one hold or one technique doesn't work, you've got something else up your sleeve to try next when you're on your own.

21:08                                Nicole: Right. Exactly. Okay. All right. Now I'm going to take a little bit of a detour. A couple of questions just popped up in my mind about things that happen like right after birth, that I'm just curious if you offer, if you know other pediatricians offer, what about circumcision? Do you do circumcisions or do you know or their pediatricians that do circumcisions?

21:28                                Phil: Yeah, so in our community, the pediatricians do circumcisions. Where I did my training, the OBs did circumcision, so we didn't really have much exposure to it when I was in my training. But here in Lincoln, all the pediatricians are the ones that do circumcisions and I do circumcision in the hospital and sometimes we have to do them in the office too. If they go home early or we just aren't able to arrange it to be done in the hospital. We do them in our office from time to time as well. In terms of, in terms of offering that to parents, I really just leave it in their court if that's something that they want done then I am happy to oblige and take care of it. But it's not something I push on parents too. You need to do this or you need to do that because it's very much a social, religious, family tradition decision.

22:13                                Nicole: Yeah, absolutely. We could have a whole podcast episode talking about circumcision. But at the end, I agree 100% it is a family choice and not something that has to be recommended. And then the other thing I was thinking is in this whole, we're talking about at least in the ob world, the fourth trimester and the first three months after birth. And actually the pediatricians are the ones who see the mom the most way more than we do because we see them maybe for one or two week checkup and then a six week checkup. But you guys are seeing moms sooner. Do you do anything to screen for Postpartum Depression in your office?

22:56                                Phil: We do. That's something that is actually something I really kind of pioneered at our office when I started five years ago or so, is we do screening at each each well visit. So mom comes in for their two week checkup, and we do a Edenberg screening for postpartum depression and we do that at each visit thereafter. So at a month and at two months and four months and six months. And that's what the American Academy of Pediatrics now recommends too, is to do screening for the first six months of life. And you're absolutely right. We see moms a lot more than their OB does once they've delivered. And so we're at that kind of critical point to intervene or at least ask the question because it's a lot of times no one has asked them. How are you doing exactly? And I always make a point, especially at the two week and that one month check and making sure that it's not just how's it going how's baby, it's how are you doing and are you getting the support that you need? And I try and make it easy for moms to tell me that they're having postpartum depression or postpartum anxiety or they're not sure if they just have blues or if it's something more. And then from there we will set them up either with their OB to discuss options or with women's therapists that we have in our community too. We take the ball and run with it and let the OB know, you know, mom came in and we're working through this and she may call you and need some extra help.

24:17                                Nicole: Awesome. A real like a group approach, team approach to taking care of not just babies but moms also cause you can't have a healthy baby if you don't have a healthy.

24:26                                Phil: Amen. Yes. 100% that's what I tell moms too because a lot of them have a lot of guilt over different things, if breastfeeding's not going as well or something else isn't going as expected. Then they have a lot of guilt and I, that's what I tell them is you know, a healthy baby has a healthy mom too. And so we have to take care of both the mom and the baby in the womb and then on the outside too, we have to care for the whole family.

24:50                                Nicole: Yeah, absolutely. Absolutely. So I want to ask you just a couple of questions to help the listeners get a sense for who you are and not just as a doctor but as a person. So why don't you tell us a little bit about what's the most rewarding part of your work?

25:06                                Phil: For me, the most rewarding part of my work is getting to see parents over the first years of life with their new baby or babies as they go through and have multiple kids over the years. Getting to see them really flourish and thrive as parents. I think my favorite is getting a new family and really getting to see, you know, all those initial questions, all of the initial worry and watch that melt away and just kind of, I feel really lucky that I rarelly have to do much other than give them reassurance and tell them what's normal. I don't have to intervene with baby a lot because most babies are just, you know, thriving and doing well and if we can stay out of their way they will just grow and thrive and do great. And so I really love getting to see the parents to come into the role as a parent and really feel confident that they know what's best for their child when they went from knowing nothing and relying on me for everything to, them being like, yeah, we didn't call you. We figured it was fine.

26:07                                Nicole: Yeah.

26:07                                Phil: And we knew that we knew that we could call you if something came up. When I get to see those, especially you know, they've got their first baby and they're so worried, the second, maybe they're not as worried and the third baby, they're just like, okay, whatever.

26:16                                Nicole: Yeah. They're like fever 103? Yeah. Okay.

26:22                                Phil: And I do get to see that a lot because with the continuity of care, that's the best part, is I get to see that over time and see the things that would have had them running into my office or into the ER with their first baby. The third baby, they're like, yeah, we were at Disney World, we really didn't even think much of it. We just gave him some Ibuprofen and trucked along.

26:39                                Nicole: Now on the flip side, what do you find that's most frustrating about your work?

26:43                                Phil: I was thinking about this question earlier today. I think the most frustrating thing, which is probably universal for most physicians, is not being able to do what I want to do to help parents the most, because of insurance issues, administrative hassles that often get in the way of providing the care or the quality of care that we would like. So I'm just thinking of, you know, a child that needs a medical stroller or a wheelchair, and all of the hassles and headaches that it takes and phone calls and time of mine and my staff's to make something like that, which should be really easy, just an easy layup and making it so difficult and oftentimes, you know, making the parents just so beat down that they give up on trying to arrange that service that their child could benefit from.

27:31                                Phil: I think secondarily, sometimes parents can be frustrating to work with.

27:36                                Nicole: Well that's honest of you to admit.

27:39                                Phil: Sometimes they're frustrating to work with. I don't find that often to be the case. And I feel really lucky. I don't know if it's just my patient population or what, but it's rarely that I'm butting heads with parents. And so that's an infrequent thing that will come up sometimes and we can usually just talk and work through it. But, overall it doesn't interfere much. And the kids are never a problem. The things that bring kids into the office aren't their fault. They didn't do anything wrong. They didn't have a bad lifestyle or something like that that resulted in where they're at, they're just trying to enjoy life and to grow and develop and thrive. So I never get frustrated with my actual patients. It's usually the things that surround them and mostly things that nobody locally has any control over.

28:23                                Nicole: So what would you say you are especially passionate about when it comes to caring for children?

28:29                                Phil: You know, and on the medical side of things, I really like chronic care. Helping families with children that have special needs or special issues. I really like that part of my practice. Things like asthma or ADHD and things like that. I enjoy getting to see those parents and patients and helping them along that course. On the parenting side, I just really enjoy getting to provide that reassurance, which is why I'm glad that I'm a pediatrician, cause all I do for most of the day is provide reassurance. And so just being able to take those fear, anxiety, worry that I see when I come into the room and help to bring that down, tell them what to do, tell them what to do you know if things change and what sort of signs to look for with their child that would say we need to reevaluate.

29:15                                Phil: That really is what I get the most enjoyment out of is just helping to provide calm, provide reassurance.

29:22                                Nicole: And I'm guessing your personal experience as a parent of four, almost five and influences that quite a bit.

29:30                                Phil: Yes. It's so much easier for me because I can just be like, oh yeah, our kids all had the flu last week. It was terrible too. Or yes, my son was just like that when he was this age. He did the exact same thing. And now two years later he's a little bit better so it will get better. And here's what what we did with our kids, you know, for all these discipline issues or parenting concerns that come up. So that has definitely colored my practice and it makes it much easier for me to relate to parents having four kids. We've gotten to see a wide gamut of, you know, the normal things that come up for sure.

30:04                                Nicole: What's the age range of your kids?

30:06                                Phil: Our oldest is eight, and our youngest, other than our soon to be newborn is three.

30:11                                Nicole: Okay. Wow. You got a nice, I guess a close group. One, two, three, four, five kids, eight and under. Wow. So let's end with what is the one piece of advice that you would give to soon to be parents?

30:36                                Phil: The one piece of advice for soon to be parents, would be to try and take things with a grain of salt and to realize that if you're already, you know, preparing in advance for your baby's arrival and trying to think about how to provide the best experience with birth, with the first months after life and all of those things. If you already thinking about all the things you are already way ahead and you will sail through parenthood. And just find the experts, the people that you can rely upon to help guide you and to help figure it out. Because parenting has been going on for millions and millions of years, so there isn't anything that is going to be so unique that you can't find the support that you need to figure out whatever issue is coming up. And I would also say when you're worried about your child, find the people that help reassure you and then ask them, when should I be worried? Because I tell parents all the time, this is what I would worry about, the rest of the stuff I don't think you need to worry about. And finding somebody that can help you, you know, adjust the worry or the level of worry, will make a huge impact on your ability to be a confident parent.

31:51                                Nicole: Awesome. Awesome. I think that's great. Great Advice. So where can people find you? Because they can hop over from me, right on over to you after they're done.

32:02                                Phil: Yeah. So my newest venture is my podcast, which is called Parenting Matters. And so you can find that on wherever you get your podcasts. I have a website, www.drphilboucher.com. I'm on Instagram at Dr. Phil Boucher and I am on Facebook and have a Facebook group called Present and Productive Parents. Those are the main places to find me, I guess pretty much anywhere online at Dr. Phil Boucher you can find me.

32:28                                Nicole: Awesome. Awesome. Well, thank you so much, Phil. I really appreciate this.

32:33                                Phil: Yeah, yeah, yeah.

32:34                                Nicole: And good luck on baby number five.

32:37                                Phil: Thank you. Yes. I'm sure I'll have pictures and videos to share as new baby arrives.

32:43                                Nicole: Yeah. All right, well take care. I'll talk to you later.

32:46                                Phil: Okay, thanks Nicole. Okay. All right, bye.

32:48                                Nicole: Well that was great, wasn't it? I've really enjoyed chatting with Phil. Now after each episode where I have a guest on one, I give something called Nicole's notes and that's just my top three or four takeaways from the episode. So here we go.

33:05                                Nicole: Number one, you can start pretty early looking for a pediatrician. I didn't realize this. You can start as early as the late first trimester, early second trimester. That way you have plenty of time. So you can do prenatal consult visits and be sure that you can get into the office in a timely fashion. Number two, it's important to assess your pediatrician's overall philosophy towards caring for children. This is the same thing that I say when you're looking for an OB doctor. It is important to find someone who has a similar philosophy to care that you do. So how do they feel about antibiotics? How do they feel about running tests? Ask those questions so you know that you and your pediatrician are a good match.

33:57                                Nicole: And then the third thing that I took away is the emphasis that Phil talked about on how your health is important for your baby's health. Just like during pregnancy you have to have a healthy mom in order to have a healthy baby that continues after your baby is born. So be sure to take time to look out for and care for yourself. It makes a difference for your baby's health when you are healthy too.

34:35                                Nicole: All right, so what has been your experience with finding a pediatrician? Let me know in the podcast community Facebook group, it's called the All About Pregnancy and Birth podcast community and we are growing every single week. It's a great place to be, so you definitely want to join. If you haven't, I will link to that in the show notes. Be sure to subscribe to the podcast in Itunes or wherever you listen to podcasts and if you feel so inclined I'd appreciate you leaving an honest review on iTunes. It helps other women find my show and I may give you a shout out on an episode. And don't forget about screen shotting the episode and tagging me in an Instagram story. I'm @ Dr. Nicole Rankins. I love to know who's listening and I would love to repost it in my own Instagram story. Now, next week on the podcast, I'm talking about what you can do for that dreaded nausea and vomiting in pregnancy, so come on back next week. And until then, I wish you a healthy and pregnancy and birth.

35:40                                Today's episode is brought to you by Women's Wellness Coaching by Dr. Nicole Calloway Rankins. Head to www.ncrcoaching.com to check out my free one hour mini course on how to make your birth plan as well as my comprehensive online childbirth education class, The Birth Preparation Course, with over eight hours of content and a private course community. The Birth Preparation Course will leave you knowledgeable, prepared, confident, and empowered going into your birth. Head to www.ncrcoaching.com to learn more.

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