TRANSCRIPT EPISODE 24 – All About Pregnancy & Birth With Dr. Nicole C. Rankins

Transcript episode #24:supplements, nutrition, and environmental toxins with dr. anne kennard

Transcript

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00:00                                  You are going to love this episode with my fellow Ob Gyn colleague, Dr. Anne Kennard. We talk about nutrition supplements and environmental toxins in pregnancy.

00:11                                  Welcome to the All About Pregnancy and Birth podcast. I'm your host Dr. Nicole Calloway Rankins, a board certified Ob Gyn physician, certified integrative health coach and creator of The Birth Preparation Course, an online childbirth education class that will leave you feeling knowledgeable, prepared, confident, and empowered going into your birth. Quick note, this podcast is for educational purposes only and it's not a substitute for medical advice. See the full disclaimer at www.ncrcoaching.com/disclaimer.

00:48                                  Nicole: Hello and welcome to another episode of the podcast. Thank you for spending some time with me today. This is a fun episode today. I have a fellow Ob Gyn on and I love supporting other Ob Gyn's who are really passionate about the work that they do to help take care of women and my guest today is definitely passionate about what she does. Her name is Dr. Anne Kennard. She is a board certified Ob Gyn. She's fellowship trained in integrative medicine and she's the mother of a toddler. She's also an herbalist, a nutritionist and a yoga instructor. She is very passionate about health and the body, mind and spirit. She is truly dedicated to an integrative approach to women's health. Now Anne I have a fascinating and informative discussion where she shares her knowledge and recommendations about nutrition during pregnancy, what supplements she recommends that pregnant women take and also environmental toxins that women should avoid during pregnancy.

01:52                                  Nicole: You will probably want to take notes with this episode, as she shares a ton of useful information. Now before we get into the episode, let me do a quick shoutout. This is to a ayequeen2b. That's a y e queen number two, letter B. She left me this review on iTunes and it says, "I love Dr. Rankin's demeanor and knowledge. As a Doula, I love what they cover and feel like I'm learning things all the time." Thank you so much for that lovely review ayequeen2b, and I do want to give a shout out to all of the doulas out there in the audience. I know I have a lot of Doulas who listened to me, so I appreciate your support and you recommending me to your clients. I'm a huge supporter of Doulas and the work that you do, so thank you.

02:40                                  Nicole: Thank you. Thank you. Now do want to let you guys know for the doulas out there, I have an affiliate program for my online childbirth education class, The Birth Preparation Course, if you're not familiar with it, it is an outstanding childbirth education class if I do say so myself. It's comprehensive Childbirth Education, eight hours of content covers everything from mindset to details of labor to postpartum period to some possible things that may happen. All kinds of great stuff and I do have an affiliate program where you can earn a commission for women who you enroll in The Birth Preparation Course. I only accept a limited number of affiliates, so if you're interested, go ahead and hop on over to www.ncrcoaching.com/affiliate and fill out the affiliate application. Again, that's www.ncrcoaching.com/affiliate and fill out the application and we'll see if we're a good fit for you to work with the program.

03:32                                  Nicole: All right, so without further ado, let's get into the episode with Dr. Anne Kennard. Hey Anne, thank you so much for agreeing to be on the podcast. You have a really unique background and I know that the listeners will found our conversation. Very helpful.

03:48                                  Anne: Thank you so much for having me on. I'm so excited to be here and talk to your, your podcast listeners.

03:54                                  Nicole: Yeah, so why don't you start off by telling us a little bit about yourself and your work and your family.

04:00                                  Anne: Thank you. I am a board certified Ob Gyn and I live in California in San Louis Obispo and have a three year old daughter and after I completed my residency in Ob Gyn, I knew I was passionate about wellness and medicine about food as medicine, mind body medicine. I had already become a yoga and meditation instructor, my Bachelor's and master's work were in nutrition and I found out about integrative medicine. So I actually went back to school, which is something I never thought I would do after completing a residency. And I did a two year fellowship in integrative medicine and from that then I learned about herbal medicine and loved that. And so I followed up with training in herbal medicine as well.

04:54                                  Nicole: Oh, very interesting. So why don't you just tell us a little bit what exactly is integrative medicine?

05:01                                  Anne: Integrative medicine is a newer discipline. It's been out maybe the last 20 years or so. One of the founders was Dr Andrew Weil. He's probably the most famous and it's a discipline of medicine that focuses on not just conventional medicine and surgery, but mind, body and medicine, things like Yoga, meditation, Tai Chi, movement as medicine, food as medicine, supplements, herbal medicine, other health systems like Chinese medicine, coming from China and India. Thousands of years old systems. And it's not the absence of Western medicine and surgery is, it is truly integrative, so it's not complimentary or alternative. It is all of those things together. So this is the way I practice. If my patients need a medication from the pharmacy, I write it. If they need surgery, I do their surgery. But we're also talking about how to live our best lives with lifestyle modifications as well.

06:12                                  Nicole: Well that is awesome because so much of your health is beyond physical health. There's more to your health for sure.

06:20                                  Anne: Absolutely, and I think pregnancy is one of those times in life where integrative medicine is so wonderful because this is a time that many women are really interested in making healthy decisions for their for their baby.

06:35                                  Nicole: Absolutely.

06:36                                  Anne: And a lot of times women are pretty healthy going into pregnancy and they, they're not needing a lot of western medication and surgery and it's a nice time to bring in other health aspects to improve their wellness during pregnancy.

06:51                                  Nicole: All right, so before we get into how you incorporate that in pregnancy, can you answer really quick, how does integrative medicine differ from functional medicine? Because that seems to be a newer thing that's coming up. How do those two things differ?

07:05                                  Anne: Yes, functional medicine will be my next adventure. I'm truly a lifelong learner here. They do differ enough that the programs are completely different. The integrative medicine trains more on herbal medicine and the other health systems, the Chinese medicine, the mind, body medicine, energy medicine, all of the evidence behind those modalities. Functional medicine is the root cause of why people got sick. And so the, the name it, blame it, tame it, game, you know, you have this, this is why you feel bad. Here's the pill for it is what functional medicine is looking to address. And so they do a lot of specialized testing and they have a lot of resources in terms of individual diets, nutrogenomix how your individual genetics play into supplements and they often are able to uncover a root cause as to why someone has the illness that they have and then kind of rebuild it from the ground up.

08:19                                  Nicole: Gotcha. Gotcha. So it sounds like those two things would work well together. Integrative medicine and functional medicine?

08:25                                  Anne: Yes. Yeah, I believe so. You know, each program is years long and costly and so, and both are relatively new. So there's not very many physicians that have completed both programs, but I think that'swhat we'll see in the future is, is people starting to move that direction.

08:43                                  Nicole: Gotcha, Gotcha. Well, so let's talk about then how you incorporate your integrative medicine training and knowledge into the care of your pregnant patients. How do you do that?

08:54                                  Anne: Integrative medicine is the way I practice. It's part of every interaction that I have. And so every time I see one of my pregnant gals, you know, I'm asking her and not just, is your baby moving? Are you leaking fluid, et cetera, et cetera. I ask her, how's your mood? Any new stressors? How are you managing stress? What are you eating? What supplements are you taking? I ask about exposure to environmental toxins during pregnancy and besides asking about, you know, alcohol and some of the things that harm pregnancy that we know more about.

09:31                                  Nicole: So it's more than just the tummy checks and heart tones that we all in many ways we're trained on.

09:38                                  Anne: Yes, exactly.

09:39                                  Nicole: Yeah. How do you do that in the context of appointments? Because I remember those days of being in the office and the way the schedule works. How do you make that work?

09:50                                  Anne: It's tough. I mean, I tend to run behind and I feel badly about that, but I also know that if this was my sister or my best friend or my loved one, this is the kind of care, you know, if she needed something in that moment, I want to give her my full attention and sit down and talk about it rather than, you know, just kind of blow over things and shoo people out the door. I tend to make longer appointments and I probably make a little less money for it, but that's fine because this is the way I want to practice.

10:21                                  Nicole: Yeah. It sounds like this is, you're obviously very passionate about this and committed to this service for women. Yeah. So let's talk a little bit about, I know one of the things you do is nutrition. So what are things that you recommend for pregnant women in regards to their nutrition?

10:39                                  Anne: Yes. Well, you know, this answer changed before and after I was pregnant myself. I had a lot of ideas about nutrition in pregnancy prior to my own pregnancy and I had imagined myself being sort of person to eat lots of kale and brussel sprouts and avocado throughout my pregnancy. And it turned out that I was just sick as a dog. And could only look at a box of cheezits. And so it really, really shaped my nutrition advice and pregnancy. And I'm really grateful that I have that experience because now I feel like I'm able to give more realistic advice. So the first advice that I have, especially during the first trimester, is that you need to try to get in calories. And if something is really, you're really adverse to a food, don't force it, you'll probably feel better in a month or two. And there's plenty of time to get adequate nutrition, varied foods throughout your pregnancy.

11:48                                  Anne: So don't stress about it, just kind of eat what you can. Things that tend to work for people are sour things like lemonades and there's quality of lemonades on the market. You know, you can go to Trader Joe's or Whole Foods. And get something that's organic. Without high fructose corn syrup. People tend to do well with cooked vegetables rather than a law. So generally people tend to start feeling better in the second trimester and that's a nice time to start adding in a variety of fruits and vegetables if tolerated. Fat is super important during pregnancy. And I think a lot of pregnant women are afraid of eating fat that they think it's going to contribute to too much weight gain and they think it's not good for them, but their baby needs a tremendous amount of fat to grow a brain. You know, the brain is mostly fat.

12:46                                  Anne: They lay down fat in the skin and around the organs and the Momma needs a lot of fat to to start making breastmil,k to be having some extra adipose tissue that is normal in preparation for delivery. And it's a great source of energy. And so I really recommend that people try to emphasize healthy fats, pour olive oil over every salad or eat avocados, coconut oil, grass fed butter, grass fed and finished meats. I think that these are all really important. Eggs are super important. Make sure that you eat the yolks. I prefer the omega three eggs, like it'll give you a little bit of extra omega three and the eggs are a rich source of Coleen, which most pregnant women are deficient in. But Coleen is a fatty substance that directly goes into myelination and brain tissue formation. So super, super important. I ate eggs everyday of my pregnancy.

13:57                                  Nicole: Listening to you, I mean I'm an Ob Gyn and I'm like, God, I feel like I knew half of this stuff. We just do not get a lot of training and information on nutrition.

14:06                                  Anne: I don't know about you, but for me I got less than an hour of training maybe in medical school and certainly nothing in residency on these types of topics.

14:16                                  Nicole: No I didn't. I didn't yet. We're also like quote unquote chastising women. You're gaining too much weight or you're not gaining but not really giving them concrete advice to help fix that.

14:28                                  Anne: Exactly, and a lot of people don't gain weight linearly during pregnancy. Some people gain a lot up front and then it evens out. Some people don't gain anything and then they start to go up more. And so I try to look at the overall weight gain rather than visit to visit. You know, personally I was a 15 pounds by 15 weeks kind of gal, which is you maybe a lot of front, but it all evened out. I think people's eating and metabolisms and pregnancies are all different.

15:00                                  Nicole: So you take a really personalized and individualized approach.

15:05                                  Anne: Absolutely. You know, I will sit down and ask people, tell me about your diet. What are you eating? You know, I asked them what did you eat the last 24 hours? And if they're eating good healthy foods, you know, I'm, I'm less concerned about the actual pounds then the nutrition

15:24                                  Nicole: For sure that's, I used to take that same approach as well because otherwise women and get caught up in like obsessing over the number and you don't want them to do that.

15:35                                  Anne: It's stressful, It's not helpful. You know, the important thing is their wellness, their nutrition and that includes their mental wellness and stressing about the scale is not contributing to a healthy pregnancy.

15:49                                  Nicole: Exactly. Now I know in addition to you try it and you just talked about it, you talk about supplements. Do you recommend that pregnant women take any supplements?

15:58                                  Anne: I do. And again, this can be tricky in the first trimester when people are not feeling well. Is it okay if I mention specific brands?

16:06                                  Nicole: Oh sure. Yeah, that's fine.

16:08                                  Anne: Okay, so one thing that I think is absolutely essential for all pregnant women is a DHA fish oil. So fish oil is Omega Three fish oil is typically EPA and DHA form. And the DHA in particular has been shown to be vital in baby's brain and I development pregnant women should get at least 400 milligrams of DHA every day. And if you eat a lot of fatty fish, it can be possible to do this without a supplement.

16:44                                  Nicole: But what kind of fatty fishes are?

16:46                                  Anne: Well, anything like salmon, trout, herring, mackerel, sardines. But those aren't prevalent in most American's diets, and I find many women are off put by fish anyway during pregnancy. And so most people need the, the fish oil. I really like the company. There's a couple of companies I like for this. I like Nordic Naturals.

17:11                                  Nicole: Yeah, no, sorry. Real quick, I know you're mentioning names, but do you have any affiliate relationships or anything with any of these companies?

17:19                                  Anne: No I don't, I don't make any money from any of this this way, it's just my opinion. All right, go for it. Nordic naturals, I like their product because they have a pregnancy DHA, fish oil capsule and it's totally unflavored. Like you don't get any fishy grossness from it. And so it's pretty well tolerated by my patients and Metagenics and Pure Cncapsulations and Carlson's labs all make reputable fish as well, that tend to not be too fishy. Okay, that's good. Um, obviously many people know about folic acid in terms of prevention of neural tube defects, I prefer the form methyl folate and a lot of the vitamins now are starting to include that form rather than folic acid. And this is actually, you asked about functional medicine list is coming out of the functional medicine literature where some people are different genetically in terms of how they're able to process folic acid.

18:25                                  Nicole: Okay.

18:25                                  Anne: Some people have an enzyme that can do it and some people don't. And so if you give the methyl folate form the methylated fully, that bypasses all of this potential individual variants in the chemical reaction to be able to use the full eight. Got It. And so that's an easy way to just make sure everyone is utilizing it properly. And a lot of the higher end multivitamins are starting to include that form. I think a multi is a good idea during pregnancy. The things I look for in a multi will be is the methyl folate, especially if the woman is Vegan or not, you know, taking in any animal products for any reason. Iodine is important for thyroid formation for the baby. I like it when they have some vitamin D in it. Typically pregnant women I've seen need about three to 5,000 units of Vitamin D daily and for multivitamins there's a lot of stuff on the market.

19:33                                  Anne: Some with iron and some without iron. Sometimes the iron is hard on the stomach, especially during the first trimester. If you take it at night, sometimes you can kind of sleep through the nausea if you get nauseous from the vitamin, right. If not, there's a a gummy that I like. The Smarty Pants brand makes a prenatal gummy and I think that's a really good product, but it doesn't have iron. So typically when people start feeling better, they transition them over to a supplement with iron in the second trimester because that's when the blood volume is really getting ramped up. You're making 40% more blood during your pregnancy and you need a lot of iron to make those extra blood cells.

20:18                                  Nicole: So what do you say for the, I don't know if argument is the right word about supplements versus getting everything you can from your food sources.

20:28                                  Anne: Ideally everything would come from our food sources. Absolutely. But we have to face the facts that in our country the soil is depleted of many micronutrients. And this has been in the literature since the 1920s. And even if we did have perfect soil and there still is all of the micronutrients we need in food, there's a lot of situations that contribute to inadequate nutrition. You know, there's nausea and vomiting in pregnancy, there's women of low socioeconomic status that perhaps live in a food island and don't have access to ideal nutrition. There's our standard American diet with reliance on prepared foods, fast foods. Most people are not able to get adequate nutrition fully just from their food sources in our country today. And that's just the reality of it.

21:26                                  Nicole: Okay. Okay. So you want people to, you know, do their best to eat healthy, but understanding that supplements are necessary or likely just because of the way our our diet is in America.

21:39                                  Anne: Yes.

21:39                                  Nicole: Yeah. Yeah. Okay. All right. So let's talk about environmental toxins. That's another thing that you brought up. What are environmental toxins that pregnant women should avoid or limit exposure to?

21:52                                  Anne: This is such an interesting emerging topic. A great resource for this is on the environmental working group page, www.ewg.org and they're the ones that put out the dirty dozen and the clean 15 produce list. That's probably their most well known work. And what that saying is we know organic food, although I think it's getting more reasonable, but it is more expensive and so, but it is good.

22:21                                  Nicole: I feel like it is, it's more expensive, but I do feel like a lot of stores, at least in my area, I'm in Richmond, Virginia, are starting to have like store brand organic stuff. So the price is coming down.

22:33                                  Anne: It's getting more popular. You know, you're able to buy a lot of organics at Costco and that kind of thing, now it's changed. And if you're looking for what to spend dollars on for organic food, the clean 15 versus the dirty dozen. So stuff that is really delicate that you eat the skins on, like Barry's tomatoes, grapes, those things tend to be highly contaminated with pesticides and are worth spending some more money on the organic version. The clean 15 tends to be things that are peeled, like bananas, pineapples, sweet potatoes that are not as heavily laden with pesticides. And so I think that that is one of the major environmental toxins for pregnant women is pesticides. And that's where eating organic, it makes a big difference because the body is burden of pesticides actually changes within two weeks of eating organic. The blood levels have been shown to dramatically decrease.

23:40                                  Nicole: Oh wow.

23:41                                  Anne: So it really does work right away. It's not like you have to this change for years. And the other thing that's fascinating is those pesticides that are sprayed on food are found in the blood, in the umbilical cord and in the baby.

23:58                                  Nicole: Seriously?

23:58                                  Anne: It goes across the placenta.

24:00                                  Nicole: I did not know that.

24:03                                  Anne: And when you look at babies, you know the reason that I really am passionate about talking about this topic, babies zero to, to actually have the highest amount of environmental toxins of anyone because they get it through the umbilical cord in the womb. And then other toxins like flame retardants, things that are on carpets, scotch guard, that kind of stuff. You know, they're crawling around on, they're putting their mouse on there.

24:32                                  Nicole: That makes sense.

24:33                                  Anne: You know, they're putting their plastic toys that have phalates them in them in their mouths and so you know, what you can do during pregnancy really does make a difference in terms of the toxic burden for the baby, which is, which is super sad. I mean this is where we're at, but doing the, the organic produce I think is really worth it during pregnancy. Even if you can just do that dirty dozen list, you know, that's a high yield thing.

25:08                                  Nicole: Yeah, we'll link to that everybody, in the show notes and you'll be able to just click on it. I'll be sure you get all the links and everything so you'll have that list readily available. Okay.

25:18                                  Anne: Other things that I think are important during pregnancy, these are common things that I see is a lot of people are decorating and new nursery, right? For the baby, the particle or pressed board furniture, which tends to be inexpensive. And I see a lot of people buy for babies rooms, that particle board emits Formaldehyde, which is classified as a carcinogen. And thosse the rooms tend to not be well ventilated. And so with that kind of furniture, you want to build it early in the pregnancy and let it air out for a long time before you're actually going to put your baby in it. Or choose a solid wood furniture. There's inexpensive options that IKEA and Target. Those are both good options. You know, if you're painting something, choose the low or no voc paint. Avoid vinyls, PVC. When you're cooking, try to not heat and plastic. And I'm also not a fan of Teflon. If you can cook your eggs in a cast iron pan, you'll avoid the exposure to Teflon and also just get a little bit more iron in the food leaching from the pan.

26:37                                  Nicole: This is all outstanding advice. I mean, I feel like we could take each one of these topics into a single show.

26:43                                  Anne: Yeah. I've really passionate about all of this. I think you can see in yeah. For good reason. You know, these things really make a difference in the health of women and children.

26:55                                  Nicole: Yeah. And Sadly, it's just not things that we're taught as part of our training that can have a big impact on women in their pregnancies. So I'm really glad that you're here to share this information. So let's talk a little bit about, just a couple of personal sort of questions. What would you say is the most rewarding part of your work?

27:18                                  Anne: So I have the lovely experience of practicing obstetrics in a fairly small town. And so when I take my daughter to preschool, I see babies that I've delivered. You know, I took her to swimming lessons like a mommy and me swimming lesson and I had delivered literally all of the other participants.

27:41                                  Nicole: Oh my gosh.

27:42                                  Anne: So it was me and like all of my babies floating around in this pool. Like in that moment I felt like my life had tremendous meaning and it just made me so happy.

27:53                                  Nicole: Oh wow. I bet that is so awesome. So on the flip side, what is the most frustrating part of your work?

28:02                                  Anne: The things that frustrate all doctors. You know, the demands of the system. I just want to provide good quality care to my patients and have them really be cared for in every aspect of their health. And I do not like being on the phone with their insurance company, arguing with them as to why I should be allowed to give them what I think that they need. You know, prior authorizations, paperwork demands for productivity. None of that is what any doctor gets into this for.

28:39                                  Nicole: Yeah, absolutely not. I mean it's part of the reason why I got out of the office. Just the frustration of that, that sort of stuff. So now I feel like this question may be hard for you to answer, but if you had to pick like what are you especially passionate about when it comes to caring for women? You're passionate about so many things. It's very clear. But where do you really especially passionate about,

29:03                                  Anne: I want women to feel empowered that they themselves can make changes that dramatically will improve their health. You know, I am not a magical wizard that makes people healthy. I provide tools that they can use to change their lives with. And it's really not about me. It's about making food choices, lifestyle choices, you know, deciding what's good for them, what will help them lead a healthy life and, and being a supporter in them doing so.

29:40                                  Nicole: So really just empowering women to help them make their change, make good changes in their life and lead healthy lives. Not just like medically wise but like healthy lives overall.

29:51                                  Anne: Yes. Yeah. Yes.

29:53                                  Nicole: So how have your personal experiences as a parent influenced your work as an Ob Gyn? I've talked about before how my first baby was a preemie at 32 weeks. She was in the Nicu. So that of course cloud, I shouldn't say cloud, but influences certainly changed how I practice. What have, what about your personal experiences as a mom? How has that influenced your work in Ob? You talked about the nausea. What else?

30:21                                  Anne: You know, I have a similar story to you in terms of having a complicated birth. I feel like, you know, for whatever reason that seems to befall obstetricians, but despite being, you know, a healthy young woman and doing yoga through my pregnancy and eating well other than the boxes of cheezits, it was an unexpected birth for me. I labored and pushed and then she just wasn't coming out. And so I had a c section with my baby and then had some complications following and I had a lot of trouble with breastfeeding. She never latched, you know, that was very emotionally difficult for me. And of course, actually I just wrote a piece that was featured on Scary Mommy.

31:18                                  Nicole: Yes. We are absolutely linking to that everybody. Yeah, you can read it. It's a great article.

31:23                                  Anne: Yeah. About postpartum anxiety and depression and all of these experiences together completely changed me as an obstetrician before I was, I just didn't know, you know, like what any of these things felt like and strike. And I couldn't really understand what my patients were going through. But now when I do a c section for a patient, I sit with them and I tell them all the doctors stuff. But I also tell them I had a c section too and this is how I remember it feeling and this is what to expect from a patient perspective. You know, since I went through nursing difficulties myself, I became an expert in lactation medicine and that's something that, sets me apart in my area in practicing that part of breastfeeding medicine and with postpartum anxiety and depression. I think since I went through it myself, I see it so much better in people. You know, I see what they're not telling me. I see them trying not to cry and you know, that's something that I've developed an integrative approach to treatment for these patients and I don't think I would have known to do that had I not gone through it myself.

32:44                                  Nicole: Yeah. You just really become changed after you go in a good way after you have some different, it's very hard at the time. I mean, I remember when my daughter was in the Nicu, I cried every day and I remember feeling, and not that anybody was being mean or anything, but like, you know, nobody called to check on me or kind of see how yeah, it is hard. It is hard. So, that's awesome that you've taken that experience and really turned it into providing better care for your patients.

33:19                                  Anne: It really helped me find meaning in the experience because those things were personally difficult, but I felt like they allowed me to provide such better care to my patients that it was worth going through.

33:30                                  Nicole: Yeah. That's awesome. So what is your favorite piece of advice to give to expect a moms?

33:39                                  Anne: Try to rest. It has my favorite advice. I think that there is so much pressure in our society to be supermom and you can be pregnant and still be doing your job 100% and you can work up until the day you deliver and you can only take two weeks off for postpartum and then then you've come back and you've, and this pressure to do it all is breaking women and it I think contributes to prenatal complications, birth complications, having higher instances of postpartum mood disorders. And so for my patients, I tell them sit when you can, you know, there's no shame in having a stool at your work. Let me write a note for that. If you're in a state that allows pregnancy leave, you know, in California you can take leave starting at 36 weeks gestation. I tell all of my patients to take that if possible and to take off as much time postpartum as possible, you know, have an active plan for support during your pregnancy and postpartum, you know, get the meal train going. Just outsource as many things as possible, cleaning, cooking, whatever. You know, other countries have protocols for this. You look at Latin America, China, India, you know, they traditionally, will have this lying in period of, you know, 40 days or so. The other family members and friends know that and they're all there to provide the support and we don't really have that cultural expectation in this country and so we don't create it.

35:36                                  Nicole: Yeah. That's one of the things I say for women, like on your baby shower or your registry lists. Think about adding creative things like contributing towards a postpartum Doula or meals afterwards, the clothes and stuff you'll be able to get that stuff for sure. You know, think about adding some different things that'll really make a difference for you.

35:57                                  Anne: Oh yeah. A postpartum Doula is as a wonderful gift. Or if you have a, for me it was my mom, you know, asking her, it's hard to ask for help, but I asked her to please come, you know, for a couple of weeks after the birth to help me.

36:13                                  Nicole: Yeah, for sure. Now you have some amazing things going on, so please tell it. This was like so educational for me. I learned so much and I know this is going to be really helpful for the listeners. What other things do you have coming out and where can people find you?

36:31                                  Anne: Thank you. I have accounts on Facebook at Dr. Anne Kennard and we'll link this. And Instagram also at Dr. Anne Kennard. That one has underscores in it because apparently there's some other doctor Anne Kennard out there. I haven't met her though. And then I have a book coming out. I'm very excited about that. That should be out in June and this is a cookbook of sorts for integrative recipes for life. And so I have recipes that I've developed for food as medicine for herbal medicine recipes. And this is perfect for, for young moms because it's exactly stuff that I use in my life, right? Like what can I cook that's healthy after work when I'm tired and hungry and I don't have a lot of time. What are simple things that I can use to help my family stay healthy and get well when we're sick?

37:34                                  Anne: You know, things like thyme cough syrup, elderberry, popsicles, just really fun stuff that is fun for my daughter to be involved in. And then it's got some mind body recipes because so many patients I see struggle with insomnia, stress, anxiety, and this has breathing exercises and yoga sequences, meditation exercises. And then it has a lot of stuff about what we talked about, you know, the considerations for diet, for environmental toxin avoidance, things like, what do I cook with, you know, how do I avoid plastic in the kitchen? You know, just kind of practical tips like that, that I'm pretty excited about it.

38:23                                  Nicole: Yeah. Yeah, that sounds amazing. I'm looking forward to picking up my own copy.

38:27                                  Anne: Thank you.

38:28                                  Nicole: Yeah. Well thank you so much for being here. I really appreciate your time. And again, this was so useful and I so much, I know the listeners learned so much. I feel like we're going to have to have you back on again to talk about something else.

38:42                                  Anne: I would love to come back.

38:43                                  Nicole: Yeah, yeah. All right, well you take care and I'll talk to you later.

38:47                                  Anne: Thank you. Alright, bye.

38:49                                  Nicole: Wow. Now I told you that was going to be a great episode, wasn't it? I know that you learned a ton. I know that I did. Now a couple quick things before we get into Nicole's notes since we recorded this episode Anne has also released a line of herbal products to help in the postpartum period. One is a salve, I don't, how do you say that word?

39:09                                  Nicole: S. A L. V E. Anyway, you can use it on a your perenial area. You can use it on your breast to help with healing. She's also created a soak and you can find those on her website. I'll link to that in the show notes and one more thing I wanted to clarify. I said during the podcast that no one called me after, you know, to check on me after I had my preterm birth. What I meant was no one called me from my doctor's office. I have plenty of friends and family who checked on me, but I wanted to say that it was really my doctor's office who I didn't hear from. We actually do a pretty bad job of following up with women in the postpartum period. Whether women have issues or not. That's a story for another day, but I just wanted to clarify that one quick thing.

39:51                                  Nicole: Okay. Now let's get into Nicole's notes. Nicole's notes are my top three or four takeaways from the episode whenever I have a guest on. So here's what I got from this one. Number one, I got a clearer understanding of the difference between integrative and alternative or complimentary medicine and functional medicine. Integrative medicine is really an approach, like it says, it integrates both, western medicine techniques and other techniques and pulls the best from all of those things in order to help you be your best, healthiest self. Not just in a physical sense, but in an emotional sense as well, which I think is awesome. That's what really medicine should be about. That's different than calling it alternative because somehow that implies that it's different or separate than Western medicine. Which they shouldn't be, they should work together or even complimentary. Complimentary to me makes it sound almost like a piece of jewelry or something, you know, an accessory. Whereas they really should work together. One is not better than the other.

40:53                                  Nicole: Also got an understanding of functional medicine about getting to the root of why something is an issue instead of kind of bandaiding things. So those were a couple of takeaways that I got from that. The second thing is that your Ob doctor probably has very little training about things like nutrition in pregnancy, supplements, environmental toxins. That's just not a lot of what we get training about. So I want to be honest, you may not necessarily get the best, most comprehensive information about those things from your doctor. We don't get a lot about it in medical school. Don't get a lot about it in residency training, Dr. Kennard took it upon herself to learn more about this and that's what she's doing now to teach that. But you may have to do a little bit of work, a little bit of research to find some more detailed information or even see a dietitian or a nutritionist to get more detailed information about things like nutrition supplements in pregnancy.

41:55                                  Nicole: And then the last thing I want to say is that all of this can feel a little bit overwhelming. All of the recommendations, all of the things trying to take this supplement, trying to eat this way, that way. Do the best that you can. Pick one thing, work on that and then add another thing. It can be, like I said, overwhelming to try and do all the things I know you want to do what's best for your baby and you know, for your health and all of those great things. But I don't want you to get too overwhelmed or bogged down and feel like, oh my God, I got all these things to do, all these things that I need to work on or learn. Just take it one step at a time and do the best you can and you will be fine.

42:39                                  Nicole: All right, so that's it for this episode. Let me know in the All About Pregnancy and Birth Facebook group community, what information did you receive from your Ob doctor about nutrition? I'm curious as to what information you received, so let me know in the group, if you're not already in the group, there's the link in the show notes. You can join or just search for the group All About Pregnancy and Birth on Facebook. Also, be sure to subscribe to the podcast in iTunes or wherever you listen to podcast and if you feel so inclined, you know I would love it if you leave a review in iTunes. It helps other women find the show and I may give you a shoutout on a future episode. For the Doulas, don't forget about the affiliate program that I mentioned. I only take a limited number of affiliates, so if you're interested, go ahead and hop on over to www.ncrcoaching.com/affiliate in order to fill out that application. That link is in the show notes as well. Now next week on the podcast, it is a special episode for me. The podcast recently crossed 10,000 downloads and actually it's now closer to about 12,000 but I thought I would use this as an opportunity to pause and reflect and share how I got to this point exactly. So it's going to be a really personal episode for me next week. So come on back. And until then, I wish you a healthy and happy pregnancy and birth.

43:59                                  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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