Writing the Washington Way

Lincoln said she found the actual writing of the book fairly easy because she learned how to write in a long, detailed way while at Washington. 

“I learned how to write and express myself, show my thinking, and do research,” Lincoln said of her undergraduate education.

Lincoln’s experience at Washington not only strengthened her writing, thinking, and research skills but also boosted her confidence. 

“Being at a small school, I learned how to advocate and speak up. I also felt like we were a small enough community where my voice mattered,” Lincoln said. “I think that is why even today, when I’m just another person on the internet, I feel that my voice matters.” 

Lincoln credits the College’s small class sizes and participation in class discussions for making her feel like she was taken seriously and teaching her the value of and ability to learn from academic disagreements. 

“The liberal arts education is so critical because it doesn’t matter how much you know if you can’t express it,” she said. “No matter how much I might tell a patient what their disease process is, if I can’t say it in a way that they can teach it back to me and know they understand it, I can’t communicate with them, and I’ve done nothing good. I think that a liberal arts education really teaches you how to communicate.” 

Advocating in a Broken System

Patient education has been a major driver for Lincoln in part because she attended a Catholic school where abstinence was the only sex education she received. After coming to college, she realized just how much she did not know about women’s health. 

“When you’re educated, you’re empowered,” Lincoln said. “You may not have gotten this information in your doctor’s visit, but let me try to help you at least know what you should have a right to, and these are the questions you can ask.”

Improving outcomes is the end goal for Lincoln and the work she does, whether it’s inside the hospital, in her book, or online through her social media channels and podcasts. 

“I started on social media because I wanted to educate people in a way that’s simple, easy to understand, and shame-free,” she said.

As it stands, the United States has one of the worst maternal morbidity and mortality rates of any developed country. And with the Trump Administration’s policies on Diversity, Equity, and Inclusion (DEI) research, even writing the word “women” in a grant proposal can have it rejected, leading to less research on women’s health, reproductive or otherwise. Access to reproductive health care also varies across the country, with many localities having limited or no OB-GYN services available, and state laws on abortion can impede access to care. 

“I really think that birth is broken in this country,” Lincoln said. “This is a uniquely American issue, not that there aren’t disparities in other countries.” 

Among her goals for The Book Birth was to be informative without being scary. She explains processes and procedures and contextualizes data surrounding medical practices. She talks about why certain practices have historically been done in a particular way, or why a patient might not have access to certain medical options. “The least helpful information is to tell people, ‘Here’s all the things you can have’ without ever acknowledging that they might not be able to access that.”

The book also contextualizes why some medical services may be unavailable: a hospital’s religious affiliation may prevent certain procedures from being offered; some hospitals are not equipped to handle certain situations; or some institutions may have limited or no access to equipment or technologies. 

Doctors Can Do Better, Too

Lincoln said she also wants people to know that the state of health care is not the medical professionals’ fault, although they are responsible for “why we have some of the outcomes we do in this country.” For that reason, there are times throughout the book where she breaks the fourth wall, as it were, to talk directly to professionals in her field. 

“I originally wrote this book just for patients. Then, as I was going through some of the research, I realized with a lot of things we do in medicine, sometimes we do it just because that’s how we were trained, and that’s not great,” Lincoln said. 

Her research, particularly statistics on the best pushing positions, whether eating should be allowed during labor, and home birth outcomes, showed Lincoln that there is good evidence supporting alternative practices to those she was taught during her medical training. 

“If something is better for a patient, but maybe it requires a little more thought and work on our part, well we should still do that,” she said. “This is not to be critical of other OB-GYNs or physiologists—I highlighted in the book that I had all these thoughts too.” 

Lincoln said that if physicians keep practicing medicine the way they have been, which doesn’t always yield great results, it will continue to yield those results. 

“But if we don’t like the fact that our preterm birth rate is going up and our maternal morbidity and mortality rates are going up, then maybe we should do something different, especially if there’s evidence behind it,” Lincoln said. “I’m hoping other doctors and midwives read this book too, and it makes them stop and think.” 

Throughout the book, Lincoln includes comments encouraging expecting parents to not only think about their birth preferences but also to research in advance whether those preferences will actually be available at their hospital or through their providers. 

Lincoln advised other medical professionals that they need to advocate for their patients not only within hospital walls but also politically. 

“I don’t care how good a doctor or nurse you are; if your patients can’t access their care, then your training is not really useful,” she said. 

The Politics of Reproductive Health Care 

“The field of obstetrics is unique in that a lot of politicians tell us what we can and can’t do—that doesn’t exist in neurosurgery or cardiology,” Lincoln said. “If you’re planning to build a family in the future, you might want to consider voting in elections right now.” 

Lincoln cited access to care and Medicaid (which reimburses 41% of U.S. births) as topics people who want to have families should consider when they vote. 

One reason Lincoln started her social media channels and podcast at a time when so many topics are politicized, and there’s so much misinformation out there, was to have a direct line of communication with listeners. Through those channels, Lincoln breaks down topics in ways that are digestible, contextualizing them within the larger historical and political landscape, and outlining these impacts. Lincoln said she is very lucky to have her job and these platforms where she can address these issues. 

“If I didn’t, I would feel helpless,” she said. “When I’m able to explain a complicated political thing, and how it could affect your pregnancy or your access to birth control, my ability to explain it in a fact-based way and watch people understand is so therapeutic for me. I feel like there is still some normalcy in the world where facts matter and can help inform people.” 

Lincoln said that sometimes people on social media tell her to stop talking about politics or posting political content, when they want the reproductive content.

“I would love to never have to worry about that, but unfortunately, health care is political. When political decisions determine whether or not you can access care, then unfortunately, that becomes my lane now,” she said. 

Setting Others Up for Success

Lincoln strives to make health care more transparent and navigable, aiming for better outcomes for patients and more collaborative practices for providers. As part of doing that, Lincoln gives back to the Washington community, specifically those interested in pursuing careers in medicine.

She has returned to the College several times to give talks and meet with students. Not only does she like seeing how the campus has changed and reconnecting with her favorite professors, but she also enjoys meeting with and staying connected to current students. 

“I’m the first person in my family to go to college, and I think in this day and age where we can remain so connected, I want to go back, and I want to tell students, ‘Look, you can do this, and we need you,’” Lincoln said. “Not only are there shortages in health care, but we need good people who are going into it for the right reasons, not just to make money.” 

She said the students she meets are always enthusiastic and that it’s really fun for her to encourage them to pursue careers in the medical field. 

“If I can give one piece of advice to current students, it’s don’t be afraid to do something different,” Lincoln said. “Never again will you be in a community where you can take classes and you can experiment. Don’t be afraid to pivot if you fall in love with something else.”

During her own time at the College, Lincoln chose a biology major and chemistry minor because she wanted to be a doctor. She added an English minor because she loved reading and writing. Taking classes across the humanities and natural sciences divisions also allowed her to use both sides of her brain. 

Lincoln said students should take advantage of the opportunities afforded by a small liberal arts college by trying lots of things, pursuing their passions, and taking on leadership roles. 

From College to Medical School

While at Washington, Lincoln wrote for The Elm’s features section, worked at the campus bar and eatery, was a peer mentor, and was a member of several honor societies. She served as secretary of Zeta Tau Alpha, where she learned leadership skills including how to communicate and organize in different ways. 

Knowing she wanted to be a doctor, Lincoln was a part of the premedical program at the College. 

“I got great grades in school and great letters of recommendation, and then I did terrible on the MCAT, and I remember thinking ‘here we go, my dream is dead.’” Despite that fear, Lincoln got into medical school during her first application cycle. 

“I think a lot of it had to do with my grades and also the fact that I had a lot of different kinds of classes—I wasn’t just going in as a bio major. I think a huge difference was that my professors actually knew who I was, and my research experience helped.” 

At Washington, Lincoln took a course on biochemistry, which she said helped her a lot in medical school, where she took a condensed version of the same course. The research she did during three summers while a Washington student had taught her how to read and write papers.

“I felt fully prepared. I was used to a heavy workload, so medical school didn’t totally scare me ,” Lincoln said. “I also felt like I knew I wasn’t afraid to ask for help if I needed. That’s what I came to expect from my professors at Washington, so I wasn’t afraid to say, ‘Hey I need a little assistance with this.’” 

To this day, Lincoln values that feeling of personalization she got from Washington, where her professors all knew her and she was able to make lasting connections with her classmates.