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Meagan Heaton
Here at The VBAC Link, our mission is to make birth after Cesarean better by providing education, support, and a community of like-minded people. Welcome to our circle, we are so glad you are here!
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Episode 355 Alma's Precipitous VBAC After an Induced Labor for Gestational Diabetes Turned to a Cesarean

Episode 355 Alma's Precipitous VBAC After an Induced Labor for Gestational Diabetes Turned to a Cesarean

Alma’s first birth was an emergency Cesarean after an induction at 40 weeks due to gestational diabetes. Due to COVID-19 policies, Alma’s husband was not allowed into the OR. She did not expect the induction process to end the way that it did, and felt robbed of the positive birth experience she hoped to have. Alma made sure to educate herself on all of her options for her second birth. She was very proactive about her health and did not have gestational diabetes the second time. She went into labor earlier than she expected at 38 weeks. She woke up in the middle of the night to her water breaking, and intense contractions began. Within minutes, Alma knew she had to go to the hospital immediately. Alma felt pushy as they made the 45-minute drive. She was admitted to a room, and her beautiful baby was born just two pushes later!Evidence Based BirthⓇ: Induction for Gestational DiabetesThe VBAC Link Blog: VBAC with Gestational DiabetesBirth Ball Amazon LinkNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello. It is almost the end of November. It is crazy to think that the year is coming to an end. But guess what, you guys? We still have so many amazing stories coming your way. Today’s story is from our friend, Alma. I’m already messing it up. It looks like Alma, but you say it. Tell me how to say it correctly.Alma: Alma, but any way you say it is fine. Meagan: Perfect. I want to say it correctly though. She is sharing her stories today. Now, you are in New Jersey now, but you weren’t in New Jersey when you had your VBAC. Is that correct? Alma: When I had the C-section, I was in New Jersey, so we just zigzagged a little bit. Meagan: So she’s in New Jersey, but the VBAC wasn’t in New Jersey. I know a lot of people when they are listening are like, “Where was this VBAC?” We will talk a little bit more about that when we get into the story, but let’s give them a little teaser of what your episode is going to be. Your first C-section, I feel like was the steps. It was the steps or the cascade, and then a little bit of what you went through. Tell us a little bit of a teaser before we get into the episode. Alma: I had a lot of interventions in my first pregnancy and did end in an emergency C-section, then for my son, my second pregnancy, it was exactly the opposite. There wasn’t time for any intervention. He just flew out. My whole labor was 2 hours from the first contraction to when he was born. I almost delivered in the car. He was too fast, but it was exactly the experience that I wanted to have. Meagan: Yes. Oh my gosh, so a precipitous labor after a lot of interventions, an induction, and all of these things. I’m so excited to get to this episode today, but we do have a Review of the Week. As usual, if you haven’t done so yet, please leave us a review. We absolutely love them. Okay, this episode reviewer is Desiree Jacobsen. She actually just left this review this year in August of 2024. It says, “Thank you”. It says, “This podcast and parent’s course is amazing. I’m not a VBAC mom, but I have been listening since 2020. I binge-listen toward the end of pregnancy to remember everything I need to remember in the birth process through my previous births. This time around, I felt more prepared than ever before having plans in place just in case. We were able to have a quick birth for my fifth baby. I love the education, passion, love, and support this podcast gives. I recommend it to everyone I know, and I have learned so much from it. I am so grateful for this podcast. Thank you”. Oh, I love that. I love that, love that, love that. That was actually sent to us via email. If you didn’t know, you can email your reviews at [email protected]. Your reviews on the podcast and on Google are what truly help other Women of Strength find this platform and find the courage and the information that they need to choose the birth that they desire. Okay, girl. Let’s get into this story. So first birth, lots of interventions. Let’s talk about it. One, what types of interventions, and two, why? What led up to needing those interventions or I don’t know if it’s “needing” or really medically needed? Tell us more. Alma: Well, my first pregnancy was very normal and healthy up until I was diagnosed with gestational diabetes. That’s where things started to change a little bit. I just failed the test by just a point, so my blood sugar was elevated, but it wasn’t as bad as it could be. I wasn’t even on insulin. I was just on diet control. Everything was going fine so I thought, but I would say a week before my due date, I was told that I needed to be induced because of the gestational diabetes. That was the first red flag of things going out of my control because I didn’t expect to be induced. Although I had gestational diabetes for a while already, I wasn’t told that this would probably be the case that I would be induced. I agreed to the induction of course. I understand why it’s done, so I went along with it. I think my daughter just did not want to be born. On that day at least, we went in on my 40th week, and I was on Pitocin for hours, and it did nothing. I tried some exercises. I tried a bunch of things. Nothing worked.Eventually, the doctor suggested to manually break my water. That’s where I wish I had asked to do other things first. I wish I had rejected that choice, but I went along with it. From that point, the labor went from 0 to 1000. I was in so much pain in a matter of minutes. Everything happened so fast, and I wasn’t ready for that. I asked for an epidural really fast. I got the epidural, and that’s also when things got worse because my blood pressure started to decrease. I didn’t know that could happen actually. Later on, I scoured through every detail of what happened, and I tried to figure out exactly what went wrong. I realized that could happen with an epidural. When your blood pressure is affected, of course, the baby’s blood pressure is affected so my daughter started to have some fetal decelerations. It was very concerning. They put me on my back to deliver to push her out. I wasn’t even 10 centimeters yet. They were going to stretch me, but her blood pressure just declined in a way that was really concerning. I was rushed to the OR and the C-section was done. Everything happened so fast. I hesitate in using the word traumatic just because in the end, everybody was fine. I was fine. My daughter was fine. She was healthy, but it was very traumatic because nothing was in my control in that moment. I felt almost robbed of the experience that I expected to have. That was my first birth. Meagan: Well, and when things are rushed like that and you are left in a sense of– you said panic, but in a sense of urgent need to save something or save someone, it does. It sets all of your alarms off. Alma: That’s exactly what happened. Meagan: Everyone has trauma differently. They view trauma differently. Someone may see one things as traumatic, and someone would be like, “How is that traumatic?” It’s okay, I think, that you’re using that word because that is how you are perceiving this. Your feelings and your alarms that were going off in your body as everything was being rushed and all of these things left that traumatic feeling. Alma: Yeah, definitely. In that moment, I felt like I couldn’t breathe. At this time too, there were a lot of COVID restrictions, so my husband wasn’t let into the OR. It was like, “What happpened to her?” He was more concerned than me probably. He thought both of us were going to die, my daughter and myself. It all just happened so quickly. Thankfully, we were okay in the end, but I had no idea I would be coming back with a C-section scar. That requires more recovery. As a new parent, we were already new to everything. It was a lot to deal with, I think. Meagan: Yeah, what you were saying, I’m sure your husband had a lot of trauma through that experience too. We know that COVID especially– I mean, birth in general comes with a lot of things especially the unexpected, but when you through COVID in with that, it’s a lot of ick. It’s a lot of icky feelings. It’s a lot of ick. Alma: Yes. Meagan: So everything was good. Baby was good. You were good. Overall, it was a less-ideal situation, but where did that leave you after you had the baby and you were starting to recover? Where was your mind? Alma: I think I had to process a lot of what happened. I think I went into the first pregnancy very naive. It’s important to be educated, and I really appreciate this podcast for that reason to encourage us to be educated. It’s not that we are doctors. At least, many of us are not medical professionals, but we need to be aware of our bodies and just what the process looks like, and even some terminology. I was totally clueless on everything. I think that what I tried to do in between both pregnancies was just learn. What’s going on in my body? What can I say no to in terms of interventions?You don’t have to agree to everything. I never want to argue with a doctor of course, but if I really feel like that’s not the best choice, I can always ask for another choice. I can consider other options. Meagan: Yes. Alma: I just didn’t know I could do that the first time. I definitely tried to educate myself as much as possible, and I think that contributed a lot to how the second delivery went. Meagan: Yeah. I just wanted to thank you so much for pointing that out and seeing that because if I were to guess, we all didn’t know that. We may have heard that you can always say no, but I don’t if we realized how much we really could say no to or ask for another opinion. Maybe we knew it, but didn’t really feel like we could. It can be hard. It can be hard to say no, but I love that you are like, “I want a different option. I’m going to say no to this right now. Give me another option.” It’s always okay. Alma: Definitely, definitely. Wanting to wait if the time allows, “Can we try this later?” There’s a conversation that needs to happen. It doesn’t have to be one thing that is suggested. Meagan: This way or no. Alma: For sure. Meagan: Where did your education start stemming from? Where did you start when you were like, “Okay, I want to do something different next time”? Alma: The podcast. The VBAC Link. I listened to a bunch of podcasts. There is All Things Pregnancy with Dr. Nicole Renkins, and of course, The VBAC Link Podcast. Meagan: We’ve had her. We love her. Alma: That’s just what I did all the time before I went to bed. I’d listen to an episode driving. I’d listen to an episode. It was very helpful. I felt like I could digest information better that way as opposed to reading, so that was a very helpful tool. I also tried to find professionals around me who could speak to my specific situations. I had a doula, and of course, I had my providers as well. They were all so helpful with helping me navigate some of the things that might have gone wrong the first time, and how I could prevent them going forward. Meagan: When they talked about some of the things that maybe went wrong the first time– I don’t want to say wrong. They went south. Alma: Yes. Meagan: I don’t know why people say that. I love south. I love the south. What were the kinds of things that stood out to them?Alma: Well, I think the first thing was the induction in the first place. I completely understand the risk with gestational diabetes, but I think there could have been more conversations with that in my specific case. Seeing as I did not have diabetes that was really out of control, it was very well controlled with my diet, and there could have been room to say, “Maybe we can go a couple days past my due date.” I wouldn’t recommend that for everyone. I think it depends on your case, but I could have tried to have that dialogue, and maybe we didn’t need to have an induction. I also could have considered different methods of induction, and I think that was the first thing because I felt like that was the first domino piece. If I didn’t have the induction, it might not have led to a C-section in the first place. Another point was also the breaking of the water. Those things, I could have just said, “Let’s wait.” I was already there for the induction, so I could have just asked for a little more time. But the big point for me too was the epidural. That was, I think, the immediate reason for the fetal distress. Meagan: The response. Alma: The response, yeah. Understanding how I could avoid that. I was told that now with the second epidural, I may not have the same reactions because I’ve had it before. Also, if you get flushed with some IV fluids– Meagan: Yeah, I was going to say if you hydrate and not even just intravenously, but literally drinking water before. If you know that you’re going to want to get an epidural, or it’s heading that direction, start hydrating. The more you can hydrate, the better. Alma: So I learned those things, then also, I tried to prepare myself for not even having an epidural, although that wasn’t my goal, because I experienced the pains before. Even though I had the C-section, I went through some labor pains. I was accepting the fact that I might just need the epidural, but I considered that as well. How can I overcome this pain without any kind of medication? Those were things I was trying to consider about how we could do it differently so it doesn’t result in the same thing. Meagan: Okay, I love those tips. So now, you’re pregnant, and we have baby number two. Tell us this journey. Alma: Yes. I guess from the time of conception, it was about 18 months apart from the C-section. My pregnancy went perfectly fine. There were no issues. The difference being I had a toddler, so I was more active, of course. I was on my feet. I took at least 10,000 steps a day. I didn’t sit much just because of my daughter. I think that definitely helped in preparing my body. I was really focused on how I can work on my pelvic floor and was just preparing for what it would take to push a baby out. I also did a lot of exercises that I found online. I never did a class or anything, but these were just Instagram videos where you could see the top three videos for strengthening your pelvic floor and things like that that were just free and available. I had an exercise ball that was a lifesaver. I highly recommend that exercise ball for anybody who is pregnant, especially in the third trimester. You can sit on it. You can lean on it. You can squeeze it between your knees. All of those things provide relief, but they also strengthen your muscles down there. I did the Miles Circuit. All of those things were super helpful, and I did it daily to prepare my body. I guess going into the actual labor, I’ll start by saying that first of all, I didn’t have very supportive providers. I learned from this podcast that that’s very important. I do 100% agree that it’s half the battle if you have someone who is on your side and wants to help you make intelligent decisions. I would say my providers were not completely unsupportive, but there were a lot of policies from the hospital side that I think restricted them from encouraging a VBAC. There were a lot of if’s, and’s, and but’s. There were so many stipulations for when or if I could have a VBAC. Meagan: Can I ask which ones stood out where you were like, “These for sure are alarms”?Alma: The biggest one was that I would have to deliver before 40 weeks. I felt statistically that doesn’t happen. People usually birth after their due dates, so I felt like I was already set up for, this is not going to happen probably. I felt really discouraged by that. Also, I guess the due date was a big thing, but also if I were to have gestational diabetes again, then the whole conversation on the doctor’s side was just completely mute. I would just need to go for the induction if I had gestational diabetes. Statistically, you do have it with each subsequent pregnancy according to what I have known. I was also expecting, okay. I’m most likely going to have gestational diabetes. I’m most likely not going to give birth before 40 weeks. It seemed like I was most likely going to have to agree to a C-section. Those things were not encouraging, but I did feel like the doctors were trying to help me find some safe loopholes. One of them being that they had to– I don’t know if this is law, but they had to schedule me for the C-section even though I didn’t want one. But they explained to me that I could go in and say to them that I didn’t want a C-section. I could ask for more time. I could ask to be induced, and hopefully, the induction wouldn’t lead to a C-section although it could. I guess they were trying to explain to me that there are some routes you could take, but given the fact that you had a previous C-section, we do have to just assume that you’re going to have another one. I felt really alone on that journey of trying to do something that I felt like I could do, especially given that the reason for the first C-section was an emergency. I was dilated. It wasn’t a failure to progress. I felt like my body was perfectly primed to do it, but because of time, we had to go for the C-section. I also had to have some conversations with myself accepting that if I do need to have another C-section, it’s not the end of the world. I guess what frustrated me about the first time was that I felt like I didn’t need to have it. C-sections save lives. They’re great tools when they’re needed, but I felt like I didn’t. Aside from the distress and all of that, I felt like I didn’t need it, so I wanted to really try for this vaginal birth. I was just in between trying to accept what might happen, but still trying to hold on to what I believed I could do. So, I guess fast forward to my 37th week, I had an appointment and I had to sign off that I would come in for a C-section, but my plan was to go in that day. This was on the 39th week. I would have the C-section. I could go in and say that I didn’t want to have it. On the night of my 38th week, my husband just finished putting together the crib, and it was midnight. He put together the crib. We went to sleep, and at around 2:45, I wake up because I thought I peed on myself. Now, I think I realize that it was my water leaking. I got up, and at that point, I had maybe cramping, but it wasn’t really painful. To make a long story short, 10 minutes later, I was having full-on contractions. They were super painful. I got out my phone to time it, and within two taps, the app was telling me to go to the hospital now. It was two taps. Everything was happening so fast. Meagan: They were coming so close. Alma: Yes. They were so close. I don’t remember how to count them. All I did was tap, and it was telling me to go. This was at 38 weeks, so I honestly didn’t have anything ready. I didn’t have my bags ready or nothing. Within a matter of minutes, I was just on the floor trying to remember the HypnoBirthing and everything, but it was all slipping because it happened so fast.We get in the car, and I’m still in a whole lot of pain. At a certain point though, I got a grip. I was doing this Christian HypnoBirthing which really helped me. I finally grasped myself and was able to calm down, but the pain accelerated very, very fast. At a certain point, though, I started to feel a lot of pressure. I was still driving, by the way. We had about a 45-minute journey to the hospital. I started to feel a pressure to push. I just couldn’t resist it, so I pushed. I hammered down really hard. It sounded like a fire hydrant was cracked open. My water busted open in the car. I’m sitting behind the driver’s seat on my knees, and my water just gushed open. At that point, I really felt like he was coming out. I couldn’t hold back the desire to push because it also relieved the pain a little bit. It was more like a pressure as opposed to a pain. I just gave into that feeling, but I did feel like he was between my knees and was about to come out. My husband made a few wrong turns, but eventually, we got to the hospital. I couldn’t even sit, actually. They put me in a wheelchair to go to the place where you would give birth. I couldn’t sit down. He was just about to come out, and when I got there, I was already beyond 10 centimeters at that point. Later, the doctor told me when she came down to see me that she could already see the hair of my son’s head. He was already so close. Remember, the talk about the epidural? I wanted the epidural. I was asking the security guard, the person at the front desk– everybody I saw, I was asking for the epidural. I noticed that they didn’t respond to me on that. I overheard them telling my husband that it was way too late for the epidural. My son was already halfway out, and they couldn’t give me the epidural. Once the doctor came, she told me to give a good push. I pushed one time. His head came out. The second time I pushed, he flew out. I had five nurses dive in to grab him. Meagan: Oh my gosh. Alma: He was born, and that was the whole thing. It was super duper fast, unmedicated, and yeah. The most touching part to me was that he came out, and they put him on my chest. That was all I wanted. When my daughter was born in the C-section, I had to beg them to let me see her. I didn’t see her until minutes later. I didn’t hold her until the next day, but this time, they put her right on my chest, and it was just so redemptive. It was everything that I really wanted to experience. Meagan: Absolutely. It was probably a lot all at the same time, very shocking, but then to have that baby be placed on your chest, oh, what an amazing moment for you. Alma: Yes, yes. It was. Meagan: Oh my goodness. Super fast. I was just going to say that was super fast. Alma: It was. It was so fast. I think this is a thing with my kids. For my daughter, too, when they broke my water, everything went very fast. I don’t know. They are just really urgent, but my son was definitely in a rush. He came very, very fast. Meagan: Did your doula even make it?Alma: No, she didn’t. She did not. She couldn’t. It just happened too fast. She didn’t make it on time, but she was happy to hear everything went fine. Meagan: Yes, of course. Of course. Oh my goodness. So after you had the baby, and you had him on your chest and everything, did all of the rest of everything go okay and smoothly?Alma: Yeah. I was bleeding a lot, and that was a concern, but I thankfully recovered fine from that. I had a second-degree tear which I hear is not terrible for the first time doing that. So yeah. I recovered pretty quickly afterward. In my experience, it really didn’t compare at all to the C-section recovery. I was in a lot of pain after my C-section, but this time, it was just maybe a week or two of taking some pain medication for the stitches and stuff, but overall, I was fine. Yeah. I was able to go home the next day actually, so that was also very good. Meagan: The next day? That is awesome. Alma: Yeah. Meagan: How did your medical team feel about it? Did they say anything? Did they have any worries?Alma: Everyone was just so shocked at how quickly everything took place. I think that was the main theme was just the speed, and also how determined my son was. With just two pushes, he just came out really fast. The concern of obviously dropping him because they all dove in to get him. I think that was the talk. This happened in the morning, so the whole rest of the day, they were just chatting about how quickly everything happened. Meagan: Oh my goodness. I bet. I think sometimes those births are kind of a lot for medical staff where you come in and your baby is crowning, but I feel like those births are the type that they really do talk about for a really long time, and they were like, “Look at this.” A lot of the times, here in Utah, anyway, they call them stop and drops where you show up at 10 centimeters. You just stopped in and dropped your baby. I feel like in a lot of ways, it shows people that labor can happen at home, and then you come and it can so beautifully happen without getting an IV, getting a heart trace, setting up fluids, doing this, having a cervical exam. There is just so much that doesn’t need to happen, and I love when medical staff can see that birth can just happen like that. It really, really can if we just leave it be. Alma: Yeah. That’s exactly another point of how I felt before because I had gestational diabetes, and because I had a previous C-section, they did make it sound like I needed to be hooked up to every machine, and I could never give birth at home. I just felt almost like a robot connected to everything. That’s how it had to be, but yeah. This time, I wasn’t even in a hospital gown. It was just so organic how it happened. That was exactly what I wanted to experience, but I think it was a good experience for the nurses as well to see that it was okay. I was fine without the IV and the other stuff. Meagan: Yeah, I love that. You had listed some tips. One of them was doing pelvic floor exercises on the ball which we kind of talked about. I love the ball so much. If you guys are interested in a ball, I’m going to link a ball in the show notes because they are actually really inexpensive and can do a lot of really good things. What other tips do you have for someone preparing for a VBAC?Alma: The number one tip which I’ve heard constantly here is about being educated and understanding what your options are. Unfortunately, I think that most providers are not going to make it easy to have a VBAC just because of the risks that are associated with it. Of course, they may have your well-being in mind, but there are also a lot of hospital policies and protocols that they need to follow. They may not make it easy, but if you understand what your options are and what the research says, it opens the door for dialogue. When you open that conversation, I think you will find that doctors will probably give you more options than what they may have initially suggested. I always spent time talking with the doctors about, “So what if this happens? How about this? How about that?” I feel like that did wiggle in some room for me to not do things just following the protocol. Meagan: Yeah. Alma: That’s really important. Meagan: It’s so interesting how if you show up showing that you’re educated, there’s this different sense of– I don’t want to say respect, but I do want to say respect because I feel like these providers are like, “Oh. They get it. They understand. I can’t just say whatever. This needs to be an educated discussion.” It should always be like that, but I also think a lot of the times, providers don’t have time to really sit down and talk about the evidence, or their evidence is flawed because of personal experience. When you come in and you’re like, “Hey, what about this?” and they’re like, “Oh, she knows stuff,” it just really gives you some wiggle room. It gives the providers respect just a little bit more because they realize how important this is that we are educating ourselves. We are learning. We know the options, and we’re not just going to be like, “Okay, cool.” I love that tip. That, and finding the supportive provider. In the beginning, you had said that the hospital policies may have trumped these providers’ stance. I think not only just finding your supportive provider, but really understanding the hospital policy. You can call, and you can talk to the head nurse. You can talk to the board and the directors of the hospital. You can say, “Hey, I need to know the hospital policies surrounding VBAC.” Alma: Yeah. You know, I believe it was on this podcast where someone mentioned that the best way to know how a provider feels about a VBAC is just to ask them very straight, “What do you think about VBACs?” Their expression will say it all. You don’t have to have a preamble about it. Just ask directly, and I think that helps. I definitely did that. It wasn’t favorable in my case, but I definitely think looking into the hospital C-section rates is really important too. How often do they have C-sections? How often do they have VBACs? If they have that information available, that’s also really helpful. In my case, I found out too late that it wasn’t the highest, but it was pretty high. Also, from this podcast, I learned that it’s never too late to switch providers if you want to. I didn’t take that route. I stuck with who I was with, but I guess I was just trying to be adamant with what I wanted to do as much as possible. Meagan: Absolutely. Do you have any tips on how to possibly find the hospital’s Cesarean rate? It used to be out there on cesareanrates.org. It used to be out there, and you could look up your hospital. You could look up your state. You could look up your provider, even. That’s gone down a little bit and changed a little bit, but do you have any advice if someone is wanting to know their hospital’s Cesarean rate? Alma: In my case, I just searched the hospital name and the Cesarean rate. This was a pretty big hospital. This was in Florida. It was a hospital with a very big network, so that information was readily available on their website. You do need to dig around, but it was on their website. If you are dealing with a big hospital with many departments and so on, they may have that information on their website easily with a Google search. You could also talk to people who work at the hospital as well. If it’s not online, I think that information is quantified normally. They might not quantify how many VBACs they have, but definitely the C-section rate is information that they are following and tracking. Meagan: Yeah. I feel like it’s always fair to ask your provider, “What’s your Cesarean rate?” A lot of the time, they will say, “I don’t know.” They know. They know. That’s something that they need to be able to give you. It’s okay to ask that. “What percentage of your deliveries end in a Cesarean?” Alma: Yeah. Being direct is really the easiest way to know clearly where they stand. Meagan: Yeah, absolutely. I wanted to really quickly talk just slightly about gestational diabetes. There’s a lot when it comes to gestational diabetes. We know, just like you had experienced, that most providers suggest an induction. They just do. According to the American Pregnancy Association, gestational diabetes occurs in 2-5% of pregnancies which is decent. For those who are at a higher risk in their pregnancy, it may be even higher up to 9%, but a lot of them are controlled like yours were through diet or even through insulin and things like exercise. A lot of people are controlling them. Evidence Based BirthⓇ, which I want to make sure that this is linked in our show notes and our blog so if you want to go read more about gestational diabetes or you had gestational diabetes with your last pregnancy and you may have it again, definitely go check it out. They talked about how there is actually very little data in how often people are actually induced because of the diagnosis of gestational diabetes. But in one of the retrospective studies, they found that out of 330,000 births from 2001-2007, they saw– okay, let’s see. It says, “The people in the study came from six health insurance plans, many different hospitals and regions, and represented a large and diverse population. Health insurance plans datas were linked to birth certificate data in order to improve accuracy compared to using birth certificates alone.” Going down a little bit further, they said, “Overall, 30% of labors were induced. When they looked at the reasons for induction, 59% of labors were induced for an accepted medical reason and 41% were considered to be elective.” Those are pretty big numbers to me. Alma: Yeah. Yes. Yeah, those are big. Meagan: Yeah, those are really big numbers. It goes on. It talks about, does gestational diabetes always mean induction? What’s the evidence for randomized controlled trials? They go way into it because Rebecca Dekker is amazing, and their team is incredible. We will also have our blog linked because I believe this is a really important topic to know more about especially if you’ve had it so you can make the right decision. And how you said, you were like, “I was in a controlled state. Everything was controlled through my diet, and I could have likely gone further,” but you didn’t. You weren’t really encouraged to go further. It was like, “Let’s induce.” Alma: Yeah, it literally was just like that. There was no conversation about it. Meagan: Yeah. No conversation about it. I think that’s where we’re going wrong a lot in the medical system. A lot of the time, there is no conversation. Even though we have the power to start that conversation, sometimes it’s really difficult when we’re being told, “Your provider thinks this. Your baby is in danger. You’re in danger if you don’t do these things.” It’s like, “Okay. Okay. I’ll do those things,” but we need to have those conversations. I think that again, having the education and knowing the evidence behind it, and the risks and the benefits and all of those things, it will help you have that conversation if and when the time is needed. So, thank you so much for chatting with us today and sharing your stories and giving us advice, and leaning into more conversations for gestational diabetes. I think it’s something that is happening. A lot of people are getting it. There are things we can do even before pregnancy like really increasing our protein and things. But sometimes, it just happens. It just happens. Alma: I will say just to be clear, the second pregnancy, I did not have gestational diabetes. Meagan: Okay. Alma: That was also something. That was my biggest concern. The two points I mentioned were that the conditions were that I couldn’t have gestational diabetes, and I needed to deliver before 40 weeks. But this goes along with education. I did my best to improve my diet even pre-pregnancy to avoid that diagnosis. It was actually a miracle that my blood test came back really well. I almost thought this was the wrong test because it wasn’t elevated at all. I was really, really thankful that through some dietary changes and lifestyle changes, I didn’t have gestational diabetes at all. Then the second point about giving birth before 40 weeks, it was a spontaneous labor at 38 weeks which also was so supernatural. I really thank God. Everything happened really perfectly. Yeah. That was really a blessing.Meagan: Yes. Oh, thank you so much for everything. You are amazing.Alma: Oh, thank you. Meagan: We just love you.Alma: Thank you so much. I had a great time sharing the story, and I hope it encourages other women as well. Meagan: It will, for sure. Alma: Great. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
40:5925/11/2024
Episode 354 Meagan & Julie + Hospital Policies Surrounding VBAC

Episode 354 Meagan & Julie + Hospital Policies Surrounding VBAC

“Hospital Policy means the principles, rules, and guidelines adopted by the Hospital, which may be amended, changed, or superseded from time to time.”Julie and Meagan break down hospital policies today, especially common ones you’ll hear when it comes to VBAC. They chat all about VBAC agreement forms and policies surrounding continuous fetal monitoring, induction, and epidurals. Women of Strength, hospital policies are not law. They vary drastically from hospital to hospital. Some are evidence-based. Some are convenience-based. Do your research now to make sure you are not surprised by policies you are not comfortable with during labor!Defining Hospital PolicyBirth Rights ArticleNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome, everybody. We are going to be talking about policies today. What do they mean? Why are they created? And when do we have the right to say no or do we have the right to say no?And I have Julie discussing this with me today. Hey. Julie: You know I’m a policy fighter. Meagan: Yes, we do. We do. The longer I have gone– in the beginning, I was not a policy fighter. I really wasn’t. I was a go-with-the-flow, sure, okay, let’s do it, you know best. That’s really how I was. Julie: A lot of people are. Meagan: That’s true. I think a lot of the time, it’s because we don’t know what our options are. We just don’t know, so I’m really excited to get into this with you today. I always love it because we kind of get into this spicy mood sometimes when we have topics like this that we are very passionate about. We are going to be talking about policies today. I do have a Review of the Week, and this is actually a very recent review which is so fun. We just posted on our social media for Google reviews. We were specifically looking for Google reviews and podcast reviews. These are so, so important for us but also for other people to find this platform. We want people to hear these stories. We want people to feel inspired and get educated and know their rights. Your reviews truly do matter, so if you have not yet, please, please, please do so. You can leave a review on your podcast platform, or you can go over to Google and just type in “The VBAC Link”, and then you can type in a review there. This reviewer is by Savannah, and she says, “I started listening to The VBAC Link Podcast around 16 weeks pregnant and continued throughout y pregnancy. It was so good and encouraging for me as a mama who was preparing for my VBAC. It helped me gain confidence, helped me know what to look for, and what to watch out for in my providers. Hearing others’ stories was so encouraging and helped me gain so much knowledge. I had my hospital VBAC unmedicated with my 8-pound, 15-ounce baby.” You guys, 8-pound, 15-ounce baby is a perfect-sized baby let me just say. “And I know that the knowledge I gained from this podcast played a huge role in being able to advocate for myself to get my birth outcome.” Huge congrats, Savannah, on your beautiful VBAC for your perfect-sized baby. I say that because you guys, let’s get rid of the “big baby” term. Let’s just title these babies as perfect-sized because an 8-pound, 15-ounce baby for some providers may be categorized as larger or maybe even macrosomic. it’s really important to know that your baby is the perfect size and your pelvis is amazing. You can do it just like our reviewer, Savannah. Julie: Your pelvis is amazing. Meagan: Seriously. All right, you cutie. Look at you. Did you just get a haircut, by the way?Julie: I did, yesterday. It’s a little short. We did some color. It’s a little smidgey shorter, but then I think I wanted it to still go in a low ponytail for births. That was my goal. Meagan: I’m totally digging it. Julie: Thank you.Meagan: I should be having fresh hair, but my cute hair lady bailed on me the morning of my hair appointment. Julie: Oh no! Meagan: Sometimes we have matching nails, but we would have had matching nails. We don’t have them today. You guys, we just miss each other. I miss you. Julie: Yeah. We need to go to lunch again. Meagan: We do. Yes. We love shopping, you guys. Let’s talk about hospital policies. Julie: Let’s do it. Meagan: We know that so many people go into– not even just birth, but really a lot of things in the medical world. They just go to a doctor’s office visit or go to a small procedure, or whatever it may be, and these places have policies. I want to talk about what it means. What does a hospital policy mean? What is the definition? The definition, according to lawinsider.com, says, “Hospital policy means the principals, rules, and guidelines adopted by a hospital which may be amended, changed, or superseded from time to time.” Julie: Oh, I love that addition. Amended, changed, or superseded. Meagan: Yep. Julie: Yeah. Meagan: Yeah. It can. Julie: And it does. Meagan: And it does. It does. Julie: It does. Meagan: You guys, let’s just start off right now with the fact of a hospital policy– or a policy, okay? A policy in general is not law. It is not law. If you decide to decline a hospital policy– Julie: It is well within your rights. Meagan: Well within your rights. You could get some kickback. You could probably expect it. Julie: You probably will. Meagan: But, that’s okay. That’s okay. My biggest advice is if you are receiving or being told that this is a hospital policy, and you disagree with the policy, or maybe you agree with the policy for someone else, but for you, it’s not working, and you say no, and they say, “Well, –”Julie: “It’s hospital policy.” Meagan: “This policy is policy, and if you choose to break it, then you can sign an AMA.” Julie: You are so funny. “This policy is policy.” It’s like that though. Meagan: That’s literally what they say. Julie: They say, “It’s hospital policy.” And you say, “Well, I don’t agree with that policy.” “Well, it’s hospital policy.”Meagan: “Well, it’s policy.” Okay. Well, I’m telling you I don’t like your stupid policy. Julie: I don’t like your stupid policy. We are spicy, huh? Meagan: I mean it, though. I think I maybe shared this a little bit, but I had a client who had a home birth planned. She decided to go to the hospital because she had preeclampsia, and this nurse was not giving her her baby. She kept saying, “It’s policy. It’s policy. It’s policy.” I was like, “This mom’s word trumps your policy.” As a doula, I was getting into some rocky, choppy waters I was feeling. I could just feel the tension building. It did not feel comfortable at all. I looked at my client. Julie: You’re just like, “Give her her doggone baby.” Meagan: They could kick me out. They could. I need you to know that they really could kick me out. She was like, “That’s okay. I want my baby.” So I pushed. I pushed. I pushed and I pushed. We did get her her baby, but we had to fight. We really, really, really had to fight, and it sucks. It really, really sucks. So there is a website called pregnancyjusticeus.org. We’re going to have this. I have not actually gone through all of it. It is– how many pages is this, Julie? It is a lot of pages. It is 65 pages, you guys. It’s 65 pages of birthright information, going through a lot. Julie: It will be linked in the show notes. Meagan: Yes, it sure will. If you want to go through this, I highly encourage it. It is from Birth Rights and Birth Rights Bar Association, the National Advocates for Pregnant Women. Like I said, it’s 65 pages, but what they said in here I just think is so powerful. It says, “There is no point in pregnancy in which people lose their civil and human rights, and yet all over the world, people often experience mistreatment and violations of their rights during pregnancy and birth and postpartum.” We see these things. Julie: You need to make that a social media post. People need to know this. Meagan: Yes. Down here even further, it says, “We also know that doulas and other people providing support to pregnant and birthing people often bear witness to rights violation of clients of loved ones. In a recent survey, 65% of doulas and nurses indicated that they had witnessed providers occasionally or “often” engage in procedures explicitly against their patients’ wishes.” This is a serious issue. Julie: It is a serious issue. I feel like it’s really frustrating, especially as a birth photographer where my lines as a doula are very separate, but I always doula a little bit at every birth I go to. It’s not hands-on stuff always, but it’s hard when you see people getting taken advantage of and they don’t know they are being taken advantage of and they don’t know that they have options or choices and they don’t know that they can decline or request changes, and that’s probably the hardest part is that people just don’t know. I have a little tangent, but I’m in this Facebook support group for this medication that I’m on. It really amazes me continuously about how little people know about a medication that they are taking, a pretty serious medication that they are taking, and how little their doctors inform them of what the medication is and what some of the side effects and issues are, and what they can reasonably expect from it because some people have completely unreasonable expectations because they haven’t dug into it at all. The other day, somebody said something like, “I’ve been really, really tired and fatigued since I started this medication, but I called my doctor and she said that fatigue is not a common side effect with this medication,” and I’m like, “What?” It’s literally listed on the manufacturer’s website that it’s a side effect. It’s listed on the insert for the medication. It’s talked about all the time in this Facebook group, and it can be caused by a number of things that this medication affects. The fact that either her doctor didn’t know or just told her– anyway, it leads me. I promise there’s a point to this. It leads me to the fact that your doctor does not know everything about everything, especially a family doctor. This medication is prescribed by family doctors sometimes and endocrinologists. It is impossible for them to know everything about everything. Something like obstetrics and gynecology is more specialized so it is more focused. It is a more centralized area of study, but still, your doctor doesn’t know everything about everything. It is not uncommon for them to not keep up in advancements in medications and technology and practices as they evolve. It’s very, very common for the medical community to be 10-15 years behind the current research and evidence. It just is. Doctors and nurses and all of these things who have to have to have a certain number of contact numbers per year to keep up with training and education, but it is impossible for them to keep up with everything. It is okay for you to have different opinions than your provider. It’s okay for you to want different things than is hospital policy, and it is perfectly reasonable for you to make those requests and for those requests to be honored. It is also okay for you to know more about a particular thing than your provider might. Meagan: Yep. Julie: Period, exclamation point, shazam. Meagan: Well, we’ve talked about this with other providers. We’ve heard other stories where people come in. They have stats that their providers haven’t even seen. They just get stuck in their own way and their policies, and there are other things going on outside, so they just point-blank say, “No, this is how it is,” and you might have more information. That doesn’t mean you are more educated or qualified or whatever to be a doctor. Julie: Yeah, exactly. Meagan: It doesn’t mean, “Oh, I might as well be a doctor because I know this information and you don’t,” but it means that you may have found information that your provider is not aware of. It is okay for you to bring that to their attention. In fact, do it. Congratulations for them to find out the information that they might not have known yet, so they can do better for the next patient. Julie: I want to say that there is an attitude with some medical care providers of, “Don’t confuse your Google search with my medical degree.” Meagan: Yes. Julie: Come on. I really have a big problem when people get like that because first of all, and I’ve said this before, and I will continue to say it again, we have at our fingertips access to the largest amount of information ever available in humankind ever at our desktops. We can sit down, and you can go and find information and studies related to anything ever. Yes, don’t go looking at Joe Blow down the street’s opinion about childbirth or whatever. Yes, that might be a credible source. It might not be, but you can literally find these same studies, the same research, and the same information that these providers have access to in their path to their medical degree. Is it extensive? No. Are you going to have the hands-on experience that they have doing these procedures and C-sections and things like that? No, you’re not, but you still have access to the same information that they have access to. I have a big problem when providers have this arrogant attitude that they know more. Yes, they do know more generally. They might not know more when it comes down to specific things that have been updated since they have gotten out of school. Meagan: Yeah. I feel like in a lot of ways, we hear these policies and these things come up, and you’re like, “But where?” Then they can’t show you the policy or stat. Julie: Yeah, then they’ll be like, “You’re 20x more likely to rupture.” You’re like, “Can you send me the research?” They’re like, “It’s the way we’ve always done it.” Meagan: I did a one-on-one consult, and a provider told someone that they had this astronomical amount of percentage of rupturing, and I was like, “Wait, what?” Julie: Seriously. Meagan: I was like, “Please challenge your provider and ask them for that.” She did, and they were unable to give her that. We can just hear things, and if we just take them, it can be scary, and it can impact decisions when maybe that’s not true. I also want to talk about policy for providers. Their policy should be that everyone should have informed consent. They have policies, too, that not only you have to follow or that they have to follow. It’s a whole thing. There are many policies. Your provider really has to explain the risks, benefits, and alternatives for any medical procedure, intervention, or anything coming your way, but we see it not happening most of the time. We just see people doing stuff because it’s within their normal routine but it’s breaking policy which is so frustrating to me. So you can break policy? I want intermittent monitoring. I don’t want consistent monitoring. I’m breaking a policy? Julie: So what?Meagan: So what? Julie: So what? Sorry. Meagan: Let’s talk a little bit more about VBAC and policies surrounding VBAC. We know that policies are just there. They’ve been created. During COVID, holy Hannah. We saw these policies change weekly, you guys. Julie: Daily. Meagan: Yeah, seriously. They went in and they were like, “This is our new policy. This is our new policy. This is our new policy,” and I was like, “What?” Julie: It was freaking whiplash.Meagan: Yes, it was horrible. It was horrible. But they can change a policy just like that. You can say no to a policy just like that. So, okay. Sorry. I digress. Let’s go back. Let’s talk about what policies often surround VBAC. I know a lot of the time, in hospitals all over, it’s a policy that midwives cannot treat VBAC. Or you can’t be induced because it’s a policy. You can’t induce VBAC. We talked about this before we started recording, and I said it just now. It has to be consistent monitoring. Julie: Yeah. Well, can I just do a little bit of a timeout and a rewind for half a second? Hospitals are businesses, okay? I just want to explain this to everybody. Hospitals are businesses. I think we know that. You don’t have to have that explained. Businesses, in order for them to run efficiently and smoothly, need to have policies, guidelines, best practices, standards of care, procedures, and things like that. It is a business. It is okay for them to set parameters for which they want their providers and nurses and everybody who is at the hospital to operate under, right? It’s okay for them to have those things. It’s okay for them to set those because if you didn’t have those, the business would fall apart. Everybody would be doing whatever the heck they want. There would be a lot of disorder, right? Meagan: Yes. Julie: So policies and procedures and these best practices and things like that are created in order to keep things aligned and have a nice model of care so that they can be more cost-efficient so that the patients know what to expect so that the providers have a routine and things like that. Meagan: Yeah. Julie: There are reasons for these things. However, when we like to push back, when we are bothered, and the thing that really is frustrating about these policies is when they are put in place so rigidly that there’s no flexibility and that it takes away a patient’s autonomy, and that it removes individualized care from the birth experience. So this is why we want to talk about this. This is why we don’t think all policies are dumb. No, we don’t. We see the reason. We understand why they are in place. However, we want you to know that it is well within your rights as a human to decline and request changes for these policies, and to desire something different, and to have that desire respected. It’s hard when some providers and nurses get so stuck in the fact that, “This is policy,” that they take away your autonomy and your right to choose. That’s what we’re pushing back against, and that’s what we want you to know. These policies are not law. You have the right to want something different and to request something different, and to have that right respected. Okay.Meagan: Absolutely. Absolutely. I couldn’t agree more. I do think it can be really hard because they have these things to keep order and to keep things tidy.Julie: And with the intention to keep you safe. Meagan: Yes.Julie: But sometimes intentions don’t always translate well. But anyway. Meagan: Yeah. But really quickly before we get into what policies surrounding VBAC are, when we start questioning policy, there are things that can come into play where there are threats, there is coercion, there is gaslighting that starts happening because they are really panicked that you are questioning their policy. They feel very uncertain that you are questioning that. Julie: They may even feel unsafe, or they might never have had the policy challenged before so they don’t know what to do about it. Right?Meagan: Yeah. Yeah. Just know that if people are coming at you with, “Well, if you don’t do this, then this,” or whatever it may be, then it can get intense, but you can still say no. You can also ask for a copy of that policy. Again, even though that policy isn’t law, you can still ask for it. Julie: Ideally, you can do this before labor begins because it’s really hard to fight and bump up against these policies during labor. Meagan: Yeah. Julie: It’s going to be a lot harder. Meagan: Yeah. Yeah. Okay, so let’s go in. I talked a little bit about fetal monitoring. Julie: Induction. Meagan: Not being seen by certain people. No induction. Or the opposite. Julie: You have to be induced. Meagan: You have to be induced. Julie: By such and such a date. Meagan: Yes. It’s just so funny because it varies all over. Julie: It does vary all over. Meagan: Let’s talk about it. Okay, so fetal monitoring. Julie: Don’t forget epidural placement too. Meagan: Yes. Epidurals. Julie: We can talk about that. That’s my favorite one to argue against. Anyways. Okay.Meagan: There are so many. Okay, let’s talk about fetal monitoring. What is the policy typically behind continuous fetal monitoring?Julie: Yeah, so most hospitals– in fact, I’ve never met a hospital where this hasn’t been the hospital policy– is that continuous fetal monitoring is required for everybody, but especially for VBAC. They double down for VBAC because one of the first signs of uterine rupture, especially for someone who has an epidural, is irregular fetal heart tones. That can be one of the first signs of uterine rupture. Most hospitals are very, very adamant about having continuous fetal monitoring, especially for people who are undergoing a TOLAC which is a trial of labor after a Cesarean. It’s not a bad word. It’s just how it’s defined in the medical community before you have your VBAC.The reason they do that, like I just said— but honestly, if you don’t have an epidural and if you aren’t under any type of pain medication, the first sign of uterine rupture for you is going to be really intense pain. That’s going to be your first sign. Especially if you are going unmedicated, I think it’s perfectly reasonable to request intermittent monitoring. Do you want me to go into why they introduced fetal monitoring in the first place?Okay, in the early 1970s, we saw lots of rapid advancements in the medical field and technology related to the medical field. Things like continuous fetal monitoring got introduced. Antibiotics became more readily accessible. The procedures themselves, especially the C-section procedure, became perfected and easier to do with fewer complications and fever rates of infections. All sorts of things started happening at a really rapid pace in the early 1970s. One of the things that got introduced was continuous fetal monitoring. The intention behind the continuous fetal monitoring when it got introduced was to decrease the rates of cerebral palsy in infants. Cerebral palsy usually happens when during either pregnancy or labor, oxygen is deprived to the brain of the baby. It can cause a stroke and damage part of the white matter in the brain. The idea behind it was if you could catch the reduced flow of oxygen to the baby by monitoring its heart rate, you could intervene and do a C-section in time to get the baby out before cerebral palsy happens, essentially. The interesting thing about that is that after continuous fetal monitoring was introduced, there was no change in the rate of cerebral palsy. It stayed the same. It still is very similar. But what it did do is that it was one component that increased the rates of C-sections and other interventions. They are more likely to take a baby out due to nonreassuring fetal heart tones, and we’ve seen no improvement in maternal mortality and morbidity rates and infant mortality rates either with the introduction of all of these interventions. Meagan: Yeah. One of the reasons why they say that it’s mandatory for VBACs specifically is because fetal heart tones decelerating is one of the signs, one of many, that a uterine rupture may be taking place. Julie: Right, right. I said that. Meagan: Oh, you did. Julie: Yeah. Meagan: I was reading the link. I missed that. Julie: No, no. You’re fine. Say it again. It’s okay.Meagan: No, you’re fine. Okay. So with uterine rupture, fetal heart decels are not always a symptom of uterine rupture. What do you feel like it means? I feel like so many people feel more comfortable having their baby on the monitor so they can hear them. Julie: Oh, they do. You know what? The staff is more likely to do that too. This is really sad, but we have a labor and delivery culture that is very, very comfortable sitting at a desk down a hall watching a monitor to see how a patient is doing rather than remaining in the room and watching them. They rely more on what is going on on the contraction monitor and the heart rate monitor than they do the visible signs of the patient. It’s how they’ve been trained. It’s how they monitor dozens of people at once in a labor and delivery unit, and I feel like continuous fetal monitoring and the contraction monitor are other ways that de-individualizes care. I don’t know if that’s a word. It takes out the individuality. It takes out the rights to the human and it takes out really watching the person, and relies too much on the data. Data is good. I love data. Don’t get me wrong. I am a data junkie 110%, but data can only take you so far. I feel like that’s why people freak out about the continuous fetal monitor thing. “How are we supposed to know if you’re doing okay at the desk because we can’t see the chart on the screen if we’re not monitoring you continuously?” It puts more work on them, which is okay. I can’t imagine being a labor and delivery nurse because sometimes you have more than one patient that you’re monitoring and watching, and you’ve got lots of other things to do including charting and all of this stuff. Meagan: Yeah, this is one of those things that was created that even though the evidence didn’t prove that the reason why it was created worked out, it stayed because it brought ease to monitoring labor, and monitoring it not in the same room, and being able to have five other patients while seeing a chart. Okay, so fetal monitoring is one. Let’s talk about the induction or the non-induction that we’ve seen policies on both ways which also is so weird to me. I know it’s hospital to hospital, but why aren’t we going off of evidence?Julie: Dude, dude. Do you know what is so funny to me? I will also cry this out from the rooftops until I die, but if you really want to understand what maternal healthcare is like in the United States, you’ve got to talk to a doula or a birth photographer because we see not only hospital births and home births and birth center births, but we see all of the different hospitals and how they vary in hospital policy. It is so funny to me sometimes the conversations that I hear or have with labor and delivery nurses who insist one thing, then the next labor and delivery nurse in the next hospital insists on something completely different. “Oh, it’s not safe to go past 20 for Pitocin on VBAC,” then the next hospital will be like, “Yeah, it’s perfectly safe as long as you are monitored and the OB signs off on it.” It’s so up, down, and sideways based on whatever this specific hospital policy is. It’s not their fault which is why sometimes I like travel nurses in labor and delivery units because they go all around the country and have vastly different experiences with all the different hospitals. It’s fun to see the culture shift that can come in when that happens. Meagan: Yeah. Okay, so in some hospitals, it is policy that you have to go into labor spontaneously. Julie: Yeah. They will not induce for VBAC. Oh, but if you haven’t had your baby by 40 weeks, it’s hospital policy to do a C-section. Meagan: Yeah, they will not induce you, but then if you don’t go into labor by 40 weeks, they have to schedule a C-section. What’s the evidence there, and why is that even being a policy?A lot of providers after 40 weeks fear or they say that VBAC uterine rupture chances skyrocket after 40 weeks because, “Oh, that baby is getting bigger. They’re stretching that uterus out,” but that’s really not necessarily the case. We’re seeing it happen more and more and more where people are then doubting their body’s ability to give birth or go into labor. They are so scared that their baby’s going to get so big that they’re going to cause uterine rupture if they go past 40 weeks. I mean, really. You guys, the amount of things that we see coming in The VBAC Link’s DM’s– I love that you guys write us. Please keep writing us, but it’s frustrating, not that you’re writing us, but that these providers are telling people these things. Then we have the opposite that we have to induce by 40 weeks. Julie: Can I read you this thing? There’s a post in The VBAC Link Community today. It was a VBAC agreement form. If you’re birthing at a hospital, you’re more than likely going to have to sign a piece of paper showing all of the risks of VBAC, but they don’t ever make you do that for a C-section. This hospital VBAC policy, hold on. I was reading it this morning. Listen to this. This is word for word from this VBAC agreement form from a hospital. “I am aware that the best chance for a successful VBAC is to go into spontaneous labor, and that the risk of Cesarean section is increased past my due date. In an effort to afford me the best chance of achieving VBAC, I agree to be induced the 39th week of pregnancy or sooner if medical issues are present if I am still pregnant.”In that same paragraph, they say that the best chance of a successful VBAC is going into spontaneous labor, but if you don’t go into labor by 39 weeks, we’re going to induce you. Meagan: It also says that after 40 weeks, Cesarean chances increase so we have to induce a whole week before. Julie: Yeah. Right? Meagan: I’m sorry. Julie: This is real life. How is this even a thing? Blah, blah, blah. That’s what I say. Screw your policy. How can you contradict yourself like that? It says, “The risk of a Cesarean section is increased past my due date, but it’s also increased if you induce me, so either way I have increased risk.” This is literally what they are telling you in this form that they make you sign. Meagan: You know, those forms are so important to pay attention to, you guys. As you are getting these forms, the VBAC consent forms, or VBAC agreement forms or whatever. They title them all differently. Julie: I’m just reading this hospital policy more. Sorry. “I am aware of the hospital policy requiring two IV access sites.” Meagan: Okay. Today, which you guys, was last– I’m trying to think. It was a month ago. Okay, a month ago– I recorded the episode today, but a month ago, when this is coming out. Go listen to Paige’s midwifery episode. She just was talking about that. That is a policy within the hospital that she helps people at. They have two hep locks. This was news to me as of today, and now you are seeing this in this policy. Why? Why? What is the evidence behind that? Why?Julie: This VBAC agreement form is every single thing that we are talking about. “I agree to have continuous fetal monitoring. I am aware of this policy by this obstetric group–.” I won’t say it because maybe we shouldn’t call them out. Maybe we should. “--to require epidural placement by the time of active labor. I am aware of the implication that certain complications of labor can be life-threatening to myself and my baby. These can only be addressed promptly at the hospital. To lessen the risk of delay during a complication, I agree (in bold)--”Meagan: Yes. All of the agrees are in bold.Julie: “--to come to the hospital immediately if I am in labor or if my water breaks.”Meagan: Ugh. Julie: “I have been adequately about the risks, benefits, and alternatives of VBAC, and have the opportunity to ask questions. I am aware that no one is able to guarantee a successful VBAC and that repeat C-section may be indicated if my baby is breech, I do not adequately dilate, I am able to push my baby out, my baby does not tolerate labor, there is a concern for uterine rupture, or if any unforeseen medical issue arises during my pregnancy which makes labor unsafe–” according to who?Anyways, “certain methods of induction of labor are not permitted to be used in patients with prior Cesarean sections. I understand that if I am induced, the only safe options include medical dilation with a balloon, Pitocin, and breaking my water.” That, I feel like, is accurate. Meagan: That is valid. That is valid. Okay.Julie: That’s the only one. Cool. Meagan: Cool. Out of ten. Julie: Are you reading this right now? Do you have it up?Meagan: Yes. I pulled it up. Let’s talk about epidural. You guys, this has 86 comments already. One of the commenters said, “You absolutely do not need to get an epidural, have continuous monitoring, or go into the hospital when labor begins. These are often things to avoid when trying for a VBAC.” Julie: Yes. Yes. Meagan: You absolutely can have these things. “You can have these things, but having an epidural before 6 centimeters can put you at a higher risk of Cesarean including continuous monitoring. Your rights override policies.” This is what she said. She said, “Are you in the States? Did you sign this?” Julie: But I love what Flor Cruz with Badass Mother Birth said. “This is atrocious. Run. I would rather give birth in the woods by myself than to agree with this monstrosity.” Meagan: Really, though. We have so many things coming at us. We’re so vulnerable when we are pregnant, and we want a VBAC so badly. We have forms like this being given, or we have policies being thrown at us, and we say, “Just say no,” but when you’re in that moment, it’s really difficult. I think something that I want to say is, as you are learning these policies, as you’re learning more, figure out if you are someone who can stand up to these policies and say no, or figure out if there’s someone on your team who you need to have be there to help you find the strength to say no. Also, make sure that your family knows and your team knows what’s important to you when it comes to these policies. What triggers you? It is very difficult to say no or, “I am not going to do that,” or to not even say a word because they just strap the monitors on you, or call anesthesia because they just did a cervical exam, and the nurse logged that you’re 6 centimeters, so anesthesia is just coming down, but you might be doing really well and not want an epidural. Okay, I want to talk about epidurals. Julie: Let’s talk about epidurals. Jinx. Let’s do it. This is my favorite policy to tear apart and rip apart. Here’s the thing. The reason why they tell you they want an epidural placed, but you don’t have to have it turned on, just to have it placed just in case, is if a uterine rupture happens, you can dose up the epidural and go back to surgery, and they don’t have to put you under anesthesia. It sounds great, right? Cool, yeah. Let’s do that. That sounds great. I don’t want to go under general anesthesia if I have to have a C-section. Here’s the problem with that. First of all, going under general anesthesia does carry more risks than having surgery with a spinal or an epidural. It does. That’s just common knowledge. Nobody is going to argue that here. We get that. The problem is that in a true emergency, we’re talking about seconds matter. Minutes matter. If you have a catastrophic uterine rupture and baby has to be out now, baby has to be out in minutes or less. They are going to do a splash and dash. They are going to throw the antiseptic, the orange stuff– Meagan: Iodine? Julie: Iodine. They’re going to throw iodine on your belly, and they’re going to slice you open. Sorry, that was a very not-sensitive way to say that. They’re going to take the baby out as fast as possible once you’re in the OR. They have to knock you out under general anesthesia. There is not enough time to dose an epidural, especially if it’s not ever turned on. But even if it is turned on, it takes 20 minutes or more to get an epidural dose to surgical strength to where you will not feel the incision and the surgery that comes with a C-section. 15-20 minutes at minimum in order to get you dosed to surgical strength. If you have an epidural, and it is urgent where minutes matter, you will have to go under general anesthesia no matter what, period. If a C-section is needed, there is time to give you a spinal which takes effect in just a few minutes, 3-4 minutes. It takes some time to get the anesthesiologist in and the OR prepped and things like that, but usually and realistically, if it’s something that’s urgent but not emergent, you can get a baby out in 10-15 minutes without already having an epidural placed. Here’s the thing. Placing an epidural is preparing you for surgery, period. If there’s an emergency, you will have to be put under general anesthesia, period. If a C-section is needed, and minutes don’t matter, but we need to get this baby out soon, you can get a spinal, period. So, screw that epidural hospital policy. It’s literally for convenience so you already have an epidural placed so that they can take you back to do a C-section. Meagan: Yeah. But again, the epidural just doesn’t get in fast enough even if it’s placed or not. Julie: Exactly. Meagan: Ugh, I hate it. I hate when it’s like, “I don’t want an epidural, but I’m getting it just in case.” Okay, then going back to this policy that she was just reading, “will not labor at home. If my water breaks, I have to come right in.” You guys, if you want to labor at home, do your research. I understand. Always, always– I don’t even care if you are a VBAC or you’re planning an induction or what. Always learn the signs of uterine rupture, always. It’s so important to know. Even though it happens very little, it happens, and we need to know the signs. But, it’s okay to labor at home. Talk to your provider about that. If they are like, “The second you have a contraction, you have to come in,” that is a red flag. You guys, they also start monitoring and pushing induction even though your labor has been going. They induce your labor more. They get it going further. What if you’re having prodromal labor, and it’s just going, and then it stops for 5 hours? There are so many things. I’m no provider. I can’t say, “You must labor at home,” or “You should really labor at home,” but really look at these things and understand what could happen if you choose to go in the second your water breaks. Let me tell you what happened to me. My water broke. I went straight in. Within an hour, I hadn’t progressed too much, so they started Pitocin. They immediately started Pitocin. They kept cranking it up. My body was struggling. I was struggling. My baby had a couple of decels. They called it. It’s just really, really frustrating. I mean, you guys. We have so many comments in this here that I could just read all of them because they say a lot. They say a lot. This is fear-based care. I’m sorry that you’re having to go through this.” “This is the dumbest thing I’ve ever heard,” someone said. Julie: Seriously. Meagan: When it comes to hospital policy, it’s not a law. It’s really not a law. Stand up for yourself. Understand the policies surrounding VBAC. When you are looking for a provider, we cannot stress this enough. Ask them about their policies. If their policy is that you must get that just-in-case epidural, you have to have that baby by 40 weeks or we induce or we schedule a Cesarean, you have to come in the second a contraction starts, if your water breaks, you must come in. You have to come in. They’re making people sign these policies like they are the law. Julie: Yeah, like it’s a legal document like you can’t change your mind. That’s what it does. It makes people think they have to agree to things. “I signed the document, so here I go.” Meagan: Here I am. I have a written agreement, but they can change. What did it say? What did the very first definition say? It says, “It can be amended, changed, or superseded.” Supersede. Julie: Superseded. Yes. But here’s the thing, too. I’m kind of glad when hospitals do this because it shows you all of the red flags. It lines out the red flags, no questions, black and white, red flags laid out for you. Then you know either how to address them before labor, or how to hightail it out of there and find another practice because nothing is worse than getting blindsided during labor by a policy that you don’t agree with and having to advocate to change that during labor.I would encourage you if your provider doesn’t make you sign a wonky form, then before you even start care with them, find out what their hospital policies are about VBAC. Find out so that you can address them ahead of time. Have your provider sign off on changes to policy that you want, and put it in your medical records so that if you get a different provider on the day that you go into labor, that provider can access your records and see that it has been signed off, or approved, or whatever your changes are that they are going to make to the policy for you and your specific needs. It is okay to ask for that. It is okay to fight for that. It is necessary to fight for that sometimes. Obviously, it would be ideal for you to find a birth location whose policies align with the things that you want. Sometimes, somebody might want continuous fetal monitoring. Maybe it makes them feel better mentally. Maybe that’s just their preference, and that’s okay. It’s okay to want that, but it’s not okay to let a system dictate how you want to birth when you want something different. Meagan: Yes. Absolutely. It’s also not okay for you to feel cornered or like you’re bad, coerced, or you’re a bad mom because you’re making a decision that goes against a policy. I don’t like that. I do not like that. It’s not okay. I highly suggest going and checking out the show notes and reading more about your birth rights, what they mean, and all of it. In part of that little birth rights document pdf, the 65-page document, it talks about down in the first 4 or 5 pages– let’s see. It says, “I have the right to–”, and then it has a whole bunch of things. It says, “To say no and be heard. To have my basic needs be met. To labor in the way that works for me. To birth vaginally. To know all of my options. To change midwives, doctors, and nurses. To not be touched. To ask people to leave. To feed my baby human milk. To leave the hospital or the birth center.” You guys, you have rights. You have rights. You are amazing. Use your rights if you are in a corner that feels like they are being taken away or they’re gaslighting you, or coercing you, or whatever it may be. You have rights. Check this document out. I highly suggest it. Talk to your providers. Check out their policies. Dissect the policies. Dissect them. Really break it down. What does that mean? Why is this being put on as a policy?In one policy that Julie just read, it said that they will not induce, and that VBAC is not applicable to being induced with certain things other than x, y, and z. Okay, if you do the research and you learn about that, that is pretty dang valid. That is understandable. That policy has been put in place for your safety. Okay? But there are others that I would say no to. They may be thinking that it’s for your safety, but there is no evidence behind them. Dissect them. Learn them. Learn how to advocate for yourself. Get your team ready. Know it’s not a law, and love yourself because you deserve more. Okay. Anything else you’d like to add, Julie?Julie: No. I love that. Love yourself. Take ownership. Take ownership of your own birth experience. Don’t give it to somebody else. Stand up for yourself. Take ownership. I love what you just said. Love yourself. You deserve to have choices in how you are treated during your birth experience. Meagan: Yes, absolutely. Okay, thanks, everybody. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
51:5220/11/2024
Episode 353 Ashley's Premature VBAC After Possible Placental Abruption + Advice From a NICU Mom

Episode 353 Ashley's Premature VBAC After Possible Placental Abruption + Advice From a NICU Mom

“Getting that VBAC meant everything to me. It helped so much with the trauma of it all.”At 36 weeks along with her first, Ashley started to have intense carpal tunnel pain. At 38 weeks, it was unbearable. Her provider said that delivery would be the only way to find relief and recommended a 39-week induction. Ashley had a difficult labor and pushing experience. Her provider recommended a C-section due to a cervical lip and no progress after just an hour and a half. Ashley consented and felt defeated. She started her VBAC prep the day she got home from the hospital. At 29 weeks with her second, Ashley had plans for a beautiful trip to Saint Thomas with her husband and toddler. She began contracting the night before her flight but didn’t think much of it and made it to their gate– while still contracting. As the plane was boarding, she passed a blood clot in the airport. She knew she needed to go to the hospital. In spite of many interventions trying to stop labor, Ashley birthed her baby via VBAC just hours later. She later learned that she had a possible placental abruption that wasn’t detected until her doctor examined her placenta after delivery. Though Ashley’s postpartum experience was tough balancing life with a newborn in the NICU for 8 weeks while having a toddler at home, the victory of having a VBAC carried her through. The power of a positive birth experience is real and worth fighting for!Pregnancy-Related Carpal Tunnel ArticleHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. It is Meagan with my friend, Ashley. Hello, Ashley. Ashley: Hi. Meagan: How are you today? Ashley: I am good. How are you doing?Meagan: I am doing great. I’m loving all of the stories we are recording and so excited to hear yours. You have a more unique VBAC in the sense that it was a very premature VBAC. Ashley: Mhmm, yep. Meagan: Yes. We are going to talk a little bit more about that. You’re going to share information for NICU moms because your baby did go to the NICU. You are a mom of two and a children’s therapist. Can you tell us a little bit more about what you do for work? Ashley: Yeah. I work with kids ages 4-18. Right now, I’m Telehealth only. I actually work in Tooele, Utah, but I live in North Carolina. Everything is Telehealth. It happened with COVID. I was out there during COVID. We moved and continued to do Telehealth since I’ve moved. I really only see 10 and up at this point. Yeah. I see a lot of teenagers all through Telehealth and it’s really wonderful that I get to keep that up. Meagan: That’s so awesome. That’s awesome that you got to keep doing it, and that you are serving our children. I’m sure that you have lots to say about our children and their mental health that is going on out there, but there is a lot. It is a lot of these kiddos of ours. Ashley: Absolutely, yeah. It’s hard and challenging, but it’s also really wonderful and rewarding. I love that I get to do it. Meagan: Yeah. Well, thank you so much for all of your hard work out there. Ashley: Yeah, absolutely. Meagan: We do have a Review of the Week, so I want to get into that, then I really want to turn the time over to share both of these journeys. This review is from Sienna. It says, “After having a very hard conversation with my OB where I learned she was in fact not VBAC tolerant or friendly, I texted my best friend through tears pouring down my face and she immediately sent me a text back with The VBAC Link Podcast. Ever since, I have been listening to every episode of the podcast. It is so beyond helpful and inspiring for anyone preparing for a VBAC. I’m due at the September, and have made the goal to listen to every single episode before then. I can’t say enough for what Meagan and Julie are doing for women like me. I can’t wait to rock my VBAC.” Oh, I love that review. Thank you so much, Sienna, and I can’t wait for you to have an incredible VBAC. Way to go for realizing that your provider may not be the right provider for you. I think there are so many people who walk through the VBAC journey who think they may have a supportive provider, then at the very last minute, they are having those conversations and realizing, “Oh, shoot. I may not be in the right place.” It is okay to switch and keep interviewing and discussing with your provider. If your provider doesn’t feel like talking to you about your VBAC or says, “You’ve got months to go. We don’t need to talk about that right now,” those might be red flags and things you might want to reconsider. Thank you, Sienna, for your review. If you haven’t yet, please leave a review. You can Google us at “The VBAC Link” or you can leave it on the podcast platform that you are listening to us on.  Okay, Ashley. Thank you again so much for being here with us. Ashley: Yeah, absolutely. I’m so happy to be here. I never thought I would be. When I was preparing for my VBAC, I was listening every single day during my walks and I just thought, “Oh, if I get a VBAC, that would be wonderful,” but I never thought I would ever be on the show. It’s crazy and wild to be here. Meagan: I love it. The more and more that we record, we learn that it goes full circle. We’re in your ear all pregnancy with all these Women of Strength sharing their stories, inspiring you, building you up, and now, here you are inspiring and building others up as well. Ashley: Yeah. Yeah. It’s cool to be here. Do you want me to talk about my first?Meagan: Yeah. Yeah. Every VBAC starts with a C-section, so let’s start with your C-section story. Ashley: Yeah, for sure. For my first birth with my son, it was a pretty easy pregnancy for the most part. There were a couple of hiccups here and there. I had morning sickness in the beginning in the first trimester, but everything else was pretty smooth. At 13 weeks, I had a spell where I had a lot of bleeding. That was terrifying. I thought I was miscarrying. I called my provider and panicked. That was just the worst 4 hours of my life because I continuously bleed. They finally got me in for an ultrasound. They checked me and he was just really active and bouncing. They never knew why it happened, but I was fine. Meagan: Did they ever say anything about a subchorionic hematoma or anything like that?Ashley: That kind of sounds familiar, so that could have been it for sure, but I don’t remember. But it stopped. After my ultrasound, the bleeding was done, and everything was fine. It was the weirdest thing, but definitely so scary. Yeah, it was terrifying. That was bad, and after that, after the first trimester, my morning sickness went away and everything was good for the most part. What happened though, I took birth classes. I took breastfeeding classes. I didn’t do a ton of research. I just took my little birth class, and I thought that was enough. I actually think I skipped the C-section part. I was like, “I’m not going to need that.” I don’t know why I was so weirdly confident that I was going to be able to have a vaginal birth, but it literally was something that I’m like, “I’m good,” and I didn’t put much thought into it. I don’t know why I did that. Meagan: A lot of people do. It’s not what we want. It’s not what we think is going to happen, so we just push it aside. Ashley: Yeah. Yeah. I didn’t do any research at all, so I didn’t need to know about that. I didn’t want it obviously, so yeah. Everything was good until about 36 weeks I would say. I started to get carpal tunnel and it just got progressively worse and worse. It was bad. The last month of my pregnancy, it was unbearable. My fingers and wrists were numb 24/7. It was waking me up at night how painful my hands and fingers were. I couldn’t do little things. I couldn’t put a necklace on anymore. I couldn’t put my earrings in because I couldn’t use my fingers. It was so bad, and it was something I didn’t know happened. It was pregnancy-induced carpal tunnel. I had so much swelling in my body. That’s what they said it was. My midwife who I had found and really loved, she referred me to PT. I did that. I did wrist braces every night, and nothing helped. I kind of knew that was going to happen just doing some research. They say the only thing that gets rid of it is delivering your baby basically. Meagan: Do they know why it really starts? Is it something within the blood flow? Do we know? We don’t know. Ashley: I don’t know. My midwife just chalked it up to the swelling. My carpal tunnel was being squeezed by the swelling. I’m pretty petite as is, and then I was carrying so much water and so much weight that I think for me, my body just didn’t respond well. I had the carpal tunnel. That was at 36 weeks when it started getting pretty bad. There wasn’t a lot we could do about it. I really didn’t want to have an induction. I didn’t know much about it either. I didn’t do a ton of research, but I knew I didn’t want it. I just knew I wanted it to all go as naturally as possible and for my baby to come on his own timeline. By 38 weeks, I was miserable. I was like, “I don’t think I can do this.” I was pretty big and uncomfortable, but that wasn’t the part that was killing me. It was the carpal tunnel. It was bad. My provider said that we could do the membrane sweep each week. We did it at 38 weeks. We did it at 39 weeks, and we decided that if nothing happened after my second sweep, we would think about an induction. I was ready. I had to stop working a week before I even wanted to because I couldn’t type anymore. It hurt to type, and I do a lot of assessments with my job where I am typing all of the time, using my mouse and keyboard. It was just awful. We did the membrane sweep at 39 weeks and nothing happened. I was curb walking. I was eating the dates. I was doing the things and drinking the tea. Nothing. So at 39+5, I got admitted for my induction at 8:00 PM. They did a Foley bulb, then they did the Cervadil I believe. That was all fine. I think they also gave me morphine. I think that’s when they did that to manage pain. I looked at my notes, but it’s kind of hard. Some things aren’t super clear. But either way, I got a really bad rash. At the time, they thought it was PUPPS, but looking back, they thought it was a reaction to the morphine. Meagan: Oh shoot. Ashley: Yeah. I was so horribly itchy. Meagan: Yeah, that’s miserable. You’re in pain and itchy. Ashley: Yeah, and the carpal tunnel was still active. That was still happening. I don’t remember it being super uncomfortable with the Foley bulb. I was more scared of it. I was more scared than it actually was painful. I was okay. I handled it okay. So then my water broke at 2:00 AM I believe. The Foley bulb came out and they started the Pitocin by 8:00 AM I believe because I wasn’t moving enough. I wasn’t dilating enough. My water broke at 2:00 AM. It was in at 8:00 AM. I started an epidural, I think, at 5:00 AM before the Pitocin because I was just in a lot of pain. That epidural, though, was done by a resident which I didn’t know at the time. That was one thing I really didn’t want. It wasn’t placed correctly, and I had a ton of breakthrough pain. It was horrible. They actually ended up rethreading that at, I don’t know, 4 hours later. They had to rethread the epidural, remove it, and put it back in by someone else. It was so bad. Meagan: You just had all of the things coming at you. Ashley: Yeah. I just say everything was botched from the start. It was during COVID. There wasn’t a lot of staff. I felt ignored. There were hours when I didn’t see anybody. The Pitocin wasn’t managed very well either. I feel like they never really increased it. Like I said, after they started Pitocin, I didn’t see anybody for 4 hours. It was absolutely horrible. Meagan: Wow. So they were just outside watching your strip, and you were doing okay so they were like, “All right, we’ll just leave her.” Ashley: I think so. There were no providers. There was barely anybody on staff. I shouldn’t say nobody was on staff. I should say that every single room was booked. They were at capacity, and they were low-staffed. It was just not great. I started Pitocin. I finally got to 8 centimeters. I had really, really bad back pain still, and then that was when the epidural was rethreaded or redone. So then it was just waiting for me to progress, but I couldn’t feel anything at that point. I think I was just maxed out on pain stuff on the epidural being rethreaded. I had no control over my body whatsoever. I couldn’t feel my legs. I couldn’t get up and move. It was so awful. I couldn’t feel contractions. I could see it on the monitor, and they would tell me I was having a contraction, but I couldn’t feel anything. By 5:00 PM, they told me, “Okay, it’s time to push.” I had no urges to push because I couldn’t feel anything. I started pushing. I remember just being really out of it because of the epidural. That, and I’m sure there was morphine still. I was just out of it. I did not feel good or in control of my body. I just remember they told me to push. I was pushing for an hour and a half. Every time, they’d be like, “Okay, it’s time to push.” I would try to push, but I felt like nothing was happening. I couldn’t feel anything. Meagan: Yeah.Ashley: Yeah. I think that was probably the biggest reason why I had a C-section. I blame it on the no feeling and no control of my body. They had me push for an hour and a half, then they said that it wasn’t happening enough. I was at 9.5 centimeters. They could see his head, but they said there was a cervical lip. They told me I wasn’t getting past it is kind of what they said. They said, “You’re not going to be able to get past it.” So after an hour and a half, they told me– well, my midwife, and she wasn’t my midwife. She was whoever was on staff. She said, “I think we should talk about different options.” C-section came into it. She didn’t think I was going to get past the cervical lip. I stalled, so they had an OB come in and talk to me. They said, “Let’s bring him in and get his opinion.” He said the same thing, “I just don’t think you’re getting past this lip, and I think a C-section is the best course.” Looking back, I’m like, “I pushed for an hour and a half and they never tried to move me.” Given I couldn’t feel my body, they never tried to reposition me. Now, I know that if that had happened, give me some pressure. Help me sit up. Maybe I could put some pressure on it. I know it’s swollen, so putting pressure could have made it worse, but I just think there could have been so much more done that wasn’t done. Meagan: Yeah, and sometimes those cervical lips are baby’s head positioning. We’ve been pushing and aggravating the cervix, so rotating and getting the pressure off of the wrong spot and equalizing the pressure, or getting it over can help. Or sometimes that’s what it needs. It’s not the swelling, the cervix is just there, and it hasn’t progressed all the way, so pushing, and pushing, and pushing against that is what causes that swelling. Then movement, time, or rest– there are so many things. There are things like Benadryl or things like that and things to help swelling, but that’s unfortunate. They were understaffed, so I bet they were like, “We just have to have this baby.” Ashley: I think that’s a lot to do with it. I felt a lot of pressure to just get the C-section. No other interventions were offered. Nobody talked about moving. Nobody talked about letting me rest. Now I know, afterward, when I was prepping with my second birth, I was like, “Yeah, I should rest. Yeah, I should let my body move. Yes, there are things I should do.” I didn’t want an epidural, or I didn’t want one that strong. That was a huge mistake in my eyes. I had an epidural with my second and it was great, but with my first, they just overdosed me. They gave me way too much. I went to the OR. I had my baby via C-section. I was so out of it. They gave me more pain meds back there because they were going to cut me open, then I couldn’t feel my arms when I pulled my son out. They kept trying to hand him to me, and I could not move my arms. I was like, “Please stop.” It was so traumatic because I couldn’t hold him, and they kept trying to give him to me. Everything was a blur for a while. I woke up in the recovery room. I didn’t get to hold my baby for 2 hours after he was born just because I was so out of it. Then I got to hold him eventually. We were back in my room. I was there for a couple of days. Yeah. Recovering from that emotionally and physically was so hard. I didn’t prep for it. I didn’t expect it, and looking back, I was angry that it went the way it went. I feel like it didn’t have to. He ended up being 9lbs, 1oz. His head was in the 97th percentile. He had a massive head, and he was a big baby, but I do think things could have gone a lot differently. Meagan: Did he have any swelling on any part of his head that would have indicated things like asyncliticism or a bruise or anything on his head from pushing?Ashley: No, but he had a cone head. He had a very– Meagan: Okay, so he was coning and getting caput. Okay. Ashley: That’s it, yeah. Meagan: Okay. I was just wondering if there was anything specific to a positional thing, but it might have just been that your cervix wasn’t fully progressed before you started pushing. Ashley: Yeah, I think that had a lot to do with it. When you think about it, I was admitted at 8:00 PM. He was born at 8:00 PM. It was 24 hours and I was on my back the whole time. I was not being moved. I was not being repositioned. Like I said, there was not a lot of staff around. I was ignored. I didn’t know any better. I didn’t know what I should or should not be doing. I didn’t know that I should be moving. I think that had a lot to do with it, a lack of moving around and I was just on my back. Meagan: Yeah. Yeah. So had him and did you immediately know you wanted a different experience or were you just such in shock with everything that you couldn’t even process that? Ashley: I knew I wanted a different experience. I remember being in my bed the day we brought my day home in the bassinet, and I remember being on Instagram just looking up C-section groups and support. That’s when VBAC came to mind. I was like, okay. I can have a VBAC. I can do it differently next time. We only wanted two kids, so I knew that was my chance. For my second pregnancy, I really had to dedicate myself to how my body would allow, but that was so important to me right away, to have a VBAC. Meagan: Yeah. Did you immediately find a lot of resources? Ashley: I did. I believe that’s when I started following The VBAC Link. I believe that’s when it happened. There were some other C-section mama groups and stuff that I followed. That was really helpful. I would read people’s comments and it brought me so much relief to know other people had experiences like mine and the way I was feeling was normal. That was super helpful. Meagan: Yeah. There’s something about having that community behind you, validating you, helping you feel like you’re not alone in this world going through this, you’re not alone in this world wanting something different. A lot of people will say, “Why can’t you just be grateful? Why are you trying to figure out a new pregnancy and birth when you’re not even pregnant? You just got this beautiful newborn.” It’s not that I don’t love my newborn, and I don’t want this time with my newborn, but I’m starting my journey now to have a different experience. It’s okay that I didn’t like my experience. I still love my baby. Ashley: Yeah. That was what I heard a lot. I heard, “At least your baby is here and they’re healthy.” I know that was just well-intentioned, but yeah. That was really traumatic. My baby is here. My baby was healthy, and it was wonderful that he was born happy and healthy, but I didn’t feel right about it. I felt like I didn’t have control. I felt like I didn’t have a choice. I felt really pressured, and I didn’t have the birth that I expected to have. That was just really, really difficult. Meagan: Yeah. You also went through a lot between the reaction, but then also with carpal tunnel. You were restricted to even move your fingers, then in your birth, you couldn’t even move your arms. It went heavier. My spinal also went higher with my second up into my lungs and into my arms. I remember feeling that panicked feeling just laying there. Everyone was doing their thing and I was like, “Oh, is this going to stop? How am I going to hold my baby?” and all of those feelings. Ashley: Yeah. Meagan: Well, okay. So you had this precious baby. You decided you wanted a different experience and how did that experience start? Ashley: Yeah. The second time around, I should say with my first that it took us a while to get pregnant. It took us 13 months. I was thinking– I don’t know why it took so long. We were really trying. I was thinking that maybe that would happen again. I was mentally preparing for that. We had been trying for a couple of months. We moved. Right when we started trying was when we moved another state to North Carolina. I needed to find a provider. After getting settled for a couple months and had been trying for a couple of months, I found a provider who had really great reviews. I thought, this is great. I got in with her. That was really just to first get checked up, and then second, to have a plan for if we can’t get pregnant in the next couple of months, what should we do? I was thinking about that one medication you can take that releases more eggs. I wanted to ask about that because almost 35 and I wanted to be on top of it. I met with her. She was really nice, but immediately, she didn’t read my chart. She didn’t know about my first birth. I had to tell her about it and give her that information. After I explained what happened, she basically said that it sounded like it was an anatomy thing for me. One, it was anatomy. I said right away, “I want a VBAC. This is my goal, absolutely.” After I told her my story, she said, “Well, that sounds like anatomy. When it’s that, you’re more likely to have a repeat C-section.” She was like, “I’ll let you try, but the odds are that you’re probably going to have a C-section.” I felt so defeated when I left that appointment. I kind of just accepted it and thought, okay. That’s probably what’s going to happen. She’s the expert. She’s got great reviews. She must know. I left that appointment and again, did some research, and I started seeing that it was not really true. You still can have a VBAC. What she was telling me was not true. I needed to find a different provider. That’s what that meant. I just left it at that and waited. The next month, we got pregnant which was amazing. It only took us 5 months that time which I wasn’t expecting. It was super exciting. I did research for VBAC-friendly providers. I found the most wonderful doctor. Her practice is pretty much all women doctors and midwives. They’re all VBAC-supportive. When I met with my doctor, she said, “That’s what I prefer. 100%, I prefer to do a VBAC. I think it’s safer. I would much rather do that than a repeat C-section.” She was very gung-ho and it was great. As soon as we met, she already knew my chart. She read my previous birth. That was super refreshing. I didn’t have to tell her anything and she had a plan for me. She said, “If you want a VBAC, this is going to be the plan. We’re going to do everything we can to avoid any type of induction and intervention. That’s what we want to do.” About the carpal tunnel, it was likely to come back because it was about my body, and it was more my body and my anatomy, and how I handle swelling. The carpal tunnel was likely to happen again, but the problem was the first time around, I got induced because of carpal tunnel. If this comes back, what are we going to do? She started me on a baby aspirin right away. That was more because I ended up having preeclampsia after I gave birth. Meagan: Postpartum-eclampsia. Ashley: Yes, yep. That didn’t didn’t affect me that much, but yeah. She said, “We want to prevent that, so at 10 weeks, I want you taking baby aspirin.” She said, “If carpal tunnel comes back, I think we should do steroid shots and that should be able to help with the pain. It will help you manage the pain, so we can get to birth without induction or interventions.” Right there, I felt so much relief because that was the reason induction happened the first time around, but I also was a little angry because I was like, why didn’t my first midwife ever talk about that? It was never brought up. It was only PT. I don’t know why that way, but again if I would have had that, I think I could have had a much better pregnancy the first time around. Meagan: Yeah, and gone through a lot less pain. Ashley: More manageable. Yeah, so I left that appointment feeling really good. I found this wonderful provider, and things were going to go differently this time around. I asked about this time if my baby was bigger, and she said, “No, it’s not about weight. It’s not about how big your baby is. It’s about the way the head is positioned and the way the head is coming out. Big babies can be delivered vaginally.” She just said all of the right things. Meagan: Yes. Yes. When you were first telling me the story from the other provider who you met, I was shaking my head. With this one, I’m throwing my hands up like yes, yes, yes. Ashley: Yeah, that’s how I felt. She was wonderful. That was such a relief. It was everything for me. I left that and right away started prep for a VBAC. I already exercised lightly every day, but I started exercising. I made that a priority. I did my 2-mile walk every day. I was drinking the red raspberry leaf tea. I was meeting with the chiropractor. I met with a doula and interviewed a doula. I got that set up. Yeah, everything was pretty smooth. I had horrible morning sickness. This was worse this time around with my second pregnancy. I got horrible pregnancy acne. I had never had acne in my life, and then during my pregnancy, it was just horrible. That’s the worst. Everything else was smooth sailing. Meagan: Interesting. I wonder why. Ashley: I don’t know. I thought for sure I was having a girl because I never had it with my first pregnancy, so I was like, maybe I’m having a girl this time around. And my morning sickness was worse, so with my pregnancy being so different this time around, I thought it must be a girl, but it wasn’t. It was another boy. Meagan: It was?Ashley: Yeah, yeah. Meagan: Maybe the testosterone. I sometimes get testosterone acne. Maybe it was the testosterone. Maybe this baby had extra testosterone creating acne or something. Ashley: Yep, perhaps. I was just so convinced that I did everything. I bought baby girl clothes and all of that.Meagan: You were convinced. Ashley: Yeah, when I found out it was a boy, I was shocked. Everything was good though for the most part. There were no big issues once we got through the first trimester. What kind of happened was, I had never truly felt contractions before because with my first, I already had an epidural when I started to have contractions. I didn’t know what they would feel like. I was exactly 28 weeks. I went to the bathroom and there was mucus. I didn’t know. It was a lot. I ended up looking it up a lot and it looked like my mucus plug from what I saw. I had a doctor appointment the next day and after reading a bunch of things online, people didn’t seem to think it was a big deal. They grow back and sometimes that happens, so I wasn’t freaking out at all about that. I saw my doctor the next day, and she said that it was okay. It probably was just part of my mucus plug. She didn’t seem very concerned. The next week, I was leaving for St. Thomas on our last vacation as a family of three. It was very important to me. I wanted to go to the beach with my toddler and have uninterrupted time with him before my baby came. This was in March. My baby was coming at the end of May, so I was going to be 29 weeks. It’s a good time to travel I thought. We would get this great beach vacation with my toddler. I was cleared to travel. Everything was fine, and then the Monday when I was 28 weeks and 6 days, that night was horrible. I had so much pressure and I was tossing and turning all night. I just kept thinking I had to pee. I kept getting up, trying to go to the bathroom, and coming back to bed, but there was a lot of pressure. I didn’t think much of it, and I just knew I didn’t get good sleep. The next day was a Tuesday. All day long, I was having tightening on my stomach and pressure, but it wasn’t consistent. I feel like it was every 20 minutes to every 40 minutes. I would feel a little bit of pain. It wasn’t really bad though. I wouldn’t even call it pain. I would call it discomfort. I looked it up online. I was exactly 29 weeks at that point. I saw Braxton Hicks, and I was like, “That’s it. I’m just having Braxton Hicks.” It didn’t happen with my first, so I didn’t even know the difference. I was fine. I just went about my day. We were packing for vacation. We were leaving the next day. That night, that Tuesday night, we went to bed by 11:00 PM. We had to wake up at 5:00 AM for the airport. That night was excruciating. I could not sleep. I was in pain. I was having contractions every 10 or so minutes and tossing and turning. There was lots of pressure. I woke my husband up at 2:00 AM and we started talking about, “Should I go to the hospital?” I was like, “No, I think it’s Braxton Hicks. I think it will go away,” which is crazy now that I look back. It was really painful, and I was really trying to–Meagan: Talk it down to Braxton Hicks, and you’re early. You don’t want to think about it. Ashley: Yeah, I was 29 weeks. There was no way. Again, it did not cross my mind that it was actually real contractions because I was so early. Yeah, then there was a huge degree of denial going on. There was gigantic denial because I just wanted that vacation so badly. Not that I wanted a vacation, but I wanted that time with my son on the beach. We had been talking about it, so I just wanted to make it happen. At 2:00 AM, I woke him up. We talked about it. I was just like, “Okay. I’m going to get a heating pad and put it on my belly. I’ll just lay here and hopefully that will kill the pain.” I took some Tylenol as well, and it didn’t do anything. By 4:00 AM, I was like, “I’m getting in that hot bathtub, and I’m just hoping that stops this.” I was in the bathtub, which again, should have been my sign that you should leave for the hospital if you have to get into the bathtub and use the heating pad. If all of this stuff was happening, I should have gone in. By 5:00 AM, I was up. We were loading the car, and we were off to the airport. The whole time I was walking into the airport, I was stopping myself in my tracks to have a contraction. Meagan: Oh my goodness. Ashley: I was walking through the airport stopping, catching my breath, then I’d keep walking. It is absolutely wild that I got that far. It was a far walk to our gate. I was doing that a lot, and finally, we got to the gate. We were waiting to board. We were 5 minutes from boarding. People are actively boarding the plane. We are waiting to board last. I was like, “I’m just waiting to go to bathroom.” I go to the bathroom, and that’s when I passed a quarter-sized blood clot. I had light bleeding on top of that. I came back, and I looked at my husband and said, “I can’t get on that plane. I have to go to the hospital,” but I said, “You guys get on the plane, you and our son. Get on the airplane, and I will drive myself.” We had our car there. I was like, “I’m going to go to the hospital, and I’ll just rebook my flight for tomorrow. I’ll come out and meet you guys in St. Thomas.” Meagan: Oh my gosh. Ashley: We debated that. My husband went back and forth for a couple of minutes. He was like, “I don’t think that’s a good idea.” I was like, “No, it’s fine. They’re going to check me out and release me. I’ll meet you guys tomorrow.” Thank God he was like, “No. Let’s not do that.” Meagan: Yeah, seriously. Ashley: I still just thought everything was fine. I really thought that. I wanted to go so badly. We ended up that they had to get all of our baggage off of the plane. The crew was really annoyed with us, but so be it. Meagan: Whatever. Ashley: Yeah. We held up the flight a little bit for sure, and then I couldn’t even at that point walk back to the car. We called a wheelchair. Someone came and wheeled me out to our car. The hospital was only 20 minutes from the airport which was great. We got to the valet and we couldn’t bring my son in, so while my husband talked to the front desk, I waited in the car with my son. They said that my son couldn’t come into triage, so me and my husband obviously couldn’t leave him in the car. I just walked myself into the hospital. I got seen by triage, and right away, they took me back to the room. I said I was having contractions. They were monitoring me, and they were like, “It doesn’t really look like contractions.” I was like, “Okay, well something is happening. I’m in a lot of pain.” They put the monitor on me and didn’t see anything. Then they admitted me to one of the rooms in triage. They really wanted to check me, but I was not having that. I did not want to be checked. They really wanted me to go home. They ended up giving me an ultrasound, and everything came back normal with baby which was great, but they were like, “We don’t understand why you’re in so much pain,” because they still weren’t seeing contractions. They ended up seeing them on the monitor, and the doctor said, “I have to check you.” At this point, it was 11:00 AM. Meagan: I have to check you. Ashley: Yeah. She said, “We have to. We don’t know what’s going on with your body. You’re in a lot of pain, so we won’t know unless we check you.” She was really kind about it. I didn’t feel pressured because I had already turned it down. They had asked me and asked me, but they were like, “We don’t know what’s happening. We have to know where you’re at.” She checked me and when she was done, she looked at me and said, “You’re at 3.5 centimeters.” I just burst into tears because at that point, I knew that it was not good. I was too far dilated for 29 weeks.She said, “You’re not going to leave tonight. You’re not leaving until you deliver basically because you’re dilated. We have to keep you until your due date.” My due date was 11 weeks away.That was the hardest part because I knew I wouldn’t see my toddler until I gave birth. That was horrible. That’s what I cared about at that point. Obviously, I cared that my baby was healthy, but it was excruciating to think about that. Meagan: Mhmm. Ashley: They admitted me right away. They took me to Labor and Delivery. I told my husband because he took my toddler home. I told him, “They’re keeping me.” He came back to the hospital. At that point, the plan was just to stall labor as much as possible. Let’s get as far to your due date as possible. They did the magnesium drip immediately. They gave me steroid shots to help strengthen my baby’s lungs. They gave me one oral medication. I can’t remember what it was called, but it was supposed to help stall labor. That was all started and up and running by 1:00 PM. By 4:00, my water broke. With all of the interventions, my water still broke at 4:00 PM, and baby was coming. My water broke by 4:30, and then I was pretty much having contractions from that point on. They were pretty consistent and pretty painful. At 3:00 AM, they really started to ramp up. They were 3-5 minutes apart. They were really painful. At that point, I asked for an epidural. I was really clear that I needed it to be the lightest possible epidural. I talked about my past experience and how awful it was. I was going to try to not do an epidural, but the contractions were so intense that I was like, “I don’t think I’m going to be able to push because I’m in so much pain. I can’t imagine pushing through these contractions.” I had a great anesthesiologist who came in. He listened to me. He was absolutely wonderful, and he knew his stuff. He gave me the lowest possible dose just so I would be able to take the edge off of pushing. I could feel everything. That was in place by 4:20. I was complete before they did the epidural. I said that I would sit really still but to please give me the epidural. They did. I pushed for a couple of times, and he was born at 5:00 AM. I got to hold him. My husband got to cut his umbilical cord, and then I got to hold him for 30 seconds, then they had to take him up to the NICU. Meagan: Wow. Wow, wow, wow. What a change of plans dramatically, so dramatically. So once baby came out and went to the NICU, what were the next steps for you and baby? You got your amazing VBAC, but also, if I could ask, did VBAC matter at that point? Were you happy that you got a VBAC but your gears changed again to my baby is in the NICU? Tell us about that quick shift of events and what it entailed mentally. Ashley: Yeah. That relief of getting my VBAC was still so important to me. I did not want to have a C-section. I still didn’t. That was still top on my mind. I was really scared when I started pushing. I kept having that fear that he was not coming out and they were going to make me have a C-section. The fact that he came out when he did, I felt relieved. That feeling of being able to actually give birth vaginally was such a great relief. It was amazing. Meagan: Yes. Ashley: But yes. I was very, very happy about that. The recovery was so much easier. He was born at 5:00 AM. By 8:00 AM, I was standing and using the bathroom. I was fine. I felt wonderful. Even with him going to the NICU, he was healthy. I knew that right away. That helped a ton, but I feel like the trauma was lessened because I got my VBAC. I can’t even imagine what hell it would have been for me if I had a C-section. Meagan: Good. Ashley: He was perfectly healthy, other than being a premature baby. They didn’t have any concerns at all at the beginning. He just needed oxygen basically, and he needed to be in the NICU under supervision and watched. He was 3,3 when he was born, so he was pretty tiny. Meagan: Teeny tiny. Ashley: Yeah. Even with that, it’s surprising how painful that was. I thought because he was a smaller baby, it would not be as painful, but it was very painful. It was still worth it and amazing. The pain was all worth it. Yeah. Getting that VBAC meant everything to me. It helped so much with the trauma of it all. It was one thing I got to control in a situation where I couldn’t. There was so much out of my control. Meagan: Yeah. It was the one thing that you had planned, prepped for, and saw happening when everything else– you should have been on the beach hanging out with your family. All of those things that you saw happening didn’t happen, so to have that one thing happen, I’m sure felt amazing. Ashley: Mhmm, yeah. For sure. On that note, every single doctor we saw and nurse who came into our room was like, “Thank God you didn’t get on that plane.” Everybody knew that story knew that we were supposed to literally be boarding a plane when I was actually at the hospital. I almost did. I almost did. It’s wild. Yeah. Meagan: It is wild. Was there any indicator why you were having the blood clot in the airport and why you were having the bleeding? Ashley: So not until I delivered my baby and then I delivered the placenta, and the neonatal surgeon took my placenta and looked at it, and at that point, he said it looked like placental abruption. He found a 2.5-inch blood clot in my placenta, so he thinks that’s why I went into preterm labor. After I learned that, I looked it up and realized that it can be deadly to my baby. It can be deadly to the mother as well. That helped with the trauma of it all to wrap my head around it and to think that if I had gone longer, something so drastic like that could have happened to myself or my baby. At that point, I was definitely thankful that I had a preterm labor because that’s what brought me a healthy baby.Meagan: Yeah, wow. They didn’t even discover it until after. Ashley: Yeah. They had no idea. I don’t know if you typically see it in an ultrasound. I had a normal ultrasound at 20 weeks, and then they had one when I got triaged. They didn’t see anything, but the surgeon who looked at my placenta said that’s what it was. Meagan: Wow. Ashley: I’m so thankful. I really am. Being able to have that information helped me process it all and feel better about what happened. Meagan: I’m sure it offered some validation and took out a little bit of the why. Why did this happen? Why am I 11 weeks early? Ashley: Yeah. They sent the placenta off for, what’s the word? Meagan: Testing? Ashley: Yeah, they sent it off for an autopsy. It came back inconclusive and the doctor said that can happen with placenta abruption too so that was inconclusive, but again, the surgeon said that’s what he thought it was, so I’m going to accept that and be so thankful that my baby is here. When I think about what could have happened if I would have waited or if my pregnancy would have continued to progress, I really feel so lucky that it actually happened. That helped. Meagan: You know what? It just confirms to me how amazing our bodies are. When something happens outside of the norm, it responds. It’s like, “Okay. This is happening. Now my job is to get this baby out.” How incredible is that? It’s just crazy. Ashley: Yeah. With all of the interventions, he was coming. I just say that he’s a smart guy. He knew he needed to get out. He knew he needed to vacate, and he did. I’m just so happy for that. Meagan: Good. I’m so glad too. So then, having a NICU baby, how long did he stay in the NICU?Ashley: They anticipated 11 weeks which would have been his due date. He ended up getting out at 8. He was there for 8 weeks. He was 37 weeks when he was released which was surprising. He did wonderfully, so that was just so great that he got out when he did a couple of weeks early. But yeah, 8 weeks in the NICU. It was a long time. Meagan: That’s a very, very long time. Do you have any tips for parents who may have a NICU baby in the future or anything like that? Ashley: Yeah. I think the biggest thing for me, the first couple of weeks, we went every single day, but we didn’t put a ton of pressure on ourselves to stay for too long. At that point, he really just needed his rest, and he didn’t need to be stimulated by us at all. They didn’t want him to be stimulated. They gave us a couple of hours which was great, but I really let go of the guilt of being there 24/7. There were parents I saw who were there 24/7, and I would compare myself and feel guilty that I wasn’t doing the same. I also had a toddler at home. That was a big thing. In the beginning, he didn’t really need me to be there. He needed his rest. That’s one thing. Give yourself a lot of grace, and do what you need to do. Your baby is getting taken care of under the best supervision. We had the best doctors and nurses. We didn’t need to feel guilty about that. The other thing I didn’t know until a couple of weeks before I was discharged is that we could request a lead nurse. That made a huge difference too because every day, we had a different nurse, a night nurse, a different daytime nurse, and different weekend nurses. We found out from another parent that if we liked a nurse, we could request a nurse to be with our baby every single shift they had. Meagan: That’s awesome. Ashley: Yeah. When we learned that, we got to request nurses that we loved, and it was night and day. They obviously only worked three shifts a week, both of the nurses we requested, but I knew the days that they worked, and I felt so much relief because I knew that they knew my baby, and I knew how they took care of my baby. Meagan: Yeah. That actually sounds like it would be so amazing because you do. You can be cycling through quite a few people in those 8 weeks, so to have that familiar face and that relationship that you can get established, I’m sure meant amazing things for you guys. Ashley: Mhmm, yeah. Absolutely. That’s a tip I wish I would have known sooner. I really think it helped him progress too. I think people had said that having that consistent provider would be really helpful for the baby, and I really think it was. So there’s that, but I think I read a lot of support groups. Again, I was in them and reading different comments. Again, I think just relying on other people. We had a friend whose baby was in the NICU, and she was wonderful. They were wonderful. Again, I think it’s just finding support, and everybody said it feels horrible in the moment, but it’s going to be a blip in this story. It’s just going to be a blip. It was so hard to actually believe that, but now, it’s like, yeah. It went by so quickly. Now he’s here. He’s perfect. Yeah. Meagan: It was all worth it. Ashley: It was all worth it, and I got my VBAC. It was not exactly how I wanted it, but I got it. Meagan: Yeah. You know, we’ve talked about it on this show where even when we get a VBAC, sometimes it’s not the ideal birth or the ideal scenario or situation or even experience that we wanted. In the end, sometimes people are like, “I actually don’t know if I would have chosen the VBAC,” but most of the time people are like, “It was definitely not what I expected, but I’m still happy with the outcome.” Ashley: Mhmm, absolutely. It made me want to have another baby. I’ve heard that on this podcast. In order to have another VBAC or to have that vaginal delivery, it was just wonderful. Meagan: Yeah, it’s funny because I had my VBAC, and it was a really long labor. I’m like, “Okay. I want to do that again, but faster.” Ashley: Yeah. Meagan: Yeah. Maybe someday I’ll have another one. I think we’re done, but yes. Such great info that you’ve shared and such a beautiful story. I’m so glad that he is okay, and that you did not get on that plane and all is well. I was thinking about inflammation during pregnancy and how sometimes people can react differently. I wanted to learn more. I just looked it up really quickly about carpal tunnel affecting during pregnancy. I was shocked. This is quick research, so I don’t know the deep, deep depths of studies around this, but it says that it occurs when the median nerve in the wrist is compressed causing pain, numbness, and tingling in the hand, and it’s actually common during pregnancy. I didn’t think it was as common, but it says it affect about 60% of women during pregnancy. Ashley: That’s wild because I’ve only met a handful, not even a handful– I know other people. I was pregnant at the same time as a long of friends, and only two people that I know who I had talked to had experienced that. I had never met anybody else who said they had carpal tunnel. I’m sure to degrees, sure. Probably maybe mild carpal tunnel is 60% and maybe that severe is not as common. Meagan: Yeah. I’m not digging deep in because I wanted to see what it is affecting. It does say that the hormones can cause you to retain fluid, which can soften the ligaments and forms the roof of the tunnel and inflammation which also brought me down to Omega-3s. I don’t know if anyone ever talked to you about Omega-3s, but Omega-3s can help because fatty acids can reduce inflammation. I struggle with inflammation just from daily activities in my joints with working out and lifting and these things. I take Needed’s Omega-3’s. I thought that was interesting, too. I wonder if you’ve struggled with some form or severity of carpal tunnel and inflammation and things like that or things swelling around the joints causing pressure and pain if Omega-3’s can help. It’s worth asking your provider, right? Ashley: Yeah, for sure. Meagan: I know. It just seems so crazy and like such a high number. But obviously, it happens. There are things that you can do. Sometimes it just gets so severe like in your case that you just needed to have a baby to be done with that. Well, thank you so much again for sharing your stories with us today, and congrats on your VBAC. Ashley: Thank you so much. I am so appreciative of this podcast. Literally, everything I learned about what to avoid and what to do, I got it all from The VBAC Link, so I appreciate it so much. I really think it’s the driving force in me getting to have a VBAC. Meagan: Oh, that makes me so happy. Listen, Women of Strength, if you are still listening and you have recorded your story, listen to just how impactful your stories have been and the things that we share because each of these stories has nuggets of information and education along the way in addition to what we share within the podcast and the blog and on our social media. And here you are. You are just going to help someone else out there get the information and the motivation to go out and do it. Also, a reminder to not get on the plane if we are having symptoms like that. Ashley: Yeah. Meagan: Don’t even consider it, and don’t send your husband and your son. Ashley: Yes, thank God. Meagan: Okay, thank you so much. Ashley: Thank you. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
58:1718/11/2024
Episode 352 Anni's VBAC at a Military Hospital + Navigating Pregnancy & Birth as a Servicemember or Military Spouse

Episode 352 Anni's VBAC at a Military Hospital + Navigating Pregnancy & Birth as a Servicemember or Military Spouse

Anni is a mom of two young girls living in Okinawa, Japan where her husband is stationed with the Marine Corps. In addition to her work as a non-profit grant writer, she volunteers with the Military Birth Resource Network and Postpartum Coalition and hosts their podcast, Military Birth Talk. A big challenge for military parents is creating care plans for older children during birth. They often live far away from family or have recently moved and don’t have a village yet. Anni’s care plan was shaken up as her induction kept getting pushed back and conflicted with her family’s travels.Though her plans changed, Anni was able to go into spontaneous labor and avoid the induction she didn’t really want! Her VBAC was powerful and all went smoothly. She was amazed at the difference in her recovery. Another fun part of Anni’s episode– she connected and met up with two other VBAC mamas living in Okinawa through our VBAC Link Facebook Community! We love hearing how TVL has helped you build virtual and in-person villages. Military Birth Resource Network and Postpartum CoalitionHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. You are listening to The VBAC Link, and I am with my friend, Anni, today sharing her stories. Anni is one of our military mamas. This is the final episode of the week of military episodes. So even though it is a little bit after Veteran’s Day, that’s okay. We are celebrating our military mamas today. Welcome to the show, Anni. Anni: Thank you so much. I’m so excited to be here this week. Meagan: Me too. I also can’t believe that you are here right now. We were just chatting before the podcast about time. You guys, it is 4:50 AM where she is at. I just can’t even believe it. You’re in Japan. Anni: Yeah. We live in Okinawa, so I’ve got to do stuff at weird times if I want to stay in touch with anybody in the States. It’s the military thing. Meagan: Oh my goodness. Yes. She is in Japan. She is a mom of two young girls and like she said, she is living in Okinawa, Japan where her husband is stationed with the Marine Corps. Her personal values are community, joy, purpose, and creativity which all drive how she spends her time. In addition to her work as a non-profit grant writer, she also volunteers with the Military Birth Resource Network and hosts their podcast, Military Birth Talk. So mamas, if you are a military mom, and I’m sure a lot of people are flocking to these episodes this week, go listen to Military Birth Talk. Can you tell us a little bit more about Military Birth Talk? Anni: Yeah. So as you said, it’s a part of the non-profit Military Birth Resource Network and Postpartum Coalition, so MBRNPC for short. That’s an organization that provides resources for military families who are in the perinatal stage of life, so if you’ve just moved to a new duty station and you’re like, “Oh, I need a doula who’s covered by Tricare,” you can go to their website and reach out to one of their chapter leaders. They provide that kind of resource. Also, there is sort of an advocacy wing of the organization that works on policy changes impacting military families. This is our podcast, Military Birth Talk. Right now, we’re featuring mostly just military birth stories, but we’re in our third season and this season, we’re going to be adding some additional episodes like policy conversations, interviews with experts, and that kind of thing. So, as you said, if you’re a military-affiliated person listening and you want to hear some firsthand accounts of what it’s like to give birth within the military healthcare system, we’d love for you to tune in. Meagan: I love it. Thank you so much for doing that and explaining more. Anni: Yeah. Meagan: I just can’t wait for you to share your stories. I do have a Review of the Week, and then we’ll jump right in. Today’s review is by RiverW88. It says, “Gives me hope.” It says, “As a mama who had an unnecessary Cesarean and a poorly planned VBAC attempt that failed and resulted in a Cesarean, listening to these stories and information gives me hope for the future. Not only do I hope to have a third baby and a successful VBAC, but as a doula and an experienced birth photographer, I cannot wait to support other women through their VBAC journeys. I look forward to sending my clients to your website and podcast, and not too far in the future, take your VBAC doula course for myself. I love the way you present facts and inform while giving mamas a platform to share positive stories about a topic that is so scary for so many people thanks to the lack of education out there.” Oh my goodness, that is so true. There is such a lack of education out there and that is why we created the VBAC course that we did and the VBAC doula certification course. So, if you are a parent looking to up your game for VBAC, or if you are looking as a doula to learn more about supporting clients who are wanting a VBAC, definitely check us out at thevbaclink.com.Okay, Anni. Let’s jump in. Anni: All right. So I am excited to share two birth stories. I’ll focus mostly on my VBAC since that’s why we are all here, but I’ll give a little bit of context about my first birth. It was pretty routine honestly. I had a breech baby, and there were no breech vaginal birth providers in my area at the time, so that’s the spark notes version. But to give a little bit more context, at the time, we were stationed in North Carolina in Newburn, North Carolina. There are a few providers out there, but not a ton. It’s sort of remote-ish, but because my husband is in the Marine Corps, we were a little bit limited. I actually was on Tricare Select at the time, so for those of you listening out there who aren’t familiar with military healthcare, as a spouse, you can be on Tricare Select which is where you get to choose your own provider. You don’t have to be seen by the military healthcare system. You pay a little bit extra. Or, you can be on Tricare Prime which is completely free, but you have to be seen within the military network. I was on Select at the time, so I was paying a little bit extra to choose my own provider which is kind of funny because there was really only one provider in that town anyway. This is one of the reasons why flash forward to a few years later, I wanted to be a part of the Military Birth Talk podcast because we often as military families get a lot of advice that doesn’t really fit our life. One of those pieces of advice is to pick your own provider. Do whatever you can to pick your own provider. Sometimes, that’s just not possible. That’s just not true for military families, right? It can be true for a number of reasons, but it’s very true for military families, so choosing my own provider was not really that possible given where we were located. That didn’t really come into play until the end when I found out that our baby was breech. Generally, the pregnancy was great. It was a really empowering, positive experience for me. I loved learning about birth. I really hadn’t been involved at all in the “birth world” until I became pregnant, then I totally immersed myself. I was super excited to give birth. I was super excited for all of the little quirky things like going into labor and my water breaking, seeing my mucus plug come out, and all of the birth nerd things that I had heard people talk about on all of the podcasts like this one that I had been listening to throughout my pregnancy. It was a pretty routine, positive pregnancy. About halfway through, we found out that we would be moving to Kansas at about 6 weeks postpartum. This is another one of those military things that people would say, “Oh, enjoy nesting and have a really quiet, peaceful postpartum.” I was like, “Okay, that goes out the window. Our house will be packed up by the time the baby is born,” because with the military, you have to send stuff super early. There was no nesting, no quiet postpartum period. There was a cross-country drive at 6 weeks postpartum. That was my first wake-up call around how birthing within the military community can be unique. Up until then, because I was on Tricare Select, I was like, “Oh, I’m not really a part of this military thing when it comes to my healthcare.” That started to shift around then. Then around 36 weeks, we got a scan and found out that the baby was breech. I was so upset. I had just spent the whole pregnancy looking forward to this experience that I now wasn’t going to have. It felt like I had been studying for a test or preparing for a final exam that now I wasn’t going to get to take. That’s obviously not true at all, but emotionally, that’s how it had felt. I had gotten so excited about the possibility of seeing what my body could do. It almost felt like I had a sports car and now I was going to be forced to drive it in automatic or something. It just felt like I wasn’t getting a chance to experience this thing that I had gotten so excited about. We were really upset, and my husband was too because he had gotten really excited about being able to support me in labor and all of those things. We decided not to do an ECV. I’m sure your listeners all know what that is. Partially, it was because I wasn’t a great candidate for it. My placenta was anterior, so that increased the possibility of an emergency outcome. I had a high volume of amniotic fluid, so that also decreases the chances of success, and the position that the baby was in, she was completely breech. She wasn’t transverse. She was totally in the wrong position. We were like, “I think we’re not great candidates. Let’s not do it.” We just booked the C-section. The C-section was fine. It wasn’t traumatic, but especially now having had my VBAC and being able to compare the two, it wasn’t a great day. I had surgery, anesthesia, and felt nauseous all day, I couldn’t really hold the baby until 9:00 that night. The silver lining of that, I would say, is that my husband got to spend the whole day holding the baby because I didn’t really feel well. I think that was really special for him after having 9 months of this abstract idea of a baby, and now he got to spend that day with her. I look back fondly on that aspect of it, but otherwise, it was surgery. The recovery was fine. I thought it was, at that point, again, now having had the VBAC and knowing the difference, not really that bad. It was a week and a few days of significant pain, and then after that, it was not too terrible. But again, just not the birth experience that I had hoped for. Then after that, I was not one of those people who was immediately gung-ho about having a VBAC. I think I was a little– I felt so disappointed that I didn’t really want to go there in my mind. I was like, “You know, it might just be easier to schedule another Cesarean and not worry about the emotional disappointment.” I didn’t want to do that either, so I just didn’t really want to think about birth at all for a while. Meagan: That’s a valid feeling and very normal. Anni: Yeah, so I took a big break mentally from birthy stuff. We did have a pregnancy in between our two daughters’ births that actually ended at around 19 weeks due to Trisomy 18 which is a genetic chromosomal abnormality that is incompatible with life, so that is its own whole story. I don’t like skipping over it because we appreciate his life, and it’s a part of our story. We love our baby boy that we didn’t get to spend enough time with. After that, I got pregnant again when we moved to Okinawa. When my first daughter was about a year old or a little bit less, we found out that we would be moving overseas to Okinawa, Japan. We arrived. We had the 19-week loss, and then a few months later, I got pregnant again with our second daughter who is now almost 9 months old. The pregnancy was so awesome for the most part. I had a little bit of anxiety around having just had the loss and feeling a little bit guarded. I would say it took a little bit of time to actually really be able to believe that she would be born. I think for a long time, I just didn’t expect it to work. I think that was compounded by my Cesarean experience. I had this feeling of, maybe my body just doesn’t work or something. That took a little while to get over, but for the most part, the pregnancy was great. Because we live overseas, we are not required to be seen on base, but the off-base options are very limited here, especially in Okinawa. The specific, weird thing about the community here is that because Okinawa is such a small island which many people don’t know that it is a small island. It’s not even off the coast of Japan. It’s floating in the middle of the ocean. Meagan: Really? I did not know that. Anni: Yes. If you look it up on the map, you’d see that it’s just a dot on the ocean. Because it’s so remote, the local vibe here is basically that if the American military is going to have so much presence on this tiny island, they should be caring for their own people which is reasonable. So getting seen out in town is not as easy as it is back in the States because the options are just very limited. The other thing is that really, the only other option that Americans have out here as far as being seen “out in town” which just means off base, is a birth clinic and they don’t accept VBAC patients there. Really, my only option, if I wanted to do the VBAC, was to be seen at the military hospital. So, my care there, I was being seen through Family Medicine. You can either be seen by OB or Family Med. I chose Family Med because I wanted to just continue to be seen by my regular PCM. I thought that that continuity of care was nice. Everything went really smoothly. I was sort of on the fence about the VBAC. I knew I wanted it, but again, I was emotionally guarded. Once we got into the second trimester and I started thinking more about birth, I started doing a little bit more digging thing, reading The VBAC Link Community posts a little bit more carefully. Actually, funny story, I posted something in that group. I can’t even remember what the question was. Oh, it was about induction actually because it looked likely that we would want to schedule an induction so that we could plan to have family fly out to be with us. They had to buy plane tickets and stuff. Even though that was not at all what I wanted to do from a VBAC perspective, it felt like what we would need to do as far as getting care for our toddler. I posted in that group to try to see if people wouldn’t mind sharing their positive VBAC induction stories. Two of the people who responded saw my picture and they were like, “That’s in Okinawa. We’re here too,” so we met up for coffee and I’m good friends with them now. Meagan: Oh my goodness. Anni: Yeah, so shoutout to Sarah and Tatiana if you’re listening. That was really nice to feel like I had a little bit of community here in that way around this very specific topic. I started really committing to the idea of a VBAC. I also, when I say committing, my goal was that I really wanted to have a joyful birth, I didn’t want to suffer. I wanted it to be joyful. I wanted to feel present like I didn’t have the last time. My thinking about it was basically that those were my priorities. If it ends up being that having another Cesarean is what would get me those things, I would rather have that than lose the joy and the feeling of being present. I’m not willing to suffer just to get this outcome. That was my list in my head. I got a wonderful doula named Bridget who was totally on board with my priorities. She and I really aligned around our level of risk tolerance around VBAC because the hospital here on Okinawa, the Naval hospital, had a couple of specific things that they wanted for VBAC. They wanted me to come in right away as soon as I felt any contractions or if my water broke. They wanted me to come in right away, whereas my preference initially was to have labored at home. So that was one example of one of the things Bridget and I talked about around, okay. What’s our preference around how we handle this? Do we want to say, “No thanks. We’re going to labor at home for as long as we can”, or do we both feel more comfortable just getting to the space where you’re going to deliver and knowing that you’ll be there and they’ll be watching to make sure that everything’s fine? Where I shook out on that was that I’d actually rather just go to the hospital sooner. That was actually fine with me. It was really nice to have somebody to talk through that with. It was nice that we felt aligned in that way. She is really used to working with military families. She is a military spouse herself with two young boys, so that was really a really supportive relationship. My husband felt that way with her as well, and she is still a good friend. That was a really important part, I think, of my preparing for the VBAC. The hospital providers were super supportive which I was very surprised about. I didn’t receive any pushback. Anybody who I saw during the course of my pregnancy was totally in support. In fact, I had a TOLAC counseling which they require so they can tell you all of the risks and benefits and whatever. The provider who gave me the TOLAC counseling, I think assumed that I would be coming in blind, so she did her whole spiel. At the end, she was like, “What do you think? What do you think you might decide?” I was like, “Yeah, no. I’m definitely going for the VBAC.” She was like, “Okay, great. I think that’s a good choice.” I was surprised by that. I think people, myself included, expected military hospitals to be very antiquated or by the book or very risk averse, which they are, but in this case, it was really nice to see that they had caught on to the fact that in many cases, a VBAC is not actually more risky. Meagan: Risky. Anni: Yeah, exactly. That was really nice to feel like I wasn’t going to need to be going in with any kind of armor on. So fast forward to the birth, as I had mentioned, I had “wanted” to schedule an induction for logistical reasons. The way that the hospital here works because they are chronically understaffed as many military hospitals are, if you’re having an elective induction, so if it’s not medically necessary, they give you a date, then you call the morning of that date and they tell you what time to come in based on the staffing ratios. Our family who we had called to come for the birth that we had scheduled this whole thing around, arrived, and the next morning, we called as it was our scheduled induction day. I will say that the only family who could come was my sister-in-law and brother-in-law, so my husband’s sister and her husband. She’s a surgeon back in New York, so she only had a 6-day period that they could come. That was part of the reason why we wanted to schedule an induction. They got here. The next morning, we called the hospital, and they said, “Oh, we’re too busy right now. We can’t safely bring you in, so call back at 4:00.” We called back at 4:00, and they were like, “We’re still too busy. We’re sorry, but you have to call back tomorrow morning.” My doula had warned me that this was very common. She was like, “Expect maybe 12-24 hours,” but I was just in this manifesting headspace that everything was going to go great, so I was super disappointed. We went to sleep. We were like, “Oh, we were supposed to be at the hospital tonight.” We woke up in the morning, called the hospital, and again, they said, “We are still too busy. For the third time, we can’t safely bring you in, so you have to call back at 4:00.” I took a long walk by the ocean. We got lunch. We just killed time. I took my toddler to the playground. I’m like, “Okay, this is it.” We called back at 4:00 PM that day and they were like, “I’m so sorry. We’re still too busy.” This was the fourth time. By this time, there was actually a day between when our family arrived and when we started calling. By this time, there was no way they were still going to be here if we had to go for the induction, have what was inevitably going to be a long induction because I never labored with my first, spend the 24-48 hours at the hospital, and then come back, there was no way our family was still going to be here.I was so stressed. They were like, “We know we’ve pushed you now four times. Why don’t you call back tonight at 8:00 or something? We think we’re going to get a discharge between now and then. We’ll see if you can come in at 10:00, and we’ll see if we can start the induction.” I was like, “You know what? Our schedule is already messed up at this point. It sounds like it’s already a crazy situation over there at the hospital. I don’t really want to go into that mess, and I don’t really want to start an induction at 10:00 at night.” I was like, “Can we just come in tomorrow first thing, at 5:00 in the morning?” By this point, it was going to be a Saturday. We were supposed to go in on a Thursday. It got pushed all day Thursday and all day Friday. I said, “Can we push it to the first thing on Saturday morning?” The charge nurse who I talked to said, “Yes, that’s fine.” We go to bed. We wake up in the morning, so happy that finally, today was the day. We say goodbye to our toddler. We get to the hospital at 5:30. It’s super quiet. Nobody was there. We bring the bags up. We unpack. I had affirmations that I had printed out, Christmas lights, music, essential oils, and all of those things. We start unloading the bag. The nurse comes in and gets me hooked up to monitors to do a non-stress test. We do that. I’m sitting there on the monitors for a half hour. Then she comes in and she says, “The NST looks good.” She starts getting an IV ready because one of their protocols is that they want VBAC patients to have two IVs actually. Meagan: Okay, what is the deal with the two IV thing? I’ve been hearing this. I apparently need to dig really far into it. Why two IVs? Anni: They said that one was for hydration. Meagan: Okay. Hydration, like for ORs?Anni: Yeah, and the other is for medication, so if they need to hang a quick bag of something like Pitocin– I don’t even know. It’s so silly because I didn’t have anything. When I eventually did get the IVs, I didn’t have anything in either one. The second one was really hard to get in. They spent an hour and a half trying to get it in. I didn’t even have anything in the first one. I was like, “Nothing is in the first one. If you need to give me meds–” Whatever. Meagan: Stop the hydration and put the meds in, or maybe they need that extra port that they can put in. That’s interesting. Anni: Yeah, so she goes to put the IV in. A nurse comes in and goes, “Wait, don’t put that IV in.” I’m like, “Why?” They were like, “We don’t know. The provider wants to talk to you.” The provider comes back in and she was like, “I’m so sorry, but we didn’t realize that you were a VBAC. We weren’t tracking that. You got pushed, and we won’t induce you on a weekend because we only have one OB and we want to have two,” so we had to go home. They were like, “You have to go home, and you can’t come back until Monday.” I burst into tears. This poor OB was like, “You can totally yell at me.” I’m like, whatever. It was so ridiculous. We go home. We were like, “All right. Now, we don’t know what we will do for childcare.” Thank goodness, my sister lives in San Francisco. Her husband had a work trip that week that got canceled, so she was like, “I can actually just fly out and be there for you.” She has two kids, so that’s why she wasn’t going to come before, but now her husband was going to be home. She hopped on a plane right when that happened. We go home, and we were like, “Okay. We will be coming in on Monday.” We go to bed that night on Saturday, and I woke up at 2:00 AM with contractions in labor. Meagan: Oh yay! Anni: I could cry now thinking about it. It was the beginning of a day that was the culmination of everything I had wanted from a birth experience for the last 3.5 years. I had been having a little bit of prodromal labor that week, but it would be one contraction at 2:00 AM and then nothing else. I woke up at 2:00 AM. My husband was sleeping on the couch by this point in pregnancy because I had one of those massive pillows, and he was like, “I can’t. I don’t fit.” Meagan: I can’t compete with the pillow. Anni: Exactly. I was like, “I’m sorry, but I choose the pillow.” He was on the couch. I woke up at 2:00, and I was like, okay. I’m having a contraction. 15 minutes later, I had another one. I was like, “Okay, I had two, but 15 minutes apart is a long time.” But then, 15 minutes later on the dot, I had another one. Then it was every 15 minutes for the next 2 hours from 2:00-4:00 AM. My dogs were there. I was just really enjoying it, honestly. I was feeling emotional. Nothing was super uncomfortable yet, so it was just period cramps and that kind of a feeling. But I was like, “Okay.” We were supposed to take our in-laws to the airport that day because that was the day that they were leaving. I’m like, “Okay. I know how this works. I’ve heard a bajillion birth stories. I’ll wake up at 6:00. The house will get busy. The contractions will peter out. I’ll have the whole day to do whatever, then they’ll probably pick up tomorrow night after I put my toddler to bed.” So in my head, I’m like, that’s the day. That’s what’s going to happen. The plan was that I was going to drive my in-laws to the airport that morning because my husband was going to pick my sister up late Sunday night. That way, we could split the trips. I didn’t want to do the late-night run. 6:00 in the morning rolls around. I wake up my husband and I’m like, “Hey, I’ve been having contractions for 2 hours, but no big deal. I’ll take Megan and Paul to the airport,” which is an hour away. “I’ll be back later.” He was like, “What are you talking about? You’re not going to take them. Nobody’s going to the airport an hour away if you’re having contractions. They can take a taxi. They’ll be fine.” I’m like, “No. They’re definitely going to stop when everybody gets up. That’s always what happens. He’s like, “No. I don’t care if nothing happens today. You’re not driving to the airport if you’re having contractions.” I was like, “Fine. That’s silly, but whatever.” Everyone wakes up. I’m still having contractions, but they were very short. They were 30 seconds long and very tolerable. There were a couple that I was like, “Okay, I want to get on hands and knees and hang out on my yoga ball.” But for the most part, they were super easy. 8:00 rolls around. We called a taxi for my in-laws and we actually had a babysitter lined up for that day anyway. I can’t remember why, but we decided just to keep her basically and have an easier day. The babysitter arrived at 8:30 and my husband went out. Right as she arrived, my husband went with my toddler to go do something quickly, so I was alone with Brittany, our nanny. I had this one contraction and I was like, “I don’t want to talk to her.” We had just met her at that point. She was new to us, so I was like, “Small talk feels really hard right now. I can’t make small talk.” I was like, “Hmm. That’s kind of interesting.”Meagan: That’s a sign. Anni: But in my head, it wasn’t. It was going to be a 48-hour experience. That was just in my head. Again, I didn’t labor at all with my first, so in my head, this was a first time birth. My body has not done this before. Once our toddler was with the babysitter, I went upstairs and I got back in bed with my dogs. I was just having contractions. I was snuggling with my dogs just trying to stay present. My husband came in and hung out with me for a little while. He said, “You know, if you’re still feeling good, I’m just going to run over to the commissary (the grocery store on base) and grab some essentials because we didn’t think we’d be here this weekend, and now we’re out of milk and eggs and whatever, so I’ll go grab some things, and I’ll be back in an hour.” I was like, “Great, no problem.” He left around 9:00. At 9:45, I was like, “I can’t do this alone anymore.” I feel crazy saying that because it was way too fast to be saying that, but I texted him saying, “I think I need you to come back.” He came back. He brought me some fruit salad because I hadn’t eaten anything yet that morning which I could barely get down. I was in labor for sure, but in my head, I still was like, “This is going to be such a long experience. Nothing is progressing yet.”I got in the shower. That spaced things out for maybe one long gap between contractions, and then right after that, they started increasing. They were getting closer together, and they were more like 7 minutes apart, then 6 minutes apart. I was having to moan through them a little bit. We called Bridget, our doula, to be like, “Hey, what should we do?” I was able to talk to her with no problem in between contractions. I was fully present and lucid, so I was like, “Okay, this means I’m not in active labor because I’m totally present. I can have a conversation,” but then during the contractions, I would really need to put the phone down and moan. Meagan: Okay, I was going to say, but that was in between contractions. Anni: But in my head, again, I was so emotionally guarded around, “I don’t want to expect that this is going to happen. I want to expect the worst.” She was like, “Okay, yeah. They are 6 minutes apart. I would really recommend that you wait until it’s been at least 1 or 2 hours when the contractions have been that close together before you consider going in, but if you want to call the hospital and ask them what their preference is, you can do that.” I was just starting to feel really anxious about laboring in the car. I also just had this feeling that I just wanted to be there. I just wanted to be where we were going to be and feel settled, which surprised me. I thought I would want to stay at home for a long time, but it was the feeling when you have an afternoon flight. You don’t want to hang out at home before your flight. You just want to get to the airport. That was how I felt. I was surprised by that feeling. We called the hospital. We told them what was happenind, and they actually did say, “Yeah, why don’t you just come on in?” We told Bridget. I was a little nervous. I was like, “Ooh, I bet she’s going to think that this is a misstep. We are going in so early.” But I just was like, “That’s what I want to do.” We got in the car. We went over to the hospital and got checked in triage. I was a 1. I had never had a cervical check before ever because my last baby was breech and in this pregnancy, I hadn’t been checked yet. I was super, super tense, and the provider, the nurse, was like, “I can’t really get up there. Your cervix is really high and hard. I can’t really get a good feel, but you’re definitely a 1 or a 2.” So I was like, “Okay, not great.” She left and was gone for a while, I guess, to talk to the provider, and then when she came back in, my water broke, and there was meconium in the water. So I was like, “Okay. All of these things are not great. I’m at a 1. I’m a VBAC. My water is broken, and there is meconium. All of these things are going to make the providers feel urgency around getting this thing going.”But I was like, “Ugh. I definitely don’t want to get an epidural if I’m only at a 1 because that’s a terrible idea, but I also really don’t want to get Pitocin if I don’t have an epidural.” I was really hoping that I could have a natural birth without any medication, but I also again, going back to my list of priorities, I was like, “I want the joy. I want to be present. I don’t want to suffer. If I can check all of those boxes and also experience an unmedicated birth, then that would be amazing, but I’m not willing to sacrifice any of those things.” So after my water broke, they brought me into the delivery room. I just started laboring. They came in maybe a half hour later and said, “We probably want to start some Pitocin.” I was like, “Let me wait on that. Just give me a minute to think about things,” which we can always do. Ask for more time if nothing is an emergency. Thank goodness I did that because in the half hour, I was thinking about it– not thank goodness that there was an emergency, but there was an emergency, and the only OB who was there that day got called away to do emergency surgery, so he became unavailable for the next several. The Pitocin was off the table for the time being, and so I just got to labor on my own. Bridget arrived, and she had me get into a whole bunch of funky positions. The baby was posterior which I knew because I was feeling this all in my back, and so she was having me get into all of these really uncomfortable, asynchronous positions with my legs in all kinds of weird places. It was super uncomfortable, but I knew that it was effective. I kept laboring. As I said, they had trouble getting the second IV in. That took a really long time even though there was nothing in the first one they had put in. I guess I also had two monitors on me. They were Bluetooth monitors, so one for me and one for the baby. I don’t remember that at all, but my doula said that they were messing with them the whole time because they kept moving. I don’t remember that. I think I was just more in labor land than I realized. But I had the two monitors. They finally got that second IV in. The anesthesiologist came to do it, and after he did the IV, he gave me the whole epidural spiel which they have to do for legal reasons which I wasn’t paying any attention to because I was just moaning and groaning and ignoring him. So he left. I kept laboring, and then around– we got to triage at noon and we got checked into our room around 1:00. Around 3:30, they came back in and asked about the Pitocin. I was like, “I need to get more information about this because I need to figure out what I’m going to do for pain management if we’re doing Pitocin.” Bridget was like, “Why don’t you just get checked again and see where you are?” I was a 7. So either I made a ton of progress in that 2 hours, or I wasn’t really a 1 when I got there, and my body was stressed and it clamped up, or the provider couldn’t get a good read. Whatever it was, in my head, I went from a 1 to a 7. Meagan: Massive change. Anni: Yes. I think I giggled. I was just so happy. So they were like, “Okay, well we don’t need to do any augmentation. You’re progressing just fine.” I was like, “Okay. We’re doing this. We’re just going to keep going.” Bridget recommended that I go to the bathroom because I hadn’t peed in a while. I went over to the toilet, emptied my bladder, then had a huge contraction and felt super like I needed to get off the toilet immediately. I hopped off and went back to the bed. A little bit of time passed, and then I started feeling like I had to throw up, but it wasn’t a nausea throw-up. It was like my abdomen was heaving kind of thing. I was like, “Am I pushing right now?” It was this involuntary feeling. I knew about the fetal ejection reflex, but in my head, I thought that was more of a sustained bearing down feeling and this was a more grunty thing. Everybody heard what I was doing, and the nurse who was phenomenal, her name is Cassie. She was such a godsend. She checked and she was like, “Yep, you have no cervix left. You’re good to go.” This was at 5:00. Meagan: 2 hours later. Anni: Yeah. I just couldn’t believe it. I still thought it was going to be hours and hours and hours because I was so guarded, but it wasn’t. There were about 15 minutes between when she checked me and when I really started pushing. I labored down a little bit. The providers lost the baby’s heartbeat at one point which is super common when they’re in the birth canal, but because this provider knew I was a VBAC, and he had experienced some things before and was very risk-averse, he wanted to do an internal fetal monitor. I was like, “You know what? Not ideal. I don’t love it, but that’s fine.” I wanted to maintain that calm environment in the room. I didn’t want people to start freaking out. I was like, “That’s fine. Do what you need to do.” They did the internal fetal monitor. I rolled over to my hip. I wasn’t having those grunting urges anymore, but I could feel the baby moving down on her own. I felt her head start to stretch me, then she sucked back in. It started to feel scary like, okay. There’s no way out at this point. I’m the only one who can do this. I’m going to feel all of this.I gave a couple of really strong pushes. Up until then, I had been breathing and pushing because that’s what my pelvic floor therapist and I had talked about, and I had really practiced that. But the provider again, had nervousness about the heartbeat. The internal monitor wasn’t picking up what they wanted it to, so the nurse was like, “Okay. Let’s give this one really good push.” I gave one really good push. I felt her head come out, then shortly thereafter, her body. My husband said, “Oh my gosh, she’s here. You did it!” They put her right up on my chest, and it was just incredible. Looking back, now I say it was incredible. In the moment, I think I was completely shocked because it was so fast. I had a ton of adrenaline. I had the labor shakes, so my chin was chattering. My husband moved the baby down a little bit because he was like, “You’re going to knock her in the head.” It was just amazing. I felt so empowered. It took me a few hours to come down from feeling shocked, but 3 hours later, we were in our room with the baby, and I had showered already at that point, walked myself to the maternity room where we would spend the next day, and it was just so beautiful. I look back on that day all the time in my head. I relive that day all the time in my head. I would do it again in a heartbeat. It was so incredible, and it was an experience that I will draw strength from for the rest of my life. It was just amazing, yeah. Meagan: Oh my goodness. And being pushed, and pushed, and pushed, and having a plan, and then it changing, and having a plan, and it changing, I mean, it was meant to work out this way. Anni: Yeah, yeah. Meagan: I’m sure you can feel that now. Oh, it is just amazing. It just goes to show that sometimes first-time vaginal births don’t take 40 hours. They can go quickly if your cervix is ready and your body is ready and your baby is ready. I love that your doula was like, “All right, let’s get in these positions.” You talked about going from a 1 to a 7. You may very well could have been a 1, but positional changes and getting better application with the baby’s head to the cervix can make a big difference. Anni: Yeah. I will say I think one of the things that also made a huge difference was that I mentioned I had seen a pelvic floor physical therapist. I had started seeing her around 20 weeks because I thought I had appeased knees at one point. I was like, “I want to nip that in the bud right away.” I went to go see her, and we really worked a lot on relaxing my pelvic floor and how I would need to do that during labor. I thought I was one of those people who was like, “I’m relaxed. I can relax my pelvic floor. That just means not clenching,” but it’s so much more intentional than that. Meagan: It is. Anni: Practicing actually really relaxing my pelvic floor through pregnancy was so helpful because I knew what I needed to do during a contraction to not tense up at all. I think that really helped things progress. Even with a posterior baby, usually that can take a really long time, but it was a really fast labor. I give my pelvic floor therapist at Sprout Physical Therapy if anybody is looking, she was wonderful. Meagan: I love that so much. I love that you pointed out that you did it before pregnancy. A lot of people, me included– I didn’t think of pelvic floor therapy before I had my baby. Why would I have pelvic floor therapy before I even had a vaginal birth? That’s just where my mind was, but it’s just so, so good. Now, I personally have seen a pelvic floor therapist, and I understand the value and the impact that they can make so much more. Like you said, they teach you how to connect and truly release and relax because we might think we are, but we are not. They can help avoid things like really severe tearing and that as well. Anni: I had no tearing. I had a first-degree tear. It was easy peasy. Yeah. Meagan: Yes, yes. I have heard that a lot of people who do pelvic floor therapy can reduce their chances of tearing based on what they know and how they connect to the pelvic floor. Anni: Yeah. Yeah. I’m just super grateful and so grateful for resources like this. I think storytelling is such a powerful tool and listening to all kinds of VBAC stories was really helpful, even the ones that didn’t go as planned because that’s always a possibility. I really wanted to be mentally strong against that. I didn’t want to be crushed and feel like I lost my hopes and dreams. I wanted to come out on the other side of what happened with some sense of acceptance, so hearing all of the stories was so helpful, and having the community here and having my VBAC friends here in Oki was amazing. Meagan: I absolutely adore The VBAC Link Community, and I love hearing that, not only did I meet people who were my friends online, but we connected in our own community because there are Women of Strength all over. You never know, if you reach out there, you will probably have someone down the street. There are thousands and thousands of people in there, so I highly suggest to go to The VBAC Link Community on Facebook. Answer the questions and dive in because there are also stories being shared there daily. Anni: Yeah. I felt so reassured. I think I got 40 responses when I asked for positive VBAC induction stories. There were so many responses, so I was like, “Okay. I can totally do this.” It made the pregnancy easier. Regardless of what the outcome was going to be, it alleviated the anxiety that I had about the induction. So even though it didn’t end up going that way, it definitely made a positive impact on my pregnancy. Meagan: Absolutely, and I know that VBAC groups can make a negative impact as well like it did for me. I was in the wrong VBAC supportive group that I thought was supportive and it just wasn’t. That is why we created this one. There are other amazing ones as well, but that’s why we created this one because we do not handle the B. S. We just do not tolerate it. It is a loving community and only a loving community. That is what it’s for. Anni: Yeah. I was also in the chat feature. There was a chat group for people who were giving birth in the same month. I was in the January group. That was an amazing group of people too. I got so familiar with those names and those stories. People were so supportive of every outcome. There were people there who got their VBACs. There were people who ended in unplanned Cesareans. There were people who at the last minute, decided that they wanted a Cesarean, and everybody was loving and supportive. It was just an awesome vibe. Meagan: It really is. Oh, that makes me so happy because these are exactly the goals that we had when we created these groups. Oh my goodness. Anni, thank you so much for taking the time to be with us today. Congratulations on your VBAC, and I am so, so happy for you. Anni: Thank you so much, Meagan. It was so awesome to be here. I love this podcast. Thank you for everything that you do, and thank you so much for having me on here today. Oh, do you know what? I had one more thing I wanted to share with Tricare, everybody. I’m a Tricare doula. I work with Tricare here in doula. Definitely talk to your Tricare rep if you’re out there listening to see because some of them do offer coverage for doulas. Anni: Yes. Meagan: I just wanted to let you know. Anni: Yes. They just announced a new set of regulations around that. Literally, new laws just came out around that so there are new details around that, but if you are on Tricare Select, you have the option to have your doula be covered by Tricare. Just a quick advocacy plug here, if you’re being seen at a military hospital, you cannot access that benefit which is a huge problem because Servicemembers have to give birth at military hospitals, so Servicemembers themselves cannot access this benefit which is a huge problem. That’s one of the things MBRNPC is trying to advocate to change coming up. So if you are listening out there and you have any access to any kind of advocacy channels, please get the word out that we need to fix that. Meagan: Yes. It does need to be fixed. Talking about hiring the doulas because it’s Select and you go outside, we do have to have referrals from that provider. We have to actually have a referral from that provider for the doula before we can start, and we cannot start before 20 weeks so just to let you know. Even though a lot of people hire doulas early on, Tricare does not allow us to be seen until that 20-week mark. So gear up, plan, know that at 20 weeks, you can start seeing a doula and learn more about it. Oh my gosh. Thank you again so dang much. Anni: Thanks, Meagan. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
50:5713/11/2024
Episode 351  Nicole's Precipitous VBAC with a Nuchal Hand After Moving Overseas

Episode 351 Nicole's Precipitous VBAC with a Nuchal Hand After Moving Overseas

Nicole is a military spouse who had her VBAC in England. She shares what it was like to unexpectedly move overseas during pregnancy, how she navigated not receiving her household goods in time, and how she made the choice to deliver on base versus off. Nicole’s first birth was a Cesarean during the height of COVID. During pushing, she was required to pause, take a COVID test, and wait an hour for the results or risk being separated from her baby after birth. Labor had gone smoothly up until that point, and Nicole knew something had changed after the pause. Things felt different, progress stalled, and ultimately Nicole consented to the Cesarean. Her VBAC was a surprisingly wild precipitous birth with only 2 hours between her first contraction and pushing the baby out! Meagan and Nicole discuss the unique challenges of precipitous births and how important it is to hold space for every birth experience. Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello. Welcome to The VBAC Link. Today is Veteran’s Day. If you are just joining us this month for the very first time, then welcome to your first specialized episode week. I don’t even know what to call it. What would you call this, Nicole? I don’t even know. Nicole: A one-of-a-kind situation. Meagan: Last month in October, we had Midwifery Week and now we have Veterans. Nicole is the wife of a Servicemember and she definitely and experience that I think a lot of military members and moms experience and people don’t think about it. I don’t think about that. When I was having my baby, it was like, Which hospital should I go to? There are 10-15 right around me. Then you’re like, “Oh, hey. I’m pregnant and now I’m moving overseas.” You know? I think it’s something that we just don’t think about. It’s fun to have it be Veteran’s Day and to have a Servicemember’s wife sharing your story today. We might even talk a little bit about navigating the military healthcare system and what choices you made. We learned a little bit about that before we started recording. We’ve got her amazing story today. Where are you right now?Nicole: I’m in England right now. Meagan: You are in England, okay. And that’s where you had your baby. Nicole: Yes. Meagan: Awesome. So England mamas, definitely listen up for sure. All mamas, really. We do have a Review of the Week so I’m going to get into that then we’ll start with your first story. This is from Roxyrutt and it says, “Inspiring”. It says, “Listening to these podcasts has been truly inspiring and I have been on my own hopeful VBAC journey. Listening to other stories has been incredibly helpful in my mental preparation.” We were just talking about that before we started recording as well just how impactful these stories can be for anyone but especially during your VBAC journey. It says, “My due date is April 17th this month–” so this is obviously a little while ago. It says, “I’m hoping to have my own VBAC story to share. Thank you all for what you do.” Thank you so much, Roxyrutt, for sharing your review. As always, we love your reviews. You can email them to us at [email protected] or you can comment “Review” on your podcast. I think it’s on Apple Podcasts, Spotify– I don’t know if Google allows reviews. You might just have to do a rating. But wherever you listen to your podcasts, if you can leave a review, please do so. Okay, Nicole. Let’s get going on your stories. I seriously thank you so much for joining me today. Nicole: Oh, thank you so much for having me. Like we mentioned before we started recording, this podcast has been extremely inspirational to me and it really led me to having the VBAC of my dreams. Meagan: And you had a precipitous VBAC, right? Did you have a pretty precipitous VBAC if I’m remembering right? It was 2 hours or something?Nicole: Yeah. It was so quick. Meagan: Okay. We are going to talk about that. Don’t let me forget about that in the end. It is something that we don’t talk about a lot. Most people think about birth being a long time. Nicole: Yeah. Meagan: Yeah. Precipitous birth can come out of left field and I want to talk about that. But first of course, every VBAC starts with a C-section so let’s hear about your first.Nicole: Okay, yeah. So I had my first in June 2020 so literally right as the world was shutting down. Everybody was terrified with reason, right? I go in. I remember I had my baby shower planned and everything was planning and everything was canceled. I just felt depleted and I was scared. I remember watching videos on how to have a birth and what to do and all of the birthing videos and there was like, “Here’s a segment on if you have a C-section.” I was like, That will never be me. I don’t have to watch this because that will never happen. That is not in my cards. That is not in my birthing plan I typed up and had signed. That is not in my cards. So I decided with my doctor that I wanted to be induced and I said at 40 weeks I had done my time. Get this baby out of me. I had committed to 40 weeks because she kept saying, “Well, we can do it at 38 weeks if you’re comfortable or 39 weeks.” I was like, “Nope. I will do it until 40 weeks. I’ve done my time. At this point, this baby is evicted.” On June 20th, I went in for my induction. Everything went smoothly. I was progressing but not as fast as they would like so we started Pitocin. That went well. I was doing really well and all of a sudden they were like, “I think we need to break your water.” I had heard horror stories about your water breaking and it’s super painful and you’re miserable after it. So I was like, “Well, let’s get the epidural because why would I put myself through that if they have the option to make this smooth and comfortable? Why would I sit there and not be comfortable during this?” So I got the epidural and I just laid there. I laid in bed for a really long time then at about 3:00 in the morning, I got the urge to push. I let the nurses know. They checked. They said I was at 10 centimeters. Everything was good to go. They came in at about 3:10 and I started pushing. I pushed until about 6:00 AM. At that point, at about 5:00 AM, I started getting really hot. I noticed that they had turned the temperature in the room up obviously for baby. I started getting really overwhelmed and really hot. I started to throw up. My doctor turned down the temperature. She was like, “Let’s turn down the temperature. I feel like you’re just getting hot.” I was like, “I’m just hot. I just don’t feel so good. I’m just hot.” They turned the temperature down then a new NICU nurse came in and she turned it up. I was watching her turn it up and I was just so uncomfortable. I started throwing up again and they were like, “Well, we need to pause because everything you’re doing is an epidural symptom but it’s also a symptom of COVID so we’re going to stop you because we have to test you. You can either continue to push–”Meagan: We have to test you.Nicole: Yeah. I had gotten tested before I went in and then during my labor 3 hours in of pushing, they literally stopped me and said, “We need to do a COVID test.” I did a COVID test and it was crazy. You see all of these doctors in scrubs and masks and then all of a sudden they come in in these inflatable suits and everybody has these– which is more terrifying. I’m already scared. Meagan: Yeah, talk about invading your space. Nicole: Yeah, then you’re telling me that I have an hour until this test comes back. I can either continue to push but if I push and have my baby, you’re immediately going to take her away until my results come back or I can pause, not push for the hour and just let my body do it naturally and then resume pushing if my test comes back negative and I can continue to have skin on skin and the one-on-one time with my baby. Meagan: Hashtag, eye roll. Nicole: Yeah. So during that time, I was pushing well up until the COVID test. My baby was descending correctly. I stopped. I waited an hour and something shifted to where she then twisted a little bit and she– once my test came back negative and I was able to push again– was getting stuck on my pelvic bone and I could not get her out. They were tying blankets together and my husband would hold one end of the blanket and I would push and pull the end of the blanket as hard as I could to try and get her down. I was doing everything to push this baby out. Nothing was working. I started to develop preeclampsia so that was red flag number one. Then my baby’s heart rate started to drop in between each contraction which I guess means that it could be around the neck and it’s more concerning if it’s between contractions versus during the contraction. So after her heart rate started dropping and continuously dropped, they decided to call it an emergency C-section. I just remember feeling devastated. I remember shouting– not shouting, but crying to my husband, “I don’t want this. I don’t want a C-section.” My doctor was like, “I have to hear it from you that you are okay to have the C-section.” I was like, “I mean, I guess if that’s the only way to get this baby out but I don’t want it.” I remember feeling the pain from my C-section and feeling so depleted. I pushed from 3:00 to 6:00 then I stopped for an hour. We resumed at 7:00. We pushed from 7:00 to 9:00 and then they called the emergency C-section and I had her at 9:36. It was a lot and I was pushing hard. I just remember getting back to the room, because my mother-in-law was there, and saying, “I haven’t held her yet.” I didn’t want anybody to hold the baby without me holding her first. I had heard stories of people who were like, “Everybody in my family got to hold the baby before I held my baby.” I just remember crying and I cried for weeks. I just felt like my body gave up on me. My recovery was terrible and that’s what my doctor kept saying. She was like, “You have both recoveries. You pushed for so long that you’re recovering from pushing and then you’re also recovering from your C-section.” Then because I pushed so hard and I was trying so hard, I had tore all of the right side abs so I couldn’t even move my legs to get in and out of bed for 4 weeks because my whole ab muscles were just torn. I had to go see therapy for that and I remember trying to drive me and this infant to therapy sessions and I was just in pain and then the drive home– it was so hard. I just felt like I was really bonding with my baby, but I felt like I was so disconnected with myself. I just couldn’t do it. I had to have therapy because I went into postpartum depression. It was the hardest moment of my life because I really just felt like everybody was like, “Oh, it’s so beautiful though. Your body did its job and it birthed this healthy baby.” I just wanted to scream every time somebody said that because I was like, “But it didn’t. I pushed for hours, literally hours, and it didn’t do its job. I had to have my baby taken out of me.” Meagan: You didn’t feel that way.Nicole: Uh-huh. Yeah. People would be like, “Well, aren’t you glad that you didn’t have vaginal tearing?” I was like, “No, but I had hip to hip tearing and not just through the skin. It was muscles and layers.” I felt like everybody was trying to comfort me and it just felt like I wanted to scream at the top of my lungs because I didn’t feel like anybody was understanding what mentally I was going through. Meagan: Yeah. I think that happens so often in the provider world but also just in our family and friends’ world. We get thrown the, “Aren’t you just happy you have a healthy baby?” It’s like, “Yeah, duh.” But then also that thing, “Well, aren’t you glad that didn’t happen to your vagina? Aren’t you glad you don’t have to deal with incontinence?” Or similar things where in people’s minds, I don’t think they realize that it’s causing harm or that there are ill feelings at all. They are just saying these things, but it’s like, “I don’t feel like I birthed my baby and I don’t feel good about it and I’m dealing with a lot of trauma physically to my body, not just even emotionally but physically to my body. No, I’m not feeling great right now and it’s okay that I don’t feel great. I understand that you’re just trying to help and validate me maybe, I don’t know.” Maybe that’s what people are doing but it doesn’t always feel good. Nicole: Yeah, people kept telling me to be mad at my provider. I was like, “I hear you. But at the end of the day, she’s new to COVID just like we are. She’s going into this trying to navigate it.” I think she did and I think she made the best calls, but everybody was like, “Why are you mad at yourself? Be mad at this person.” I was like, it wasn’t her fault necessarily. She didn’t know what was happening. COVID was so new and it was just blowing up in Utah. It was just this big thing and it seemed like nobody was listening to the fact that I was upset with my body and how my body handled this. Everybody was just like, “Well, it’s a healthy baby. Blame this person or that person. It’s COVID.” I was like, “But what about me? You’re not listening to me.” That was so tough. I felt like I was screaming it and people were trying to silence it without purposely trying to silence it. Meagan: Right. Okay, so I have some questions for you. So when they were offering you sheets and it sounds like you were maybe playing some tug-of-war. What I call it in my doula mind is tug-of-war where you are pulling and tugging and all of those things. Obviously, they were really trying to help this baby get out vaginally and things like that. Did they offer you changing of positions even though you had that epidural? Were they like, “Hey, let’s try to get you on your side or get you on your hands and knees?” You said you kind of felt your C-section a little bit, right? Is that what you said? So it maybe wasn’t as deep of an epidural so maybe you could have done hands and knees or something? Did they ever offer anything like that?Nicole: They didn’t. They did try the vacuum three times but it immediately would just pop right off of her head because she was shifted. Meagan: Asynclitic a little bit, maybe?Nicole: Yeah, so they said that after three times it was unsafe at that point and it was going to have the same results. Nothing was going to happen. I didn’t want to do the vacuum, but once we were at that position, I was like, “Let’s just try it.” I agreed to three times and then we were done. Keep it safe. That’s when we started doing the tug-of-war and we did that for a long time. My husband was holding it and he was like, “The first time, you almost knocked me down because I wasn’t expecting you.” I was pulling so hard. I just wanted this baby out. Yeah, they didn’t move me in any positions. I was just on my back. Now that I know better, I wish I would have tried. Meagan: But again, you didn’t know what you didn’t know. For listeners, if you are in a situation where your baby might be tilted to the side asynclitic or transverse and maybe you have done tug-of-war and things like this, and even then, sometimes it doesn’t work. For some reason, the baby is where they are, but a little bit of a tilt to the side especially if there is one side where they feel the baby’s head or try to get on hands and knees to change that pelvic dynamic can help. But I love that they were like, “Let’s do tug-of-war. Let’s do these things.” I love that providers are still encouraging other things in other ways. It sounds like they really did try and avoid a Cesarean by doing a vacuum and doing the tug-of-war. That is super awesome. I was also wondering if you have any tips for moms who have maybe pushed for a really long time like you did and had essentially have vaginal pelvic floor trauma and also gone down the Cesarean route. Is there anything you would suggest to moms? Or even for moms who maybe had a C-section and had this possibly happen. Yeah, do you have any tips that you would suggest to help with healing both physically and mentally?Nicole: Yeah. One of the biggest things that we did which was incredibly helpful– I’ll give you a funny story after– but one of the biggest things that we did was my husband would get out of bed. We breastfed. He would hand me baby. I would breastfeed her and burp her and then he would get out of bed, change her, and put her back down. That was incredibly helpful because all I had to do was go from laying to sitting. I couldn’t pick my legs up to move them out of the bed without it being excruciating, so having him just help me sit up and hold baby made a huge difference. Having that support person there to help do the heavy lifting technically to get in and out of bed was next-level game changer. It helped me. I got to sleep more because he changed the diaper. We took turns then he would sleep during feedings. We were really changing. I do remember going to the pediatrician and my husband talking to the pediatrician and I was like, “Wrong person to ask.” He was like, “She keeps waking in the middle of the night and rocking holding this invisible baby and bouncing it.” It was because I would forget that I gave the baby back to my husband. Meagan: Yeah, because you’re so tired. Nicole: I’m so tired and he would be like, “It’s freaking me out.” I picked up my little Yorkie and I was rocking her. My husband was like, “That’s the dog.” I thought I had fell asleep and the baby was next to me so I picked up the dog. I remember the husband talking to the pediatrician and I was like, “That is the wrong doctor. He knows nothing about my mental state,” and him being like, “It’s terrifying,” but it really did help me. It might have scared him, but it just was so helpful and I just felt like I didn’t have to worry about dropping the baby walking in and out of bed. It helped speed up my recovery because I wasn’t constantly getting in and out at all hours of the night. Meagan: Yeah, that is so impactful. I love that you pointed that out. I know that some postpartum doulas do that too but if your partner is able to help you in that way, I also think it’s really great because that helps them bond with the baby too. I mean, they might not be feeding the baby but they are changing and carrying and soothing the baby back to sleep as well. I love that. I love that you did that. How long did you do that until you were feeling better and getting in and out of bed was feasible?Nicole: It took me about 3 weeks until I felt comfortable and confident. That was another thing. I could feel comfortable but wasn’t confident to get in and out of bed without worrying about a sharp pain or something glitching or stumbling. Meagan: Mhmm. I’m so proud of you guys for being a team and making sure that you took care of that. Nicole: We’ll keep him. Meagan: You needed to take care of yourself and I love that you were like, “This is what we need. This is what we need to do.”Awesome. Well, before we get into your next story which is amazing, we’re going to take a quick moment and listen to me, I guess, about our sponsor. Okay, and we’re back. Let’s get onto this VBAC story. Nicole: So being military, we had decided my daughter was so great and so fun at about 8 months or 9 months and we were like, “Let’s do this again. Let’s have another one. We want them close in age. Let’s try again.” So she turned 1 in June. In May, we decided to go on a long weekend because my husband had just graduated college. He’s military and was going to school which is a whole other added pressure. Meagan: That’s a lot. Nicole: Yeah. We flew our mother-in-law out. She stayed with our baby for Memorial Day Weekend and him and I went to Tahoe for the weekend. We decided starting in May that we were going to start trying again. We were like, on May 1st, we’re going to start trying for a baby. We get back from Tahoe on June 1st. I think it was June 1st. It was right at the end of May and the beginning of June. His coworkers were like, “Guess what? You have orders to RAF Lakenheath in England.” My husband was like, “No, I don’t. You’re kidding. I don’t. That’s a joke.”He called me and he was like, “I have bad news.” We had just dropped my car off at the dealership that morning so I was like, “Oh no, what we thought was a minor issue was huge.” He was like, “We have orders to England.” I was like, “That’s not terrible news. That’s the best news I’ve heard all month.” He was like, “No, that’s terrible,” because he was planning on getting out of the military. Meagan: Oh no. Nicole: We had 2 weeks to decide if he was going to stay in and take these orders or if he was going to get out. We spent 2 weeks going back and forth if this was the best option for our family and if this what we wanted. What could we do over there? We decided that we would go overseas if we decided to wait on having a baby. We cut it off. No more babies at the beginning of June. We were like, “We’re done. We’re going to have our one. Towards the end of our 4 years is when we are going to start trying for our second. That way, we can get back here and have our baby back in the States.” We were like, “We’ll travel with our one child because it’s easier to travel with one than two. We’ll travel with one kid. We’ll do our 4 years there and when we come back, we’ll have our next baby.” It wasn’t ideal because we wanted them close in age, but at least we were traveling and eventually, we would have our second. He took the orders on June 2nd. I was prepping for my daughter’s first birthday. We were having a pool party. I was like, okay. Her birthday’s on June 20th. It is June 16th. I wonder when I’m going to get my period because I don’t want to be on my period and swimming. Meagan: During the pool party, yeah. Nicole: I looked at my app and I was 7 days late. I was like, What? I don’t think that’s right, but let’s just take a test. I took a test and I was pregnant. So, the joke was on us. Meagan: Oh my gosh. Nicole: Yes. We found out in June that we were having our second and we were due to be in England in November. So at the end of the month in November was our DEROS date or the day that we were supposed to be in England and he was supposed to be signed onto the base. We decided that we would just pack up and do this all while I was pregnant. We moved over there on November 15th. Once I got here, I was like, Well, what do I do now? I am halfway through my pregnancy. I have nothing because COVID again, had stopped all of our furniture stuff because the ports were closed and that whole issue of everything being shut down. The world was still closed so we were like, “What do we do?” We had sent our stuff at the beginning of October to arrive in England and they were like, “Well, you’re not expecting anything.” We had bought all of our baby stuff before because we were like, “Well, we’ll just buy it here and ship it over there, and then we won’t have to worry about trying to buy it over there.” There are different sizes of cribs there, and the bedding size is different. I don’t want people to buy us sheets then all of a sudden it’s UK sizes and it doesn’t fit and it’s unsafe for baby. It was a big thing. We bought all of our stuff. I was ready to have it. Then we got here and they were like, “It looks like you’re not going to get any of your household goods until April.”Meagan: November to April?Nicole: October to April because we shipped in October. Meagan: Oh my gosh. Nicole: Uh-huh. Yeah. We were living in temporary furniture that was terrible. We had to go out and buy blow-up mattresses because those were more comfortable than the beds that they gave us. It was wild. Then I’m trying to find a doctor. I’m trying to find a provider. I don’t know what I’m doing. I’ve called all of the birthing doulas because of the podcast that I had been religiously listening to. I was like, “I know what a doula is. That’s what I need.” They were all booked up because by the time we got here in November and I got the chance to interview them, they were all booked up for the month of February when my baby was due.So now I’m sitting here, “Well, what do I do? Do I have the baby on base? Do I have the baby off base?” I don’t know. I don’t know anything about where we’re living. I don’t know anything about the hospitals. I don’t know anything. I’m just guessing off of people’s posts on Facebook, but they are so hit-and-miss. Somebody is going to post a really great story, then all of a sudden, somebody makes a post of a traumatizing story which scares you. It’s like, was the good story one in a million, or was the traumatizing story one in a million? I was just navigating this. I started going to my doctor’s appointments on base because I knew that Tricare covered the OB/GYN. I was trying to navigate how it would cover overseas. I had to make a lot of phone calls and all of that fun stuff. I was like, “Well, I’ll just start on base and see if I need to transfer off base.” On base was okay. It’s way different seeing a military doctor than it is seeing a provider who chooses this field and who wants this field. All of my prenatal care was okay. There were a few things that I wasn’t a fan of and if we weren’t talking about it, I could tell you what is the strep B test, right? Meagan: Group B strep?Nicole: Mhmm. They test you. They swab you to see if you have a skin infection to see if you need to be on antibiotics. In the states, my doctor performed that on me. Here, they gave me a test tube and told me I had 5 minutes to complete it. I was like, “What? I can’t even see down there let alone swab myself.” I just remember crying in the thing and begging people to do it and they were like, “We don’t do it. You have to perform it on yourself.” My husband was home watching our toddler, so I had no support with me. It was definitely different. I looked at the hospitals off base and I was really unsure with the way that I had them. You would give birth in a birthing suite with your husband, then they would send him home and move you to this big room with other moms who had their babies. I was really navigating, what is the best fit for me and how am I going to have this baby and my VBAC? I want this VBAC. Who is going to advocate for me? I don’t have a doula. I’m doing this by myself. My husband only knows so much. He doesn’t understand it all, so he is only retaining half of what I’m saying. I made it to 40 weeks. I was like, “Get this baby out of here.” My mother-in-law was here to watch my daughter. That’s another thing. You have to find childcare for your toddler because you don’t have family around to watch your baby. We were so new here. We didn’t have friends here to watch our baby. My mother-in-law luckily came out and made it for the birth. She watched my daughter. I decided that since she was here, and I needed to get this baby out before she left so I had childcare, I would do a membrane sweep because I was 40 weeks and I think I was 2 days at that point. I did a membrane sweep. That was unsuccessful at 40 weeks and 2 days. I did a second one. That was very successful. We had my membrane sweep in the morning. I remember just doing lunges and squats all day long. We took my daughter to a forest. She just ran, and I did lunges behind her. There are videos of my husband following my daughter around, and I’m in the background just doing lunges and doing anything to keep active, to keep this baby going. I went to bed that night on February 23rd. I went to bed at about 9:00 PM. I woke up at 2:00 AM. It was about 2:30 when I woke up. I felt this really sharp pain in my stomach. I thought he had kicked my bladder, so I stood up on the bed. It was like a movie. You heard the gush, and then all of a sudden, water was just trickling down my legs. I was like, “Well, I still feel like I have to pee, so that was definitely my water breaking not me having to go to the bathroom and him kicking my bladder,” which signaled me having to go to the bathroom. My husband had just come to bed at about 2:00 AM. He had only been asleep for about 30 minutes. I was like, “Hey, no rush. This is going to take hours.” Again, nobody thinks that labor happens fast. I woke him up. I was like, “No rush. I just need you to go downstairs and get my military ID,” because at this point, I decided to have him on base. I was like, “I just need you to get my military ID because they are going to ask for that information in labor and delivery. Let them know that my water broke and that we would be in in a few hours. No rush. I’m going to take a shower. I’m going to go back to sleep. I’m just going to sleep this off. We will wake up in the morning, say goodbye to Naomi, and then go to the hospital.” Again, I had told my daughter that I would see her in the morning, and then I left the room that night saying, “Why did I say that? There’s no guarantee.” I had been saying for weeks, “I hope you sleep good,” and that’s it. Then of course, the one time that I accidentally said, “I’ll see you in the morning,” I wasn’t seeing her in the morning. He calls Labor and Delivery and they were like, “Well, because of her past, we want her in now.” I was like, “No. No. I don’t want to labor in a hospital. I want to labor as long as I can at home. I want to do this by myself. I want to be comfortable. I don’t want people to tell me what I should be doing then it going against what I want to do. I really want to do this by myself.” He’s arguing with Labor and Delivery. He was like, “Well, let me talk to my wife, and I will call you back.” I was like, “I’m going to get in the shower real quick and wash myself off because my water just broke.” Meagan: Had you started contracting at this point or just trickling? Nicole: Very minimal. It was every 5 minutes. It was very minimal, nothing crazy. I could totally go clean my car at this point. I was walking on water. My water broke. I’m great. I feel good. I feel nothing. I’m in the shower. All I did was put shampoo in my hair. I didn’t even get it rinsed out, and all of a sudden, my contractions went from 0 to 100. I could not breathe. I could not talk through them. I could not even do anything. I felt like my mind was so focused on the pain. My husband was trying to ask me questions, and I couldn’t even register what he was saying through each contraction. I told him, “Call them back because we are on our way now. I need to get out of the shower. I need you to throw conditioner in my hair while I have this next contraction. I need to rinse it out, then we need to go.” He’s trying to talk to them and put conditioner in my hair. I’m having a contraction. I put my pants on, and as I’m pulling them up, another contraction hit. Then they started going from having a contraction for a minute and a half to a break for 30 seconds, and then immediately back into another contraction for a minute and a half. I was like, “What is happening?” I never felt this with my daughter. I had the epidural. Things went so smoothly and so slowly that it was cake. This was the next level. I waddled into the car. I remember sitting in the front seat and saying, “I can’t do this.” I climbed into my toddler’s car seat because I had the infant car seat up, and I couldn’t fit in between the two car seats, so I had to sit with my knees in my toddler’s car seat. I was holding onto the back headrest for support and just standing there. I was on my knees, chest against the back of her car seat, and I’m just holding onto this headrest with every contraction. I’d have three in a row. I’d have one for a minute and thirty, a break for 30 seconds, a minute and thirty, a break for 30 seconds, a minute and thirty, then I’d have a two-minute break, and then they would kick back up again. My husband was just flying. The roads were closed on our normal fastway to base. We lived 30 minutes away, so it was an extra 15 minutes to get to base. He was flying at 2:50 in the morning at this point. I’m sorry, it was 3:50 in the morning at this point. We get to the hospital at 4:05. I am hugging a tree outside because my husband couldn’t figure out how to open the wheelchair. Poor guy, he was trying so hard to help me. Meagan: I’m sure. It was a frantic moment. Yeah. Nicole: Yeah. He couldn’t figure out how to open it. He had to go to the ER and get somebody in the ER to help him. They were wheeling me up, and I remember yelling at them because they kept saying, “We’ll have to do triage and see if you’re in active labor before we can bring your husband back.” I remember telling this poor ER nurse, “You’d better not split my husband and I up. I am not doing triage. We are going into a room. We are having this baby.” She was like, “Ma’am, I think we’re just going to put you in a room. I don’t think we are going to need triage.” I get into the room. I am continuously having contractions. They tried to stop me to do a COVID test. I death-glared this guy because he wanted to do a COVID test on me. I was like, “Been there, done that. Not doing that again.” I remember them trying to put an IV in my hand. I was like, “I don’t need an IV. This kid is coming out of me. I know I tested positive for the strep test, but I don’t need an IV. He’s already out. There’s nothing that this is going to help.”I get up on the bed. They tried to get me to lay on my back to push and I couldn’t. I remember my husband was like, “No, that’s not how she wanted to push. She wants to push with her knees on the bed and her chest against the back holding on. That’s how she wants to deliver him.”He was advocating for me which I was so grateful for because I felt the entire time that he didn’t know what I wanted because he didn’t understand my terms, he didn’t understand why, he didn’t understand the VBAC world, so I felt like I was talking to thin air. So for him to sit there and be like, “No, that is not how she is going to deliver this baby. She wants to be on her knees hunkering down.” I did. I got up there. I pushed two pushes, and he was out. His hand was stuck to his face. Meagan: Nuchal hand, wow. Nicole: He was holding onto his face. He got a little stuck because of his elbow, so after I got his head out, they made me flip over and deliver him on my back which I was totally okay with because we had done the hard part. I remember my husband saying that was the weirdest thing watching me turn around with this baby hanging out. He was like, “You just flipped around like it was nothing.” I was like, “I knew he was fine.” I tore because his hand was up and it was added pressure. But yeah, he came out in two pushes. He was born by 4:36, so 2 hours and I had my baby. It was absolutely wild. I just remember that I had him. I was just in the chaos of it, and about two minutes later, my husband was like, “Nicole, you had a VBAC.” I just started shouting it. I was like, “I had a VBAC.” It didn’t even dawn on me in the craziness of it all that I pushed this baby out of me. I was just like, “Is he okay? Is he healthy? Does everything look good? Are you sure he has 10 toes and 10 fingers? Is everything good?” My husband was like, “Nicole, you had a VBAC. You really did it.” Yeah. It was crazy. He came so fast which was unexpected and nobody tells you about that. It was just wild, but I had a VBAC. Meagan: You had a VBAC with a nuchal hand too. That can be a little tricky sometimes, right? That is amazing, but I love just how intuitively from the very beginning, your body too was like, hands and knees. Forward-leaning position. That’s what your body intuitively was telling you to do to get this baby here. I love that you just went with that. I love that he advocated for you despite not really understanding. I can relate to that. My husband did not understand why I wanted to do what I wanted to do, but it’s so nice to have them be there for you in that ending moment when it really matters so much. Nicole: Absolutely, yeah. I was shocked. When he started saying it and he was like, “No. She wants to push like this,” I was like, “What? You listened?” Meagan: You listened. I love that. Oh, well thank you so much for sharing that story. Huge congrats and man, precipitous labor like you said, people don’t talk about it. It does happen. It’s funny because I had a long, 42-hour labor. Someone asked me, “Would you rather have a long labor that took forever like that or would you rather have a precipitous labor?” I had said that I really wanted a fourth and I just hoped it went faster. I don’t know. I don’t know which one I would prefer because long is exhausting and hard, but man, precipitous– and I have seen them. I have supported them as a doula and seen 2-3 hour-long labors. It’s a lot of change in a body to happen in such a short period of time, and it’s so intense. I mean, it is the next level. So, I don’t know. Nicole: It’s crazy. It’s crazy that they are so fast, but your body just knows what it’s doing. That blew my mind. With my daughter, I felt like I was trying. I was listening to everybody, and they were telling me what to do. I was just following suit, but with this one, there were no decisions being made. My body was like, “This is how it’s going to happen and that’s it.” I remember shouting for the epidural when I got in the hospital room. I was like, “I want that epidural. Call the anesthesiologist now.” They were like, “Honey, I think he’s already here. I don’t think we have time for that.” My body was like, “No, you’re not sitting down. You’re not going to do this. This is how–” I didn’t even have time to focus on my breathing. My body was just doing it itself which is crazy thinking back on it. My body just knew. I was so down on myself thinking my body had failed me, but then having a super fast labor, my body was just like, “Nope, this is how we’re going to get it done and that’s it.” Meagan: Okay, so with precipitous labor too, like you said, it went from 0 to 100 like that. Do you have any tips for moms with that experience of that type of intensity? Obviously, listening to your body and getting to your birthing location on time. I’m assuming that’s continuing. Sometimes, I feel like it can be really intense when it feels like they are ramping up and then they piddle out. But it does, it seems to ramp up, like you said, from 0 to 100 and it hangs on. It holds on tight and it is not stopping.Nicole: Yeah. Definitely listen to your body. I felt like I spoke up a lot with what was happening at one point. I’ve always been this way where there are certain sounds that make me nauseous if I’m under a lot of stress or if I’m feeling sick, so my husband talking– it’s funny because he was like, “Say your affirmations. You are brave. You can do this.” His talking was making me nauseous. I was like, “Stop. Stop talking. Although it is what I want to hear, it is not helping.” Being super open about what was happening like when he went to get the wheelchair, I was like, “I can’t sit in this car. I have to get out.” He was like, “Just sit in the car. Let me help you.” Being super aware and open about what I was feeling and what my body was telling me to do because going up and holding onto this tree, and every time I walk past this tree at medical, I’m like, “I almost gave birth right there had we not gotten that wheelchair open.” Hunkering down on that tree gave so much more relief that it was sitting in the car waiting for him. Although, I know that the car probably would have been the safest option for me rather than the tree with dirt and bushes–Meagan: Hey, that’s actually pretty cool if that happened. Nicole: Right? But knowing what it was and being communicative. Even through all the chaos, every second that I could, I was saying, “This is what I need right now. This is what I’m feeling.” That was helpful not only for myself mentally because I didn’t have the option. Things were just happening, but mentally being aware, and also allowing my husband to help me and support me where I needed was also really helpful. Meagan: I love that. Speak up. Follow your body. Have an awesome partner to help guide you through. I think too like what you said earlier, he listened. That goes with speaking up, talking about our feelings, and talking about our desires. Even if you don’t think it’s being understood or really heard, it probably is. Nicole: Yeah. It was just so crazy to me with him being like, “I’m so confused why somebody would want to push like that,” then him being like, “No, she’s going to push like that.” I was like, “What? You remembered.” Even in all the craziness, and he thought for sure when I told him to stop when we were driving, he thought I meant to stop the car because he thought I was going to have the baby before I could finish after my contraction, “Stop talking.” Yeah, so even through all of the craziness and his mind going rampant, because he’s going through it too thinking, “Am I going to deliver this baby on the side of the road?” Now that we’re in a different country, who do we call? Do we call 9-9-9 or do we call 9-1-1? Do we call base or do we call locals? We’re in the middle of the country. His mindset is going, so having him say that in the craziness was even more powerful. Meagan: Mhmm. Oh my gosh. Well, huge congrats again. Thank you so much for coming on and sharing your story. I do know that it’s going to impact someone out there, probably hundreds and thousands of people to be honest, so yeah. Thank you so much. Do you have any other tips or any advice that you’d like to give to any moms in regards to VBAC, in regards to birth, in regards to preparation, or in regards to navigating military changes? Delivering on base or off base? Are there any other suggestions that you’d like to give? Nicole: I would say to really trust your instinct. I was obsessed with my first doctor with my daughter and she was my second daughter going into this. Obviously, I couldn’t keep her. I tried to get her to come over here, but she wouldn’t. Trust in your instinct in what you think is right for you and your baby. It’s so interesting to where you believe that this is one thing and this is how it should be, but then when your instincts are kicking in and they are telling you, “This is what’s best for you and your baby,” it’s a whole other path. I just recommend to listen. Listen to your body. Listen to what your gut is telling you. It will fall into place. Things are scary and sometimes things are wild, especially with the military and moving in the middle of a pregnancy. It is terrifying. I’ve known spouses who stay after and they bring their baby over when their baby is 8 weeks old and can finally get a passport. But knowing that you can do it overseas, I definitely think it’s special because your partner is there. It’s just a crazy ride, but if you trust yourself, your self will always guide you in the right way. Meagan: Yeah. We’ve been saying it since this podcast started in 2018. Your intuition is so impactful. Trust it all the way. Go with it. I love that advice. Thank you. Nicole: Thank you. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
47:1211/11/2024
Episode 350 Wyn's VBAC with a Unicornuate Uterus + Follow Your Intuition

Episode 350 Wyn's VBAC with a Unicornuate Uterus + Follow Your Intuition

After having an HSG (hysterosalpingogram) due to infertility, Wyn was diagnosed with having a left-sided unicornuate uterus. A unicornuate uterus is a rare condition in which the uterus is smaller than normal and only has one fallopian tube. Common complications from a unicornuate uterus include infertility, IUGR (intrauterine growth restriction), and preterm labor. Wyn had two unsuccessful IVF treatments followed by two miraculous natural pregnancies! Her first pregnancy ended in an unexpected Cesarean due to a fever and tachycardia in her baby. Her placenta was difficult to remove during the surgery and she was told she had placenta accreta. The OB who performed her surgery also said she had “very interesting reproductive anatomy”.Wyn deeply longed for the opportunity to try for a VBAC and experience physiological birth. Her original midwife supported her decision to VBAC and Wyn made sure to prepare physically and emotionally. At 41 weeks and 1 day, she went into spontaneous labor, declined cervical checks and other interventions she wasn’t comfortable with, consented to the things she felt good about, and pushed her baby out soon after arriving at the hospital. Wyn also shares her experience with taking Needed products during her pregnancy and postpartum period this time around. Her strongest advice for other women preparing for VBAC is to find a supportive team and really listen to what your intuition is telling you to do. Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Welcome to the show. We have our friend, Wyn, from Alaska with us today. She’s going to be sharing her VBAC story and Wyn has a pretty unique– and maybe Wyn, you can tell me more. Maybe it’s not as unique as it feels but a pretty unique situation where you had a diagnosis of a unicornuate uterus. Tell us a little bit more about that. I feel like we hear some uterine abnormalities. I’m quoting it where it’s bicornuate and all of these different things and people say, “Oh, you can’t have a vaginal delivery with this type of uterus or this shape of uterus,” but tell us more about what it means for you and what it meant for you back then. Wyn: Yeah, so they found it through an HSG test where they shoot dye up through your uterus and through your fallopian tubes. Basically, just one-half of my uterus formed. I guess when the uterus is forming, it’s two tubes that connect and open up so just the one half formed so I have a left-sided with a left fallopian tube. I have both ovaries so you can still conceive but there are less chances because you have just one side. Then once you get pregnant, there are higher chances of miscarriages because the blood flow is less. Intrauterine growth restriction and preterm labor are common and then a lot of time, the breech position is common as well. Meagan: With this one, you did experience IVF as well, right? Wyn: Yep. Meagan: Yeah, we’ll have to hear more about that too because there are a lot of people who are getting pregnant via IVF which is amazing but there are some things that come with IVF as well. So we want to talk a little bit more about that before we get too deep into things. I do want to do a Review of the Week, then we’ll let Wyn start sharing away. This review is from I think it’s Amir, I think. It says, “This podcast was my constant source of reassurance and inspiring stories throughout my last two pregnancies. I achieved my VBAC in 2021 and was so empowered with so much knowledge and mental strength going into this birth because of The VBAC Link. I had my second section in 2022 which was not what I wished for but I do plan on having more children and know that VBA2C (vaginal birth after two Cesareans) is a possibility for me because of this podcast. I continue to listen to your inspiring stories each time I hop in the car and I’m so grateful for all that you share. I hope to share my own redeeming story with you in time too.” Well, Amir, thank you so much for your review. I also wanted to mention that for Amir, not only does VBAC after two Cesareans apply, but there are even risks that are lower because she has had a vaginal birth. So if you have had a vaginal birth and then you want to go on to VBAC, your chances are even higher for a VBAC and lower for things like uterine rupture. I wanted to throw that tip out there. But if you have not left us a review yet, please do so. We love them so much. You can leave it on Google or wherever you listen to your podcasts or you can even email them. Okay, Wyn. Let’s get going into this story. Wyn: Okay, thank you. Thank you for having me. I feel like it’s come full circle. I listened to The VBAC Link Podcast a lot throughout my pregnancy and even before that and I still do today. So I hope that maybe a little detail from my story resonates with somebody and helps them as well. Meagan: 100%. Wyn: Yeah. A little back story, before I got pregnant, we did try for a while and my cycles were regular. I was healthy. I didn’t see anything wrong but we went in and got the test done with bloodwork and they suggested the HSG test. I saw my original OB then I had a second opinion with another one. Both said it was still possible but that IVF was probably going to be more likely. And of course, this is all happening in February and March of 2020. Meagan: Right as the world is in chaos. Wyn: Yeah, so I started researching IVF options. We live in Alaska so there isn’t a reproductive endocrinologist here and I found a clinic. Our closest option was Seattle or Portland. I found a clinic in Portland that was willing to work with us. In August 2020, I went down for my first transfer or egg retrieval and transfer. That was a chemical pregnancy or early miscarriage. But also, that was the closest I had ever been to being pregnant. It was a little bit hopeful at the same time. We regrouped and went down in October and had another transfer that didn’t take at all. We decided to take the rest of the year off and revisit it after the beginning of the year. That brings me to my first pregnancy which was a little miracle and I got pregnant the cycle after my failed transfer naturally without IVF. Meagan: Yay!Wyn: That was very exciting. I was a little bit in shock like, How can this happen? Because it had been a couple of years of trying. I went back to the second OB who I had a second opinion from. We didn’t really vibe very well. I went in early at 6 weeks because I was nervous and she was like, “Why are you here so early?” So I didn’t end up rebooking with her but I rebooked with a midwife who some of my friends had seen during their pregnancies and explained my situation and she got me in that week. We did an ultrasound and saw a little heartbeat. It was going well. She had me come in the next week too to just make sure things were progressing and everything was good. Meagan: Yay. So it was IVF treatment, IVF treatment, and spontaneous?Wyn: Yep. Meagan: Yay, that’s awesome. Wyn: It was pretty exciting and just gave me some renewed faith in my body too that maybe it could do it. Meagan: Yeah. Wyn: So pregnancy went smoothly. I felt great. I loved being pregnant and I was measuring small consistently from about 30 weeks on about 2-4 weeks behind. I wasn’t really worried about it because I figured I had a small uterus but they suggested a growth scan. I went ahead and did that and baby was all fine. She was small and we didn’t know it was a she. We didn’t find out but then my husband and I did some birth prep. We watched The Business of Being Born and that solidified my desire for a non-medicated birth. I was okay being in the hospital because there were unknowns with the uterus and I just wanted to experience it all. I wanted to experience everything without medication. I have a low tolerance to medication so I didn’t want anything to derail the birth. I made it to 40 weeks. I made it to my due date because it’s common that you go into preterm labor with a unicornuate uterus but I made it to my due date so that was exciting. I was feeling anxious to meet my baby but I was feeling good. I was just listening to whatever the midwife told me or suggested because I was a little bit nervous so she offered a membrane sweep and I thought, Okay, I’ll go ahead and do that. It’s not medicated. But still, it was an intervention that I learned later. Then we did a non-stress test at 40.5 weeks and she started suggesting induction. I went into my 41-week appointment and I still didn’t want to do any medication but she offered the Foley bulb which he offered to put in there at the office and I would just come back the next day if it didn’t come out or if it started things then it started labor. Meagan: Then great, yeah. Wyn: Yeah. She went to put it in and my water broke. Meagan: Oh, change of plans. Wyn: Yep. Yeah. It was just a trickle. It wasn’t huge. She sent us home and told us to rest and to come back in the next morning. Come in if labor progressed or come in the next morning to start more induction since my water was broken. I went home and relaxed. I woke up about 2:00 in the morning to my water fully breaking everywhere and contractions started pretty instantly. I had adrenaline and I didn’t ease into it. They were 5-6 minutes apart, full-on contractions. Within a couple of hours, they were closer like 3-4 minutes so we went ahead and went to the hospital. There was a lot of rushing around and a lot of nurses coming in and out. I was in my own little world. I was stuck on the bed because they wanted to have the fetal monitor on. I was holding on for the non-medicated. I declined the IV because I thought that would be that much easier. Meagan: Easier access, mhmm. Wyn: But I had spiked a temperature from my water breaking. I couldn’t keep any Tylenol down so we went ahead and did the IV which took over an hour to get in because I have bad veins and lots of people tried and they eventually got an ultrasound to find a vein. Meagan: I was going to say for anyone who may have harder veins or situations like that, you can ask for the head anesthesiologist if there are multiple and for an actual ultrasound and it can really help them and get that in a lot faster. Wyn: I wish they had started that sooner. I was just being poked. Meagan: Lots of pokes, mhmm. Wyn: Yeah, and trying to labor through at the same time. They got that in. It didn’t really calm down. The baby’s heart rate was elevated to 170-180. It wasn’t really slowing down at all. Our midwife seemed a bit concerned and started suggesting a C-section. Yeah, just laying there, I was ready to give up. I didn’t want to, but she checked me and I was only 5 centimeters so I wasn’t even close to getting there.They prepped me for surgery. I went in and baby girl was born in the morning at 8:50. Of course, they took her straight away to the warmer then I didn’t get to hold her until the recovery room. I was still shaking from medication. Basically, the birth was completely the opposite of what we had hoped for. Meagan: What you had planned, yeah. Wyn: Then later, the OB who did the surgery came in and told me that I have very interesting reproductive anatomy. He confirmed it was a left-sided unicornuate uterus. There was a small horn on the right side and my uterus, I guess, was really stretched out and almost see-through. Meagan: A uterine window. Wyn: Then the placenta was really attached and they had to work to get that out. They labeled that as placenta accreta. I was advised not to labor again if we ever had another baby and just to plan a C-section. I felt like I went through all of the stages of grief after and in postpartum for my birth. First, I was in denial because I just blocked it out. I was happy to have my baby. Then you add the sleep deprivation and postpartum hormones and I was a bit angry at myself for not advocating but also just all of the suggestions. Baby wouldn’t have changed anything. It was just a lot of what if’s. Meagan: Which is hard. It’s hard to what if this and what if that. Sometimes those what-ifs come up and we don’t get answers. Wyn: Yeah, but it just fueled my fire to try for a VBAC. Meagan: Mhmm. Wyn: So that was my first birth and C-section then our second pregnancy which again, we felt like our little girl was a miracle so we just didn’t know if we would be able to conceive again naturally or if we would have to go through IVF. We waited a little bit and another little miracle came in September 2023.Meagan: Yay. Wyn: Yeah, that was pretty exciting. Of course, I had been researching VBAC from 6 months postpartum with my daughter. I felt like my best option for a physiological birth or as close to it would be at home. I didn’t want to fight the whole time in the hospital so I contacted two home birth midwives and they were both very nice and informative. They felt like I could VBAC but neither were comfortable supporting me at home with my previous birth– Meagan: And your uterus, yeah. Wyn: They both suggested I go back to my original midwife. I was a little upset at first that they wouldn’t support it but I also understood. I made an appointment with my original midwife. I went in with my guard up and ready to fight for the VBAC. She surprised me and was actually supportive of it. She said that we would just watch and see how things would go. She said there wasn’t any reason why we couldn’t try. I was a bit surprised but wondered if she remembered all of the details or had looked at my records. I just went with it at first but eventually, we talked about everything that happened during the birth. She got second opinions from people in her office and it was okay. Meagan: Awesome. Wyn: Yeah. I also reached out and hired a doula, Dawn, who was a wealth of information and super supportive. We met regularly. She gave me exercise assignments and movements for labor and positioning. She was just there to help me debrief after each appointment with my midwife. If anything was brought up, she gave me information or links so I could feel confident going forward. That was really cool. I saw a chiropractor and did massage. I drank Nora tea from about 34 weeks on. I just tried to cover all my bases to get the best outcome. This pregnancy, I actually grew quicker and was measuring ahead, not behind. A growth scan was suggested again, but I respectfully declined because I felt like everything was okay. I was just trying to lean into my intuition and I didn’t want to get a big baby diagnosis that could possibly–Meagan: Big baby, small uterus. Yeah. I don’t blame you. Wyn: Yeah. Eventually, I ended up evening out at 37 weeks and was measuring right on. I just was a little bit quicker I guess. So I made it to my due date again at 40 weeks and I was offered a membrane sweep. I was offered a cervical check. I declined everything. I was doing good. I knew I went over with my daughter so I was prepared to go over again. 40.5 weeks, induction was brought up. I said I wouldn’t talk about it until 42 weeks. Meagan: Good for you. Wyn: We scheduled a non-stress test again at 41 but I didn’t make it to that because I was starting to have cramping in the evenings. I wouldn’t consider them contractions but they were noticeable. Things were happening. I was trying to walk every day and just stay mentally at ease to keep my body feeling safe. So at 41 weeks exactly, I was having cramping in the evening. That was a bit stronger. I was putting my daughter down. My husband and I watched a show. I didn’t say anything to him or anything because I didn’t want to jinx it. We went to bed at 11:00. I fell asleep and slept really hard for an hour and a half. I woke up to contractions starting again full-on. I thought my water broke but I don’t think it was. I think it was just bloody show originally. Meagan: Yeah.Wyn: I got up. I sat in the bathroom for a little bit and I was just super excited that it was starting on its own. I held out. I tried to time contractions a little bit at first. I knew it was happening so I just moved around the house quietly. I went and laid with my daughter for a half hour while she was sleeping because that was going to be our last time as the three of us. Yeah. I kept moving around for another half hour or so. By then, I needed the extra support. I woke my husband up. We texted our doula, Dawn, and she told me to hop in the shower for a little bit and she would get ready and head over soon.She made it about 3:30 AM and I think I was in pretty full-blown labor. I was mostly sitting on the toilet laboring in there but I came out to the living room when she came and I was on all fours. I made a music playlist. I had the TENS unit. I had all of these coping skills prepared and I didn’t use anything. Meagan: You were in the zone. You were in the zone. Hey, but at least you were prepared with it. Wyn: Yeah, so about 4:45-5:00 in the morning, she suggested if we felt ready that maybe we would head into the hospital. My body was kind of bearing down a little bit wanting to push. We called my mom to come over and stay with our daughter. We called our midwife. She actually lives in our neighborhood. We called to give her a heads-up to get ready to meet us at the hospital. We got there at about 5:45. They did intake and called a nurse to bring us up to the room, and that nurse was our only real hurdle in the birth. She was not really supportive of natural birth or physiological birth. She made a couple of comments. She was trying to force me to get checked to admit me. I was obviously in labor because I was kind of pushing. I declined all of that. Eventually, she ended up not coming back in. She switched out with another nurse or maybe they told her to switch out, I’m not sure but that was nice that she removed herself from the situation. Meagan: I was going to say, good for her for realizing that her views didn’t align with your views and that she probably wasn’t needed at that birth. I don’t love when people are that way with clients of mine or whatever, but for her to step away, that says something so that’s really good. I’m glad she did for both of you.Wyn: Yeah, before she left, she was trying to get an IV too. She couldn’t get an IV. I don’t know. Meagan: She was frustrated and you’re like, “Yeah, you could go.” Wyn: So yeah. Again, I was noticing all this going on but I was in my own little world. We got there. Our midwife, Christina, showed up. She asked if she could check me. I didn’t want to have cervical checks but because I was getting pushy, she didn’t want me to not be fully dilated and start pushing. I let her check and she said, “You’re complete and baby is right there. Lean into it. If you want to push, start pushing.” I couldn’t believe it. I prepared for labor. I had a moment that I had to wrap my mind around it because I couldn’t believe we were already there to start pushing.I had requested my records so I was able to see all my time stamps. At about 6:30 was when she checked me. I pushed for about a half hour and the baby was born at 7:09 in the morning. It was exactly 41 weeks and 1 day, the same as my daughter. Meagan: Wow, and a much faster and much better experience. Your body just went into labor and was allowed to go into labor. You helped keep it safe to do what it wanted to do. Wyn: Yeah. Yeah. I was really excited to just be able. My body just did it all on its own which was pretty awesome. It was a pretty awesome feeling. Meagan: Very, very awesome. Do you have any tips for people who may feel strongly about not getting cervical exams or not getting IVs or doing those things but may have a pressuring nurse or someone who is like, “You have to do this. You have to do this. Our policy is this.” Do you have any advice on standing up for yourself and standing your ground?Wyn: Yeah, be respectful but also just be really strong. I had my husband and my doula backing me up. We prepared for things like that. I had a birth plan that had my wishes on it so just yeah, standing strong and keep in with what you want. But also be ready to switch gears. Like I said, I didn’t want a cervical check but when my midwife got there and suggested it, I felt like, okay. I can go ahead with that. Meagan: You felt like it was okay at that point. That’s such a great thing to bring up. You can have your wishes and desires. You can be standing your ground and then your intuition may switch or your opinion may switch or the situation may switch. You can adapt with how it’s going or change your mind at any point both ways. You can be like, “I do want this and I actually decided I don’t want this anymore. I changed my mind.” We ask in our form, “What’s your best tip for someone preparing for a VBAC?” You said, “Find a great support team. Research all of the facts to make informed decisions and really lean into your motherly intuition.” I feel like through your story, that’s what you did. You learned the facts. You said even before you became pregnant, right? Your baby was 6 months old and you were starting to listen to the podcast and learn more about VBAC and what the evidence says and the facts then you got your support team. You just built it up. You knew exactly what you needed to do so you felt confident in saying, “No. I don’t want that IV” or “No, I don’t want that cervical exam for you to admit me. I’m going to have this baby with or without that cervical exam.” I think the more you are informed, the more likely you feel confident in standing your ground. Wyn: For sure. Meagan: Yeah, for sure. Well, oh my goodness. Huge congrats. Let’s just do a little shoutout to your midwife and your doula. Let’s see, it’s Christina? Where is she at again?Wyn: Interior Women’s Health in Fairbanks, Alaska. Meagan: Awesome. So great of her to support you with a more unique situation too. She was like, “Let me do some research. Let me get some opinions. Okay, yes. We’re good.” I’m so glad you felt that support. Then your doula, Dawn, yes. Where is she again? Oh, Unspeakable Joy. Wyn: Yes. Yeah. Meagan: That is so awesome. I’m so glad that you had them. We love doulas here as I’m sure you have heard along the podcast. We absolutely love our doulas. We have a VBAC directory as well so you can find a doula at thevbaclink.com/findadoula. Then last but not least, in the form, you said that you took Needed. Wyn: Yes, I did. Meagan: Yes. Can you share your experience with taking Needed through pregnancy? Did you start before pregnancy? Wyn: Yeah. Right as I got pregnant with my second one, I took the prenatal. I took the probiotics and I still take them today postpartum. Then also, the electrolytes or the mineral packets and the nighttime powder that my husband and I take. We put it in our tea every night. Meagan: It’s amazing. It really is so amazing, huh? It’s kind of weird because I don’t have to finish it. I’m just sitting there sipping on it and I can just feel everything relax. I have a busy brain. I call it busy brain and my busy brain is a lot more calm when I take my sleep aid. Wyn: Yeah. I slept amazingly through pregnancy. Normally with my first, I had a lot of insomnia. It was very nice. Meagan: Yeah. Then the probiotics, I want to talk about probiotics in general. We never know how birth is going to go. We could have a Cesarean. We may have a fever and have to be given antibiotics or Tylenol or whatever it may be. If we can have a system that is preloaded essentially with probiotics, it really is going to help us and our gut flora in the end so no matter how that birth outcome it, that probiotic is so good for us because we never know what we are going to get or what we are going to receive in that labor. I’m excited. Wyn: Yeah, what is that stuff that they test you for? Meagan: Group B strep?Wyn: Yeah, yeah. Sorry. I didn’t want that because I didn’t want to have an IV. Meagan: So, so important. I love it. They usually test for that around 36 weeks so really making sure that you are on the pre and probiotic. What I really love is that it is pre and pro so it really is helping to strengthen our gut flora so much. With GBS, with group B strep, they like to give antibiotics in labor. It’s sometimes a lot. They like to give rounds every 4 hours so you really could be impacting your gut flora. I love that you took that. You didn’t even have group B strep. Well, thank you so, so much for sharing your story. Is there any other advice or anything else you would like to share with our listeners today?Wyn: Yeah, just again, find your support team and lean into your own intuition. You know what is right for your body and your babies. Meagan: It’s so true. I mean, from day one of this podcast, we’ve talked about that intuition. It is powerful. It is powerful and it can really lead us in the right path. We just have to sometimes stop and listen. Sometimes that’s removing yourself from a situation. Go into the bathroom and say, “I have to go to the bathroom.” Go to the bathroom, close your eyes, take a breath, and hear what your intuition is saying. It is so powerful. I couldn’t agree more. Thank you so much.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
30:1006/11/2024
Episode 349 Prepping for a VBAC? How to Obtain Your OP Reports with Meagan

Episode 349 Prepping for a VBAC? How to Obtain Your OP Reports with Meagan

Meagan records a short and sweet episode for you today talking all about OP reports. What are they and why do you need them for your VBAC prep? How do you request them? If you have a hard time interpreting your OP reports, try reaching out to your provider for clarification. You can also send us an email at [email protected] where you can schedule a one-on-one consultation with Meagan for extra help and encouragement!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everyone. It is Meagan today. We are going to be talking about OP reports. What is an OP report? Why do we want to get an OP report? How do we get an OP report and how long are OP reports available before they go away?We do have a Review of the Week so we are going to get into that and then I’m going to go over OP reports. This review is from Brittanyhenley9478. She says, “Such an amazing resource.” Her review says, “I am pregnant with my second baby and will try for a VBAC in 4 months. Since finding this podcast, I have learned so much and gained a lot of confidence in my decisions. I’m so thankful for the podcast, their Instagram, and the website. I can’t wait to come back and share my successful VBAC story with them later this year.” Brittany, if you are still listening to us and you are still with us, let us know how your birth went. I hope that it was amazing and thank you so much for your review. You guys, I say it every single week multiple times a week now, we love your reviews. I seriously love them so much. It makes me smile. It makes my heart so warm so if you have not yet left a review, would you mind doing that for me? I would love it and appreciate it so much. You can go to wherever you listen to your podcasts and leave us either a rating or a review. I know Apple Podcasts and Spotify actually I believe, allows you to do a written review or you can Google “The VBAC Link”. Remember VBAC is V-B-A-C, and then you can leave us a review there. That also helps people find the podcast, find the website, the blog, and even our Instagram account. As a reminder you guys, if you are just listening to the podcast, hello. Welcome. I am so glad that you are here but I also don’t want you to miss out on all of the other amazing resources that we have. We have our Instagram account and Facebook account. We have a private Facebook group. You can look that up at The VBAC Link Community on Facebook. You do have to answer some questions so answer those questions and then we can let you in. It is such a beautiful space with people who are really in the same place as you– wanting to know their options, wanting to know the evidence, and wanting to feel that community love during this journey. We have a YouTube account and we do have our blog and our website and we also have a course. You can find all of that at thevbaclink.com. You can enter in your email there. We can put you into our subscription where we send weekly emails on updated blogs, updated studies, tips, resources, and all of the amazing things that we feel is really important for you to know during your VBAC journey. Again, you can find that at thevbaclink.com and of course, you can check it all out for free and again, enter your email in and we will make sure to get you those weekly emails. Okay, I’m going to go really quickly today but I really feel this is such an important thing to know. It’s not something that I one, knew was even a choice that I could have or two, was something that I should do so I could really learn more and understand more of what my provider was saying about my births and the reasons why the births happened with my body and my post-recovery and all of these things. It’s so good to know what they are saying about your procedure and your Cesarean, your birth. So okay. Steps to get OP reports. There are multiple ways and I know since I started requesting my reports back in 2015, it has changed a lot. A lot of people have an online portal with your provider where you can get your labs and a lot of these things. A lot of the times, their OP reports are included in there or there is a little drop-down option where you can request your OP reports. So if you have that, I highly suggest trying that or you can call your provider and ask for your medical records and your OP report. Sometimes they don’t really have them and they don’t want to give them to you so they may make you go to the medical records department in the hospital. Now, that is what I had to do. I called my hospital that I gave birth at. It was the same hospital for both of my babies so if you have to go to multiple hospitals, definitely make phonecalls so you’re not running around. Give them a call and say, “Hi. I really want to request my OP reports. I’ve had a Cesarean. What do I need to do to get those?” For me, I had to go in and request them with a form. It took about 5 minutes. It was really quite quick and easy and it took about 15 minutes to print them out. They did give me a hard copy which I loved having so I could highlight and write down and everything. But these forms are so important for you to have so you can understand and then for me, I did it before I was pregnant and I used it so I could have this form with me as I was going to find my supportive provider so they could have a better, deeper understanding of what was said about me and my body and my reasoning for a Cesarean. I want to give you a little bit of a warning. Sometimes you’ll find different reasons from what you were told and that can be very frustrating so just a heads up there. Another thing that is important to remember is that every state is different. They don’t just have these medical records saved on file forever. Here in Utah, I was told that it was 7 years. I know that it varies all around. I know Arizona is 6 years. New York, I think, is 6 years. Florida is 8 years. California and Utah, like I said, I think is 7 years. So definitely get your records as soon as you can. Now, I know most people are having babies anywhere from 1-5 years apart but I do think the sooner the better you can get these records is just better. So again, check out the portal. Call your provider. Go to medical records. Do whatever you can to obtain these OP reports and if you have a hard time understanding them, they have all of these weird things in there, don’t hesitate to reach out to your provider and say, “What does this mean? What did you mean by this?” I have also done one-on-one consults with many people to go over and process their medical records and help them come up with a path for what their next step could be for their future births and VBAC. I’m no medical professional by any means but I have been doing this for years and love doing it so if you would like to learn more about a one-on-one consult, you can email us at [email protected]. I would absolutely love to chat with you. Okay, everybody. Like I said, it was going to be short and sweet, but I really, really think it is important. If you are preparing for your VBAC, put this on the list of things to do. If you have just had a Cesarean, put that on the thing too to request. You don’t even have to look at it right now. It’s something you can have and put away but I do believe so much that it is important to have these and understand what our providers are saying and writing down about us. Okay, everybody. We’ll talk to you later. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
09:0204/11/2024
Episode 348 Rebekah's Birth Center VBAC After an Unexpected Breech Cesarean

Episode 348 Rebekah's Birth Center VBAC After an Unexpected Breech Cesarean

Rebekah’s first Cesarean was a birth center transfer after her baby boy unexpectedly flipped breech during labor. Though she was confident in her decision to consent to a Cesarean, she was devastated and left with a lot to process. Right away, Rebekah’s midwives instilled confidence that she was a great VBAC candidate and introduced her to The VBAC Link. Rebekah thoroughly researched and prepped for her VBAC knowing it was the path she wanted to take. She decided to stay with the same birth center as she felt so loved and supported by them. Her second pregnancy was filled with physical, mental, and spiritual preparation for her VBAC. Rebekah developed a deep connection with her baby girl and shares precious stories during both her pregnancy and labor when she knew just what her baby was trying to communicate. Rebekah’s VBAC was healing in so many ways. It was particularly special to birth in the same suite that she labored in with her first and have such a different outcome. All of Rebekah’s intentional work paid off to help her have a very sacred birth and postpartum experience!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Welcome to The VBAC Link. We have our friend, Rebekah, here today and she is local to me here in Utah so it’s always so fun to hear a Utah story especially because I usually know the provider and the location and things like that or I’ve served with them so it’s fun to hear the stories that I have served with the people who are serving these amazing VBAC mamas. We have our friend, Rebekah, like I said and she is a mama of two. She is a stay-at-home mom and is in Spanish Fork. She is passionate about birth and hopes to one day pursue birth work. She hired one of our VBAC Link certified doulas so just as a reminder, if you guys are looking for a doula, let me just tell you that our doulas are amazing. These doulas truly love birth and love VBAC and are all certified in VBAC so you can check that out at thevbaclink.com/findadoula if you are looking for a doula. Rebekah left us a note. It says, “The after-birth high doesn’t always happen. I have heard so many stories of women who experienced it and I was expecting to feel that. I however did not.” She says, “Don’t feel robbed of it.” She was confused why she didn’t feel it but she is going to talk a little bit more in her story. I love that message because I didn’t feel the birth high with some of my kids either and it is weird. I remember sitting there thinking, Wait, aren’t I supposed to be crying right now or aren’t I supposed to be screaming how happy I am right now? It just didn’t come. Please know that if you didn’t have that immediate birth high, it’s okay. It’s totally okay. We do have a Review of the Week. It is from Yulia and this is actually on our VBAC Course. It says, “This is an amazing VBAC Course that helped me understand how I can educate and support families in the best way.” She is actually one of our VBAC doulas so again, if you guys are looking for more information on VBAC and you really want to learn just all of the history of VBAC and Cesarean and how you can increase your chances of VBAC, check out our course at thevbaclink.com and let us know if you take it. Let us know what you think about it. All right, Ms. Rebekah. Your hometown is Utah, same as me. We are here together. You’re in Utah County. You’re probably 45-50 minutes away from me so just shy of an hour. Where did you give birth for your VBAC? Rebekah: It was the Utah Birth Suites in Provo. Meagan: Okay. Awesome, awesome. Well, I’m so excited to get into your stories today. I know that with your first one, you went through it. It was spontaneous labor turned unplanned Cesarean. Now if you are listening, I’m sure you can raise your hand. How many of us are having the same situations? We are going into labor and we have that unplanned Cesarean. It’s so, so hard. Before we get into your story, are there any suggestions that you would give to the listeners or any tips for moms just like us for moms who went into labor and had an unplanned Cesarean?Rebekah: The heartbreak and the trauma that comes with that is really hard to navigate so in planning a VBAC, my number one piece of advice is hire a doula. Hire a VBAC-certified doula and do all of the hard work you can to mentally prepare. Try not to blame yourself for the C-section because I know we all do that at some point if it wasn’t planned. Meagan: Yeah. I love that you said that. Don’t blame yourself but at the same time, let’s arm ourselves up with information and even first-time moms, there are so many times that we go in and we think we sort of educated ourselves but we didn’t. If we can try and educate ourselves a little bit better, we can hopefully be a little bit more armed for the unexpected and even then when the unexpected happens, it’s not easy to be armed. It’s not easy to be prepared. Okay, so let’s talk about that first birth that was an unplanned Cesarean. Rebekah: Yeah. I got pregnant in 2020 so COVID insanity and I had known even before I got married that I didn’t want to be in a hospital. I’m number 6 of 7 kids and my mom had all of us unmedicated. I was a home baby. Some of us were born at home. Some were in a hospital. Some were in a birth center. I just really felt that in my bones and in my genes that I can give birth. It’s not scary. My mom did this this many times without medication. My sister did it 5 times so I really felt confident. With everything happening in hospitals during COVID, I just was like, I don’t even want to try to mess with that so let’s go the midwife route. I got in contact with a friend of mine who was a doula and she recommended the Utah Birth Suites in Provo. I reached out to them. We toured a couple of different birth centers and that birth center just felt right. We met almost the entire team that first day in the interview. They spent almost an hour just chatting with us. I was about maybe 18 weeks, 20ish weeks. I was about halfway through my pregnancy. I had two or three meetings with an OB because I didn’t have a midwife and it just wasn’t my favorite. It was so long between visits and they lasted about 15 minutes. I saw a different person each time. It felt very impersonal and I don’t like repeating myself over and over again to all of these different people. It didn’t feel right. It wasn’t really what I was looking for. I found the Birth Suites and they took care of me for the rest of my pregnancy. I had a little bit of hypertension issues toward the end so the last three or four weeks were really juggling this game of, are we looking at induction this weekend? My blood pressure would read really, really high then I would do all of the things to bring it back down. I was watching my nutrition and taking the vitamins and everything to bring it down. It would come down just within a safe enough range to keep giving me care. Legally, if it crossed that line into worries of preeclampsia, then legally they had to transfer me into the care of an OB. My midwife was really working hard with me to keep it down. It was doing this up/down thing and by the end of each week, it was like, “Okay, we might have to induce you in a couple of days if you want to stick with us.” I was okay with that. My midwife had talked with me about that so it wasn’t pushed on me. I was doing everything to stay within their care. That was my whole goal so if I had to be induced, that’s what I would do. But every weekend came and passed and my blood pressure would come back down. Finally, it was the day before my due date. I went into labor in the middle of the night. It was maybe 2:30 in the morning. I felt my first contraction. I could tell it was labor because it was different than all of my Braxton Hicks. The only sign I had that labor was going to start was that I had cramping the day before. I was like, “Oh, this is kind of uncomfy.” I didn’t think anything of it. As a first-time mom, I didn’t know a ton. I did as much research as I possibly could but labor is so random with every mom and baby. There really is no way to tell. I go into labor early in the morning and I woke up my husband. I said, “I think I’m in labor. I think these are contractions. They’re not stopping. They’re getting really intense.” Intense compared to the Braxton Hicks I had been feeling. I let him sleep and I went into a different room and classic first-time mom mistake. Instead of resting, I got up and started moving and trying to get things going because I was all excited. I didn’t want things to slow down. I was timing them and texting my midwife. She said, “See if you can lay down. Take a Tylenol if they are super uncomfortable and try to get as much sleep as possible because you’ve got some time.” I tried doing that. It wasn’t working for me. I was super uncomfy laying down. I did not like it at all. I felt good when I was up and moving because I think that slowed things down but I didn’t know the difference. I just knew it was less uncomfortable. I was like, “I’m not going to be sleeping. Let’s just go do something.” We went on a drive. We did a little shopping. We walked around. We went back home. We hung out for a little bit. Then my husband was like, “Do you think I’m okay to go to work?” I was like, “I think you are. You can go to work. I think we have plenty of time. Things are still pretty spread out right now. We can call our doula and she’ll come hang out with me at home.” So that’s what we did. Our doula came over and my husband went to work and everybody was like, “What are you doing here? Your wife is having a baby. What’s going on?” He was like, “She’s fine. She has our doula.” Our doula was with me for a couple of hours and things had picked up enough to where I felt like he needed to be home so we called him back home. Things were moving on not slowly but slower than I wanted. I was just trying to be patient and let things go–Meagan: Trusting the process. Rebekah: Yes, exactly. I’m not a very patient person so this really was a big learning experience for me. So my doula is keeping contact with our midwife and eventually, it was like, “Okay, I think you’re good to head to the birth center. It looks like things are pretty steady now.” We got to the birth center. I really wanted a water birth so they drew a tub and I relaxed in the water and tried some different positions. Hands and knees in the water were hard and uncomfortable. They gave me a towel to keep from slipping around but it was really uncomfortable. My knees didn’t like staying in that position and I didn’t want to be laying back. So I just wiggled around in the water a little bit. They were like, “Let’s see if we can get you in a different position and try to get things moving a little bit.” So they got me out of the water. We tried the birth stool. I did not like the birth stool but it helped me progress a ton so that was good. I think I lost my mucus plug on the birth stool. I was feeling tons of pain in my lower back, like lots and lots of pain in my lower back. My thighs were shaky and I felt a lot of intense sensations in my thighs whenever I would have a contraction. There was a lot going on with my body that I wasn’t really prepared for or expecting. I got back in the water to help relieve my back a little bit and I ended up getting stuck on my back lying back in the tub. It was getting to the point where I was almost passing out between my contractions because I was so, so tired. My body had been working for so long and it just felt like things weren’t quite where they needed to be with how long I had been working. Again, my midwife said, “If you pass out, we will have to transfer you.” They gave me the oxygen and some essential oils to smell to keep me awake. They were trying to help me as best as they could. I guess my husband was out in the hall with the midwives and it was student midwives who were taking care of me and there was the head midwife who was overseeing them. They had a little pow-wow about what they thought we should do. The midwife was very big on mother-led labor. She was like, “Well, she’s a first-time mom.” I had been in labor for so long that things were concerning at this point so it was just, “Let’s give her a little bit more time and try to keep her awake and see how things are going. She’s doing great. She’s tired and this is normal.” A bit more time passed and one of the student midwives was like, “We need to check her. She should be farther along by now. She says she’s pushing. She feels like she’s pushing but we are not seeing the water separation and as much opening as we would like to see.” They got me out of the water and onto the bed and the head midwife performed a cervical check to see what was going on. I had a contraction while she checked me and my water broke. It was just full of meconium. She said, “I can feel his bum. He’s breech.” It was crazy because we thought he had been head down the entire time but when I was in the water, there was a big movement in my belly and I was like, “Oh, that was kind of crazy.” We thought, did he flip? When we realized he was breech, was that movement him flipping while I was in labor?Then my midwife also made a comment later, “Well, maybe he was bum down longer than we thought he was. Maybe that wasn’t the flip.” It had everybody baffled. My midwife has been practicing for a couple of decades. She’s very experienced and this had everybody stumped. She had never really seen anything like this happen before so at this point, she said, “Well, you have two options. We will send you home and send you a midwife who can deliver breech babies,” because she was licensed and in Utah, licensed midwives aren’t allowed to deliver breech babies which I think is silly. She had the training and experience. She just legally wasn’t allowed to do it. She said, “We can send you home and send you a midwife or you can go to the hospital where they will definitely do a C-section.” She gave us a couple of minutes. We weren’t in any emergent situation. The baby wasn’t in distress. His heartbeat had been great the whole time so there was no reason to believe that he was struggling at all. She gave us a couple of minutes to decide. Earlier in my pregnancy, I received a blessing from my husband and was told something like, “However our child is supposed to come into this world–”, and I was like, “Well, that’s silly. He’s going to come how we are planning on him to come.” I remembered that in this moment and said, “I think this is what that meant. I think he was always supposed to be a C-section.” It was a very interesting combination of feelings happening at the same time, remembering that and knowing this was how it was supposed to go but also being beyond devastated that this was the path things took. So we chose the C-section not because first of all, the thought of having more contractions in the car was like, I’m not going to do that. I just knew it wasn’t safe. I was almost passing out and I knew that a breech baby can sometimes be a bit more work. I was in no position to do that. So my husband drove us to the hospital and I had maybe three contractions in the car. Our midwives called the hospital to tell them what was going on and that we were coming so they were ready for us. It was very quick. We got there. They took great care of us and had me in the operating room and the rest was history. We had the C-section. The anesthesiologist was so sweet. He was this old man who spoke really softly and assured me that everything was going great. He stayed with us the whole time through the surgery. I heard him cry and it was great. They wrapped him up. They held his cheek against mine for a minute and then they took him out. My husband followed him and then they stitched me up. That was my C-section. We spent 3 days in the hospital. My birthing team came to visit me one by one in the hospital and every single one of them told me that I was a great candidate for a VBAC. They told me about The VBAC Link so that’s when I started on my whole journey listening to you guys and started to really plant those seeds that, “You are capable. You didn’t fail. You are able to do this still.” I know that some moms after having a birth experience don’t really want to hear these things and they weren’t in a place to hear those things, but for me, it was really great to immediately have that confidence spoken into me. That was my C-section. Meagan: Yes. I love that your team knew you so well to know that that was what you needed to hear in that time. Those were the things that you needed to hear. So knowing right away that you were a good VBAC candidate, was it something that stayed with you and you were like, this is what I want to do?Rebekah: Yes, absolutely. It wasn’t ever a question if I was going to have a repeat Cesarean. That was never part of my plan. You can’t really plan birth but I had never really had that fear of, Am I going to need another C-section? There’s always a little bit of it there, but it was always, I’m going to have a VBAC. That’s what we’re going to do from that point forward.Meagan: You knew. You felt that it was right. You found out about us at The VBAC Link. You had your providers already. Did you stay with the same providers or did you switch? Rebekah: Yeah. Meagan: Okay, stayed. Rebekah: Well, technically yes. I stayed with the same Birth Suites and the head midwife who was overseeing the student midwives who cared for me in my first pregnancy was the one who cared for me during my second. I got to know her a little bit better during my second pregnancy and she was ahead of everything at that time. Meagan: Okay, awesome. So you are pregnant now for the second time. Tell us about this amazing VBAC journey. Rebekah: Yeah. So I got pregnant– when was it? It was probably late summer, early fall when I got pregnant with my second. I immediately reached out to– she’s a licensed midwife now but the student midwife who was in charge of my care the last time. I reached out to her because I loved her so much. I said, “I’m pregnant again and I would really love for you to take care of me.”She said, “Well, when you are due is right when I go on leave.” I said, “That’s great timing.” I reached out to another girl who was on our team who I loved and the same thing. They were taking their leave at the same time. She was like, “But it’s within a week. You’re due within a week of when I go on leave. If you end up having your baby before I go on leave, are you okay with me being there?” I was like, “Yes. I would love for you to be there if you can to support.” That’s not what ended up happening, but it was fine.I reached out to Melissa. She’s one of the owners at Utah Birth Suites. She started that whole business. I got to know her with my first so I reached out to her and said, “I’m pregnant again and would love to be in your care.”It was really great that she already knew my history with my first pregnancy and first birth. I had stayed in contact with them. They do a lot of things in the community and they try to stay in touch with their moms who they take care of. It’s not like it had been 3 years since I had seen her. I had seen them here and there so I felt really comfortable with her. I had a couple concerns with this pregnancy with the hypertension issues and stuff that we had with him being breech. There were just things that I really wanted to stay on top of and keep an eye on. My blood pressure was fantastic throughout this entire pregnancy. It was at such a healthy level the entire time. We never had that concern of preeclampsia or hypertension because it just wasn’t a factor. It was really nice. I was doing all of the things this time around with the vitamins and supplements and nutrition and water intake and all of the things that I neglected with my first pregnancy. I was super, super determined to have this VBAC. My midwife really pushed protein– lots and lots and lots of protein. We really wanted to strengthen that uterus and try to be as strong as we possibly could so I really took that to heart and tried my best. I got really excited when I came up with a new recipe that had a ton of protein. I would take a picture and send it to her and write up the recipe. I was like, “I’m so excited about this one.” It’s like when a kid draws a picture and is so excited and their parent sticks it on the fridge. That was how I felt. I was like, “Look at me. I’m working so hard this time.” I was worried about her flipping breech but that was never an issue either. She stayed head down the whole time. This was a little side note that was interesting. During my anatomy scan to find out the gender, the ultrasound tech was looking over everything and he said, “There’s no way to really tell for sure because your uterus has expanded now,” but he said, “I wonder if you have a bicornuate uterus.” He said, “Because your birth was breech, right? He flipped?” We had seen this ultrasound tech for the first so he knew everything that happened there. So I said, “Yeah. He flipped breech.” I had never heard that word before. I didn’t know what that was. He explained it to me and said, “It’s really common for women with a bicornuate uterus to have babies who flip breech.” So I was like, “Okay, that’s interesting.” He said, “After you have this baby and your uterus shrinks back to normal, we should take a look at it.” I have yet to do that but I’m curious too. She never flipped breech so I don’t know. Maybe I just have a goofy-shaped uterus. I don’t know.Meagan: Maybe or it was just a freak thing. Baby needed to be head up. Rebekah: I don’t know. That was interesting and I’m curious to see what the results of that are. But anyway, we got in contact with a doula, a VBAC-certified doula in the area. Her name is Isabelle and she is fantastic. She is absolutely phenomenal. She is also a birth assistant so she is fully immersed in this birth world. She is so knowledgeable and has tons of experience. We clicked really fast and I knew that I wanted her to be our doula. She really just was invaluable the whole time. She recommended that I do some fear-release exercises and meditations to work through some of the trauma that I didn’t really realize that I had from my first birth. I thought I had processed and accepted as much as I could but I think healing isn’t a linear process and being pregnant again and having another baby brought up a lot of stuff and a lot of fears. On a personal note that I won’t really get into, I had a different set of fears surrounding this pregnancy for different reasons so there was just a lot to work on emotionally and mentally. I took that very seriously. This was a very sacred and spiritual pregnancy for me. Maybe it’s just like that mother-daughter bond. I don’t know. I felt way more connected to my baby this time and I really wanted to do my due diligence in making sure that my mind and my spirit were in a good spot for this pregnancy and this birth. One of the fear release exercises she sent me was one provided by The VBAC Link. It was a little worksheet to get your mind going and there are specific questions on there about what are some fears you have and where do you think those fears come from? It was that kind of stuff and toward the bottom, it helps you reframe those a little bit. Meagan: Yeah. Rebekah: It had me write out what my fears were and then to write an affirmation to counter each fear. I had 20 affirmations all written down just to go along with this list of fears. Then I actually used a couple of those and printed them out as my visual affirmations for when I was in labor. So fast forward, we’re about 38 weeks and I was thinking for whatever reason that this baby girl was going to be early. So 38 weeks came around and I was starting to get excited. I’m like, “I think she’s going to be here pretty soon.” I was starting to have some prodromal labor which I didn’t experience with my son so that really reinforced the idea that she would be here soon and that was not the case. I had 2.5 weeks, well yeah. I guess it was about 2.5. Normal labor started around 39 weeks. So every night on the clock from 8:00, I would start getting really intense contractions that felt like early labor with my son but I also had much stronger Braxton Hicks this entire pregnancy so I was like, “I can’t really tell the difference.” I told my doula that. I was like, “I’m afraid I’m going to miss you and I’m not going to reach out to you in time or you’re not going to make it to us in time because I won’t know when labor is actually happening.” That was a big worry of mine this time around. It was so different than with my son. She said, “It’s okay. You can just text me as much as you need to and as much as you want.” So I did. I texted her a lot the last few weeks and she was like, “Your body is doing great.” She told me that in her experience, she said, “Just from what I’ve seen with my VBAC moms, I actually see prodromal labor happen a lot. I personally think that it’s the body’s way of being more gentle rather than doing all of the labor hard and fast at once. It’s lots of little bits of labor to get your body ready and ease into it so it’s not as intense on your body.” I was like, “You know, that makes sense.” I don’t know. I don’t think there are any studies around that that I know of, but that made sense to me. I really tried to just internalize that and not get too discouraged when things would stop as soon as I went to bed which they did every time. At 8:00, they would pick up and be there for a couple hours then it would stop when I fell asleep then I’d be fine until the next night when it would pick up again. My husband and I would go on a walk every single night and on these walks, I could have sworn that she was going to fall out. I could feel that she was right there. I could feel that my body was literally opening. I could tell that I was dilated. I never got cervical checks this time around which was oddly empowering. I really trusted my body and knew that things would happen regardless of the number that my body was dilated. I had no idea but my midwife was like, “You know, it wouldn’t surprise me if you are sitting at a 4 right now.” So if anyone has experienced prodromal labor, you know how exhausting it is and how discouraging it is mentally, physically, emotionally– all of it. It had been a couple of weeks of this and I had officially gone past 40 weeks. I’m officially overdue and my son being born right on time, it was really frustrating that I was going past my date with this one. I didn’t want to be induced. There was really no reason for it other than I was getting tired of being pregnant. My midwife was supportive if I wanted an induction. After I hit 40 weeks, I think she would have done it. She said, “Oh, we can do this,” but she also was really encouraging and assured me that my body was doing what it needed to. It was normal to feel discouraged, but let’s just give your body time, especially with a VBAC. Induction can come with its own set of risks. I knew that. It was just such a mental battle trying to remember that. I know the risks sometimes can be small, not that it would worry me personally. For some moms, I know it would but for me, the risks that came with induction weren’t enough for me to say no to it completely. But also, you never know so let’s not play that game. Let’s just be as patient as we can. A couple of days before I went into labor, I had it. I was over it. I was in the middle of a breakdown in tears just exhausted. I was with my husband and I said, “Why isn’t she here yet? Why doesn’t she want to come?” I was just processing things out loud and I said, “I know my body is ready. I can feel it. My body is open. She is so far down there. I feel like her head is going to pop out any second. What is going on? Why have I not gone into labor?”Then he just was really comforting to me and letting me process how I needed to and then I said, “I feel like she’s scared.” That was a really interesting feeling. Like I said, I felt more connected to this baby and it was like a lightbulb that was the answer. Your body is ready but your baby is not. We were overdue at this point so I said, “I feel like she’s scared. I’m not quite sure why, but I’m almost positive that’s it.” So I took a moment to kind of then go into myself. I went into a different room by myself and again in tears was just sobbing and praying and spent some time talking with the Lord and then I spent some time talking to my baby. I told her, “We’re ready for you. We are so, so ready for you. I know you are scared. I don’t know why but you’re not going to be alone. We’re going to go through this together. You’re going to be safe. Mommy and Daddy are going to take care of you. You’re going to be okay.” It just was a really, really sweet moment. Two days later, I went into labor. Meagan: Ohh. Rebekah: I guess she just needed that reassurance that things were going to be okay. Meagan: She needed the okay. Yeah. Rebekah: Yeah. I think she felt that something was coming with all of this prodromal labor. She knew that things were picking up and she just needed a little pep talk. So this time around, again, around 3:00 AM– I guess that’s when babies like to come. I hear that so, so many times between 2:00 and 3:00 AM is when things start to happen. I don’t know why that is the magical hour, but it is. This time, because we know I was afraid I wouldn’t know when labor had started, this time is started with my water breaking. My water didn’t break until after 17 hours of labor with my son. I was asleep and woke up to re-situate myself and I felt this pop inside my body. It kind of hurt a little bit. I was like, what was that? It was a really weird sensation. I thought, Was that my water? I reached down and I feel around. I’m like, Well, I’m not wet. I stood up just to see what was going on and there was this huge, giant gush. I was like, Well, yep. There it is. This was probably my favorite part of my entire labor. My husband was asleep and I said, “Honey, honey, my water broke.” He was still half asleep and he said, “Do you want me to fill it up for you?” He thought that I had dropped my water bottle or something. I was like, “No, honey. My water broke.” He jumps up and he’s like, “Oh, oh.” He started freaking out and he was like, “What are you supposed to do?” He was frantically looking around. He was still half asleep. I was like, “Okay, take a breath. Go get me a towel first of all,” because I was gushing all over the floor. “Get me a towel and then text Melissa (my midwife)” or my doula. I didn’t know who it was. I said, “Let them know.” He said, “Are you okay? Do we need to go somewhere? What’s going on?” I said, “No, we have time. Water breaking is not a big deal.” I had done lots and lots of research and listened to a million birth stories so at this point, I feel like a pro because I am fully immersed in this birth world. I said, “No, I’m okay. I’m just going to change and lay back down because I’m not having contractions yet. I feel fine, but I do need to rest so I’m going to change myself and lay down.” That’s what I did. I wasn’t going to repeat the mistakes of my first birth of moving too fast. Meagan: Getting too excited and yes. Rebekah: Yeah, especially with the exhaustion that I was feeling toward the end of my labor with my son, I was like, I don’t want to feel that again. I lay back down. I know myself well enough that I wasn’t going to fall back asleep. There was no way that was going to happen, but I was like, But I need to stay as relaxed as possible. We kept the lights really low. I put my birth playlist on and just really did some breathing to keep myself relaxed and as open as I possibly could. That’s how I labored for the next several hours but things got intense really fast. As soon as my water broke, I knew that my contractions were going to be more intense. Even though labor had technically just started, I had a feeling that I wasn’t going to be in labor for very long because it had been 2.5 weeks of prodromal stuff. I was like, I think this is going to be quick. I was really unsure of what to do though because I was timing my contractions. I have screenshots and was sending them to my doula. She said, “Oh, those look great but let’s wait an hour and see how that goes.” But I was feeling like things were picking up. I felt like things were getting more intense but people kept telling me to wait. My midwife was like, “Oh, you have time.” My doula was like, “Oh, you have time.” I told my husband, “I don’t know what to do because everyone is telling me that I have time but I don’t think we do.” Every time I stood up to go to the bathroom or get in the shower– I tried the water in the shower because my doula said, “Sometimes that can make things a little bit more comfortable. Some women like to labor in the shower for a little bit.” I thought I’d try that. I loved the water but I did not like being upright. I did not like standing because it made contractions so, so intense but they were short. They were half the length than when I was lying down. I think they thought I had time because there were still several minutes between contractions and they were still pretty long. They were like, “We want them just a little bit shorter and a little bit closer together,” or longer contractions. I don’t remember. I was like, There is something in me that is telling me that this is moving pretty quickly. I don’t like being upright and I feel like I need to rest. It was a lot of weird stuff going on in my head trying to figure out how to handle things. I stayed in bed. It was this instinct in me, “You need to stay lying down.” Any time I stood up, it picked things up and for any birth with other moms, that’s what you want, right? You want things to pick up and you want things to progress and technically standing upright was progressing things, but it didn’t feel right to me for whatever reason. I knew I needed to be resting and lying down. I was starting to get tired. I texted my midwife and said, “I’m starting to get worried because I don’t feel like I should be this tired this early, especially with how much I’ve been lying down and resting.” She said, “I think you need a little boost of energy.” She said, “Eat a snack and go outside and take a walk. Get some fresh air. Get some sunlight.” In my head, I was like, I don’t want to do that. I don’t want to be up. Every time I stand up, I can’t explain it. Everything in my body and spirit was like, “You need to stay lying down.” I was like, “You know what? She’s been doing this longer than I have. I’m going to trust her. I’m going to do it.” I make my way upstairs and as I’m getting a snack, I have a contraction that just had me seeing stars. I almost passed out. It was so, so intense and I told my husband, “I’m going to throw up. I’m going to pass out.” I leaned against the counter. He rubbed my back and when it was over, I ate my snack really, really quick. It was a sugary snack to give me a blood sugar boost. I ate my snack really fast and then immediately went to the living room and got on my knees and leaned against the couch. Again, I can’t be standing. Meagan: Yeah, and gravity is causing it to happen too much. Rebekah: Yeah, and I was like, I don’t have the capacity right now to handle these standing. I need to be more grounded. I got on my knees on the couch and my husband was like, “Are you okay?” I was like, “Yes, I just can’t stand up.” I had a few contractions on the couch because everyone was telling us to wait so I was like, “Okay, let’s just do a few more contractions and see how these were going.” That’s when I hit transition. It was a little before 9:00 AM or it would be 8:30-8:40. I had a few contractions and they got really, really intense really quickly. It was starting to get a little bit more painful. I was feeling a lot more pressure in my bum and I had to physically relax my pelvic floor and open it because things were starting to feel a little bit pushy. I say that’s when transition was. I actually don’t know. I feel like I breezed through the transition phase because things just happened so fast. I would guess that’s when it was. We called our midwife. Our doula hadn’t come to us yet. I called maybe an hour before and said, “Why don’t you make your way to us because things are starting to pick up?” She said, “Okay.” She lives maybe an hour away. So she’s on her way to us and hasn’t made it to us yet. We call our midwife and say, “Things are pretty intense over here.” She listened to a couple of contractions over the phone and she said, “Those sound great. You’re doing awesome.” These contractions, I was getting really, really vocal through them, and having gone through labor unmedicated with my son, I knew that I was pretty close just based on the noises that I was making and the way my body was feeling. I was like, We’re pretty close here. She said, “Okay, do you want to meet me? Let’s meet at the birth center at 10:00,” which means we would have had to leave 20 or 30 minutes from that time or from the time we were at. I said, “We can’t do this at home for another 20 minutes.” I had another contraction and my husband and I both go, “No, we’re coming now. We can’t stay here and do this for another 30 minutes. Things are moving too fast.” She said, “Okay, great. I’ll meet you there.” We called our doula and we said, “Go straight to the birth center.” The birth center is kind of in the middle of us so she didn’t have to backtrack. We get to the birth center. Our doula met us there. She said, “You had one contraction after you got there and the next one, you were pushing.” My midwife was there maybe less than 10 minutes after we showed up, between 5-10 minutes but I had a couple of pushing contractions with just my husband and my doula at the birth center. When I got to the birth center, I assumed the position. I got on my knees and leaned against a chair because that’s how I had been doing it at home. I loved it. Every time I would have a contraction, I would put my hands on the ground so I was on hands and knees and I would lean back a little bit. Everything in my body just told me to get as low to the ground as you possibly can. Any amount of pressure or sensation on my body was amazing. It just kept me feeling grounded because of my son, when I was in the tub leaning back, I kept reaching up like this saying, “Help me. I need help. Help me.” I felt so untethered and nobody knew what to do for me because I was in the tub. They couldn’t do counterpressure on my hips or my back because of the position I was in. It was just like, there’s nothing we can do for you. I refused to move so it was like I got stuck in this position where I felt so ungrounded and untethered. But this time around, I was solid. I loved it and I actually had a bruise on my forehead the next day because I was pushing my forehead against the chair every time I had a contraction. But it was awesome. I loved that feeling of feeling so solid and grounded. I had pushed for maybe an hour before she was born and I felt that ring of fire. It made me say a bad word. I was like, “Oh my gosh,” because I didn’t feel it with my son. When I leaned back during a contraction, I could see some blood on the chucks pad on the ground that I was moving on and I asked them, “Am I tearing?” There was a pause and my midwife said, “Your body is stretching exactly how it’s supposed to.” So that was tearing. She was not going to tell me, “Yeah, you are.” She was really encouraging and she was like, “Your body is stretching the way it is supposed to,” but in my head, I was like, I know I’m tearing. I could feel it. It wasn’t horrible, but I could tell. I had this memoir going on in my head the whole time where I literally had to tell myself, You’re not going to break. You’re not going to break, because those sensations on my pelvis while pushing her head out were so intense. Meagan: Intense, yeah. Rebekah: It just felt like my pelvis was going to crack but I knew that wasn’t the case. My body was made to do this. It was doing what it was supposed to do. It was really a big mental battle. I’ve heard a lot of women talk about how they go into labor land and it was this out-of-body experience, but when I tried to do that and let go I guess is the term, that’s when I started to feel fear set in and I felt really uncomfortable when things got more painful so I really had to keep myself in my body. I am not the type that can just close my eyes and say, “Okay, my body is just going to do the work.” I couldn’t do that. I had to really stay fully present. I guess I needed to feel that sense of control so I was talking myself through it the whole time. “You’re doing okay. Keep your voice low.” I was very, very loud. “Keep your screams and your moans in a low tone and keep yourself open. You’re not going to break.” I had to keep telling myself these things. My husband was talking to me, “You’re doing so great. You’re amazing. Our daughter’s going to be beautiful. You’re doing such a great job.” My doula was scratching my back and doing counterpressure. Everybody was just amazing. The vibe in the room was just absolutely incredible. She started to crown and my midwife said, “Rebekah, why don’t you feel down and you can feel her head? That might be encouraging to you.” I think she could tell I was getting frustrated. Every push I was sure she would come and she didn’t. I would get so mad and I would push harder than I probably should have and maybe that’s why I tore because I was being impatient. I feel down. I could feel her head crowning. I started talking to her. I started crying. I’m like, “Sweetie, I’m so excited to meet you. Hi, sweetie. You’re doing great.” A couple of contractions later, her head came out. Then we chilled with her head out. We chilled between contractions. One of the girls on our team got an awesome shot just from right behind. She took a picture of her head sticking out so it was just a straight shot of my bum with her head and it was just a beautiful, beautiful picture. So I feel down and I feel her head. I’m rubbing her head. I’m talking to her and I’m breathing. I got water between every single contraction. I took a drink of water. I took some electrolytes. Oh, between contractions, I would sit up and lean on my husband. I would lean on his lap and then during a contraction is when I would go down on all fours. It was just this up, down rhythm that I got into. That’s what I did. Meagan: That is awesome. Rebekah: It was awesome. I really got into a groove. I felt safe and comfortable. After her head came out, the next contraction, her entire body just slipped right out and I got to reach down and grab her and pull her up onto my chest. It was just amazing. But I didn’t feel that birth high. I was expecting to feel it. Everyone talks about this incredible rush of endorphins and “I wanted to do it again. I had just done this amazing thing and I got a rush of these feel-good hormones”. I was expecting to feel that and I didn’t. It was a beautiful moment and I was so happy to be there but I kept waiting for that high to hit me and it wasn’t hitting me. I was like, “Oh, that’s weird, but okay.” I had hemorrhaged after my placenta came out. It wasn’t enough to really be emergent, but it was kind of concerning. They were doing the fundal massage. They were putting pressure on it. I was holding my baby the whole time leaning on my husband and my husband was like, “Is she okay? What’s going on?” I asked him to say a prayer and to pray for us. So the midwives were working on me quietly. My husband says this quick, beautiful prayer just that everything would be okay and that things would go the way they were supposed to. My midwife asked if I would be okay with Pitocin to help stop it and that was fine with me so we did a quick shot of Pitocin and a couple of minutes later, it completely stopped and I was good to go. It was just a few minutes of this and even hearing the word “hemorrhage” or “You are losing more blood than we would like,” I still never really panicked or felt afraid because I trusted my team so much and I knew that if things were emergent, things would be going differently. There would be a different energy but no one was concerned. No one was rushing around. No one seemed panicked. It was just like, “You’re losing a little bit of blood, but–”Meagan: We’re taking care of this. Rebekah: “We’re taking care of this.” It was so quick. It was so quick. It was taken care of and I’m so blessed that that was how things go because I know sometimes that’s not the case for other moms, so in my case, it really wasn’t that big of a deal. Meagan: Yeah. Rebekah: I got to take a postpartum bath. Well, I guess they did the stitches first because I had a second-degree tear that required stitches, and when they were checking my tear and they told me, “You’re going to need some stitches,” I immediately burst into tears because for whatever reason, that sent me back to my C-section because to me, stitches meant, “We’re stitching you up. We’re closing you up.” Meagan: Yeah, yeah. Rebekah: It was this weird flashback moment that caused me to panic and I started crying. I told them it reminded me of my C-section and I know that sounds silly. It’s just a few stitches from tearing in comparison to stitches from a C-section.Meagan: It doesn’t sound silly. Rebekah: But to me, it wasn’t. Oh, also, I was in the same birth suite that I was laboring in with my son the first time around. I was on that same bed when the midwives told me, “He’s breech. We have to do something else.” So it just was like I was back in that same space where I was being told that I have to do something that I don’t want to do that was scary to me. My doula was really sweet and talked me through it. My whole team talked me through it. They were like, “You’re fine. It’s okay. It’s not a big deal.” They were very validating like, “I understand. That’s why you are scared and why this is bringing things up again but you are safe. We’re going to take care of you. You’re not even going to feel it. We’re going to numb you.”Meagan: Numb it up, yeah. Rebekah: Yeah. My doula stayed with me through my stitches and she was like, “Let’s put on some music,” because I was talking about this music that I loved. She was like, “Let’s find this album and let’s listen to it.” So she found this album and she talked with me the whole time through the stitches. Then I got to take my beautiful postpartum bath in the salts and the flowers and stuff. It was just beautiful. My doula got a picture and she was like, “You look so angelic like a mermaid.” I was lying sideways and my hair was all draped. She was like, “There are flowers in the water. It is beautiful.”Again, it was a healing full-circle moment when they handed me my baby to take this bath together because the tub was another source of stress and anxiety from my first birth. I felt stuck. I felt abandoned. I felt like I didn’t have a ton of help. I had help but it didn’t feel like it. So just a lot of little moments throughout this suite that I was in that helped heal me a lot from my first birth that were all of these trauma points from my labor with him. They did the newborn exam. I got to hold her and be in the same room as her the entire time. I held her the whole time they did my stitches. We waited to cut the cord until it was white. My husband got to cut the cord. It all was incredibly, incredibly beautiful and healing. I did have to have two bags of IV fluids because of the blood that I lost which kind of helped rebuild that. My doula fed me soup while I was in the tub snuggling my baby. It just was a night and day difference. Meagan: Yeah, such a different experience. Rebekah: She’s 7.5 weeks old and we’re doing great. I healed very well, so much faster than with a C-section. Again, night and day. I don’t even feel like I had a baby. Healing this time has been incredible this time especially having a toddler and worrying, Am I going to be able to do these things?Meagan: Yeah, that was actually one of the reasons among many that I did want a VBAC too. A lot of people were like, “What are your reasons?” One of them was that I want to have a better postpartum experience physically as I’m recovering because I just remember being so– and it can happen with vaginal birth too. Vaginal birth doesn’t just eliminate your chances of not a great experience. You can still have a not-great experience with that with a vaginal birth, but yeah. I was like, “I want to be able to pick up my kids. I want to be able to drive if I needed to. I want to be able to–”. Rebekah: Go to the bathroom and shower by yourself. Normal human things. Meagan: Right, not have my husband holding me up showering. Yeah. That, for me, was such a big difference too in my recovery. That alone. Yeah. I’m so happy for you. I’m so glad that you were able to not only just have a different experience that was healing just in general but then all of these little things that you were able to heal from in addition like you said with the tub and these peaceful experiences and your connection with you and your daughter like, “Hey, I think she’s scared and I need to go talk with her. I need to be with her.” And even during the pushing, you had that connection again. “Hey, honey, we are excited.” You were touching her and talking to her. It just goes to show so much how much more connected these babies are than we think they are. They really, really are and your body was ready. Your baby wasn’t ready and sometimes that is the case and we have to understand that usually when spontaneous labor is going on or whatever, it’s a team effort– body and baby together. Sometimes it’s not and we have to help them. Rebekah: Yeah, exactly. It was crazy actually pushing a baby out. I don’t want to say that I’m scared of doing it again but I wasn’t expecting it to be as intense as it was. With my son, I was complete. I had dilated to a 10. I was fully effaced. His bum was right there. I think if we hadn’t known sooner that he was breech, I wonder if we would have had an accidental breech delivery at the birth center because I was complete. I was ready to push a baby out. My body was already pushing. I had done all of the labor up to the pushing a baby out part. I think I had just built it up in my head, “Oh, you’ve done this before. You’ve done this before. You’ll be okay.” I had done everything but the pushing phase. Feeling her actually coming out of my body was such a bizarre sensation. After her head was out, I actually felt a little wiggle. She wiggled her body in there and I said, “I can feel her moving.” My midwife was like, “Yep. She’s getting ready to come out.” It was incredible that I was able to actually feel all of these things even though it was painful and it was hard. That’s the only thing I wanted. I wanted to feel what it was like to actually birth my baby out of my body and do what it was designed to do. It just was incredible and it doesn’t take away from the experience with my son at all. Both labor experiences and both birth experiences taught me so many things in completely different ways. When I tell my birth story with my daughter, I really hope that it doesn’t come off that I was trying to rewrite history or trying to erase the way things happened with my son because it’s not the case. The stories don’t exist without the other. It’s just been incredible to see how their personalities are different just based on how labor went with them. I really believe that the way your labor goes and the way your pregnancy is, you can almost tell what your baby’s personality is going to be like based on those things and how they go. Definitely with my kids, that has been true. Meagan: Yeah. A lot of people especially with breech are like, “Oh, this stubborn baby. This baby wouldn’t flip. This baby threw us a curveball,” then they come out and they’re like, “They’re still throwing curveballs. They’re still stubborn.” I mean, I’ve heard that is definitely something that can happen. The babies set the stage. Rebekah: Yeah, absolutely. I kept saying when I was pregnant with her that I felt like she was going to be a feisty baby and be fiery. That is how she is. It was beautiful. Meagan: Well, I’m so happy for you. I absolutely love, love, love your birthing team over there. They are just so amazing and I’m so glad that you had a doula and you had the support and that you were able to find healing through this birth experience. You know, every single birth is unique. You’re going to heal and grow through every single experience. It’s the most beautiful thing. Rebekah: This podcast helped a ton. That was another thing that I did during my prep. I was listening to The VBAC Link Podcast and a couple of other podcasts. I watched lots of birth stories so for VBAC moms, it is another piece of advice I have. Really just soak in all of those VBAC stories and instill that confidence in yourself because I have heard some moms who stay away from podcasts and they like to just have their thoughts and their experiences be their own. That’s great and that’s fine, but for me, I really needed that support and I really needed that constantly spoken into me. So hearing birth stories, especially VBAC birth stories for VBAC moms is invaluable. It was incredibly empowering. I’m so thankful for your podcast and the fact that you do this and put this community together for moms who listen to it.Meagan: Thank you. It’s definitely something that I missed out on in my pregnancies and wanted. I was searching and searching and searching. There would be VBAC stories here and there but I really needed something more. That’s why we started this so we could hopefully help people along the way and have more and have that community and that support and just that drive. I feel like you hear these stories and it really helps you be like, “Oh, okay wait. These hundreds of women before me have done this. These are not even half of the women out there.” The amount of submissions that we get and the amount of stories on social media, there are so many stories out there. You are all Women of Strength and you can do this. I think you are right. Listening to these stories, you’re going to find something. You’re going to find connection and nuggets. You might even find healing through other people’s stories. It’s weird to think about that but truly, yeah. Rebekah: Even the repeat C-section stories, I loved hearing those and that was what my mental and emotional prep this pregnancy revolved around. I was like, If we’re going to have a VBAC, we’re going to have a VBAC. That’s not what I was worried about. It was that I wanted to make sure that my mind and my spirit and my body were in a place to receive another C-section if it needed that. If I have to have another one, I’m going to make sure that it’s a positive experience this time around. So hearing those stories from women who had repeats and even that was healing for them was awesome to hear. Meagan: Yeah, and you were talking about that in the beginning with that unexpected. Your unexpected was that you had an unexpected breech, surprise baby and you were exhausted. That was the route that felt right and some people go into spontaneous labor and it turns into a Cesarean for whatever reason or they go into an induction and the body wasn’t responding and baby wasn’t responding. We have these unexpected experiences and it’s hard because when we are preparing for unmedicated vaginal birth or a medicated vaginal birth or vaginal birth in general, we don’t want to think about that Cesarean. We don’t. It’s easy to push it aside. That’s one of the reasons why I think sharing CBAC stories and scheduled C-section stories on the podcast is so important because it does happen and it’s important to learn your options there. We just share stories here and we want everyone to find what’s best for them and if we limit what we can learn, I think we are doing ourselves a disservice. Rebekah: Absolutely, yeah. Yeah. I hope to get into birth work someday. Ever since I got pregnant with my son, I have been completely immersed in all of it. My Instagram feed is 90% birth workers. So I have learned so much and I used to do that. I used to only really pay attention to the holistic, natural, unmedicated side of things but now, I follow several labor and delivery nurses and OBs and take little pieces from here and little pieces from there. As you are preparing for a new baby, you can’t possibly know everything or prepare for everything but knowledge is power and knowledge helps to dissipate fear. As much as you possibly can, learn and arm yourself with it. Like you said, I think that’s why doulas are so important too. They can help you in that process of figuring out what education you can focus on or should be focusing on based on what you want. Yeah, it’s just incredible. Birth is incredible no matter how it happens. It’s hard and it’s gritty and beautiful. Meagan: Absolutely. I couldn’t agree more. Well, thank you again so much for being here with us and sharing your stories. Rebekah: Thank you so much. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
01:03:3030/10/2024
Episode 347 Colleen's VBAC After Fertility Challenges & Navigating Trauma + MTHFR & Velamentous Cord Insertion

Episode 347 Colleen's VBAC After Fertility Challenges & Navigating Trauma + MTHFR & Velamentous Cord Insertion

Colleen’s first pregnancy ended in a miscarriage at 6 weeks. At 12 weeks along with her second pregnancy, Colleen and her husband found out that their daughter would be born with a genetic condition called Trisomy 18. Colleen shares her experiences with Trisomy 18 and how she found the right support to help her navigate through it all. Due to IUGR and other medical concerns, Colleen had her daughter via Cesarean with an 85-day NICU stay afterward. To her surprise, Colleen had a third pregnancy just 6 months after her daughter’s delivery which ended in a heartbreaking second-trimester miscarriage. After discussing her pregnancy and birth histories at an appointment, Colleen’s doctor referred her to be screened for a MTHFR gene mutation for which she came back positive. MTHFR (methylenetetrahydrofolate reductase) is a gene that impacts your ability to process and absorb folate. It can be responsible for complications during pregnancy and is detected through a simple blood test. Colleen and Meagan talk more about what MTHFR means, and what Colleen was able to do to have a fourth uncomplicated pregnancy and a beautiful, smooth VBAC delivery! Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome to the show, everybody. We have our friend, Colleen, on with us today sharing her stories and navigating through this amazing journey that we call birth. Birth is such a journey, wouldn’t you agree, Colleen?Colleen: Absolutely. Meagan: One of the most unique things about it is obviously through the stories we all hear. They are all unique and individual to us and even one birth that you’ve given doesn’t mean the next birth is the same. So we’re going to be talking today about navigating through birth and we know that a lot of the times through these journeys whether it be because of a Cesarean or because of how we were treated or because of how our body responded or whatever it may be, sometimes and a lot of the times, we experience trauma. Trauma is viewed differently from everybody and processed differently. We are going to be talking about navigating through trauma. Then Colleen is actually going to share some of her fertility journey as well. I think that’s also a really important thing because we have so many mamas out there– we know. We know. We see it. They have to navigate through fertility challenges. We’re going to be talking about that along with a VBAC. Let’s get into that here in just a minute. We do have a Review of the Week then like I said, I’m going to introduce Colleen and turn the show over to her so she can share her beautiful stories. This review is from lexieemmarie. It says, “So thankful. I just wanted to say thank you for creating this podcast. I had my baby girl via emergency Cesarean at 30 weeks due to several medical complications with my baby. We spent 95 days in the NICU and while in there waiting for my sweet girl to grow, I started to research VBACs to see if it was right for me. Once I found this podcast, it sealed the deal. I absolutely can’t wait to VBAC with my next pregnancy. You all are incredible to listen to because you provide the wealth of knowledge and positivity but are also fun and entertaining to listen to. Amazing job, ladies.” Aww, that just made my heart so happy. Oh my goodness. Thank you so much, Lexi, for your review. As always, we love these reviews. They make our hearts and our minds so happy. You guys, this is what we want. We want you to have that wealth of knowledge. We want to have you feel inspired and guided and uplifted and educated along the way through all of these stories. As usual, leave a review if you haven’t yet. We would be so grateful. Meagan: Okay. We have Ms. Colleen. She lived in Michigan. Did you have your VBAC baby in Michigan? Colleen: I did, yes. Meagan: You did. Colleen: My husband and I live in a suburb of Detroit in Gross Point so that’s where I gave birth in August of 2024. Meagan: Awesome. Awesome. Okay. Wait, 2024? Just right now?Colleen: Yeah, I’m 2 weeks postpartum. Meagan: Yes, I love it! So really, really fresh. Colleen: Fresh. Meagan: I love sharing stories that are so fresh like that. It is right there in your brain. Colleen: Exactly. Meagan: Oh my gosh. Okay. She has two beautiful children now and one two-week-old baby. Your two-year-old daughter is Gianna? Colleen: Gianna, yes. Meagan: She was born via Cesarean due to chromosomal abnormality. Do you want to share what that means?Colleen: Yeah, I would love to. Gianna has a chromosomal condition called Trisomy 18 that we did find out about through the genetic screening early on in pregnancy that she was considered high risk for coming down with Trisomy 18. As the pregnancy progressed, it became pretty evident that it would be the reality. For those of you who don’t know, Trisomy 18 on its surface means that the baby will have an extra 18th chromosome in some or all of their cells. How that manifests itself is through some pretty serious medical complexities that require quite a bit of care. I will get into that a little bit more with my story but that is the quick version of Trisomy 18. She is also now 2 years old and a bubby, sometimes sassy, little girl. Meagan: Is there another name for it with an E?Colleen: Edwards Syndrome, yes.Meagan: I have another friend who has that and I seriously adore him. He is thriving and doing amazing in life. Colleen: Yes. She is a warrior. She is so strong. She is so beautiful and has brought nothing but love and joy to everyone who knows her or who don’t know her. There are so many people from near and far who love her. It’s great. Meagan: Yes. Awesome and then we’ve got Sonny who was born via VBAC just two weeks ago you guys. She says, “As a mama of a medically complex child, she is passionate about awareness and education for those within her daughter’s condition. She also enjoys running, reading, cooking, and volunteering.” Colleen: Yes, that’s a little bit about me. Meagan: I love it. Welcome to the show and thank you so much for being here with us. I would love to turn the time over to you to start sharing Gianna’s story. Colleen: Amazing. Thank you so much for having me on. The VBAC Link was a staple on so many of my walks when I was getting ready to give birth. I just found it to be so uplifting and empowering and I’m so glad that I found you as a resource. A little bit of background before getting to my VBAC– it really does begin in about 2022. It starts out with some of those fertility issues that you had mentioned at the start of the podcast. My husband and I decided to start trying after about two years of marriage and we got pregnant pretty quickly. That ended early in a miscarriage at about 6 weeks. But we said, “Okay, let’s try again.” We had processed and accepted that miscarriages do happen so we quickly said, “Let’s give it another go.” But we had those reservations and that in the back of our mind of moving forward cautiously. We did get pregnant quickly again. Throughout the first trimester, we just kept it tight-lipped. We just told immediate family and then decided we wanted to do the genetic testing of course to find out the gender. We didn’t really give too much thought to what else you learn from that bloodwork. As my pregnancy progressed throughout the first trimester, I was feeling confident then at about 12 weeks, we received a call from my midwife. She told us that it was a girl and that she came back high-risk with Trisomy 18. We weren’t expecting that. It was scary and a shock and the more we learned and the more we read in those early days was devastating to us. We were just coming off the heels of a miscarriage so then to have this thrown at us was just a real curveball. In order to move forward and navigate that, my husband and I were always planning on keeping the pregnancy so it just meant, what does that mean going forward? After talking with more specialists and maternal-fetal medicine at the health system that I was at at the time, it became very apparent that they weren’t really willing to help. We needed to find another health system. We are so fortunate because we were living out of state for quite some time then moved home before we started to try. We were living in Chicago and then moved back to Michigan. University of Michigan, so CS Mott Children’s Hospital is for sure the best in the state and one of the best in the country for caring for kids with my daughter’s condition. We switched all of my prenatal care there and they provided us with hope and were willing to monitor me and have a very wonderful NICU. They were willing to provide interventions and things after she was born. But as it related to my pregnancy, it completely deterred any sort of plans and any sort of “normalcy” that one might have. It was shrouded in sadness and anxiety and fear and unknown. Each ultrasound and each week was closer and closer to meeting her but also closer and closer to what does this mean for her? What does this mean for our family? I completely abandoned any apps or what size fruit she was going to be at a certain week because she had intrauterine growth restriction. That rulebook and those guidelines went out the window. I was really afraid to connect with her when I was pregnant. A lot of the time I would say, “Okay, be in tune with her. Read to her and rock her and listen to music with her,” and I would just end up in the nursery that we decorated in tears because I just had so much fear and sadness around what was to come. With that being said, because my plans had been derailed, I really threw myself into learning about her condition and learning about what would come afterward. That gave me hope as a very Type A person. I needed to be doing something to prepare and connected with other families from around the country to give me and my husband hope and learn about what life with children with Trisomy 18 looks like and what they are capable of really was our main driver throughout pregnancy. With that said, I did not prepare for birth at all. I didn’t learn about how it could possibly go. I really just, like I said, focused on what care for her would look like. Just as a very small example of what that even looked like was when I came to write my birth plan, I probably wrote a couple of things like, “Oh, open to epidural. Do you have a birthing ball?” I honestly had a line in there that said, “If she is born not breathing, resuscitate her.” That is where my head was throughout pregnancy and it just came to however she was going to arrive, that was second to her being here and us starting to care for her. Meagan: Yeah. Colleen: That said, my care team, obviously I was being seen by the MFM department at CS Mott. They were very supportive. I never felt like they weren’t looking out for both me and her. I think they wanted me to deliver vaginally and with the understanding that if it came to a Cesarean that would be what it was. My husband and I made it very clear that we wanted to be treated however they would handle a typical pregnancy. Meagan: Anybody else, yeah. Colleen: Yes. Yes. If it meant a C-section, that’s what it was going to be kind of thing. She was showing that she wasn’t tolerating labor. We got to the end of pregnancy and we were discussing what birth would look like. We all agreed that an induction at 37 weeks was going to be the plan for a couple of different reasons. From our perspective, we wanted to just start caring for her knowing that she was going to have complexities. We were in the best place possible to start that process. There is some research that would show that the longer that babies with Trisomy 18 are in utero, you could run into a stillbirth situation. Now again, it’s a little bit more on the anecdotal side because many, many kids with Trisomy 18 are born vaginally at 40-41 weeks and it’s how you want to play it. Meagan: You have to weigh it out for what’s best for everybody. Was IUGR becoming a problem at all or was she still small but staying within her own growth chart?Colleen: Toward the end there, we were seeing some stagnated growth so yeah, they were very much of the mindset, “Let’s just get here here,” kind of thing. She was born at 3 pounds, 12 ounces. She was just a peanut. Meagan: Little tiny, yeah. Colleen: I was induced at 37 weeks without having much knowledge of what the induction process was going to look like for me and I went in at a centimeter. They started with a cervix softener so that they could then insert the Foley balloon. I was in bed a lot. I utilized the tank of nitrous oxide. I labored that way for a while just to mitigate that pain. I was walking around a little bit but honestly, the Foley balloon for me in the whole induction process was probably the worst part. I was in quite a bit of pain after that. Meagan: Were you dilated at all before when they tried to insert that or was it a closed, posterior cervix? I’m assuming at 37 weeks, it’s not doing much. Colleen: I was a centimeter when I came in and I was maybe a 2 when they inserted it I believe. Yeah. It was very apparent that my body was probably not ready for that process. Meagan: Yeah. Colleen: Yeah. That also became apparent once the Foley balloon came out but then pretty much I got to 5 centimeters and just parked it there for quite a bit. The pain was pretty intense so I received an epidural after laboring I would say probably 14-16 hours or something like that. The attending OB wanted to take additional steps by breaking my water and my husband and I were talking. We said, “If they break my water and then I don’t progress, then what situation are we in?” We also knew beforehand that my daughter did have a confirmed heart defect. We wanted a more gentle approach to induction especially when it came to Pitocin. We really wanted to take it slow and monitor her to make sure she was tolerating it and things like that. We opted for Pitocin before breaking my water and took it slow. I would say probably another 6-8 hours went by. We were taking it very slow. I wasn’t progressing and then we started to see some sporadic, not super consistent but enough to keep make us aware of her, decels that she was having. Again, the attending OB really wanted to continue on. She wanted to break my water. She wanted to optimize my chances for a vaginal birth, but again, I think my husband and I were so zeroed in on having her here safely that even the attending OB after observing some of the decels into the night was like, “Okay, I think–”Meagan: That was enough. Colleen: Exactly. She arrived via C-section on October 28, 2022 at 3:18 in the morning which we find incredibly special because 318 is a universal number around Trisomy 18. We just feel that she was meant to be here just as she is. That was enough for us to say, “Okay. We did what we think we needed to do to get her here safely.”Meagan: And happy birthday to her today. She will be 3?Colleen: She’s actually turning 2. She’s turning 2. Yep, yes. So that was my obviously first birth experience and it was– I can’t even say different than what I expected because again, I really went into that not having much of a reference or much preparation at all. I say, “Okay. That was my experience. It was a C-section.” We weren’t thinking at the time. We always knew we wanted future children but with the timeline, we had an 85-day NICU stay with her. There were other things that we were focusing on. Meagan: You and the reviewer. You NICU mamas are amazing. Colleen: Perfect review for today. After 85 days, we came home in January of 2023. We were getting settled into home life and then fast forward to about 6 months postpartum. We had just been home for a couple of months and much to my husband and I’s surprise, we were pregnant again. From the first miscarriage to my daughter, we had that hope and that mentality of, “We have no reason to think that anything is going to go wrong so let’s just operate from the stance that everything is going to be okay.” We took a similar approach this time around. We said, “Okay. We’re going to roll with the punches. Gianna’s going to get a sibling a little bit sooner than we initially had thought. Let’s just play it like everything is going to be okay.” We had met with a geneticist and knew our risk for having another child with Trisomy 18. We were just slightly above the general population when it comes to the statistics there. We weren’t super concerned. It was a very, very low risk. We decided to do the genetic testing anyway. I didn’t consider myself to be high risk so I moved my care to a little bit closer to home. The University of Michigan is a little over an hour for us. I had a great experience but wanted to move just a little bit closer to home to a practice that is very utilized on this side of town by many women. I did the genetic testing and everything was good. We were having a boy and then the very next day, I woke up to a very large gush of blood. I went to the emergency room. This was on a Saturday. They did an ultrasound and said, “Baby is looking good.” I was again, about 12 weeks at this point. They said, “Sometimes just bleeding in the first trimester happens.” I took that at face value. I came home Now mind you, with my daughter’s condition, she has a lot of medical equipment and lower muscle tone so it’s a lot of carrying her around and at that point, she was still pretty small but again, I’m pregnant and I’m hauling her medical equipment plus her some days. I’m a stay-at-home mom so I’m trying to navigate all of that. I’m going about my daily life not really thinking much of it just saying, “Okay, that’s what it is. The first trimester bleeding.” I went back to the OB that week and they also confirmed, “Oh yeah, it could just be bleeding.” I said, “Okay.” Then about 2 weeks later I’d say, again on a Saturday, it happened again. The bleeding had tapered off then it happened again. I went back to the emergency room to make sure everything was okay and it was a different emergency department. The nurse practitioner came back in after the ultrasound and said, “You have a really large subchorionic hematoma.”Meagan: I was going to ask if that’s what it was. Colleen: Yes. We had done research obviously between the two ultrasounds and people said, “If you do, it likely will heal on its own.” Meagan: It takes time, but if you do activity and things like that. Colleen: Yes. I would say probably about 2.5-3 weeks went by with me not knowing I had it. I hemorrhaged again. This time, I really tried taking it easy leveraging my husband, my mom, and my mother-in-law to really help care for my daughter so I would be able to rest and recover. When I had gone to the OB that Monday just because I had been in the emergency room over the weekend, they painted it like there was not much you can do. If you can take it easy, great. If not, I actually went in that Monday and I had brought up the subchorionic hematoma and the provider that I met with said, “Oh, yeah. You have it but actually, I want to talk to you about something else.” It was a potential marginal cord insertion or a velamentous cord. Meagan: Okay. Colleen: She said, “I actually want you to be more aware of this than the subchorionic hematoma.” Again, it was pushed to the side. At that point, in partnership with some other pretty inappropriate and I would say frankly bad bedside manner from the practice, I was looking to move again. They were very insensitive around my daughter’s condition. They made me to be othered because of her. I just didn’t appreciate that. I was like, “This is a different birth.” I didn’t appreciate that treatment. They asked very inappropriate questions about her and her life expectancy and things that were very triggering for a) someone who was fresh out of birth and a very traumatic pregnancy. I just felt that was very inappropriate to ask those things especially when we are also not talking about my daughter. We are talking about this pregnancy at hand that was having some issues. I was looking to switching providers. I have my best friend in the area. I loved her. She was pregnant at the time as well. She loved her OB so I was looking to switch. I couldn’t get in for a couple of weeks so I just said, “Okay.” At the next month’s appointment, I would switch practices away from where I currently was. In the meantime, I would say about a week and a half later, I was bleeding again. It was on a Monday so I got in that day and I personally had a little bit of peace around it because I just said, “Okay, this has happened before. Baby has always been okay, but let’s get in.” So I got in that Monday and I was given an ultrasound and the ultrasound tech put the wand over my belly and then very quickly went out of the room. My heart sank. I just knew what that meant. She came back and I asked, “Was there a heartbeat?” She just shook her head no. I was by myself because my husband was home with my daughter and it was just completely unexpected and devastating. It crushed us because we again had just come off of something so difficult and had so much hope and for that to be the result was quite crushing. I had reached out to the OB that I had planned to switch to and I just explained the situation. She said, “I’d like to still see you.” I went in about 2 weeks after my miscarriage and just laid everything out for her. She shook her head after me telling her about my first miscarriage and then my daughter and this most recent miscarriage. She took it all in and she goes, “I think there is something going on. I don’t think these are just flukes so I want to run some tests.”She ordered some pretty extensive bloodwork mostly in the autoimmune space but she also ran for MTHFR. After many vials of blood and a few weeks of waiting, I came back negative for anything autoimmune but I did in fact come back for MTHFR and she is a provider who believes that it does make a difference. She said at the time that she provided us with this glimmer of hope. She said, “If I know that a patient has that, I start them ideally on a pretty ‘easier’ regiment or something to get them started to see if that makes any difference in their pregnancies. If not, we can build with Lovenox injections and things like that.” Basically she said, “I want you on additional folic acid.” I took methylfolate and a baby aspirin. But she posed it to my husband and I. “Do you just want to go the Lovenox route? Once you go on Lovenox, I won’t be able to walk you back on additional pregnancies. If you have a successful pregnancy–”. Again, knowing this wasn’t going to be the answer and that we could potentially have another loss or more issues with pregnancies but we wanted to start on that first step before jumping forward.She said, “Pick up those supplements when you feel like you are ready.” We needed time. We needed months of healing and of focusing on my daughter’s care to just really level-set for our family. But in December of last year, we felt strongly that we wanted Gianna to have a sibling so we decided to try again. I got pregnant and began those supplements. From that perspective, my pregnancy was very difficult. Now, it also gave me that time both prior to getting pregnant and then throughout my pregnancy to really– I really wanted to level-set my approach and my outlook on pregnancy. I had felt like I had been always in this cycle of seeking out information or researching based on issues and I think my and as well as my husband, the trauma aspect always played into it of, okay. Here’s a symptom. It could be something very normal or it could be these very unique, rare things that we got used to feeling comfortable in that space. Meagan: Yeah. Colleen: I sort of recognized that as something that I needed to work through. I needed to work through some things that were either emotions I pushed aside. I pushed aside the thoughts and feelings around especially that second miscarriage because I said, “Okay, I have a daughter with medical complexities.” I needed to jump back in and I think that distraction helped me push those thoughts away but then I will say they came back. They reared their head and I said, “Okay. It’s time for me to deal with them.” So going back to talk therapy has been really helpful for me for working through some of those emotions as well as unprocessed things with my daughter’s pregnancy and birth and care and things like that, the realities around her life and how it’s impacted myself, my family, and things like that. I went back to talk therapy and then also got pregnant. I thought that was the perfect time to really sort of level-set my outlook on pregnancy. We forewent the genetic testing around. We just said, “What will be will be.” For now, the fourth time, we are choosing to believe that all will be well. We will have these feelings. My first trimester almost felt like the closer I got to the end of my first trimester, the more anxiety I had because I had that second-trimester miscarriage that I just had the opinion that it could happen at any time and why wouldn’t it just happen to me again?There were some friends who didn’t know that I was pregnant until my anatomy scan just because I felt like I needed to hold it close to my chest. Meagan: Just keeping your space safe. Colleen: Exactly. Exactly. And protecting my own emotions. So the first trimester for my son did have some of those thoughts and feelings. The OB who I had switched my care to was very accommodating. She had a little portable ultrasound machine in her office if I felt like I needed that reassurance that she would provide the ultrasound for me. She asked me how often I wanted to come see her. She was just very understanding and accommodating based on my previous circumstances. It also allowed me the space, especially as I moved through pregnancy, to really think about birth and think about how that process could be healing as well. In my second trimester, I remember going on a walk because I needed to clear my head and just feeling so overwhelmed by not knowing where to start and then I was being hard on myself because I was like, I should have done this with my daughter. I should know these things already. This is my second birth. I was being very self-critical as if I didn’t have other things to focus on with her. That’s when I came across The VBAC Link. I actually came across it because my husband and I had taken some on-demand birthing classes through Mommy Labor Nurse and we very much so said that we needed a refresher and probably to take some more diligent notes this time around. It was a resource that she has promoted so I checked it out and I just immediately felt like it was going to be so helpful as it was throughout pregnancy just listening to the podcast episodes, referencing the blog, getting your emails, and just really feeling like I had a resource that was going to support me. I can’t express how grateful I am for that because– and I’m about to get emotional– of how along pregnancy and that journey has felt. I’ve constantly felt like I’ve been up against walls that it’s been exhausting to have to overcome and to break down. Meagan: Yeah. It’s a terrible feeling to feel so alone in this really big moment in your life and not feel like you know the direction all the time and then also making decisions and then having the world pretty much question why you are making that decision. It’s so heavy and that’s why I love this community so much because they make you feel connected to people that are not even within reach. They are hundreds and thousands of miles away. Colleen: Absolutely. Absolutely. Just to have that support because it very quickly became my goal to VBAC because I flipped the script after finding The VBAC Link. I said, “There is nothing pointing to my body not being able to do this. I’m going to go for it.” I’m a competitive person and sometimes I’m competitive with myself and I said, “This is going to be a competition and I’m going to do this.” I will say getting into the true VBAC part of it, my OB was very supportive. She said, “I think you are the perfect candidate to VBAC.” She did want to see what my body did closer to which made me a little bit nervous. She was like, “I’m not for induction but I would do augmentation.” I was like, “Okay. Let’s see.” Again, it was a motivator to me to do all of the things that I could do to edge myself along kind of thing. The biggest thing I leveraged was walking. I walked a ton and I just found a routine in the business of life that worked for me that I could rely on each and every day and say, “Okay, these are the three things that I’m going to do throughout the rest of pregnancy to a) give myself peace mentally and physically, but also just to say life is busy, but this is what I’m going to do to move myself forward.” It was a lot of walking. It was a prenatal that I just really adored and I just committed to a pretty nutritious diet to make sure that I was nourishing my body in all the ways that I could. Around 36 weeks, I received a cervical check and was starting to dilate and efface. I was about 2 centimeters. Meagan: Wow. Colleen: Yes, with about 70% effacement at that time. My OB said, “Things are looking good. You are on the right track here.” I just kept doing what I was doing. I did opt for a membrane sweep at 38 weeks and I will say having never labored before, between that 36 and 38-week mark, I was having a ton of prodromal labor which was very frustrating because I never knew what was real. We went to labor and delivery once. I got turned away and sent home. I thought it was the real deal. Yes. Prodromal labor is a tease. But after the membrane sweep, it became very apparent that I was actually in labor. That afternoon, my husband and I and my daughter lay on the couch. I was having closer and stronger contractions and we joke that it was absolutely the real deal because all the times leading up with prodromal labor, everything was squared away. My meals were prepped. Everything was squared away with my daughter. My in-laws and my parents were ready to go and jump in. The day that I started to be in labor, our basement flooded with our sewage backed up. Meagan: Oh no. Colleen: I’m actively in labor and my husband comes up and says, “This is absolutely the real deal because this wouldn’t have happened if you weren’t.” I’m in labor and my father-in-law are bleaching the floor and scrubbing. It was a whole thing and I was like, This isn’t funny right now but it will be funny one day. And it’s funny. I was able to labor at home for a few hours. I got to the hospital. I had the membrane sweep at noon that day. I got to the hospital around 9:30 PM and was at a 5. I was feeling pretty good about that. I was feeling those contractions of needing to pause. I wasn’t really able to talk through but still at that point now knowing what later labor felt like that it was just the beginning of things. I had a wonderful labor and delivery nurse who was super supportive. I never felt being there like I had to convince anybody. They knew that my plan was a VBAC. The attending OB was cool with it. My OB lived just a few minutes away from the hospital and said that she would be there within a moment’s notice when I did deliver so I would have her for the moment of. I got to a 5. They did put me on the monitors and had me hooked up so my movement was pretty limited which kind of limited what I was able to do. I wanted to walk a little bit more. I was only able to sit on the birthing ball in a certain area of the room. That was a little bit tricky. The shower was really nice and I did appreciate laboring in the shower but it was the attending OB who had checked me when I first got there and determined I was a 5. A few hours later, the labor and delivery nurse checked me and said, “Oh, I think you are a 7.” My goal was to get to active labor before I decided if I wanted an epidural but ideally, I wanted to go unmedicated. So when they said I was a 7, I was like, “Oh, okay. All right. That’s the motivation I needed to keep pushing on. I can do this.” My contractions were becoming more frequent but they weren’t getting stronger. It almost felt like at a moment’s notice when they had to put the IV in or if the pain was too intense that I would start to space out again which I found to be interesting. But when a few hours went by, the pain was intensifying. They wanted to check me again and it was the OB this time who had checked me earlier and she said, “Oh, you’re a 6.” My husband and I said, “Well, they said I was a 7 when they checked me last time.” She said, “Yeah, but I’ve got the frame of reference and you’re more of a 6.” That messed with my head. Meagan: I’m sure. Colleen: My breathing was no longer effective. The pain was getting to me. The next step they wanted to take was breaking my water. I just didn’t feel like I was in the headspace to continue on without the epidural. Meagan: You were mentally derailed. That can happen. Colleen: Yeah. When it came to my birth plan this time around, I was a little bit more descriptive because I had done more research. I wanted to go the unmedicated route if I absolutely could. If not, at least active labor. I really didn’t want any augmentations or interventions when it came to breaking my water or Pitocin. I really wanted to be able to do it on my own but I will say and I think this is one of my bigger takeaways from this birth is that even when things don’t go according to plan, you really have to trust your gut. I will say in those moments, my gut was telling me I think what needed to happen to service the overall goal which was my VBAC. I said, “Okay. I think in order for my body to relax, I want the epidural.” I get the epidural. My body did just that. I was able to relax. My contractions were getting closer together again. They did break my water and now we were into the morning hours here. I get a call from my OB and she said, “Hey, I’m aware of your situation. I see that your contractions are getting closer together but they are still not at that strength that we are really wanting to see.” She said that, “If you are okay with it, they want to start me on very low doses of Pitocin.” She said, “I think you will need a whiff of it in order to get to where you need to be.” My husband and I looked at each other and I think because of our experience with Pitocin previously and not wanting to stall out or anything go wrong, we really struggled with that piece but I think ultimately, we said, “Okay, we’re already here. If this is what my OB thinks this is what I need–” and again, I personally felt okay with moving forward in those directions, “then, let’s give it a try.” She was absolutely right. They started at a 1 and bumped it up 45 minutes later. I was feeling some pressure and I wanted to switch positions. I had the nurse come in to help me. She lifted up the blanket to move me and she said, “Oh, his head is right here.” He had been crowing for we don’t know how long.Meagan: Oh my gosh. Colleen: My husband looks down and he goes, “Yeah, his head is poking up.” My OB gets there. It was super relaxed. She just walked in. She had her sunglasses on. She was just like, “Okay, let’s do this.” She was getting set up. He had a bunch of dark hair and she was giving him a faux-hawk while she waits for things to get set up. For the moments that led up to that with anxiety around the interventions, the moment of his birth was very relaxed, very calm– Meagan: Lighthearted. Colleen: It had this great energy around it. I pushed for about 15 minutes and he was born. Meagan: Oh my gosh. That is amazing. What a way to end such a lead-up to get to this moment in your life. Colleen: Yes. His birth, the moment of his birth and the half-hour leading up was so joyous and healing like I had always hoped it would be and exactly what I think my heart needed. Just not necessarily VBAC-related, but I think I also struggled with all of the needs of my daughter and having now split time, I think going from one to two for some mamas can conjure up those feelings and that guilt around what your firstborn is not getting especially with all of her extra needs and things. I was really feeling that guilt. Now he’s here and he is exactly what my family needed. He is just this puzzle piece that was missing. We didn’t know it. We didn’t know it until he was here and now we feel that way on so many levels. Meagan: Isn’t that crazy sometimes? This is one of the coolest things I think about being a doula is that we see these couples and they think that their life is so amazing and it is. Don’t get me wrong. It is amazing. They think that they love each other more than they ever could love each other. I can see the love in their eyes. I can see the support as the labor goes and then this human being enters their family and like you said, it’s just this puzzle piece that fit that you didn’t know you were missing. It’s this extra joy and this deeper love that they didn’t even know existed and it’s one of the coolest things to see families transform. Yeah. It’s absolutely amazing. Even from no kids to one kid and from one kid to four kids, it doesn’t matter. Like you said, it’s the puzzle piece that they didn’t know they were missing. Colleen: Absolutely. I just can’t wait to watch my daughter learn from him and him learn from her. That relationship– I even had the thought where I was like, “I’m the most important thing to my daughter,” then I’m like, “Okay, but she’s going to have a sibling and that is such a gift in and of itself that I just am happy to be able to provide that,” but to your point, it is. It’s a love unlike any other love. You will always obviously hold your partnership with your partner. It’s so important and so instrumental to providing that love for your children as well but that love that you get from birthing a child is unparalleled. Meagan: Oh my gosh. It’s so amazing. It is so amazing. I feel so grateful as a doula and as someone who is done having kids– my youngest is 8 years old now but I get to keep living through all of these couples. It’s just so amazing. Oh, well congratulations. Colleen: Yes. It’s so beautiful. Again, it didn’t go on the micro-level according to plan, but on the macro-level and in my big-picture goal of having a VBAC, it was all I could ask for. Rolling with the punches and I will say again, going back to the beginning of the podcast and sharing that I’m a very Type A person, I think had my past not happened, any of these little interventions that were needed throughout this birth could have also derailed me or discouraged me and I just think all of these experiences I had up until this point taught me that rolling with the punches and just understanding that things might not always go according to plan but healthy me, healthy baby– Meagan: And a good experience. Colleen: Exactly. Meagan: Rolling with the punches while trusting your intuition because some of those punches might look like punches but it’s actually what you need. Colleen: 100%. Trusting your gut, advocating for yourself, also important to keep in mind. Meagan: Super important. Well, before we go, I wanted to quickly give some more depth into some of the things that you had brought up along the way. We talked about your daughter’s condition and then there was something that you said that is a really big tip that I give to my clients when it comes to breaking the waters versus starting Pitocin. It’s okay if you don’t agree with me, everybody out there. A lot of people would rather break water over starting Pitocin because it’s the “more natural way to get things going”. But I’m such a person of, let’s try a whiff of Pitocin that we can turn off, but if we are artificially meaning we are breaking the bag of waters by ourselves against mother nature’s choice, we can’t patch that back up and we don’t know what’s going on so we don’t know if baby’s in a weird position. We don’t know if baby is too high. We don’t know what’s going on so sometimes I think just starting that 1-4 mL drip of Pit and then you can always turn it off and it’s gone. I was going to say that’s weirdly one of my suggestions that over all of my years of doing this, I would weirdly suggest that sometimes over breaking your water. That really depends on where we are at too. If we are 9 centimeters and baby is +2 station, we’re really engaged, I dont know. It might change. But if we are at the point where you were at, I actually would suggest that. I wanted to really quickly talk about VCI and marginal. So velamentous cord insertion. You mentioned that the OB was like, “Yes, subchorionic and we’re here but then we’ve also got this.” With VCI, that is where the cord is inserted abnormally into the placenta. It can cause things like IUGR which we talked about earlier so intrauterine growth restriction. I don’t know if they gave you any stats on this but it’s a 1% chance of that happening with a singleton baby, a 6% chance with twins and then if they do share the same placenta, it can go up. I want to say it’s upward of 15%, so much higher. But a lot of the time, even VCI babies carry to term and everything is okay. I do want to throw it out there that a lot of providers do suggest a Cesarean with VCI. I don’t know if you’ve ever heard of that. People can have vaginal births but a lot of providers will suggest Cesareans. If you have VCI or are being told that you have VCI, just know that might be a conversation and you want to discuss that with your provider earlier on. She also mentioned a marginal cord insertion which is where that attaches to the side I believe so also an abnormal insertion. I don’t know. Did your provider tell you anything about that? Colleen: Not the statistics around it but they also said that I was 6 months postpartum, post-C-section when I did get pregnant again so their recommendation I think regardless was going to be a repeat C-section. Meagan: Yeah, so it can happen. Then last but not least, I just want to throw out anything that you have about MTHFR to the listeners who may have gone or are going through experiences like you. MTHFR really depends on a provider. Some people still roll their eyes at it but it’s definitely a thing. Do you have any suggestions toward anybody who may have it or maybe finding out that process?Colleen: Yeah. Meagan: Or going through the process?Colleen: For sure. Just through my own research, again, my OB was like, “Just additional folic acid.” Meagan: I love that you mentioned that by the way. Colleen: So I obviously am no expert or dietician or nutritionist but when you do have MTHFR, you can either have homozygous or heterozygous mutations. There are also two different variations. There’s the A variant and the C variant. I think there is research around the severity or the impact of each of the variants on fertility and things like that but sort of the biggest takeaway when it comes to MTHFR is that it can make you more prone to clotting issues as well as malabsorption or the inability to use folic acid effectively. That is why a lot of research will indicate that you should be on the purest form of folate which is methylfolate because it’s so easy for your body to absorb when you do have the MTHFR mutation and then when it comes to having additional methylfolate, essentially I found a prenatal that had methylfolate and was just chock-full of a bunch of good stuff. I was also taking additional micrograms of methyl folate on the side just as a pure supplement. Personally, I found that to be helpful and again, that is something that I baked into that consistent routine of mine making sure I was on a really optimal prenatal as well as taking the methylfolate every day. In addition to the baby aspirin, that was to mitigate some clotting issues. The other thing I will plug is a resource and a follow on Instagram if you don’t already follow is Lily Nichols. Meagan: Yes. We love her. She has been on the podcast. We have her books. Colleen: Yes, exactly. In addition to when you know you have MTHFR, just really ensuring that you are getting proper nutrition and that is top of the line in pregnancy when you are trying every day of your life basically. I definitely broke and cheated with my little guilty pleasures here and there of course. But I really largely throughout pregnancy tried to stick to a really vitamin and nutrient-dense diet. Meagan: Yes. I don’t know what prenatal you took and I don’t judge you for any other prenatal of course. We love Needed but you said the optimal amount. That’s what we are finding. So many of these prenatals don’t have the optimal amount and they don’t have the purest forms. We love Needed and truly 100% suggest it. But yeah, exactly what you said. It’s so important. It’s so important.Colleen: Exactly. That would be my advice to anyone who wonders. I would also advocate and press to be tested if you are having issues. I just think it would be so beneficial just to have that piece of information in your toolbox so that if you do want to ask either on your own or you do want to press your provider to take it seriously, then I would definitely recommend just saying, “Hey, can I get the bloodwork to find out?” Then you can go from there. Meagan: Yeah. Yeah. Bloodwork. You can start there and know. Colleen: Exactly. Meagan: Oh my gosh. Thank you so much for this amazing information along the way, your beautiful stories, and thank you for taking the time to share with us. Colleen: Thank you so, so much for having me. It was such a pleasure. Meagan: Absolutely. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
56:2628/10/2024
Episode 346 Katie's Placental Abruption with Twins + VBAC After Four Membrane Sweeps + IVF & Retained Placenta

Episode 346 Katie's Placental Abruption with Twins + VBAC After Four Membrane Sweeps + IVF & Retained Placenta

Katie is a newborn and family photographer based out of Chicago. After going through IVF, Katie was surprised to find out that her first pregnancy was with identical twins. At 33 weeks, she had an unexpected bleed and then another at 35 weeks. Because of placental abruption, she went straight to a Cesarean and her babies were in the NICU for 7 days.Katie wanted to know what a singleton pregnancy and VBAC birth could be like. She found a supportive midwife group through her local ICAN chapter that had around a 90% VBAC success rate! She also hired a doula. As her due date approached, Katie decided to opt for membrane sweeps to avoid a medical induction starting at 38+6 weeks.After four membrane sweeps over the course of two weeks, spontaneous labor began. She arrived at the hospital and her sweet baby was born vaginally just 5 hours later!Though she said she has a low pain tolerance, Katie's VBAC was unmedicated and she also shares her experience with a retained placenta and a second-degree tear. Katie, that is no small feat-- we know you are an absolute warrior and woman of strength!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome to the show, Katie. Thank you so much for being here with us. You guys, Katie is from Chicago, right? Chicago. Katie: Yep. Meagan: She is an IVF mama. She’s got three girls. She is a girl mom and two identical twins and then a baby girl. How old is your baby girl now? Katie: She’s going to be 3 months tomorrow. Meagan: 3 months so still little tiny. Oh my gosh. I love it. So yeah, and then you guys, when she’s not doing the mom thing with all of her girls, she is also a newborn and family photographer which is awesome. Can you share with us your handle so we can come follow you?Katie: Yeah. On Instagram, I’m at katiemichellestudios. Meagan: Okay, katiemichellestudios and we are going to make sure to have that in the show notes so you can go follow her and follow her amazing work. And if you’re in Chicago and you need newborn or family photos, hit her up. Is there a specific– Chicago is big. Is there a specific area that you serve?Katie: I’m in the northwest suburbs but I do in-home sessions wherever. I use a studio in Oak Park. Meagan: Okay, awesome. Then with your stories today, we’ve got a couple of highlights. We have IVF, placental abruption, and sticky placenta. I’m excited to talk about sticky placenta for sure because it’s not something a lot of people talk about that could happen. Then, of course, the twins and all of that. We are going to get into that but I do have a Review of the Week. You guys, I know every single week I know you are probably sick of me asking but I love your reviews. Thank you so much for your reviews and remember, we always accept your reviews. Okay, this is from cassie80. It says, “Extremely educational and super empowering.” It says, “After a traumatic C-section in 2016, on my research journey about VBAC, I came across this podcast and instantly fell in love.” You guys, that just says something to me. 2016 is when she had her C-section and 2018 is when this podcast started. It’s crazy to think that it’s been going for so long but I’m so grateful for all of you guys sharing your stories like you, Ms. Katie, and helping this continue. It says, “I am currently trying for number two and am on a mission to VBAC. Hearing all of these wonderful stories of strength has given me the confidence that I can do it when the time comes. You and all of the women who courageously share their stories are just amazing. You all provide healing and support for all of us mamas.” Thank you so much, Cassie, and I’m so glad that you are here with us and have been with us for so long. Okay, Katie. Thank you again for being here. Katie: Thank you so much. I am so excited to be on this podcast myself because I listened to you guys nonstop my entire pregnancy even before and I always had it in the back of my mind that, Oh, if I get my VBAC, I’m going to come on here and tell my story. I am super excited and thank you for having me. Meagan: Oh my gosh, thank you so much. Let’s talk about these twins. Let’s talk about that birth. Katie: Yes. They were IVF but they were obviously surprise identical twins. My embryo split into obviously identical twins but they were an interesting pregnancy because usually with IVF, the twins are mono-di which means they share a placenta and have two sacs but my girls are actually di-di so they had two placentas, two sacs, so that meant they were a little bit less of a risky pregnancy and a vaginal birth was a possibility. That’s what I was planning on. Everything was pretty smooth up until 33 weeks which is when I had my first bleed. It was just the middle of the night. I got up and I just started gushing. The doctor said that it was a marginal placental abruption. That means it was on the edge of the placenta and it wasn’t a risk to them. Obviously, it was super scary. I thought that I was going to lose them both but everything with them was fine. They sent me home after a few days at the hospital. They just told me to take it easy, but they said it might happen again. It did at 35 weeks and 3 days. I had another bleed. At that point, they said, “They are almost to term for twins.” It’s technically 37 or 38 weeks is when they like to induce for twins so they just said not to risk going any further and let’s just get them out right now. I was planning on a vaginal birth, but because of that abruption and we didn’t know what state the placenta was in and what would happen if there was an induction process that was started, so with the doctors, we decided I didn’t want to risk induction and then needing a C-section anyway for the other twin so we did the C-section. It was a really, really rough recovery and they were in the NICU for a week. One of them needed breathing support and the other one was there for growing and feeding. Meagan: How big were they?Katie: 5 pounds, 3 ounces, and 4 pounds, 13 ounces. Meagan: Okay, okay. Katie: They were a good size. They were overall healthy but it was for me, super duper rough as a first-time mom to twins especially. The breastfeeding journey was really hard. I dealt with low milk supply and they were so tiny that it was hard for them to latch so I ended up exclusively pumping for 11 months. That’s their story. Meagan: Wow. That’s a lot of work by the way for someone maybe who hasn’t pumped a lot. Holy cow. Good job. Katie: Yeah. So when we decided to have a third which was a tough decision for us, my husband was not on board. We ended up deciding that we wanted to experience what it’s like to have a singleton baby and just having a singleton pregnancy hopefully and a VBAC. I definitely knew that I wanted a VBAC and started doing all my research. I found a very VBAC-supportive midwife group in my area. They have a 90-something percent VBAC rate in the hospital which is crazy. Meagan: Wow, yeah. That’s amazing. What do you think they do so differently that a lot of other groups don’t do that makes them so successful? Or are you going to share about it?Katie: I’m not sure. I think the hospital might be part of it, like the hospital policies might be more supportive. They deliver at Evanston Hospital if anyone is interested. Overall, I think the doctors that they work with because it’s a midwife group that they work alongside doctors that when there is a delivery for the midwives, the doctors are also in the hospital. I think the doctors are also very VBAC-supportive so I think that helps when they are working together. Meagan: Yes, absolutely. Katie: That’s that story. Meagan: So you found them. You found the providers. Did you go and ask them questions? How did you feel like you realized that they were supportive? Katie: Yeah. I went on– what’s that group that have a Facebook group all around the country for different areas about lowering the C-section rate?Meagan: Oh, cesareanrates.org? Katie: I’m not sure. They are an organization. Meagan: Oh, ICAN?Katie: ICAN, yes. I went on my local Facebook group for ICAN and I asked around. I got their info. I first went for an appointment with one of the doctors at that practice before I was even pregnant because I was planning for the transfer and I liked that doctor, but then I realized that they have midwives and people really raved about the midwives. They said if you are looking for a more holistic experience and they spend more time with you than the doctors do. I just decided to go that route and somehow picking the midwives made me dive into the whole unmedicated birth side of things as well. I ended up hiring a doula as well. I never thought I’d be someone interested in unmedicated birth. I consider myself to have very low pain tolerance. Meagan: So tell us more about the birth. You have a low pain tolerance but you did go unmedicated?Katie: Yes. I ended up doing it. Meagan: Okay. Did you go into spontaneous labor?Katie: Yeah, it was interesting. I ended up having four membrane sweeps which is not that spontaneous. Meagan: Well, hey. This is the thing. A lot of people ask about membrane sweeps and sometimes people feel, Hey, this is worth it. Let’s do this. Some people don’t. Sometimes it works and sometimes it takes many and sometimes it doesn’t. It’s whatever feels right. So do you remember where you were with the first membrane sweep cervical-wise and how many weeks and things like that? Katie: Yeah, so I wanted to start them. Remember, I had never been pregnant past 35 weeks. Meagan: Right, yeah. Katie: I really thought that I was going to have an early baby again, but that really wasn’t the case. I had her at 40 and 5. So the membrane sweep, I started the first one at 38 and 6 so basically at my 39-week appointment. I had no change after that one. Nothing happened. That’s kind of what I assumed would happen so I had another one the next week at 39 and 6 and at that point, I was 2 centimeters, 80% effaced, and -1 station. Meagan: Okay, so pretty good cervical statistics there for a membrane sweep. Katie: Yeah. So then it was my due date and I was starting to feel more pressure. The mucus plug was coming out and baby was acting super active which I heard can happen close to when a baby is ready to be born but nothing really happened at that point. So then I decided to get my third sweep. I think that was 40+2 and at that point, I was 2.5 centimeters but the same for everything else. But things were starting to happen. I was having more stuff come out and I was like, Oh my gosh. How much longer am I going to be pregnant? Meagan: I’m sure. This is the thing. When you had either preterm or just early deliveries before and then you go past that, it feels like, No. I cannot be pregnant longer than this. This is eternity. Katie: Yes. It was really hard because I had the two-year-old twins also. It was getting to be a real mental and physical struggle. Meagan: Yes. Yeah. Katie: Also, I was doing pumping to try to induce labor and that wasn’t doing anything. Meagan: Yeah. Was it causing contractions at all or was it just causing them and then you’d stop and it would stop?Katie: Yeah, basically it would just cause the Braxton Hicks contractions and nothing else. Meagan: Then it would go away. Katie: Yeah. So I had my third sweep and that one really started to do something because I went into prodromal labor which was a doozy. Meagan: Yeah. You know, that can be a risk of trying a membrane sweep. It can cause some prodromal labor but again, a lot of the time, prodromal labor still does stuff. It’s tiring and it’s exhausting but it’s still doing something. Katie: Yeah, and it definitely did for me. My prodromal labor was a nighttime thing. The sun would go down. I’d put the kids to bed and it would start with irregular contractions. It felt like period cramps then I wouldn’t sleep all night with that. I had that for two nights and then I was finally– Meagan: Typical prodromal. Katie: Then it would go away during the daytime. Meagan: It’s so annoying. It’s like, seriously? Fine. If you’re going to do prodromal, at least do it during the day when I’m awake but don’t take away my sleep. Katie: I know. At that point, I was getting super disheartened. I decided to schedule my induction because if this was going to happen every night, I would have zero energy for this VBAC. I did schedule my induction for 41 and 3 I believe if I made it to that point but I decided to go back and get my fourth membrane sweep June 3rd so the day before she was born. That started something. The midwife was like, “Okay, if I do this, I might see you back here later tonight.” Meagan: That’s a promising thing to hear. Katie: Yeah, so once she did that sweep, I was actually already 4.5 centimeters dilated. That prodromal labor was doing something. Meagan: Um, 100%. Katie: Yep. That morning I had that sweep. We went to get lunch. We walked around. I was starting to right away have contractions and these were during the day so I knew something was up. By 4:00 PM that day, I was feeling it. I was starting to need counterpressure and had to stop what I was doing. Based on what the doula had said, that was when I should call them. I texted her and I told her, “I’m having these contractions that I’m having to stop and breathe through but they are still 10 minutes apart so I don’t know what’s going on.” She’s like, "Okay. I think you need to stay home a little longer. You’re probably not in active labor yet.” I’m like, "No, I think I’m there. Things are really intense.” Despite what she said, I headed to the hospital.It’s a good thing I did because by the time I arrived at 10:00 PM, I was already 6.5 centimeters. Meagan: Okay, nice. Katie: I was very surprised because usually what the doula community says is sometimes when you head to the hospital when you are not in active labor, things can slow down because of the change of scenery and yeah, your body just shuts down. But in my case, it actually was the reverse. I went from super irregular contractions to walking up to the hospital doors and they started coming super regularly like 2-3 minutes apart. Yeah. Meagan: I do feel like the opposite can also happen where our body gets to that final destination and it’s like, Okay. You can do this now. You have this sense of release. What you were saying, yes I’ve seen that too where the mom has to reacclimate to the space and labor stalls a little bit then it goes on, but this one it sounds like it was the opposite where it maybe brought you relaxation and safety. Katie: Yeah. I think maybe part of it was that this hospital experience was so different than my last one. At the last one, it was rushing to the hospital while I’m bleeding. I get there and there’s this rush of nurses. Everyone’s checking me and this time, I waddled up to the hospital. The room was dark. There was one nurse checking me in. I’m just chilling on the bed. I was just relaxed. I think a lot of the things that I did with the doulas to prepare, like they did classes about comfort measures and things like that and I was really trying to use those. I got the twinkle lights set up and got the music so that really helped. By 1:00 AM, I was already feeling the urge to push and I was feeling so much pressure, especially in my butt. I needed counterpressure for every single contraction up to that point then I was like, “No more counterpressure.” I was screaming for my husband to stop doing it because it was starting to hurt. I knew that something was happening. I was on my side trying to get some rest in between and I was starting to give up at that point. I know what they say is when you are starting to give up, you’re starting transition. Meagan: You’re right there. Katie: For me, I was thinking, I need an epidural right now. Meagan: A lot of people do though. A lot of people are like, “I can’t do this anymore. I’m done. That’s that. I need that epidural. I need relief now.” Katie: Yep. I hadn’t had a check since I was admitted. It had been about 5 hours since I showed up or 4 hours since I showed up to the hospital so I was like, This can’t be it. I can’t be ready to push because I’ve only been here 4 hours and it’s my first labor. I was in disbelief but I was like, “I need a check right now because if I’m not close to pushing, I’m getting the epidural.” The doula was trying to talk me out of it. She was like, "Are you sure? What are you going to do if you’re not there?” I’m like, "I’m going to get the epidural.” I was 9.5 centimeters at that point. Meagan: Oh yeah. Right there. Katie: Yeah, and I was like, "Oh my gosh. This is actually happening.” My body was starting to push on its own and it was such a weird feeling. It was so different than my friend’s birth that I photographed. She had an epidural and it was an induction. That’s the only other birth that I’ve seen and this was so different because my body was pushing. I can’t control it. Yeah. That was about an hour of pushing which felt like an eternity and the contractions were actually fine at that point. I couldn’t feel them. I could just feel loads of pressure and the ring of fire which was intense, super duper intense. Then my water broke about 10 minutes before she was born and yeah, she was born. Meagan: You get to 10, your water is probably going out through breaks and baby comes down. Katie: Yeah, I had a bulging bag at the end which is really interesting to feel. She was born at 2:34 AM. Meagan: Aww, that’s awesome. So pretty dang quick. Katie: Yeah. If you don’t count the two nights of prodromal labor. Meagan: Prodromal labor, yeah. But your body was doing it slowly and surely. Each sweep did give you that extra nudge. It maybe gave you some prodromal labor along the way, but it seemed like it was helping and doing something. Katie: Yeah, if that helped me avoid a medical induction, I’m super glad that I did those. Meagan: Yeah, that’s something when it comes to someone facing an induction or facing that hurdle, a membrane sweep might not be a bad idea. But too, with that said, if we go in and we are barely 1 centimeter or our cervix is really posterior and we are 30% effaced, we need to know mentally that if we go for a sweep, the chances of it working is a lot lower. It’s just lower because our body is maybe not ready. It also doesn’t mean it’s not going to work. So like I said earlier, you had that ideal cervical stat. You were that 2 centimeters and 80% effaced. Things were looking good and softer, starting to open and they were able to get a really good sweep but even then, it took time. Katie: Yeah, definitely. My midwives never pressured induction on me. I was pressuring myself mainly because IVF pregnancies– there are differing opinions but some doctors say that you should be induced at 39 weeks and some say you shouldn’t go past your due date because of the placenta not being as good. Meagan: Well, yeah. It’s so hard because– so twins were IVF and was this baby IVF too?Katie: Yeah. Meagan: Okay, that is hard because there are a lot of people who do say that you should induce at 38-39 weeks with IVF and we do know out there that with IVF, the chances of having placenta issues and abnormalities like abruption are increased. Accreta, previa, and things like that. But if everything is going okay, all is looking well, it’s that battle of do we induce? Do we not induce? What do we do?Obviously, your providers weren’t pushing it so they didn’t see any real medical need but then we have other providers on the complete opposite end where they are pushing it hard. Katie: Yeah, in some of my IVF groups on Facebook, basically every single person is induced or has a C-section. It’s pretty rare for a provider to say you can go to 42 weeks like mine did. Meagan: Interesting. I actually don’t know the real stats on IVF placental issues after 38 weeks. Had anybody ever talked to you about what your chance of issues really were after a certain point?Katie: No. The abruption was I think more of a risk factor was that it was twins and my uterus was so stretched but no one really mentioned placental issues or even said, “Let’s look at your placenta after 40 weeks.” They do have the standard ultrasound to look at baby and do the BPP test, but they said that there is nothing really you can see from an ultrasound after your due date. Meagan: We know that ultrasounds can be off by size and by all the things. Katie: Yeah, and she was measuring bigger. She was 85th percentile which was actually true. She was born 8 pounds, 4 ounces so she wasn’t tiny like my twins were. Meagan: Yeah. I Googled really, really quickly. This isn’t even a study. This is just an article on it. I’ll try to get some more studies and things in here but I’m going to include this article. It’s from the Real Birth Company. It looks like they are teachers of birth classes. It’s highlighted. It says, “What do you need to know if you are pregnant through IVF and you’re being advised to have an induction because you are told that there is a higher chance of stillbirth?” It says, “The only study that we found that gives us the information also noted at higher risk of stillbirth for IVF pregnancies, but crucially, they said no increase in their rate of stillbirth after 28 weeks of pregnancy. It just says, “This research therefore tells us that induction at terms would not necessarily reduce stillbirth rates for babies who are conceived by IVF.”Katie: Yeah. From my understanding, it’s hard to do studies on this because a lot of women who need IVF have other health factors which can increase the risk of obviously stillbirth and other issues in pregnancy. Meagan: Yeah, it’s showing that sometimes IVF moms have placenta accreta and placental abruption at a higher risk. It shows that IUGR babies have a higher chance for being smaller. It also says that gestational diabetes and preeclampsia have an increased chance. So like you said, there are other things that they may have. I’m just going to throw this in there in case anyone listening is an IVF mama and wants to know more. It’s interesting that you’re saying that in that group– are they scheduling C-sections?Katie: Yeah. Most women get scheduled C-sections, not scheduled C-sections, scheduled inductions but they end in a C-section because they aren’t ready. Meagan: Okay, so they aren’t necessarily scheduling them right off the bat just because they are IVF. Katie: Right. Meagan: But again, like you said, they aren’t ready and inductions are happening and people are ending up in a Cesarean. Katie: Yes. Meagan: Interesting. Well, this article was written in 2021. I’m also going to put a couple others in here that says actually 2024 so I need to look more into this but it’s something to consider because again, this is a space where we are trying to reduce unnecessary Cesareans. We’re seeing that it’s happening so it might be something that you want to research if you are out there and you are doing IVF, research that and see if it’s something that really is necessary for sure. Katie: This is just my personal story, but my placenta looked perfectly fine at 40+5 with this baby. Meagan: Yeah, so everything was looking good at that point. We did talk about that in the beginning– sticky placenta or really retained placenta. Did you have that with this? Maybe you can talk to us more about the placenta. You gave birth to babe. It was a VBAC that was a lot faster than anticipated and you went unmedicated when you didn’t think you could. I kind of love that so much that you were like, “I have a low pain tolerance,” but then you did that. It just goes to show how possible it is, right? But yeah, talk to us about your placenta. Katie: Yeah. That was actually worse than the pain of the entire birth and something I didn’t expect because I had asked about this because it can be an issue with IVF pregnancies. I had asked about this in one of my prenatal appointments and the midwife said, “We don’t know if you’re going to have that or not. IVF is a risk factor for it,” but since I had the opposite of a sticky placenta. I had a placenta that was coming off the wall. With my last pregnancy, she was like, “I’m guessing that you’re not going to have that,” but I did. After baby was out, my placenta was not coming out after 10 minutes and around 30 minutes, I think they like to have it out by then. So they gave it 10 minutes for it to come out naturally, but my contractions completely stopped. Nothing was happening at that point. My body wasn’t expelling it. They were trying to pull on it. Eventually, it came out but I was still having bleeding when they were pressing on my stomach than they would like to see. They gave me the Pitocin and that didn’t work and then they tried two or three other medications. Meagan: Did they give you Cytotec at all? Katie: Yeah, I think so and another medication that goes in the back in the booty. Meagan: Oh, yes. They usually will insert it rectally. Yes. Yes. Cytotec is not okay when we are pregnant and we are trying to go into labor, but because it makes the uterus contract so hard which is the whole issue with Cytotec and VBAC, it can help reduce bleeding and help the placenta and all of these things. Yeah. Katie: Yeah. They gave me the max dose of Pitocin in my IV and none of that worked. They gave me the Pitocin in the leg and that didn’t work, the Cytotec. Then they brought out the ultrasound machine and scanned around and saw that there were some pieces left inside. So she had to stick her hand up and get them. That was horrible. Meagan: And you were unmedicated. I’m just going to tell you right now that you have a high pain tolerance. I think you might be incorrect on that. Not saying that really, but holy cow. Unmedicated and a retained placenta retrieval scrape– they are essentially scraping and fishing for your placenta. Katie: Yes and she had to go in two or three times. They gave me some kind of IV medication and all it did was make me feel drunk. Meagan: Probably fentanyl. Katie: It was something with a D maybe. Dimerol.Meagan: Dilaudid. Katie: Maybe Dilaudid. It made me feel loopy and nauseous but did nothing for the pain. I was holding my baby the whole time and I just want to forget that horrible experience. Meagan: That is rough. Sometimes placentas “stay sticky” and it really can take up to an hour even for a placenta to come out. Sometimes we don’t know why and like you said, IVF stuff maybe could have helped but the placenta usually is in that 5 to 30-minute period and providers do start to worry if it’s more than that because after we have our baby, our cervix was 10 centimters. It dilated and everything was open and thinned and then it starts coming back and closing again which is the normal process. Katie: Oh my gosh. I didn’t even think of that. Meagan: Yeah, it’s just that normal process where it starts closing so providers start fearing that if the cervix is closed or too small, the placenta can’t move through and then we’ve got the placenta inside and retained placenta is a very serious thing. You want to get your placenta out. It’s an amazing organ and functions amazingly. It raises these amazing babies through these 9 months. It supports them and feeds them but we need to get it out because retained placenta can make you very sick. They start fearing that and sometimes when they are tugging, it can make it so the blood vessels get ripped off or they weren’t ready so then we have bleeding and retained placenta and all of these things. They start fearing it and things like breastfeeding, Pitocin, Cytotec, and all of these things that they are trying to get to help you contract more is an effort to help get that out. But yeah. That is a lot. That’s a lot. You had this beautiful birth and then whoa, quite a lot right there. Katie: Yeah, a bit of a turn and in addition to that, I had a second-degree tear that they also had to stitch me up. I don’t remember if that was before or after the whole extraction. Meagan: Your provider fishing could have caused more tearing. Yeah. There is also a possibility that if for some reason it doesn’t come out that you will have to be taken to an OR which is a more rare circumstance but I’ve had one client in all the 10 years of doing this and she was a VBAC client too actually. She had a beautiful birth and then had to go in and get it manually removed. So yeah, breastfeeding as soon as you can, changing positions and also emptying your bladder is something that you can do because if your bladder is full then it can hold things up so sometimes it’s detached but not coming out so there are things we can do and then of course, taking medication and going a step further if we really need to. Katie: Yeah. Overall though, I don’t regret any of that. It was still such a beautiful birth even though the end and the golden hour took a turn, it still was more than I had imagined. Meagan: Yeah. I was actually going to ask you. Even with that which is a lot, would you still suggest doing it or would you have done it differently if you could go back?Katie: No regrets. The recovery was a million times easier even with the tear and all of that. I was going to the botanical garden 4 days postpartum with my family. Meagan: Oh my gosh. You were out walking around. Katie: Yeah. Meagan: Oh my gosh. That is amazing. That is amazing. Katie: With toddlers, you’ve got to get back to real life. Meagan: I know. It’s so hard to take that break and recover when we have life that is still moving around us. Katie: Definitely. Meagan: Remind me, you said you took Needed’s collagen, right? Katie: I did. Yeah. Meagan: That actually probably helped healing as well. Katie: Yeah. I love that stuff because I wanted to get more protein in. I just put it in my shakes along with all of the other things that I did like the chiropractor and the dates. I did all of the things. Meagan: Yes. And your doulas, do you want to do a shoutout? Katie: Yeah, 3-1-2 doulas and I worked with Heather. Meagan: Awesome. Katie: Yeah, and they have awesome classes too. If you are a doula customer, they are free and if you’re not, you can still sign up for them and they are super great. Meagan: That is so awesome. We love our doulas and to all of those listeners out there, just a reminder. We have a major doula directory from literally all over the US to outside of the US if you are looking for doulas too. You can go to thevbaclink.com/findadoula. We love our doulas so dang much. Obviously, I love doulas so much I became one. Doulas are so amazing. I love that you said you did chiropractic care and dates and all of the things. Are there any other suggestions or tips that you would give our listeners as they are going through their VBAC journey? Katie: Yeah, just listen to these podcasts a lot and you’ll learn so much. Join The VBAC Link group on Facebook. Meagan: Yes. I love that community. Isn’t it just amazing? Katie: Yeah, it’s great. There’s also another VBAC Facebook group that I loved as well. Meagan: Do you remember the name?Katie: I don’t remember. Meagan: There are a few on there. We love– Katie: VBAC Support Group. Yeah, that one’s great. Meagan: Awesome. Katie: Yeah, just believe in yourself. You can do it. You are a badass. Meagan: You are a badass and you can do it. I agree. We’ll end on that note because that is such a true statement. Girl, you are amazing and I’m so grateful for you sharing these beautiful stories today. Katie: Thank you so much for having me.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
42:2323/10/2024
Episode 345 Rachel's VBAC After the Unexpected + Back Labor + Strategies for Improving Your VBAC Chances After a Complicated Birth

Episode 345 Rachel's VBAC After the Unexpected + Back Labor + Strategies for Improving Your VBAC Chances After a Complicated Birth

Rachel is a professor, an author, and a VBAC mom who is here to share her story from a traumatic C-section birth through a VBAC. This episode really dives deep into how picking the right provider is key to improving your chances for a VBAC. They give practical questions to ask your providers, more than just yes or no, to really get to know their birth philosophy and what qualifications and experiences your provider might have that would make them a better fit for VBAC chances. Rachel and Meagan also give a lot of validation and advice on how to start the process of overcoming birth trauma; it’s reality and to not be ashamed of it. You’re not alone. Through the many important messages of this episode, they both mention many times to trust your intuition. If something feels off, listen to that. And if a change in provider is necessary…it is never ever too late to change. Invisible Labor: The Untold Story of the Cesarean SectionHow to Naturally Induce LaborHow to Turn Prodromal Labor into Active LaborMembrane Sweeps for VBACHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello everybody! Welcome to the show! I am so honored to have Rachel Somerstein on with us today. She is a friend of ours from New York. She is a writer and an associate professor of journalism at SUNY New Paltz. She is an author of Invisible Labor: The Untold Story of the Cesarean Section.  And her writing has also appeared in the Boston Globe, The Guardian, The Washington Post, and Women’s Health. She lives in Hudson Valley, NY with her husband and her two children and is here to share her stories with you today. Rachel had an unplanned Xesarean section with her first child and the experience was anything but routine. I know that there are many of us who have been through this journey and on this podcast, maybe listening today, that also had an unexpected experience and it may have left us with trauma, or doubt, or fear, or all the feelings, right? And so she is going to be talking to us today about her experiences, but then also we’re going to talk about some guidance on how to find peace and to offer ourselves grace and to set ourselves up for a much better experience next time. We do have a review of the week, so I want to get into that and I’m going to turn the time over to Rachel.This review is by Deserie Jacobsen. The review title is “Thank You.” She actually emailed this in and it says, “This podcast and parents course is amazing. I am not a VBAC mom, but I have been listening since 2020. I binge listen near the end of every pregnancy to remind me of everything I need to remember in birth and process through my previous births. This time around I felt more prepared than ever before, having plans in place just in case. We were able to have a quick birth of my 5th baby. I love the education, passion, and love this podcast gives. I recommend it to everyone I know, and I have learned so much from it. I am so grateful for this podcast, thank you.”Thank you so much Deserie for your review! Seriously you guys, I just love hearing that people are finding the information that they need, they’re finding community, they’re finding that they can do this too. Just like them, and all these reviewers and all the people that have shared their stories and all these reviewers you guys can too. This birth, VBAC, is possible too. Better experience is possible. A healing CBAC; it’s possible. You guys, all it takes is getting the information, the prep, finding the provider, to have a better experience.Meagan: Alright Ms. Rachel, welcome to the show and thank you again so much for being here with us. I kind of talked about this a little bit before we started recording about how I think your episode is going to be so powerful and deep and raw too. You’ve got these feelings and these words. I love it. I love reading your book and I can’t wait to hear it from your own mouth. Which speaking of book, can we talk about that a little bit? What kind of just inspired you, jumpstarted you into writing a book about this?Rachel: Well, I’m a writer. And I wrote an essay about my birth about two years after I had my baby, my first birth, my C-section. And I realized I had a lot more to say and also I heard from a lot of moms when that came out and that made me start thinking that I think there was a bigger project. Meagan: Absolutely. And an amazing project that you completed.Rachel: Yes.Meagan: And remind everybody before we get into your stories where they can find your book. I actually have it here in my hands. It’s Invisible Labor. So where all can they find that? And we’ll make sure that we link it. Rachel: Sure, thank you! Yeah, so it’s Invisible Labor: The Untold Story of The Cesarean Section. And you can get it on Amazon, you can get it from Barnes and Noble, you can get it from your local bookstore, you can get it as an audiobook? Or you can also get it as an ebook.Meagan: For the audiobook, did you record it?Rachel: I did not. The narrator is Xe Sands and she did a great, great job. It sounds excellent. Meagan: Awesome. We’ll be sure to link that. I think it’s definitely a book that everyone should check out. There's a lot of power in that book.Rachel: Thank you.Meagan: And it’s not even just your story. I mean there’s a ton. Like if you go through the note section there’s a ton of research in there, and history and studies, and so many really great things. Well okay, let’s hear about the story that started the inspiration and behind this amazing book.Rachel: Sure! Thank you. So like so many moms, I had an unplanned C-section that I was completely unprepared for, which is another reason I wanted to write this book because I think a lot of people go into pregnancy just assuming they’re going to have a vaginal birth and like me, I didn’t even read the parts of the books about C-sections, I skipped them. Because I was not going to have a C-section. Which is whatever, hindsight is everything, right? But I had a totally textbook pregnancy. I switched to a different group of midwives and OB’s about halfway through because I just didn’t have a connection I felt with the providers in the first one. And frankly, I didn’t have a connection with the providers in the second one either, but by that point, I was like well whatever, it’s fine. Which I think is actually, if I could go back and do it again I would have changed that. But you kind of are like, I don’t want to, could I possibly change again? And I think that for people who are VBACing, yes you can and sometimes you actually really need to, even like late on in your pregnancy, people will switch groups or providers even late in the third trimester, so. Meagan: Even if you’re changed already, you can do it multiple times.Rachel: Exactly.Meagan: It’s not a bad thing to find the right provider for you. It’s not. Rachel: It’s not. And It's hard. And you can feel like, Oh my god. Am I really going to send all my records over? It can feel like so much effort and it can really be worth it. I just wanted to say that as someone who switched once and then was like, Okay, I’m done, and wished I’d switched again. So anyways, it was late in week 39 I went into prodromal labor but I didn’t know that prodromal labor even existed because nobody told me about it.  And it was my first baby. So I was like is this labor? I think I’m having contractions, these are not Braxton Hicks. And in the end, we talked to the doula I was working with, and in the end they ended up petering out. And at that, I think that that for me marked the beginning of, this is not going to look like the way I had expected it to look. And again, hindsight is everything. What I wish I had known at the time– and I think this is really relevant to some VBAC moms is that sometimes prodromal labor means that your baby is not in the best position for having a vaginal birth. And I can’t exactly say oh I would have done this or that differently if I’d known it, but it would have helped me understand what I was going into with the labor and the birth. So anyway, I eventually went into labor in the middle of the night. It was exactly my due date and I knew it was different. I could just feel this is labor. And I was really eager to get it going quickly. And again, I wish someone would have said, “Rachel, rest. It’s early. You’re going to need your strength. You’re going to need your energy however your baby is born.” And instead I quite literally was running up and down the stairs of my house to try to push labor along. Which is, I have compassion for myself, I understand why I was doing that. What I really needed to do was get in the bath, or I don’t know, lay over the birth ball. Watch a silly movie, right? The feelings I was having were real pain and I was scared. But you kind of can’t run through this, especially a first labor as we all know, those take a long time, right?Meagan: Yeah. And if we were having prodromal labor, our body may be kicking into labor, but still might need some time to help that baby rotate and change positions. Rachel: Exactly, exactly. And this is the kind of education that is so missing from birth classes. And that is one reason why this kind of podcast is so helpful because that’s how I learned about these different things. I didn’t ever learn about them from a provider being like, “Let’s talk about what will happen in your birth, and let’s talk about why you had prodromal labor.”So anyway, we went to the doctors office where we met a midwife and my doula for a labor check. And I was hardly dilated, I was at a 2 but I was in extreme pain. And I have to say, I have a very, very high pain tolerance and I now know I was having back labor. Meagan: Baby’s position.Rachel: Exactly. And the contractions were like boom boom boom boom. They were not, I didn’t have any rest in between them. Which again, I think my baby was like I gotta get in the right position, this isn’t working out, I’m freaking out, ah! Plus my mom is running around, ah! Right?Meagan: Yeah. Rachel: So we went to the hospital and I was checked in and the midwife who checked me in was like, “Oh you’re actually not even 2 centimeters, you’re just 1 centimeter dilated.” And they checked me because I was in so much pain I think. And I don’t know that that was necessarily wrong,  but again, no one was sort of explaining, “Here’s what we think is going on.” And it’s partly because I believe those providers thought I was exaggerating what I was experiencing physically. They didn’t know me. Well, they didn’t know that I’m usually pretty stoic. They didn’t know that I’m not a squeaky wheel. And I wasn’t like screaming or crying or pounding. I was like quiet and I was like I’m in a lot of pain.Meagan: An intense quiet.Rachel: Intense quiet. Exactly. But that doesn’t look like what we think pain looks like to people. And the fact is that people are very individual and how they express pain especially during labor where you’re already kind of like leaving the regular plane of reality.Meagan: Yes. Rachel: So an important takeaway is like, even experienced providers cannot read your mind and make mistakes in assessing what's truly going on with you. And this comes up later in my second birth, but my husband now does a much better job of saying, “You might look at Rachel right now and think she looks like she’s doing great, but this is what’s really going on with her.” And he does that in a way that’s not like he’s speaking for me in a way that’s annoying, but it’s like I actually can’t advocate for myself, I can’t express this. So anyways, I asked for an epidural. They said that the anesthesiologist was busy. Which may have been true, but may have been they were trying to put me off because I was hardly dilated. And they told me to get in the birth tub. And I remember hanging over the side of the tub and staring at the clock on the wall and being like, I actually don’t know if I’m going to survive this hour. I was just in so much pain. Incredible pain from back labor that was incessant. Eventually he showed up. They hooked me up to all the monitors. At that point, one of the nurses was like, “Oh, you are having monster contractions.” Like the contractions that were being measured were so intense they were going each time to the edge of what was measurable. And now that the computer said it it was like oh…Meagan: You’re validated now. Rachel: Exactly. Right. And the anesthesiologist, it took him three tries to get the epidural working properly which would echo problems to come. But he did, and it took away the pain. And then I was just in the bed and kind of left there. And the nurses and the midwife did not use a peanut ball, they didn’t move me around. And obviously, listen, I’m attached to the monitors. You know you cannot really move that well, the belt slips, and that increases the chances you’ll have a C-section. And there are still things that can be done. It’s not like you’re a loaf of bread, you just lay in a bed. But they didn’t do that stuff and I wasn’t dilating. The nurse and doula eventually basically were like, “Well, we’re going to go out for dinner and we’ll be back in a few hours and we’re going to give you this thing to sleep and if you haven’t dilated by the time we get back you’re going to have a C-section.” And at that point I was exhausted. It’s evening now, I’ve been up since the middle of the night. I’m totally like, what is happening with this birth? No preparation; I took birth classes, I read books, no preparation suggested that this series of events could take place. I felt completely abandoned by my providers, including my doula who I was paying out of pocket. And one thing that came up at this time also was I had this colposcopy in college, like scraping of cervical cells. I didn’t hide it from anybody, I was open. And the midwife said well maybe that’s why you’re not dilating is because of this colposcopy.Meagan: Do you think you got scar tissue?Rachel: That’s what she said. And I remember at the time being like why are we only talking about this now? Why has nobody brought this up in any of the prenatal visits that I’ve done? And I felt blamed. This thing about your body is defective. After a few hours when the midwife and the doula came back and I rested and it was quiet, I had dilated to a 9. And I think what that’s about is that I had been in too much pain to dilate. I was so frozen up and tense and also extremely scared.At this point people are like, “Oh wow.” And finally my water broke,y water hadn’t broken. So you know, things are kind of continuing and I am starting to actually feel even more fear and my room is getting really crowded with people. And the midwife asks me to start pushing. And I was afraid and I was excited. They turned on the baby warmer, and they were like, “Okay, your baby is going to come out.” And I started to push but I couldn’t feel what I was doing. I had no idea. And the midwife was like, “Do you have an urge to push?” And I was like, “No.” The epidural that hadn’t gone well from the beginning had then come down with a very heavy hammer and I felt total numbness. It was not helpful. I needed someone to have turned it off or something, or turned it down so I could feel an urge to push and feel how to push, where to push, what muscles to use. And at a certain point I could tell something was going not right and it turned out that my baby was having heart rate decelerations. So just to sketch the scene. At this point it’s 1 o'clock in the morning, I’ve been awake for 24 hours. I’m exhausted. My husband is exhausted. Neither of us has any idea that things could have gone like this. The midwife says I think it’s time to do a C-section. And I don’t disagree with her. I don’t even know what to think at that point. I’m also feeling tremendous fear. I was like I’m afraid I’m going to die, I’m afraid my baby’s going to die. And the overall sense in the room…and people were like, “Oh no, you’re going to be fine”. And the sense in the room was that I was hysterical and I was not in my right mind. Which I wasn’t in my right mind; I had been awake for a long time, I’d been trying to have this baby, nobody really told me what was going on and I felt totally unsupported. Actually, my response was completely reasonable given the circumstances and nobody really attended to that and saw that and recognized that as completely valid. Plus, I don’t have evidence to stack this up absolutely, but I have since come to find out that there is a medication that some laboring women are given to help them rest and one of the side effects is an impending sense of doom. And I have a friend who had a baby at this same hospital and had the same response after having been given something to rest during her labor. I could go back and look at my records and I may do that but I’m like, well that would explain also why I had the response I did. Meagan: Mhmm.Rachel: Anyway, we go to the OR. I hunch my back for the spinal that the anesthesiologist has to do a couple of times to get it right. I’m still contracting at this point. My body is still like, Come on, let's get this baby out. Let’s get this baby out. And I’m so uncomfortable. And you know that advice to not lay down flat on your back when you’re pregnant, but that’s what you have to do when you’re in the OR. The whole thing felt like I was going to choke under my stomach and very exposed like you are in the operating room. Meagan: Yeah, it’s cold and it’s bright and you’re very exposed. And you can’t move your body normally, especially if you’ve had a spinal. Rachel: And also in retrospect, again I’m like I cannot believe that the first time I learned what happened in a C-section was in my C-section. I really should have at least learned about this even though it would have still been scary and I still would have been surprised. So when the OB goes to operate, he starts his incision and I say, “I felt that.” And he says, “You’ll feel pressure.” And I say, “I felt that.” And he continues operating and I was not numb. I felt the operation. And according to his notes..parts of this I don’t remember…but he wrote it down and my husband has also told me that I was screaming, my legs were kicking. There’s no question that I was in tremendous pain. And I was moaning and it was horrible. And it was horrible for the people in the room too by the way.Meagan: I’m sure. Rachel: Right? Like it’s really important to say that. My OB didn’t listen to me. That is a super common thing that happens in healthcare, especially for women. Especially for pregnant women. He’s not a sociopath. He didn’t want to be evil, but he didn’t listen and the consequences were so steep and so dire. And I think that it was traumatizing to him and I know it was traumatizing to some of the other providers in that room, the nurses to watch this. He kept going and when the baby was born, which I don’t remember, apparently they held her up to my face and they put me under general anesthesia and sent my baby and my husband away and stitched me up. Then I woke up in recovery. The doula and the midwife had gotten the baby to latch while I was unconscious and were talking about me without knowing that I was awake about her latch which really, really bothered me because it just underscored how it felt like I was just a body. And even people who were supposed to be there to take care of me and be tender and advocates, I felt they disregarded me. And under other circumstances I really would have wanted to breastfeed my baby like right away. But I wasn’t even there to say yes I want to do this or no I don’t want to do this. It was a terrible birth and I would not wish it on anybody. Meagan: And I think, kind of talking about what you were just talking about with breastfeeding and stuff, these people in their hearts and in their minds were probably like this is what she would have wanted. We’re trying to help. But in whole other frame of mind over here, I’m not present. I haven’t said those things. And I know you’re trying to help and I know that’s where your heart is, but I’m not okay with this. Rachel: Totally.Meagan: And I think sometimes as doulas, as birth workers, as any one of you listening, remember that words matter. Actions matter. These moms' feelings matter and it’s sometimes in our minds we’re trying to do what’s best, but it might not be. Rachel: Totally. Absolutely. Yes and I again, it’s so important to point out. Yes they were coming from a good place. They really were coming from a good place. But it wasn’t the way that I felt it or experienced it. Meagan: And it left you with trauma and angst and heartache. Rachel: Absolutely. Totally. Yeah. Meagan: Well that definitely sounds like a really rough birth. And it’s so crazy because it’s like you went from not progressing to baby in a poor position, to getting an epidural. I love that you talked about that. That can be an amazing tool. A lot of people are very against epidurals, and there are pros and cons with epidurals. We’ve talked about those. Fetal heart decels is one of them. I don’t think, maybe in this situation it sounds like a lot of other things happened; baby’s position being one of the biggest ones. But that can really be a tool that helps you just relax and be more present and have less trauma. We talk about this in my doula practice of where there’s a difference between pain and suffering. And pain, progressive positive pain that’s bringing our baby to us that’s one thing. But when we’re suffering and we’re so tense that our body’s not even able to try; that epidural could come into great play. But again, we’re not that loaf of bread in a bed and it is important to move and rotate. And it doesn’t have to be drastic. It doesn’t have to be crazy big movements. Just subtle movements to change the dynamics of the pelvis and to encourage our baby to keep coming down. So there were so many things that just went poorly but also went well, and then poorly again and then well and then real poorly there at the end. Rachel: And I think like to your point, I went into my birth I should say, I was planning on having an unmedicated vaginal birth. I was like I’m not going to have an epidural. And I think that if my providers had different skills I would have, I may have been able to have that baby vaginally. And I say that based on what happened in my second birth. So it’s not just like wishful thinking, right? And I’m really glad I had that epidural. I really needed that. I was suffering. The pain I was experiencing was not productive pain. And an epidural can help you with suffering, alleviate your suffering. But it can’t and doesn’t substitute for emotional support. And I think that’s what was missing for me, throughout that first birth. Even if I had gone on to have ok fine, a cesarean, or even a vaginal birth, I still think I would have been like that wasn’t a good birth because I didn’t feel emotionally supported. And an epidural can’t do that. Meagan: Yeah. No an epidural cannot do that. And I, for anyone listening who supports birth, or even who are going for a birth you kind of mentioned it. You’re in this other land and sometimes it’s hard to advocate and open. You might be thinking something and you might so badly want to say it. It’s right here, coming out. And you can’t say it for whatever reason. It’s a weird thing, it doesn’t make sense sometimes but it can happen. But really being heard, validated, understood; which are so many things you weren’t. Right? And when we’re not heard and when we don’t feel safe, and we don’t feel supported, those things leave us with PTSD. In fact there was, in your book, I’m just going to read it. It says, “2022 study by anesthesiology and obstetrics professor Joanna and colleagues found that what’s important about women who feel pain during childbirth is how mothers feel about their pain. And how their providers communicate with them overall…”You were communicating, and no one was communicating to you. “...feeling positively about pain and heard by providers protects a mother from developing PTSD.” And I mean it goes on which is why you need to get the book so you can read more about it. Rachel: Yep. Meagan: But really, feeling heard. Rachel: It’s not just crunchy whoo-hoo feels good, feels right, sounds good. It really matters. And I have to say that I’m participating in and helping to work with providers on designing some studies about providing different pain options for moms during C-sections. We literally had a conversation about this yesterday. And one of things we were talking about is it’s not just the pain. It’s not just pain relief. It’s also being listened to. Because there will be people who are like, I might say I’m in pain, but that doesn’t mean I need an epidural or want an epidural. But I’m feeling pain and I want to be heard and I want somebody to…even if you can’t express this. You can’t even express it because you’re the one having labor. What you’re needing is someone to see you and look you in the eye and be like you’re going to be okay. And I think as mothers we totally are experienced with that all the time. When your child is hurt or sick, part of your job obviously is to get them the help they need, but it’s also to assure them this nosebleed is going to end. You’re not going to have a bloody nose for the rest of your life. Which, when you’re going through something really hard you can sometimes forget, right? And you’re pointing out from the studies this helps to prevent people in birth, in labor, from developing PTSD. The stakes are really high. They matter so much. Meagan: When you were just talking, I don’t know if you saw my eyes kind of well up a little, but I connected a lot with my first birth when I was clinging to a bed, literally clinging. And I was looking at my husband and I’m like, “Do something!” I had a baby in a poor position. I was being jacked full of pitocin. My water had broken, there was a lot of discomfort going on. I had told him I didn’t want an epidural and he’s like what do you want me to do? And I was like I don’t know, I just need something! And I was terrified and desperate. And he was just like… It wasn’t fair for me to put him in that position either but at the same time he was like I don’t know, I don’t know what to do, right? And the nurses were just like we’ll just get you an epidural. And I was like no, I don’t want an epidural. And then it just was like epidural, just went down from there. And I wish so badly that there was something else. Let’s get you out of the bed. Let’s get you in the shower. Let’s give you some nitrous. There was so much more that I could have had, but wasn’t even offered. And I think too, I needed someone to tell me that nosebleed was going to end. Rachel: Yes. Meagan: And it was going to end and it was going to come back every five minutes and it was going to end again and I was going to be okay. And I was going to survive that. And just hearing you talk about that, why my eyes got all welly, is that I don’t know if I realized how much that impacted me until just barely. And here I am, my daughter is almost 13.Rachel: Just like how powerful these things that, I don’t know, this is part of why we have these conversations. They shed different corners of light on our experiences that it’s like oh my gosh, I didn’t even know I knew that. And that’s so why we, even though I’m not postpartum immediately, it’s valuable for me to talk about it too; to hear what you’re saying, you know?Meagan: Yeah. Ah, so after a not-so-amazing experience, going into that postpartum, you’ve talked a little bit about that in your book. Well, not a little bit, you’ve talked about that a lot. Tell us about that journey and then what led you to deciding on VBAC and ultimately going and having a VBAC. Rachel: So I should say, I was really…Talk about not realizing things right away. It took me a long time to figure out how traumatized I had been by that birth. And I was about two years postpartum and I was having a procedure for something else and I just completely, I had a panic attack. I had never had a panic attack before, I didn’t know what it was and couldn’t have explained what was happening. And when the anesthesiologist who did this procedure was like have you ever had any issues with anesthesia, which is exactly the question that should be asked, and I had said what had happened he was so taken aback. He was shocked and didn’t know what to say and walked out of the room.Not in the way of, I’m abandoning my patient, but just like from his perspective here’s this kind of routine thing. This patient is crying and shaking and talking about this very traumatic incident which I had not talked about. I didn’t go to therapy. I had talked about it with friends and my family, it wasn’t a secret, but I felt a lot of shame. I felt like I must have been this total freak of a person that this had happened to me. And after that I remember saying to my husband, I just don’t know if I’m ever going to be able to get over this trauma enough to have another baby. And I didn’t even know if I wanted another baby, like separate from the trauma. In therapy I started to see that I felt very stuck in my life and that included how and whether to grow my family. And that was actually because of the traumatic birth. It just like made this big block. I think one thing that’s important to think about for those who have had a traumatic birth is that sometimes that can show up in your life in ways that you don’t expect. Meagan: Yes. Rachel: And so to be compassionate with yourself about that and also to be open to that. We’re in the era of warnings and trigger warnings and those are important, but sometimes for a traumatized person the things that are triggering or activating are not what you would think. Like for me, I couldn’t watch a scene of a hospital birth even if it was happy without getting very uncomfortable and having to walk away and there wouldn’t be a content warning on that. So it’s just to say be patient with yourself. Accept that…don’t, I guess if you’ve had a traumatizing birth you don’t have to struggle against these things. As horrible as they might feel, as uncomfortable as they might feel it’s normal and it’s ok and it shows up differently for everybody. Rachel: Yeah so I had this big question and then I was like ok, it took awhile for me to be like I do want to have another baby. But I wasn’t ready emotionally. And so I waited. And then about, let’s see, October of 2019, I was like I think that I’m ready to try to have another baby. And we had met this midwife who lived in our community, who my daughter actually made friends with her niece at our public pool which is so beautiful. I ran into her one night while she was walking her dog. She was like your husband shared a little bit with me, if you ever want to talk. And this, I feel like, I could not be more grateful that this person came into my life. She just is, her skills are phenomenal. Just as a clinician in terms of trauma-informed care, and I’ve felt safe enough going to her for prenatal care to decide that I was ready to get pregnant. My joke is that I should tour high schools and be like it only takes once to have unprotected sex to become a parent. And I was really lucky that I got pregnant right away and at that point I was 37. So I should say I had my first baby at 33 and I got pregnant again at 37. And that’s not always the case for people. Obviously it can take a long time and especially after a C-section, secondary infertility is real. Meagan: It is. Rachel: Yeah. Not talked about enough. Really not talked about enough. Meagan: There’s a lot of things, right, about C-sections that is not discussed about. For personal, for the mom, for the individual, the infertility, adhesions, all those things. Just the emotional and the physical. Then even the baby. There’s risks for the baby, the allergies, the microbiome getting messed up. All the risks, it’s just not discussed. Rachel: No, it’s really not. And you kind of only find out later if you’ve had a C-section and you’ve had a problem down the road that you’re like, maybe that’s because of my C-section. It’s ridiculous.So we got pregnant and I was not sure if I wanted to have a VBAC, but I started thinking about it from the beginning. And I also was like, if I don’t have a VBAC how am I ever going to get myself into an OR, I just don’t know. And I really think that VBAC is the under-discussed pain point for moms. And I’m preaching to the choir here but we’re talking about half a million moms every year have to make this decision, if it’s even available to them. Meagan: I was going to say, if it’s even offered. Rachel: If it’s even offered. Which is totally not a given. But theoretically, they do have this decision and I really have not…I should say, in the course of writing this book, but also just being a mom who had a bad C-section and then had a VBAC, I hear from people a lot about their journeys just like on the playground. Every person I’ve talked to, they agonize over it. No matter what they choose, no matter what. Why is that not talked about more? I mean that part of what this podcast is doing that’s so important, but I still can’t believe how under the radar it is, yet it’s such a big deal when you’re going through it. So anyway, I told myself I did not have to decide right away about a VBAC or a C-section. My midwife was like you can totally have a VBAC, you can totally have a C-section. Even if you have a C-section you can keep seeing me. I was worried like oh would I get bumped out of midwifery care. One of the things I’m really fortunate about and that I think is really good about that practice is that she has a very close relationship with one of the OB’s there. Like they kind of share patients, I should say that. And that’s because she’s worked with him for a long time and he really respects her clinical skills and vice versa. The other thing about her that’s unique and that I didn’t know how important it is she’s a Certified Nurse Midwife, so she attends births in the hospital. But she previously had been a homebirth practice and at a birth center as a CNM. So her skills are, like I said are phenomenal. A C-section is truly like we have to do this. I’ve run out of my bag of skills or like the baby or mom’s health suggests that like we need to do this now. She worked with me to work with the scheduler so that I saw her for every visit which helped me to learn how to trust her and she didn’t pressure me. Either way she was completely open. She also worked with me to make sure that I could see her for virtually every visit so that way she earned my trust. And I got to show her who I am. She got to understand me which was really important to the birth. Meagan: Yes, which I want to point out. There are a lot of providers these days that are working in groups. And I understand why they’re working in groups. They’re overworked, definitely not rested. There’s reasons why, both midwives and OBGYNs are working in these big practices. But the thing is it’s really nice to have that established relationship but for some reason specially for VBAC it’s so important to have that one-on-one relationship. So if you can, during your search for finding providers, if you can find a provider that is going to be like Rachel’s midwife where she’s just like I want to get to know you, I want to establish this relationship. Yes, we have this OB over here but I want to be your person. I definitely think it’s impactful.Rachel: I totally agree with you and I didn’t even know that was possible. And she works for a big group and even so she told the schedulers, hey make sure you schedule her with me. She didn’t just do that with me by the way, it wasn’t just a special favor for this traumatized patient. And frankly it’s better for the providers too because they’re not coming in cold. Like ok who’s this person, and she’s saying this. And what’s her prenatal care like? What’s her pregnancy like? Of course they’re looking at the notes, but it’s not the same. Meagan: It isn’t. And I love that she said that. But I also want to point out that you can request that. If you’re in a group and you can connect whole-heartedly with someone and you feel it’s definitely who you need, it’s ok to ask hey. I know that I am supposed to meet Sarah Jane and Sally, but can I stay with whoever. And maybe you might not get every visit, but if you can get more visits than only that one? It’s worth asking. Rachel: Totally. And also then you know their style. So like she was not an alarmist. Let’s say I was over 35; I had to see a MFM just because of my age. That went fine, but if something had come up, like let’s say I had a short cervix or there was something I found in an appointment with an MFM specialist I would know her well enough to take that to her to be like, put it to me straight. How worried should I be about this? As opposed to maybe this one’s an alarmist, this one is more like ahh let me put this in…And the only way you’re going to learn about that is from meeting with them again and again. And for VBAC that’s so so important. Meagan: It is. It kind of reminds me of dating. It’s weird. I had said this with my provider when I didn’t switch. I was like, I feel like I’m breaking up with him. Like he’s my second boyfriend, it’s just weird. It’s not really boyfriend but you know what I mean. But it is, we’re dating them. And anyone, in my opinion, can come off really great for that first date because they’re wanting to make that impression. They’re wanting you to like them. But the more you get to know them, the more they may show their true colors. And you also may realize, I don’t think I’m the right person for you. My desires aren’t something that aligns with you and so I don’t want to put you in this situation. And so if we date our providers, “date our providers,” a little bit more than just one time it really will help us know. And like you said, if something were to come up you could have that trusted person in your corner, which is so important for VBAC, that you can go to. Rachel: Totally. Yeah. So yeah, so pregnancy went well. And then right as I entered my third trimester it started to be COVID. Meagan: Mhmmm. The joys. Rachel: Nobody saw that coming. And then you know, things for the entire society obviously went completely off the rails. Obviously something like COVID is, we hope, not even once in a generation. Once in a hundred years experience. But given all the stuff that was up in the air, boy was I glad that there was one provider who I trusted. Who I could be like ok what do I do, what do I do. And I have to tell you that she and my daughter's pediatrician…I’m a professor. So I should say I’m in the classroom with young people who, you get sick a lot anyways. They’re living in dorms, like they’re not taking the best care of themselves. So COVID was circulating, and we live right outside New York City, COVID was circulating early here and I have a lot of colleagues that ended up getting it. And both my midwife and my child's pediatrician told me early you need to stop going in person, it’s too dangerous for you. And I trust my daughter's pediatrician a lot, you know we have a nice relationship and I really trusted my midwife. Right? So I followed that advice and was really fortunate because boy. You know what you don’t want while pregnant? COVID. And you know what you really didn’t want? COVID in 2020 when you were pregnant and nobody knew anything, you know?Meagan: Right? Rachel: So, the blessing in disguise was that I was able to work from home. And it was super stressful because I had my daughter and my husband was here and you know, my husband is a photographer…I mean the funny thing is that I ended up, not my head but my body, being in these different photos he ended up taking and my belly was getting bigger and bigger and we kind of had to hide it. I’d be holding a book, or cleaning something. It was an absurd, crazy, isolating, scary, and also funny time. You know the blessing in disguise was that I wasn’t on my feet as much and I think that that was really good for me as a pregnant person. There is also data that preterm birth went down during the lockdowns because people got to stay home and they don’t necessarily get to do that leading up to birth, which tells us a lot about what we need and the rest we need and aren’t getting. So anyway, at first everything went virtual and then when I started going in again for my appointments I had met the OB who works closely with my midwife. And we talked about what would happen if I went over 40 weeks. And he was like well, we’re not going to automatically schedule a C-section, we would talk about potentially waiting or induction. And I really appreciated having that conversation with him because I understood where he was coming from and it wasn't again like we’re going to schedule a C-section right now. So we know if you get to 40+3 and you haven’t had the baby, bing bang boom. And that was very important information about his risk tolerance and his stance. Just like with my first birth I went into prodromal labor a few days before my due date. I had had a membrane sweep with my midwife. My in-laws came to stay with my daughter and we went to the hospital on a Saturday night. I didn’t know this but my father-in-law told my husband I think she’s getting ahead of her skis. And he was right in the end. So we get to the hospital and my contractions stop. And I’m like oh no. And my midwife was like, they put me on the monitor to get a strip which is like you know, what happens. Meagan: Normal.Rachel: And my midwife was like listen, your baby, he’s not looking that good on the monitor. I want you to rest for a little bit and let’s see. So I’ll check back in with you in like half an hour. And I was so upset. I remember being like I can totally see where this is going to go and I had learned about VBAC in terms of like what could increase the chance of rupture or not and I was like I’m going to end up with another C-section and I’m going to be caught in the net. I didn’t even have a shot, is what I felt. And then she came back half an hour later and she was like, “He looks great. I think he was just sleeping, and if you want to go home you can go home.”  And it was like 1 o’clock in the morning. And I was like, “I think we should go home.” I just felt like he's not ready. He’s not ready to be born.  And remember, I trusted her so much. She would not tell me this if she thought that there was something…Meagan: If there was something wrong. Rachel: Exactly. She wasn’t trying to be my friend. She was my provider. And so it felt really weird to leave and come home and not have a baby. And I thought was this the wrong thing to do, because I live like half an hour from the hospital, and was like no this is it.And then everything was quiet for a few days. And then just like my first labor, my daughter, I went into labor in the middle of the night and I had intense back labor, and I knew like this is the real deal, here we are. And this time I tried to rest. I did like cat/cow and just like anything, child’s pose, just anything to feel more comfortable. And I called my midwife at 7 in the morning and she was like, “Okay, I want you to come in and be prepared to go into the hospital from this appointment.” So we did that and at that appointment, I had a headache, I had higher blood pressure, I was dilated to a 6, and she said to me, “Listen. Just so you know, they’re not going to let you go home. You’re going to the hospital, no matter what if your contractions stop or not whatever. This is what’s happening because of how dilated you are, the fact that you have this headache, this BP readings, whatever.” And I was like that’s completely reasonable, I felt that way too. You know what I mean? But I really appreciated she communicated that with me so clearly and explained why. So I planned initially to try to have an unmedicated, vaginal birth. My midwife and I had discussed these saline boluses you can have in your, by your, what’s it called. Like the triangular bone in your back? I’m totally blanking. Meagan: Your sacrum?Rachel: The sacrum. Yeah, that that can alleviate some pain. And very quickly the pain was, I found it to be unbearable. And I asked for an epidural. And the anaesthesiologist came right away and did a very good job. And the nurses and the midwife who were at the hospital were using a peanut ball and helping me move and really supportive emotionally. And I was still really scared, right? Because I had had this terrible birth before, I thought something would happen to me. And nobody treated me like I was exaggerating or you know like, unreasonable. And that mattered a lot. And I think what’s important is you shouldn’t have to have gone through a bad birth for people then to take you at face value. With your first birth, it should be the standard for everybody. Meagan: Such a powerful saying right there. Rachel: And they were wonderful, truly, clinically and beside.Meagan: Good.Rachel: And then my midwife surprised me by showing up. She was not on call, she came in at like 9 o’clock, no she came in at like 5 o’clock, like once she'd seen her patients and I was just like oh my god,  so moved to see her. And you know, I was pretty far along at that point and she kind of helped me get into different positions and then it was like okay, it was time to push. And they had managed that epidural so I could feel when it was time to push, and I could feel how she and the nurse were telling me to like push here, right? Like use this, make this go. The pain was really intense but it wasn’t suffering, like okay, I’m getting instruction. And as I was pushing I could feel that it wasn’t going to work. I was like he’s not, his head…I could just feel it. Apparently he was kind of coming and kind of going back up, like his head forward and back. And my midwife was like do I have permission from you to try and move his head? I think his head is not in the best position. And I said yes, and she tried to do it and she couldn’t. Her fingers weren’t strong enough and then she went to the OB and she told me this later.She said to him can you come and move his head? He’d been trained by midwives in the military, by the way, which is one reason his clinical skills are so amazing.Meagan: That’s awesome. Okay.Rachel: Awesome. And at first he apparently was like, oh she’s a VBAC, like I can’t believe you’re asking me to do this. And my midwife, again they trust each other right, and she was like the baby’s doing great and the mom’s doing great. I really think this is going to work. And he was like okay. So he came in, asked my permission, I said yes and he moved my son’s head. My water had not broken again, right? So it’s like the same thing as the first one. And once he got in position and I started pushing my water broke in an explosion all over my midwife. That’s why they wear goggles, now I know. And she went and changed her clothes. I pushed for 45 minutes and then he came out.Meagan: Oh my gosh. Rachel: It was amazing and I felt so proud and I was completely depleted. I was so high and also so low. And I think what's amazing to me is that it was almost the same labor as my daughter, which just tells me that's how my body tends to do.Meagan: Your pelvis. And some babies need to enter posterior or even in a weird position to actually get down. So that can happen. Rachel: Thank you. And also my water didn’t break until the very end so there was buoyancy to be moved, right? And again who knows what would have happened if I had been with this provider the first time. Like maybe these decels really meant that my daughter had to come out like then. That is possible. And that first team did not have the skills of the second team. None of this was even brought up, wasn’t even a possibility. And I should say that first birth, I didn’t even mention this. The OB that gave me that C-section, later told me that my daughter's head was kind of cocked when he took her out. Which suggests that it was just like my son. And how I’m grateful for my epidural. I’m grateful for, you know, all the things that technological kept me safe, but it was these skills of facilitating vaginal birth that made the difference for me to have that VBAC. Meagan: Absolutely. And the hardest thing for me is seeing that these skills are being lost. Rachel: Yes.Meagan: Or maybe it’s not that they’re being lost, they're being ignored. And I don’t know which one it is. I really don’t know because I see people using them. So I feel like it’s got to be there. But then I go to other births and I’m like, wait what? You’re not going to do anything to help her right here? Or you know, it probably could have been a vaginal birth if we had a provider come in and be like we have  a little asynclitic head, why don’t we change into this position and let me see if I can just ever so slightly help this baby’s head turn. It just isn’t even offered. Rachel: Yes. Meagan: And that’s something that I think needs to be added to questions for your provider. In the event that my baby is really low and coming vaginally, but is in a wonky position, what do you do to help my babys’ position change to help me have a vaginal birth. And then even further what steps do you take past then if it doesn’t work and my baby’s so slow. Do we do assisted delivery? What do we do, let’s have this conversation. So if it does come up, you’re aware. Rachel: I love that. Meagan: I was going to say if your provider says, I don’t know/I don’t really help, then maybe that’s not your right provider. Rachel: And I think what’s so smart about that framing is that it’s not putting the provider on the defensive of like, what’s your training, right? Then it’s like, what is your problem? But you’re actually asking about their skills and you’re asking about their approach, without coming from a place of seeming doubt. Just like, I’m just curious. Meagan: Yeah. Like what could I expect if this were to happen, especially if in the past. Say your C-section was failure to descend, mostly based off on position, we know that this is a big thing. But if your past cesarean was failure to descend, ask those questions to your provider. What steps can you take? What steps can we do together, you and I, to help this baby come out vaginally? Rachel: Totally. And I think also, that way, let's say the VBAC doesn’t work out, you won’t then be looking back over your shoulder and being like I should of/could of/why didn’t I/if only. And you know, what do you want out of your birth experience? Well a lot, but part of it is a sense of peace. Right? That I did the best that I could. That my team did the best that they could.Meagan: Yes. Yeah and really interviewing your provider. Again, dating your provider and asking them the questions, learning more about them and what they do and their view. Taking out the yes and no questions and really trying to get to know this provider and letting them get to know you. I think it’s just so impactful. I also, kind of like what you were saying with your first birth, also learning the other types of birth that could happen, you know learning about assisted birth. This is a new thing. Learning if assisted birth trumps a cesarean for you. Would you rather go for an assisted birth, even if it may end in cesarean, would you rather attempt that? Or would you just rather skip that and go right to the cesarean. Really educating yourself and trying not to push off the scary even though it can be scary. Rachel: Yes, yes. I love that you’re saying this and I was just thinking about this and talking about this with a friend; there’s stuff we hope doesn’t happen. But not talking about it or thinking about it isn’t going to protect us from it happening, it's just going to mean you’re not prepared. Meagan: Yeah.Rachel: If it does happen. And yeah. Meagan: It’s a disservice to ourselves. And it’s weird. And it’s hard to hear those stories. It’s hard to hear the CBAC stories, it’s hard to hear the uterine rupture stories that we do share on this podcast. Kind of what you’re talking about the trigger warnings earlier, yeah it might be a trigger. It really might. But if we know all the signs of uterine rupture leading up to, we can be aware. And it’s not something to hyperfocus on. We don’t want it to be like oh my gosh I have this weird pain, right now, I don’t know. It’s not to make you scared, it really isn’t. It’s to just help you feel educated. Kind of what you were saying too. I don’t know what a C-section looked like until I was in my own C-section. Rachel: Yeah. I’ve been talking about this recently with an anesthesiologist, some anti-anxiety medicine which you might get during a C-section, can cause memory loss. That’s a side effect. So the time to decide…Let’s say you’re not planning on having a C-section. And then you’re having a C-section and you’re really anxious, really reasonable. The time to decide whether to take that anti-anxiety medicine which might cause memory loss; you should have an opportunity to reflect on that and talk about that  and think about that not only in the moment when you’re scared and should I take it right now or not. Meagan: Yeah.Rachel: It’s just like that’s not a good way to make a decision, you know?Meagan: Yeah. And also learning about alternatives. Okay, these are the side effects of this medication, and I don’t think I’m willing to accept that. So let’s talk about other medications and those side effects so we can see if we can switch it up.  They have a whole bunch of things in their toolbox when it comes to medication. Rachel: Exactly. Meagan: For nausea. You know I had a medication and it affected my chest. It went all the way into my chest and I had to consciously focus on my chest moving. It was the weirdest feeling. Rachel: Terrifying, yeah. Meagan: I wish I would have known the alternatives to that. Right? So having these educated discussions, learning as much as you can. It’s hard and it’s scary and it’s intimidating to not learn what you don’t want. It’s understandable, too.Rachel: Completely, completely. But that's informed consent, right? The risks, the benefits, the alternatives. And to go back to the anti-anxiety thing. You might be like okay, what could you do for me non-pharmacologically? Let’s say I have a C-section and I’m feeling really anxious. Can I have a doula with me there who’s giving me a massage? Can I have a doula there who’s maybe put some lavender essence on a washcloth to hold to my nose. Can the anesthesiologist hold my hand and tell me it’s going to be okay? And then you start actually opening up real options. Like wow I can have a doula with me?Meagan: Yes. That is something that I am very passionate about. We need to get doulas in the OR way more than we are. And I understand that it’s like oh we don’t have PPE, or oh it’s an extra body, and oh it’s a very big surgery, like I understand that. But I have been in the OR a good handful of times. And I understand my position in that room. I understand and respect my position in that room. And I always let an anesthesiologist know, if at any point something happens where I need to leave this room you just tell me. I will leave. No questions asked. But please let me be here with my client. Please let me stroke her hair. Please let me talk to her when dad goes over to baby so she’s not alone. When you were put under general anesthesia to be there by your side, whether or not you were waking up in the OR. Because sometimes you could wake up sooner, or waking up in post-operative. Let's get these people here. Let’s play music. Let’s talk to them. Let’s communicate the birth.I mean with my first C-section, they were complaining about the storm outside, they weren’t even talking to me, right? And it would have impacted my birth in such a more positive light if I would have been talked to. And I wouldn’t have felt like, what’s going on. You know and all those things, you talked about it in your book. This drape that is separating us from our birth, it’s just wild. So one of the questions we ask when you sign up to be on the podcast is topics of discussion that you would like to share, and one of those things is you said, why it’s important to balance preparation for VBAC with an understanding of the systemic forces that promote C-sections. We’re kind of talking about that, but do you have anything else to say on that? Rachel: I think that there is so much self-blame for having a C-section, when you wanted to have a vaginal birth. And go back to pain and suffering, that causes suffering. And it’s heartbreaking to see that and to feel that. And when I think about it, I think what’s important to keep in mind is like there are the particulars of your experience, right? Like your providers had the skills or didn’t. They listened or they didn’t. Your baby had decels or didn’t. Like all that is real. And you’re not the first or only person any of that is happening to. So why are we hooked up to electronic fetal monitoring, EFM, as soon as we walk into the hospital? Well that is because of how technology reigns supreme right now in every aspect of our society, but medicine too. And also that like it’s an efficient system and medical birth, medicalized birth is all about efficiency and making as much money as possible frankly. Meagan: And there’s even deeper history, we talk about that in our VBAC course, about why that was happening around cerebral palsy and what it actually did for cerebral palsy rates. All of these things. It’s pretty fascinating when you get into it and understand one, why they do it and does it work? Does it make sense? They do it and just became practice and norm, but it did it actually impact the things that, okay how do I say this. Does it impact the things that they were originally creating it to impact? Rachel: Right. Totally. And it’s actually the opposite; it was supposed to bring down the number of C-section rates, or the number of C-sections, when the number was like 4.5% in the early seventies and it’s just gone in the opposite direction.There’s so much evidence that you use it and it makes you more likely to have a C-section. And so yeah, okay, not your fault. That’s the system. And I don’t mean it in this way like, that’s the system, give up, lay down, don’t try to make your own feet, but also just to accept that that’s what you’re operating in and that’s what your providers are operating in too. Right? Use it as a way to let go of the guilt and the shame and the, I messed up. My body messed up. Meagan: Yeah. Because there’s so many of us that feel that. Rachel: Yes. Meagan: And it goes into the next topic they were saying that I think really can help us walk away with less of, I messed up. My body messed up. My baby failed me. You know whatever it may be. And doing effective research about the hospitals and their employment patterns and the chances of you even having a VBAC. That does kind of go into the balls in our court where we have to get the education and understand. But even when we do that, even when we don’t have the best experience, in the end we’re still going to look back at it as we did, WE did, the best we could. Right? And it takes less of that blame on us in a way because we know we did everything we could. Rachel: Yes.Meagan: And sometimes it just still happens. Even if you have the doula. Take the VBAC course. Read all the VBAC books, listen to all the podcasts, understand all the risks. Sometimes it still happens. Rachel: Totally. And I mean I think about in my case, like let’s say my midwife hadn’t come in for me and my OB hadn’t been the one who had been attending that night, maybe I would have had a C-section. Because maybe the people there wouldn’t have known how to effectively move my son’s head. Even though I like did my best and that’s okay. It has to be okay because you can’t kind of change it. And again, not to be defeat-ist. But to find peace, just to find peace. Meagan: Yeah. I wish that for our VBAC community is finding peace and giving ourselves grace along our journeys. Because we’ve had 100’s of podcast stories and there are so many of us who are still searching for peace. And still not offering ourselves grace, and putting that blame on us, or whatever, right? Everyone’s so different and again, we talked about this earlier, it’s just different. But I would love to see our community offering themselves more grace and finding more peace with their experiences along the way. And I don’t exactly know what that healing looks like and how that peace is found. Do you have any suggestions on ways you have found peace with a very very very traumatic experience that not only led to trauma in that experience, but even in future procedures, in future experiences you know. Do you have any tips on just, guidance on finding peace? Rachel: I mean, I struggle with this still. And it sounds counterintuitive, but I think like not pushing away your feelings. And in the sense of not wallowing, but also not like struggling against them, trying to quiet them, make them be like ugh I hate this. Ugh I hate that I feel this way. Ugh if only I could get over it. So I’ll say like, when I go to the doctor now, I get really scared especially if it’s a new person and my blood pressure goes up and sometimes my heart rate goes up and it just sort of happens. And I hate it. And there are times when I’m like ugh I hate this part of me. I just hate it.But then when I’m kind of more accepting and it’s like, this is how my body responds. It’s understandable that this is how my body responds. And I take a Xanax actually. I say that to really take away the stigma I think that still exists around medical trauma and taking medication to manage your symptoms. I take a low dose Xanax before I go to see a provider and it helps me with my suffering. And also just like accepting. Because also there’s this saying, if you struggle against the feelings of suffering, then you kind of suffer twice over. Right?Meagan: You do. Rachel: So I would say that, and then specifically for people who feel they had a traumatic experience, I’ve found EMDR treatment to be very effective, to deal with stuff in the body. That was pioneered more to deal with people who’ve been in like combat trauma, but it’s very effective for traumatic birth. Tapping is another thing that can be very effective. And you can find that online, like there are different…Meagan: I was gonna say, you can go to YouTube and google trauma tapping or anything like that, and you can actually find some pretty great videos for free on how to do that. And it’s pretty wild actually how well it works. Rachel: It really is. Meagan: Sometimes it’s like wait, how is this working? It really does work. Rachel: Totally. And also I would say like in terms of again, peace, I think it’s really important to speak openly about what has happened to you. And to the extent possible, we’re conditioned to be like I’m just going to tie this up with a bow and it’s okay. Someone says to you, you’ve expressed something hard, and they’re like oh I’m so sorry and you’re like it’s okay, I’m going to be okay. Like you don’t have to worry so much about reassuring your listener. You can be like yeah I had this C-section, and I’m still kind of upset about it. And yeah, that’s how I feel. You don’t have to self-qualify that. You know, but my baby is healthy. But I’m okay. But I love my baby. We do that; there’s a lot of pressure to do that. And it’s okay not to do that. It’s okay to be like these are my feelings. And two things can be true at the same time. You can love your baby, and you can also be like I’m not that thrilled with the birth. Meagan: Awe yes. Julie and I have talked about that for years. They don’t have to be separate. They can go together. You can love your baby and feel connected to your baby and really not like your birth experience. And you can also, we have found that people prep and then they have a vaginal birth and they’re like I actually didn’t really like that either. So you know, they don’t have to just always be separate. You can be really happy and really be upset at the same time. It’s okay to have those feelings, right? I have had things in my life where I’ve done something and I’m like dang. I really like how it turned out, but I hated the journey to getting there. And that's okay. So I love that you pointed that out. Rachel: Yes. or if you think about how you feel on your children’s birthdays. So like I have very different feelings on my daughter’s birthdays then my son's birthday. I had a good birth with my son. And it was good not because it was a VBAC, but because I was respected and I felt safe. That’s what made that a good birth. Right? Just to be totally clear. I’m really glad I had a VBAC, I’m happy I got what I set out to do. One hundred percent. Recovery was easier, like I’m not going to lie. And like you said, sometimes you can have a vaginal birth and you don’t come out of it being like, that was a good birth, right? So I feel differently on my son’s birthday but I also still feel that mix of happiness and a little sadness that he’s getting older. Right? He’s four now. You can contain both of those and they don’t cancel each other out, they just make you have a more I don’t know, dynamic emotional person. Meagan: Well-rounded. Rachel: Yeah, right? I’m experiencing all these parts of life, right? Like I have access to all of them and they’re complex and that is okay.Meagan: That is okay. Last but not least you say, what kinds of qualifications to look for in a midwife, obstetrician, and a doula to ensure your team is best experienced in supporting a safe VBAC? We talked about that a little bit. Asking those questions that seem kind of random, but also what to expect and what those trainings are. Do you have any tips or advice on any qualifications that you were looking for or you think impacts someone's qualifications. Rachel: I would say I learned this more having had a VBAC and having recorded my book. So in addition to the questions you suggested, which I thought were so excellent, like what would you do if whatever, we had failure to progress, would you proceed or would you use assistive technologies. I would look for a provider who has, especially if we’re talking about an OB or a midwife but especially an OB, who has been practicing for a long time. The providers who were trained earlier have more experience not only attending VBAC, and attending twin births, and things now we tend to automatically kind of have a C-section for. But they’re also more open to it typically. Not all the time, but I think that there’s this feeling in general like oh a younger person’s going to get me better and duh duh duh, but really sometimes these providers who are older would be a better match in terms of their clinical skills and their risk tolerance. A lot of time, some of the OB’s coming out earlier, or more recently from their residencies, their risk tolerance is not very high. Even some OB’s have joked to me, who are now really working to help bring down the C-section rate, like in the beginning my like auto reaction was like we should do a C-section. So they get better with time and age and that’s something to remember. Also providers who are trained not in the United States. So in Europe, for instance, VBAC in most of the countries, not every country, VBAC after C-section is the automatic choice. Here, it’s not even an option all of the time and the default is to have a C-section. So again, you're going have a provider who has a totally different mentality if they trained in the UK for instance. That’s another thing I would look for. I mentioned about my midwife, that she’s a Certified Nurse Midwife, but she also had attended births at home and at a birth center. If you can find someone with that kind of experience I think that means they’re drawing on all different types of skills that would really assist with a VBAC. And they have the bedside manner, and they know how long labor takes, and a deep interest in being with you through it. There are providers like that out there, she’s not the only one. Meagan: Yeah. She’s not, she’s not. We have some providers here that were out of hospital and then needed to go into hospital just because of schedules, and there’s a big difference in midwives lives I feel like sometimes in the two different locations. But there’s this weird sense of trust in these providers that, and it shouldn’t be weird let me just say that, but it’s this trust in the ability to birth that I feel like sometimes is lost in the system, in the hospital system. Rachel: I totally agree with you. Meagan: It’s just this weird thing. Where it’s like oh no, it’s been four hours and we've only gone 2 centimeters so we have to do these other things. Where’s it’s like no, let’s step back and let’s let this body go and progress. That’s something I learned with my third birth. I mean 42 hours long. My body takes its time. My babies, like you, go into weird positions. I had back labor and oh my gosh you guys, back labor is another beast of a labor. It’s so different. But you guys, trusting the process is so important. And so if you have a provider that’s like yeah after a few centimeters we’re not progressing we’re going to need to start pitocin or…well wait, that might be a red flag. Unless you want that. Some people want that. Rachel: That’s a great point. Think about it, if you choose any provider, do you want someone who is like more into like medical interventions, or like let’s see if we can address this with lifestyle changes. Right like more exercise and diet as opposed to like oh your blood pressure’s high, we’re going to put you on medicine right away. That’s a really personal comfort preference. But I think to your point, these providers who’ve been out of the hospital now are in the hospital midwives, they know. They have seen physiologic vaginal labor and birth. And so many people who attend birth exclusively in the hospital just haven’t. So they’re exposed to it. So they have the trust because they’ve seen it, they’ve attended it, and they’re like sit on your hands. Be with her. Comfort her. Let it be. Meagan: Yeah. Let it be. I love that. Last but not least…I actually just lost my train of thought, I wanted to talk about something very specific. What was it?Rachel: Um, trained providers, trained overseas. Midwives.Meagan: Oh my gosh. Oh! I wanted to go back to it. Last but not least I wanted to talk about what we talked about earlier in your first pregnancy where you didn’t have a provider who wasn’t jiving and then you went and they still didn't jive and we kind of said that you can change. Can we talk a little bit about the process of changing? We talked about it being scary. It can be very intimidating you guys, but it’s so impactful.So as we’re learning about our qualifications about our providers and as we’re learning more, we’re realizing we’re not in the right place, right? We want to do something.A couple tips. One, getting your own op reports from your history. So then you don’t have to request anything to be sent over to anybody else, you can just take them with you and go to another provider and meet with them. Two. If you’re like I know this is like my person, then you don’t even have to go in and say goodbye. You could just transfer it over. Guess what? If you find out, like Rachel did, that it’s not going to work, you can do that again. Okay? But do you have any tips for anyone who may be coming to terms with the fact that maybe they’re not with the best provider. Maybe say they’re 39 weeks. Do you have any tips, from your standpoint, to anyone going through that? Rachel: Well just to say that it’s really there’s a lot of evidence; meaning researchers have looked at this and people who seek VBAC, are likely to switch providers like through after week 33 even. And I don’t have the exact study in front of me but that it’s done, and it’s okay. And you will get pushback, I mean realistically providers are going to be like whoa whoa whoa. And that it’s really different to be seeking a different provider late in your pregnancy when you’ve been getting care all along. Just keep that in mind. You’re not like wandering in from the woods being like uh I haven't seen anybody, I don’t know. That’s a scenario that providers would potentially be very uncomfortable with, with good reason right? Because you know…Meagan: They don’t know who you are. Rachel: Exactly. And there are some providers who, from talking with them, they’re really at the edge of what their hospitals will tolerate and they are the ones who are probably the most willing to take somebody right at the end. And I’m talking about, there’s probably one in like every cluster of states, you know what I mean, especially just, I don’t even know so much in the South at this point but in the Northeast. And I would think about, to that end, there are some OB’s who work with midwives to run birth centers and those OB’s will also sometimes see people in the hospital; and if you can find them, they deeply know what you’re up against. They understand the system in a way that moms can’t even put their hands around right? Because this is like their workplace and they're working against it. So I would look for, you’re probably not going to be able to have the baby in the birth center right, the birth center would like lose their accreditation, they can’t do that, but a lot of those OB’s will also attend births in the hospital. I would go that kind of back route if you know what I mean. If I were week 36 or 37 and my provider’s like alright let's get you scheduled, you know what I mean? Suddenly we’re not talking about, like wait I thought I was going to have a VBAC, that’s what I would do. Meagan: I love that, thank you so much for your advice. And to your point, what you were just saying, you know if the majority of people who do switch is around that 33-35 week period, there is a reason because this is what happens. We got this bait and switch, which then goes more into you guys, find the right provider if you can in the beginning. Ask all the equations, do the research, establish that relationship, and follow your gut. What is your intuition saying? And the second your intuition is saying something’s up, like mine did at 36 weeks, do something about it. It’s okay too. And I know it’s intimidating, I know. I do know. But it is worth it. And maybe it’s that you need to do a pros and cons list. Like what do you want for this birth, and what do you want to do to make it happen. Rachel: And I would also add like do you imagine having more children. I think that’s the other part of this. When people ask me like…I have a couple friends right now who are pregnant and have had C-sections and they’re like what do you think I should do, as my friend?And I’m like well, what I would think about is like do you want to have another baby? Do you want to have a…because this person is facing a third C-section or trying to VBAC after 2 C-sections. Do you want to have a fourth baby? Would you be comfortable having a fourth C-section? If the answer is absolutely no, then that means it’s really important to find a provider who would potentially attend a VBAC and that is partly intuition. And sometimes you don’t know till you’ve had that third baby or whatever. Sometimes you do have an inkling, like I don’t want that potentially to be closed to me or I wouldn’t feel comfortable with that fourth or fifth cesarean. Meagan: Yeah. And it’s harder every time to find the support. Not only do the risks keep following us and keep growing, it is harder to find the support if you do change your mind after that third cesarean and you don’t want the fourth cesarean and want to VBAC after 3. Which we know can be done, and we know is relatively safe right. But it is really difficult to find that support. So even ask yourself then, really dig deep. Am I really okay with more? And if you are, that’s amazing and wonderful. If you aren’t, make change. It’s okay to make change. Rachel: Yes. Yes. Yes. I think that it is so important to call that attention to that. That the likelihood of finding that provider who will attend a VBAC after 3 C-sections, I know a handful of OB’s that will attend those, and it gets harder for them to do it even every year. I wouldn’t bank on that as like well next time.Meagan: It’s harder. It’s hard enough after two. It’s hard enough after one. It’s way hard after two, and it’s extremely difficult after three. After three, we know again we know people do it but you guys they go through so much. And so really sit back and think about that. And also asking your providers what the risk of that repeat cesarean is. There are risks you guys, so yeah. Okay. Well, is there anything else you want to share? I feel like I’ve taken up so much of your time today. Rachel: Oh no. I wanted to say, when I was working on this book I was thinking about a lot of stuff, but I was really thinking about moms facing VBAC or not to VBAC. That was one of the driving forces for me and I just want to say you’re not alone. And it’s a tough road no matter what you decide. And you know I hope that you can share resources with the people around you to help them understand what it’s like for you. Because you’re not alone. And part of not being alone is like having your community, right? And for people who have not had to do this they really don’t know. They really don’t understand that first you have to find someone, maybe you have to find someone else, then you have to work up your own courage. Meagan: I know. Rachel: Right? Then you have to look at well why did I have that last C-section, why did I really have that last C-section. There’s so much involved in this, so to the extent that you can draw others into it with you I think that that is super super important. Meagan: Yeah, it’s really impactful. Tell us where you can be found and we’ll make sure to link you in the show notes. You guys there’s going to a lot of links in the show notes today, things like prodromal labor, what is it, what can we do to help. Membrane sweeps and things like, it’s not necessarily non-traditional, but non-medical induction methods things like the membrane sweeping and everything. Of course all your book links and now yeah, where we can find you. Rachel: Yeah. On Instagram it’s @rachelesomerstein with an O. I’m on Twitter and I have a website that’s just rachelsomerstein.com. And I will be in Providence doing an event on November 21st and then possibly on the West Coast in the spring but I’ll have details on my website. Meagan: Awesome, awesome awesome. And a reminder if you are not in the show notes and you have been on our Instagram, we’ll also have her tagged there so it will be really easy to just click and go follow and go check out when and where she’s going to be. Thank you so much for being with us today!Rachel: Thank you. Thank you so much!Meagan: Like seriously. Like just after reading the book and having this book in my hands and then getting to talk to you and see you and hear this story through your own words in a way that is not written, to hear them not read them, it’s just been such an honor. So thank you so much. Rachel: Thank you. Oh, it’s an honor for me too. Thank you so much. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
01:29:5421/10/2024
Episode 344 Advice for First-time Moms: How to Avoid a C-section From the Get-go

Episode 344 Advice for First-time Moms: How to Avoid a C-section From the Get-go

We hear SO many of our listeners say things like, “I wish every first-time mom listened to these stories” or “I wish as a first-time mom I heard these stories because I truly believe it could have helped me avoid my Cesarean.” First-time moms, we want to educate you to make informed decisions during your birth. We want your first birth to be an empowering experience, no matter the outcome. And if possible, we want to help you avoid an unnecessary Cesarean.  Meagan shares some of her best tips for first-time moms regarding induction, big babies, ultrasounds, and more. We also asked members of our VBAC Link Community to send in their best tips for first-time moms. We hope this episode becomes a great starting point for you to then go on and listen to the powerful stories shared in our other episodes!VBAC Link Supportive Provider ListEvidence-Based Birth: Evidence on Inducing LaborThe VBAC Link Blog: The ARRIVE TrialNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. This is Meagan and you are listening to The VBAC Link Podcast. I am so happy that you are here. Normally, we have episodes that are filled with VBAC stories, CBAC stories, and guests sharing educational pieces on VBAC. However, today, I’m going to a quick episode for our first-time mamas out there. For years, we have had people write in a review saying things like, “Oh my gosh, I wish every first-time mom listened to these stories. This is not only for VBAC moms or VBAC-hopeful parents. This is for anyone who is giving birth,” or again, going back to the first-time mom, people saying, “I wish as a first-time mom I heard these stories and learned this education because I truly believe it could have helped me avoid my Cesarean.” Women of Strength, if you know someone who is expecting or if you are a first-time mama, listening on how to avoid unnecessary and undesired C-sections, listen up. This is going to be an episode specifically for you. As always, I have a Review of the Week so I’d like to dive into that but then get back into what first-time mamas and what our community wants first-time mamas to know. Today’s review is from Emmalyn. I don’t even know how to pronounce the last name, but Emmalyn. It says, “Uplifted and educated. I have been binging this podcast since I found it a couple of weeks ago and I’m addicted. As I prepare for my HBA2C” so for the listeners who are new, HBA2C means home birth after two Cesareans, “I have experienced so much healing and inspiration through hearing these stories after two attempts for vaginal deliveries with my first two kids. One preeclampsia hospital birth and HBAC (home birth after Cesarean) transfer to the hospital. The content they provide is diverse, thoughtful, and inclusive. There is so much stigma around home birth and VBAC and this is the first and only community plus the Facebook group I have found to truly be welcoming and nonjudgmental. I feel like this is going to be an instrumental tool to my birth prep for my baby coming this Christmas Eve.” You guys, I could not agree with her more. This is a place where we want you to know that you are safe, that you are heard, that you are understood. We in no way, shape, or form believe that there is only one way to birth. There just simply isn’t. We just want you to know your options and feel empowered to make the best decisions for you along the way. So if you are one of these first-time mamas listening today, I am so excited that you are here and I do encourage you to continue going on through all of the other episodes. Women who are sharing their stories likely have had a Cesarean before and I think this is such a great opportunity for you to learn how to avoid a Cesarean by listening through others who have come before you and have given birth and have also learned along the way. I’ll tell you right now that with my first baby, I was not ready to give birth. Although I felt ready, all I knew was that I was pregnant and I was going to have a baby and I could not wait. But there was so much more that I didn’t know that I wish I knew. I have learned throughout the way and I’m going to be sharing some more experiences with you along with, like I said, really tips from our own community members. You guys, I reached out on Instagram and asked for tips for first-time moms and I’m going to go over some of those tips along with learning how to avoid a Cesarean and unnecessary interventions. Here we go. Okay, everybody. Welcome to the show. Thank you for joining me. If you are new to the podcast, my name is Meagan Heaton and I am a VBAC after two C-section mom and a doula who wants to help educate and empower anyone who wants to learn more about their options for birth after Cesarean as well as learning how to avoid a Cesarean from the get-go. I had a Cesarean when I was pregnant with my first. I went into labor at 39 weeks and 5 days spontaneously with PROM which is called premature rupture of membranes. What that means is my body went into labor as far as my water broke, but then nothing really followed for quite some time. Contractions didn’t really get going and labor itself did not start. I, along with many first-time moms, was told that if your water breaks you go straight to the hospital. I went to the hospital and from then on out, it was induction. They wanted to induce my labor and they wanted to intervene instead of just letting my body do its thing. I started getting Pitocin and that led to an epidural. It unfortunately led to a Cesarean. Now, I want to tell you that Pitocin and an epidural do not always lead to a Cesarean but these are going to be common things that you’re hearing in women’s stories along this podcast that do seem to impact the end result of a Cesarean. With my second, I really wanted a VBAC, a vaginal birth after a Cesarean, and I went looking more into what it was and what my options were and what I should do. I ended up staying with my same provider who was a great guy. Do not get me wrong, but he wasn’t the provider for me and I didn’t learn that until after my second Cesarean. I stayed with him and I went into spontaneous labor again with premature rupture of membranes. This one took a lot longer for my body to kick in and unfortunately, I really never was allowed the time. I ended up walking down for a second repeat Cesarean with that one because I was told that my body just did not know how to do it. This is also another very common, common thing that so many Women of Strength are being told. Their body doesn’t know how to do it. Their body can’t progress. Their pelvis is too small. Women of Strength, if there is any pet peeve that I have, it is someone telling another person that their body is not capable of giving birth vaginally. I might sound grumpy about it. Let’s be honest, I am. You are capable of giving birth vaginally. What are some of the things that I would suggest you do as you are going along as a first-time parent?Number one, I really believe that provider is key. If you have a provider who is on board with your birthing desires, that is going to help you so much during your labor and your pregnancy journey. If you have a provider who is very induction-happy, intervention-happy, and pushing you to even schedule an induction before you even reach 39 weeks or 40 weeks or 41 weeks, that’s a problem. That is a red flag. Take a moment if you can. Go to thevbaclink.com/blog or just click the link in the show notes and check out how to find a supportive provider. Now, this blog that we have is how to find a provider who is supportive in VBAC, but I think all around it goes in line with any provider whether you are a VBAC or not. You want to find someone who doesn’t put stipulations on when you have your baby and what happens during pregnancy meaning that if they are requesting or demanding that you do multiple growth scans in your third trimester and there is really no medical reason to indicate the reason to do that, that’s a problem. If they are talking about the size of your baby early on or the size of you and how you look and, “You must be carrying a big baby. You are so petite,” there is already doubt that is being placed. As I mentioned, if they are encouraging an induction at 39 weeks or just getting it on the schedule, let me tell you right now that being pregnant at 39 weeks is not always fun. Being pregnant at 40 and 41 weeks is not fun. There is a lot that goes into it. Your hips hurt. You’re tired. Your pelvis hurts. You’re peeing all of the time. You can’t sleep. Okay, it doesn’t sound that great, right? But it really is such a great time and it’s a time that we need to cherish and really just embrace but it’s hard to do that. That’s the fact. It’s sometimes really hard to do that so when we have providers giving us an “out” to give birth sooner, it’s very enticing. I don’t shame anyone for taking that opportunity of being induced and picking your baby’s birthday, but there are a lot of things that go into that. Now, as a first-time mom back in 2019 I want to say, a study came out and they called it the ARRIVE trial. The ARRIVE trial is where they had a whole bunch of people, and really actually not that many people, but a whole bunch of people in two groups. They had one group where they induced at 39 weeks and they didn’t always have a “favorable” cervix. Favorable versus unfavorable meaning the cervix was showing signs of readiness to give birth. They had these moms in one group who were induced at 39 weeks then they had another group who chose not to be induced or to wait for spontaneous labor but would not let them go past 42 weeks. There were a lot of things that their goals were to point out and study in this trial which you can find out more about on our blog. It’s in the show notes. We’ll make sure that we have the ARRIVE trial link in there. But they really wanted to also see what it did for Cesarean. In the induction group, 79 out of 82 people were induced at 39 weeks. The people in the expectant management group, meaning they were waiting for spontaneous labor or didn’t elect to induce at 39 weeks, 79 out of 80 waited. 44% of them gave birth spontaneously and 56% of them gave birth after induction for medical reasons. Now, medical reasons. There are a lot of things people can talk about or providers can talk about why you should be induced. So let’s talk about some of the main reasons for an induction or some common reasons for an induction that you’ll see but then always, I want you to know that you can question. If someone is saying there is a medical reason for you to be induced, question them. It’s okay for you to question them. It is always okay to say no and question, always. No matter what it is in any medical scene, birth or not birth, you are always able to question and say no or no, thank you. What are some medical reasons? Medical reasons may be preeclampsia. Maybe you’re having blood pressure issues or HELLP syndrome where now your liver is being affected. We’ve got high blood pressure or elevated liver enzymes and it really is best for you and baby to be born and to give birth. So preeclampsia may be one. Maybe you’ve got a unique health condition that is now impacting your personal health to stay pregnant. That may be a reason for induction. IUGR, intra-uterine growth restriction. Maybe your baby is no longer thriving inside the uterus and inside the womb and needs to come out so they can thrive on the outside. If IUGR is happening, that is a medical reason to consider induction. Those are just a few that you may encounter. Some other things may be low fluid– that one can be debatable for sure. It can be serious, or high fluids. There are so many situations. Just know that if you have a situation or if someone is suggesting an induction at 39 weeks or at any point due to medical reasons, discuss that with your provider. Definitely discuss and question and make sure that you are all on the same page and you are really understanding what the medical reason is for your induction. Don’t fear to question the evidence saying that induction is the best route. Okay, so the people in the expectant management group like I said– 79 out of 80 waited. 44% gave birth spontaneously 56% gave birth after induction. So what did this study really show, really, really show about C-section? Well, let me tell you. They really tried to show that it lowered Cesarean rates from 19% to 22% but if you really dig into it deeper, it really doesn’t say if Cesarean really is lowered or not. Between the two groups, there really were no significant difference in birth outcomes for the baby so again they showed that maybe 19% versus 22% were likely to end up in a Cesarean and then they also showed that they were less likely to develop high blood pressure– 9% versus 14%. That is a thing. We do know that blood pressure can elevate in the end, but overall, as of 2024, there really are a few studies that have been able to look at the effects of the ARRIVE trial and have concluded that the elective rate has significantly increased or decreased the Cesarean delivery. This is the problem though. It’s being so heavily– and maybe heavily isn’t the word– done. It’s being so heavily performed all over the world now after this trial came out. For some reason, we looked at that and we’re like, “Yep. See? It impacts the Cesarean rate. It lowers it.” But we are still having a really high Cesarean rate and first-time moms are still, still, still, still having Cesareans after induction is happening. Induction. Women of Strength, that is what we call the women who listen to our podcast, if you are being proposed for an induction or being offered an induction, maybe take some steps back. Do some research. Read our blog. Talk about induction methods. There are also a lot of different types of induction methods. I want to also say that coming back to your provider, if you have a supportive provider who is willing to induce very gently and understands the process of induction especially for a first-time mom whose cervix might not be favorable or ready, you may have a higher chance of giving birth vaginally. But if you are at a place where they like to push inductions really fast on you and all of the things, increase all of the interventions, you are going to likely have an increased chance of Cesarean. In 2023, the rate of C-sections in the United States was 32.4%. 32.4% which is really the highest it’s been since 2013 and just astronomically gross in my opinion. Years and years and years ago, it was 10-15%. Even before that, it was 5%. We are seeing a peak. We are seeing a serious peak and what’s happening is we are seeing a lot of the times first-time moms will have a C-section for whatever reason and then people are being told that they cannot have a vaginal birth after Cesarean, that the option is now gone or they won’t even approach VBAC as a topic. It’s just, “For the future, you will have to schedule a C-section.” Okay, now this is another one. If you are a first-time mom who has a friend who had a C-section and doesn’t know their option, please share this podcast with them. This is such a great place for them to come and learn and know their options. Okay, so let’s dive in. I asked our community. I mentioned that before. What do our community members want a first-time mom to know? What do they wish they would have known before as a first-time mom?One of our followers, Elizabeth, mentions, “Wait as long as it takes for baby to come and to change positions frequently.” Oh my gosh, I cannot agree more. This is what we are talking about, right? Waiting for our baby to come and not inducing unless it really is medically necessary and letting our bodies do what they are made to do and are totally capable of doing.Changing positions frequently is something I highly encourage and as a first-time mom or any mom giving birth, I highly suggest a doula. Doulas are amazing. I know they are not always affordable and I don’t know if you have ever heard of this, but you can go to behervillage.com and you can actually register for a doula so instead of getting all of the million onesies and wipe warmers or a million sized-newborn diapers, you can register for a doula and people can help pay for a doula. It is absolutely amazing. I highly encourage it. Check out behervillage.com. We also have doulas at thevbaclink.com/findadoula. They are VBAC-certified doulas but these are doulas who are trained and educated and certified in helping you avoid a Cesarean so I highly suggest a doula because they can help know what positions to change to and they can help guide you. If you don’t have a doula, that is okay. Change positions frequently. I mean, every 5-10 contractions, if you went from hands and knees and you want to stay on hands and knees, go hands and knees but put a pillow under and elevate that left leg or that right knee. Change things up because changing the dynamics of your pelvis is going to help bringing baby down. One of the main reasons for a Cesarean is that babies are in a wonky position or failure to progress or failure to dilate. That, a lot of the time, is because baby is not in a really great position and movement will help baby get in a better position and help your labor speed along. Okay, our friend, Emily, says, “Wait to go to the hospital.” I mentioned this earlier that I was told when my water broke to go straight to the hospital. Do your research to wait. Learn how long to wait, how long is too long, and again, that’s when a doula comes into play. They are really great on helping to guide you on knowing when to go. Emily also– she has a couple of tips here. She says, “Trust your own intuition and what your body is feeling in the moment.” I could not agree more. Your intuition is huge and if you continue listening to this podcast, let me tell you that you are going to hear about intuition a million times. Intuition is huge. You have it and it’s amazing. It’s super important to follow. Sometimes we question our intuition and that is hard. Try not to question your intuition and again, do what your body is feeling in the moment. Emily says, “I didn’t have a doula and it’s my biggest regret.” Okay, so we were just talking about that. Doulas are amazing, you guys. I didn’t have a doula for my first two. That was also a big regret. My husband was not on board with my second. After I learned about a doula and after having a doula, he said that there is no way we would have another baby again without a doula. They are just incredible you guys and there are actual statistics on doulas. They lower the chance of Cesarean. They lower the time of birth by 45 minutes. 45 minutes might not sound like a lot, but 45 minutes in labor is impactful. They also lower the chances of induction and interventions and they overall help you walk away with having a better experience. Okay, another follower says, “Trust your body. Don’t accept interventions. Plans can change and breathe.” Love that so much. We have Sarah who says, “Ask for help even if you feel fine.” I love that. It’s okay. Use your voice in labor. Use your voice during pregnancy. Use your voice during that postpartum experience. Even if you think you are feeling okay, it’s okay to ask for help or if you have a question that is bobbling around in your brain, ask it. Don’t be scared to ask it. Another follower says, “Be patient with yourself and your baby. Enjoy your pregnancy and push with an open lotus.” I love that so much. Oh my gosh, that just made me smile. We have a follower named Ash. She says, “Be informed so you can make decisions you are happy with under time and pressure.” Okay, this is something, Women of Strength, that we have found through many of these stories. These first-time mamas are going through labor who have not had a lot of education, me being one of them, going into birth. You guys, birth is a very big event. It is a very important day and impactful day. Sometimes things can change just like what one of our followers was saying. Plans can change and that means sometimes things can be offered to you that you don’t really know about. You don’t really know what is being offered to you so you feel like you have to say yes or no. You don’t really know what you’re making the yes statement to so being informed is so important.We have a blog at thevbaclink.com/blog that shares so much information along with this podcast and then we actually have a course for parents to learn how to avoid Cesarean and how to navigate through labor and avoid a Cesarean so if you are interested in learning how to avoid a Cesarean and learning more about what this VBAC stuff is even like, check us out at thevbaclink.com. Gracie says, “Don’t let your doctor pressure you into unnecessary induction.” It goes along with the theme in the first part of the podcast. If you can tell, induction and pressure is something that a lot of first-time, even second and third, oh my gosh, many-time moms have. Ash says, “Have a clear but detailed birth plan.” I love that so much. Birth preferences are so important. As you get informed and get educated, you are going to learn what is important to you, what you want, what you don’t want. We had a story not too long ago how as a first-time mom, she didn’t realize how much her birth experience meant to her until she didn’t have that birth experience. You guys, this is such an important day. Oh my gosh, it’s just incredible and if you can be informed and you can have that clear birth plan– now, let me tell you that some of these birth plans don’t go exactly as you’ve written them down. Go in with an open mind but know your desires and know the evidence and the information behind those desires and why they are important to you. Okay, M says, “Be open to birth preferences changing.” This is just going right along here. Okay, like we were just saying, sometimes they change and it can be really hard. I have a sweet and sour view on birth plans because birth plans are incredible. It helps our team and reminds them what we need and what’s important and what we want, but sometimes if we write them down on paper and they don’t go as planned, we can view them or view ourselves as having failed or like we did everything and it didn’t work so it failed so what’s the use in trying that again or wanting that again? I also want you to know that if you can go into it having an open mind, it can help you. It can help you a lot and knowing again that birth preferences change is so important. Okay, so we have a photographer here. Lilabqz_photography. She said, “It’s not pain. It’s power. Breathe and it will be all over soon.” I love that. These contractions are powerful. They are amazing. Oh my gosh. Okay, hypnobirthingnorthyorkshire says, “You are amazing. First-time mamas, you are. You are amazing.” Everybody listening to this podcast, let me tell you that you are incredible. You are such a Woman of Strength and you are capable of more than you have ever known. Okay, we have another follower who says, “Give yourself all the grace. You did a big thing. You are your baby’s best mama.” Birth is amazing, you guys. It is a big thing and you are incredible for doing it. Another follower says, “Educate yourself and get a doula.” The next one also says, “Hire a doula.” You guys, hiring a doula is a common theme. Like I said, if you are not in a financial means or don’t have the financial means, check out Be Her Village. It is absolutely incredible and can make it possible for you to have the support that you deserve. Rachel says a couple of things here. She says, “Just because you feel good to do all the things so soon doesn’t mean you should. Find someone who will listen to your birth story without interrupting or opinions.” This is more for postpartum. I agree. Take it easy. Even for pregnancy, take it easy. Just because you feel like you can run a marathon doesn’t mean you should. Rest up. Rest easy. Give back to your body. Hydrate. Fuel with good nutrition and find someone who will listen to your birth story without interrupting or opinions. You guys, opinions will come in all around even before you have your baby. I mean, here I am. I’m sharing some opinions. Just find someone who will listen and validate you. You deserve it. Okay, Lauren says, “If you don’t want a C-section, listen to The VBAC Link. You’ll learn so much.” Oh my gosh, Lauren, thank you so dang much for that. That is what this episode is all about, to help you learn how to avoid a Cesarean. Our friend, Jess, says, “Eat to replenish yourself from birth and pregnancy. Meal trains are great.” Oh my gosh, I can’t say that enough. If you haven’t set yourself up for a meal train before and you haven’t had your baby yet or even if you had, they are incredible and they will help your birthing partners so much. Julie says, “Surrender. Surrender it all. Birth is incredible. You’re going to feel so many sensations.” Even if you don’t want to go unmedicated, you guys, you’re still going to feel so many sensations that are new and somewhat shocking but also incredible. You’re birthing a baby. It’s just absolutely amazing.Then Rachel says, “Do your research. Be mentally prepared for either type of birth and recovery and have a postpartum plan or a birth photographer and take pics.” Okay, you guys. Such incredible information. I echo all of them. Obviously, we’ve also been talking about some of those topics. You are strong. You are capable. Don’t let anyone doubt you. Okay? Don’t let anyone doubt your ability. Keep listening to these stories. These stories are meant for you as well. They are meant to help you learn, to help empower, to help grow, and honestly, one mama at a time, we’re going to see the Cesarean rate drop, you guys. We’re going to see it drop. Thank you so much for joining me today. I’m absolutely honored that you are here listening to the podcast and like I said, if you want to learn more about The VBAC Link and what we have to offer along with so many free resources, you can join us at thevbaclink.com. We’ve got the podcast, the blog, the course, resources, and so much more.Oh, and for kicks and giggles, I want to throw out the fact that we have a supportive provider list so if you are looking for a supportive provider whether it’s a VBAC or not, don’t forget to check out our provider list. You can find us at thevbaclink on Instagram, click on linktree, and you’ll find the supportive list there. Thank you so much and take care. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
32:2016/10/2024
Episode 343 Melanie's VBAC With a Big Baby + Ways to Avoid PROM

Episode 343 Melanie's VBAC With a Big Baby + Ways to Avoid PROM

“Inhale peace, exhale tension.”Did you know that the cascade of interventions can not only contribute to a Cesarean but may cause one? Melanie believes that was the case with her first birth. Her difficult recovery included going to EMDR therapy to help with her PTSD. Her OB/GYN did mention that she would be a great VBAC candidate. Not knowing VBAC was a thing, Melanie’s research began. Cue The VBAC Link!Melanie vigorously dove into VBAC prep before she was pregnant again. Her journey is one that shows just how powerful intuition and manifestation can be. Melanie went from having PROM with her first to arriving at the birth center at 7 centimeters and even being able to reach down to feel her bulging bag of waters as her baby began to emerge en caul!Other talking points in this episode include:Achieving a VBAC without a doulaHusband support Birth affirmationsRecommended podcasts and booksSpecific ways to avoid PROMHypnobirthing by Siobhan MillerThe VBAC Link Blog: 9 VBAC Books We RecommendThe Birth HourDown to BirthNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Happy VBAC Link Podcast day, whatever day it is that you are listening. We are so happy that you are here. We have our friend, Melanie, from Texas. Texas, is that where you are? That’s where my mind is thinking. Melanie: Yep. Yep. Wiley, Texas just outside Dallas. Meagan: Perfect and did you have your VBAC in Texas?Melanie: Yes. In Dallas. Meagan: In Dallas, okay. We have her sharing her stories with us today you guys. At the end, we’re going to be talking about PROM. Right before we got recording, I was talking about how important I think talking about PROM is which if you haven’t heard lately what PROM means, there are all of these acronyms all over the place when it comes to VBAC birth, but it’s premature rupture of membranes. We are both PROM moms here and so we are very passionate about the topic. If you have had your water break before labor really started and got going in the past, definitely hang on in the end because we are going to be talking more about that and maybe some ways that could or maybe not, we are hoping these are the ways that helped us avoid premature rupture of membranes. We are going to be talking about that and of course, her beautiful VBAC story. I do have a Review of the Week and this is by milka. It says, “VBAC Podcast Review.” It says, “Hi. I love listening to your podcast. I had an unplanned C-section with my first birth and am preparing for my second birth now. I didn’t know what to do to make sure I didn’t end up with the same situation. Hearing so many women’s stories and experiences validated mine but most importantly, I learned so many tips and ideas to help my VBAC. I had a successful VBAC and now recommend this podcast to all expecting moms. Just such a great no-pressure and enjoyable way to learn.” I love that she talked about no pressure because that is what this podcast is about. This is a place where people share their stories, where they share information both on VBAC and CBAC, and all topics when it comes to birth. We want you to just be here, be in this space, and have it connect with you how it connects with you and take these women’s stories and these providers who are coming on and the information given and apply it however, it looks for your journey. Melanie and I were just talking a little bit before the episode about how it just feels so full circle. So many of these Women of Strength who have come on before Melanie here and have shared their experiences and people listening, it really is so impactful. Right, Melanie? You were saying that I was in your ear. We were in your ear and these people’s stories were in your ear doing what? Empowering you. Melanie: Mhmm. Oh yeah, it’s incredible. It feels very full circle to be here. Meagan: Yes. We are very excited that you are and you guys, we are going to jump right into her story in just a second. Okay. The table is yours. Melanie: Okay, so happy to be here. Meagan, like you said, you guys have been in my ear for over a year so it just feels incredible to be here. As I was listening to these stories, I was always hoping to find that birth story that was like mine just to find out what went wrong with mine and also on the flip side, what did people do? What were people seeing in things that went right and how they were able to get a successful VBAC? I was very motivated and inspired by the podcast. I listened to every episode so hopefully, my two stories out there can hit home with anyone. But yeah. I’ll start with, of course, the C-section just briefly. I got pregnant in March 2021 so everybody remembers it was COVID times still. Meagan: Wild times. Melanie: Wild times. Actually, at the beginning of my pregnancy, my husband wasn’t able to come to the appointments. But thankfully, it being 2021, by halfway he was able to come. That pregnancy, I was really healthy. I ran. I’m a big runner so I ran every day. I had no morning sickness. I was very active. I never even until the very end– I ran the day my water broke and I never had that feeling like I didn’t want to be pregnant.Not the case the second time as we’ll hear, but the first time—Meagan: And you do that competitively, right? Did you compete during pregnancy at all? Melanie: I’ve ran my whole life so I ran cross country and track division one in college. Now, I do more marathons. Yeah. I ran both pregnancies. Not anything too crazy. During the second pregnancy, I did run a half marathon. I was 16 weeks but then it went downhill after that. But yeah. I run pretty competitively. I take it really seriously and it’s a passion of mine. Yeah, the only thing I got the first time and the second, but I did. I’ve heard it before on the podcast is SPD, symphysis pubic dysfunction. The first pregnancy, so the one I’m talking about, a prenatal chiropractor literally cured it. I had to go back a couple of times because it would get out of alignment again, but for anyone who is suffering from SPD like I was both times, it’s amazing. I would just call them witches because they would literally cure it and it would get me back to running. It was amazing. So my birth education the first time around, I thought I was educated like so many women here. I read the typical What to Expect When You’re Expecting. I did a podcast but it was more so of what size is your baby? What’s going on in utero? I didn’t listen to many birth stories and I became so obsessed with that the second time. And truly, I feel like you get the best birth education through birth stories because you just get the whole shebang. We did take a hospital birth class and now I know that a hospital birth class is really just the hospital policies. I remember there was a section that they had mentioned very quickly in passing, “If you’re going to have a C-section, you should take this class. Okay, the next thing.” I thought like so many women, That’s not going to be me. I’m not going to have a C-section. I’m healthy. I feel great. Most C-sections are not planned so I feel like it really did a disservice to not even mention anything about a C-section in that class, but anyway, I just assumed that you have a baby in the hospital. You get an epidural. You take a nap and then you wake up and you push out a baby. I was not against hospitals or anything. I was not against the epidural or anything like that. I mentioned that I ran the day my water broke. This was past 40 weeks. 40 weeks came and went. A couple of cervical checks I got I was not dilated at all. They had scheduled a 41-week induction date. When I was checking out at the front desk at the time, I just remember it feeling really, really wrong scheduling that date. Meagan: Your intuition was speaking right there. Melanie: 100%, yeah. Of course, I didn’t realize it at the time. It was my first baby and everything but when I look back, that just felt so wrong. 41 weeks came and I was supposed to go in at 9:00 PM that night but the interesting thing is that my water broke actually 4 hours before I was supposed to go in. It was 5:00 PM and I was supposed to go in at 9:00. Like you mentioned Meagan, it was PROM so it was a trickle. I was like, Wait. Am I peeing? What is happening here? No contractions at all. And with the little education I did, I knew that just because your water breaks, it doesn’t mean that you have to go in and you should labor at home as long as possible. However, because I was set to go in and I guess because I was 41 weeks, I called them and I just remember they were like, “No. You’re in labor. Come in.”I was like, “Okay.” Meagan: This is labor? Melanie: Yeah, I was like, “Oh, okay.” So I got to the hospital literally not dilated at all. I was maybe half a centimeter and they inserted the Cervadil at 9:00 PM which hurt really bad because it turns out if you are not dilated, it really hurts to get Cervadil inserted. Meagan: And if your cervix is posterior, it’s hard for them to get it into your cervix so that can also cause a lot of discomfort. Melanie: That’s exactly what it was too because I think they had a hard time. I didn’t even think about that. It was probably posterior. Man. Yeah, see? My body just wasn’t ready for that. But contractions did come eventually. I don’t know if Cervadil can cause it or if it was just time. I was going into labor but that was around 1:00 AM. The contractions started to get uncomfortable. I had not practiced coping with contractions at all because I was planning to get an epidural. I never had any inkling of going unmedicated or anything so this is where I think everything went south.This is where I just think it was the cascade of interventions. First I had fentanyl which I don’t know why because I think I was trying to delay the epidural for whatever reason. I don’t know why. I had fentanyl first. It was awful. It felt like I was so drunk. The room spun and it was terrible. Then an epidural, which has fentanyl in the epidural. That was fine. After the epidural, of course, you feel amazing, but you are stuck on your back forever. I just think this cascade of interventions, being stuck on my back, not moving, I never ever take medicine as it is. I think my body and my baby just hated all of this. So then eventually, terbutaline was given around 6:00 AM. Meagan: To stop the contractions. Melanie: Yep. I think that’s when some decels started happening then they did pull the Cervadil to stop the contractions. There were some decels then yeah, eventually it’s all a little bit fuzzy but at 6:45 AM the decision was made for a C-section. At 8:01, he was born. They called it an emergency C-section and now I look back and I’m like, yes. I do believe that it was needed. However, I’ll never really know but I really think it was caused and also, if it’s an emergency, I understand that they don’t wait hours like they did for me and they usually put you under. I think it was more unplanned and I look back and I really think it was caused. Meagan: That is the hard thing to know. A lot of these Cesareans, I would agree with you that they are caused by the cascade of interventions and things like that and then a lot of providers will say “emergent” so there are emergent Cesareans where we need to get this baby out quick and then there is a crash where they do put people under with crash Cesareans. But if they are waiting for hours, it’s almost like they gave the emergency title to make themselves feel better or make it look valid to justify that Cesarean. Melanie: Yeah, I definitely agree with that. That experience was really awful for me. I think for some women, I think it’s awful for a lot of women and then I think for some, it’s not that awful. For me, no skin-to-skin. I know that’s not very common at all. It felt like it was forever for them to bring him to me. No one was talking to you in this moment and I just don’t think these doctors realize in the moment that you’re being robbed of something that you envisioned and a really important experience. It just felt like forever for them to give him to me. It was 30 minutes or so. He was fine. He came out completely fine with great APGARS. I was fine. It just ended up in the way I didn’t want it to. I did have PTSD from that experience because I was having a lot of flashbacks to it. I went through some EMDR therapy. I had a great therapist and of course, I talked to her about it. She was there for my VBAC as well. But yes. That postpartum was just– the healing sucked. I just felt really awful and I think mentally, it took a really big toll on me. Breastfeeding was really hard. A lot of that I attributed to my C-section. It was not desired. It was just not great. So that was the first birth. I never knew VBAC was a thing or a big deal at all. I don’t even think I knew the term VBAC. I went to the 6-week post-doctor’s visit and I remember she was like, “Yeah, you’d be a great candidate for a VBAC. However, you have to go into spontaneous labor by 39 weeks.” I’m sitting here like, okay. He was just a 41-week baby. My mom has a history of going late. I don’t think that’s very likely that I’ll go into spontaneous labor by 39 weeks so I already made up my mind that I wasn’t going to go with her. I learned later that that is a very common thing that hospitals and OB/GYNs will say to you. Yeah, that was the first one. So then cue The VBAC Link. I started listening to The VBAC Link Podcast before I was pregnant. Maybe my son was a year old and I binged every episode. You and Julie were in my ear a ton. The thing that I heard from The VBAC Link was that the likelihood of a successful VBAC for many of these women did happen out of the hospital and like you yourself, Meagan. That’s not to say that of course, you can be in the hospital. You can have an epidural and get induced and have a successful VBAC, but when I just heard the overwhelming thing was how much of a better chance you have. I should also mention that my husband works in medicine too. He’s a physician assistant. I will talk about that. He had a little bit of a hard time just with the safety aspect of it. But once I let my mind go toward the possibility of an out-of-hospital birth– because I wanted a VBAC so badly. I was so motivated. Then I realized that it was something that I actually really desired, a physiologic birth and unmedicated. When I look back, I think that’s why I had such a hard time mentally with my first birth because I think I didn’t know that I cared how my babies come into the world and I wanted to experience that. I don’t know and in some weird way too, it felt like doing an unmedicated out-of-hospital birth made me almost feel connected to my ancestors. It seems really weird, but I was like, this is what they did. I just think it’s something really cool that our bodies do. I wanted to experience that. But I do. I recognize that it was a trauma response for me for sure to become obsessed with research. I binged all of the episodes. I would look for anything related to VBAC. I read so many books and I actually toured. I had a neighbor and a friend who was pregnant at the time and she was going with the birth center that I ended up going with. We would go on walks and she would talk about her experience and how amazing and wonderful it was. I was just like, man. I want that, especially knowing that we were planning to most likely have just one more child. I hated to have that thinking of, this is my last chance, but I did. Meagan: I understand that so much because my husband told me that too and I was like, “I really want this VBAC. I really want this VBAC.” Melanie: Yeah and that’s okay. We’re okay. It’s okay if we have these desires and these wishes. You only get one life. It’s okay to want what we want. I’ll never forget. I toured the same birth center that my friend was at and again, I was not pregnant yet. It was an education class. I was like, let me just see what these midwives are all about and what birth centers are like. It just immediately– again, it’s that intuition. It immediately felt so right. I remember I walked in and just before even finishing the class, before we even really heard them out, I just knew that this was where I wanted to give birth in my next pregnancy. It felt so right. And also, I’ll never forget. I had asked questions about VBAC because unfortunately, not all birth centers support VBACs which I don’t understand, but I had asked a lot of my questions related to VBACs and I remember the midwife saying, “Well, unfortunately and fortunately, we do a lot of VBACs.” I’m thinking, why would I not want to be with a provider who does the most VBACs? Hospitals don’t do a lot of VBACs comparatively. A lot of people are like me. They go to a birth center because they really want a VBAC. That just was really calming to me. I felt like I was with experienced hands. I was safe and there also was not really anything different about a VBAC. I’m with people who understand and trust birth. I brought this up to my husband and I mentioned that he had his reservations because he’s a physician assistant and he works in orthopedic trauma but he was in PA school, he had to do OB/GYN rotations. He unfortunately saw some bad birth outcomes so to him, the hospital was a safety net but I was so, so grateful that he was supportive of my desire to go out-of-hospital even though it seemed kind of crazy to him. He came to– we had one meeting with the midwife so he could ask questions and everything. She was so great and answered all of his questions and I actually was unknowingly pregnant at the time. I didn’t know it.Meagan: No way. Melanie: It’s really weird. I toured the birth center first by myself and it’s almost like my body needed that to be like, boom. You found the place where you are going to give birth and then I got pregnant. It was really weird. We were trying but also, it takes my body after coming off birth control some time so it still was a shock. I was like, oh wow. So anyway, the second pregnancy was much harder as I mentioned. I was not able to be nearly as active. I ran that half marathon like I mentioned and then– it was the Dallas half– then my body just went downhill. It was much, much harder. My sleep was horrible. I have an Aura ring and it tracks your sleep and everything then at the end of the year, it will give you a summary of every month’s sleep. I will never forget because I got pregnant in September and it’s like, January, February, March, April everything is fine and you look at the bar graph time series and it plummets in September. It stayed that way. It was my deep sleep. My deep sleep really, really decreased a ton. Maybe that’s normal and I just didn’t know that the first time, but I did not tell many people I was going with a birth center. I lied about my due date which I learned from this podcast which is very smart to do. I highly recommend it just because I didn’t want to let in any of that negative energy or anything. The couple people I did tell, I did get a couple of people who would be like, “Oh, they’re going to let you do that,” like the “let you” language. Meagan: We both did the same thing at the same time with the air quotes. The “let you”. Melanie: Yeah, exactly. I don’t blame them. I just think that a lot of people don’t have that birth education. And in hospitals, it’s very normal to do a repeat C-section even though we all know it’s not evidence-based. So very briefly, I want to talk about the prep that I did in this pregnancy that made such a huge difference for me. Number one, all of the podcasts like I mentioned. This one, of course. The VBAC Link, I binged it. I found the Down to Birth podcast at the end and that’s a really, really good one. I know everybody does The Birth Hour as well which is good but that one has everything. I loved the more VBAC-specific ones. Then also, they haven’t produced any episodes in a while but the Home Birth After Cesarean Podcast was really good too because they were all unmedicated. I was hoping to do that and they were all VBACs. Then books– I read a lot but these were my favorites. Of course, Ina May’s Guide to Childbirth. Emily Oscar’s Expecting Better is really good. Natural Childbirth the Bradley Way is a little outdated but that one I really loved. It really taught me what productive contractions looked like because I didn’t really experience labor the first time. I never made it past a 3 the first time. I didn’t know what that meant. I didn’t have coping mechanisms. They really focused on breathing. The best book I read and I hadn’t heard this one on it. Maybe you know of it but I had never heard about it but it was Hypnobirthing by Siobhan Miller. There are a lot of books on Hypnobirthing but Hypnobirthing by Siobhan Miller. I was just thinking of Hypnobirthing as a possible way to cope. That book was the best book because I really like the science, the physiology, and what is actually happening in your body when you’re getting contractions and how do you work with your body. It just had such a great way of explaining all of that.That was the last book I found. I was 3 weeks away from my guess date. That one was great. She also creates the Freya app if you’ve heard of that. The Freya app times contractions and it helps you with breathing. They give you a lot of mantras. Yeah. That book was amazing. I did get the Freya app too. I did not know I was going to rely on it so much in labor. Also, in that book, it was really big on affirmation cards. I would make affirmation cards then I would read them in the bath and sometimes practice my breathing through the app. I did some pelvic PT and then, of course, the prenatal chiropractor like I mentioned, I continued to do that. Like I mentioned, the care with the midwives was great. Very positive language. I noticed what was really important to me was not, “I hope I can do this,” because of course, I hope that. But my midwives were amazing because every time, they would just speak it. They would say, “You are going to have a beautiful, redemptive VBAC.” They would just say that. Of course, I know I am 50% of the birth story. The baby is the other 50%. Of course, I know that but it was so important for me to have that positive language. I really worked on my mindset this time around. I only followed accounts that served me. I unfollowed news accounts. I had to be very careful about what I watched and things like that. I don’t think women realize how important our mental state is. I get very sensitive. Meagan: Yes. So talking about that, protecting your space, our bubble, or whatever it may be. Protecting our space is so important because mentally, like you were saying, I don’t know if people really understand how precious our mental space is but mentally, if we are thrown off, it is sometimes really difficult to get back onto that rail. I had a situation on Facebook in a VBAC-supportive group. I’ve talked about it in the past. I was so excited to announce that I was going to birth outside of the hospital. I also wasn’t telling people that I was birthing out of the hospital. I didn’t really tell people my plan I thought I could in that group and I wasn’t supported. I had to leave that. Sometimes it means leaving groups. Sometimes it means staying off social media. Sometimes it means muting people who may be sharing their opinions or telling people flat-out, “I appreciate you so much but unfortunately, I can’t have you in my space,” because mentally, they are not serving you well. Melanie: 100%, yeah. I hate that that happened to you and I know that happens to so many women. It’s just so unfortunate and I hate that there is such a stigma with VBAC because if you do the research which people who have really “easy” births don’t have a reason to really do the research but if you are like us where we are all very motivated to have a VBAC because we already have this stigma going against us, it’s all unwarranted. It’s not evidence-based to not be supportive of a VBAC and if you really research and do the stats, you realize that it’s not a big deal. The craziest thing that I heard on the Down to Birth Podcast was, “You have a chance of uterine rupture even as a first-time mom.” Meagan: Yes, you do. Melanie: It’s not that much higher as a VBAC and first-time moms go their entire pregnancy never once hearing about uterine rupture but yet if you are a VBAC mom, that’s all you hear about. So it’s so crazy to me. Meagan: Yeah. Yeah. So mentally, you were unfollowing. You protected your space there. Is there anything else that you would give tip-wise to protect your mental space?Melanie: I think just believing in your body and believing that we are made to give birth. I think that’s a really big one. Of course, like you said, unfollowing and maybe not talking about it with people, unfollowing accounts that do not serve you. I think the most important thing, I know we’ve heard it a million times on this podcast, but where you give birth and who you give birth with is the single most important thing because you want to be with a provider who believes that you can do it, whoever that is. Yeah, believing in yourself. I think that’s going to look different for everybody of what they need. For me, I am a data person so I needed the stats. I needed to read the books and also listen to lots of women who have done it before me. Meagan: Mhmm, love that. Melanie: So okay, here we are. I was 40+5 so again, not 39 weeks with spontaneous labor but 40+5. I woke up at 5:00 AM to what I thought was contractions. I had some Braxton Hicks at the very end which I never experienced before. I didn’t know if maybe it was prodromal labor but it didn’t feel like Braxton Hicks because it was waking me up. I just tried to move through them a little bit. They were coming very, very sporadically. I would get a short contraction one time an hour and this went on for most of the day and they were not long at all, like 30 seconds. In my mind, I’m thinking, I’m a hopeful first-time vaginal birther. So I’m like, okay. This could be 24 hours. It could be 48 hours. Who knows? But I did not want to waste any energy timing the contractions so I was just guessing the whole day. It was a Sunday. I stayed home with my toddler. Yeah, I should mention that he is 2.5 so I waited about 2.5 years between the two births. So yeah. I just labored at home with my toddler and my husband. We are big track fans so it worked out perfectly. There was a Diamond League track meet on so I did the Miles Circuit while I was watching that. I texted my midwives and kept everybody updated but I think again, we all thought I still had a ton of time. Then I would say around 4:00 PM that day, I started to notice them a little bit more. They were still pretty inconsistent. I would say maybe 8-10 minutes apart and still only 30-45 seconds long. That was something I learned from again, that Bradley Method book I read is that productive contractions for most women– I will say not for me. We will get into that. But for most women, they are a minute plus. Those are the most productive contractions. I texted my midwife then that I felt like it would likely be that night. I felt pretty confident that they were coming but I was like, it could be the middle of the night. It could be tomorrow morning. Who knows. She texted back and she advised that I take some magnesium, take an Epsom salt bath and then go to bed and try to reserve my energy for when they are 4-1-1. We had a birth photographer this time so I texted the birth photographer. I texted our friends who I’m so grateful for. We had a neighbor and a friend who was going to come to our house and be with my toddler. So, so sweet. Yeah. I took the magnesium and then my husband, Brandon, drew me a bath and then disappeared with our toddler. I sat in the bath and I was reading my affirmation cards. This makes me so emotional but I discovered that my husband had snuck in his own affirmation cards into my pile and that’s when I found them. Oh, it was so sweet. Meagan: That’s adorable. Melanie: I know. It still makes me cry when I think about it because it just meant so much. It makes me so emotional. It was super sweet and one of the best things he’s ever done for me. I found those and was reading through them in the bath and just trying to relax and really work with the contractions. I know from my research that you need to relax. To get them to be productive contractions, you have to relax. You have to get your body out of the way and it will go faster that way. They really started to ramp up when my husband was putting our toddler to bed around 7:30. I got in the bed and I put the pregnancy pillow in between my legs. I lay there and was trying to establish a pattern. Yeah. I know manifestation sounds pretty woo-woo but I want to say and this is where I’ll start sprinkling these in because there were 10 things that I had manifested or really, really prayed would happen and I was very intentional that I really, really hoped that this happened. This was the first one. I don’t know why I had envisioned laboring with my dog. You have a dog. You understand. My dog is my firstborn. She is my baby. I love her. You know, birth is so primal so I was just like, She’s going to know. She’s going to know when I’m in labor and she’s going to know what to do. She did. She followed me. I didn’t even realize it at the time. She followed me in my bed and I took a picture with her at 8:19. She was lying next to me on the bed as I was going through these contractions and it’s a very, very special memory for me. I was already starting to get the labor shakes at this point. It’s 7:30 and laying down in bed did really help to establish more of a pattern but they still were not a minute long. They were 40-50 seconds long. Then I moved to the toilet as many women do at this point, backward on the toilet. I lost more of my mucus plug because I had lost it sometime earlier in the day then at some point, I looked down and realized that I was having my bloody show. Again, none of this I had ever experienced before with my first. My husband was an absolute rockstar in this moment. He was so cute. He was running back and forth between the toilet and then packing up the car because I think he realized it was starting to get pretty serious. He brought me water and he put on the back of the toilet, cleaned it, gummy worms and things. That was not what I wanted at that moment but it was super cute. Oh, and I should mention that I did not have a doula so he was kind of like my doula. I was trying to prepare him as best as I could beforehand but he didn’t need it. He did really well. I know the hip squeezes are great and I learned that from this show of course. As they were coming, I would scream at him, “Hip squeezes! Hip squeezes!” He would come over and do it and he did awesome. He was saying that I left my body in this moment and I was possessed because when I was having a contraction, again, I was trying to do the deep moans and really trying to relax but it’s just funny. He was telling me about it after and he was like, “Yeah, it was like if you were looking at it from the outside, it’s like you were possessed then you would scream at me and just moan.”Then by 9:24, they were coming. I mentioned they were not a minute long, but they were coming on top of each other. So every 2.5-3.5 minutes apart, but still not quite a minute long so my husband was calling the midwives and she still was like, “Well, they’re not quite a minute. Just have her keep laboring at home until they are a minute.” Eventually, he called her back and I think he put it on speaker so she could hear me and that’s what did it. Meagan: Uh-huh. She’s like, “Load her up.” Melanie: Yes. Because we live outside of Dallas. The birth center was in downtown Dallas so it’s pretty far. It’s usually a 45-minute drive for us so I think my husband was just like, “I don’t want to have a car baby.” Meagan: Sure. Melanie: Yeah. It was ramping up. So yeah. She called back. I mentioned the Freya app. I really relied heavily on the Freya app because when you are timing the contractions, it helps you with the breathing, in for 4, out for 8, and then one of the mantras I learned from that Hypnobirthing book that I did not know I was going to rely on so much– and I think you never really know when you’re going into it and when you’re in labor. You never know what’s going to stick. My mantra that I must have repeated to myself 500 times was, Inhale peace, exhale tension. Every single contraction, I just repeated that over and over and over. I was trying to make it until 10:30 PM when we called them again, but that’s when we got in the car and started heading there. He made it to the birth center in 33 minutes. The car ride was not fun like many women talk about. I think I hardly opened my eyes and I was just timing them, repeating my mantra, Inhale peace, exhale tension. I arrived at the birth center at 11:00 PM. I had a contraction on the step right there as I was trying to get out of the car and trying to make it. I eventually made it inside and I had my first cervical check of the whole pregnancy. I again, something I had manifested was that my two favorite midwives would be there and they were. One of them, she wasn’t even on call but she came anyway. So many sweet things happened. I got on my back. She asked if she could check me and I was like, “Yes. I really want to know.” One thing again, I manifested that I really wanted to be at least a 6 when I showed up. The first thing she said was, “You are much farther along than you ever were with Rhett.” You are a 7 and you are very stretchy. I can feel your bulgy back of waters and the baby’s head is right behind it. That’s the other thing. We mentioned PROM. Here I am and my water still had not burst and it was amazing. Being on my back felt awful by the way. That’s why I just don’t understand. Being unmedicated in a hospital must be so, so hard because I know a lot of the times they want you to be on your back and I just can’t imagine because that was the worst position ever. She started filling up the tub right away. Like many women, I was like, “I have to poop.” I get on the toilet and I was like, “I swear I do.” But no, I don’t. Nothing was happening but it feels like I do. I got in the tub right away. I did a couple of contractions. They were still coming on top of each other. I was sitting down and eventually, I moved to hands and knees. Very shortly after, that was very fast. That was only about 5 minutes after getting checked. Very shortly after, my body was starting to push and I was like, “This can’t.” I mentioned something. I don’t really remember this but I mentioned something to my midwife about how it seemed to soon to push. I was like, “You just checked me and I was a 7-8. Why is my body pushing right now?” I was really wary of a cervical lip or a swollen lip which I learned from this podcast. I can’t remember exactly but she said something to the nature of, “If your body is ready to push, let it push. This is your body getting ready to birth your baby,” which is again, something else I had really, really envisioned. I would have loved my body to do the pushing and it did which was amazing. My water had not broken still at this point and the really cool moment was that the baby was en caul for a while. I remember her saying something on the phone about baby being en caul. I was birthing the sac before I birthed the baby. It felt like a water balloon. She kept telling me, “Feel down. Feel the sac.” It felt like a water balloon coming out of you. It was so weird. Yeah, my midwife stayed behind me so quietly the whole time. I never knew she was there. My husband set up my birth playlist and music and he just was such a rockstar in this moment. He was getting a cold rag and putting it over my shoulders which felt amazing, getting water and electrolytes and continuing to help me with that. Yeah. My body pushed for about 30 minutes and I don’t want to scare anybody, but truly, that was the worst part. I remember– I guess maybe it’s the ring of fire, but I just remember feeling like my body was ripping in half. But then it goes away. Meagan: Yeah. It’s intense. It’s intense. Melanie: It’s so intense. I don’t think anything can really prepare you for that. I follow that account, Pain-Free Birth. I don’t understand and I would watch videos of women who were smiling and they look great. I’m like, oh my gosh. That part was so, so painful. Handling and dealing with the contractions is one thing and I felt like I was really strong. I felt like I did a good job with that, but that pushing part is something else. His head was out. It was a boy. His head was out for a little while but nobody panicked and my husband was ready to catch him. His hand was right there. At some point, I remember my midwife was like, because again, my body was doing all of the pushing. I didn’t do any of it. I guess after the head was out of a little bit, she was like, “You can try to push.” My husband told me because his hand was right there that my pushes were nothing. They were baby, tiny little pushes compared to the ones my body was doing. Then at some point, my midwife asked if she could help or something and I was like, “Yes, please.” I don’t know what she did. My baby was kind of big which I’ll say in a second, but I think maybe his shoulder was stuck or something. She did something that was pretty painful but then within a second–Meagan: A sweep. Melanie: Yeah, like a maneuver because I definitely felt more stretching then a second later, he shot out. He did have the cord wrapped around his neck one time but nobody freaked out and they just literally took it off then he pinked up right away, cried, and he ended up being 9 pounds, 5 ounces. My first was 6 pounds and 14 ounces. I’m like, “No wonder running felt awful. He was pretty big.” I look back and I just feel very proud. I was never once scared for myself. I never once thought about uterine rupture and I never was scared for my baby. I do have some memories of– they did the intermittent checking and I have this memory of the decels. That is why I ended up having the C-section so I was always very curious to see how he was doing during the check. He was always fine and I was never scared. Yeah. We got out of the tub quickly. They waited for me to deliver the placenta on the bed. It was about 30 minutes and yeah. My baby latched right away which was such a relief because I mentioned we had some struggles the first time. The crazy thing was– we sat there. We ate. We chatted for a little bit then once they did all of the newborn tests right there, we were home by 3:45 AM. My toddler went to bed as an only child and then he woke up to a little brother. And that’s his story. The postpartum has been so different and it’s been so much better. I can’t help but think that a lot of that is because of such a smoother birth and the recovery has been so much better than a C-section. Different, but still so much better. Meagan: Yeah. Melanie: Yeah. I just thank this community so much. I also was on the Facebook page and I just got so much strength from all of the women before me. Meagan: Yes. Oh my gosh. Such an incredible story. I love– okay, a couple of things. One, we talk about it on the podcast. I love when people go and look for providers before they are pregnant. I absolutely love it. I think it’s very powerful. But two, you were actually pregnant and you didn’t know it. Melanie: I know. Meagan: That’s so cool that you were doing that and it felt so right and not only was your intuition before pregnancy kicking in but you were actually pregnant and it felt right. You were like, this is the place. This is the place. Then you showed. You went past that 39-week date. You never had gone past 3 centimeters before. So much strength and power happened through all of this and then you pushed out a 9-pound baby. All of these things that a lot of the world doubts. Did you look at your op report? Melanie: I did and everything was normal. Then the main thing was the decels and that’s why they said was the reason. Meagan: Decels. I just wondered if they said anything like CPD or failure to progress. Melanie: Yeah, no they didn’t. I was looking for that specifically. I just barely made it. I was 2-3 centimeters before the decels started happening and then they called it. Meagan: Yeah. A lot of the time we are told and the world doubts us in so many ways so if you told a lot of people who are uneducated about VBAC the things that happened with the first and then the stats of your second, I bet people are like, “You did that?” But you guys, this is normal. This is beautiful. This is what you deserve. You deserve these experiences and these joyous moments. I’m just so proud of you. I’m proud of you. I’m proud of your husband. He sounds absolutely adorable. Shoutout to him. Melanie: He’s so sweet. Meagan: Your midwives and everybody. You did it. Melanie: Aw, thank you. Meagan: I’m so happy for you. Melanie: Thank you. Thank you so much. I’m glad I didn’t know how big he was before but also with my midwives, there was no pressure at all to even see how big he was. Meagan: Mhmm, yeah. Melanie: The second baby, I always say that he healed me because he really did. My first birth was really traumatic for me but then my friends all laugh because they say, “You’re the only person who would say a 9-pound baby would heal you.”Meagan: Seriously, though. But how amazing. It’s so amazing. Our bodies are incredible. Okay, we talked about PROM. This time, total opposite. Encaul for a little bit. I did some things. You did some things. Let’s talk about if you’ve had PROM, premature rupture of membranes, there are things you could do to try to encourage no PROM next time. I am PROM, PROM, then with my third, I was contracting. My water did break way earlier than pushing but it still waited a little longer. I still feel like my efforts in a lot of ways helped. So anyway, tell us what you did. Melanie: Yes. So mainly two things. Again, being with providers who are more holistic, they are more likely to mention nutrition. We talked about nutrition a ton during the whole pregnancy. I think two main things. The first thing was collagen. They got me on collagen from the get-go. I know research shows that upping your collagen helps a strong sac. Then the second thing was Vitamin C. I didn’t take any Vitamin C supplements or anything, but again, your body is amazing. I was craving oranges in my pregnancy so I think that’s part of it. My body was craving oranges. I ate a lot of oranges so I think the combination of collagen and oranges really made my sac strong. And it was. It literally did not break until he came out. It was so different. Meagan: So incredible. I would echo that. Vitamin C and you can supplement with Vitamin C 100mg a day starting anywhere between 18-20 weeks. Some providers even say to do it from the very beginning as the placenta is forming and things like that. Collagen absolutely and protein. Protein and collagen. I know you guys have heard about Needed but I absolutely love their protein collagen. As pregnant women, we don’t get enough collagen and we don’t get enough protein in our daily eating habits so supplementing with that and getting more collagen really, really can create a healthier, thicker sac. Something that was interesting that I found out after my second– so back story. I had kidney stones. I don’t know if you had any infections or anything like that with your first that made you be on antibiotics but antibiotics is what an OB told me can also weaken membrane sacs. I got UTIs and kidney stones and was put on antibiotics. The OB described to me that my OB was fighting in other areas so the nutrients that my body was getting was going to fighting and healing versus creating a stronger sac which is interesting. I’ve never seen any research about it but he was pretty adamant about avoiding antibiotics during pregnancy with my next one and I did. I didn’t have what I had before. Melanie: That’s interesting. I never heard that. Meagan: I know. I know. This is a doctor who doesn’t even practice anymore. This was years ago but I was like, it kind of makes sense. It kind of makes sense. I haven’t researched it. Melanie: Yeah. I can see that. Meagan: Antibiotics wipe our gut flora and things like that anyway so I can understand that but protein, collagen, Vitamin C, and possibly avoiding antibiotics. Nutrition is so huge with our bag of water. Then big babies. You guys, big babies come out of vaginas. I just have to say that. It happens. 9 pounds is a healthy, beautiful baby. Melanie: Yeah. When he came out, everybody was very shocked even before weighing him. He’s thinned out now but he was swollen. Everybody was taking bets on how big he actually was. Meagan: I love it. I love it. I’ve seen so many babies when they come out and their cheeks are so squishy and you’re like, that’s a big baby. You can tell just by their face. Melanie: Yes. That’s exactly it. Meagan: Oh my gosh. Well, thank you again so much for completing the circle, for helping other Women of Strength out there. I too believe that women listen to these podcasts and they want to find stories that are similar with theirs in so many ways. You didn’t dilate past 3. An induction that didn’t turn out to be a vaginal birth so an “unsuccessful” induction that turned VBAC. A lot of people, I think, do doubt their body in that way. They are like, “Well, I was induced. Not even medicine could get me there,” but there is a lot that goes into that. Sometimes our body is just not ready or our babies aren’t ready or something is going on. It doesn’t mean that’s your fate for all future births. Melanie: 100%. Yeah. So well said. Meagan: Awesome. Well, thank you again so much and huge congrats. Melanie: Thank you so much, Meagan, and thank you to everybody. Everybody who has told their story, the community, and everything was so helpful for me. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
53:0914/10/2024
Episode 342 CNM Paige Boran + What Midwifery Care Looks Like + How Can a Midwife Impact our VBAC?

Episode 342 CNM Paige Boran + What Midwifery Care Looks Like + How Can a Midwife Impact our VBAC?

“Labor is supposed to happen naturally. It’s not this big medical intervention that occasionally happens naturally. It’s this natural process that occasionally needs medical intervention.”Paige Boran is a certified nurse-midwife from Fort Collins, Colorado. She and her colleague, Jess, practice independently at A Woman’s Place. They have rights to deliver babies at the hospital but are not employed through the hospital system so they are not subject to physician oversight. Their patients benefit from a low-intervention environment within a hospital setting but without the restriction of hospital policies.Lily Wyn, our Content Creator and Social Media Admin, joins us today as well! Lily shares why she chose Paige to support her through her current VBAC pregnancy. Lily is a beautiful example of how to diligently interview providers, keep an open mind, process past fears with the provider you choose, and what developing a relationship looks like to create an empowering birthing experience. Paige shows us just how valuable midwifery care can be, especially when going for a VBAC. If you’re looking for a truly VBAC-supportive provider, this is a great episode on how to do it! The VBAC Link’s VBAC Supportive Provider ListA Woman's PlaceHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Paige: Yeah, so I’m a certified nurse-midwife. I work in northern Colorado in Fort Collins at A Woman’s Place. We’re a small midwifery-owned practice. Right now, there are just two CNMs. That’s the whole practice. It’s just me and my colleague, Jess, who owns it which is really cool because we get to push the boundaries because we are not really locked into the hospital system. We are able to catch babies there but we are not actually employed through the bigger hospital systems which is nice because we don’t have that physician oversight and stuff like that. I think we are able to do a lot more and honor that midwifery care model which is really cool. Sometimes people feel locked into policies and their overseeing physician and things like that but when it’s just two midwives, we get to do what we want and what feels best for the patient. I really like that. That was a big thing when I first got into the certified nurse midwifery world. I was like, where do I want to work? I had offers from bigger hospital systems and it just didn’t feel like the right fit so working at a small, privately-owned practice felt like the right answer for me so I was able to practice in a way I felt was right for people. I didn’t want to be locked in by a policy and overseeing physicians. I just wanted to grow with other midwives. Meagan: Yes. I love that so much. I don’t know. Maybe I should say I know it feels to me– I don’t know it as an actual fact, but that feels like a unique situation and a unique setup to me. We don’t really have that that I know of here in Utah. We either have out-of-hospital CPMs or we have in-hospital CNMs who are just hospital. I know that one hospital system is trying to do the attached birth center, but it is still very different. They are still the hospital umbrella midwives I guess I could say. So is that unique or is that just something that feels like it?Paige: I think it’s unique because where I came from in Florida, if you were a CNM, you 100% practiced in the hospital which we do but it was that you were owned by a larger group of physicians essentially. Florida was working towards independent practice when I was there. Colorado is an independent-practiced state for nurse practitioners which is really cool because we don’t have to have that oversight. I don’t know if Florida ever got there but I know it varies state to state on if you have to be overseen by a physician or not. Honestly, that’s why a lot of people when they are ready to become a midwife, if they don’t have independent practice rights as a CNM even if they are a nurse, they will go for a CPM which is a certified professional midwife because they actually have more autonomy to do what they want outside of the hospital because they are not bound by all of the laws and stipulations which is interesting. Meagan: Exactly. I think that’s a big thing– the CPM/CNM thing when people are looking for midwives. Do you have any suggestions about CPM versus CNM? If a VBAC mom is looking at a CPM, is that a safe and reasonable option?Paige: Absolutely. Yes. I think CPMs and CNMs are both reasonable, safe options. They both have training in that. They both can honor your holistic journey. I would say the biggest thing is who you feel most connected to because I think trusting your team, you will have people who have the worst birthing outcome and horrible stories but they are like, “I look back and I feel so good about it because I trusted my team.” I think that is what’s important. If a CPM seems like your person and that’s who you are going to trust, then that’s who you should go for whereas a CNM, if that seems like that’s your person and who you trust, I think that would be a good route too. I think a lot of people think, “Oh, they do home births. They must catch babies in a barn and there is no regulation. Even sometimes when I say, “midwife,” people are like, “What? Do you dress like a nun and catch babies in a barn?”Meagan: Yes, this is real though. These are real thoughts. If you are listening, and not to make fun of you if you think this, this is a real thing. This is a myth surrounding midwifery care, especially out-of-hospital midwives where a lot of people think a lot of different things. Paige: Absolutely. Meagan: I think I had a chicken chaser or something where a dad was like, “Do you chase chickens?” I was like, “What?” He said, “Well, that’s what the midwives do so that’s what the doulas do.” I’m like, “What? No, we don’t chase chickens.” Paige: That is such old-school thinking but realistically, midwives started in the home and that was their history. It’s cool that they’ve been able to step into the hospital and bring some of that back into the hospital because I think that is needed. Meagan: It is needed, yeah. Paige: We are starting to see that physicians are starting to be a little bit more holistic and see things in the whole picture, but I’m glad that the midwives did step into the hospital because I think that needed to be there but I’m so glad that people are still doing it at home because I think that is such a good option for people. Meagan: Yeah, so talking abou the midwives in the hospital, a lot of people are talking about how they are overseen by OBs. Is this common? Does this happen where you are at? You kind of said you are separated but do the hospital midwives in your area or in most areas, are they always overseen by OBs? Paige: Not necessarily. It would vary state to state and hospital to hospital. We actually just got privileges and admitting privileges a couple of years ago. Actually, my boss, Jess, who owns the practice where I work, had worked in Denver where they were allowed to admit their patients and everything. They didn’t have to have any physician oversight but when she was there, she had to have physician oversight. She was like, “It’s an hour drive north, why would that make a difference?” It was the same hospital system so she fought when she bought the practice and the physician who owned it prior left, she was alone and she had to have that physician oversight so she fought for independent practice privileges and she got it. Some of the midwives at first weren’t so happy about it because they had liked being overseen by the doctor and someone signing off on all of their things. Some of the midwives were like, “Finally. We should be able to practice independently.” It’s going to vary at each place. But I think that’s a good thing to ask, “If something is going wrong, will a physician just come unannounced into my room in the hospital?” That’s not the case with ours. We have to invite them in and if we are inviting them in, we’ve probably had a conversation multiple times with the patient where it’s like, we need to have this. Meagan: Yeah. For the patients who do have the oversight of the OBs, do you have any suggestions? I feel like sometimes, at least here in Utah with my own doula clients when we have that situation, it can get a little confusing and hard when we’ve got an OB over here saying one thing but then we’ve got a midwife saying another. For instance with a VBAC candidate, “Oh, you really have a lower chance of having a VBAC. I’ll support it. I’ll sign off, but you have a really low chance,” but then the midwife is like, “Don’t worry about that. You actually have a great chance. It is totally possible.” It gets confusing. Paige: Yeah, and it’s like, who do you trust in that scenario? I think that’s where evidence comes in because I think midwives and physicians both practice evidence-based but some people may have newer evidence than others. I’ve worked with OBs who probably roll over in their grave when I say certain things because it wasn’t the old way but it is the new way. If somebody can come in with their own evidence and they’re like, “I’ve looked into this and I think I’m a good candidate for x, y, and z,” I think physicians respond well to that because they are like, “Okay, they’ve done their research. Maybe I need to do some research.” Meagan: Yeah. Paige: When they have that thought, they know that this is an educated person and I can’t just say whatever I want and they’re going to take my word as the Holy Bible. Meagan: Yeah. No, really. Exactly. It always comes down to education and the more information we can have in our toolbelt or in our toolbox or whatever it may be, it’s powerful so I love that you point that out. I think it’s also important to note that if you do have two providers saying different things, that it’s okay to ask for that evidence. “Hey, you had mentioned this. Can you tell me where you got that from or why you are saying that?” Then you can discuss that with your other provider. Paige: Yeah, and following intuition too. I think you can have all of the evidence in the world. What is your gut telling you too? Who do you trust more and what feels right in your body in the moment? I think we are all experts of our own bodies and there’s a lot that goes into a VBAC and stuff like that. It’s more than just the evidence. People have to feel mentally and physically ready for it too. I wish more people focused sometimes on the mental and spiritual aspect of it because I think a lot of people get ready physically but maybe mentally they weren’t prepared for the emotional switch there. Meagan: Totally. Thinking about that, Paige, I mean Lily, tell us a little bit about why you went the midwifery route. I know you really wanted to find the right provider. Lily: Yeah. So I think for me, I have always been drawn to midwifery care. I was a little bit of a birth nerd prior to even working for The VBAC Link or even having my own kiddos. Prior to my son, we had a miscarriage and an ectopic pregnancy so I experienced OB care with my ectopic. I was bounced around a lot in a practice and had OBs who were great and equally some OBs where it was such a rushed visit that I had an OB miss an infection in my incisions because my pain was dismissed and just some really tough stuff. When it came to getting our rainbow rainbow baby, I was like, I really don’t want to be in a hospital at all. I want midwives. That’s the route that we went. The very brief story of my son is that he flipped breech 44 hours into labor and that’s when we legally had to transfer to the hospital and I had my Cesarean. So in planning my VBAC, I planned to go back to the birth center and was a little devastated when it was out of our financial means this time. I was so panicked. I remember texting you, Meagan, and being like, “What do I do? I can’t be at the birth center anymore and I don’t want to be in a hospital.” We interviewed another birth center that’s about an hour away that is in network with our insurance and talk about trusting your gut, it just didn’t feel right. It didn’t feel warm and fuzzy. Those are the feelings I got with our first birth center. I loved them so much and I still do. Then I met with Paige and her practice partner, Jess, and I came in loaded to the teeth. I was prepared to fight with someone because that’s what I had in my brain and that’s what I expected. I sat down with them. They met me after hours after clinic. I sat down with my three pages of questions and by the way, if you are listening and you have questions, we have a great blog on it and some social media posts of the questions that I specifically used. We talked for over an hour and every question I asked, they just had the ultimate answer to. I felt so at peace after talking with both of them and I remember telling my husband going into it, “I’m really worried that I’m going to like these people because I don’t want to deliver at a hospital and then I’m going to have to choose a far away birth center that is out-of-hospital or providers that I like but it’s a hospital.” It just feels like everything has been serendipitous for us. Our hospital opened a low-intervention portion of their birth floor so I’ll still get to have the birth tub and all of the things, but truly have just been blow away by Paige and have just buddied up. She’s dealt with all of my anxiety in pregnancy and VBAC and all of my questions. It just feels like such holistic care compared to my experience with OBs in the past. Meagan: That is so amazing and I was actually going to ask how has your care been during this pregnancy? It sounds like it’s just been absolutely incredible and exactly what you needed. I remember you texting me and feeling that, oh crap. I don’t know what to do. What do I do? You know? I just think it’s so great that you have found Paige. Did you say that Jess is your partner? Paige: Yes. Meagan: Jess, yeah. I’m so glad that you found them because it really does sound like you are exactly where you need to be. Lily: Yeah. It made a huge difference for me and I just tell Paige all the time I truly didn’t know that care in a hospital setting could look the way that it does. I feel like I’m getting– I experienced birth center care. I had an out-of-hospital experience until we transferred and I can say with confidence that my care has been the same if not better with Paige and just having the conversations and the good stuff and feeling really safe and confident. One thing that they pointed out that I thought was great when I went in and asked all of my questions is that Jess looked at me and she was like, “Okay, it sounds like you have a lot of anxiety around hospital transfer.” And I did. With my son, that was my worst fear and it came true. I had a lot of anxious, what if I have to transfer? She was like, “The thing is there is no transferring. We can induce you if you need to be induced and we can come with you into the OR with your Cesarean if that ever happened to be another thing.” For me, that brought a lot of peace to know that no matter what, the provider that I know and feel comfortable with is going to be with me. I again, didn’t expect to feel that way, but it’s been a really great reassurance for me personally. Meagan: Yeah. It’s the same with a doula. Knowing that there’s someone in your corner that you know who you’ve established care with who can follow you to your birth with you in your journey is just so comforting. So Paige, I wanted to talk about midwifery care and also just lowering the chance of Cesarean. Sometimes people do choose midwifery care specifically because they are like, “I think I have a lower chance of a Cesarean if I go the midwifery route.” Can we talk to that a little bit?Paige: Yes, that’s true. A lot of people know that there are benefits to midwives but I think when people think of midwives, it’s just like, “Oh, it’s just a better experience. I trust my team more.” That’s definitely there. There have been studies and people felt more at peace and empowered through their birthing journeys with midwives than they did with OBs. It’s been studied but there is also a decrease in C-section risk. Your C-section risk drops 30-40% when you have a midwife which I think is a pretty significant drop. Meagan: Yeah. Paige: Yeah, especially when we look at the United States at our birthing outcomes and birthing mortality and C-section rates, it is way too high for as developed of a country as we are. I think that’s really where midwifery care is stepping in and starting to help lower those rates to get it down to where it should be. The World Health Organization has been nominating and promoting midwifery care because it really is the answer to how we get these C-section rates lowered and these bad outcomes lowered. Midwives also have lower chance of an operative vaginal birth. That would be with forceps or a vacuum or an episiotomy so lower chances of those things as well. Lower chance of preterm birth which is interesting and probably because one, we do take lower-risk people. I think that’s true but also because we are looking at it holistically. We are looking at everything. We are not just looking at you as a sick person. A lot of people look at pregnancy as an illness and pregnancy is not an illness. It’s just a natural part of life and we’ve got to look at the whole picture of life if we’re just going to look at the one thing too. I think that helps to reduce preterm birth risk. We also have lower interventions just overall. We’re more in tune with people’s bodies and we want to honor what their bodies are meant to do. Labor is supposed to happen naturally. It’s not this big medical intervention that occasionally happens naturally. It’s this natural process that occasionally needs medical intervention. The midwifery model is so important. I think when you go to the traditional medical model, you look at the present illness so they see pregnancy as an illness. What can go wrong? Don’t get me wrong. There are a sleu of things that can go wrong in pregnancy and you do have to watch for them. But I think with midwifery care, you know when to use your hands but you also know when to sit on them. Meagan: Yes. Oh my gosh. I love that so much. I feel like we need– we used to get quotes from our podcast episodes and turn them into t-shirts and I feel like that is a t-shirt podcast quote-worthy. Oh my gosh. It’s a worthy quote. That is amazing and it’s so true though. Paige: It is. Meagan: It’s not to rag on OBs. You guys, OBs are amazing. They are wonderful. They do an amazing job. We love the. But there is something different with midwifery care. You mentioned preterm birth. I remember when I was going through my interview process to have my VBAC after two C-section baby and I finally established care mid-pregnancy because I switched. That was one of the things in the very beginning that my midwife was like, “Let’s talk about things. Let’s talk about nutrition. Let’s talk about supplements. Let’s talk about where you are at.” It was just honing in on that which I was surprised by because I figured she’d be like, “Let’s talk about your history. Let’s talk about this,” but it was like, “No. Let’s talk about what we can do to make sure you have the healthiest pregnancy,” but also started commentingo n mental stuff. It helped me get healthy in my mind. I just would never have had that experience with OB where they wanted to learn what I was scared about and what I was feeling and all of those things. Not only was I learning how to nourish myself physically, but mentally and it was just a really big deal. I do feel like it played a big impact in my labor. Paige: Yeah. A lot of people discredit how much nutrition and debunking fears and stuff like that can go because I think a lot of that– I mean, we look at nutrition-wise and we could avoid almost all of preeclampsia with nutrition alone which is incredible. I’m like, “I really think you should read Real Food for Pregnancy and people are like, “Oh, but it’s such a big book,” and I’m like, “But it’s so important to know this information about what we should be putting in our bodies.” 100 grams of protein– you’ve already got it. Meagan: I want to see how many pages for it. It’s got, okay. We’ve got 300 pages but it has recipes and all of these amazing things in the end so it’s not even a full book. Paige: Yes. People are like, “Oh man, I don’t know if I want to read the whole thing,” but I’m like, “It’s so important.” I think when people do read it, they come back and are like, “Did you know that I could decrease my risk of this if I ate more Vitamin A?” I’m like, “Yes. That’s why I wanted you to read this book.” It is a wealth of information and I have such healthier pregnancy outcomes when people follow that high protein diet and looking at micronutrients with their Vitamin A, their choline, and all sorts of things. Meagan: Yeah. All of the things that we talk about a lot here on the podcast because we are partnered with Needed and we love them so much because we talk about the choline and the Vitamin A and the Vitamin B’s and the Vitamin D’s. Lily Nichols, not this Lily on the podcast today, she also wrote Real Food for Gestational Diabetes and that’s another really powerful book as well. But yeah. It’s just hard because OBs don’t tend to have the time. I think some OBs would actually love the time to sit down and dig deep into this but they don’t have the time either. I do think that’s a big difference between OBs and midwives. What does your standard prenatal look like? When a mom comes in, a patient comes in, what do you guys do through a visit? Paige: Yeah. We follow the standard what everywhere in America does like once a month roughly in the first trimester and second trimester then when you hit 28 weeks, every 2 weeks, and then when you hit 36 weeks, every week. If you go to 41, we’ll see you twice in that week. We follow those stipulations but our appointments are a little bit longer. When you are in a big practice, a lot of time it’s driven by RVU use so the more patients somebody can see, the more they are going to get paid and the bigger their bonus is at the end of year. A lot of people feel like they are running through the cattle herd and they’ve been in and out in 15 minutes if that. At my practice, it’s a little bit different because we are not RVU based. We’re not getting any bonus. We’re not trying to see as many patients as we can. Will we ever be the richest at what we do? No, but that’s okay with me and Jess. We are small on purpose and we love to take the time. At Lily’s appointments, we always book her for at least 30 minutes because we know that me and her like to talk. We’ve done an hour for some people because we know there is always going to be that long conversation. Don’t get me wrong though, that fourth mom whose had three vaginal births and going for her fourth, she may be like, “Paige, there’s really nothing to talk about today and that’s okay.” Sometimes they are 15 minutes. Sometimes they are 30. Sometimes they are an hour. Our first appointment is always an hour because there is just so much to dive into with how we can be preparing ourselves, what does your history look like especially if they are brand new to our practice and we’ve never met them before, starting to build that relationship early on. It just depends on how far along they are, who the person is, and those things. But I do like that I can spend as much time as I need. Sometimes I tell my people, “Bring a book because I tend to get behind because I tend to talk to people longer than I book for,” but that’s okay. We know that we can do that because we are a smaller practice. I think when people are thinking about what kind of care they want, they should probably consider how are these people paid? Is it by how many they can see in a day? Because you’re probably going to get a different level of care than a practice that isn’t drive by those RVUs. Yeah, that’s a really good point. I feel like my shortest visit with my midwife was 20 minutes. Paige: Yeah. Lily: Yeah. Meagan: Which to me is pretty dang long because when I was going with my other two daughters, I think it was probably 6-7 minutes if that with my provider. I mean, it was get in. My nurse would check my fundal height and all of that and then oh, the doctor will be in here. Then came in, quick out. Yeah. It is really, really different. Lily: I know for me too, I love that we don’t just talk about nutrition and things like that but even in my last appointment, I was talking with Paige about the things that can be triggering coming back into labor and going back into a hospital so my ectopic pregnancy was at the hospital that I’ll be delivering at and I had to go into the emergency room and the way that you go to labor and delivery after hours is through the ER so Paige and I were talking. She was like, “I can just meet you outside. We will badge you in and we will avoid the emergency room if that feels triggering.” It’s just those things that you don’t get with an OB necessarily to talk through tiny little triggers. They are probably generally less accommodating to those little things of, “Well that’s just the standard. You’re going to have to get over that and just go through the ED and come on up.” I think that’s been huge. I also have a dear friend who is going to school to be an OB. I told Paige at my last appointment that she may possibly be at my birth. She’s my crunchy friend so she’ll be a great OB but I have such a desire to be like, “Come see a VBAC. Come see it so that you have it in your brain and you know that they can be safe and look at what can be done,” so I think that is so huge too as we continue to train and uplift our next generation of providers. What does that look like to show them? I think her internship or something is going to be a midwife and OB partnership practice which is really cool but I’m like, “Yes. Come. Come to my birth. Please. I want you to see all the things.” That’s really cool too and that Paige is open to, “My friend might be there.” Meagan: Yeah. Paige: Bring whoever. Meagan: I love that. I love that you were pointing out too this next generation of providers. Let’s see that birth and VBAC is actually very normal and very possible because there’s a lot of people who have maybe seen trauma or an unfortunate situation which could have happened because we blasted them with interventions or could have happened out of a fluke thing. You don’t know all of the time. But I do think if we can keep trying to get these providers, these new provider to see a different light, we will also see that Cesarean rate drop a little bit. We really, I always tell people that we have a problem. They’re like, “It’s really not that big of a deal.” I’m like, “No, it’s a very big deal. It’s a very, very big deal. We have a problem in this medical world.” I do believe that it needs to change and midwifery care is definitely going to impact that. I hope that what you were saying in the beginning how policies don’t trump a lot of the midwives. I wanted to ask you. This isn’t something we talked about, but is it possible to ask your midwife, “Hey, what policies do you lie under?” Is that appropriate? Paige: Yes. Actually, that was one of my favorite things when Lily came in to meet and greet us. She came and she was like, “What are the policies for a VBAC?” We dove into that. We’ve been diving into that and what are we going to be okay with and what are we not going to be okay with? That’s the beauty is that I’m not employed by the larger hospital system that I work under so I feel like a policy is not a law. I feel like there is informed consent and I think informed consent is so important but at the same time, there is informed declination and you should be able to decline anything. That’s true. We can never force anybody into surgery. We can never force anybody into anything. I think a lot of people aren’t having those conversations where it’s actually informed so then people are like, “Oh, they are just refusing everything.” I hate the word refuse because no, they are not refusing it. They are declining it because they are informed. They know the risk. They have all the information at their fingertips and they know that this is the best decision for them and their baby and we have to honor that. That’s why I’m really glad that I’m able to practice in that way, but I do know I’ve met and I’ve worked with people who feel like they are boxed in and have to follow those policies. We’ve started to talk about what our policies are with TOLACs and VBACs and things like that. One of them is that they are supposed to have two IVs. I’ve already gone against that before and I’ve had a beautiful, unmedicated VBAC. She walked in. I said, “We’ve talked about it. She was also laboring outside when we talked about it. It’s not an issue when you come in. You know what? When we get up there, I’m just going to tell them that you know why they recommend two IVs and you are declining.” She walks in and she’s clearly going to have this baby within the hour. I told the nurse, “We’re not doing the IVs. We’ve talked about it. We’re going to decline them.” That was the end of the discussion. We didn’t have to talk about it again which was nice. She shouldn’t have had to advocate in that moment for herself. We’ve already had those conversations. Meagan: Yes. Paige: Another one is continuous monitoring and the whole idea is if you start to rupture, that’s how we are going to catch it. The baby is going to tank and that’s how we are going to save the baby’s life. Don’t get me wrong. I think continuous monitoring can be really valuable for a lot of things but it’s actually not evidence-based. We have not improved neonatal outcomes with continuous fetal monitoring. We’ve talked about that with Lily and she’s going to opt for intermittent oscillation and I think that’s very appropriate because she plans to go unmedicated. Let’s be honest, if you are unmedicated and your uterus starts to rupture, moms will tell me that something is not right. This is beyond labor. Her saying that and being aware of that, we would notice it a lot sooner than we would the baby tanking kind of thing. Meagan: Yeah. I do know that with uterine rupture, we can have decelerations but like you were saying, there’s usually so many other signs before baby is actually even struggling and I know a couple of uterine rupture stories where providers didn’t believe the mom that something was going on because that one thing wasn’t happening. The baby wasn’t struggling. Paige: Yes. Meagan: It’s like, you guys! When it comes to continuous fetal monitoring in the hospital, people have to fight to have that intermittent. It’s yeah. Anyway. These policies are not law. I love that you said that too. There’s another t-shirt quote. Paige: I think people should start asking if they are planning a VBAC, start asking what is the policy and start thinking, is that what they want? I do have some moms who are like, “No, I want the two IVs because it’s hard for me to get a stick,” and they need that backup in case. That makes them feel more at peace but other people are like, “It makes me feel like a patient. I don’t like it.” People don’t like needles and that’s okay. They have that right to say no. I tell people that in a true emergency, we will get an IV in you if something really, really bad were to be happening. That’s part of training if somebody walks in off the street. We’re not going to be like, “Oh, when was the last time you ate? Sorry, you can’t have the surgery.” We know something bad is happening right now. We will get the IVs. We will do all of the things. Getting the IVs really won’t save as much time as people think it will. Meagan: Yeah, and there are other things. Say we are having our baby and we are having higher blood loss than we would like or we have some concern of some hemorrhaging, there are other things that we can do. We can put Pitocin in a leg. We can do Cytotec rectally. There are things that we can do. We can get that baby to our breast and start stimulating and try to help that way. There are things that we can do while we are waiting for an IV, right? Paige: Yes. I tell people that all the time. Most of the postpartum hemorrhage meds that we use can be given without an IV. There is only one that truly has to be given through an IV and that’s TXA but the rest can all be given other routes. A lot of times, those work better than IV Pitocin. Sometimes the ion Pitocin works better. Sometimes the ion Methergine works better. It’s not this, oh we have to have a little just in case kind of thing because if there was a just in case moment, yes. We can be working on the IV and doing other things. I have to be kind of secretive about it. I have tinctures and stuff with shepherd’s purse and yarrow. Those things actually have great evidence. They are really helpful for postpartum blood loss. I have a lot of moms who are more interested in doing something more holistic and natural before they try medication. Cypress essential oil, you can rub that in. I’ll have doulas use my cypress roller and give them a massage while I’m trying to manage the hemorrhage and that cypress oil can help a lot too. Sometimes going back to our instinctual, old medicine that we have been using well before medicine was used for birth. Meagan: Yeah. This is a random question for both of you. Lil, I really wonder if you have seen it or heard about this too because you are so heavily in our DMs. This is going to be weird. People are going to be like, what? But I did this. We did this because we weren’t sure. We cut the umbilical cord and put it in our mouth. It’s really weird. Paige is like, what? You put it down in the gum area like in between your teeth and your cheek. It sits there. Okay, you guys. I’ve seen it just a couple of times, myself included. Yes, I put my umbilical cord in my mouth. Yes, it’s weird. Paige: That’s okay. Meagan: It felt like a little gummy. It was fine. I wasn’t chewing on it. It was just sitting there. But anyway, it’s weird but with my other client too we did it and all of her hemorrhaging symptoms just went away. Paige: That’s cool. Meagan: I know this is really random but we just cut a little piece of our umbilical cord and put it in their mouth. Paige: That’s so interesting. So a piece of the umbilical cord or the entire thing once it’s clamped and cut and still attached? Meagan: They clamped and cut it, cut a piece, and put it in my mouth. Paige: I would be so willing to try that. I mean, what is there in that nun? Meagan: I don’t know. I don’t know, but it did diminish the hemorrhaging symptoms. Paige: Cool. Meagan: So very interesting, right? Okay, so are midwives restricted when it comes to VBAC on what they can accept? Lily, you are a VBAC. I was a VBAC after two C-sections. You can obviously take Lily. Could you accept me?Paige: Yes. Luckily in midwifery care, at least in Colorado, there is a lot of gray for certified nurse midwives. It’s not always black and white. VBACs are okay but there is no direct, “Oh, if you have this many C-sections, we can’t do it.” I think that’s because ACOG also strangely doesn’t have an opinion on that. They actually agree. There is limited evidence beyond one C-section. My practice has done several VBACs after two Cesareans. I don’t think we’ve ever done one for a third or greater than two probably because I think those people a lot of times don’t even consider VBAC and they just already have been seeing their doctor for their repeat C-section with each pregnancy. But I’d love to see more people going for a VBAC after multiple Cesareans because I think VBACs after two Cesareans have a whole different level of feeling empowered after that. I thin that’s really cool and even special scars and stuff, there is really limited evidence on all of these things and I’d like to see more people pushing the limits a little bit. Especially since I am in a hospital, I do have an OB hospitalist on call 24/7 at the disposal of my fingertips if I need them. We are close to an OR so I think if for somebody the fear is there and they are like, “I just don’t know if it’s more risky because of this,” I think it’s worth it to try because the more people who go for it and are successful, the better evidence we’re going to get from it. Meagan: Yeah. That is exactly what I am thinking. There’s not a lot of evidence after two Cesareans because it’s just not happening. It hasn’t really been studied and a lot of that is because people aren’t even given the option. Paige: Yeah. I’ll have people where it is their third or fourth C-section and they were never even given that option. They were told, “Oh, I was told I have CPD.” I’m like, “The chances of you actually having CPD are low.” Then you look at their records and it was fetal distress or something like that. Yeah. CPD is so rare. I’ve heard it so many times. “Baby is never going to come out of that pelvis ever.” That breaks my heart every time I hear it because there are times when I’m like, I don’t know and then an 8-pound baby comes out. We can’t go off of those things because the body does what it’s supposed to in those moments. Don’t get me wrong. Things do go wrong and C-sections do happen sometimes but yeah. To hear everybody has CPD just because they’ve had three C-sections, I’m like, I don’t know. That would be quite a few people. Way more than we know are true. Meagan: Yeah. We’re all walking around with tiny pelvises. That’s just what everyone thinks anyway.Lily, being in our DMs, hearing the podcast, understanding and seeing so many of these people and what they say, do you have any advice for them when they are looking for their provider or just any advice in general? Do you have any advice from a VBAC-prepping mom? Lily: Yeah, I think for me, it is to go into it open-handed. I think we hear so many horror stories about providers often and I think that’s why I went into looking for a provider with both fists up ready to fight and what has surprised me the most is just I think I said earlier that I didn’t know hospital care could look like this. I remember we even posted something and I had posted on The VBAC Link that a hospital birth can be equally as beautiful as an out-of-hospital birth and there were people arguing and people saying, “No, absolutely that’s not possible. That’s not a thing.” Gosh, how discouraging if we go into things thinking that we can’t have beautiful outcomes in different settings. Certainly, there are areas around our country that need improvement. There’s not a low-intervention floor at every hospital and there are not midwives who are doing what Paige is doing everywhere but I think the more that we seek out that care and look for that care and advocate for that care, the more we will see it. As much as it sucks that we have to be our advocates, it’s also a really cool opportunity that we pave the way for VBAC moms and the moms who have never had a C-section that we are paving the way for care that doesn’t end up in a Cesarean. I would just say to be open-handed and yes. You can be prepared to fight and you can be prepared with your statistics. Be prepared to ask the why behind questions, but ultimately, I think that care can be so much more than we expected if we go into it thinking, Gosh, well what can I get out of this and how can I make these things happen? Like Paige said, we’ve had lots of conversations around, Well, this is the policy, but the policy is not the law. I’m here to support you in that. At our last appointment, she was like, “Hey, make sure you bring your doula to your appointment where we are going to talk about your birth plan because I want to make sure that she is there, that we all hear each other, that we are on the same page.” I think that’s helpful too. And then having a doula. My doula was my doula with my C-section. She was with us. She was whoever was on call at the birth center actually and again, I think it was so serendipitous because she is a VBAC mom. I think I needed her then and I’m so stoked to have her now that she is just a really special human who I know is also always in my corner and constantly texting her like, “Oh my gosh, look at the new birth rooms. Oh my gosh, I had this great conversation. Oh my gosh, I’m so excited.” I think having your doula there to be your partner in advocacy is really helpful too. Meagan: Yes. Okay, that’s a good question too when it comes to doulas and midwives. Sometimes I think people think that if I’m hiring a midwife, I don’t need a doula and then we of course know that a lot of people just mistake doulas and midwives together. But Paige, how do you feel about doula care and working with doula care? Is it necessary? How do you work together as doula and midwife?Paige: Yes. I love doulas. I wish everybody had access to a doula truly because doulas, just like midwives, have been studied and they have better birth outcomes, more empowered births, and all of the things. Doulas are so important and doulas and midwives work really closely. I think a doula is there with that constant presence, that constant helping with anything and a really good advocate which I think is important especially if you don’t have a good relationship with your provider maybe or you don’t know who you’re going to get. Maybe you see 7 different providers and you get who you’re going to get when you’re in labor. So to have that doula there to constantly be advocating for you is such an important piece. Yeah, I really wish everybody could have access to a doula because it just makes a world of difference. I can’t think of any bad outcomes I’ve ever had when a doula was present. It’s just a different level of care. Usually, people who have sought out a doula have also taken the time to seek out and do all of the things that are going to make a healthier pregnancy and a better birthing outcome. It’s why I think everybody deserves doula care. It’s because it does lead to better outcomes. Midwives are always known to work closely with doulas and really support them. It’s a team effort. Meagan: Yeah. Yeah. We love our relationships with our midwives here. It’s really great to just know how we work and know how we need to support the client and it is sometimes hard when we go to a hospital and we don’t know who we are getting. And sometimes that OB or that midwife we have worked with before and sometimes it’s a whole new face so it does bring us comfort to know that the client and the family know us and we know them and we can all work together. I love that. Okay, do either of you guys have anything else that you would like to say to our beautiful VBAC community before we go? Paige: I don’t think so. Yeah, thank you so much for having me. This was wonderful and I just hope that everybody who is thinking about a VBAC really does their research and looks for the best provider and really finds that perfect fit because there are so many good providers out there– OBs, midwives, professional midwives, all the things. Meagan: I agree. It’s okay to interview multiple people. It’s also okay that if mid-pregnancy, the end of pregnancy, during, and even in labor that if something is not feeling right, you can request a different provider. You can go out and start interviewing again and find that provider that is right for you. Paige: Yes. Meagan: Well, thank you Paige and Lily for joining us today, and thank you so much for doing so much in your community. I really love your setup and hope that we can see that type of setup happening in the US because it just feels perfect in a lot of ways. Yeah. Yes. I’m loving it. Okay, ladies. Well, thank you so much. Paige: Thank you. Lily: Yeah, thanks, Meagan. Meagan: Bye. Lily: Bye!ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
44:1609/10/2024
Episode 341 National Midwifery Week + Meagan & Julie Talk All About Midwives

Episode 341 National Midwifery Week + Meagan & Julie Talk All About Midwives

Happy National Midwifery Week!We are so thankful for and in awe of all midwives do. Great midwives can literally make all the difference. Statistical evidence shows that they can help you have both better birth experiences and outcomes.Meagan and Julie break down the different types of midwives including CNMs, CPM, DEMs, and LPM as well as the settings in which you can find them. They talk about the pros and cons of choosing midwifery care within a hospital or outside of a hospital either at home or in a birth center. We encourage you to interview all types of providers in all types of settings. You may be surprised where your intuition leads you and where you feel is the safest place for you to rock your birth!Midwifery-led Care in Low- and Middle-Income CountriesEvidence-Based Birth Article: The Evidence on MidwivesArticle: Planning a VBAC with Midwifery Care in AustraliaThe VBAC Link Supportive Provider ListNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hey, hey, hey. You guys, we’re talking about midwives today, and when I say we, I mean me and Julie. I have Julie on with us today. Hello, my darling. Julie: Hello! You know, sometimes you’ve just got to unmute yourself. Meagan: Her headphones were muted, you guys. Julie: Yeah. That’s amazing. Meagan: I’m like, “I can’t hear you.” You guys, guess what? This is our first month at The VBAC Link where I’m bringing a special subject. Every month we are going to have a week and it’s usually going to be the second week of the month where we are going to have a specific topic for those episodes of the week and this is the very first one. It is National Midwives’ Week so I thought it would be really fun this week to talk about midwives. We love midwives. We love them. We love them and we are so grateful for them. We want to talk more about the impact that they leave when it comes to our overall experience. Julie: Yes. Meagan: The overall outcomes and honestly, just how flipping amazing they are. We want to talk more and then we’ll share of course a story with a midwifery birth. Okay, Julie. You have a review. I’m sticking it to her today to read the review because sometimes I feel like it’s nice to switch it up. Julie: Yeah. Let’s switch it up. All right, this review– I’m assuming “VBAC Encouragement” is the title of the review.” Meagan: Yes. Julie: “VBAC Encouragement”. It says, “My first birth ended in an emergency Cesarean at 29 weeks and I knew as I was being rolled into the OR that I would go for a VBAC with my next baby. Not long after, The VBAC Link started and I was instantly obsessed.” I love to hear that. “I love the wide range of VBAC and CBAC stories. Listening to the women share honestly and openly was motivating and encouraging. As a doula, this podcast is something that I recommend to my VBAC clients. I’m so thankful for the brave women sharing the good, bad, and ugly of their stories and I’m thankful for Meagan and Julie for holding space for us all.” Aww, I love that. Meagan: I do too. I love the title, “VBAC Encouragement.” That is what this podcast is here for– to encourage you along the way no matter what you choose but to bring that encouragement, that empowerment, and the information from women all over the world literally. All over the world because you guys, we are not alone. I know that sometimes we can feel alone. I feel like sometimes VBAC journeys can feel isolating and it sucks. We don’t want you to feel that way so that’s why we started the podcast. That’s why I’m here. That’s why Julie comes on because she misses you and loves you all so much too and we want you to feel that encouragement. Meagan: Okay, you guys. We are talking about midwives. If you have never been cared for by a midwife, I think this is a really great episode to learn more about that and see if midwifery care is something that may apply to you or be something that is desired by you. I know that when I was going along with my VBAC journey, I didn’t interview a midwife actually at first. I interviewed OB after OB after OB. Julie did interview a midwife and it didn’t go over very well. Julie: No, it was fine. It just didn’t feel right at that time. Meagan: What she said didn’t make it feel right. What I want to talk about too and the reason why I point that out is because go check out the midwives in your area. Check them out. Go check them out. Really, interview them. Meet with them but guess what? It’s okay if it doesn’t feel right. It’s okay if everyone is like, “Go, go, go. You have to have a midwife. OB no. OB no.” That’s not how we are in this podcast. We are like, “Find the right provider for you.” But I do think that midwives are amazing and I do think they bring a different feel and different experience to a birth but even then sometimes you can go and interview a midwife and they’re not the right fit. We’re going to talk about the types of midwives. This isn’t really a type. We’re going to be talking about CPM, DEM, and LPM. Julie: In-hospital and out-of-hospital midwives, yeah. Meagan: Yeah, but I also want to talk about the word “medwives”. We have said this in the past where we say, “Oh, that midwife is a ‘medwife’” and what we mean by that is just that they may be more medically-minded. Every midwife is different and every view is different. Like Julie was saying, in-hospital, out-of-hospital, you may have more of a ‘medwife’ out of the hospital, but guess what? I’ve also seen some out-of-hospital midwives who act more like, ‘medwives’, really truly. Again, it goes back to finding the right person for you. But can we talk about that? The CPM or DEM? CPM is a certified professional midwife or direct entry midwife, right? Am I correct?Julie: Right. It’s really interesting because all over the world, the requirements for midwifery are different. You’re going to find different requirements in each country than in the United States, every state has its different requirements and laws surrounding midwifery care. In some states, out-of-hospital midwives cannot attend VBAC at all or they can as long as it’s in a birth center. Or sometimes CNM– is a certified nurse midwife which is the credential that you have to have if you are going to work in a hospital but there are some CNMs who do out-of-hospital births as well. There is CPM which is a certified professional midwife which a lot of the midwives are out-of-hospital. That means they have taken the NARM exam which is the national association of registered midwives so they are registered with a national association.Meagan: Northern American Registry of Midwives. Julie: Oh yes. They have completed hundreds of births, lots and lots of hours, gone through the entire certification process and that’s a certified midwife. Now, a licensed midwife which is a LDEM, a licensed direct-entry midwife just simply means that they hold licensure with the state. Licencsed midwife and certified midwife is different. Certified means they are certified with the board. Licensed means they are licensed with the state and usually licensed midwives can carry things like Pitocin, Methergine, antibiotics for GBS and things like that which is what the difference is. Licensed means they can have access to these different drugs for care. Meagan: Like Pitocin, and certain things through the IV, medications for hemorrhage, antibiotics, yes. Julie: Right, then CPMs who are certified, yeah. There are arguments for both. And DEM, direct entry midwife means that they are not certified or licensed. That doesn’t mean that they are less than, it just means that they are not bound by the rules of NARM or the state. Now, there are again arguments for and against all of these different types. I mean, there are pros and cons to holding certification, holding licensure, and not holding certification and not holding licensure. Each midwife has to decide which route is best for them. Certified nurse-midwife obviously has access to all of the drugs and all of the things. They are certified and licensed. You could call it that but they have to have hospital privileges if they want to deliver in the hospital. You can’t just be a CNM and show up to any hospital to deliver with them. They have to have privileges at that hospital. They have to work and be associated with a hospital just like an OB. An OB has to have privileges at any hospital. They can’t just walk into any old hospital and deliver a baby. Meagan: Right. I think it’s important to know the differences between the providers who you are looking at. Like she was saying, with a CNM, you are more likely to have that type of midwife in a hospital setting than you would be outside of the hospital but sometimes there are still CNMs who have privileges and choose to do birth outside of the hospital. I think it’s an important thing to one, know the different types of midwives and two, know what’s important to you. There are a lot of people who are like, “I will not birth with anyone else but a CNM.” That’s okay. That’s okay but you have to find what works best for you. Julie: Sorry, can I add in? Meagan: You’re fine. Yeah. Julie: It’s also important that you are familiar with the laws in your state if you are going out of the hospital. I don’t want this episode to turn into a home birth episode. It should be about all of the midwives in all of the locations, but also, know what the laws are in your state and in your specific area about midwives. In Utah, we are really lucky because we have access to all the types of midwives in all the different locations, but not everywhere is like that. Yeah. Just a little plug-in for that. Meagan: Yes. I agree. I agree. I did mention that I didn’t really go for midwifery care when I was looking for my VBAC– Lyla, my second. I don’t even know why other than in my mind, this is going to sound so bad but in my mind, I was told that midwives are undereducated. Julie: Less qualified? Meagan: Less qualified to support VBAC. I was told this by many people out in the world and I just believed it. Again, I have grown a lot over the years. It’s been so great and I’m glad that I have. That’s just where I was.Julie: A lot of people think that though. People don’t know. They just don’t know. Meagan: No, they don’t know so I wanted to boom. Did you hear it? I’m smashing it. Julie: Snipping it. Meagan: That is a myth that is going to be smashed. Midwives are fully capable of supporting you during your VBAC journey. We are going to start going over some stats and things about how midwives really actually do impact VBAC in a positive way but you may even run into and at least I know there are some places here in Utah where providers kind of oversee the midwifery groups in these hospitals and a lot of them will say that midwives are unable to support VBAC. That’s another thing that you need to make sure you are asking if you are going in the hospital when you are birthing with midwives because a lot of times you are being seen with your midwife, you’re treated by your midwife and everything is great. You’ve got this relationship with these midwives and then you go into labor and all of a sudden you have an OB overseeing your care because that midwife can oversee your pregnancy but not your birth. Know that that is a thing so make sure that if you are birthing in a hospital with a midwife that you ask, “Will I be birthing with the midwives or am I going to be seen by an OB?” But also know, like I said, you can be seen in a hospital by a midwife. Okay, let’s talk about some evidence and what midwives bring to the table and maybe some differences that midwives bring to the table because I do think that in a lot of ways, it is scary to think, Okay. If I have to have a C-section, if I do not have this VBAC and I have to go to a C-section and I have to be treated by an OB– because midwives do not perform Cesareans. They do assist. Let me just say, a lot of midwives come in and they assist a Cesarean, but they do not perform the main Cesarean, that can be intimidating because you want your same provider but I don’t know if that’s necessarily needed all of the time. Maybe to someone that is. But just know that yes, they cannot perform a Cesarean but they often can assist. That’s another good question to ask your midwife, especially in the hospital. If I go to a Cesarean, who will perform it and will you be there no matter what?Okay, let’s talk about it. Let’s talk about the evidence. Let’s talk about experiences and how they can differ. Julie: Do you know what is so funny? I want to go back and touch on the beginning where you said you didn’t know and you thought that midwives were less qualified and honestly especially in-hospital, in-hospital midwives– I want everyone to turn their ears on right now– have the exact same training and skills to deliver a baby vaginally as an OB does. The difference between a midwife and an OB in a hospital is a midwife cannot do surgery. I just want to say that very concisely. They are just as qualified. They can even do forceps deliveries. They can do an episiotomy if an episiotomy is necessary. They can do vacuum assist. Well, some hospitals have policies where they will or will not allow a midwife to do forceps or a vacuum but they can administer all different types of medications. They can literally do everything. They can do everything except for the surgery in the hospital.Out of the hospital, I would argue that they still have similar training depending on if they are licensed or not. They may or may not be carrying medications like Pitocin, Methergine, antibiotics, IV fluids, and things like that. But out-of-hospital midwives, many of them, at least the licensed ones, carry those things and can provide the same level of care. The only difference between– not the only difference, a big difference between out-of-hospital midwives and in-hospital midwives is they don’t have immediate access to the OR and an OB. But guess what? In states like Utah and many, many states operate similarly, there are very strict and efficient transfer protocols in place so that when a midwife decides you need to transfer, say you are birthing at home, first of all, a midwife is going to be with you a big chunk of the time. They are going to be with you. They’re going to be noticing things. They’re going to be seeing things. They’re not going to be there for just the last 10 minutes of deliveries like these OBs are. They are going to be in your house. I feel like out-of-hospital midwives are more present with you than in-hospital midwives even. They’re going to notice things. They’re going to see things. They’re going to notice trends a lot of the time before a situation becomes emergent if you need to be transferred. There are those random last-second emergencies and there are protocols for how to handle those too, but the majority of the time when there is a transfer needed, you are going to be received at the hospital. The hospital is already going to have your records. They’re already going to know what you’re coming in for and they’re going to be able to seamlessly take over your care, no matter what that looks like there. Now there are rare emergencies when you might need care within seconds. However, those are incredibly rare and that is one of the risks. Those are some of the risks that you need to consider when you think about out-of-hospital versus in-hospital care. But often, I have seen many instances where things have safely gotten transferred to a hospital before they reach the level of needing that severe emergent care. I think that is the biggest thing people don’t understand. I don’t know how many people I’ve talked to as a doula and as a birth photographer where they don’t want to birth at home because they don’t understand the level of care that is provided by out-of-hospital midwives. I’m thinking of a birth I just went to last summer and she was thinking about home birth but the husband was like– this was 36 weeks so they weren’t comfortable transferring or anything like that, but I was like, “These home birth midwives are trained in emergencies. They know how to handle all of the same obstetric emergencies in the exact same ways that they do in the hospital. They know how to handle them and address them. If a transfer is necessary, they are going to transfer you. They carry medication. They have stethoscopes and fetal monitors and everything that they do in the hospital to care for you.” The dad was like, “Oh, I didn’t know that.” It’s not your mom coming to help you deliver your baby. It’s a trained, qualified medical professional. I don’t know. I saw this quote. Never mind. I’m not circling back. I’m going in a completely different direction. I saw this quote or a little meme thing on Facebook the other day. I was going to send it to you but I didn’t. It said something like, “Once your provider and birth location is chosen and locked in place, choice is mostly an illusion.” Meagan: Wow. Mostly an illusion. Julie: Yes. Like the fact that you have a choice in your care is mostly an illusion. I was thinking about that and I was like, Is it really? I’ve seen some clients really advocate hard, and stuff like that. But I have also seen the majority of clients where providers, nurses, and birth locations have a heavy sway and you can be convinced that things are absolutely necessary and needed by the way that you are approached and if you are approached a different way, then you might make a different choice, right? The power of the provider and the birth location is so big and massive that choice, the fact that you have a choice involved, is mostly an illusion. I was sitting with that because I see it. I’ve said it before and I’ll say it a million more times before I die probably that birth photographers and doulas have the most well-rounded view of birth. Period. Because we see birth in home, in birth centers, in hospitals, in all of the hospitals, in all of the homes, in all the birth centers, with all of the different providers. We can tell you what hospital– I mean, there are nurses at one hospital that will swear up, down, and sideways that this is the way to do things and the next hospital 3 miles down the road is going to do things completely different and their nurses are going to swear by a different way to do things because of the environment that they are in. Meagan: Yeah. 100%.Julie: So if you want to know in your area what hospitals are the best for the type of birth that you want, talk to a birth photographer. Talk to a doula because they are going to be the ones with the most well-rounded view. Period. Meagan: Yeah. We definitely see a lot, you guys. We really do. Remember, if you are looking for a doula, check out thevbaclink.com/findadoula. Search for a doula in your area. You guys, these doulas are amazing and they are VBAC-certified. Julie: What were we going to circle back to? You were saying something. Meagan: Well, there’s an article titled, “Effectiveness of Midwifery-led Care on Pregnancy Outcomes in Low and Middle-Income Countries” which is interesting because a lot of the time, when we are in low and middle-income countries, the support is not good. Anyway, they went through and it said that “10 studies were eligible for inclusion in the systemic review of which 5 studies were eligible for inclusion in the meta-analysis. Women receiving–”Julie: I love meta-analyses. They are my favorite. Yeah. Sorry, go ahead. Go on. Meagan: I know you do. It says, “Women receiving midwifery-led care had a significantly lower rate of postpartum hemorrhage and reduced rate of birth–” How do you say this, Julie? It’s like asphyxia? Julie: Asphyxia? Meagan: Uh-huh. I’ve just never known how to say that. It says, “The meta-analysis further showed a significantly reduced risk in emergency Cesarean section. Within the conclusion, it did show that midwifery-led care had a significantly positive impact on improving various maternal and neonatal outcomes in low and middle-income countries. We therefore advise widespread implementation of midwifery-led care in low and middle-income countries.” Let’s beef this up in low and middle-income countries. But what does it mean if you are not in a low and middle-income country? Julie: Well, I see the same and similar studies showing that in the United States and all of these other bigger countries that are larger and more educated. It’s interesting because– sorry. I have a thought. I’m just trying to put it together. Meagan: That is okay. Julie: Midwifery-led care is probably more accessible and maybe accessible isn’t the right word. It’s more common probably in lower-income countries. I’m thinking third-world countries and second-world countries because it’s expensive to go to a hospital. It’s expensive to have an OB. In some countries like Brazil, the C-section rate is very, very high and it’s a sign of wealth and status because you can go to this private hospital with these luxury birth suites and stay like a VIP, get your C-section, save your vagina– I use air quotes– “save your vagina” by going to this affluent hospital. Right? Meagan: Yes. Julie: I think in lower-income countries, it’s going to be not only an easier thing to do but kind of the only thing to do, maybe the only choice. And here, it’s funny because here, out-of-hospital births– first of all, insurance is stupid. In the United States, insurances are so stupid. It’s a huge money-making organization, the medical system is. Insurance does cover a big chunk of hospital births and they don’t cover out-of-hospital births so a lot of the time, an out-of-hospital birth is kind of the opposite. You have to have a little bit of money in order to pay for an out-of-hospital midwife because your insurance isn’t likely going to cover it. More insurances are coming on board with that but it will be a little bit of time before we see that shift. But there are similar outcomes in the United States and in wealthier countries that midwifery-led care, not just out of the hospital, but in-hospital midwifery-led care has lower rates of Cesarean, lower rates of complication, lower rates of induction, lower rates of mortality and morbidity than obstetric-led care. You are going to a surgeon. You are going to a trained surgeon to have a natural, non-complicated delivery. Meagan: It’s interesting because going back to the low income, in our minds, we think that the care is not that great. But then we look at it and it’s like, the care is doing pretty good over there in these lower-income, third-world countries. Yeah. This is actually in Evidence-Based Birth. It says, “In the United States, there are typically 4 million births each year.” 4 million. You guys, that’s a lot. The majority of these births are attended by physicians which are only 9% attended by certified nurse midwives and less than 1% are attended by CPMs, so certified professional midwives or traditional midwives. You guys, that is insane. That is so low. She says in this podcast of hers which we are going to make sure to link because I think it’s a really great one, “If you only look at vaginal births, midwives do attend a higher portion of vaginal births in the United States, but still it’s only about 14%.”Julie: Yeah. If you have a normal– I use normal very loosely– uncomplicated pregnancy, there is absolutely no reason that you cannot see a midwife either out of the hospital or in the hospital. Now, I would encourage you to go and interview some midwives in your local hospitals. I would encourage you to look into the local birth community and see what people recommend because even if you are going in a hospital and have a midwife, you have the same access to the OR and an OB that can take care of you in case of an emergency. A lot of people are like, “Well, I’d just rather see an OB just in case of an emergency so that way I know who is doing my C-section,” I promise you that the OB doing your C-section, you are only going to see for an hour. They probably are not going to talk to you. It doesn’t matter how personable they are or what their bedside manner is or if you know anything because I promise you, when you are on the operating room table, you’re not going to be worried about who’s doing your surgery. You’re just not. I’m sorry. That’s maybe a harsh thing to say, but it’s going to be the farthest thing from your mind. Plus, in the hospital, your midwife is more than likely going to be assisting with the surgery too so you are going to have a familiar face in the operating room if that happens. I also think everybody knows by now that I am not on board with doing something just in case when it comes to medical care. Just in case things can cause a lot more problems that they are trying to prevent. So yeah. Anyway, that’s my two cents. Meagan: Yeah. You know, I really think that when it comes to midwives, there is even more than just reducing things like interventions and Cesareans and inductions which of course, lead to interventions and things like that. I feel like overall, people leave their birth experience having that better view on the birth because of things like that where midwives are with you more and they seem to be allowed more time even with insurance. You guys, insurance, like she said, sucks. It just sucks. It limits our providers. I want to just point that out that a lot of these OBs, I think that they would spend more time with us. I think they want to spend more time with us in a lot of ways, but they can’t because insurance pulls them down and makes it so they can’t. But these midwives are able to spend so much more time with us in many ways. Okay. Let’s see. What else do we want to talk about here? We talked about interventions. Midwives will typically allow parents to go past that 40-week mark. We talked about the ARRIVE trial here in the past where they started inducing first-time moms at 39 weeks and unfortunately, it’s stuck in a lot of ways so providers are inducing at 39 weeks and that means we are starting to do things like stripping membranes at 37 and 38 weeks. It seems like providers really, really– and when I say providers, like OB/GYNs, they are really wanting babies to be born for sure by 40 weeks but by 40 weeks, they are really pushing it. Midwives to tend to allow the parents to go past that 40-week mark. That’s just something else I’ve noticed with clients who choose VBAC and then end up choosing midwives. They’ll often end up choosing midwives because of that reason and they will feel so much better when they reach that point in pregnancy because they don’t feel that crazy pressure to strip their membranes and go into labor or they are going to be facing a Cesarean and things like that. I feel like that’s another really big way to change the feeling of your care with midwives is understanding when it comes down to the end of things, they are going to be a little bit more lenient and understanding and not press as hard. Like we said in the beginning, there are a lot of people who do press it– those “medwives” where they are like, “No, you need to have a baby.” We just recorded a story where the midwife was like, “Well, you need to see the OB and you need to do a membrane sweep,” and they were suggesting these things. But really, typically with midwives, you are going to see less pressure in the end of pregnancy. Midwives spend more time in prenatal visits. We were just talking about that. Insurance can limit OBs, but a lot of the time, they will really spend more time with you. They are going to spend 20+ minutes and if you are out of the hospital, sometimes they will spend a whole hour with you going over things. Where are you mentally? Where are you physically? What are you wanting? Going over desires and the plan for the birth. Past experiences may be creeping in because we know that past experiences can creep in along the way. So yeah. Okay, Julie is in her car, you guys. She’s rocking it with her cute sunglasses. She is on her way. She is so nice to have the last half hour of her free time spent with us. So Julie, do you have any insight or any extra words on what I was just saying? Julie: You know, I do. Hopefully, you can hear me okay. I’m going to hit a dead spot in two seconds. Meagan: I can hear you great. Julie: Okay, perfect. I have this little– there’s a spot on my road where I always cut out so stop me if I need to repeat what I said. I wanted to go back to the beginning and just talk for half a second because we know my first ended in a C-section. For my first birth, I actually started out by looking at birth centers because I wanted an out-of-hospital birth. I knew that from the beginning. I interviewed a couple of midwives and there was one group that I was going to go with at a birth center and I was ready to go but something didn’t quite feel right. It wasn’t anything the midwives did. It wasn’t anything that the birth center was. It wasn’t that I didn’t feel safe there. It was just that something didn’t feel right. So I just stayed with my OB/GYN. I had to get on Clomid to get pregnant. I just stayed with that guy who is the same guy that Meagan had and the same guy who did my C-section because something didn’t feel right. I mean, we know now and I can look back in hindsight. This was, gosh, 11.5 years ago. I know that I ended up having preeclampsia and I ended up having to get induced because of it. Had I started out-of-hospital, I would have had to transfer. There was nothing– I would have had to transfer care before I even got to 37 weeks. I had a 36-week induction. That’s the thing though. Out-of-hospital midwives have protocols. Each state has different guidelines, but there are requirements for when they have to transfer care– if your blood pressure is high, if you have preeclampsia signs, if you deliver before a certain due date, or after a certain gestational age. You’re going to be safe. If you have complications in pregnancy, you’re going to be safe. You’re going to be transferred. You’re going to be cared for. But also, I just want to put emphasis on this which is what I’m tying into the last thing I want to say which is going to be forever long, is that you can trust your intuition. My intuition was telling me that the birth center was not the right place for me even though it checked all of the boxes. Your intuition is not going to tell the future every time, but what I wanted to lead into is that– oh and do you know what is so funny also? I had three out-of-hospital births after that, but with my fourth birth, I started out with the same midwife I had for the other two home births, and for some reason, I felt like I needed to transfer care back to the hospital so I went back to the hospital for two months and all of a sudden, my insurance change and the biggest network of hospitals in my state wasn’t covered by my insurance anymore so it felt right to go back to out-of-hospital birth. I don’t know why I had to do that whole loop-dee-loop of transferring to a hospital just to transfer back to the same out-of-hospital midwife that I had in the first place but I believe there was a purpose to that. I believe there was a purpose to that. I want to tell you guys that if seeking midwifery care whether in the hospital or out of the hospital feels uncomfortable to you or feels like, I don’t know. These midwives still sound like chicken-dancing hippies to me, I would encourage you to go talk to some local midwives whether in a hospital or out of the hospital. Just sit down and talk to them and say, “Hey.” It’s easier to talk to an out-of-hospital midwife. Out-of-hospital midwives do free consultations for you. In-hospital midwives, you might have to make an appointment and it might be harder but you should still try and see and get a vibe or just transfer care to them and go to a few appointments and see. You can always switch care back to a different provider or an OB because your intuition is smart but it does not know, it cannot guide you about things that you do not know anything about. I would encourage you to go and chat with these different providers, even different OBs if you want because your provider choice is so, so, so important. It is one of the most important decisions you’re going to make in your care for your birth. It should be a good one. Your intuition can’t tell you to go see x, y, z provider if you don’t even know who x, y, z provider is. Gather as much information as you can. Talk to as many providers as you can. Go see the midwife. Interview the doula. Check out the birth photographer’s website. See what I did there? See how it feels because even as a birth photographer, whenever I’m doing interviews with people, I’m not a fly-on-the-wall birth photographer. A lot of birth photographers brag about being a fly on the wall. You won’t even know I’m there. No. I don’t buy that because who is in your birth space is important. I am a member of your birth team just like every other person in that space, just like your nurses, your OB, your midwife, your doula– everybody there is a member of your birth team. I am a member of your birth team too and I will hold space for you. I will support you and I will love you. I am not a fly on the wall. Now, your provider is a member of your birth team. They probably arguably are one of the biggest influencers about how your birth is going to go and you deserve to be well-informed about who they are. You deserve to have multiple options that you know about and have thoroughly vetted and you deserve to stick up for yourself and do the provider who is more in line with the type of birth you want. How do you do that? You do that by finding out more about the providers who are available to you in all of the different birth locations and settings. Meagan: Yes. So I want to talk more about that too because there are studies and papers out there showing that the attitude or the view on VBAC in that area, in that hospital, in that birth center, both midwives and OBs, but we are talking about midwives here, really impacts the way that a birth can go. So if you don’t interview and you don’t research and you don’t find those connections and even try, you will not know and in the end, it may not be the way you want. Even then, even if we find those perfect midwives, even if Julie went to the hospital midwife, she probably would have had a great experience, but who knows?Julie: Also, arguable too though, you could be seeing the most highly recommended VBAC provider in your area in the most VBAC-supportive hospital in your area that everybody goes to and everybody raves about, and if you don’t feel comfortable there for whatever reason, you don’t have to see the best, most VBAC-supportive provider if it doesn’t feel right and if it doesn’t sit right with you. Meagan: Yes. Julie: It goes both ways. Meagan: Yes. Julie: Sorry, I’m really passionate about this clearly. Meagan: No, because it does. It goes both ways. I mean, that’s what this podcast is about is conversation and story sharing and finding what’s best for you because even with VBAC, VBAC might not be the right option for you, but you don’t know unless you learn. You don’t know unless you learn more about midwives. Really though, people usually come out of midwifery care having a better experience and a more positive experience. I think that goes along with the lines of they do give a little bit more care. They do seem to be able to dive deeper to them as an individual and what they are wanting and their desires. They are a little less medically minded and a little bit more open-minded. You are less likely to have interventions. You are less likely to have those things that cause trauma and that causes the cascade that leads to the Cesarean. I’m going to have all of the links but I’m just going to read this highlighted. It’s a study from Europe actually. It says, “A recent qualitative study in Europe explored the maternity culture in high and low VBAC countries and found that–” I’m talking a lot about high and low countries. Sorry guys, I’m realizing I’m talking a lot about it but a lot of these studies differ. It says, “Clinicians in the high VBAC countries had a positive and pro-VBAC attitude which encouraged women to choose VBAC whereas the countries with low VBAC rate, clinicians held both pro and anti-VBAC views which negatively affected women who were seeking VBAC. Both of these studies have shown that having midwifery care can have a positive influence on VBAC rates with an increase in maternal and neonatal morbidity.”Right there, not only doing the research on your provider, but doing the research within your location, what their thoughts are, what their views are, what their high-VBAC attitude or low-VBAC attitude is. If they are coming at you, even these midwives you guys, and they have all of these stipulations, it might be a red flag. It might not be the right midwifery group for you. Julie: Absolutely. That’s where the intuition comes in. I like what you said about the VBAC culture. You can tell at different hospitals. We have been to many, many hospitals in our area. Sorry, can you hear my blinkers? It’s distracting. Let’s see. I absolutely guarantee you that every hospital has a culture around VBAC. Some of them are positive and supportive and uplifting and some of them are fearful and fear-based and operate on a fact where they are going to be more likely to pull you toward a repeat C-section or other interventions. I encourage you to look into the culture of your hospital but not only hospitals too. I realize it’s not just hospital-specific. It’s also out-of-hospital midwives. They all have their culture around VBAC. Your out-of-hospital midwives and your in-hospital midwives, all of the midwives, your group whether you see a solo practice or a group OB practice or you see a group midwifery practice or whatever, there is a culture surrounding VBAC. You need to do yourself a favor and figure out what that culture is. I got to my appointment and I need to head in so I’m going to say goodbye really fast. I’m going to leave Meagan alone to wrap up the episode, but yes. My parting words are honoring your intuition, talk as much to your VBAC provider as you can and find out what the culture is surrounding that no matter who you choose to go with and also, do not automatically write off midwives. You are doing yourself a huge disservice if you are not considering a midwife for your care. It doesn’t mean you have to go with one, but I feel like everybody should at least look into them. I love you guys! Bye!Meagan: Okay. And wrapping up you guys, I am just going to echo her. I think that completely discrediting midwives without even interviewing them at all is something that is a disservice to ourselves. I’m going to tell you that I did that. I did that. I didn’t even consider it. I interviewed 12 providers, 12 providers which is crazy and I didn’t interview one midwife. Not one. I was interviewing OBs and MFMs and I realize I don’t remember interviewing a single midwife. The only thing I can think of is that I let the outside world lead me to believe that midwives were less qualified. Yale has an article and they say, “First-time mothers giving birth at medical centers where midwives were on their care team were 75% less likely to have their labor induced.” 74% less likely to have their labor induced, 74% less likely to receive Pitocin augmentation, and 12% less likely to deliver by Cesarean which is a big deal. I know most of us listening here are not first-time moms. We’ve had a Cesarean. Maybe we’ve had one, two, three, or maybe four, but the stats on midwives are there. It is there and it’s something to not ignore so if you have not yet checked out midwives in your area, I highly encourage you to do so. Like Julie said, you don’t even have to go with anybody, but at least interviewing them to know and feel the difference of care that you may be able to have is a big deal. I highly encourage you. I love you all. I’m so grateful for midwives. I’m so grateful for my midwife. My VBAC baby was with a midwife and I did have an OB. I was one of those who had an OB backup who could care for me and see me if I needed to. That for me made me feel more comfortable but it’s also something that can get confusing. I think we’ve talked about where sometimes you will do dual care and you will have one person telling you one thing and the other provider telling you the other thing. That can get stressful and confusing so maybe stick with your provider. But do what’s best for you. Again, another message. Don’t just completely wipe out the idea of a midwife if you have midwives in your area as an option. It may be something that will just blow your mind. Thank you all so much for listening and hey, if you have a midwife who you suggest or you’ve gone through a VBAC with, we have our VBAC-supportive provider list and we would love for you to add to it. Go check out in the show notes or you can go over to our Instagram and click in our Linktree and we have got our provider list there for you. Or if you are looking for that midwife to interview, go check them out. We definitely love adding to this list and love referring it for everybody looking for a VBAC-supportive provider. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
47:1707/10/2024
Episode 340 Denise's VBA2C + Pediatric Physical Therapy + VBAC Doula Gina Shares About the Microbiome

Episode 340 Denise's VBA2C + Pediatric Physical Therapy + VBAC Doula Gina Shares About the Microbiome

Dr. Denise DeRosa is a Pediatric Physical Therapist from New York City. She had two Cesareans and was confident that those would be her only birth stories. But when she unexpectedly became pregnant with her third, Denise started looking into her options. She researched VBAC, found The VBAC Link, and felt that she could have a VBA2C. Having worked in the hospital where she planned to give birth, Denise knew she would face pushback. She knew they were skeptical and she knew they would try to meddle. She worked hard with her doula to get her mind solid, her body strong, and to prepare for any situation or anything that would be thrown at her. Ultimately, she believed in herself. So with an unsupportive provider in an unsupportive hospital with an apprehensive family, Denise’s preparation paid off! She labored hard, advocated for herself, and vaginally birthed a 9-pound, 5-ounce baby. Gina, one of our VBAC-certified doulas from California, co-hosts today’s episode and shares information about how C-sections affect an infant’s gut microbiome. She also mentions things we can do to help mimic the benefits of birthing vaginally if a Cesarean is necessary. Dr. Denise DeRosa's WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Welcome to the show. We have our friend, Denise, from New York City with us today. Hello, Denise. Denise: Hi. Meagan: I’m so excited for you to be sharing your stories. You are a VBA2C mama just like myself. Denise: Yes, I am. That’s right. Meagan: Yes and when we were talking about the C-section aspect of things, it reminded me a little bit of myself. Didn’t dilate, baby didn’t come down. What do we know? We know that this is a very common, common thing. In addition to Denise, we have a very special co-host today and her name is Gina Benson. Hello, Gina. Gina: Hi. Meagan: She is one of our VBAC doulas. Tell us where you’re at, Gina. Gina: I am in the Sacramento area of California based in Roseville. Meagan: Okay, all right. Then we‘re going to make sure that she has her website and everything so if you guys are in her area looking for a doula, go check her out for sure. She is going to do a Review of the Week for us today. So I’ll turn the time over to you. Gina: All right. “I’ve waited and prayed about this moment to be able to write the words, ‘I got my VBAC’ feels surreal. Two years ago, I gave birth to my daughter via Cesarean and since the OR, I’ve been dreaming of a VBAC. It felt like a primal right I was robbed of. Yesterday, I gave birth at home with gestational diabetes to a 9-pound, 2-ounce baby. I pushed him out of my vagina, pulled him out of the water, and sobbed in joy relishing in my redemption and power. This would not have been possible without The VBAC Link. I listened every day postpartum, sobbed and cheered with the Women of Strength. I cannot recommend this podcast enough to all expectant parents. Thank you, thank you, thank you.” Oh my gosh, do you guys have the chills? Because I literally have the chills. You know how when as a woman you shave your legs and you’re like, Oh, I just felt my leg hairs grow? Yep, that just happened. Oh my gosh, thank you for such an amazing review and huge congratulations. I’m so glad that you’ve been able to walk the walk with us here at The VBAC Link. This is why we’re here. We want to inspire, encourage, empower, and help you know for yourself what is best for you. We don’t judge here at The VBAC Link, but we really, really do love your reviews. So thank you so much. Okay, so that review also talked a little bit about a big baby. Denise also had a larger baby with her VBA2C baby. I feel like there are so many things that are going to come together within this review and within everything. So, Denise, I want to turn the time over to you to share your C-sections to start and then your VBAC. Denise: Perfect, thank you. Hi everybody. I’m Dr. Denise DeRosa. I’m a pediatric physical therapist. I feel like I have to lead with that because who I am is what I do. That with motherhood is all merged together and really helped me in my journey for a successful VBAC. We’ll start at the beginning with my first baby. I was pregnant. Everything was going great. Everything was wonderful. I was still working. I had an uncomplicated pregnancy. The only thing that was a little off was that the baby was measuring big. I was like, okay. Whatever. It should be fine. Those machines are way off anyway. I go to 40 weeks, 40 and 1, 40 and 2, 40 and 3. I’m 40 and 5 days and my doctor is like, “All right. I want to induce you tomorrow.” I’m like, “Okay, sounds good.” I didn’t know anything. I worked at the hospital as well so I’m just trusting that we’ve got this and we were good. I loved my doctor. Everything was going great. That night before I went in to get induced, I actually did start feeling something. I was like, What is that? It feels like cramps or something. I don’t know. At 3:00 AM, I think I’m in labor. “Hon, get up. We’ve got to get to the hospital. Let’s go. Let’s go.” We get to the hospital. It’s 3:00 AM and I’m 3 centimeters dilated. I’m like, “Oh, okay. I guess that’s good. I don’t know.” We get all the things– the epidural, the Pitocin, and I pretty much just lay in the bed, sleep, do a puzzle game on my iPad, and relax because that’s what they tell me to do. It is very easy for me to relax now. It gets to be 11:00 AM the next day. I’m like, “I feel a little bit different. Can I be checked?” I get checked. 10 centimeters, wonderful, beautiful. They turn off everything. You know when they turn off that epidural, it’s like, bam. This is intense. Meagan: Especially when you were not feeling anything before. Denise: Exactly. Meagan: It can definitely pick up and be a little bit more than maybe you were expecting. Denise: Yes. I am in a Semi-Fowler position which is the one where you’re essentially leaned back but not all the way back. You’re inclined at a 45-degree angle. My hips and knees were at 90/90. It was essentially like I was sitting on the toilet but I was leaning back. I’m sure everybody knows the position that I’m talking about. That’s the position to push. My husband is holding one leg. The nurse is holding the other leg. My doctor is telling me to push. It’s just a disaster. I have to be honest with you. It was crazy because I didn’t know how to push so he was telling me to push like I’m pooping and I’m pushing like I’m holding it in. Everything was spasming and everything was just a disaster. I remember saying, “Let me get up. Let me move my body. I’m a physical therapist. Let me move my body. I just need to move around a little bit and I’ll be good. Just let me get up.” “No, you can’t get up. You have the catheter in.”Meagan: Intuition. Your intuition was kicking in to move. Denise: Yeah, exactly. My pelvis was stuck in the position. I was just lying there. The only thing they did was flex my knees up and down. I think I got the peanut ball at one point but it’s not like it was side-lying. There was no internal/external rotation. It was just one plain movement. Anyway, I pushed for 2 hours and nothing happened. My doctor was like, “All right. Why don’t we give you a break? We’ll turn on the meds. Relax for an hour and then I’ll come back and we’ll push again for an hour.” I’m like, “Okay, sounds good. I need a break. Wonderful.” A rest. He’s like, “But you know, if nothing happens, we’re going to have to get the C-section.” I’m like, “Okay, well let me try again.” No food. No water. Only Jello and ice chips. I hadn’t eaten since the day before. I was just so out of it between the drugs and the not eating. I did sleep a little bit when I was relaxing there but I was shot. My doctor came back after an hour and he goes, “Denise, I just went across the hall and the girl across the hall, I turned off her meds and she pushed 3 times and the baby came out.” I was like– let’s just say my hand went up in the air with one specific finger up. I essentially flipped off my– it wasn’t even the doctor. It was just the situation. I was like, “Forget this. This is ridiculous.” Okay? Now that’s the kind of relationship my doctor and I have that we can joke around and all of that stuff and after, I apologized. He was like, “Don’t worry. I deliver people in handcuffs. That was not the worst thing.” Meagan: What? Denise: Yeah, you know if you are stationed at the hospital, you deliver everybody. You know?Meagan: Yeah. Denise: What do you think happened? I stayed in the bed. I pushed. Inefficient pushing. Baby never dropped. I was dilated to 10 centimeters but nothing happened. Okay, by the end of it, I was like, “Please give me a C-section. This is the worst day of my life.” She came out. They lifted her up and everybody in there was like, “Oh my god. Look at this big baby.” I was like, “What is she, 100 pounds?” I was so delirious. You know, at that point you are so delirious. Anyway, it was a girl. She was 9 pounds, 10 ounces. It was a big baby. She never dropped down. I didn’t move my body and had a healthy baby, a healthy mom. Everybody was happy and I was just like, oh gosh. This is the best and the worst day of my life. When you become a mom, it’s just the best but maybe not the best experience. Meagan: Yeah. Denise: That was my first birth. At the time, I was like, okay. It is what it is. I’ll try harder for the second one. Now that I know what my body does, I’ll VBAC. My doc was like, “That’s fine. You can VBAC for the second, no problem.” Okay, great. In between my first and my second, I actually was pregnant and I was 8 weeks. I went to the doctor. I had a heartbeat but my doctor was like, “Come back in 2 weeks. Something is not right on here.” I’m like, “Okay.” I was going down the shore, the Jersey shore with my family. All 20 or us, a big Greek family vacation and I remember I was there and my doctor was like, “Okay, I want you to come back after that because the baby is measuring a little small.” I’m like, “Okay, no problem.” I’m down there and of course, that baby didn’t make it. I wound up miscarrying while I was on vacation with my family. I called my doctor and he was there for me. He would call me every day and be checking in, “How are you doing?” I thought that was something doctors don’t really do. He’s a special guy. I could really tell. I felt like he really cared about me and cared for what was happening. In between my first and second, that happened and then I wound up getting pregnant with my second and I was like, oh I’m going to VBAC. Everything’s going to be good. I took a labor and delivery course. I read my whole textbooks because sometimes physical therapists will be part of labor. So I’m like, I’m going to read up on this a little bit more. I take the course. Fast forward to 40 weeks and I started. I woke up in the morning. It was 6:00 in the morning and I was like, Oh, I feel something. This is great but let me not call my doctor right now. Let me stay home. Let me do the movements. I’m bouncing on the physioball. Of course, I have one of those. I’m walking around, doing the stairs, doing lunges, doing different positions. I’m like, “Let me just see where this goes,” and waiting as long as I can. I’m in touch with my doctor the whole day. 7:00 comes around. My husband comes home from work. I call my doctor. He’s like, “Okay, well why don’t you just come to the hospital and I’ll check you? You’ve been in labor the whole day.” I’m like, “Okay, that sounds good.” I go to the hospital. He checks me. I’m 0 centimeters dilated. Zero. I’m like, “Come on.” He says to me, “Well, you’ve tried. You did.” He’s like, “But what do you want to do? You want to keep contracting on an old uterus scar and something bad happens?” Meagan: Oh dear. Oh dear, oh dear. Denise: I was like, “No, I don’t want to do that.” At the time, I didn’t educate myself enough on risks. I just thought it was me. I was like, I’m a physical therapist. I’ve got this. I exercise every day. I’m good. I’m going to do it. When he said that to me, I was like, “No, I don’t want something bad to happen.”Essentially, I had a repeat C-section because I wasn’t really in labor is what I tell people. Yeah, that was my second and he was fine. This baby was 9 pounds, 4 ounces. Meagan: Staying in the 9’s. Denise: Another large baby. Yeah, it was fine. I felt like at the time, I was like, I did everything I could. Obviously, now I know I could have done more but at the time, I was like, I did my best. This is just my story and I’m fine with it. It is what it is. I have been growing my business for a few years at that point. My pediatric physical therapist business here on Statton Island and I felt like that was my third baby. You know, when you are a businesswoman, your business is like your child. Meagan: Yeah. Uh-huh. 100%. This business is one of my children. Yes. Denise: Yeah, exactly. I was like, I have my boy and my girl. I have three bedrooms in the house. I have a healthy boy and a girl. That’s another thing too. As a physical therapist, I see a lot of different things and all babies are miracles. That’s how I feel. All babies are amazing and I’m like, You know what? I’m good. I’m going to work on the business. I’m going to go back to work. We have healthy babies. We’re good. You know that expression? You make plans and God laughs. Right? You know? I was like, you know what? I wound up getting pregnant when I wasn’t trying to get pregnant. I had been trying for the other two and I was nursing and that’s the other thing. You can’t get pregnant, right?Meagan: A lot of people think. Denise: But you know, it’s funny. I got pregnant the month after my ya-ya passed away. Ya-ya is Greek for grandma. I was like, You know, this biotch just had to reincarnate herself and she hit me. I’m like, Why couldn’t she get my cousins? They don’t have any kids. They could have kids. I’m like, Ah man. She reincarnated herself. She cursed me. I don’t think babies are a curse. It’s just at the time that I was feeling all the feels. Meagan: You weren’t in that space. Denise: I was like, you know? I was done having kids. I was like, oh my god. I can’t get pregnant. I’ll have another major abdominal surgery. Here we go. Also, Meagan, I know you know. No one wants to watch more than one kid so it was– I was shocked. Yeah. I was shocked. Denise: I was like, you know what? I did have two miscarriages. One before my first and one between the first and second. Let’s just see what happens. I’m not going to tell anybody. Let’s just see where it goes. I’m not going to decide what to do now. I’ll just wait a little while and see what happens. You know, when you have two kids and you’re pregnant with a third, that pregnancy flies. Meagan: So fast. Denise: Very fast. I was like, oh my gosh. I’m almost in the third trimester. What am I going to do? At every appointment, my doc’s like, “Denise, when are we going to schedule your section?” I don’t like to pick baby’s birthdays. For me, I would rather they come when the baby is ready and I wanted to go into labor at least and then get the C-section. Then I was like, I got to this point where I was like, I have to make a decision here. What am I doing? Am I going to just schedule a Cesarean or am I going to actually try to do this? So I’m like, let me look things up. I found you guys. I found out that women actually have vaginal birth after two Cesareans. This does happen. I’m thinking with my own individualized plan here, I had no complications with either one. I didn’t have high blood pressure. I didn’t have anything go badly so I really felt like I was a great candidate. Then there’s there my doctor who was like, “No, you’re not a good candidate. Your baby never dropped. Your babies were big and you didn’t dilate on your own.” I’m like, “I know, but I just feel like I can do it.” So this is something that I tell my patients all the time that you need to listen to your mom intuition. There’s nothing that can steer you wrong. If you feel like something’s wrong with your baby or yourself, you need to get it checked out. It’s probably nothing and everything is going to be fine, but at the same time, the way that mom feels directly impacts baby and I just felt like, you know what? I feel like I can do this. I feel drawn to this and I’m going to go for it. Then the things that really drove me over the edge was that my cousin had a successful VBAC at the beginning of my third trimester so I was like, oh. If she can do it, I can do it. Then I also got in touch with a doula who I had been talking with professionally and we met. She said something to me that I will never forget which is, “I have total and complete trust in your body’s ability to birth.” I’m like, “No one has ever said that to me. I’ve only been told I don’t dilate and my pelvis is too small and I grow too-big babies,” not “You grow really healthy babies, really chunky ones with lots of rolls and that’s the best.” I was never told that. I’m like, you know what? If anyone can do this, it’s me. I trust in myself. I’ve got to go for it. This is my last chance because if I got another section, then it would be my tubes tied and that would be the end of the road. That would be fine with me too because I don’t really want more than three abdominal surgeries anyway. I made that decision to go forth with trying to achieve my VBAC. I have to tell you, I left all my cards on the table. There was no stone left unturned. I went in. I stopped working in September and I used all of October to prepare myself mentally, physically, emotionally, and spiritually because I would be reading even on The VBAC Link, the Facebook group all of the things people did. I didn’t do everything. Listen, you only have so much time in the day when you have two kids already. But at least I was doing things that felt right for me and my body. Meagan: I love that you pointed that out because there are so many things, right? We even suggest it here at The VBAC Link. We’re like, here’s a whole list of things you can do to improve. Gina, I’m sure as a doula you have things that you suggest to your VBAC clients and I know I do too but it one, can get a little overwhelming honestly and two, like you said, time is a thing but three, here’s a list. Pick what is appropriate for you. If every single one of those things is achievable, great. If not, pick some. Go with it. Right?Denise: Yeah. There are a thousand, bajillion things you can do. Meagan: There really are. Denise: Like I said, I picked what was right for me. I met with my doula. We did a pre-labor class specific for my body and how I would plan to move my body based on my anatomy. I know I’m a little asymmetrical from holding baby on one hip. I’m like, oh I’ve got to get that checked out. I prepared a lot and it was actually fun now that I’m looking back. I listened to you guys. I listened to other podcasts. I listened. I watched documentaries. I read books. I tried to do what felt right for me and then also educating myself on papers and even looking at my own research about different things that they tell you to watch out for when you’re trying to achieve something that I achieved. Meagan: Out of the list– sorry to interrupt you– what were maybe your top three things that you were like, these were the best things? Obviously, you hired a doula and you got some education. What are, in addition to those, the top three things you did that really, really impacted the situation?Denise: The top three things were that I got my mind solid. I literally was like, Denise, you can do this. There was no– I had an intention. I think I listened to that– Henci Goer. Meagan: Henci Goer? Uh-huh, so good. Denise: I listened to that podcast maybe the week before and she said something like, “Have an intention, but not a goal because when you don’t get it and it’s a goal, then you feel all the feels. You feel like you failed.” I had an intention but I also had a feeling of, I’m going to do this. I’m not going to try. I’m just going to do. I’m an athlete as well so if you’re an athlete or you’re someone who pushes yourself physically, you can labor naturally like I did. I’m telling you, you can. You know like when you’re on the treadmill and you’re running and you just keep going and going? It’s the same thing in labor. If you mentally train yourself with the physical, you’re going to be successful. My top three tips would be get your mind solid and really find your why. Why do I want this VBAC? How is it going to feel? What is it going to be like? Imagine it. Then two, get your body right and then three, prepare for any situation that they’re going to throw at you because they are going to throw things at you to make you sway the other way. They’re going to tell you that you can’t do it. They’re going to tell you, as I get into my story, when you get to the hospital, they’re going to throw things at you. I’m not even mad at the doctors in the hospital and the nurses because honestly, I really feel like doctors are really great people. They’re not bad people at all. They are good people and the nurses are part of birth. This is the most sacred part of healthcare in my head– also palliative care and hospice care is important too but birth is really so important. Unfortunately though, there are policies in place and there are rules and regulations. I think everybody is just doing their best with that but my top tips would be mind solid, body solid, and prepare for anything they are going to say and throw at you because it’s going to come. Meagan: Yeah, it’s probably going to come. I love that. In our VBAC course, we focus so much on the mental prep too. I think a lot of times, we are more focused on that physical prep and what we can do with our body, but I think the mental part connects so deeply to the physical part that we cannot skip it. Denise: No, you cannot. Meagan: I skipped it with my second and look at what happened, I had a repeat section. Denise: So yeah, that’s that. I guess I’ll get into my third birth now yeah? Meagan: Yeah. Denise: Okay. Another healthy pregnancy, uncomplicated, everything was fine. I get to my third trimester and that’s when I decided to go for the VBAC. I’m doing all the things like I said and I get to 40 weeks. I get to 40+1, 40+2. I go to the doctor and I’m like, “I’m not going to get checked today. I’m just going to talk to him.” He comes in the room, arms folded, you know? He’s like, “What’s going on? You don’t want to schedule?” I’m like, “Doc, I want you to know that I have so much respect for what you do.” I essentially did a fear release which you talk about in the course as well. It’s so important and holding things back and preventing it from labor. I essentially did a fear release with my doctor where I told him that I loved him and I respected him and I didn’t think I know more than him because I definitely don’t. I don’t know how to cut through and do all of the surgeries and everything. I’m a conservative health profession, okay? We don’t do any surgeries. No blood, no thanks. I just said that to him. “I don’t think I know more than you. I just feel like I can’t schedule it and I feel like there are things that I can do.” We talked about successful VBACs after two Cesareans at the hospital and it was essentially, “You have to get there when you’re pretty much ready to push. They’re going to try and give you a section and they’re going to try and give the epidural and they’re going to try and do the things and they’re going to try and meddle. You come to the hospital in pain, you’re going to get pain medicine because it’s part of hospital regulations and all of that stuff.” I was like, “Okay.” He gave me my answer. It was too late to switch at that point. I thought about switching to a midwife and having my baby at home, but that was just something I really knew my husband would never go for. He was already scared that something bad was going to happen to me and the baby because that’s what he was told at the appointments.We did essentially fear release on the 7th and on the 8th of November, I woke up with the same cramping I had with my second. I was like, oh, this is something. I think the fear release must have worked. Awesome. All right. Let’s just see how this goes today because I have to keep my mind right. I have to go about my day. That’s what everybody in every single VBAC Link story said they did. I walked my daughter to school. I take my son for a walk around the block. I did the curb walking. I did the Miles Circuit. I ate my dates and my tea. It was a normal day. I just ignored it and the contractions would get closer together and they would get farther apart and then change in intensity so I thought this was prodromal labor. I think I said that right. Meagan: Prodromal. Denise: Prodromal. Okay, sorry. I’m like, okay. This is what this is. I’m just going to rest and that evening, I put the kids to sleep and I was like, let me try to rest because I don’t know what tomorrow is going to bring if I’m going to be fine or if I’m actually going to do this. So I go to sleep. I wake up 2 hours later at 12:00 and between 12:00 and 4:00 AM, I was laboring by myself. I didn’t want to wake up my husband because I didn’t want to go to the hospital too soon. I didn’t want to wake up my kids obviously because no one wants to be around them when you’re in labor, right? Or maybe you do. I don’t know.I went in the bath. I’m trying to manage my contractions. I’m in the shower for an hour. I’m in the bath for an hour. I’m trying to sit. I’m trying to stand. Everything was worse sitting. 4:00 AM comes and I’m like, I think these are getting closer together. I download the contraction timer on my phone. I’m like, let me actually time these. They were 5 minutes apart. I’m like, okay. Let me text my doula. I text her but you know when you are past 40 weeks and everybody is texting you, “How are you doing? Did you go into labor yet?” All of the questions. I turned my phone on the Do Not Disturb thing a day before because I couldn’t take anymore of these questions. I already had my own anxiety and stress about this. I turned my phone on Do Not Disturb. I called and texted her and then she texted and called me back and I wasn’t getting any messages because I turned my phone on Do Not Disturb. I was like, oh goodness. 6:00 AM rolls around. I finally get in touch with her. I text my mom, “Can you please come here?” My doula gets there and at this point, I’m trying to just focus on my breath like we’ve practiced.I’m like, okay. Breathe in. Breathe out. I was trying to do whatever I can to manage this pain. I didn’t want to go to the hospital at all at that point but I didn’t want to go too early. When my doula got there, it was a complete 180. Oh my gosh. She came. She did the pain pressure points. She massaged. She got the essential oils. She did the rebozo think. I put on my Folklore and Evermore soundtracks for my Swifties in here and I was just jamming. It was like I was on the treadmill running like I used to do back when I was young and had better knees. It was great. I could have stayed there forever. I probably did it for an hour because I remember I listened to both albums and I was just fine. I was kneeling on the physio ball and everythings was good. I thought, man. I should have tried for a home birth. Oh well. I’m not going for a fourth so no home birth for me. My doula was like, “All right, Denise. Do you want to try to bring baby down and try some different positions?” I’m like, “Yes, let’s do it,” because I knew that would be one of the things. I go to my stairs with one leg up and one leg down. I go to down on the floor into a half-kneeling position and I’m like, “Okay, let’s do this contraction. Breathe in. The contraction comes.” My water breaks. I’m  like, “Oh my gosh.” Water is just dripping down my leg. That never happened before. My water just broke. Wow, this is amazing. I’m like, “Okay, let’s go get changed.” My doula was like, “Okay, this is time to go to the hospital.” I’m like, “Oh my god. This is great. I’m getting on way.” I go upstairs and change. She’s like, “Okay, we’ve got to move,” and my mom is like, “Come on, Denise. We’ve got to go to the hospital now. Come on!”My mom was very anxious and I said to her, “Mom, I know it’s your birthday and I’m trying to be nice to you but please don’t push me. If I’m not ready to go to the hospital, I’m not going to go.” I love my mom. She’s my best friend and she really just cares for me.Meagan: Yeah, and a lot of the time, they’re like, if you’re in this much labor, you go to the hospital. That’s how they were raised too. Denise: Right, exactly and that’s fine. It’s just that I knew I didn’t want to go and also, I think the day before I listened to your podcast with Julie about going to the hospital and how everything shifts from when you’re at home and you’re so calm, cool, and collected and everything is good but when you get to the hospital, it’s like, bam. Interventions, stress, people talking at you. Meagan: Touching, talking, questions, lights, new voices, new space, new smells. You have to re-acclimate. Denise: Meddling. Right. That was fresh in my brain too. I’m like, “I’m going to go when I’m ready.” Anyway, we’re ready. We’re ready to go. Let’s go. I get in my husband’s car. My mom is in the back seat. My doula drove herself because she was going to leave from the hospital when it was done. I live in New York City. There’s traffic everywhere. It’s Thursday at 10:00 AM and there really shouldn’t be traffic then but of course, there was. I couldn’t sit, right, because everything was getting worse. I’m leaning on my husband’s truck with my arms in the middle and my butt at the window. God help whoever was next to us in the car like, “What is happening over there?” Meanwhile, my mom is in the backseat crying in between. I lost control of my breath so I was literally screaming during contractions. It was like I was at a concert except it wasn’t fun. I said to my mom while she’s in the back, “Mom, I’m okay. The baby is getting ready to come out. It’s going to be fine. I’m going to be fine. The baby’s fine. I’m fine. See? I can talk in between contractions just when it comes, it’s very strong.” She was like, “I know. It’s okay. It’s all right.” My poor mom on her birthday. She thought I was going to have the baby in the car. That’s what she thought. Meagan: I’m sure she did. Denise: Yeah, she was like, “Oh my god. There’s a police cop over there. Flag him down. Flag him down.” She opened the window but then we already passed. It was quite a scene actually now that I think about it. Anyway, we get to the hospital and of course, there’s construction at the hospital so it takes me 10 minutes to walk up to L&D.” Now this is the hospital that I used to work at so I’m like, oh god. Please don’t let anybody see me like this, not my old co-workers or my boss. Please let me get to L&D. Please, please. All right, I make it up. It took me 10 minutes but I make it up. It was 10:45 AM. I get there and the nurse was like, “Come on, hon. Let’s get in the room.” I have a contraction, I’m like, “Please wait.” She’s pushing me, “Come on, come on.” I’m like, “Please don’t push me. I’m in the active stages of labor.” Who do I think I am? I think I know stuff. Meagan: You do know stuff. You do know stuff. Denise: Thank you. I get into the room and girls, I’m not joking. There are 12-15 people in that room with me. They’re all talking at me, talking at me, “Do you want the epidural? Do you want the C-section? We need to give you an IV. We need your insurance card.” Where am I going? You’re going to get my insurance card. Relax everybody. Chill. Because you can’t get a bracelet on me? Everybody knows who I am. The doctor has probably been talking about me for days. It’s fine. You’re going to get the insurance card. Meanwhile, I’m in such late stages of labor at that point. I’m contracting every 30-45-1 minute. I forget. I was like, “Please. I prepared for this.” I knew they were going to come at me like this. Not me, specifically. It’s not a personal thing. It’s just what I was. Meagan: It’s just what they do. It’s just what they do. You’re a label. Denise: And I’m not offended. I didn’t take it personally. I was ready though. I knew they were going to come at me and I had a plan which was, don’t say no and don’t shut down. I also heard along my journey, “Don’t say no. Don’t have negative energy.” You’re not able to control other people’s feelings, but you are able to control yourself. When they came at me like that, I was like, “Please just give me a second. Can you wait a minute? Please let me get through this contraction. I just want a second. Not right now.” I had all of the things listed of what I was going to say when they came at me. Came is a bad word. When they said things, I just knew how they were going to say things. Meagan: When they were approaching you, you knew your response wasn’t going to be no. It’s, “I prefer. Not right now. In just one moment,” and stuff like that versus, “No, no. Get away.” Denise: Right, exactly. Exactly. I could have been like that but I wanted to bring my baby into the world in the most positive way that I could and that’s just how I approached it. I’m like, “Just check me. Just check me before you do all of these interventions.” They checked me and I was 9 centimeters. I’m like, “What’s that? I dilated by myself.” My doula was like, “That’s amazing.” My OB was like, “Yeah, but the baby is really high.” I didn’t even hear him say that. She told me he said that after. I think I was blocking out a lot of negative things on purpose. That was one of the things I prepared for. He’s like, “Oh, but the baby is really high.” I’m like, “Okay, just give me a second.” The anesthesiologist was like, “Let’s give you the epidural just for insurance.” I’m like, “Not right now, just give me a second.” They’re like, “The baby’s heart rate is dropping.” I knew they were going to say that too. I said, “Okay, well what’s it dropping to and what’s it coming back to?” When they said it something that was essentially normal, I said, “It’s a 9-pound baby in there. Of course its heart rate is dropping. It’s being contracted by a strong uterus to get it out. Give it second.” I don’t remember saying this but my doula said that I said this which is, “I’m okay. My baby is okay. I know no one in this room thinks that I can do it, but I can. Okay?” I was like, “That’s what I verbalized.” I don’t really remember saying that but I was outside of my body I guess. She was like, “I got the chills when you said that because everybody was so anxious in that room and only you held it together.” I was like, “Well, yeah. I knew what was going to happen.” I worked in the hospital for 7 years. I get it. There is litigation. There are policies in place and people are scared for their jobs. I get it. It’s fine. So anyway, that went on for about a half hour and then the nurse who pushed me in the hallway that I wasn’t so nice to was like, “All right, Denise. Can we try a position?” I was like, “Yes, please. Let’s do it. Let’s try to switch positions please.” She gets the peanut ball and I got onto my side into internal rotation where you put your knees together and you have your feet on the physio ball. That opens the outlet of the pelvis to get the baby to drop down. I already know all of these things but no one had offered it and I wasn’t thinking straight to even bring it up. I flipped into the position and the anesthesiologist was like, “Can I give you the epidural while you are on your side?”I’m like, “No.” Meagan: Oh my gosh, he’s still pushing this epidural. Get out of my room, sir or ma’am. Denise: I know. I didn’t push anybody out because I didn’t have time for that. I was focused on what I had to focus on and what I came here to do. So I go on my side. One contraction and I’m like, “Um, I think I have to poop.” I was saying it but I had that feeling that baby dropped but I really thought that it was number two. They flipped me on my back and they were like, “All right, hold your knees up to your chest.” I’m like, “I don’t like this position.” Remember, this is the position that they put me in with my first to push baby and it didn’t work? I had PTSD from it. I was like, “I don’t like this position.” They were like, “Just try it. Just try it.” I hear my doula say to me, “Denise, J breathe.” I’m like, “Oh my god. That’s the cue. That’s the cue that I need to push. The breath that I need to push this baby out. That’s the cue we talked about. Oh my god. It’s almost over. It’s almost here.” Then I hear the whole room shift and my OB says, “All right, well if she wants to have a vaginal birth, let’s do it.”I hear my husband say– my husband was very nervous about this whole situation and he wasn’t really talking. He was there but he wasn’t really saying anything. I hear him say– everyone was saying, “Push, push.” But I hear him specifically say, “Push, push. Breathe in. Breathe out. Push the right way.” This 9-pound, 5-ounce baby shot right out of me. The doctors didnt even catch him. He landed on the table. I didn’t know that but I heard that later. That was it. I said, “Baby, baby.” They let me hold my baby right away. We did skin-to-skin. My husband got to cut the cord. I got to call out the gender and you feel the room anxiety shift. The anesthesiologist leaves of course. Meagan: He’s done. Denise: The whole energy of the room just shifts into, “Oh, okay. She did it. All right.” Meagan: It’s actually possible. Maybe we shouldn’t doubt her. Denise: Yeah. I don’t mean that in a negative way, but there is so much anxiety and nervousness about birth whether if you don’t educate yourself enough like I did or didn’t do with my second and even in the L&D, room, things can go wrong. He could have gotten stuck. I don’t know. So many things could have happened. When the air in the room changed, everything was great. Everybody laughed. The doc stitched me up. I got to nurse the baby right away and the nurse said something to me. She was like, “Wow. You are such a strong woman.” I was like, “Oh yeah, I’m a Woman of Strength now. I can say that.” She was like, “Wow, you are a really strong woman. I’m surprised the doctor let you have a TOLAC.” I said, “Oh, no honey. This was not his choice. This was my choice.” My choice was not the same choice I recommend for everybody. I put in a lot of work for this obviously as I’ve said and it’s not really for everybody and that’s okay. It’s okay to have the birth that you feel the safest and the most comfortable with because this is your start into motherhood. But if anyone feels inspired today, I’m glad that I was able to help with that. Obviously, I joke around and my OB, I still love him. He came into my room the next day and said, “Ah, here’s the champion.” Yeah. You know and he said, “Listen, you were the right person to do it. You put in the work and you knew what to do.” Yeah. Meagan: You put in the work and knew what to do. Denise: Yeah, so that’s my story. It’s a doozy. Meagan: Oh my gosh, I love it. Gina: It’s perfect. Meagan: Yeah, right? I mean, Gina, tell me about your area. Do you have a lot of unsupportive hospitals and providers in this way where they come in and you would expect a scenario like Denise’s? Gina: Probably not quite. They actually have gotten a lot better. Meagan: That’s good. Gina: They are pretty supportive even after two C-sections. We do have supportive providers for that and hospitals for that. It’s not unheard of. It’s not like, oh. You can’t do this. Meagan: Right. Right. Gina: Yeah. Meagan: That is the case in so many places. Gina: Yes. Meagan: Like in Denise’s situation. Denise: Yes, New York City and New Jersey as well. In New Jersey, if you have two Cesareans, you cannot be with a midwife. It’s not allowed. Meagan: Yeah. Even here in Utah, which is a supportive VBA2C state, but some of those hospitals also do that. They are like, “Oh no, if you’re a VBAC in general, you can’t be with a midwife.” It’s a little frustrating. We have a lot of work to do but Denise, I bet you probably didn’t change your provider’s perspective completely on VBAC. I bet the next VBAC after two Cesarean mama that came in, he likely may have said, “No. Not going to happen.” But you never know. He might have been like, “Okay. We can try it.” It takes us to show the world that it’s possible, that it can be safe, that it’s reasonable, our bodies are amazing, and so many of the things you could have had with the heart rate or the baby wasn’t coming down or a bigger baby or whatever. All of these things could have stalled you up and you were like, “No. I can do this.” You put the power in your pocket and took the lead. Denise: Yeah. Yeah. And you know, I also read this along the way too. I had three births. My doctor has been to 20,000 births. Does he remember my birth? Probably because it was so dramatic. Meagan: Monumental for him, yeah. Denise: I’m his special patient as he calls me. But it’s not the top of his list. He’s on to the next thing and that’s okay. This is his job. This is what he does. Like I said, he’s not a bad person. He just wants to control the situation so he can make it the most safe in his opinion. But for me, I felt like by the end of it, my grandmother didn’t curse me. She blessed me with an opportunity. My son is of course named after her and a lot of other amazing people like my dad and I just feel like you have to make your own story your own and you have to be comfortable with what you feel comfortable doing. I was more comfortable staying with a provider and a hospital I knew wasn’t going to be like, “Oh yeah, Denise, you can do it,” but I knew in myself that if I believed in myself and I did the work and put in the work, I could do it. And it worked out for me. I wish I had that for three births but at least I had it for one and I get to come on here and share it with everybody that they can have the same experience I did. Meagan: That’s really how I feel. Yeah, I didn’t have the experience that I wanted for birth number one and birth number two but it brought me here today and that’s okay. That’s okay. So you have said that you have even more detail of your story on your website. Can you tell everybody, and we’ll have it in the show notes, but can you tell everybody if they want to read more details on your story where they can find that?Denise: Absolutely. My business is milestonesinmotionptw.com and on there I have blogs about lots of different things but I decided to write my birth story which took me the entire fourth trimester because I had three kids by then. I wasn’t sleeping. You know all the things. But yeah, it’s a completely unedited version with a few more details. If anyone ever wants to reach out to me, I do have resources and I’m working on some virtual stuff with the business so if you have any issues post-birth with the baby with tummy time and crawling and stuff, I have some resources up there for you guys if anyone wants to check it out. And just reading the story– reading and listening to stories like on this podcast really made the difference for me too so thank you for doing it. Meagan: Oh my gosh. Thank you and like I said before, we’ll have her link in the show notes so you can go and check it out. I love that you were pointing out tummy time and all of those things that you can help with. Then cute Gina actually is going to be talking about the gut biome and the effects of it and what birth can do and all of these things. Gina, I’d love to turn the time over to you to add this extra topic. Gina: Thank you. One of the reasons that we want to try to avoid unnecessary Cesarean births is because of the type of impact that that type of delivery can have on a newborn’s long-term health. Some of the outcomes that we know can be associated with C-section births are increased risk of diabetes, obesity, and asthma. There is some research that indicates that those increased risks are because of the way the newborn’s gut microbiome develops after a C-section versus after a vaginal birth. The microbiome is basically an ecosystem of bacteria and there are microorganisms that live in a digestive tract. For a C-section birth where the amniotic sac hasn’t even been broken before you get to surgery, the baby basically has no exposure to any of the flora that are in the vagina which they would get in contact with if they were coming through the vaginal canal. That’s part of what helps to populate that healthy gut biome. It gets the healthy gut bacteria in there for the newborn. The other part we know that helps build that healthy biome is actually the contact the newborn has with the perineum. If you think about where the perineum is in relation to your anus which is the exit of your digestive tract, that’s where those bacteria are going to be. The baby also gets that exposure so it’s a combination of all of it. In a C-section birth, sometimes they get none of it or only part of it. That’s what seems to be a trigger for some of those outcomes that we see long-term for people if they have had a C-section birth. With all that said, is there anything we can do about it? Actually, yes. There is. There are a few things. One of the things that I do with my doula clients is I discuss the choices that they have for their birth and we use that to draft birth plans. I make sure we cover options for spontaneous vaginal births as well as induction and also C-sections because reality is that some babies are going to be born via C-section and I don’t want anybody unprepared for it or not knowing what their options are to make it a better birth experience than just a sterile, surgical procedure. We have documented preferences for each of those outcomes. There are a few things that I make sure we include in a family-centered C-section birth plan that help support that healthy newborn microbiome. I learned about that somewhat from The VBAC Link doula training and I also attended a conference earlier this year called Micro Birth that was basically two days worth of people talking about newborn microbiome and how breastfeeding helps with it and everything. It was fascinating. The first option that I make sure we include in the C-section birth plan is to delay the use of the prophylactic antibiotics. That’s what they give you ahead of time to try and prevent an infection from coming on during surgery. That’s not a bad idea, but when we do it right away before the baby is born and before the cord has been cut, they can also get some of those antibiotics and that will interfere with their ability to build that bacteria in their gut. One of the ways that we can easily manage that is just delay it. Make sure they don’t give us antibiotics until after the baby is out and cord has been clamped so we know that they have gotten all of their blood and they aren’t getting anything else from the surgery or anything else from the IV. In most non-emergency C-sections, that should be an absolutely reasonable request because there’s just a matter of timing. You’re not trying to tell them, “Don’t give it to me,” it’s just a matter of when and all they do is just push it through your IV. It’s also possible for some emergency ones depending on how much time they have. That’s one of the really important ones that helps all of the other suggestions. Meagan: Fascinating. Gina: Yeah, the other one that we include in the birth plan is vaginal seeding. I know that’s part of the VBAC Link course. Vaginal seeding is using gauze or a swab in the vagina to collect the fluids that are there prior to surgery and then you use that and you wipe it on the newborn’s face. You make sure you get it in around their mouth and nose the same way they would be exposed to it if they came through the vagina during birth. That helps to transfer that to the baby. You can also make it even more effective if you make sure you include the perineum so maybe after you do the vagina one, make sure you include the perineum swab as well so you get all of it at one time and transfer it to the baby. There are a couple of times where some things that you don’t want to use this for if the birthing parents has Group B strep or genital herpes, especially if they have an active outbreak, some of those conditions we know pose a risk to newborns and this wouldn’t be a good idea. You don’t want to try to introduce that just to get the flora there. It can be difficult to get the hospital to participate in this directly. I believe that ACOG has said it’s still under research so unless you are being supervised, you shouldn’t be doing this, but if you include it in your birth plan and you actually want to do it yourself, you can get the gauze. You can get the swabs. You can do it and either you or your partner can do it for the newborn. They can’t stop you from doing it yourself but they may not want to particpate. Meagan: Yeah, they usually don’t. We have clients who have ordered the gauze and everything online and then in Denise’s situation where she was like, “I want to labor at home as long as possible,” and all of this stuff, they did it right before. They washed hands really, really well, got gloves even and did it, put it in a bag, and put it in their hospital bag because in case it does go a Cesarean route or whatever, they had it and then they don’t even have to deal with the staff. Gina: Exactly. There are always those types of things where you can take it upon yourself and do it yourself. Yeah. Like you mentioned, doing it at home would be a great idea because you want to make sure that you’ve done it and the swab and everything is out before they start prepping you for surgery because they will use the sterile cleansing options and that will destroy some of it. Always make sure you do it beforehand if you can. Then the last thing that I talk about which isn’t necessarily part of the birth plan, but it’s a really effective way to help restore and build the healthy microbiome for the baby is probiotics. You can start them yourself prenatally and have a prenatal probiotic that you take. You can continue using it while you are lactating because it will transfer to the baby as well. There is one I know Needed offers.Meagan: There’s a pre and probiotic. I really love it. I take it myself. Gina: Yeah. That one’s on my list of options that I give to people. I have a few different ones I’ve looked into that have the right mix of bacteria that they’re looking for so that’s a great one to use. The other one is that you can actually have probiotics for a newborn. That’s proven to be pretty effective if you have a C-section baby. That’s one of the most well-researched ways of helping rebuild that microbiome for them especially if you are using it in combination with breastfeeding because human milk has the perfect sugars to feed those bacteria that we are looking for so it’s a really great combination. There are a lot of different infant probiotic options out there and not all of them have the right mix of bacteria or the right type of bacteria that we know research shows comes through a vaginal birth and is also associated with good long-term health outcomes. There’s one that they have studied the most to be effective. It’s in Australia and it’s called Imploran. You can buy it online and I’ll provide the links as well but I also have a couple of others that have similar makeups that you can use. That’s what I have to say about that but it’s a very fascinating topic. I love to see even some of the negative outcomes with C-sections be improved by things we have learned along the way. Meagan: I love that. Thank you so, so, so much for sharing that with us. Denise, thank you for sharing your stories and your VBAC and your journey and all of your tips are so incredible. I’m so grateful for you. Denise: Thank you. Thanks for having us. Gina: Yes, thank you. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
55:2202/10/2024
Episode 339 Caitlin's VBAC with Preeclampsia + Signing an AMA & Switching Providers

Episode 339 Caitlin's VBAC with Preeclampsia + Signing an AMA & Switching Providers

Joining us from Texas today is Caitlin and it is her birthday!Caitlin’s first baby was born at 34 weeks via an emergency C-section due to elevated blood pressure and fetal distress. Though she was scared, it was not a traumatic experience and her recovery went well. She just knew that moving forward for future births, she wanted to experience labor and she wanted something different. Caitlin talks about the importance of knowing not just your provider’s general stance on VBAC, but their specific policies surrounding it. At 39 weeks, she went to the hospital with preeclamptic symptoms. Still counting on her provider to support her VBAC, Caitlin started to face things she wasn’t comfortable with. Her symptoms were under control, but she could tell that her baby wasn’t yet ready to come. She knew she needed to sign an AMA and go home. When the time came, Caitlin was able to advocate for the birth she wanted, declined the interventions she knew she didn’t truly need, and leaned on those who felt safe in her space. “Having the VBAC made me so proud and confident in myself and any future births that I’m blessed with.” Happy Birthday, Caitlin!!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello Women of Strength. You guys, I am so excited for today’s episode. We have our friend, Caitlin, from– are you from Texas? Where are you from?Caitlin: I’m from Texas, yes. Meagan: Texas. Yes. I wanted to say that then I started questioning myself. She is from Texas and we just went over a quick rough draft of all the things that happened in her birth and there are so many points I feel like to her birth. One, she’s a VBAC. She had preeclampsia with her first and her second. This is her second baby during her VBAC and with her first, she signed an AMA so we are going to talk about that and what that looks like. We’re going to talk more about preeclampsia. We’re going to talk about switching providers. One, switching providers but two, maybe trying to set ourselves up to not have to switch in the future and setting up ourselves to have a supportive provider from the beginning because she definitely had that and so much more. I’m really, really excited to get into the story. I do have a Review of the Week. This review is– I don’t actually know how to say the name. Sidsie, maybe? It says, “Such an amazing resource for VBAC-hopeful mamas and others preparing for birth who haven’t had a previous Cesarean. Their podcast has amazing birth stories and their blog has amazing articles. They have a ton of resources to find doulas and providers and are excited and happy to help support VBAC mamas. I recommend their podcast to my doula clients and I listen to each episode as it comes out. Definitely check it out.” I love that. This is a birth worker. Birth workers, we love you and we love your reviews. As you know, we do have a doula directory so if you are looking for a doula, these doulas are absolutely incredible. Go to thevbaclink.com and click on “Find a Doula”, search your area, and find out which doulas are close to you. Also, if you haven’t had a chance, I’m requesting a specific place for reviews today. If you would not mind, head over to Google at “The VBAC Link” and click on it then leave a review. I would absolutely love it. Meagan: Okay, Caitlin. I’m already so excited that I just am going to turn the time over to you but before I do, I have to say one thing. Caitlin: I’m excited too. Do it. Meagan: Happy birthday. Caitlin: Thank you. Meagan: It’s not your birthday the day you are recording, but we have determined it will be the day your episode comes out which we didn’t do on purpose. Happy birthday. Caitlin: Thank you so much. I appreciate it. Meagan: You’re welcome. You are welcome. All right. Well go ahead and share your stories. Caitlin: Okay, well I guess we should start with my first birth which was August 18, 2021. I was 34 weeks pregnant. I had lingering high blood pressure for about a week and it was elevating over time. My doctor was like, “Let’s look at the baby.” With that check, baby was showing signs of distress and it was pretty immediate and quick. We went in for an emergency C-section. In the moment, I was so scared. It was my first child. I know what that meant. I didn’t really care what that meant for my future births. I didn’t really think of what that might mean for my future birthing experience. My main concern was that my current baby isn’t doing well and let’s do what we need to do to keep him and myself safe. That’s how that went. I do want to say that my C-section was not traumatic. I didn’t have a terrible recovery. It really was all good. I just knew that moving forward for future births that I wanted to experience labor. I had never experienced labor. I wanted to have more children than just two so I knew moving forward from that the risks that come with it. That’s how my first kiddo was born. It was an emergency C-section. He was healthy. He was in the NICU for a little bit but that’s just because he was so little at 34 weeks. Meagan: You actually had a preterm. That was another thing I forgot I wrote down. You had a preterm Cesarean. Caitlin: I did. Yes. It was very quick. We were at my doctor’s appointment at 10:00 and got to the hospital and baby was born within an hour or two. It was a quick turnaround. It was a very high stress situation but it all worked out okay. Now my 3-year-old is wonderful. I’m grateful for how that all worked out and I’m glad that he was safe and that I was safe.That was my first birth. For my second, I knew that I wanted to try for a VBAC. I did extensive research and when I say extensive research, I mean I went crazy a little bit. No. there’s never too much research. I did obtain all of the information I could find. I was listening to podcasts 24/7. I looked at studies and articles and the actual science behind it all. I just dove headfirst into it and I knew that this was what I wanted to try for. I wasn’t scared of a repeat Cesarean. Again, I wasn’t like, I can’t do that again. I just knew this was the route I wanted to try to take. My due date for my second was August 19, 2023, so literally 2 years and a day after my first was born. I told my doctor at every single appointment even as early as it gets at the appointment where you hear the heartbeat and the appointment before they could even find the heartbeat, I was like, “I want a VBAC. I want a VBAC. I want a VBAC.” He was extremely receptive. He said, “You’re a perfect candidate.” He was super receptive so I felt really good about it. I was thinking about this last night with my husband as I was running through all of the little details and I think my provider being so on board made me feel like I didn’t need to do the little additional prodding questions to make sure that it was going to work out. It just seemed like every time I brought it up that it was a no-brainer. It was going to be VBAC fine. That’s kind of your caveat for later but I felt like it was all going to be great. My provider was on board and that’s the number-one checklist. But the thing I didn’t do was ask him specifics. I didn’t ask if I needed an induction, what does that look like? I didn’t ask him, how many successful VBACs have you done? What is your approach if x, y, and z happens? I didn’t get details because it just seemed so positive the whole time. Meagan: And that’s the hard thing. It can be so easy to be like, “Hey, I want a VBAC. Do you support that?” “Yeah. Cool, no problem. Yep. Of course, we do. No worries.” Or like you said where he was like, “Yes, I know you want a VBAC. Let’s move on,” instead of talking about that VBAC. I feel like that was maybe a little bit of a flag in ways. Caitlin: Yes. I should have picked up on it because it got to the point where I would walk into an appointment and the first words were, “I know you want a VBAC. We’ve got that.” I’m like, “Okay, great. We’ve got it.” I think I was a little naive that that was him checking that off the appointment list maybe and being like, I don’t actually need to give this girl a VBAC when push comes to shove. Meagan: Or tell her anything, yeah. I really encourage people to ask open-ended questions like you said like, “How many VBACs do you support? How do you feel about VBAC and what does it look like? For some reason if I have to be induced, do you induce them and what does it look like then?” and all of those types of things. Caitlin: Definitely. Definitely. I started to feel all of this pressure because toward the end, we didn’t really talk about a plan. Then the language changed to, “We can’t really make a plan because we just have to wait and see if you’re going to go into labor.” So then I was like, “Oh dang, then I really need to go into labor.” Then we got to 36-37 weeks and I’m getting more and more in my head, “What if I don’t go into labor? What happens next? We still don’t have a plan.” We started to do membrane sweeps. I got three membrane sweeps and I did them on the time period– I don’t remember what it was. I think if you do two within 48 hours or something like that, people say– I don’t know who people are. I was just a maniac with my research and they were like, “Maybe that will increase your chances of your body going into labor on its own.” I did three membrane sweeps trying to get the ball rolling. I stayed at 1 the whole time. No changes. I was doing all of the things at home up to week 39. I was eating dates, curb walking, drinking raspberry leaf tea, bouncing on the ball. I was pumping colostrum. My baby is 9 months old and I still have colostrum in her freezer. Meagan: Holy cow, girl. Caitlin: I was doing everything begging my body to please do this for me. Please. There were no changes. Meagan: It wasn’t listening. It wasn’t ready. Caitlin: It wasn’t. I was also forgetting to consider the fact that my body with my first did not go into labor. This was my first real experience with childbirth and labor. Do you know what I mean? My C-section grew and changed me in so many ways and like I said, I don’t regret that at all, but in my head I kind of counted that like, my body should be going into labor, when in reality, my body wasn’t going to go into labor. At least not as early as I was trying to make it. So moving on from that, I did all of the things. I kept doing the things. I felt frustrated doing the things because the things weren’t thinging and I couldn’t but I tried and all I kept doing was being positive. My blood pressure was fine my entire pregnancy so we got past that 34-week mark which with my first, my high blood pressure started at week 33 and we got past that point. I felt really good about it. There were no high readings then on August 4th, I was 38 weeks. It was a Friday. I had felt kind of off during the day but I was also like, I’m 38 weeks pregnant. I’m probably going to feel off for the next however many weeks I’m pregnant. Then later that night, I noticed major swelling in my hands and my feet. I was like, this is something I am familiar with. I am not familiar with other things that are coming, but this is something that I am. We didn’t have a blood pressure cuff so husband had me go to a CVS or Walgreens or something like that and take it in one of those machines and it was extremely high. I was apprehensive. I was like, I don’t want to rush right in. I called my on-call person and obviously their response was to go to the hospital. They can’t guide you through anything when it comes to high blood pressure over the phone. I go to the hospital. I was planning on going there for my VBAC even though I’m 39 weeks now and still at a 1 but I’m like, It’s going to be fine. My doctor’s on board. The bummer with that was that it was a Friday night and it was probably closer to the middle of the night and early Saturday morning. The nurse who had us at intake was actually– we recognized her and couldn’t figure it out then she was like, When did you have your last baby? It was the same nurse who helped us prep for the emergency delivery of my first son. She was super sweet and super comforting. It was nice to have somebody who had seen what we went through previously. My blood pressure was still high at the hospital. They started some IV fluids and I was just resting. They checked on baby and he looked great. No issues with him which from my prior experience, that’s what changed everything for me was that he was fine. So I kept asking throughout our time sitting and watching our blood pressure, I was like, “Baby is fine?” They were like, “He’s doing great.” That was super, super– and that was completely different from my first time around. Then finally, the doctor came in who was working for that night and the first words out of her mouth were, “We’ll do a C-section first thing in the morning. We’ll get you on the calendar.” I was like, “Oh, well my plans were to try for a VBAC,” and that was basically met with an eye roll. She was like, “You can talk to the doctor who is in for your doctor this weekend because he’s not the doctor over the weekend. You can talk to her and see what she thinks.” I was like, “No, yeah. I’ll be happy to talk to her. Do you want me to call her right now? Because I’m not going to stay here. Don’t put me on the schedule for tomorrow morning.” She actually did. She called the doctor who was in for the weekend from my doctor’s practice and I mean, basically what I kept getting was, “Protocol is when you have high blood pressure this late in pregnancy, we just do a C-section.” Then every time I asked, “Why?” I was like, “If my baby is fine, why do we do a C-section? If my baby is doing okay,” and my blood pressure at that point was getting lower. We were managing it. I think the fluids helped, elevating my legs, resting, and all of those things. My blood pressure was lowering and my baby was fine. I was like, “Why?” They didn’t really have an answer every time I asked that. I got on the phone with the doctor who was in for my doctor over the weekend and the one who would be doing the C-section the following morning. I’m telling you. We were on the phone for– I had her on speakerphone so my husband could hear what she was saying and what I was saying. My husband knew I did all of this research but as I was debating with this doctor, I could see on his face that he was learning things. He was like, “Oh, that’s a good point. Oh, really? Okay. Okay. You’re not that crazy, Caitlin. I see it. You know?” So I could see him learning through what I was saying to her about my why and why I wanted to do it this way. She was basically saying, “I can have a baby in your arms by lunch tomorrow. You could be walking around.” I was like, “That’s really not my goal. That’s not what I’m trying to do.” Finally, I was like, “Hey, look. Based on what I have found, I know that a good induction method would be a balloon Foley. Can you come do that? I’m not going to say yes to a C-section tomorrow with my baby doing fine and my blood pressure dropping. It’s getting better.” She was like, “Okay.” She was like, “I can do it.” I was like, “Have you done it before?” She was like, “Yes I have. I will come in and do one tonight. We can see how you progress overnight and so on and so forth.” They put us in our room and my blood pressure was looking good. They take monitors off of me. They don’t need to be watching baby anymore. All is good. We’re sitting in the room. We are waiting for the doctor to come to start the balloon. Finally, I asked the nurse. I’m like, “Hey, is the doctor coming? She said she wanted to give me time to progress overnight so we could see how we were doing in the morning.” I’m aware of the fact that this could take a long time. I told the doctor that. I said, “I’m very patient. I’m not trying to rush this.” She’s like, “I’ll go check on the doctor and see where she’s at.” She comes back in the room and said the doctor was asleep at home. The doctor said she was going to come do the balloon Foley first thing in the morning. I was like, “That’s not what we talked about on the phone. The doctor told me she was going to come do it tonight so we could progress overnight and all that stuff.”Me and my husband are sitting in this room. Our kid is at home, our other child and they are not even checking me anymore. They’re not monitoring anything. My blood pressure is good. The baby is healthy. I’m like, “Why is there no urgency?” If this was something that needed to be done, why are we not doing anything? I guess that was my concern. As I’m verbally processing this with my husband, the nurse was extremely professional but I felt a vibe. I asked my husband, “Did you feel the same thing when she was affirming what we were discussing verbally?” Just between him and I but I felt like she was like, “Yes. You’re not wrong.” The second I said to my husband, “I think we should leave. I feel like this isn’t right,” the nurse was like, “I can get you those papers whenever you want them.”She went and I was like, “I think I want them. I don’t know. I’m a rule follower. I don’t want to risk anything.” My husband was like, “Caitlin, I don’t know. I don’t know if this is safe,” but I just felt like if there was no urgency to get things moving now, then what’s the urgency in waiting until Monday when I could talk to my provider who had encouraged me and said that the VBAC was possible the whole time? So we left against medical advice. It was very intimidating for somebody who was a rule follower. We felt like we were going to be dogs with our tails tucked between our legs walking out of the hospital with our bags on our shoulders. I was like, “Oh my gosh, those nurses are going to watch us and think we are causing harm to our baby.” But as we were walking out, it was the coolest thing ever. All of the nurses, I think they could tell that I was a little bit insecure about my decision or just not sure, but they were giving me thumbs-ups and silent, “You’ve got this” clapping. I was like, Oh my gosh, okay. This wasn’t a dumb call. One nurse stood up and said to me as we were about to leave the door, “Thank you so much for advocating for your own health and standing firm in the decisions that you want to make for your birth.” It was so affirming for me. Meagan: I seriously have chills and goosebumps right now just hearing you say that and her saying that to you and you being able to leave feeling that especially when you felt like it was right, but then the way the world makes us feel about going against medical advice, you had that, Oh, I don’t know if I should be doing this feeling as you were walking out. To have that advocacy as you were walking out I’m sure put so much power in your pocket. Caitlin: Totally. Totally, totally. That nurse was life-changing for me and I just felt okay going into the next day waiting to see my doctor whom I thought was going to be on my team with all of this stuff that I had been sticking up for. I get to my doctor on Monday. I rested for the weekend. There was nothing crazy. We just relaxed. I got a blood pressure cuff to monitor. It wasn’t good. It was elevated but it never got to that zone where it was on Friday night when I went in. I went to my doctor on Monday. My blood pressure was elevated but not very high. He said, “Let’s have you just lay low. Let’s check you again on Thursday morning.” I went in Thursday morning and it had gotten higher again. He was like, “I’m not comfortable playing this game with your past and how your baby was the first time around.” He was like, “Let’s not do that. Let’s not push it to that point again and see.” I agreed with him in that. I was like, “Yeah, no. We’re now playing Russian Roulette of it’s high. It’s not as high. It’s high. It’s not as high.” I was like, “Okay, great. What are we going to do to get the VBAC going? How do you usually approach this?” He completely froze. He was like, “Wait, no. I think we’re going to do a C-section.” I was like, “What?” I was shocked and so confused and still only at 1 centimeter. I was like, “What are we talking about here? This is not what I said to you at every appointment.” My husband knew. He saw it all over my face. I was like, “Where is this coming from?” My doctor said, “I’ll let you guys talk about it.” He left the room for a minute. When he left, my husband was like, “Caitlin, we have to trust our doctor.” I was like, “I do trust the doctor, but I trust what I know more,” then he was like, “You’re not a doctor.” I was like, “No, I know but I’ve heard enough where these stories come into play.” All of the stories that I heard of people who had been successful with this, that’s where it all comes into play and that’s why I’m so passionate about sharing this because that’s what made me be like, No. I know it can work and I’ve heard of it working. I went on. I think my doctor came in and he thought that he was going to come into a room and us be like, “Okay, yeah. We have to do what we have to do,” and no. Instead, I was like, “I would like to give myself all chances for a vaginal birth.” Now again, I said this before. “I am not scared of a C-section. I had a great experience. I recovered really well but I want to give myself a shot at this.” A question I should have asked way previously was about the balloon Foley thing but here I am, he was still positive the whole time that I just assumed that surely, if push came to shove, we would know what we were going to do. He told me that he had ever only done one and he doesn’t really know or feel comfortable doing another. He said that I might not be dilated to get one in. Meagan: Okay. Caitlin: I was like, “Okay. Well, typically that’s how you approach inducing a VBAC.” Meagan: Yeah. Caitlin: I was like, “Okay.” I told my husband, “I don’t know what either of you want me to say. I would like to do a balloon Foley.” My doctor was like, “I don’t feel comfortable.” Meagan: Did he say why? What about it didn’t make him feel comfortable? Caitlin: He said he had only ever really done one. Meagan: That’s why. Caitlin: I was like, “I’ll be your second.” Meagan: Yeah. Yeah. Caitlin: Then it was more so the approach of, “I don’t think one would fit.” That might be true. I don’t really even know. I was at a 1 so I don’t know but– Meagan: Usually if you’re at a 1, and even people without an open cervix like even at half a centimeter, they can get it in. It’s usually a little less pleasant, but typically a Foley will go in. Sometimes the cervix is still posterior which is also a sign that our baby is not ready to come, but if so, it can go out and around. One in his whole career? He’s only placed one? That seems kind of crazy to me. Caitlin: That’s what he told me. That’s what he told me. I’m like, “Okay. Here’s what I need you to do. Phone a friend or I will.” The power of Google, I started to Google local doctors in the area who were VBAC-friendly who were at the same hospital I had already been registered at and all of those things. He looked at me like I was absolutely insane. My husband did a little bit too, but I was like, “No. Find somebody then. If you won’t do it, find somebody who will.” It was very awkward because when he did find a doctor who would do it for me, that was great. I was in the room or whatever and they were– he wasn’t at the hospital when I got the balloon Foley, but the doctor who would, before I left my actual doctor’s office, all of those nurses were very not on board with the call that I was making so that’s an awkward feeling to be like, Okay. Everybody in this room thinks that I’m doing something wrong. It felt really good to leave. It felt good to go get to the hospital with a new set of nurses and a different doctor doing it. All went well. She placed it just fine. I’m so grateful that she was willing to just pop in for a patient that wasn’t even her own. We got to the hospital around 12:15 and I had a male nurse. He was awesome. I was at a 1.5 when I got there so more than a 1. The doctor who did the Foley for me was great. When she got it in, she said she might have broken my water. She wasn’t sure. She couldn’t tell. It was pretty tight. It wasn’t comfortable but I wouldn’t describe it as painful. They started low-dose Pitocin and we hung out basically. I waited on that Foley to do its job and yeah. From noon until 6:00 PM, I was dilating. Things were happening and I think I got the epidural and it fell out right about the same time. I got the epidural right before it fell out. My contractions were picking up and coming really fast which was interesting because I just didn’t expect it to happen that quickly. Everybody told me, the doctor on the phone, everybody told me, “It’s going to take forever. Forever. You’re not going to dilate. It’s going to take forever.” It really wasn’t taking forever because I had been there from noon to 6:00 and things were happening. The nurse I had was wonderful, wonderful. He was super helpful. He was super team VBAC. You’ve got this. When it came time for my shift change, I was so bummed. He was like, “I’ll get a good one for you. I’ll get a good one for you.” When the nurse came into the room, she was so excited it was me. It was the nurse who stood up and told me, “Thank you for advocating for yourself and how you want to bring your baby into the world.” She was just amazing and she was so excited it was me. I was so excited it was her and that was just a huge full-circle moment. She was like, “You’re doing it. You’ve got it.” I was like, “Girl, you have no idea.” Once the balloon fell out, we spent the night repositioning just to keep things moving along. At midnight, the doctor came in to check and see, “Okay, did your water break when I put the balloon in or did it not?” It turned out that my water was already broken, but she also said there was pooling of a lot of blood. I was losing a lot of blood. She was very confused by that. She did a rushed ultrasound in fear of placental abruption and she did prepare us that if that was the case, I would be going back for an immediate C-section. My husband thinks it’s funny. He made a joke, “Well that would have made all of this worth the time.” I was like, “It’s not time for that but whatever.” That would have been a bummer if that was the case but there was a lot of bleeding so I knew that if it was placental abruption that we would go back for a C-section and all would be fine. That’s the biggest thing that I want to say is that it would have been okay. It wouldn’t have been earth-shattering to me. But the placenta looked good. I was like, “Praise be. Let’s keep trucking along.” She was going to monitor the bleeding. She wasn’t sure where it was coming from. We’ll just wait on my body to do its thing. I’m just so grateful that this random doctor, I’d never met her. I never had met this woman but she made me feel that I was the one making the decisions about my body and my baby because that isn’t how I had felt by the other three doctors who I had talked to in the process of this up to that point. Meagan: Yeah, which is sad. Three out of four providers made you feel like that versus uplifting, being part of your birth, making choices for yourself and your baby. Caitlin: Totally. Totally. I felt like maybe everybody who was looking at me thought I was maybe a pushover or just didn’t know what I was talking about so when I pushed back on things, people backed off and were like, “Oh gosh, we don’t want to deal with that girl.” Nobody wants to be that girl but everything continued to go great. We did lots of new positions and dilating was happening fairly quickly. I got to 9. In the morning, that same male nurse requested me again. I loved that. My nurses changed my life. They were amazing and the nurses were my cheer squad. They were amazing. They made me feel like things were going great. Meagan: They were doulas. They were acting as doulas in here. They were requesting you which is awesome and very rare. That’s very rare. Caitlin: Yes. They were phenomenal and every time one of the familiar ones came in, I was like, “We’re good. I’m good. I trust you with my life.” They were amazing. That was encouraging for me because having a doula wasn’t really in our budget unfortunately, but I did need somebody else because my husband is very like, “Yeah, Cait. Whatever you feel passionate about you needing to do,” and he was totally on board, but it was nice to have somebody with a medical background saying, “No, you are doing the right things. Here’s how we can progress you forward. Here’s what we should do next.” I had never had a vaginal birth. He came back. He requested me. He was my nurse again. Then at 10:00 AM, my contractions became so intense and so on top of each other. I think it was worse that this happened after. I wish I had either never gotten the epidural and built up to that. The taste of having the pain relief and then it going away was not fun at all. It would have been better to just never have had the pain relief at that point. I was at 9 and they called the anesthesiologist. They did a flush of medication to offer some relief. That didn’t change anything. So 2 hours later, they came back and he checked. He was like, “Oh, your epidural became dislodged.” I wasn’t getting any of the medication that I was getting previously. So unfortunately, at 9 centimeters, you’re in full-blown labor labor and they didn’t realize for 2 hours what the problem was. Finally, it took my husband saying to somebody, “I don’t think she is just feeling intense feelings. I think she is feeling the actual contraction,” which also was discouraging for me because that 2-hour span of no changes was the longest span I had gone with no progression in the entire experience. I was getting nervous about that. I was like, Not only am I in immense, excruciating pain, but why am I not dilating to a 10? Why am I not a 10? What’s going on here? The anesthesiologist said to me, “Hey, you’re at a 9. You can wait it out and when it’s time to push, just push. You don’t need the epidural to be working.” I was like, “I could do that, but I also got an epidural for the pain relief.” I was like, “No. I want the relief and I also want to be able to relax and see if that gets me to a 10.” They did place a second epidural. It helped. It took a while. It was basically the whole process restarting. My doctor told me, “Hey, since you were just up for 2 hours with contractions on top of each other, how about you try to rest? I’ll check on how you guys are doing in a little bit.” He popped in a few minutes later and asked to check me. I was like, “Yes.” He lifted up the covers and my baby’s hair was there in 30 minutes. Meagan: What? You were crowning? Caitlin: Yes!Meagan: Oh my gosh. Caitlin: I went from 2 hours at a 9. They gave me the second epidural and then within 30 minutes, they went to check and they didn’t have to check anything because the baby was there. It’s funny because we had just reset the room to be dark, comfortable, rest, and it was like, “Nope. Open the blinds. Get ready to go.” It was a crazy turnaround. My husband and I didn’t believe it when he said it. We were like, “Hair? Already? We just sat here for 2 hours at a 9.” I never even got measured. Do they measure at a 10?Meagan: I mean, they can go in and be like, “You’re complete.” Yeah. Caitlin: Right. Right. It went very fast. I was shocked by that. I pushed for 15 minutes and baby was born. It was smooth sailing from then on out. It was 24 hours total. Everybody’s biggest threat to me was, “It’s going to take forever. You’re going to be there forever. You’re going to be doing this forever.” It was 24 hours from start to finish. Baby being born. Baby being healthy. Me getting the VBAC. Me getting the golden hour because with my first, he was straight to the NICU. I didn’t get to hold him or anything and I really wanted that. It was super redemptive for me and just super special that my husband and I were in the same room after the baby was born because he went to the NICU with our first. Having the VBAC made me so proud and confident in myself and any future births that I’m blessed with. Now I know. I’m an advocate and other moms can put their foot down for themselves. You have control of what happens to you as you bring a baby into this world. I don’t think I knew that before being in the thick of it that I actually did get to make the calls. Meagan: Yes. Caitlin: Yeah. All of these medical things that came up like the high blood pressure and how easy I could have been like, “Okay yeah, whatever you say,” but just because of things that come up in pregnancy, it doesn’t mean that you need to get straight to a surgery room. Meagan: I mean look at that. Your blood pressure did go back up to that high range and you didn’t just go in and have a C-section. You had a slowly induced VBAC. Did your original male provider ever come back to the scene? Did that provider catch baby? Caitlin: He is the one who when I was stuck at the 9, he was in at that time. Meagan: Okay. Caitlin: He was there from being at 9 centimeters and he is the one who delivered my son. The other doctor came in to check on us after which was super sweet. She was incredible. But yes, he did come back for all of that. There was a sense of me being like, “Huh. This all worked out.” Meagan: Look at that. Caitlin: It all worked out. Would you look at that? It was interesting because he was very much like, “I knew you were determined.” I was like, “Okay, yeah. I was but you were trying to make me not be.” Meagan: Yeah. Caitlin: I don’t know. I do believe that he did incredible with my first birth and especially with a first-time mom with that scary of a situation happening. I just think that sometimes it’s what’s more comfortable. It makes me sad because if that was my first baby, I literally would have not ended up in the situation I was in. I just wonder how many moms get put in these positions and then have to make– don’t get to make the call because they don’t know they can make the call. They don’t know they are the ones who get to make the choice. Meagan: Yeah, exactly. It goes back to the review where it says that this podcast is for people who have had a previous Cesarean but also for people who haven’t had a previous Cesarean and who haven’t had these experiences and who may not have that full education yet. Caitlin: Right. Meagan: I think this podcast is so great for people who want to learn what happens out there and what could happen and what your options are and how people advocate for themselves. I’m so grateful for the nursing staff. Caitlin: Oh my gosh. They were so amazing. When we got moved to the other room after the baby was born, the nurse who was there when I signed my AMAs and stuff, the one who did all that with us, she came into the room and was clapping. She was like, “You did it!” Everybody was so on our team which was truly incredible. That meant everything for us. Meagan: Absolutely. Absolutely. Oh, go ahead. Caitlin: Another thing just for new moms too who haven’t gone through it, the recovery is different. C-section moms are absolute heroes. They are tough as nails but also, the doctors were telling me, “You’re so young and you’ll bounce back so fast from a second section. It’s not that bad. You healed great the first time.” That’s all true. But the recovery was different because I didn’t have a major abdominal surgery. Meagan: Yeah. Yes. Oh my gosh. Well, thank you so much for sharing your stories. Thank you for advocating for yourself and being an example to others on how to advocate for themselves. We know with preeclampsia that it really can be an overnight serious thing but it doesn’t always mean that you have to just go and have a C-section. There are so many times where I see births where we have preeclampsia with really high blood pressures and proteins and all of the things. We go in for an induction and then it’s managed. The blood pressure is managed throughout the entire rest of the pregnancy so I don’t know. There’s that. I just want to say there is that. Caitlin: There is. Meagan: A lot of times, providers say, “Oh, your blood pressure is so high. Labor would be far too stressful,” but there are so many ways to help manage the blood pressure. We do know that sometimes there are medically emergent reasons to go in and have a C-section but it doesn’t always mean you have to. We have a preeclampsia blog. We are going to drop it in the show notes so if you want to learn more about preeclampsia and the risk factors and how to prevent it because there are ways that we can try to prevent them– getting our omega 3’s, calcium, choline, getting a good salt intake, getting really, really great rich foods, proteins, fruits, vegetables. The Brewer’s Diet is another amazing thing to check out. They have a whole preeclampsia section. Definitely check these things out. If you also have had preeclampsia before like Caitlin, the risks of having it again are slightly higher just because we’ve had it and things like that so if you’ve had it before, definitely check this out even before getting pregnant. I think there is a lot of preparing to do before we get pregnant. Sometimes it happens no matter what efforts you’ve had. Maybe you’ve done all of the things. Sometimes it just happens and it’s out of our control. Like Caitlin was just talking to me about this before, she doesn’t struggle with high blood pressure. It just comes during pregnancy. Caitlin: Mhmm. Yeah. My hope is that in future pregnancies that I wouldn’t have high blood pressure again, but if I do, I just feel more equipped and more confident in how I want to manage that. Meagan: Exactly. Caitlin: Yeah. It’s hard because when you are being told things by medical providers who do know what they are saying in regard to some extent and you want to continue to be like, “I’m going to do what’s safest throughout my baby,” but my favorite question throughout my whole experience was, “If my baby is okay, if my blood pressure is lowering, then why are we making the decisions that we are making?” That’s the pillar that my husband and I lived on in those disagreement conversations. Meagan: I wanted to point out before we go just piggybacking off of that that it is okay to ask questions. You can say, “Okay, but why?” or “What is the evidence on that?” or “What are the medical reasons you are suggesting for this or that?” You can ask questions, Women of Strength. That is advocating for yourself. Ask the questions so that you can make the final decision. Caitlin: If they don’t have an answer, it’s probably because there isn’t an answer. Meagan: Right? And/or if there is some gaslighting happening, that probably means there is also not an answer but they are trying to create an answer and make you feel scared or like you would be stupid to make that choice.Caitlin: Mhmm. Mhmm. I really wish all nurses were like the ones we had. We had awesome nurses. Meagan: They sound incredible, absolutely incredible. Caitlin: They were. Meagan: Shoutout to them. Happy birthday again. Congratulations. Caitlin: Thank you so much. Thank you. Meagan: We will talk to you later. Caitlin: Thank you. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
45:2230/09/2024
Episode 338 Sabina's Healing FBA2C After HELLP Syndrome + Lack of VBAC Support

Episode 338 Sabina's Healing FBA2C After HELLP Syndrome + Lack of VBAC Support

Sabina is one of our VBAC-certified doulas from Canada and is sharing her peaceful FBA2C today. While free birth comes with its own risks and benefits, we know that many women feel drawn to this option when they have no support or do not feel safe birthing any other way as Sabina did. We want to share all types of births after Cesarean and honor all stories! The way Sabina trusted in her body and in the physiological birth process after a traumatic experience with HELLP syndrome is truly inspiring. Among the many important messages from this episode, Meagan says: “If you are a provider listening and you perform C-sections, please, please hear what we are saying today. What you say to us while we are on the table in the most vulnerable position… impacts us. Every word that comes out of your mouth, please think about it. Please think about it because it impacts us…I’m getting emotional because I remember my provider talking crap like that and saying things like that. It impacts us longer than you will ever, ever know and it will impact us for every future birth. Please, providers. Please, please, please from the bottom of my heart, I beg of you. Watch what you say to people.” The VBAC Link Blog: VBAC with PreeclampsiaNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello Women of Strength. It is Meagan and I’m so excited to be recording wtih you today. You’ve probably been listening all summer but I’ve actually not been in the recording studio all summer. I record up until May until my kids get out of school then I take June and July off so I can be with my kids and save you guys from the screaming and the dog barking and all of that in the background. It’s August and we are back in the studio and we have our friend, Sabina. Hello. Sabina: Hello. Meagan: I’m so excited to have her on today. You guys, she is one of our VBAC-certified doulas which is so exciting. She is also a mama of three. She is a FBA2C. Okay, you guys. F is a new one. We haven’t been sharing a lot of F. We’ve had H and V and breech B so what does F stand for?Sabina: F stands for free birth which means I did not have any kind of provider with me during my pregnancy or during my birth. I just did it all by myself. Meagan: Yep, you did. Sometimes I feel like it’s a mother-led pregnancy. Sabina: Yes. Yes. Meagan: This is something. We’ve talked about this a little bit before we got recording. The world, when we look at free birth, frowns deeply upon it. It’s not for everyone. Sabina: No. Meagan: That’s why a good majority doesn’t. However, I think it’s important to share these free birth stories. They are still beautiful stories and it doesn’t mean because you didn’t have a provider that your story doesn’t deserve to be heard, right?Sabina: Right. Meagan: I think that it’s also important to talk a little bit about the fact that so many people are not getting the support. You’re going to tell us a little bit more about why you chose free birth, but the world as we know it is not VBAC-supportive in many ways, in most ways. Sabina: Still. Meagan: Yeah, as we know. You are in Canada, right?Sabina: Yep. Meagan: We know that there are some hurdles there too. Even here in Utah, over the last 10 years of me being a doula and having babies of my own, I’ve watched the VBAC support wane and actually wane in the less-ideal way which is really unfortunate. We have a lot of people who try. They try and find the support. They try and get what they deserve. You deserve support. Women of Strength, no matter who you are or where you are, you deserve support. Most people who choose to free birth ran out of those options and decide that they are still going to do what’s best for them. That is what Sabina did and I’m excited for her to share her stories. In addition to free birth, we have some other little things in there. HELLP syndrome, if you’ve ever heard of HELLP syndrome you guys, or if you haven’t ever heard of HELLP syndrome, we’re going to talk more about that and what that looks like, the symptoms and things like that, and what it could mean. Then larger babies and then yeah, I want to talk a little bit more about VBAC doulas too because we love our VBAC doulas. I don’t know. Are you serving right now? Sabina: I am, yeah. Meagan: You have a new babe, but you are. Okay, if you are in Canada– and where are you again?Sabina: I’m in Ottawa. Meagan: Ottawa. Okay, you guys, give her a call. You can find her on our website at thevbaclink.com/findadoula. Sabina: I don’t have a website but my Instagram is @letsdoulathisvbac. Meagan: Let’s doula this. We will make sure to tag her so just go to today’s Instagram or Facebook and find her. We do have a Review of the Week so we will jump into that and then get into your beautiful stories. This review is by mitaya. I don’t know. I think it’s probably an abbreviation. I don’t know. Maybe it’s a name but it says, “I vote this place on over the speaker in every OB/GYN office.” I love that. It says, “I cannot even begin to describe what an encouragement these podcasts have been for me. I have completely binged on these in the past few weeks and they have grown my confidence for my up and coming baby. I cannot stop sharing everything I am learning and even helping to encourage first-time moms on how to educate themselves to avoid a Cesarean in the first place.” Ding, ding, ding. We’re actually going to have an episode about that, y’all. So if you’re ready to share an episode with a first-time mom, it’s coming up. “Thank you so much for this no-B.S., truth-declaring, and empowering platform that I know has encouraged so many more than just myself. Keep being amazing. I can’t wait to share our story in just a few short months. All of my love.”Thank you so much for your review and I hope that you had your VBAC and had a beautiful birth. If you are still listening with us, let us know. Give us a shoutout on my email or on Facebook or Instagram. Meagan: Okay, Ms. Sabina. Are you ready to dive in to these beautiful stories? Sabina: I am. Meagan: Let’s do it. Sabina: This is surreal because I’ve been picturing this whole pregnancy how I would talk about things if I was on the podcast. Every time I had a symptom, I thought about how I would say it on a podcast so it’s very cool to actually get to do it. Meagan: Tell us all of the things. Here you are. Sabina: Okay. I’ll start with my first birth. I was pregnant in 2019 and I had one appointment with an OB then realized it wasn’t for me. I switched to midwives and had a perfectly uncomplicated pregnancy. I’m very athletic so I was in shape working out the whole time. No symptoms of anything other than heartburn and some rib pain. We had midwives who were great and then around 41 weeks, actually on 41 weeks to the day, we had our ultrasound just to make sure everything was going well. When we got there, I started getting a lot of pain in my right side. Again, I had rib pain so I just brushed it off. It’s nothing. I had seen my midwives the day before and everything looked good. Blood pressure was fine. We were sitting in the waiting room and it just kept getting more and more uncomfortable. I started sweating and I asked my husband if we could just step outside for a bit then I remembered one of my friends saying that when she was in labor, she would put her arms around her husband and just dangle to open everything. I tried that hoping it would relieve some pressure and I just started panicking. My husband who was very naive at the time was like, “Oh, this is it. You’re in labor.” I was like, “No. This is not right. It’s not going away.” Meagan: Something’s off. Sabina: Something’s off. We went back in and I asked the receptionist if I could just go lie down. They brought me into a room and at this point, I couldn’t sit still. We called my midwife and she asked if I was prone to panic attacks and I said, “No, I’ve never had one.” They checked the baby and he was totally fine. But my midwife was like, “Okay, I’ll meet you at the hospital.” We called the ambulance and this is where it starts to get fuzzy. I was in shock. I couldn’t remember everything but we took an ambulance and the only reason we took an ambulance was because I thought they would help but they didn’t do anything. They just waited and took me to the hospital. I spent the ride on my hands and knees and when we got to the hospital, my blood pressure was 275/174. Again, we had just checked it the day before and it was totally normal, 121/80. My midwife was there and they asked if they could check my cervix just to see if it was a bizarre labor and I was barely a centimeter. I was still very posterior so nothing was really happening. I do remember my mom quickly poking her head in. My husband must have called her but then they were like, “Okay, let’s do a C-section.” I don’t remember a lot. I remember as soon as they gave me the epidural, I could relax. Everything just went away. I briefly remember seeing my husband and being like, “Oh my god. We’re going to have a baby.”I remember hearing him cry. They showed him to me the first time. I also had a cyst on one of my ovaries so they showed me that. It was kind of cool. Then in the recovery room, I very briefly remember trying to feed my son and then I told them that my vision was jumping around and I couldn’t focus so they handed him over to my husband and then I don’t remember anything else. Basically, they never treated my blood pressure. They just–Meagan: Wait, they didn’t do anything? They were just like, “We’ve got to get the baby out” type thing then they ignored the astronomically high blood pressure?Sabina: Yes. Meagan: Okay. Sabina: Even though the baby was fine because we had just had the ultrasound and checked everything, they completely neglected the blood pressure. Obviously, it dropped when I got the epidural because it gets rid of the pain so it goes down a bit. Later, I found out that they had the medication ready, they just never gave it to me. So as soon as the epidural wore off, my blood pressure shot right back up and I ended up having a seizure. My husband, I mean I don’t remember any of it, but my husband was kicked out into the hall shirtless holding our newborn not knowing what was going on. My parents were down the hall and heard the code blue and just knew it was for me. Then I was just talking to my mom about it yesterday. She said that they were at the nurse’s station demanding to know what was going on. They were telling her to calm down and they just sent them to see my husband. He was in a dark room by himself with a newborn who was crying because he probably wanted to eat or whatever. He just looked like he was a ghost. He didn’t know what was going on. It was horrible. Even to this day, it hurts knowing that that was his entrance into parenthood. Meagan: And both of your experiences too. His entrance and both of your experiences. It didn’t start off very positively. Sabina: No. Definitely not. I remember seeing my dad briefly and then I don’t remember anything until the next day. I woke up and my dad was there and I just said, “What happened?” He told me I had a seizure and then the first couple days, I don’t remember much. My son was in the NICU just because I couldn’t take care of him and they would bring him to me once in a while so I could feed him. My mom said she noticed that every time he was with me, my blood pressure would drop obviously. It makes sense. She advocated for him to get to stay with me. I started breastfeeding even though I was honestly half-dead. They told my family the day it happened that the next 24 hours would determine which direction I went so it was pretty scary. Meagan: Oh my gosh. Sabina: Yeah. Pretty scary. We ended up getting a private room in the ICU and my son was allowed to stay with me as long as somebody else was there. My mom and husband just kept switching off. The nurses were phenomenal. Every nurse we had was great. They brought us a full cart of baby supplies because we had nothing. We didn’t even have a hospital bag but I saw every other person in the hospital. It was incredibly frustrating. We saw residents. We saw random specialists who had nothing to do with me. We saw interns. I never saw the same doctor twice and I was there for a week.Meagan: Whoa. Sabina: Yeah. We kept being told by one doctor that, “Okay, if your blood pressure stays below this level for the next 24 hours, you get to go home.” Then the next day, a doctor would come on and I’d say, “Okay, it stayed below. Can we go home?” They were like, “Oh no, no, no. You’re probably here for the next several days.” It was back and forth like that and it was incredibly frustrating. Eventually, I left against medical advice because I knew I couldn’t heal in the hospital. I knew I needed to go home. We went home with two blood pressure medications and by day two, I had to stop taking them because my blood pressure was so low. Meagan: Whoa. Sabina: Obviously, I made the right choice. It got to the point where I could hardly get out of bed and I was so lethargic because of the blood pressure being so low. Meagan: Your body truly was responding. It was in that flight/fight mode where you’re probably so tense the whole time you were there. Your body was not able to even try to recover. Sabina: Yeah. I mean, that was our first week as parents. It was in the hospital. Eventually, we got moved to the labor and delivery ward but still, we were not home. We weren’t comfortable. We were bored because we were just there and then we’re seeing everybody and their uncle at the hospital coming in because I was a unique case. It was super frustrating. I do want to mention with the HELLP syndrome that my kidneys were failing. I had swelling in my brain. I had to get one MRI or two CTs or the other way around. I only remember one of them. Meagan: Your liver obviously. Sabina: Yes, yeah. My liver was definitely not ideal. Meagan: That was the start of the pain. Sabina: Yeah, again, I thought that was the rib pain. Meagan: Kind of up there. Sabina: I was perfectly healthy. Yeah. I was perfectly healthy. I had worked out that morning. Meagan: Wow. Sabina: I felt totally fine. It was very sudden. Meagan: Did you have any other symptoms like headache, blurred vision, swelling, nausea? Sabina: Not until after that pain. After the C-section, my vision was jumping. Meagan: Yeah, you said. Sabina: Yeah. I couldn’t focus and then the next two days, right here on my head on the right side had severe pain. Nothing would help. They were giving me pain meds and stuff and nothing was helping so eventually, I just stopped taking them. But beforehand, there was absolutely nothing. They didn’t test my blood or urine because it wasn’t routine to check it at that time and they had no reason to check it but it was very, very sudden and very severe. Because they didn’t deal with the blood pressure, I still wonder to this day if they had dealt with it or tried. Meagan: Given you magnesium or something. Sabina: If it wouldn’t have been as severe of a reaction or a problem. Meagan: Yeah. Sabina: It’s very frustrating to look back. Of course, after that I had PTSD but I didn’t know that I had PTSD and the support wasn’t really there. My midwife was like, “Well, of course, you’re going to have some hard times,” but that was kind of it. That was the only support I got. My sister actually was pregnant at the same time and was due a month later. She got induced because she just went past her due date and I was so upset when she was in labor because I was so jealous. It’s a horrible feeling because you’re happy for them but I was just so jealous. My midwife came over that day. Again, there wasn’t really much support surrounding that. It was just like, “Yeah, that’s normal. Move on.” My sister ended up getting a C-section just because she got the cascade of interventions. It was a typical story. For the next year, it was extremely difficult mentally. Any time I tried to talk to somebody about it, it was always like, “Well, you have a healthy baby,” so trying to justify that everything was worth it because the baby is healthy. Again, I didn’t tell my family how much I was struggling but anytime like for example, I would talk to my mom about it and be like, “I missed all of those moments with him like the first night. I wasn’t with him at all.” She would always say something like, “Well, he was taken care of,” because she was there. I’m super grateful that they were there, but it would crush me inside because–Meagan: But not by me. Sabina: It should have been me. All of those moments should have been me. Then toward my son’s first birthday, we were talking about his birthday party and again, my sister did not mean anything by this because she just didn’t know what I was going through but she was like, “Well, you didn’t really give birth so we’ll call it his removal day.” I just played it off like it was fine, but my insides just crumbled. Meagan: That would impact me. That just made me have a little bit of an ick. I’m sure she didn’t mean any harm by that, right? But that just gave me the ick. Sabina: Yeah, she didn’t mean harm at all. So I just would play these things off and smile and nod sort of thing, but inside it just crushed me. Meagan: I’m sorry. Sabina: I never thought that I would have a C-section. You just don’t think that’s going to happen to you. His first birthday was really hard and then after that, I just started looking forward to the next one which was good but also not good because I didn’t really do any healing or recovering. I just was like, “Okay, it’s done. Let’s move on.” So my second birth was in 2021 and it was more of a classic unsupportive provider scenario. I went with the same midwife because she was amazing during our first birth and I had a lot of trust with her. She was amazing but she told me I needed to see high-risk as well. I went to see the high-risk doctor and he did not want to see me. He just was l​​ike, “You are a pretty low high-risk because it happened so late in your pregnancy. Take baby aspirin. Get some extra ultrasounds. We don’t need to see you.” I said, “Great. That’s perfect. I don’t care.” But my midwife was like, “Nope. You need to see him every month if you want to continue with us.” Meagan: Was that the protocol of their staff or was that just her opinion giving her comfort of you seeing an OB?Sabina: Yep. I think it was her comfort because she said that then if something did happen, we had him on hand sort of thing. Meagan: Okay. Sabina: I still wanted a home birth. I wanted a home birth with my first. Obviously, it didn’t happen so I still was totally comfortable. I knew it wasn’t going to happen again. We were going to take every precaution but my midwife was like, “Nope. It’s too risky because you are a VBAC and you’ve had that happen, we can’t support you in a home birth.” Again, I didn’t know all of the red flags at this time and I just trusted her too much to think otherwise. I pretty much left every midwife appointment crying because any time I had tried to be positive and be like, “Okay, well if I can’t deliver at home, I’ll deliver at the hospital,” they’d be like, “No. You can’t deliver at this hospital. You have to go to a higher-level hospital.” Those were the ones where I stayed in the ICU for a week so I didn’t want to go there. Meagan: Triggering. Sabina: Yeah, and that’s where I had to go for the high-risk too. I was going there once a month and then 2-3 times a month toward the end of this hospital where we had been through all of this trauma. Eventually, I asked if I could do the appointments over the phone because you’d get the ultrasound then you’d have to wait 2-3 hours to see the doctor because they were always so behind. I checked my blood pressure. I was just like, “Can you just call me?” That was fine so it made it that much easier. Yeah. Eventually, my midwife said that if everything was fine by a certain point, she would talk to the OB at the hospital that I wanted to deliver at and see what they thought. Ultimately, they said I had to transfer to OB care if I wanted to deliver there. It was stupid. Again, another red flag. I had to be induced and yada, yada, yada. There were all of these stipulations and everything needed to be what they needed. We saw the OB once and I did not– we were in and out in 5 minutes. I did not like it. She could not have cared less about me. It was very obvious. My midwife said that starting at 38 weeks, we should try and do stretch and sweeps every few days to get things going before my due date. Meagan: She really wanted you to have a baby before that 41-week mark. Sabina: Yes, exactly. She was more scared than we were. Even my husband wasn’t as scared and he is a very anxious person. Yeah. We started doing the stretch and sweeps and again, I should have refused but you don’t know what you don’t know at that point. I found The VBAC Link when I was 37 weeks so I wish I had found it earlier so that I could have done the course and saw all of these red flags and had taken things into my own hands. Eventually, we kept going in to get induced but we got sent home because there were no beds. Again, I was like, “Why are we doing this then? I’m obviously not high on their priority list.” Eventually, we went in. They broke my water. We waited to see if anything would happen and nothing did. They started Pitocin. For the first 6 hours on Pitocin, I was able to handle it but my husband and I were so uncomfortable in the hospital room mentally, physically, and emotionally. We didn’t want to be there. We were never in the room alone so we couldn’t be ourselves because there were strangers there. I eventually asked for the epidural. I told my midwife that if I asked for the epidural, try everything else first, then do the epidural. As soon as I asked for the epidural, she was just like, “Okay, let’s do it.” No pushback, so that was super frustrating as well. We got the epidural then 2 hours later, a different OB came in, checked me, and was like, “No. You are not dilating. It’s not working. You need a C-section.” Again, I didn’t know this at the time, but she said there was no progress but I had dilated a centimeter. I had fully effaced and– yes, fully. Not just a little bit. Fully effaced. Meagan: If everybody could see my face right now, I’m like, what? That’s not change or progress?Sabina: Then my cervix had come forward too. Meagan: Big changes all around. Sabina: Big changes. Big changes, just not fast enough for this doctor. I knew it wasn’t necessary. I waited for my midwife to come in and fight for me and she just went along with it. I was like, “What? No.” I didn’t know I had the right to just say, “No, I’m not doing that.” Neither did my husband. Meagan: Even though you had the right, it’s still very hard. Sabina: It’s very hard. Meagan: It’s a very difficult thing to be like, “Actually, no. I’ve got two medical professionals here telling me what I should do but I think no and how do I say that?” Sabina: Yeah, and you’re already in such a vulnerable state then there is all that negative energy too which really affects me. I’m a highly sensitive person so energies really affect me. Meagan: You were proof in your first birth too. As soon as that doctor walked in, I could feel that negative energy. I knew she didn’t care about me. She wasn’t in this job for the right reasons. I bawled and my husband tried to comfort me. He was like, “It’s going to be different. We’re going to remember everything. We know what’s happening this time.” I just kept saying, “Yeah, but we don’t need it. The baby is fine. I’m fine. It’s just not necessary.”Anyway, eventually, we had the C-section and I just laid there on the table sobbing. I did obviously remember everything but I was just miserable. I was pumped full of every drug so I was exhausted. I think it really affected the bonding experience between me and my baby. That first night with my son, I wanted him constantly. I wanted him on me. I didn’t want anyone to take him with her. I wanted her to sleep separately so I could sleep which is very unlike me. I really think all of the Pitocin and everything blocked my natural hormone releases. While I was lying on the table, my husband and the baby got taken away to the recovery room and I was just trying to rest. The OB was like, “So do you want more kids?” I was like, “Yeah.” She was like, “Well, they’ll all have to be C-sections,” while I was laying on the table after sobbing that whole time. It was just horrible. Meagan: I don’t want to interrupt you but I do because I want to point out to everyone that especially if you are a provider listening and you perform C-sections, please, please hear what we are saying today. What you say to us while we are on the table in the most vulnerable position– some of us are strapped down to a table– what you say to us impacts us. Every word that comes out of your mouth, please think about it. Please think about it because it impacts us and it impacts us longer– I’m getting emotional because I remember my provider talking crap like that and saying things like that. It impacts us longer than you will ever, ever know and it will impact us for every future birth. Please, providers. Please, please, please from the bottom of my heart, I beg of you. Watch what you say to people. Okay, sorry. Keep going. Sabina: That’s okay. I totally agree with you. The lack of bedside manner, especially for VBACs because when you’ve gone through a C-section, even if it was planned or whatever, it still can be traumatic and they just don’t get it. She even told me, “I had 3 C-sections. Once your baby is out, you won’t care how it happened.” It’s like, good for you but not everybody is the same as you. Maybe you don’t care about birth experiences but lots of women do. It was super frustrating. We stayed one night in the hospital and then left. Of course, the PTSD came back. The midwives all tried to tell me that the C-section was necessary because her hands were up over her face so she wouldn’t have come out anyway but their stories weren’t the same so I realized that they were lying and were just trying to justify that it was necessary. Meagan: Yeah. That’s unfortunate.Sabina: Yeah. The PTSD came back and I it got to a point– I can’t remember how many months my daughter was but I was visiting with a neighbor and I was talking about my experiences and I was like, “Next time, I’m going to have a VBAC. I’m going to do whatever it takes to have a VBAC.” She was like, “Why would you even try that?” I was like, “What do you mean?” She was like, “Well, there’s the risk of rupture so why would you even do that when you could just have a C-section?” It broke me. I came home. I bawled to my husband and a few days later, I was still really upset about it. He didn’t know how to help which is fair and he was just like, “Maybe you need to see a therapist.” I’m sure there are some out there, but I couldn’t find any that fit here and therapy is not something that I thought would help me. I know it helps lots of people so I started looking up my symptoms and things. I found out that it was PTSD. It got to a point where I was like, okay. I need to fix this for myself. I took The VBAC Link Course which already was super helpful just because I felt empowered going forward. I knew that my potentially both C-sections weren’t necessary but definitely the second one. I knew the risks and benefits of having a vaginal birth after two C-sections. I had all of the proof in front of me. Then it also pushed me to become a doula. I’ve always wanted to be in the birth world. I became a nurse to work in obstetrics but then left nursing after 4 years because it just wasn’t for me. I was like, “This is what I’m meant to do.”I wish I had known about doulas for my other two births. I took a doula course and then I took The VBAC Link Doula Course and within a month of starting my doula page, I already had a VBAC client who reached out which was super exciting. She got in with the midwives that I had, with the particular midwife that I had. I was like, “Okay. Maybe this is a good thing. Maybe I can teach her about VBACs.” The first appointment, she was great apparently then after that, it was constantly, “Well, you have this so maybe we should do a hospital birth or you have this.” Every time she saw them, they were trying to push her to a hospital birth. She ended up having a free birth with me which was really cool. Meagan: She did? Really? Sabina: I told her from the get-go, “If that’s something you want, I’m here for you. I’m totally comfortable with that.” Her original plan was just to maybe not call the midwives unless she felt something was wrong but then after some of those appointments, she was like, “No. They’re not coming. We’re not calling them. If we need help, we’ll just go to the hospital.” Yeah. She had a free birth and it was awesome. It was great to be there. I was 14 weeks pregnant at the time so it was great for me. I actually met my doula a year before we even tried to conceive because I wanted to be prepared. She wasn’t a VBAC doula, but she was newer and very open to the idea of having a home birth after C-sections. We became friends to the point where I actually attended her birth 3 months before she attended mine. Meagan: Oh my gosh, so cool. Sabina: Yeah, when I got pregnant with this one, I pretty much knew right away that I wasn’t going to have a provider. It wasn’t for me. I did apply to the midwife groups but every one of them either refused or said I was on the waitlist but I wasn’t. As soon as they saw I wanted a home birth after two C-sections, that was thrown out. I mentioned it to my husband once and then the second time I mentioned it, he was fully on board which was mentioned. Meagan: Really? Because you said he was anxious about things yeah. Sabina: Anxious, yeah. But I had been educating him along the way too with everything that I learned. Any time I told him stories of other women who had difficult births or my client who was having these horrible appointments, he would get angry too so yeah. He really had become pretty educated on the topic which was amazing. He was very comfortable with our doula as well. He was like, “She’s really knowledgeable.” We had a plan in place for if there was an actual emergency and if I wanted to transfer for whatever other reason. We had it set up and most other things I felt like I could handle myself unless it was one of the few very serious emergencies. My mindset going into this birth was amazing. I read daily affirmations to myself before bed and then I would listen to her heartbeat. I could hear it with a stethoscope around 15 weeks so every night I would listen to her heartbeat and I just felt so connected and so in tune with my body and my intuition which was something that kept getting shut down with my other births I found. It was the most stress-free pregnancy. We didn’t do any tests. We got a couple of ultrasounds just because I like seeing the baby and I’m a very visual person but that was it. Both me and my husband were like, “This is amazing. We’re just living our lives normally and not these stipulations and all of these worries being pushed on us.” I was checking my blood pressure but I just eventually was like, I don’t really feel like I need to do this. It was very low. It was 90/50 for most of the pregnancy so I was like, I’m fine. I was still taking the aspirin just as a precaution but that was it. I wasn’t in a rush. I wasn’t like, baby has to be out at a certain time. I was just like, let’s let things happen because we didn’t get that opportunity with the last two. I had my mucus plug start to come out around 39 weeks and 4 or 5 days which was very exciting but I told my husband that it doesn’t really mean much. Things are happening as they should. A couple of days later, the bloody show came out as well. Again, I was like, “We are fine. This could be going on for weeks. Whatever.”Then that night, so it was actually the morning of my due date, I had prodromal labor. I started feeling contractions and of course, I got excited but it started I think at 4:00 in the morning. I just sat there and breathed through them. They weren’t intense. They were very easy to get through then me and my husband got everything ready when he got up then it stopped. I was like, “Okay, whatever. My body is just practicing.” For the next week or so, the mucus plug kept coming out throughout the week just in little bits. I didn’t have any other contractions until– I have it written down here– the night of July 3rd into the morning of July 4th so probably 10 hours. I had prodromal labor overnight then it stopped as soon as I got up in the morning. I tried doing the Miles Circuit and both times it stopped the contractions so I was like, okay. Whatever. At least I know how to stop them. Meagan: Sometimes Miles Circuit does stop them because a lot of the times prodromal is a positional thing. Baby is trying to figure it out so the Miles Circuit helps with position and if it moves baby, it can stop them. Sabina: Yep. I was a little bit frustrated that day because I was like, I’m losing sleep now. I don’t know if I should rest during the day because I still could be weeks away from giving birth. I was like, “We need to stay busy. We need to have plans for every day just so I don’t feel like I’m rushing.”Meagan: Take your mind off of it. Sabina: Yeah. We kept busy that day then we were sitting after dinner. Around 8:00 PM I started feeling them again and I was like, “Great. Another night of no sleep. Okay, whatever.” The second night I had them, they were stronger than that first time but I could still breathe through them and stay lying down. That night they were even stronger which is odd because usually prodromal labor is the same. Meagan: It’s monotone, yeah. Sabina: But these ones, I couldn’t lay down which was really frustrating because I was so tired. I had to keep getting up. I tried doing the Miles Circuit and it didn’t help so I was like, “Okay, I guess I’m going to stay awake all night.” In the morning, I got up and I was waiting for them to stop. I tried to have a hot shower and they were still going. It was 10:00 in the morning at this point and the other ones had always stopped at 8:00. I was like, “Okay. Maybe this is something.” My husband was like, “Get Jess here.” I was like, “Well, I’m fine though. I don’t need the help.” But I texted her to let her know what was going on and then for my husband’s sake, told her to come because I knew he needed that comfort. We called her and we called our friend who was going to come watch the kids. For the whole day, I was contracting and dealing with it beautifully. I was breathing through it no problem. I was excited every time I got a contraction. I wasn’t timing them because I felt like that was stressing me out. I felt like they needed to be a certain length and a certain time apart. I stopped timing them and it was just really nice. Our friend was taking the kids swimming. Me and my doula were mulling around the house and she would play with the kids too. It was like we were all just hanging out. It was so peaceful. Then around 4:00, she does reflexology, my doula, so she got me to lay down and did some acupressure stuff on my feet. While she was doing that, I had a really big contraction and after that they pretty much stayed. I think that was the shift into active labor. My husband made everybody dinner which was nice and I was just in the kitchen picking up the food while going through contractions. Eventually, the kids went to bed and our friend left. At this point, it was 8:00 at night. I had the TENS machine on. I had been going back and forth from the toilet because the toilet is the dilaton station. Any time I had to go to the bathroom, I would stay there for 4-5 contractions. Again, I was still fully in control and mentally fully aware. I was happy in between contractions so around 9:30, I decided to get in the tub because they were still increasing. My husband and doula were both there. My husband and I really got to connect during this labor and he was so present. I had asked him after my previous births if he was proud of me. He was like, “I don’t know if I would say proud.” He didn’t mean it negatively, but it just hurt that he wasn’t. So throughout this labor, anytime I looked at him, he’d tell me how proud he was of what I was doing or he would tell me how amazing I was and it was just so nice. He could hold me and we could just be ourselves without feeling the pressure of people watching. So then around 10:30, transition hit. I struggled. I was so mentally tired because I hadn’t slept in three nights of no sleep and my mental strength had been what was keeping me going the rest of the time. I was struggling. It lasted 3.5 hours so it was a long transition. Of course, I had the moments of “I can’t do this. I’m not strong enough” or whatever and my doula just went, “Okay, if that’s how you feel then we need to talk about the alternative.” I was like, “No.” I shut it down. I can do this. We’re not going anywhere so that was great. All she needed to say was that one thing. I felt my water break at 12:30 which was amazing because I’d never felt that before and it gave me that push then a couple of contractions later, my body started pushing on its own which again, was amazing. It was very intense and I just couldn’t stop it. Every time I got a contraction, I couldn’t stop myself from pushing so I just went with it. I could feel her. I reached up inside me and I could feel her head around 1:40ish which was so incredible. How cool is that? So a couple of contractions later, I could feel her crowning, and my husband– I sat up and my husband was like, “Oh my god. I can see the hair.” He was so excited. It was adorable. It took me another 20 minutes to get her head out. I had a lot of pressure in my back and on my right side so I was like, “Maybe she’s posterior,” but I didn’t know. Once her head came out, she wasn’t posterior. Meagan: Was she looking sideways a little?Sabina: I think she was asynclitic because all the pain was on the right and I ended up tearing only on the right side so I’m pretty sure she was crooked. Her head wasn’t really coned either so that’s what I’m assuming. That’s my guess anyway. Meagan: Yep. Coming down a little wonky. Sabina: Her head was out. I got to feel her. We didn’t know the gender of this one either which was very exciting. We were 99% sure it was a boy so I kept referring to her as “it”. “Oh, I can feel its ear. It's turning.” I felt her turn too which was cool. My doula took videos. In the video, right before she came out, I said, “She’s all gooey,” which is crazy to me because I thought it was a boy but in the moment I said “she”. It was very cool. I’m pretty sure that was all intuition. Meagan: That is crazy. Sabina: I had a 3.5-minute break between when her head came out and the next contraction then on the next contraction, I pushed 3 or 4 times. I felt her come out. I sat back and got to pull her up to my chest. I just looked at my husband and I was like, “We did it. We did it. She’s here.” His reaction was everything. I don’t think he realized she was out because I had been moving around so when I sat back I think he thought I was just readjusting then all of a sudden, I pull her out. He had a huge smile on his face. He put his hands on his face because he couldn’t believe it. He started bawling and it was just, oh my god, incredible. She cried. The second I took her out of the water, she squawked and was moving around and everything. It was the best moment of my life. It was everything and even though it felt like a dream because I was so tired and of course, you’re in shock that this actually happened, but it was incredible. She was totally healthy. I got to feel her cord pulsing. I didn’t even get to see the placentas with the other two even though I wanted to so then we just stayed in the tub for a bit. I was extremely sore. Once that initial high wore off, I was like, “Holy crap. My crotch.” Meagan: I just had a baby. Sabina: I was like, “My crotch hurts.” My husband ran the other tub for us and we got to see the gender too which was super fun and a big shock to both of us. I got up to switch over to our shower tub and I was like, “Oh, there’s a little bit of pressure.” I grunted and the placenta came out which was very cool because I didn’t get to experience that the other two times. We went to the other tub and I got to do the placenta tour by myself. I got to let her latch by herself. I love those videos of babies finding the nipple themselves so I let her do that. She was coated thickly in vernix. For a 41-week baby, it was super thick. I think it was intentional for me because I always wanted that gooey baby and she was extremely gooey. I have photos of it all over my face, all over my nose. It was just everywhere. Yeah. Then we transferred to the bed. We got to cut the cord. I made a little cord tie because I hate those plastic chip clip things. I made her a cord tie and I got to put that on. When the kids woke up in the morning, they just got to come in the bedroom and she was there so it was the best. My doula was great. She did counterpressure and she helped my husband any time he was having moments of panic. At one point, I said, “What’s taking so long? Is she stuck?” That’s his trigger. For some reason, he’s terrified of the babies getting stuck. You can see in the video that he looks over to my doula all panicked. I didn’t know because she just calmed him down without me knowing which was great. Sabina: I did tear. When I was in the tub, I looked down and I saw something floating. I was like, oh is it gunk? But it was a piece of my inner labia that had ripped off. Meagan: So what did you do about that? Did you let it heal naturally? Did you do the super glue thing?Sabina: I’ve never heard of the super glue thing but I wouldn’t have tried that. Meagan: Yes, super glue. There are some midwives here in Utah, birth center and home birth midwives who when there’s a little bit more tear that would maybe make them say, “We need to do some stitches but not too bad,” they would superglue it. It’s pretty minor, but they would superglue it. They just say that it causes more trauma to put a needle in, a needle in, a needle in, yeah. Sabina: I originally told myself that if I tore, I would just let it heal, but I couldn’t actually figure out where it attached to. We even got a mirror and we were trying to figure out where it had actually ripped off of so I was like, “You know what? We’re going to have to go in.” There’s a really small hospital about 20 minutes from us. We went to the emergency room and told them, “I just gave birth. I don’t have midwives. I need to be stitched up.” They sent us to the OB unit. The doctor really took his time and he stitched up every little tear that he saw which I didn’t really want but I didn’t know any different. At one point, I asked, “How many stitches are you putting in?” He was like, “You’ve kind of got a zig-zag tear up.” That was part of it and then beside my urethra. “I’m trying to fix it but I’m also trying to make it look aesthetically pleasing.” I was like, “Okay, I appreciate that. I want it to look decent afterward.” We did have some issues with her. They wouldn’t leave her alone even though we didn’t want her looked at. There was one doctor in particular who just really caused a lot of problems and threatened to call child services and stupid stuff like that. In hindsight, I would have just let them call child services because she was perfectly healthy and they would have come here. They did end up coming here even after we did what they wanted and she was like, “Why am I here? This is so unnecessary and such a waste of my time.” In hindsight, that’s what we would have done. Anyway, the stitching was fine then we came home. I healed. The stitches were the most uncomfortable and sore part. With everything else, I healed relatively quickly. I was back to working out just after two weeks which I know is very quick. Meagan: Whoa, that’s really quick. Sabina: That’s just me. I did that with my C-sections too. Meagan: You felt really good. Sabina: After the C-sections too, I was back after two weeks with light stuff. I worked my way up. I didn’t just go back to the intense stuff. My husband even said that it was the best experience of his life and he would gladly do that again over what we had been through. It was amazing. It was amazing. Meagan: I’m so happy for you. I can see the joy. I can see this cute little one right here. Oh my goodness. I am so happy for you. Sabina: Thank you. Meagan: I’m happy you had that support. You had that team. You even had support for your kids. You had everything planned out and I’m so, so, so happy for you. Sabina: Thank you. I should point out too that she was our biggest baby. Meagan: Was she?Sabina: Our other two were 6 pounds, 14 ounces and she was 8 pounds, 5 ounces. Of course. Meagan: Okay, that’s definitely a lot bigger of a baby. I wanted to talk about that too. It’s actually going to be in another episode where we are talking about big babies. Did people ever comment on your pregnancy like, “Oh,” and did that ever impact you like, “Oh my gosh, maybe I’d have too big of a baby?” Sabina: I honestly instinctively knew it was going to be our biggest baby because I knew that I was going to deliver vaginally. With the other two, their heads were in the 5th percentile and they would have slipped out. I knew it was going to be challenging and I knew that I was meant to have the biggest challenge that I could basically. She was very fluid-filled so she lost over a pound after birth. She dropped down to the low 7s so I don’t know if the vernix had anything to do with that, but I looked the exact same as the other two pregnancies, maybe even smaller. It just looked like I had a soccer ball stuffed up my shirt. I was not big at all. Meagan: Okay, okay. That’s good. Sabina: Yeah, we never really got comments about a big baby or anything. 8,5 is big but not crazy big. Meagan: It’s not but it’s bigger than 6 pounds. So many people are being told, “Oh my gosh. You’re so big.” All of these things. Don’t let people get to you, Women of Strength. Believe and understand that your body is going to make the right-sized baby.Sabina: Yep, exactly. Just because you’re big doesn’t mean your baby is big. You could have lots of fluid. It could be how you’re carrying. It’s all so silly. The ultrasounds are silly. Meagan: Torsos. Sabina: Yeah, exactly. If you have a shorter torso, you’re going to stick out further which makes sense. I weighed myself before and after birth just out of curiosity. I had gained 18 pounds during pregnancy and I lost 16 of it with her coming out. So 16 pounds of baby, fluid, and placenta is a lot. Meagan: That is a lot and that’s amazing. People have a hard time bouncing back like that. You just bounced back right after the baby was born. I also wanted to talk about HELLP syndrome a little bit because there are people who worry about it happening with future pregnancies. You had mentioned that your provider was like, “Well, you are a low risk because it happened so late in pregnancy.” According to the Preeclampsia Foundation, HELLP syndrome, there are two L’s in this and is it hemolysis?Sabina: Hemolysis? Meagan: I’m like, I never know how to say that. Elevated liver enzyme levels so that pain that she was describing in the beginning was her liver. It was her liver. Anyway, we’ve got symptoms of blurry vision, pain or sharpness in that upper-right middle part of the belly, headache– and she mentioned it was on her right side but these are things that are common with preeclampsia. A headache, blurry vision, overall not feeling well, fatigue, sweats– I only had one client who had HELLP but she had night sweats. She would wake up and was just Iike, “I just was so wet then I would feel yucky.” Sabina: I had a lot of that in the recovery of HELLP syndrome. I was very sweaty at night. Meagan: Very, very sweaty at night, yeah. Super nauseated that continues to get worse. Nose bleeds are kind of a weird thing but that can be a symptom and they can have a hard time stopping. You keep getting nosebleeds. And seizures. They are the last and most serious and weight gain and swelling. Sabina: Yeah, the major one. Meagan: But according to the Preeclampsia Foundation, women who have had HELLP syndrome in previous pregnancies have a 2-19% chance of getting it again. 2-19% is pretty low.Sabina: That’s the range. Meagan: Women who experience HELLP before 29 weeks of gestation in their first pregnancy may have an even higher risk though. So where your provider was like, “It was 41 weeks,” you had a lot of a lower risk. Just know if you have had HELLP syndrome, could you get it again? Yes. Will you get it again? Maybe, but your chances are lower than if you got it earlier on. Sabina: Yeah, and there are a lot of precautionary things you can do to prevent it. Meagan: That’s what I was just going to say so we can talk about that. If you’ve had HELLP syndrome, and even just preeclampsia, what are some things? You mentioned aspirin. What are some other things you did to try and avoid it in future pregnancies?Sabina: As I mentioned, I’m a very active person so obviously a healthy lifestyle in general is going to help but then we did a lot of extra urinary tests and blood work. Even if you have no symptoms, it can still show up in those tests so maybe if we had done blood work for me or a urine sample, we would have known ahead of time. Those are really the only ones I did to help prevent it. Then I checked my blood pressure twice a day at home which was excessive but with all of the pressure from my providers, I just felt like I should. Meagan: I think it’s warranted for sure. Sabina: Yeah. It was a good way to monitor. Sometimes it would go up slightly so you’d be cautious and then if it went back down, you’re like, okay it’s fine. It was just a one-off thing. Like I said, with this pregnancy too, I did all of those things other than the tests. I took the aspirin. I stayed healthy. I made sure I was well-hydrated the whole pregnancy. Meagan: Yes. I was going to say hydration. Sabina: Yes, that’s a hard one. It’s something I struggle with on a daily basis. Meagan: I know. I struggle and I’m not even pregnant. That’s why I love our Needed hydration packets from our Needed partner and it helps me because hydration is so hard. Sabina: It is. Meagan: Hydrate. Make sure you are watching out for those symptoms. If you’ve had it, don’t hesitate to call your provider or take charge of your care. Thank you so much again for sharing your beautiful stories. I really appreciate you so much. I’m trying to think if we’ve had a free birth, an intentional free birth. Sabina: You’ve had one and I’ve listened to it. Meagan: Have we had one?Sabina: You’ve had one and it was Ashley Winning. Meagan: Oh, duh. Of course. Yes. Sabina: She was the first one who I had ever had of a free birth then I found Free Birth Society after that so she started me down this path. Meagan: Yes. Oh, she’s so great and she’s in Australia. Definitely someone to listen to for sure. Okay. Well thank you so much and congrats and we’ll talk to you later. Sabina: Thank you. Thank you so much for having me. This was a dream come true in so many ways. Meagan: Oh, it makes me so happy that you’re here. And remember if you’re looking for a doula, go find her. Her link will be on today’s episode. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
57:5825/09/2024
Episode 337 Lauren's Surprise Unassisted HBA2C with a Special Scar & Gestational Diabetes

Episode 337 Lauren's Surprise Unassisted HBA2C with a Special Scar & Gestational Diabetes

Lauren joins us today from Australia sharing her two Cesarean stories and her surprise unassisted HBA2C story! Lauren’s first birth was a crash Cesarean under general anesthesia at 40+1 due to nonreassuring fetal heart tones. Her second birth was a TOLAC going into spontaneous labor at 40+3 under the midwifery model of care. She labored naturally, had an artificial rupture of membranes at 6 centimeters, baby was posterior, and didn’t descend. She pushed for an hour then had a spinal given to help baby manually rotate. Lauren’s birth ended in a CBAC which she later learned included a special scar along with the diagnosis of CPD (Cephalopelvic Disproportion). Two years later, Lauren was vigorously planning for a VBA2C. She had her birth team picked out and was ready to go to the hospital for when baby would come at what she thought would be 40 weeks again or later. At 38 weeks and 2 days, her husband went on a work trip 3 hours away and her mom, who was planning on caring for her boys during the birth, was an hour away on a day trip. Lauren’s labor began in the evening while she was alone with her two boys and ramped up extremely fast. With the help of her doula and paramedics supervising, Lauren labored and gave birth to her baby on the bathroom floor in just 2 hours from start to finish!Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. You guys, we have another story coming from Australia for you today. We just recently had an Australian mama and I love our Australian episodes because I cannot get enough of your accent. I love listening to you guys. We’re so excited. We have our friend, Lauren, and we have our little baby. Lauren: Yes. Little Wren’s awake and joining us. Meagan: It’s 11:00 PM there so she stayed up extra late to record with us today. We are going to get into her stories. You guys, she had two C-sections. Lauren: Yes, two Cesareans. Meagan: And then a surprise. I feel like you really had very unique things. You had an OB and you were under general– Lauren: For my first. Meagan: Then you were with midwifery care and then a surprise which you are going to be sharing here in a second. You guys, I’m really excited to hear her stories. We do have a Review of the Week and it’s called, “So Grateful I Found This Podcast” by shinefortheworldtosee. It says, “After having an emergency C-section last year, I struggled with all of these displaced emotions. Here I was so grateful for my healthy baby but I found myself feeling hurt like I had something taken from me that I struggled finding a safe place to share and it felt as if no one around me had ever experienced the same thing I did. This podcast and group of women are my safe place. I am expecting baby number two and am so, so grateful for the empowerment that those stories told here have given me. I am so excited to try for a VBAC this time and the more I learn here, the more confident I become.“Thank you from the bottom of my heart for making this podcast.” You are so welcome. I love this podcast so much. I love all of the stories. I love the empowerment, the encouragement, the education, and also, I’m a big person who relates. I love relating. I think it brings validation to my heart when I can relate to someone because like this listener said, she felt alone. She didn’t have anybody else in her space and this space is so amazing because even if it’s a different outcome or there are different parts of the story, there are usually little blurbs of each story that you can truly relate to. Thank you so much for your review, shinefortheworldtosee. As always, if you haven’t yet, please leave us a review. We are always so grateful for them. Meagan: Okay, cute Lauren. Oh my gosh. Thank you so much for staying up way late because by the time we are done recording this, it’s going to be midnight. Oh my goodness. Oh my gosh, thank you. Lauren: That’s okay. I got the time and said, “Oh, it is late,” but I was so excited anyway. I just can’t wait. With that review, I was thinking the exact same thing. I remember when I found the podcast, I can’t even remember. I was trying to think how it popped up. I didn’t even know VBAC was a thing after my first birth. I just remember listening to it and so much of it resonated. I could relate to those little bits. It was like I was meant to hear it. I just had that strong feeling when I started listening to the podcast. I’d be crying in the car and it was just so powerful. It definitely was life-changing when I found the podcast. Huge. I feel like there are so many situations where you’ve never met them ever in your life. Sometimes we don’t even know where they are at and it feels like they are literally sitting on the phone talking to you. Lauren: Speaking to you, yes. Meagan: Speaking to you. Yes. Lauren: Yes, exactly. I felt it. I was just like, This is what I’m supposed to be listening to at this exact time because it was speaking directly to me. It is so special what you have created. I think there is a podcast now in Australia for VBAC but there was never anything before and I would just eat them up. I’d be waiting every week for the podcast because I would be–Meagan: Is it Ashley’s? Lauren: There’s that one. I think I’ve listened to her podcast with you actually. There’s the “Australian VBAC Stories” as well. They are only maybe up to 8 or 10 episodes so they are quite fresh. Meagan: Yay. Lauren: I just love all VBAC stories. I could listen to them all day. Meagan: Absolutely. Well, let’s get going on sharing yours. Lauren: Yes. Okay, so my first birth was– I got pregnant in 2017. We’ve got three little ones now. Nate was our first baby. We had private health insurance. A few of our friends had gone private. Some of them had gone public. Some had Cesareans. Some had natural births. I hadn’t really had a plan of what I wanted to do. I always knew I wanted to have children but I hadn’t really given much thought to the pregnancy or the way of birth or anything like that. We just signed up with a private OB. I think from our GP, you get a referral then you start seeing them from about 16-20 weeks. You get all the regular scans. Everything was really straightforward. We were really fortunate with our pregnancy. We found out we were having a boy. We found out in– I think I’ve written it down– January. I had morning sickness for the first 3 months then I had a bit of Vitamin D deficiency so I had to take supplements throughout the pregnancy for that. I had a growth scan around 36 weeks. Now, I obviously know after doing a lot of research that there’s no real need for it and it’s just something to give them ammunition to schedule the big baby and the scan actually came back that he was measuring fine. I was like, “Yep, that’s good.” Being a first-time mum, I was so excited to see him on the ultrasound anyway. Meagan: That’s what I was going to say. I feel like they get you especially for first-time moms but really in general because it’s so fun to see our baby. Yeah. Lauren: Of course I want to see him. Definitely. Meagan: We get in there and they’re like, “We’ll do this plus you’ll get to see your baby.” You’re like, “Well, I haven’t seen my baby since 20 weeks, so okay. I’ll do that.” Lauren: And you don’t know any different so you’re just like, “Yep, that seems fine.” I think we even did a gender reveal and I think my husband’s cousin mentioned something about her friend doing Hypnobirthing. I remember I just wasn’t in the right place to hear that at the time. I’m like, I wish I would have listened but it just wasn’t meant for me at that time. I took maternity leave. I had 4 weeks off because I thought, Whoa, from 36 weeks the baby could really come any time. Looking back, I know 40 weeks is not even your due date. It could be any time, anywhere. Meagan: Estimated. Estimated. Lauren: A guess date I’ve heard a lot of people refer to it. And first-time moms tend to go over the 40 weeks so it’s not uncommon. I remember it being such a mind game toward the end when I was getting closer to the due date. I think my OB offered me a stretch and sweep around 38-39 weeks and I was like, “Yep. I’m ready. I’m over it. Anything that we can do to get the baby.” I didn’t really think of it as being an intervention. I didn’t really know what the word intervention was at that time. I do remember her saying to me afterward something like, “Oh, I hope we’re still friends after this,” after she did it. Meagan: Oh. Lauren: I was like, “Oh, that’s a funny thing to say.” Then yeah. I think it was around 39 weeks and there was nothing. It didn’t get anything moving. I was just automatically booked in for an induction at 40 + 1 for postdates which is not even near postdates but I was just like, “Yep, great.” I think like you said before, being a first-time mom, I was just ready to see my baby and over it so I was like, “Yep. That’s great and exciting.” We got booked in. When I went back through my records, I saw on my induction paperwork that it even said, “Small mummy and postdates,” because I was small apparently. Meagan: Nuh-uh. Lauren: Yeah. I’m quite short. But they were already preempting that I probably wouldn’t be able to anyway. We went in. I think we got admitted at 7:00 in the evening. We got ready to do a CTG monitoring and just an initial assessment. When we got in, they said I was having uterine activity but I couldn’t feel anything. It was showing on the monitor I was having some Braxton Hicks or some contractions. They were concerned that the baby wasn’t really reacting very well to that at the time so they called the OB who just happened to continue with the induction. They did a vaginal assessment and I think I wasn’t obviously at anything. They did another CTG for the fetal heart rate and it had gone down, I think, to 90 BPM and had recovered within 2 minutes with a change of position and it had come back to what they were happy with. About an hour after that, they did an intravenous drip in and they did another exam. I was 1 centimeter and my cervix was posterior so obviously, I wasn’t anywhere near ready. I think maybe half an hour after that, there was another decel and it said, with pointless uterine activity. It wasn’t doing anything, but there was something. Then the OB was asked to come in for that. Obviously, the baby wasn’t doing very well when I wasn’t really even in active labor and they were a bit concerned with that thinking he wouldn’t be able to tolerate full-blown labor at that point. So then it was 9:00– so two hours after we got there– when the OB was in the room. They did an ultrasound and were able to determine that I had a calcified placenta and a pocket full of fluid. There was discussion around maybe booking in for a Cesarean just because of the nonreassuring CTG they were having. I awfully now remember feeling a sense of relief and being like, “Oh, good. I don’t have to go through labor and all of that,” because I think probably admitting to myself, I was a little bit scared about the whole labor because I hadn’t done any preparation or any planning. The only thing we had done was the antenatal appointment– what’s the word? The antenatal class at the hospital where they go through it. After we left, my husband was like, “That all sounds awful.” It was just really interventions and how to get the baby out. He was like, “None of those options sound good.” When they said “Cesarean”, I was like, “Oh, perfect. That will be great.” I think at 9:30, we got prepared to go to theater. My husband got in a gown. My mum had actually just arrived into the hospital so it was all exciting. We were going to meet the baby. This was at 9:30. We didn’t know it at the time, but there were a few alarms going on outside our room and there were a few people milling around. I don’t know. I don’t think that was related to us. We got wheeled out on the bed to go to theater and then all of a sudden, Josh disappears and they were rushing us to the theater room. I was like, “What’s happening?” I’ll never forget. I remember– I don’t know who was pushing me, but he said to me, “I don’t think you understand. Your baby needs to come out right now.” We just thought we were going in for a normal Cesarean. We didn’t realize it was changed to a general anesthetic so I started getting upset. I said, “Can I just say goodbye to my husband?” They rushed him back. I quickly kissed him and said goodbye. He gave them his phone and we went into theater. I was sobbing at this point because I just didn’t know what was happening. There was somebody putting a catheter. They were putting the general anesthetic in then I think my OB popped her head in. At least, I knew some sense of calm. She said, “It’s me. I’m here. We’re just going to get the baby out.” I remember I could see them prepping my stomach under the mirror and the anesthetist was lovely. He rubbed my cheek and said, “It’s going to be okay. We’re just going to get the baby.” That’s it. That’s all I remember and then I was gone. After that, I think at the time, I read back on the notes that it was 9:45. It got upgraded to an emergency call. I went under at 9:50 and he was born at 9:52 so it was very quick. He came out. He cried. He was fine. His APGARS were 9 which are healthy. Meagan: That’s great, yeah. Lauren: So fine, yeah. I think he was 3,000 grams which is 6.8 pounds and the surgery was complete at 10:05 so it was super quick in and out. Meagan: Wow. Lauren: He went to Josh straightaway. Poor Josh was obviously just waiting and didn’t know what was happening. They brought Nate out and he said, “Well, that’s great, but where’s Lauren? Where is she?” So then I didn’t make it into recovery until 20 minutes later which I know is still really fortunate compared to what some people experience. It was really quick. When I came to, I was still sobbing I think it must have been because I went under crying. When I came out, I was in tears and I could just see Josh sitting on the bed next to me holding Nate. Instantly, I knew he was okay and he was fine. I was able to hold him and breastfeed him so I think from then on, everything was really quite lucky. We got in straightaway. I think we were in recovery maybe another 20 minutes and then we got taken to the ward. At the time, I don’t think I really registered how full-on it was. I just had a healthy baby. I was okay. Postpartum was a beautiful experience. We were in the hospital, I think, for 5 days together because we were private. Josh got to stay with us. It was like a second honeymoon. We were in there. It was like a hotel where we were getting food. That side of it, I think, was just beautiful and I didn’t really feel like I missed anything birth-wise at that point. That was it I guess with that. Then in 2019, we started thinking about having another baby. I hadn’t really thought too much about a VBAC or what I would do. I guess I was like most people where you just are once a Cesarean, always a Cesarean and there wasn’t another option. I really wish I could remember how I came across it because I can’t remember at all, but I must have found your podcast and I remember listening to it even before I was pregnant. I was just like, I have to try and do this because I never got to experience any labor at all with Nate and then with this pregnancy, I really felt like I missed that and I wanted to have something. I wanted to go into labor and at least try and be given the chance. We were really fortunate and fell pregnant straightaway. That was in 2019 and I knew I wasn’t going to be doing private obstetrician this time so I did a bit of research before I was even pregnant actually with a public hospital that had a midwifery program attached to it. You attended all of your appointments at a clinic and they had a VBAC-specific clinic then you birthed at the hospital. Meagan: That’s awesome. Lauren: Yeah, but you have to apply straightaway. As soon as I got the positive, I filled out the application form and applied directly with them. I got accepted and I was like, If I’m going to go for this, this is going to give me my best chance to go and have a VBAC. I think, I can’t remember how far along I was but I still went. The hospital we were going to is a half hour away but all the appointments with the midwives were only 10 minutes away. That was really good. I knew the drive was a half hour but it was going to be okay. I also had signed up to do the VBAC course with you guys. I got my handout for that and I ate it up. I love that. I went through it and was doing it at night time. After listening to the podcast, I also knew I wanted to do Hypnobirthing so I did Hypnobirthing around 7 or 8 months which was when COVID started to come into the picture. It wasn’t around in Australia but it was happening. The course was supposed to be a group environment with a few classes. We ended up doing an online course which was actually really lovely because when Nate was asleep, Josh and I would sit in bed. We would do all of the Hypnobirthing courses, listen to the tracks, watch the videos, and then we had one in-house visit where we went through all of the positions and acupressure and things like that that I wanted for pain management during birth. That was really good then I think from 37 weeks, I started doing all of the things. I was doing raspberry leaf tea, eating Medjool dates, and sitting on the birth ball. In my head, I felt like I was really getting prepared in the best way possible. Now I know in my third birth, I thought I was but I wasn’t as prepared as I probably could have been. I was still doing more than what I did for my first birth. I had one chiropractic appointment at 38 weeks to get everything balanced and aligned. I never had chiro before so that was all new to me. Then at 39 weeks, I had an acupuncture appointment. I had never done acupuncture before and I loved that. I felt that was really nice. I think it was just my hands and my ankles and then they just put the music on and I felt so relaxed. I really loved that. That was good. I remember when I went in, I said, “I hope I haven’t left it at too late.” They said, “You’re pretty much a first-time mom. You’ve never had labor. Your body has never been through that.” He did some statistics and he said to me that from 40-41 weeks was the average time. I remember with Nate, when I got to 40 weeks, I thought the baby was going to come any day so with this pregnancy, I pushed it out to 41 weeks. In my head, that was when my due date was. I don’t know what I would have done if I got to 41 and I hadn’t gone into labor but I had that I was going to 41 weeks. I had an online hospital tour. We couldn’t go in to see it because of COVID then I had an online appointment at 39 weeks. When you have midwifery care, you still have to be signed off by an obstetrician in the hospital to give you the okay and run through all of the stats and everything. I was prepared to be up against an uphill battle when I went to that appointment. They were pretty supportive. They just talked about postdates, the risk of rupture, and things like that. I said I was comfortable going to 41 weeks and reassessing then so I think that was around 39-40 weeks and then we were rebooked in for 41 weeks if I hadn’t gone in. So then I think I was 40– oh, sorry. I’m jumping around a bit. My due date was a week after Nate’s second birthday so in my head, I just wanted to get to Nate’s birthday and then the baby could come after. We had a little birthday celebration for Nate a few days before I went into labor. We were happy that was done then at 40+3, in the afternoon at about 4:00 I felt a few little tinges but obviously, I didn’t know what anything was so I was thinking this might be it or this could be prodromal labor or Braxton Hicks. I just wasn’t sure. I was like, well, I know from the podcast that I don’t pay attention to it. I’m just going to go about my normal routine with Nate. I’ll get dinner, do bathtime, all of those things, and try not to focus on it too much thinking it might either go away–Meagan: Or fizzle out. Lauren: Yeah. In my head, I’m like, It can take days. By 4:00 it started, then by 7:00, I was getting Nate ready for bed. He was in a cot at this stage. I remember taking a big breath in and slowly exhaling like in Hypnobirthing. I noticed I was having to do that as I put him to bed. I remember being so excited like, This is happening. My body was doing it naturally. I really wanted to try to not get induced if I could avoid it. I remember I really had to focus on my breathing. I was leaning on the bed with my knees on the floor leaning on my bed and just breathing and really trying to relax and listening to my Hypnobirthing tracks. The plan was my mum was going to come over and watch Nate if I went into labor at nighttime. I think it was around 10:00 and I think someone said from one of the podcasts as well to gauge the distance you need to go with how well you are managing and how well the drive is going to take if you’re going to be okay. I called my mum to come. I was like, “I feel like I’m not struggling but it is ramping up a little bit.” I was like, “I don’t know how much longer I can be at home and sitting in the car for a half hour to go.” She arrived. We called the midwives and we let them know we were going into hospital. My mum came and you could just see she was like, “Oh gosh.” She had me naturally. She had three naturals and then her fourth was a Cesarean. She couldn’t understand why I wasn’t trying for a Cesarean because I already had one and why would I not just have another one?Meagan: Why would you not just do that, yeah? Lauren: She came and I remember walking out of my room to the front and I had to stop a few times on the way and stand in the garage and just take a few breaths between each contraction. I went to go sit in the car. In my head, I thought I was going to be on my knees leaning over the chair. I just couldn’t even fit down in that area so I was up against the back of the chair. Obviously, it was not comfortable but I was just thinking if anybody was driving on the freeway and looking, it would have been such a funny sight. I still had my podcast in and I was really focusing on breathing. Josh was just driving. He had never been to any of the appointments with me because of COVID. He hadn’t been to the hospital so we were almost there and his navigation was doing funny things. I had to in the middle of labor try to direct him on how to get to the hospital. We pulled up and I just automatically went to where I would park for all of my appointments which wasn’t in the front of the hospital. I went to get out of the car and I was like, “I can’t walk to the front of the hospital,” so I had to get back in. We drove right to the front and then we went in and we had to get assessed for the COVID triage which was a real pain. We had to wait and do that before we could walk in and get triaged. I think we arrived at the hospital around 11:00. We got admitted at 11:00 at night and then we were triaged maybe at 11:30. By that stage, my contractions were every 3 minutes and lasting about 40-50 seconds. I had a vaginal exam and I was 4 centimeters. I remember just being so excited because I was already progressing. I was hoping I would be further along, but I was like, “4 centimeters is good.” I was 90% effaced and I was thin and soft so I was like, “Oh, that’s good.” I think by midnight we had gone to the labor and delivery suite. They dimmed the lights per my request. I asked to go in the shower because I really wanted to be in the shower. They told me I had to wait until my midwife had come because she wasn’t at the hospital. Meagan: They checked you and got everything assessed. Lauren: Yeah, so I had to wait. That was fine. I was at the stage. I was leaning on the bed swaying. Josh was doing a bit of acupressure on my back and I was really enjoying it at that time. My midwife got there at about 1:00. I was still coping well through it. By 1:30, I don’t think it was my midwife. I think it was one of the hospital midwives who came in and assessed me again. I was at 6 centimeters and I was -2. There were a little bit of complicated decels on the CTG and momentarily in my head, I was like, Oh no, not again. It evened out and it was okay so I think it just must have been a bad reading because of the bulky monitors that they had to put on. They didn’t have the mobile ones. It was the bands that you had to be attached to and monitoring. They suggested to artificially break my waters and I hadn’t felt too much about that in my prep. I think I was just focused on going into labor naturally as opposed to actually being in labor. They asked to break my waters. I had gas for that and I remember getting on the bed to do that which I think was one of my first bad things because then I never got off the bed once I got on there to do that. I couldn’t manage to get back off. I wish I would have known or asked to be helped to get taken off but I was just not in the position to get off the bed. I was stuck there. Yeah. I didn’t remember this but when I read in my notes, they offered me a Cesarean at that point and I was like, “No. I’m trying for a VBAC,” so they said, “That’s okay.” We tried repositioning some fluids and then the CTG was back to where they were happy with it. Then at about a half hour later, I was on my side. I felt a bit of pressure and my sound changed a little bit. I remember my midwife saying to me, “Oh Lauren, that sounded a bit pushy.” It felt a bit pushy so I was like, “Oh, that was really exciting.” That was at 2:00 and at 2:30 in the morning, they assessed me and I was fully dilated. I was so excited. They were seeing some complicated decels on the monitor. I think they said– do you know what the normal heart rate is? I’ve written them all down but they were saying it was 140 without a contraction and then they’d ask the registrar to come in the room so the registrar came in to see what the CTG was doing for progress and pushing. I had a bit of a funny moment. When I was doing the pushing, I was on gas. I must have taken a big inhale of the gas and my vision went dark. I couldn’t see anything. I remember getting a bit scared at that point. I didn’t know what was happening. I could hear everything and I could feel everything but I just couldn’t see. I think it was just from inhaling the gas and the contraction and something. Meagan: It was just too much all at once. Lauren: Yeah. It was really scary but it was a one-off and it was fine after that. Then I think at 2:40, the ped was paged to come in and attend delivery so I think at this stage they still thought things were happening and we were going to have a baby vaginally. 5 minutes later, they gave me an in-dwelling catheter to drain my bladder in case that was creating a blockage for the baby to come down. Meagan: Which is actually something that does happen. Lauren: Yeah. Meagan: If baby is not coming down, sometimes it’s urine blocking. Lauren: Yeah. They said, “Only 50mL came out so it wasn’t a lot,” but I was like, well that was good. At least they tried that. They said the registrar did an IV and said that it was ROP so right occiput posterior so not in a great position and at my spine. They said there was some descent with pushing but not enough. I think that’s when they decided to call to be transferred to theater. The plan was to have a spinal and try for some instrumental assistance to get the baby out. I think at that point, it was quite quick. It was quite intense and I was relieved. I didn’t think I had it in me to push anymore so I agreed to go up to theater and have forceps or manual rotation to help assist the baby out. We got up to theater and I think they called them at 2:40. We got to theater at 3:20 so it wasn’t that long of a wait but it felt like an eternity when my body was contracting and pushing and they were telling me not to push and just to pant through the contractions. I just remember it felt like a really long time. I will never forget that we got to theater. I had to sit up on the edge of the bed and the person trying to put my spinal in asked me to scoot up the bed. I was sitting there mid-contraction and I just remember looking at my midwife and I was like, “You’ll just have to wait until after this contraction and then I can just move up for the spinal.” I got the spinal and they discussed the options of an episiotomy and using forceps to aid the baby. At that stage, I said, “Yep, whatever we need to do,” I would really like to try to get him out. They tried a manual rotation while pushing and his heart rate dropped to 93. They assessed the position and then maybe decided to do the forceps. They must have said that then changed to apply a vacuum because then they did a vacuum and they went to do the first pull and his heart rate dropped to 67. They did another pull and his heart was up at 133. Then a couple of minutes later, they decided to do forceps. They attempted to do the forceps. They applied them and his heart rate dropped to 86 then they reapplied to get a better position around his head and his heart rate again dropped to 75. The baby, even though he had changed position and was now facing– I think his head was facing my back which was OA and he was at a -1 station, they obviously thought he was just not in a great enough position to aid him out so they decided to convert to a Cesarean. I remember at that point, I didn’t feel like it was a failure or I hadn’t done it because they had given me every opportunity to try and I still got to experience so much more than I had with my first birth. Even though I still didn’t end up with a vaginal birth, I got 95% of the way and I was still so happy and proud of my body for getting to that point. I was just like, if they couldn’t even get him out with forceps, there was no way I was going to be able to do it. I was quite happy and content with the decision. They did say he had been down there quite a bit so he might come out not great. Because he was so far down, they did have to– and they did write the word “extract” him which I thought was quite an interesting term to use but the extraction was breech because he was so far low. He came out. His APGARs were 8/9. He was 7.4 pounds and a similar size in length to my first. I think we were there maybe for an hour or two in recovery. He fed straightaway and then we returned to the ward. On my notes, it said, “Repeat C-section due to failed TOLAC.” I was just like, I had that word “failed” but I understand that’s the terminology they used. It says that about an hour later, we had a debrief. They came back into the room and went through all of the happenings and made sure I was okay with it all. They actually discussed any future deliveries and the recommendation for an elective Cesarean. I don’t even remember that conversation. Meagan: Oh really? Lauren: Yeah. I don’t even remember so when I went back through my notes, I was like, “Oh, that’s interesting.” Then in the notes, it also says, “CPD?” I can’t pronounce that word either. Cephalic Pelvic Dysproportion. They said that and then they also said there was a small extension to the upper midline of my Cesarean incision. I had my normal scar and then it obviously had come farther up and it said it was sutured separately on the uterus. I’m reading it in real-time now but I didn’t realize that until my recent birth when I went back through my notes with my midwife. I was like, Well, that’s really interesting. They obviously told me but I must have not registered that at the time. Then obviously we were in hospital due to COVID so Josh wasn’t allowed to stay with us. An hour after his birth, he had to leave and being a Cesarean, I was in hospital for a few days and my other son, Nate, wasn’t able to come in to visit us. I really missed out on us being a family of four for those first few days. Yeah. We got home. I think I was in there for two nights then we got discharged. They met us at the hospital and that drive home was really special. That was the first time they met was in the car driving home. We always knew we wanted a third but it was a lot, the transition to two, and we probably weren’t ready straightaway. We gave it three years then when Call was two, we decided we would try again for baby number three. We fell pregnant really quickly with the first two so we just assumed that would happen this time and we were trying for a few months and it just didn’t really happen. We were trying for 6 months and gave ourselves a bit of a breather and just let it take its natural course because we took the pressure off and then the both of us were saying before the boys were born a week apart in May and we found out we were pregnant with our third in between the middle of their birthdays. It was really special. May has always been a special month but yes, we had Nate’s birthday. I found out we were pregnant then a few days later we had Call’s birthday. So it was really special timing. I knew I wanted to try again. It would be our last baby. If I was going to have a natural birth, it would be this pregnancy. I went to go through the same model of care that I was with Call, but they had changed their practice. The midwife group that I went to no longer existed. It was the MGP so Midwifery Group Practice. They were based in the hospital this time so all of my appointments were in the hospital and they were VBAC-supportive. I think we went in and then you still have to have your OB appointments around 36 weeks and we didn’t find out our gender with this one. We had the two boys and for our third, we weren’t going to find out what we were having. I had the same sort of morning sickness with my third. I was a lot sicker this time. I knew this time I was going to have a student-midwife and a doula. I got a visit. Obviously, The VBAC Community group on Facebook, I posted in there and I also posted in a Western Australia VBAC support group there about recommendations for student-midwives and doulas. Then I spoke to a few of them and then obviously whoever I felt that connection with, I went with them. The doula– I did research doulas with Call, but I don’t know why I didn’t do it that time. I think that would have made a difference. I was like, this is the time I’m going to do it and I’m going to have a doula. We did that. I did a bit of a refresher for the Hypnobirthing as well. I met my doula at about 25 weeks and we sat. We met at a park and we just chatted for hours. She had a VBAC as well herself. Meagan: Oh, that’s awesome. Lauren: Her second was a home birth and a surprise as well. She had a boy and then she had a surprise for her girl. So much was similar with our situations. I just felt like she was meant to be our doula. Yeah. So that was at 25 weeks and I think at 6 months, we had a suggestion of a fetal growth scan again which was the same and I was like, they were already preempting that but I was more prepared even if I went to that scan and it was a big baby that I would be okay with that. Then at 28 weeks, I did the normal blood test and the fasting for gestational diabetes. I didn’t have it with the two boys and I had it this time around. That was a bit of a surprise. I didn’t really know much about gestational diabetes. You have to do your three blood sugars after your fasting and the third one had to be under 8.5 and I was 8.5 so I was just on the cusp. I remember my midwife saying to me, “Who knows? If you had waited another 15 minutes before your blood test, you probably would have been fine.” Meagan: Yeah, it could have been lower. Lauren: I started snowballing with all of the things. I thought it was going to mean I was going to be induced for bigger babies and I didn’t want to be induced. I had gone to 40 weeks with the boys so I didn’t assume I would be having an early labor so I started really worrying about my chances of having a VBAC at that point. I did a lot of research and listened to podcasts with people who had gestational diabetes. I tried to get in a good headspace again. I just took it as a positive to eat healthier and watch what my weight gain and things like that this pregnancy. I had to check my blood sugar four times a day– after fasting in the morning first thing when you wake up, and then every two hours after a meal. I was able to manage it with just my diet which was really good so I didn’t have to have insulin. Meagan: Insulin, yeah. That’s awesome. Lauren: That was really good and then the diabetes, they were checking with me and I could change to testing every alternate day. Thankfully, I was able to manage it from that side but it just meant there was increased monitoring of the growth of the baby and my weight and things like that.I also had low iron which I never had with my first two pregnancies but this pregnancy was just a real curveball from the start. Yeah. So then at 29 weeks, I went in for my next appointment. I checked diabetes and everything was still fine. My youngest tested positive for COVID so that was a little bit of an interesting one. None of us got it which was really lucky so I didn’t know how that would go being pregnant and getting COVID. I had noticed I started to lose a bit of my mucus plug which I’ve never experienced before and it was quite early but my midwife said, “That’s fine. It doesn’t mean anything. It can happen. It builds back up again.” But that was a bit different and exciting. Then I think at about 32 weeks was my appointment with my midwife and that was when we went through all of my previous births just as a debrief. Meagan: Op reports.Lauren: Yeah. That was a bit of an eye-opener because I think those things that we highlighted in Call’s birth weren’t really brought to my attention until this one. You could see as my midwife was reading it that she wasn’t really aware of that either in the notes. It just said there was a sign of obstruction, a loss of station between the manual and the vacuum rotation, an inability to place the forceps, and an understanding of why the labor was abandoned and the vaginal birth. Then it says that a VBAC was not recommended. The midwives would still support me if I wanted to try for a VBAC after two and if I wanted an elective that they would support with that. I remember leaving feeling so disheartened. I was only 4 weeks away from my due date. I came home and I remember Josh and I talking it over and I was like, “Is it worth going through all of that over again just to get to that point of pushing and not being able to fit through my pelvis and being through a scary C-section again?” We went through all of our options and Josh was happy to support what I wanted but I was so torn. I didn’t know but I kept coming back to a VBAC. I just didn’t feel content with a Cesarean. I just said, “I’ll never know if I don’t try.” I spoke to my doula and I said that I was just frazzled. My head was all over the place. I had a good chat with her over the phone that stuck with me. She said, “Different baby, different birth.” Meagan: Absolutely. Lauren: I just kept saying that to myself. I think I listened to one of The VBAC Link podcasts and they said the same thing. It just was the right information that I needed to listen to at the time and the whole CPD with the pelvis. She said, “You don’t even have an official diagnosis.” She said, “That’s just somebody’s opinion as to why they are saying that the baby didn’t descend. He just wasn’t in a great position.” She highlighted that they broke my waters at 6 centimeters before he even descended which maybe led to him being even more stuck. All of these things, and then I remember just trying to focus on positive VBAC stories and get my head in the right space so I was listening to lots of podcasts at this point and I was following a lot of Instagram pages about pelvic mobility. I didn’t really do a lot of research about that with my first or my second pregnancies about your pelvic inlet, your pelvic outlet, internal and external rotation. This was all news to me and I really, really enjoyed that. It made sense that the pelvis is not rigid. It can move and I just kept visualizing that when I was trying to be positive toward this labor. I was doing a lot of exercises for only a couple of minutes at night before bed. I was doing a lot of window wipers where you lay back and rotate your knees from side to side, deep squats in the shower, I was doing a lot of lunges and just creating a lot of space and room that I felt like I could in my pelvis. I did a lot of visualization. I remember I just kept putting my hands between my legs and imagining feeling my baby’s head. I don’t know why I did that and it probably might seem a bit strange but I just really felt that and I was imagining going through labor and having that moment. Yeah. Meagan: It doesn’t. Lauren: That was really quite powerful at that point to get back on the right track for having a VBAC. There were two other podcasts I was listening to which are Australian-based– The Great Birth Rebellion and that’s really, really good, and The Midwife’s Cauldron. They just question a lot of things that are expected or standard and not to question. I thought that was really good. One of the ladies who does The Midwife’s Cauldron has a book called Reclaiming Childbirth as a Rite of Passage. I didn’t get all the way through it but it was another thing like finding your podcast. It just really resonated with me and everything I read, I felt was meant for me. It was really, really powerful. The two Instagram pages that I followed were The Body Ready Method and they have little reels of exercises and things to do to get your body ready. Then I got to 35 weeks. We went through my last appointment and I was happy to go through with the VBAC and that they would support me. They advised of the standard guidelines of having an IV, CTG monitoring, and regular vaginal examinations. At 36 weeks, I had my OB appointment and I had my growth scan. The baby was in the 90th percentile. I thought I was going to have to say, “I know they can be inaccurate.” But the OB wasn’t worried about that at all and he said, “Yep. Baby’s size is fine.” He discussed the pros and cons. He pulled out graphs and figures and I was like, oh gosh. Here we go. He’s going to tell me all of these problems. He was so pro-VBAC and supportive. He was from the UK and he said, “I came to Australia and I didn’t realize what the problem with VBAC is.” They are so supportive in the UK with VBAC and the hospital I was going to has a 60% VBAC success rate which I was like, well that’s pretty positive. I did my GBS screening and then he rebooked me in for 39 weeks. I’ll never forget he said to me, “I’ll see you at 39 weeks if you are still pregnant.” In my head, I was like, Of course, I’m still going to be pregnant because I went to 40 weeks with the boys so we will see you at 39 weeks and reassess.You don’t have a set obstetrician either so you get whichever one is there. I was really hoping he would be at my next appointment and when I went into labor. At 37 weeks, we went on a little holiday down south. It was a big drive. We came back. I was having regular chiropractic appointments I should say. I had my chiro appointment when I got back. I had been sitting in the car and she mentioned that the baby was sitting asynclitic which is the head tilted. I thought, Oh no. I was so focused on getting the baby in a good position. She said, “It’s probably because you were sitting for such a long time. It’s no concern.” She realigned me and then gave me some pelvic tilt exercises to get into the right spot. Then on the 14th of January which was around 37, just before 38 weeks, we had a meet-up with my doula again just pre-birth to run through everything. She got to meet Josh and we left feeling really positive and excited and happy with everything. She was on call. I got to 38 weeks. I had an appointment on Thursday with my chiro and then on Friday, I was working from home. I still had another week. I was sitting on the exercise ball pretty much all day doing lots of circles and pelvic tilts. I had maybe one or two twinges and I was like, Oh, that’s interesting. Nothing eventuated from that. Nothing through the night so I didn’t really read too much into it. The next morning which was the 20th of January which was 38+2, Josh had to go down south for work which was a 3-hour drive away. A lot of people were like, “Oh, that’s a bit dangerous.” I said, “Oh no, I’d rather he go now and be back for my due date.” I said that. I said, “I’d rather have you go now and be around for 40 weeks.” He headed off first thing Saturday morning. He did the drive. He did a full day’s worth of work. It just was a normal day. At 4:30 in the afternoon, I got two boys in the car. We went to the shops. I had to do a bit of shopping for a birthday the next day. Then at 5:00, I do Click and Collect. I don’t know if you have that but you do your grocery shopping. You pull up. They just put it in your boots and then you drive home. Meagan: Yes. We do have that. Grocery pickup is what we call it. Lauren: They came out from COVID and I just haven’t stopped doing that. It’s so handy with children. That was at 5:00. We did that. We got home. At about 7:00, I’m getting the boys ready for bed. They were in the bath. I was just tidying up a few things. I squatted down to pick a few things up and I had a bit of a leak. I was like, I just felt like I wet myself a little bit, but not a gush. Not anything. I had a pad on so it was just a little bit of water. I called Josh. I said, “I don’t know if this is anything, but maybe just have an early night. If things do start to happen, you might have to drive home early in the morning to get back.” This was at 7:00 then at about a quarter past 7:00, I sent a photo to my friends because they were out. I was just at home. I bought a special birthing robe. I just for some reason put it on that night. I was sitting on the couch in my birthing robe. I took a photo and sent it to them completely oblivious of what was about to unfold. I got the boys in their pajamas and brushed their teeth. We were getting ready for bed and it was about just before 8:00 and I had a little bit of a cramp so I was like, Oh. It was really weird because with my previous birth, I didn’t notice the contractions or take note of them for a long time. But at 7:55 was my first contraction and then 10 past 8:00 was my next one. I was like, Oh. That’s weird. It was 15 minutes later. The next one came 5 minutes later. I was like, That’s weird. The next one was 4 minutes. I was like, That’s weird. I stopped writing them down. I was like, Obviously, I’m not writing them down properly. I must be doing something wrong because that just can’t be right. During that, I must have gone to the toilet and there was a slight tinge of red in the bowl. I remember taking a photo of it being like, I’ll just keep it. Meagan: Like some bloody show?Lauren: Yeah, but not a lot. Really faint in the water. I took a photo because I wasn’t even sure if it was there. Then at about 8:20, I called Josh again and said, “Maybe start heading back because things might be happening. The contractions don’t seem like they are slowing down but we will just see what happens in the next few hours but it’s 3 hours so maybe start heading back.” I called my mum at that point as well. She was an hour up north. She never goes up there but she had just gone for a day trip so she was away as well. At that point, the boys were still awake and I couldn’t get them. I wasn’t capable of getting them into bed and doing all of that. I said, “Just pop on the couch,” and they were watching Bluey which is a TV show they love. They were watching that and I just hopped in the shower. It must have been 8:30 at that time and I called Megan, my doula. The plan was I was going to labor at home as long as possible and she was just going to meet us at the hospital. I called her and I just said, “Josh isn’t here. My mum’s not here. I’m alone with my boys. I’m going to try and put them to bed and focus and get into my breathing techniques and then I’ll check in and touch base with how I’m going.”That was about 8:30 then 10-15 minutes after that, I jumped in the shower and things started to ramp up quite a bit. I was really upset because I was in the shower thinking that would be my mode of pain relief and it just was not. Meagan: Uh-huh or slow it down. Lauren: Yeah, I’ve heard that as well. If you hop in the shower, it will slow down if it’s not the real thing. It did nothing and I was like, Oh no. This is not good. I remember thinking to myself, I just need to press pause. I just need to stop this because it can’t be happening right now because I’m literally on my own. This is not how it was supposed to happen. I was in the shower and then I had a little bit of a bloody show in the shower and then at that point, I called my doula again. I was like, “I think you need to come over. I just need a little bit of support just to watch the boys.” In my head, I was still thinking I had hours to go. In my head, I was like, If you could just watch the boys until Josh gets here, then you can head home and we can give you a call when we head into hospital. At that point, I got out of the shower because it wasn’t doing anything. The contractions started to feel different. It felt like I was having to bear down a little bit. I was like, Okay. But I still feel like I was oblivious because I just– it was so quick. In my head, it wasn’t happening that fast. I remember thinking, When I get to the hospital, I’m not going to be able to do this all night. I’m going to get the epidural because it’s too much. I got out of the shower and Megan had given me a TENS machine. I was like, that is in the bedroom. I’ll get the TENS machine. I couldn’t even make it to my bedroom to get my TENS machine. I was like, oh goodness. I put a nappy on and then I went and I sat down. I think I must have made it to the toilet so then I sat back on the toilet and that was a really comfortable, familiar place that I was sitting and I was sitting down there. That was really nice for the contractions to break through. My boys wouldn’t have known what was going on. They kept coming in and checking and asking if I was okay. I said, “Yeah, mummy is fine. I think the baby is coming.” They knew something was going on because I was making some noises. My eldest was a little bit scared but he was okay and then I was sitting on the toilet and I remember I had locked the whole house up. We’ve got a side gate security door and a front door. I thought, Oh my god. When Megan arrives, she’s not going to be able to get in. Nate found the keys for me and he gave them to me. He was so happy with himself that he gave me the keys and I managed through contractions to walk. It was probably 5 minutes to the front door and I only had a nappy on at this point. I was completely naked because I just got out of the shower and had a nappy on. I unlocked both doors. I was in a little side area and I thought, Goodness if anyone walks past and hears me and sees me– thankfully, it was late and nobody saw it but I don’t know how I managed to do that. I got back in and I was on the toilet. I think that was around maybe 8:50 at that point when I had moved to the toilet. The light was off in the toilet and the hospital bag I had packed had lots of candles and LED lights to have to set the mood. In the boys' bathroom, I have one candle on which is just for their nightlight if they need to go to the toilet. That was the little nightlight that I had on in the toilet. That was actually quite nice to have a dark room with a little candle on. At this point, I’m sorry. I unlocked the door at about 9:00 and then it was 9:23 that my doula arrived. She came in and my eldest son, Nate, ran into the door and he was just so excited that somebody was there to help mum. He’s like, “Mum’s there. She’s in the toilet.” I remember Megan coming in and she was so calm and she was so relaxed. She looked at me and she said, “Lauren, are you pushing?” I remember looking at her and I was like, “I think I’m pushing.” She just said, “Okay. I’m just going to call the ambulance.” She was on the phone and she was calling. I think in my head at this point, I still hadn’t registered it was that sudden. I still just thought I was– Meagan: And this has been maybe 2 hours. Lauren: Yeah. 2 hours. You can push for hours so in my head, I was like, We’ve still got hours. We’re fine. It was intense, but I was just so excited. Things were happening and it was all going. Then I don’t know how we got to it but we called my neighbor to come over because my doula was trying to support me but then the boys were there. She said, “I just need somebody else to watch the boys.” My beautiful neighbor came over. We are friendly but not in the middle of birth naked friendly. She comes and the toilet is off the hallway so I remember her walking in and she’s like, “Hi.” I was like, “Sorry, Adrienne.” I was pushing and she was walking off the hallway to sit with the boys on the couch. I was about to have a baby. It was so crazy. Yes. I think that was just about 9:30. Megan gave me some water and she was rubbing my back. She put a cold towel on my back and I was still sitting on the toilet at this point and my legs were quite shaky. I just felt a bit sweaty then I instinctively just got up to move to sit on my knees in the toilet and that toilet’s not very big. You can put your arms up and hold the walls. I was on there on my knees. I had one leg up and I was rocking, circling my hips. I was doing all of the things and just instinctively. I didn’t really notice that I was doing them. Then I think she had towels and she had pillows. She was still on the phone to the ambulance that were coming. I’ll never forget. The guy on the phone was just like, “Put her on her back. She needs to be. Can you get her on her back? You need to be able to see.” They were asking her to tell them when I was having contractions. I remember we were looking and each other and I’m like, “He can hear when I’m having a contraction. I’m starting to make the noises.” Megan would just be like, “Now.” He could tell when I was having contractions. Obviously, he had a script to read off but it was so obvious when I was contracting and when I wasn’t. The head wasn’t there but I could feel bulging. I remember putting my hand down there and I was just so excited and happy. I was just so calm. I don’t know how because none of it was planned. It was happening so quickly. I guess there was no time to really process it or even think about it or get scared about it. It was just happening. There were two paramedics that arrived. This was just before 10:00 at this point. I was there. I could feel bulging. There was still no head or anything yet. They came in and they turned the lights on in the toilet and I was like, “Oh no.” It was too bright. They turned it off. They looked at me and said, “Lauren, are you okay? Do you need anything?” I don’t even know if I could speak. I just shook my head. In hindsight, we couldn’t have gone. It was too late. We couldn’t have gone anywhere anyway but they just stood back. They turned the light off and they literally just watched which was so special. They didn’t interfere. They didn’t try to take over. They just sort of let me go and I don’t know how it happened but the doula gave the paramedics my phone and they recorded the birth. Meagan: Oh that’s awesome. Lauren: Yeah, which was not planned. I guess it was so special because Josh was still an hour away. Meagan: Yeah, and your mom? Lauren: My mum wasn’t there so at least they could see it. I’m so glad that they thought to do that and to record it. They were recording it and I was getting close. I remember in the video, you can hear me say, “I can’t do this anymore.” Obviously, I was very, very close and I put my hand down. I was just saying, “Ow, ow, ow, ow,” because I could feel the stretch. I know people call it the ring of fire but I tried not to think of it like that. I tried to just visualize the stretching of everything. Then I could feel the baby’s head and then I just remember sobbing because I was so happy. I could feel and I was saying, “Ow, ow, ow, ow,” and then her head– I didn’t know it was her at the time, but her head sort of popped out through my contraction. You could just see my relief. I was so happy and she cried. Her head was out and she made two little cries. Meagan: She did? Lauren: I’ve never heard of that happening before. Meagan: I have never seen that ever.Lauren: Yeah, it was incredible. Even the doula was like, “What in the world?” I knew she was fine at that stage. I heard the little cries then it was maybe a minute before the next contraction then I was like, “She’s coming out.” The doula had her hand under. She guided her head to me and then her shoulders and I just pulled her up to me. It was just– yeah. The look on my face. I just could not believe it. I had done it. I think I just kept saying, “Oh my god. Oh my god.” I just held her. I keep saying her but I held the baby. I just could not believe that she had come out just so quickly and so easily. I was so worried in the lead-up that the baby would get stuck or I wouldn’t be able to get the baby out and none of that was even in my mind at that point. She just was there. I was holding her and it was the most incredible, special moment. Even now, even when I hold the top of her head, I always remember feeling her head coming out. Yeah. I don’t even know if I’m doing it justice because it was just the most incredible feeling. I was holding her. Our neighbor brought the boys down so within the first minute, she’s walking down the hallway and she had Nate and Call and they were both in the doorway of the toilet looking at me holding their little baby. My youngest sort of looked in and was like, “No.” He just walked away. It was all a bit much for him. Then my eldest walked straight in. Stuff was everywhere and he was so brave. He walked straight in and was like, “Mummy had the baby. The baby is here.” I said to him, “We don’t know what it is. Do you want to have a look and see if it’s a boy or a girl?” He looked down and I said, “Is there a vagina or a willy?” He looked down and the whole time he said he thought she was going to be a girl. He goes, “I think it’s a girl.” He looked down and I don’t know what he saw, but he said it was a boy. I was like, “Is it another boy?” He must have seen something that he thought looked like a willy. Meagan: Maybe an umbilical cord or something. Lauren: Yeah, maybe the cord or swelling but they get quite swollen so he might have thought it looked like little testes so he said, “It’s a boy,” and Megan whispered something in his ear and in that split second, I was just like, Oh my gosh. It’s not a boy. I’m like, “Is it a girl?” I just couldn’t believe it. The fact that she was such a surprise, her birth, and the way she came, and then that she was a girl as well and then we were just sitting there in the toilet for so long and then we were like, “Oh, we’d better call Josh.” Megan was like, “I’ll call Josh.” She said, “You need to pull over Josh. Can you pull over?” He was on the highway doing 110 to get back to us. He was like, “Okay.” So we FaceTimed him and I’m just sitting on the floor holding Wren on the toilet saying, “She’s here. We had the baby.” He was so happy. He was still an hour away. My mum– I think we just sat in the toilet. My mum arrived 20 minutes after she was born. She just came and sat on the floor of the toilet with me. We just sat in there. She couldn’t believe it. Then about maybe 40 minutes after, we walked up and I was able to sit in my own bed and I sat in the bed. They were sort of a bit worried about the placenta and things like that. I hadn’t birthed the placenta yet. They asked if I wanted to cut the cord. I said that I wanted to leave it as long as possible until it goes white. We were hoping for Josh to come at that point so then I was sitting down. I stood up for a little bit and I remember my mum was in the bed with me and my doula was there. I said, “Oh, I’m so sorry. I think I need to do a number two.” Then she was like, “No, I think that’s your placenta.” Meagan: Probably your placenta sitting in there. Lauren: The placenta came straight out and she caught it in one of my mixing bowls because we didn’t have anything prepared. She stayed attached to that for a while. Because they had gestational diabetes, they had to do a heel prick on Wren. Her sugars were fine. Josh was still about an hour away. We didn’t even have a capsule for the car so I hadn’t picked up the capsule so we got transferred because she came so early. We got transferred to the hospital in the amublance and Josh met us there at 10:30. I should say she was born at 10:09 which was just pretty much 2 hours. Meagan: So 7:40-something to 10:09. Lauren: I remember the midwives when we got to the hospital were like, “Why didn’t you know?” I was like, “I just had no idea that it was happening that suddenly.” Now looking back, obviously, the signs were all there but it wasn’t happening that quickly in my head. We got to the hospital and Josh got to meet us at the entrance and it was so special. I just still could not believe that it had happened and I was on this high. I was just so incredibly happy. We went in and they just didn’t know what to do with us. They didn’t know to put us in labor and delivery or to take us to the maternity ward. We went to labor and delivery. They did all of the assessments. She was my biggest baby. She was 7.8 pounds so 3.5 kilos compared to the boys so it’s quite funny that Call wasn’t able to come out but she was able to come out. I think it was just positioning and I was relaxed. I was at home. I didn’t have any interventions or anything played a huge part in it. They did an assessment. I think her APGARs were in the hospital but she was 10 and 10. She was perfect. They did assess me for a tear and I remember saying, “Oh, I don’t think I teared,” because in my head if I had torn, I thought it would have been a painful feeling. I actually had a 2nd-degree tear which I didn’t realize so I had to have some local anesthetic which was probably the most painful part of it all. It was excruciating. I had to have stitches for that and then just a superficial tear at the top. Josh actually went home at that point because we still had a few hours before we could get discharged. He drove 3 hours in the morning, worked the whole day, drove 3 hours, hadn’t slept for 24 hours. I said, “You go to your parents. Have a quick sleep.” He came back. They did a few checks on Wren. She had to go to the special care nursery just for some monitoring really quickly because there was a difference on some of her monitoring with her heart rate. They did an echo which came back fine so there was no follow-up. It must have been a funny reading. They were all fine so I think we got discharged at about 9:00 the next morning. She was born at 10:00 at night. We went to the hospital at midnight. We left there at 9:00 in the morning and were back home literally within a few hours with the boys. It was just so surreal and so special compared to the other two birth experiences that I had. One, to be able to get up and walk around and just do things without being conscious of a scar and recovery and things like that and even when I walked in home– because my mum had stayed at home with the two boys, she said, “You don’t even look like you just had a baby.” I just felt like I was on top of the world. It was such a different experience. I remember saying to her that obviously I didn’t know what it was going to be like but now that I’ve experienced it, I can’t imagine going through life never having experienced that and having birth that way. It was just so– I remember a few of the midwives looked at me as if I had planned to have a home birth and I was like, “Absolutely not. There was no way I would have planned it like that with no support, with nobody here.” Meagan: Yeah. You’re like, I would not have planned to do that. Lauren: My boys didn’t know anything about natural birth. I was going to the hospital to have a baby and coming back with their baby brother or sister. There was no way that I was– that was a bit funny. I was like, no. It was not planned. It was all very sudden. I remember my doula said to me in the coming days after Wren was born, “How special for Wren to have been born that way and then also for your boys to just see that their sister was born at home and that it wasn’t a scary experience. It can be calm and it can be peaceful and it can be special and it didn’t have to be some scary thing.” I remember it’s so funny the people who I would tell the story to after. They would be like– you could tell people’s reactions about their views on birth. They’d be like, “Oh, how traumatic for you. That would be so scary.” I was like, “That was the least traumatic birth out of the two.” It was so beautiful. It was everything and more that I ever could have dreamed of. I wanted to try for a natural birth and I remember saying to Megan, “I had a VBAC.” She was like, “You had an HBAC. You pretty much had a free birth.” Meagan: Seriously. You did. Lauren: I didn’t have my obstetrician or midwife or anybody. Someone was like, “How did you know? You didn’t have any exams? You didn’t know how far along you were? Who delivered the baby?” I was like, “I did. I did it all.” It was so unplanned but so perfect the way that it happened. Even my mum was like, “I don’t think you’re ever going to get off.” I was just on cloud 9 for so long. I was like, “I think it’s going to be forever. I just don’t think it will ever change.” I think it’s so special after having a Cesarean. I don’t think it’s the same. Meagan: There’s something about it for sure. Lauren: I think only someone who has had a Cesarean can relate to not thinking you can do it or not being able to do it and then actually being able to do it. I remember in your podcast, I think after your birth, you told your obstetrician, “I don’t have a small pelvis” or “I did it” or there was something that you wished you could have said afterward to them. Meagan: I said, “Screw you.” Lauren: I just remember thinking that. Meagan: And then “I did it”. Lauren: I said, “What small pelvis? I can push a baby out.” It’s so empowering and I just literally think I even posted it in The VBAC Link Community. I remember all of the comments were like, “Never stop telling your story.” People need to see more positive, good outcomes of births because you don’t hear about that. You just hear about the scary things. Meagan: Yeah. Lauren: Yeah. Every time somebody asks, I’m like, “Are you ready for it? Because I will keep talking about it and I will love talking about it.” Yeah. I just think it’s something that should be heard and experienced by women if they want to. Obviously, it’s completely your own choice but if you want to, you should be able to try and have a VBAC. I think it’s such an incredible experience and I’m so glad to share my story because I honestly don’t think I would have thought that I could have done it or that it would be possible without listening to the stories that you had on your podcast. It just gives you so much confidence that it’s possible and that you can do it and that people do it all the time. People didn’t even know what VBAC was. “Are you allowed to have a VBAC?” It’s just such a funny concept now. Yes. If they are having a private obstetrician, I’m like, “Maybe have a look at your options.” I could go on and on. Meagan: I know and there are so many times that we doubt ourselves. We doubt ourselves. we get in our heads and it’s because we’ve been told those things. We’ve been made to feel like we’re not able to. Then on top of that, we have things on our op reports like CPD or failure to progress or we’ve got a special scar now so she should definitely never do this and now she’s got gestational diabetes on top of this so then we’ve got a bigger baby. When it’s all said and done, look at you. Lauren: That’s what I remember thinking. None of that came up. At the end of the day, that was such a high risk and issues to be scared of and at the end of the day, we didn’t tell the paramedics I had Cesareans. They were like, “Is there any medical history?” Then afterward, they were like, “Oh my goodness.” I was like, “But it wasn’t scary. It shouldn’t have been a scary situation.”Meagan: It doesn’t have to be. Lauren: I understand there are situations where it can be but the fact that there was none of that and you do. You get it all in your head and you think, I can’t do this and you’ve heard all of these things but I do think I was so much more mentally prepared for this birth than I was for my second birth and I think that was a huge difference being in your head and believing that you can do it as well. Meagan: Absolutely. I echo that completely. And then to add in, I know you added some books to recommend and things like that. Another one that I would recommend is the Real Food For Gestational Diabetes by Lily Nichols so that’s a really great one. If you are listening and you have had gestational diabetes in the past or you were maybe just diagnosed, this is a really, really great book for gestational diabetes parents. Thank you so much for recording with us today or tonight in your sense or actually in the morning. It’s now 12:15 in the morning. Oh my gosh. Your story is amazing and I agree. Do not stop sharing it because that was true physiological birth. Lauren: Yes. It was everything. Meagan: That was complete and there are so many things about your story where, “Okay, I’m now on the toilet and I have to go all the way down to get the door unlocked.” Those things were probably actually helping your situation and helping your babies. Keep these things in mind, Women of Strength. During labor, walk, crawl, move through your labor because it really can help impact the way your baby comes down. Thank you so much again for sharing your story. Congratulations and I hope that you have an amazing sleep tonight. Lauren: Oh, thank you so much for letting me share. I love everything that your community that you have created has done. I’m so glad I found it because I definitely attribute my births to that. Thank you so much. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
01:16:4123/09/2024
Episode 336 Katie's 2VBAC After a Breech Baby + Induction at 41 Weeks

Episode 336 Katie's 2VBAC After a Breech Baby + Induction at 41 Weeks

As a first-time mom, Katie was struggling with potty training and feeling like she didn’t know what she was doing. She later became a potty training consultant to help other struggling moms and now hosts the Burnt Pancakes podcast. Katie’s first birth was a scheduled breech Cesarean. Her second birth was a spontaneous 36-hour labor at 39 weeks and 1 day with 1.5 hours of pushing and a tough recovery from a 3rd-degree tear and labial adhesions.Katie wanted to go for a VBAC again with her third. Though she thought she would go into labor at 39 weeks spontaneously again, she actually ended up getting induced at 41 weeks. She got an epidural right at the end of her labor, but was able to push her third son out in just two pushes!Meagan and Katie talk about how pelvic floor physical therapy is necessary for both Cesarean and vaginal birth recoveries. No matter how long it’s been since you gave birth, it can still be a game-changer!Katie's WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome, welcome everybody. We have our friend, Katie, with us today sharing her 2VBAC stories and before we got started, we were talking about once you have that C-section and you’re contemplating having a VBAC and you talk to people and they’re like, “Wait, you can’t do that. Doctors won’t let you do that.” Right? Katie: Mhmm, yep. Meagan: But what have we learned? What have we learned over all the years? Yes, we can. Yes, you can. Women of Strength, if you are listening and you have had one C-section and you are wanting to know your options, we are going to share two stories today. Okay, so Katie– you guys, she is the host of a podcast. Is it Burnt Pancakes? Katie: Burnt Pancakes, yep. Meagan: Tell us more about that. Katie: Okay. So when I became a mom, my oldest son was potty training and it was an absolute disaster. That’s probably the point in motherhood I felt the absolute worst. He had a tendency to poop his pants whenever we were in my friend’s backyard running around and playing. One day, he had this awful mess. I was cleaning it up. I was frustrated. I was like, “Oh my gosh. He’s never going to get it.” My friend looked at me and was like, “Katie, don’t worry about it.” Everyone burns their first pancake. I was like, “That just made me feel so validated as a mom.” Fast forward about 8 years and I decided to start my own motherhood podcast and I named it “Burnt Pancakes” because we are all figuring out this thing as we go. Meagan: I love that so much. It’s so true.Katie: So true. I’m still figuring it out. Meagan: I know, every day. As soon as I feel like I’ve started figuring out motherhood and parenthood and all of that, it starts to change on me. Katie: Right. It throws you for a loop. Meagan: Right. If you can relate here, go listen to her podcast and it’s just called “Burnt Pancakes”. And you are everywhere, right? Katie: “Burnt Pancakes”. We have mom-versations each week. I love to chat with moms. One of my favorite things to do was meet a mom at a park and hit it off and start chatting. That’s what I wanted my podcast to feel like– real moms chatting about motherhood. Meagan: Real moms chatting about motherhood. Then maybe was the inspiration between that whole experience with your son what led to also potty training consulting? Katie: Correct. At the time, I was teaching. I taught for 17 years. It was potty training my first son which was an absolute disaster. But fast forward, I have two more kids. I potty trained them and things got easier. I started feeling very confident in my skills and people started asking me for tips. I decided to become a full-time potty training consultant so now I actually help moms with the potty training process which blows my mind because if you had asked me 8 years ago, “Would you be doing this?” I would have said, “Heck no. I have no clue what I’m doing.” But what I am doing is trying to help moms who are in the same shoes I was in. You can do this. I can help you get through it. I have the answers for you that I didn’t have back then. Meagan: Yep. That’s exactly how we are here at The VBAC Link. We were in the thick of it. It was a rocky journey. There were a lot of unknowns and if you asked me 8-9 years ago if I was going to be doing a podcast sharing VBAC stories, I probably wouldn’t have said yes. I would have been like, “Probably not,” and here we are inspiring and encouraging. Katie: Heck no. Meagan: I’m so excited for you. So tell us where people can find you for potty training because I’m sure a lot of people listening right now especially being pregnant, you probably have a toddler as you are preparing for your birth. Katie: Yes. You can find me at my website. My website is burntpancakes.com. On social media, you can find my potty training information at @itspottytime. Meagan: I love that. Thank you so much for sharing. Katie: Yeah. Meagan: I do have a Review of the Week to share before we get into these stories. Katie: Go for it. Meagan: This is by theblanchardbunch. It says, “Get PUMPED!!!” It says, “Listening to this podcast just gets me pumped. You’ve had a C-section and you want a VBAC. Absolutely. You’ve had two C-sections. You go for that VBAC. Oh, you’ve had three or four? Go get that VBAC, mama, because you are a queen and 100% capable. Seriously, this podcast not only informs you of all the amazing things our bodies can do but also, you are immediately welcomed into a space of understanding and love. Our bodies are powerful but sometimes we just need a little help becoming empowered. This podcast does just that. I’m preparing for my VBAC and I’m currently 36 weeks pregnant. I think that all the time what I’d say or share if I were on the podcast because I am so sure this VBAC is happening. Thank you to all of the mamas who have shared their stories and thank you to Julie and Meagan who have created a space for all of these mamas needing to be uplifted and empowered.” What a fun review. Katie: Aww, that’s amazing. Meagan: Oh my gosh. I love this. It’s in all caps right here. “GO GET THAT VBAC, MAMA, BECAUSE YOU ARE A QUEEN AND 100% CAPABLE.” I couldn’t agree more with theblanchardbunch. I hope that you got your VBAC. Congratulations on your birth and as always, if you have a review, I would love for you to share it. I read them every single week and they really do truly bring me all of the joy. Katie: I love that. Meagan: Okay, Ms. Katie. Let’s turn the time over to you. Let’s share these stories. Katie: Okay. Well, my story starts 10 years ago. It’s really hard to believe it’s been that long but I was pregnant with my first son and we got the news at 28ish weeks that he was breech which I at the time didn’t even know what that meant. It was just a regular appointment and my doctor just nonchalantly was like, “Oh, he’s head up. Okay, you’ll probably end up having a C-section.” Meagan: Whoa. Katie: I was like, “Come again?” First of all, what’s head up? I don’t know. Meagan: At 28 weeks? Katie: Yes. Yes. Crazy. She made it seem like no big deal but for me, it was. I’m a taller girl. I’m 5’9”. I’ve always had bigger hips, a nice pear shape so I always thought, One day, these hips are going to serve a purpose. When I’m giving birth, these things are going to come in handy. My instant thought was, My body is not going to be able to do that. How can you just drop that on me and not feel anything? She basically said, “Most babies won’t turn. There’s a chance he could turn but you might just end up having a C-section.” I was like, “Well, is there a chance? What’s this?” She’s like, “You can try something to turn him but that’s just the way it was.” Meagan: No offering of an ECV or anything like that in time? Katie: As the weeks went on, she mentioned it, but for her, she was like, “I’ve been doing this for years. Most of the time, I don’t see them turn.” She just made it seem like a C-section was totally cool and totally normal. I was like, “What? How can this be?” I did try almost everything to get him to turn. At the time, I was taking a yoga class. Side note– Drew Barrymore was in my yoga class. Looking at you right now, I’m like, “You look so much like her.”Meagan: I’ve been told that for so many years– Drew Barrymore and Winona Ryder. Apparently, those two people I look like. Katie: When you hopped on the call, I was like, “Oh my god. You look like Drew.” I tried to play it super cool because at the time, we were living in LA and I was like, “Oh my god, Drew Barrymore is right next to me.” She even said something to me like, “Hey, mama.” I tried to play it so cool.Anyway, in that yoga class, all the moms were like, “You need to go see this chiropractor. You need to try this.” They were super supportive so I did go see a chiropractor. I forget what they called the procedure but it was massaging your hip flexors really, really hard. I don’t know why that makes him turn. It was loosening some ligaments to make them turn. Meagan: Like your round ligaments and stuff? Katie: Yes. I believe that’s what it was. It was extremely painful and the chiropractor at the time was like, “You’re going to do great in birth because you have excellent pain tolerance.” I was like, “Okay, thank you.” He did not turn. At the time, there was a website called Spinning Babies. Meagan: There still is. Katie: Okay. I literally Googled everything to get him to turn. I lay on my couch with my hips up. I had my husband sing to me “Turn Around” over and over. I did everything. He did not turn so in April, they were like, “Okay, here’s your scheduled C-section appointment.” I at least had time to prepare for the C-section. It wasn’t an emergency. I took all the notes on tips to do to help recover and in that sense, I felt prepared and I got to be at peace with the fact that I wasn’t delivering vaginally. But it was still weird when they were like, “April 26th. That’s going to be the day when he comes in.” I’m like, “You’re picking his birthday. What if he’s not ready at 39 weeks to come?” Then two days before, “Oh hey, the doctor has an opening on the 25th so we’re going to take you on the 25th.” I called my husband, “They’re changing it to Friday.” Meagan: It’s a weird feeling for them to be like, “Hey, you are going to have your baby this day around this hour.” Katie: Yeah and it was earlier than the due date so it just felt really weird. Meagan: Was it a week before?Katie: It was a week before, yeah. He was born at 39 weeks and 1 day. I still wonder. His sign– I can’t remember which one it is but the sign he was born on was not what he could have been born and it just doesn’t match up. He seems more like a Taurus than this and I’m like, “Is it because they chose when you were going to come?” We showed up that Friday for the C-section and of course, I got to do my hair. I got to take a shower so that was nice. You show up at the hospital and they’re like, “Okay, your 8:00 appointment.” You’re like, “Am I checking into a hotel here or giving birth?” I never once felt a contraction. I mean, it’s weird to say I was sad that I didn’t feel that because later I learned what that feels like and I’m like, “That was fun.” Meagan: It sounds weird but at the same time, it’s this natural feeling that we’ve been taught and told that our body does so you mourn that. Katie: Yeah. I want to feel it. That was it. I was mourning the fact that my body wasn’t doing what it was supposed to do. A weird thing– we did the hospital birthing class. It was 4 hours. They talked about C-section for maybe 5 minutes of the whole class but then they said, “3 out of 4 people will have a C-section.” That was the statistic from the hospital. I was like, “Oh, well that’s not going to be me.” This was before I knew he was breech. That’s not going to be me. But I’m like, Why would you spend only 5 minutes if 75% of us end up in a C-section? How is that possible? Yeah. It felt weird. But I did go in somewhat prepared. It still felt very sterile and scary but we had him via C-section. He’s totally healthy. There were extra doctors in the operating room just because he was breech so there were four pediatricians. My husband was like, “The room was filled. It was pretty crazy.” But he was healthy. He was fine. Everything turned out great. I do feel like with a C-section though, I was completely out of it for 24 hours. I don’t remember my parents coming. I vaguely remember but my husband was like, “Your mom and dad were here.” I was like, “Oh gosh, they were.” I vaguely remembered. Meagan: That’s how I was too. I was in and I was out. Katie: Yes. I didn’t breastfeed him for the first hour until they got me to the other room and they were like, “Oh, were you planning on breastfeeding?” I didn’t know that I could breastfeed him in the first few minutes. I wasn’t aware. The recovery for that was a lot harder. Just getting out of bed to go to the bathroom the first day was excruciating. But we were fine. I recovered from it and it was all good. Moving 3 years forward, we got pregnant with our second kid. I found out I was having a second boy which for anyone who has experienced gender disappointment, it’s a real thing and it’s totally okay to mourn the loss of a daughter or just feel unsure about the gender of your baby. I remember crying. I got home from the ultrasound and was just bawling because I was like, This was my girl. Where is she? This is a boy. It did take me a couple of months after he was born before I was feeling pretty good with it and that’s a normal feeling. I think no one really talks about that. But it was a totally normal pregnancy. What we did discover from the first one is that I had very low water fluid in my amniotic sac so they said that could have been the reason. My second son, I definitely didn’t have that because I put on about 40 pounds and was much bigger. I was able to stay super active during that pregnancy doing boot camp and lifting weights until the last month. We moved from LA to Orange County so I had to get a different doctor for this pregnancy. The doctor I saw from day one was like, “If you want a VBAC, we can absolutely go ahead and try that.” She actually more encouraged it. Everything I had heard when I had the C-section was, “Your son was breech so that doesn’t mean you can’t deliver naturally in the future,” but a lot of hospitals and doctors were kind of hesitant about it.” This doctor was like, “No. I don’t see any reason why you can’t try.” You do have to sign your life away pretty much. I had to sign a thing saying these are all of the things that could happen and that is terrifying. Meagan: I’m accepting that. Katie: Yes and it’s my liability here. The doctors are off the hook but she was very supportive about it but she never made me feel like I couldn’t do it. His pregnancy went just fine. I went into labor naturally right before the 39-week and 1-day mark. I actually had him at 39 weeks and 1 day exactly the same as the C-section so it made me feel a little bit better like I didn’t take my older son too early. I was always worried, Did I take him out too early? I did have a lot of baby blue and a little bit of postpartum with my first and sometimes I wondered, Was it because of the C-section? I don’t know if there’s any science behind that. He wasn’t ready to come yet. Meagan: You guys didn’t have your bonding. Your body didn’t naturally go into labor. There are a lot of things that could come into play. Katie: All that ran through my mind. Yes. Yeah. Meagan: But sometimes those who go into labor still get those postpartum depression and baby blues. Katie: Totally, yeah. Absolutely. I went into labor and this one was about 36 hours. It was very long. I didn’t realize that a few hours into getting contractions, my water actually broke. I thought I peed myself. I was sitting at home laboring and laboring. Things were just taking forever. I was having regular contractions. They weren’t as close as I thought they were supposed to be. I don’t know what it is. I don’t know if other moms feel this but when you go into laobr, it’s almost like you go into the zone and it’s like, I’m just doing this thing. My husband was like, “Should we call the doctor?” I was like, “No, not yet. I don’t think we are supposed to.” I was just in the thing. Meagan: You’re focused. Your focus shifts. Katie: Looking back, I should have called the doctor the second I went into labor just to get tabs and figure out when I should go in but I was just like, “No. We’ve got to keep waiting. I don’t feel like I’m ready to have him yet.” We finally got to the hospital hours and hours later and they were like, “Oh, your water broke a while ago.” I ended up being in labor with him for a very long time. I ended up pushing for an hour and a half. I do remember at one point they said, “Okay, if we can’t get him out, we will have to go and do a C-section.” That was like, no. I really, really wanted this. I didn’t do a whole lot of preparing. With the first one, we did the classes. I did research, but this one was kind of like, I’m just going to go in and trust my gut. I’m just going to see what happens. I was totally prepared that if it was going to be a C-section, I knew what to expect but I really wanted to see if my body could do it. I remember the nurse kept saying, “You’ve got to keep your eyes open when you push.” For me, it just felt so unnatural to keep my eyes open. I just wanted to scrunch up. She was like, “Relax your face and keep your eyes open.” I was like, “That doesn’t feel right.” I think my son had a giant head. He still to this day has a larger head than my oldest son. It just was hard to get him out but he finally came out. I gave birth to him. I was able to walk around so much quicker and the recovery was a lot better. I did end up having a third-degree tear so it’s not like vaginal birth is less damaging than a C-section. I have scars from both kids. Meagan: Not always. Katie: But it was so nice to know, I know what it feels like to go through it. I had an epidural with him. I think I was maybe 5 or 6 centimeters so it’s not like I ever got to crazy intense contractions and I didn’t feel anything when I was pushing. Part of it was I didn’t feel anything when I was pushing and I think that was kind of hard because I didn’t feel anything to get him out. Meagan: Sometimes that can play into tearing actually weirdly enough and then the lack of ability to push in a position if we are in a back crunch position. We are putting more pressure so if we do have a baby with a little bit of a larger head or is having a harder time coming out– which by the way, first-time moms, you guys, 36 hours with an hour and a half of pushing is crazy but it can be very normal. Katie: It’s normal. It’s so normal. I think what was hard for me was I looked at the clock when I started pushing because I had friends who were like, “Oh, I pushed for this long. I pushed for this long.” With my third, I decided, Don’t look at the clock. Don’t think about how long it’s going to take. It’s just going to take as long as it needs to be, because it was an hour of pushing. One thing that was kind of scary is that his heart rate would go down every time I’d push so they were like, “This could be dangerous.” Another thing was that I might have to get him out sooner so they would have me push for a contraction and then wait on a contraction. It was literally 6 minutes in between pushes. It just took a long time. But he was a healthy little boy and all was good. We thought we were going to have two kids. Everything was wonderful and then a year later, my husband was like, “Okay, are we ready to get rid of the baby clothes?” I’m like, “Umm, actually, I don’t think we are done yet.” Part of me still wanted a girl but I just did not feel like our family was complete. It was the weirdest feeling because we had always said, “We are going to have two kids.” We’ve got a three-bedroom house. It just made sense. Then we both decided– we had a little talk. If we were to have another kid and it ends up being a boy, are you okay with that? We were both like, “Yes. I feel like three is what’s going to make our family complete.” I was a little bit older. At the time, I was 38 so I’m like, “If we want a third, let’s try for it this year and if not, that’s a sign.” We did get pregnant with the third. I did not find out what I was having on this one because I was like, I have a feeling it’s going to be a boy and I don’t want to feel that disappointment again while I’m pregnant, and if it’s a girl, what a fun surprise to wait and find out. We didn’t find out. I don’t know if anybody else feels this way, but I had dreams about having a boy. My mom gut was like, You’re going to be okay with another little boy.  I kind of knew, but I still wanted to wait. This pregnancy went fine. With my middle, I was all for working out and going to boot camp, and felt really great. With this one, I was like, I’ve got two kids and I am exhausted. I put on more weight than I ever had. I could not move around. I hurt the most. I had the worst pelvic bone pain. Meagan: SPD?Katie: Probably. Probably, but I did not really speak up. I told my doctor, “Oh, I’m feeling some pain.” She was like, “That’s normal during pregnancy.” Now, looking back, I know people who saw a chiropractor during pregnancy and I’m like, “That’s what I needed.” Meagan: Or even pelvic floor. Katie: Yep. That’s what I needed because for a year after having him, I would get pain when I would walk and I’m like, I wish I had known that there was something I could do about that. So if you are feeling pain, speak up because I could have done something about it. With this one, I was very large. I was ready to have him. I got to that 39-week mark and was like, He or she is coming. I know it’s any day now. Then my due date hit and he was not there yet. The doctor was like, “Oh, you’re already dilated. It’s coming soon.” She stripped my membrane and was like, “Oh, in a day or two you’re going to have him but let’s just schedule an induction in case.” We get to 41 weeks and still was not having a baby. Having two at 39 weeks and then having to wait until 41 was an eternity. It felt like the longest wait ever. I think this was God’s way of saying, “You’re done now. You’re good,” because I remember feeling like I never wanted to be pregnant again. I am never giving birth again. This is the last time and I felt very complete with that whereas with the second one, it was like, Is this really the last time I’m going to carry a baby? Is this the last time I’m going to give birth? It felt really nice. I was still seeing the same doctor I was seeing with my middle son. She was on board. She was actually telling me that if you’ve done a VBAC and then you have another one, it’s not considered a VBAC. Is that what you’ve heard?Meagan: No, it’s still considered a VBAC but your risks go up. Your risks go up for vaginal birth and down for things like uterine rupture. Unfortunately, you’re always going to be a VBAC. Katie: Yeah. Okay, so risk went down. Okay. But she was totally on board with it. I had to be induced with this one. I literally have tried everything. I’ve had a C-section. I’ve had an epidural birth and I’ve had an induction. I can’t say that one is better. I feel like they are all part of my birth stories. Each one is special but I had to do the Foley bulb. I had to almost not get the epidural. My water broke a couple of hours into the hospital and then a contraction started very fast. I remember waiting for the anesthesiologist and going, “If he doesn’t get here, I’m having this baby.” As he was giving it to me, I felt like I needed to push. I didn’t say anything because I was like, I really want the epidural, but I was literally like, Oh my god. I have to push. I have to push. This is so hard. I actually did feel the worst contractions with that because I was literally at the end. After he was done, the nurse came in and I was like, “Hey, can you check me because I think I feel like I need to push?” She checked and she was like, “Let’s get the doctor. You’re ready.” It was like, epidural and now it’s time to push. My husband was actually getting food because they didn’t allow him in the room when I got the epidural so he was like, “I’m going to go get breakfast.” I’m like, “Cool, cool.” Then I’m sitting there like, “Umm, is he going to get back in time?” They were like, “Let’s do a practice push,” and I’m like, “He’s not here yet!”I got him out in one and a half pushes and there was my third boy. It was just such a different experience going from, I’m going to have to push for 3 hours. With this one, I remember thinking, I’m just going to let my body do what feels right. I’m not going to have the nurses tell me to push this way and do that. I’m just going to close my eyes and scrunch my face like they tell me not to do, but it felt so much easier. I remember asking her, “I did my practice push. Did that do anything?” She was like, “Yes. Please stop. I need to get my gloves and I need to get this.” So he was out and I had my third boy. I would say with the two vaginal births, my recovery was so much easier. Just hospital-wise, I was able to move around a lot faster. With my middle son, I was able to go to the park with my boys a week later whereas with the C-section, I don’t think I left my house for the first 6 weeks because I was so uncomfortable and it didn’t feel right. All three births gave me scars but in a different way. Meagan: Yeah. I actually really love that you pointed out that even with vaginal birth, there can be an extra recovery or extra things because I think sometimes in this world, it’s like, C-section is bad. C-section is bad. C-section is bad. VBAC is amazing. VBAC is wonderful. Okay. Absolutely. I believe that VBAC is amazing and wonderful. I do not believe that C-section is bad. I do believe that we have way too many unnecessary C-sections and that is bad. Katie: Right. Meagan: We know though that vaginal birth sometimes isn’t all sunshine and butterflies. We have tearing. We have prolapse. We have pelvic floor dysfunction for the next however long because we pushed for 2.5-3 hours or even an hour and a half or we labored for a really long time and we are sore or whatever. Sometimes C-sections can be just the most healing and beautiful experiences for someone. I love that you pointed that out. It’s just important to remind everybody listening to go with what you feel is best. No, you don’t have to schedule a C-section just in case. No, you don’t have to do these things but if you want to and that’s what feels right, do it. We encourage you. Katie: I absolutely did not have any incontinence problems after the C-section but after the vaginal birth now, doing jumping jacks and running is a different story. Yeah. It’s different. Meagan: I want to talk about that because I also didn’t have a lot of incontinence. It’s not like I have incontinence now but I have pressure and things like that. I just went to a pelvic floor specialist and she said– oh crap. What did she call them? My bones, the birthing bones, they are my pelvis, but my pelvis was stuck in a flared state from birth. Katie: Oh whoa. Meagan: She manually closed my bones. It was insane. I could feel it. She was like, “Oh, there’s no give. Can you feel it?” I was like, “Oh my gosh, yeah.” She worked it, did her PT thing and closed these bones. She said, “Sometimes people have these bones get stuck open after birth and it puts a lot of trauma on their pelvic floor and they have incontinence and all of these things.” Katie: Whoa. Meagan: She did two other things which blew my mind. I’ve never had that happen with a pelvic floor specialist before but my uterus was really, really hard and she was like, “It should move and float within.” She massaged my uterus and then she went internal and my bladder was adhered from the inside. Even though we have C-sections, Women of Strength, and you have had vaginal births and everything, if you’ve had that C-section, there is a likelihood of you having adhesions or scar tissue in there that may cause pelvic floor issues and incontinence. So anyway, my bladder was adhered and then there was a part of my cervix that needed to be released. She was like, “I wonder if that’s why you had such a long end.” My cervix would stretch but it wouldn’t stay. Or she said, “I see this a lot with failure to progress or cervical lips where there is this thing that needs to be released.” As soon as it was, I can’t even tell you the difference in how I feel. Katie: Wow. Meagan: The pressure is really pretty much gone. I would say there is maybe a little. She even said, “The next visit might need a little bit more tweaking.” I just ran the other day, 3 miles for the first time in forever. Usually after 1 mile, my pelvic floor would just give out. I did fine. Katie: Don’t you wish that was something every OB/GYN was like, “Okay, you’re going to see me and you’re going to go here”? Or you give birth and it’s not like, “6 weeks, you’re good.” It’s like, “Oh, now you need to go see this.” Meagan: Yes and it’s not talked about with C-sections either. A lot of time those C-section scars can cause back pain and pelvic floor things, urine incontinence, pain during sex, and things like that. We don’t even know that it’s related to our C-section because we’ve never pushed a baby out of our vaginas. Right? It’s so crazy. Katie: My youngest is 4 and I’m like, I should finally book that PT consultation and just find out what’s all going on down there. Meagan: Yes! My VBAC baby is going to be 8. At this point of this recording, he is 8 and here I am this year just going. I have done physical therapy before and pelvic work but I’ve never done it to this extent where I was like, Okay, I’m going to get down to the bottom of this and had results like this this fast. Katie: Whoa. Okay, let me ask you a question. Did you go through your doctor or did you just search and find one yourself? Meagan: I did search and find one myself. The craziest thing is I did call to see if insurance would cover it. They do not. It’s all out of pocket. So like you said, I feel like this should be a standard thing regardless of C-section or vaginal birth. It should just be part of our postpartum care. I actually think it should be part of our prenatal care. Katie: Totally. Oh my gosh. I know. Someone I know was getting really bad pains so she went while she was pregnant to PT and I was like, That’s exactly how I felt a year ago, because she was having it after me. I was like, I wish I would have known about that, because that would have really, really helped. Meagan: Yeah. Chiropractic care for sure. Pelvic PT. Know that not every birth is going to be amazing and beautiful but all we can do is prepare and understand. Katie: Right. Right. And be at peace with whatever is meant to be. I look back at my C-section. I tell my husband this all the time. If we would have lived on the prairie, I would have died during that breech birth. It would have been almost impossible to deliver him. I did seek out, are there any doctors who deliver breech babies? In LA there was one, but to me, it just felt a little too risky to even go down that route. 100 years ago, I might not have survived childbirth so the C-section for me was a lifesaver. It was so comforting to know that. My first vaginal birth though, I did have some complications after so just because you deliver vaginally doesn’t mean it’s a piece of cake and it’s over. At  my 6-week appointment, I remember telling my doctor, “Something doesn’t feel right down there.” She was like, “I’ll check it out. Let me see.” I was like, “No, really. Something feels wrong.” My labia actually, part of it fused together. She said there were probably mini tears and it literally was. I was like, “I just don’t think the hole is big right now.” She was like, “Oh, yes. I see what you’re talking about.” It literally fused together. She was a teaching doctor. She worked for a hospital so she was like, “We never see this. Do you mind if I take a picture for my students?” I was sitting there with stirrups. She was like, “I won’t get your face or say your name.” I was like, “Yes. For science, yes. Please take a picture of this.” I ended up in just the hospital visit where she had to cut it and then sauter it back together. I was able to do it in the doctor’s office. It was a super easy procedure, but I was numb during that and the recovery from having an open wound in that area when you’re peeing is not comfortable. So being 6 weeks postpartum feeling like, I should be getting back to normal, then oh God, this. Meagan: There are always hurdles. Katie: It’s not all roses when you deliver naturally either. But I was happy that maybe some other mom– because it was extremely embarrassing. I didn’t even want to have my husband look or tell my husband what this was but being able to share it with other moms, they were like, “Why doesn’t anyone tell you that stuff like this happens?” And thank God for modern medicine because again, had this been the prairie, I would have never had another child after that. Meagan: Might have been too traumatizing. Yeah. It’s just so hard to know. Everybody internalizes and processes differently their births and their experiences. Do the research. Get in your head in a good space. Find your provider and do the things and choose the birth that is right for you. Katie: Absolutely. Absolutely. Meagan: Thank you again for sharing your stories. Congrats. Katie: Oh thank you. Meagan: Definitely go see a pelvic PT. Katie: I’m booking one today. It’s time. It’s time. Meagan: It’s time. Women of Strength, I think it’s really important that sometimes we forget this. We deserve to give back to ourselves. After having a baby, it’s a really big deal. It’s a really big deal no matter how you have this baby. And then on top of it, the lack of sleep and feeding a baby, all of the things. Remember to give back to yourself. Katie: Yeah. Yeah. I learned after my third. It took me three kids that asking for help is okay. I remember with my first I felt like, I don’t want to ask for help because they’re going to think I don’t know what I’m doing. I didn’t know what I was doing. By the third, someone was like, “Can we start a meal train for you?” I’m like, “Yes. Please do. Yes. I would like everything.” “Can we take your kids to the park so you can have some time?” “Yes please. Let me know what time you’re picking them up.” Meagan: Yes. It’s okay to say yes. It’s okay to take breaks. Well, thank you again so much. Katie: Thank you so much for having me on. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
38:2218/09/2024
Episode 335 Meg's 41+3 VBAC & Babies Born 17 Months Apart

Episode 335 Meg's 41+3 VBAC & Babies Born 17 Months Apart

In today’s episode, Meg from Nebraska shares her Cesarean and VBAC story. Meg’s first birth was an unexpected Cesarean after an almost 40-hour induced labor at 41 weeks and 3 days due to failure to descend. Her pain was not managed well during her surgery and her experience was much more difficult than expected. Meg surprisingly found out she was pregnant just 9 months after her Cesarean. Though she was anxious, Meg decided to go for a VBAC. She found The VBAC Link, prepared her body and mind more than before, found a supportive provider, and hired a doula. At 41+3, Meg went in for a gentle induction. She trusted the outcome would be different and it was. With the help of her doula, Meg was able to move much more, and with the encouragement of her midwife, pushing was a much more successful experience this time around. Meg says that bringing her 9-pound, 14-ounce baby up to her chest was the sweetest and best moment. Asynclitic BabiesHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello everybody. Welcome to The VBAC Link. Today we are going to be sharing our friend, Meg’s, story. She is a stay-at-home mom in Omaha, Nebraska and she has a two-year-old daughter who was born after a post-date induction and almost 40-hour labor that ended in a Cesarean. Just 9 months later, she was blindsided by a positive pregnancy test and spent the duration of her pregnancy preparing mentally, spiritually, and physically for the birth of her son. She had a VBAC and she is here today to share her story with you. Some of the things along the way through her story that I thought stood out were one, post-dates. Obviously, this is something that we– if you have been here at The VBAC Link, you’ll know that we talk about this. Post-dates– we have seen such a shift over the last few years, well really since the ARRIVE trials in dates and we really see that now the 39-week mark is more true to a 40-week mark. The 40-week mark is more treated like a 41-week mark and it’s really starting to become rare to even have people go to that 41-week mark and especially past it. She’s going to be sharing her story with you today actually with both births that went past 41 weeks. They were actually both induced so we have an induction that turned Cesarean and an induction that ended in a VBAC. She also has that close duration– that 9 months later, 17 months apart. So if you are listening and you are one of those mamas who may have been pregnant by surprise or chosen to get pregnant sooner than the 24-month mark or even 18-month mark that many providers suggest, definitely listen up for this episode. She also has a larger baby. Her VBAC baby was larger than her Cesarean baby. She also has a failed epidural. There was something that she said in her story that I wanted to point out. That is after many, many, many attempts that were not going well with this epidural, she asked for the highest anesthesiologist there. That is something that you can do right from the get-go. If you are wanting an epidural, you can say, “Hey, I want to make sure I have the top anesthesiologist,” because sometimes it is harder for people to place an epidural or if after one attempt it’s not going really, really well, you can just say, “Okay. Stop. I want the head anesthesiologist.” Another thing that we are going to talk about in there is the question. She mentioned The VBAC Link blog that talks about the questions for your provider. If you have not checked this out yet and you are still looking for a provider, I highly suggest checking it out. We will make sure that the link is in the show notes so that you can see more about who you are looking for when it comes to support versus lack of support because if we have not learned anything over all of the years of supporting VBAC clients, our own VBAC journeys, and listening to story after story, that is that support is huge so make sure you find the best supportive provider that you can. Something I wanted to add to this is if you have a female provider, you may want to ask them about their births if they have kids. We have seen here in Utah that there are some providers who will just schedule a C-section. They won’t even go into labor and for some reason in my head, that feels like a red flag if a provider doesn’t even believe in birth and their own ability to birth. I don’t know that they are going to believe in other people’s ability to birth so that might be something to consider. Last of all, I want to talk about asynclitic. We have seen many asynclitic births over the year and a lot of the time, once a baby is recognized to be asynclitic, they are pretty low and it can be a little bit harder to get a baby rotated and into a more ideal position for a vaginal birth. I wanted to share some tips that are right here actually on Spinning Babies. Check out spinningbabies.com. You know we love them and we will have a link here in the show notes as well. Do pelvic floor releases and the side-lying releases. Something that is really, really cool about this story is she had her pelvic floor specialist who was also becoming a doula but she had her with her which is so cool. If you are seeing a pelvic floor specialist, I highly suggest asking them if they would be able to visit you during your labor or come and do an exam or treatment during your labor. Just like chiropractic care is a really, really great one to do during labor, so are pelvic floor releases. You want to follow that with the lunge. The lunge will help you work better with the pelvic floor and help that side-lying release become better engage. Doing the dangle should follow the pelvic floor release and the lunge. Again, Spinning Babies is phenomenal and they have all of these like the dangle, what that is, and the lunge and all of these things they have in the link. Make sure you check out this link. Sometimes resting and not pushing is going to really, really help because if we have an asynclitic baby and we are pushing and pushing and pushing, that can get the baby further down and more stuck in the asynclitic position. Something that I have seen work with my own clients is an abdominal lift. We will do an abdominal lift into that side-lying release. You reach your hand underneath your belly and you slowly reach. You pull up and in and it can help pull baby up and in. Vertical positions such as standing, slightly bending your knees during a surge and also that abdominal lift is more ideal during a contraction. Standing with one foot on a stool, we know that asymmetrical movements are really, really great. Even if you can’t stand, say you are in a bed or something like that, you can try on your hands and knees or even trying to lay down and try to make your hips asymmetrical that way. Sitting on a toilet with one foot on the stool and the other foot on the floor, pulling on a towel or a rebozo during a pushing contraction, shaking the apples, and keep moving. You’re going to notice in this story that is what they did. They just kept on moving. If you have had an asynclitic baby before or you are in labor and you find that your baby is asynclitic, jot these notes down. These are wonderful tips on how to get that baby out of that asynclitic position. All right, right before we jump into this story, I do have a Review of the Week. This one is from srmnewyork and it says, “Thank you, VBAC Link.” It says, “My first birth in 2018 was a traumatic home birth turned emergency C-section. I had done everything I was supposed to to avoid interventions and a C-section but ended up with all of it anyway. The whole experience was crushing and it took years to recover from. Listening to The VBAC Link was a huge part of my emotional processing. Hearing other women’s stories helped me feel less alone and gave me the courage to try again. When I became pregnant in 2022, I knew I had to do things differently. I took all of the advice I had gotten from The VBAC Link and put it all into action. I got a doula. I found a VBAC-supportive provider. I took the VBAC online course and was emotionally prepared and surrendered to the birth process. Well, just 12 days ago, I had my VBAC. It was amazing and left me euphoric for days. So much of my success I owe to this podcast. Thank you for helping me experience my dream birth. I am forever grateful.”That was left just about a year about a year ago so srmnewyork, if you are still with us, I just wanted to give you a huge virtual hug and huge congratulations. Thank you so much for sharing that amazing review. As always, if you have a moment, please press pause right now and leave us a review. We love them and love sharing them on the podcast. Meagan: Well, welcome, Meg, to the show. Thank you for being here with us. Meg: Yeah, it’s great to be here. Thanks, Meagan. Meagan: Oh my gosh. I’m so excited to talk about your story. I feel like two key things about your story are things that we see honestly on a daily basis in our inbox. That is, “I’m 40 weeks and my provider is telling me that I have to have a baby today,” so the post-date thing. Can we go over post-date? And then honestly, the stress surrounding the close duration of babies is insane for moms out there because these providers are just putting so much stress on these moms saying they can’t VBAC with a close duration and we know that studies vary, but I am excited to talk about your stories because you have a 17-month gap, right? Meg: Yes. Pretty tight, yep. Meagan: Okay, so we’ve got the post-date and 17-month gap. All right, let’s talk about baby number one. Meg: Absolutely, yeah. So with my daughter, we found out that we were pregnant just a couple of months after I had a miscarriage actually. So going into that pregnancy, I was already feeling just tender and raw and didn’t really know what to expect with how well the pregnancy would go. I did as much as I could to prepare. I took a birth class that a friend had recommended with a doula here in town and really just sailed through that pregnancy. Everything was healthy and good. There was never any real concern from my providers but there was always in the back of my mind, What could go wrong here? Yeah, I was just anxious going into that whole labor. Meagan: Do you think it was from your previous loss? I know it’s very common after a loss where you do have that feeling of, I just want this baby so badly so I don’t want anything to go wrong.Meg: Yes, absolutely. At every appointment, I was holding my breath waiting to hear the heartbeat, and every time it happened, it got me through to the next appointment. I had actually with that previous pregnancy seen a practice of OBs and then shifted my care to the midwife practice at the medical center here in Omaha. For me, that shift helped reset a little bit for these different stories. With the midwives at the med center, you see a rotating group so you never know who is going to end up being at the birth. They want you to see all of the midwives for your prenatal care. There were definitely some who I connected with more than others. I was definitely hoping and praying that I would get the one who I bonded with the most and also was hoping and praying that labor would happen naturally. Unfortunately, I ended up at post-dates with my daughter. I was 41 weeks and 1 day when the midwives wanted to go ahead and induce me. I went in for that induction and it’s kind of funny because I think I expected that induction to go a lot more smoothly than it ended up going. I had heard of one of my husband’s coworkers who had been induced at the same hospital a few weeks before and her induction went just right as rain. She had her baby within 6 hours. Meagan: Oh wow. Meg: Was she a first-time mom? Meg: Yeah, she was a first-time mom so I was like, I can do a 6-hour induction. That sounds great. It did not go that way. We went in for my induction at 7:00 in the morning. They started me on Pitocin pretty much right away. They basically said that my cervix was ready enough that they didn’t need to do any cervical ripening or anything like that. I was like, Okay, here we go. Pitocin– I know you’re not really supposed to go on Pitocin, but I’m here for this induction so I have to do what they tell me to do. It was just me and my husband so we just went with the flow and we just hung out. We watched TV while we waited for the Pitocin to kick in and they came and did their checks every once in a while. I felt like I was in a good headspace at the beginning and was ready for whatever to happen. When they came in and did the first cervical check, I think it was maybe 6 or 8 hours in. I had made little to no progress so I was pretty discouraged by that but I was like, Okay. We’ll just keep rolling with the Pitocin. They had to amp up the Pitocin almost as high as it would go and things gradually started to pick up but I think at one point, they took me off of the Pitocin and did a little Pit break or reset my body. I think that did help. When I went back on the Pitocin, it definitely ramped up my contractions more. About 15 hours into all of this, they did another cervical check. I was like, Surely I’m going to be 8 centimeters. I’ll be into transition soon. I was still 4 centimeters. I was extremely discouraged at that point and I was exhausted. I hadn’t had any pain management up until that point. I was like, Okay, I think I’m ready for the epidural. I don’t think I can do 15 more hours of this. If I’m only at 4 centimeters, I’m not even halfway there. Who knows how long the rest of this labor is going to go? I ended up getting an epidural. They let me take a bath before my epidural which I was really grateful for because that’s what I originally wanted my pain management to be was hydrotherapy and at the time, I couldn’t be on Pitocin and be in the tub. That was the last little shred of comfort that I got before being grounded to the hospital bed. I was able to get some rest then with my epidural and just laid there in my bed. One of the nurses came and she tried to do all of these rotating moves to help things along and I was just exhausted. I didn’t want to have anything to do with it. They tried the peanut ball. They tried rotating me and all of this. My daughter was handling the labor really well. I was just so burned out after so many hours of everything. At one point though, they decided, “All right. We’re going to go ahead and break your water and see if that gets things moving.” They did that and then they placed a fetal monitor in her scalp which just didn’t go super well. I think the midwife tried– I don’t know. She tried for a while and my husband was really upset with how long it was taking and how much pain that I was in. Meagan: Oh yeah. Meg: The nurse at one point was like, “Should we call OB and see if they can help you out with this?” The midwife was stubborn and she didn’t really want any help with that. She did finally get it in and things moved along great but I was definitely put off by that lack of humility for lack of a better word. I just wanted to have the best care that I could. Yeah. Basically from there, my daughter was doing well again, but toward the end of everything, I finally hit 10 centimeters. I was ready to push. I was so excited. They took a picture. They were like, “All right. This is going to be your last picture as a family of two.” I look like a beached whale in the picture. It’s the most horrific picture I’ve ever seen. Meagan: Aww, I bet you don’t. Meg: But we were excited. We were like, All right. The time has finally come. At this point, I think I had been laboring for 25 hours so I was ready to push. With the epidural, for some reason, I just didn’t have a ton of mobility. Obviously, with some epidurals, you have mobility and some you don’t. With this one, my legs were dead weight so pushing was extremely challenging. Yeah. I pushed for a while. I felt like I wasn’t getting any feedback from my midwife or the nurse. My sweet husband was just like, “You’re doing great. You’re pushing so well.” My provider– I felt like I was staring into a blank face. Nobody is making any sort of encouragement and for me, that was just like, I don’t know how I’m doing with pushing. They say everything is fine but I’m not getting a lot of encouragement or feedback. At one point, they brought the mirror because I thought, Maybe that will give me some good feedback. I hated the mirror. Meagan: You did? Meg: For some reason, I was thinking, Oh, if they’re bringing the mirror out, you must be able to see the head. That’s why they would bring the mirror out. No. You could not see the head. You could not see anything so I was just like, What am I just staring at? I don’t want to look at this. Meagan: Maybe they did it a little prematurely because a lot of the time they bring it out and it can help you. They say it can lower pushing time because you are seeing it and there’s that connection. Meg: Sure. Meagan: I could see how that would just be frustrating. Meg: Oh man. It was terrible. Meagan: You’re like, What am I looking at? Why am I just looking at myself but nothing is happening down there? Meg: Yep. Not great. I had them take that away and continued pushing. I think I ended up pushing for almost 3 hours and at that point, my husband and I were like, “What do we do next? This is clearly not working.” My midwife was like, “Well, let’s call in OB for a vacuum delivery consult.” We’re like, “Oh, great. That’s not a C-section. This will be great.” We waited probably for an hour. They told me not to push while we waited for the OB and she was attending to some other matter in the hospital. We just kept asking, “When are they coming? When are they coming?” They sent I think a resident to come and check things out. By this point, I had so many hands up my vagina. I was like, “If she’s going to check, if this resident is going to check my cervix and then the doctor has to check the cervix, can we just skip one of them and just have the OB check so I don’t have to have that many hands?” Thankfully, they respected that and we were able to wait for the OB. Finally, they came in and we’re thinking, Okay, great. She’s going to do this consult and we’ll get the vacuum going. She came in and was basically like, “It’s not possible for us to do a vacuum delivery at this point.” My baby wasn’t low enough for that to even be feasible. So then she was like, “Let’s check for forceps delivery.” That wasn’t going to be feasible either. She basically said they wouldn’t be able to fit the forceps around her head the way that it was. Meagan: She was too high. Meg: She was too high and I think she was also asynclitic so she just wasn’t going to come down. After hemming and ha-ing, she was like, “You could push for another hour and then we could attempt a vacuum but we might still end up needing to do a C-section.” We were like, “I don’t really want to keep pushing for an hour if a vacuum is a maybe and probably not.” At that point, we basically decided, “Okay, we’ve been laboring for so long. It doesn’t seem like these are going to be feasible solutions,” so we just decided to go back in and have the C-section. I just remember that being a whirlwind process of them getting me ready and I was in so much pain from having pushed for so long that I was just shaking. My shoulder blade just had raging pain while we headed back to the operating room. I just remember feeling everything. I know they had me on an epidural. They had me on pain meds but I felt like I could feel the tugging and the pulling. I was apparently very verbal during the process asking for more pain meds. My husband actually works at the hospital so he knew the anesthesiologist. He is a critical care pharmacist so he is very familiar with medications. He was advocating for my pain meds at that point. Things just didn’t go well during that whole process. They did finally pull my daughter out and they held her up to the clear plastic. I just remember she grabbed my little finger through the plastic. Meagan: She did?Meg: Yeah, it was so sweet. They pressed her up and I just stuck my hand up. She grabbed my little finger and after all the trauma from the whole day, that was definitely the bright spot in getting to meet her. Yeah. It was kind of crazy. Then afterward, they rolled us into recovery and I ended up being in the hospital for 3 or 4 more days just from recovering. We had nurses and doctors all say, “You can attempt a VBAC. You should try a VBAC with your next baby.” I was like, “Hold on. What’s a VBAC? I just had a C-section. Why are we talking about my next baby?” Yeah. I didn’t really know what I wanted at that point. Meagan: Yeah. Meg: Yeah. I was just trying to wrap my head around the disappointment of everything going wrong and just feeling overwhelmed with feeling like all of the things that I had hoped and planned for the birth didn’t go as I had hoped. Yeah. So yeah. Meagan: So eventually you did decide, Okay, baby number two. Did you decide? Meg: We didn’t. Meagan: That’s a legit question actually, right? Meg: My next pregnancy was definitely a surprise. I had spent a lot of time trying to actively work through my recovery with my C-section. I had seen a core and pelvic floor therapist. She and I actually became really close. She worked with me for months. I mean, probably really from my birth until my next birth she worked with me. I felt like I was just starting to recover and I remember the day that I found out I was pregnant. My friend and I had gone shopping all day. I was just exhausted coming home from this shopping trip. I was like, I feel like I’m next level exhausted. Maybe I’m pregnant. I took a pregnancy test just on a whim. My daughter was napping. My husband was on the couch. I was like, This is probably going to be negative. I’m just tired from walking around all day. It was positive and I was shocked. I called my husband into the bathroom and I was like, “I’m pregnant.” He was definitely shocked too. I think I was more devastated because I was like, I’m just recovering from this C-section. Meagan: 9 months out, yeah. Meg: Yeah. My immediate response was just fear and anxiety about giving birth again. I wasn’t sure if I wanted to attempt a VBAC because I wasn’t sure if I wanted to go through another 36-hour labor to just end up in a C-section again. For me, preparing throughout that pregnancy was critical just preparing emotionally, physically, and mentally. The doula who had taught the birth class for my daughter, I ended up hiring her right away. I was like, “Are you available? I know I need a doula.” I started listening to The VBAC Link. She recommended your podcast and your website so I knew that I wanted to have a doula in the picture. I had pastors and family and friends praying for us for this decision about whether or not I should attempt a VBAC and I also just spent a lot of time. I felt like for me, I really needed to wrestle through some of the spiritual aspects of what I had gone through during my daughter’s birth. I found a couple of books that were a really huge encouragement to me as a person of faith just thinking about the concept of birth through scripture. One of the books was called Holy Labor by Aubrey G. Smith. She walks through doing some spiritual exercises to prepare your heart and mind for the process of birth. I think that was just something that I hadn’t really done with my daughter so I wanted to spend some time really preparing for this birth and making sure that I was seeking the Lord’s guidance and submitting to what I felt like He was asking me to walk through with this birth as it wasn’t something that was in my plan to have this birth so close together. For me, that definitely helped prepare my heart and my mind. I also spent some time with guidance from The VBAC Link. I looked through the questions that you guys have for asking a provider about if they are truly a VBAC supporter or not and with it being a team of midwives, with it being a research hospital and a teaching hospital, they are definitely very pro-VBAC. Several of them had VBACs themselves so I definitely felt like I had a great team of midwives who were going to be advocating for me through my labor and delivery. I found out partway through my labor that my pelvic floor therapist was also training to be a doula so I invited her to the birth as well. We had quite the posse with my doula, my pelvic floor therapist, and then this team of midwives. I think in the process too, I’m not sure who recommends it. I’m sure I heard this on your podcast as well. I started doing all of the Spinning Babies exercises pretty early on. I was trying to eat better and walk more and just be healthier in every aspect of that pregnancy. Something that happened during my labor at the med center was that they approved water birth at the hospital and then also included VBAC moms in that so I was super excited to try a water birth. I had wanted to use hydrotherapy with my daughter so getting the opportunity to do that for my next birth, I was really excited about. Throughout the process too, my midwives were very supportive about waiting as long as I could to start labor. I really wanted to labor naturally. I did not want to go through another induction but as we were getting past 40 weeks, I think I went in for at least two membrane strippings before 41 weeks. I think at basically 40 weeks and then midway through the week, I went through and did another one of those. I definitely started to have more contractions after those, but nothing that was picking up and getting ready for actual labor. They basically started encouraging me, “Let’s go ahead and schedule your induction.” I remember just being so upset about that and also really not wanting to have the midwife who I had previously. For me, I felt like I needed to have a clean slate going into this to try and attempt a VBAC. Two of the more senior midwives, I ended up meeting with them. I had my regular prenatal appointment and then the one came in and joined us. They basically helped me talk through my fears around induction and my previous experience. They really listened to what had happened and they really wanted to make sure that I had the support I needed going in to attempting this VBAC.Basically, we plotted out, “Okay. We are going to do the induction on this day.” It ended up being 41 weeks and 3 days. The midwife who was going to be on duty throughout that weekend, it was a Saturday. She was going to be there Saturday and Sunday. I would have her basically regardless of how long my labor took. She was going to be there. To me, that was a huge encouragement. She was actually the midwife who I hoped to get with my daughter. I felt really good about scheduling that induction even though I really didn’t want to. Yeah. I basically just tried to do everything I could before that. In that week, I was walking curbs. I was doing my Spinning Babies. I went and I talked to my doula. I was like, “Is there anything else you recommend to try to get this labor going?” I had been drinking my raspberry leaf tea. I had been eating my dates. I had been doing all of the things and she recommended acupuncture. Meagan: I was going to say acupuncture maybe? Meg: I went and I tried it, yes. I saw the chiropractor throughout. I had basically been doing all of the things you guys recommend and my doula had recommended throughout my whole pregnancy. The acupuncture was not helpful. It felt like torture for me. I was just sitting there. I think it did start some contractions because that night I felt a lot more contractions but then they waned off, unfortunately. Yeah, so then Saturday morning, the day of my induction, I was finally mentally prepared for, Okay. I’m going to go in and do this induction. I have my doula. I have my pelvic floor therapist. My husband is going to be there. I know the midwife. I like her. I knew that I was going to have this great team there for me. I’m in the tub just getting ready psyching myself up and I get a call from the hospital. They basically were like, “We’re going to need to push your induction.” I was so mad. I’m finally ready for this induction. Please don’t push this induction. We waited. They were like, “You’re on the top of our list to call in. You’re 41 weeks plus 3 days. We definitely want to make sure that you get induced today. Call back if you don’t hear from us.” I think we did. I think we called back two or three times like, “Hey, are you ready for us yet?” They were like, “We’ll call you. Please just wait.” We finally did. I think we went for a walk that morning. We spent some time with my daughter and my mom who was there to stay with my daughter. We enjoyed the morning and we finally sat down to lunch I think and we got the call that they were ready for us and they asked, “How soon can you get here?” We made our way. We put my daughter down for a nap. For me, that was a really sweet moment. I didn’t know if I would be coming home from a vaginal birth or a C-section so I wanted to pick her up and put her in her crib one last time, then leaving her knowing that she was asleep and going to be fine during my labor. Yeah. We went for the induction. I think when we got there, they did their initial checks and all of that and started with a membrane sweep. At that point, I was 4 centimeters, 50% effaced. Meagan: Oh, that’s good. Meg: Yeah, I was pumped that I was starting from 4 centimeters. I was like, Okay. I’m not going to labor for 15 hours and still be at 4 centimeters probably. Yeah. We all started in really high spirits. They started Pitocin. This time, they had it where I could walk around with it which was really nice. My doula had me walking the halls. We were squatting. We were leaning over the bed. We were sitting on the ball. We were doing everything. She was like, “I’m going to work you to get this baby going.” We did that for a couple of hours. I basically didn’t want to get checked for as long as possible. We labored as much as we could. I think we started that at 2:30 in the afternoon. At about 6:30, I started needing a little bit more help from everybody with counterpressure and all of that, then I was requesting a cervical check. I started to feel like something was going on. My midwife came in and did the cervical check. She told my doula because I was like, “I don’t want to know if it’s bad news.” My doula was like, “Do you want me to tell you?” I was like, “I suppose.” I was still at 4 centimeters but I was 90% effaced. Meagan: Huge progress. Meg: Yeah. For some reason though, I was so stuck on the fact that I was only at 4 centimeters that I was like, “90% is nothing.” Meagan: Oh my goodness. From 50 to 90, that is huge progress. Meg: Yes, so I was like, “Okay. We’ll just keep going how we’re going.” She was like, “Do you want to try the tub?” I was like, “Oh yeah.” For some reason, I was thinking I was going to love the tub because I was thinking I could just lay in the tub and relax. My doula was like, “No. You need to be squatting in this tub.” I just could not get into a position in the tub that I was enjoying. We got out of the tub and just labored on the toilet. That, I think, is where I spent most of the time actually. Meagan: Dilation station. Meg: Yeah, there you go. My husband and I would just sit in there in the bathroom and just talk and giggle. He really kept me in high spirits throughout the whole labor. I was definitely getting to a point though. I think it was a couple of hours after that first check and I started asking for the epidural. My doula was like, “I think we should wait. You’re doing really well.” I’m like, “I’m not doing well.” My husband, the pharmacists that he is, was like, “What else can we try? Can we try some nitrous?” I was like, “I don’t think I’m going to like nitrous. I don’t know if I’m going to be able to do that.” We were mulling over that. They did a second check at 10:00 PM and I was finally 5 centimeters. I was like, “Okay. We’ve bumped up the centimeters.” I was 100% effaced so I was like, “Okay, things are moving. I don’t want to do an epidural yet.” So we started on nitrous. I labored on nitrous for a couple of hours. That was going well at first. I was in bed because I was just so exhausted at this point. I remember on the nitrous, I could definitely feel pain but I did not care. Meagan: Yeah, it takes the edge off. Meg: Yes, yeah. It was kind of wild. I would have these thoughts while I was on the nitrous like, Oh, this is horrible and everything is going to be terrible, but then the contraction would pass and I would be like, Oh, everything is fine. It was such a wild experience. At that point, they were setting up the table for baby so I was thinking, Okay, they’re setting up the table. I must be really close if they are setting up the table for this baby. I was in so much pain and I was like, Surely I am 9 centimeters and we are getting this room ready for this baby. I think toward the end of that couple hours, it was almost 1:00 AM, I was definitely starting to not cope as well. Even with the nitrous, I was screaming and rigid and couldn’t handle it. My midwife mentioned pain management. She was like, “I think we should do a cervical check and maybe it’s time to think about an epidural.” I was like, “Finally. I’ve been asking for this for hours,” even though I didn’t want to do it in the first place. Oh, I forgot to mention in all of this, my birth plan was to have this water birth. While I was on nitrous, they roll in this birth tub which is one of those soft-sided which I think was a home birth tub. They started filling it with this tiny hose. It was going to take hours for this thing to fill to the point in which it was going to be therapeutic. So I basically took one look at that tub and was like, “Yeah, that’s not going to happen.” It was kind of disappointing. I had really wanted to try a water birth. I thought that was going to be so sweet. This is going to be my story. VBAC, first water birth VBAC at the med center since water births were approved. I just let that dream die a little bit. I’m like, If we just have a VBAC, I’ll be fine. Yeah. They placed the epidural. They checked me. I was 8 centimeters finally. I was like, Okay. This is moving more quickly. They placed the epidural so I could get some rest and it worked for a little while then it did not work. So they came. Anesthesiology came and tried to problem solve. They were moving me all around trying to get me in a good position to see if that was the problem. My doula was just horrified during this whole situation. She was like, “This should not be happening.” I think they ended up calling in basically the head anesthesiologist finally who was like, “Do you want me to place it again?” I was like, “Yeah, why haven’t we done that yet?” So then they placed it again and then it was the perfect epidural. It made the pain manageable but then I could still move around. I got a nap at that point and then we did another check after I took a nap so this was at 4:30 in the morning. They came in and did the check. I was at 9 centimeters so I felt really good about that. I think they put me on Benadryl at that point because there was some swelling from when I was on nitrous. I think I was subconsciously pushing while I was on the nitrous so they were like, “I think we’re just going to try to calm this down a little bit.” At that point, my midwife mentioned that if I didn’t make progress in 6 hours, we might need to discuss a C-section. I was just devastated. I’m like, “No.” As soon as my midwife left the room, I talked to my doula and I was like, “Okay, what do we need to do to prevent the C-section because I absolutely don’t want to do that again?” For the next 2 hours, my doula, our nurse, my pelvic floor therapist, and my husband every 30 minutes were rotating me into a different position. I was on the squat bar. I was over the top of the bed. I was side to side with the peanut ball. I mean, seriously, we did not stop moving basically that entire time. We set the goal of 2 hours to have another check. I think during that time, I had my arms over the back of the bed. I looked down at my belly and was like, “All right little boy, let’s do this. I want to meet you today and I don’t want to have a C-section.” I was kind of whispering to him. My doula was like, “You’re going to meet him today. It’s going to be okay.” Yeah. Finally, it hit 6:30. The midwife came back in and I was basically there. I was a 9 or a 10 with an anterior lip. It went away with contractions so she was like, “I think let’s wait to push and let your uterus do a little bit more work.” We set the goal to start pushing at 7:30. In that hour, I was psyching myself up to push because, with my daughter, I had obviously pushed for 3 hours and still ended up in a C-section. I was excited to push with him but I was also like, This isn’t over yet. We might still have a C-section here.” It hit 7:30 and I think I started crying. My doula was like, “This is a different birth. This is going to go differently than it did with your daughter.” I think I had my husband come over and pray with me. We started pushing. My midwife did not leave my side from that moment on. My team during that whole time was my husband on one side and then my doula and pelvic floor therapist trading off on the other side. My midwife was doing some internal counterpressure to help me feel where I needed to push which after my last pushing experience where I had zero feedback, her telling me exactly where to push every time was such a huge encouragement to know, Okay, I have this purpose and this goal. Meagan: Direction. Meg: Direction, yeah. I know exactly what I should be doing. She gave me encouragement after every time like, “Oh, that’s the push.” My doula and everybody was cheering me on. I think I was in such a better headspace during that whole pushing experience. We tried a bunch of different positions but I think I ended up mostly pushing from my back. About an hour in, they started to see his head during the contractions. I think I started crying again. I was like, “I’m going to have this baby from my vagina.” I think that’s when it finally hit me, “This is the VBAC. I’m going to have this VBAC.” I think they did bring in the mirror one more time and again, for me, it was nice to see his head this time because I could see his head but it was just too distracting. I couldn’t push effectively and look at myself in the mirror. I had them take that away again but they had me feel his head and that to me was really sweet being able to feel his hairy little head. That was the first thing my midwife said was, “Man, this kid’s got a head of hair.”Yeah. I just kept pushing. It was kind of funny because again, they were getting the room ready and I’m thinking, All right, this baby is going to come out at any minute. We’ve been pushing for a while now. He was really stubborn and he would crown a little bit then he would get sucked back in. I think my midwife was getting frustrated at one point looking at some of the video. She basically stuck her hand in there on his head like, “You’re going to come out.” Yeah. Finally again, 3 hours later– I started pushing at 7:30 and at 10:21, he was finally born. He came out and everyone in the room, everyone– nurses, doula, everyone– “Whoa.” There was this audible, “Whoa.” We had done a prediction of his weight earlier in the day. My daughter was 7 pounds, 14 ounces and I didn’t gain as much weight with this pregnancy so I was like, “I think he’s probably smaller. I bet he’s only maybe 7 pounds, 7 ounces.” Everybody had their predictions. I pull him out to my chest. I don’t care how big he is at this point. I’m just like, “He came out. He’s so sweet.” I’m crying. My husband is crying. We did it. We’re having our moment. Well then, they get him all cleaned off. They get him weighed and the nurse who weighs him gets the attention of everybody in the room like, “All right, any last guess of how much he weighs?” 9 pounds, 14 ounces so a full 2 pounds heavier than my daughter and I was shocked. I’m sure that’s why it took him so long to come out. I’m like, This boy was a big boy in there. Yeah. It was just wild getting to meet him. Yeah. It was really sweet because once they got him back on my chest, I looked up at my husband and I said, “You have a son.” It was such a different experience than my C-section baby. Being able to have this baby and bring him right to my chest was just so sweet. Meagan: Absolutely. There is something about that. It sounds like your husband and everybody was so invested in this birth. Meg: Yes, yep. Definitely. Meagan: I’m sure the room, the positivity in the room and the emotions were high. Meg: Yep. Definitely. Yeah. Yeah. Meagan: I’m curious. Did you ever get your op reports with your first baby? Meg: Yes, I did. Meagan: Did they give any reasons why you had it? Obviously, you said asynclitic so positioning, but I’m wondering if they ever said anything else in your op reports. Meg: From what I could tell, and the OB who I had at the time said, “This is not because of your lack of ability to push. You have very effective pushes.” I think in the op report, they said it was that her head was tilted and asynclitic and that she was failure to descend basically. I think she was only ever at– I never remember– at one above zero. She wasn’t going to come out that way. Meagan: -1 station. We know with asynclitic it can be harder. There are positions and things like that which could help but often are not offered or even known about. Meg: Yeah. Yep. I did look at my chart after listening to your podcast because I was like, I want to know what they said about me in these notes. I definitely scoured those notes and after hearing some horror stories on the podcast, I felt like the care that I had was very respectful and I had a lot of support from everyone at the hospital. Meagan: Yeah. Support is so important. Meg: Yeah. Meagan: So important. Meg: Yeah. Meagan: I’m so glad that you got your powerhouse team and you had this induction that you weren’t really wanting but it ended up really great. Meg: Yeah. Yeah. Yep. Yeah. Meagan: Well are there any tips you would give to moms who are listening and going in for an elective induction or medically necessary induction? Any tips for them? Meg: Mhmm, yeah. I definitely think a doula is key, especially after that 2 hours where it was like, “Hey, you might need to have a C-section,” then my doula and my team worked me like a rotisserie chicken to get that baby in a good position. I do think that part of– who knows with my C-section what could have gone differently but I think if I had a doula there to support me, things would have gone so much differently. I think for inductions in particular, you’re going to be there for a while probably so having somebody there who can make that time productive is definitely a game changer. Meagan: Absolutely because if you didn’t have someone there, you might have just been hanging out, chilling, and not doing too much. In that 6 hours, maybe something would have happened and maybe not. Meg: Yeah, yeah. Who knows? Yeah. Meagan: Well congrats again and thank you so much for sharing your story. Meg: Thank you. Yeah. Thanks for having me. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
52:5416/09/2024
Episode 334 Susana’s VBA5C Story

Episode 334 Susana’s VBA5C Story

We have received so many messages and emails from you requesting more VBAMC stories and today, we are giving you just that. Susana joins us from Mexico sharing her VBAC story after five Cesareans!Each of Susana’s Cesarean experiences was unique in their own way, but the dream of a vaginal birth never left her heart. When she found a supportive midwife and doctor during her VBA5C pregnancy, Susana knew this was her chance to finally achieve that goal. With her husband by her side encouraging and supporting her, Susana powerfully pushed her baby out. The hospital staff and community buzzed with shock and amazement over what she had achieved!“That moment was unlike any other moment in my life.”ACOG Article: Dr. Angelica GloverEvidence-Based Birth: The Evidence on VBACNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Women of Strength, this is the moment so many of you have been waiting for. We have a VBA5C so for anyone who doesn’t know what that means, it is a VBAC after 5 Cesarean story for you today. This has been requested so much. We received emails in our personal email. We have gotten it on social media saying, “Please, can we get some stories that have VBAC after more than 3 Cesareans?” We know so many people out there don’t know that this is an option or they know it’s an option but they don’t find the support or they can’t find the support. They are few and far between but we have our friend Susana today who is going to be sharing her VBA5C story. Welcome, Susana. How are you?Susana: Hi. Thank you so much for inviting me. I’m so excited. Meagan: Oh my gosh. I am so excited. Yes. I am so excited and you are in Mexico, correct? Is that where your VBAC was? Susana: I’m sorry? Meagan: Was your VBAC in Mexico?Susana: Yeah, but it was a very, very hard way. I’m going to share what I did. First of all, I can’t separate this way from my faith because I prayed so much for this and I trusted so much and also, I trusted so much in the process and in the body and those things But okay, I’m going to tell you what happened with me and why I had five C-sections. First of all, I got pregnant in 2009. My pregnancy went very healthily with no problems at all. I was 41+5 weeks and I had a doctor who was– well, he said he was for natural birth. I don’t know how to say it. He was pro-birth. Meagan: Yeah, that he’s pro. He’s supportive. Susana: Supportive. Yeah, that’s the word. But in reality, he was more C-section-supportive. While we were passing a very difficult part of our life because my father-in-law passed away exactly on my due date. We were very emotional and very sensitive. Labor wasn’t starting so the doctor said, “No, baby is not engaged. You are only 3 centimeters. I can say that baby is not going to birth naturally. I say that it is better for you to go directly to the C-section.” I was disappointed because I was walking so much every day, but for the situation for my husband and all of the family, I accepted. We went to the C-section. I got pregnant again in 2010 8 months later and I was very excited to now get a VBAC. The doctor said he wasn’t going to support me but in the end, I had a TOLAC, a trial. I was progressing well. I was 5 centimeters when I went to the hospital and the doctor was a little bit nervous because the C-section that I had before was one year and five months before so he was like, “You have to be fast because we have the risk of uterine rupture.” He started to make an impression on me and I was starting to be stressed. After 5 hours I think, he said, “Baby is not getting down. You are still at 5 and we are going to the C-section again.” I cried a lot and my husband said, “We tried and we can’t do this anymore. It can be dangerous. Go to the C-section.” It was very traumatic because they put in the epidural and it only worked in half of my body. I started to scream, “No, please. No. I can feel everything.” They put the epidural in again. It was difficult. Then I got pregnant again in 2012 but I didn’t fight anymore. I decided for a repeat C-section. The good part is that it was peaceful because I was accepting the situation. Everything went well. Then I got pregnant in 2013. Also, we were going to opt for a C-section because I didn’t have any other chance but the doctor started saying, “No more babies. Four C-sections is a thing,” and things like that but my husband and I were talking about it and we thought that it wasn’t an option for us to have– I don’t remember the word. Tying the tubes. Meagan: Oh yeah, a tubal. Susana: Yes. The sterilization. So we went to a repeat C-section. It wasn’t as smooth as the one before because my baby was 37.5 weeks so we had a little problem with maturity. Is that the word? She was very small. Meagan: She was technically preterm. Susana: Yeah. Preterm. She showed signs of preterm. She was whimpering and something like that. We had to go to the neurospecialist. Everything was going well and there was no problem at all, but we were careful for another pregnancy. We waited a lot and we got pregnant again in 2017. I spent the half of my pregnancy with the same doctor, but at half of the pregnancy when I was 20 weeks, some friend told me, “Oh, you know what? There is a mom in Brazil who had a VBAC after four C-sections.” I was like, “What?” I didn’t know that existed. I started to inform myself and I found a supportive midwife but she said, “We aren’t going to chance it to go to the hospital. We have to have the birth in your house.” We prepared everything for the home birth and the bad thing is that I was anxious at 39 weeks and had prodromal labor. I passed the due date. I was 41 and 42 and then 42.5 weeks so stress started to play a role here. I started labor but I passed three days in labor so that was really, really hard. I passed two days at 5 centimeters dilation. Then my midwife said, “I don’t know what has happened. I think we can’t wait anymore. You have to go to the hospital. Baby is good.” The heart rate was optimal but I didn’t know what to do anymore. We went to the hospital. It was the only public hospital. Oh, the doctors were freaking out like, “What are you doing? Come on. You have to get the C-section 2 weeks before.” I suffered very, very much obstetric violence. It was very traumatic. Baby was very low. I was at 8 centimeters when I got to the hospital. I was begging for them to let me try and let me push but they said, “No. You are crazy. We have to go to the C-section right, right now.” When they pulled baby out, they broke the uterine artery and I lost a lot of blood. I was very weak and it was very painful. That was a disaster. We were like, “No more babies I think”, but by the grace of God, I got pregnant again in 2021. Sadly, I had a miscarriage on Christmas actually. It was very sad. But I don’t know. That miscarriage let me know that my body works and that I would be able to have good contractions and my body was able to give birth. I prayed, “God, if you want, I want another baby.” In November of 2022, I got pregnant again and that time, I was totally strong to fight for another try to have a vaginal birth. My husband was totally against the trying. He was so scared. Also, I was a little bit scared, but I was trusting at that time. I was trusting so hard. I was praying so hard. I decided to not go to the doctor because I was so scared of the doctor. I was hesitant. I don’t know why I didn’t want to hear, “You are in danger. No. This is so dangerous. You can’t try. You have to go directly at 38 weeks to the C-section and you have to have a blood transfusion and you are of advanced maternal age,” because I am 41 years old, but I don’t know. I said, “I don’t want that in my pregnancy.” Actually, I had a friend who had seven C-sections and then had four home births. She was telling me, “No. Trust God. You have to know when they talk from fear and when they talk from the truth.” I could tell that a lot of people were speaking to me from the fear they felt, not from the truth. I stayed with that doctor until 28 weeks. I found a doctor who wasn’t judging me and who was open but he didn’t have experience with VBAC after multiple C-sections so he said, “I can check you and support you but not in the birth. I can’t do that. I have no experience.” Well, for me, it was like, “Oh, I’m at the beginning of the way.” Okay, so I kept praying and when I was 34 or 35 weeks in the pregnancy, I had a doula who gave me a contact of a midwife that she was supporting VBAC after three C-sections in a hospital with a doctor. I said, “Maybe there’s a chance for me.” I contacted her. I talked to her and she was very optimistic. She said, “Yeah. Of course. I can support you. We can prepare a home birth. I can support you. I can be your attendant.” I don’t know the word. Meagan: Maybe advocate? Susana: Not advocate. I mean, she was the one who received the baby. Meagan: Oh, like catching. Yeah, attending. Susana: Yeah, attending the birth. But my husband was like, “No, not a chance.” Because for my husband and also for me, it was very difficult and not secure. We were scared. We thought about what if something happened. That midwife told me, “I can speak with the doctor and maybe we can have a plan.” I said, “Okay.” I was 36 weeks so it could be difficult that he started to attend me in these late weeks. But I still had trust and confidence in God. I kept praying all of the time. One day, she called me and said, “Susana, good news. The doctor said yes. I told him all of the truths. I didn’t hide anything and he said, ‘Okay. If you are with me, I can attend this birth. But I need to watch her in the next days.’” So we went to the doctor. The doctor was in another city 40 minutes to an hour away from here. My husband couldn’t be with me so my parents went with me. My parents were so scared. Meagan: I bet. Meagan: They were very against trying. My husband wasn’t completely confident about it. All of my environment was against the VBAC. When we went to the doctor, the doctor was so supportive and so humane and so good and so kind. He said, “We are going to try. We are going to make our best. We are a good team. The midwife and I work together very good and very successfully but I’m going to keep all of the team here if we need the C-section in the last moment.” We agreed on that. My parents were so relieved. We talked with my husband and he was relieved also but he also had doubts. But in the environment of a hospital and– oh, I don’t know the word. The place where they make the C-section? Meagan: The operating room? Susana: Yeah, the operating room. In the side of the room, if everything was good, we trusted. He was supportive for the first time. He said, “Okay.” Two weeks passed after this visit and there was the moment when I started getting excited with things with labor. It was on the 11th of August last year in 2023 when I saw my mucus plug and the bloody show. I said, “Oh. I think things can be starting at any moment.” But in my last experience when I had the bloody show, it was two or three days before the labor really started. I patiently waited and the contractions started to be hardest but there was a half hour in between them. It was very manageable and still manageable. I passed the day with my normal activities. I had lunch with my parents and my five kids. I went to gymnastics class with my daughters and actually at night, we went to mass with friends and families that we know. A friend of ours invited us to dinner and I said, “No. I want to go home.” My husband was like, “What? You don’t want to go anywhere.” My husband started to sense that something was wrong. We returned to home and contractions started to be closer and intense. I wrote to my midwife and she said, “Okay. You have to count how many contractions happen in one hour,” so I started counting and from 10:00 PM to 11:00 PM, I had nine contractions. I wrote her and she said, “Okay, you are starting. I’m going to go to your home.” By the way, she lives 2 hours from my city so she came to my place at 2:30 AM and checked me. I was only 3 centimeters and 60% effaced. She went and she said, “Oh, congratulations. You are a 3. We only have to wait 7 more.” She was so positive and so kind and so lovely. But for me, it was like, What? 3 centimeters. There’s a long way to go. I was so disappointed and I started to have a crisis thinking, Okay. This is going to be three days of labor. It’s starting to be unbearable. I don’t know what I’m going to do. My husband told me, “You have to know that this is not going to be easy.” I was like, “Oh my god. What is going to happen?” I wrote a friend and she told me, “Maybe you were wrong. Maybe you are not in labor yet. Maybe it is prodromal labor so calm yourself and keep making your activities as normal.” I said, “Yeah, maybe that’s true. Maybe I’m not in labor yet.” One of the things is that my contractions don’t hurt in the uterus or in the belly. They hurt in the legs. Meagan: Oh. It radiates down. Susana: Exactly. I felt like it started in the hips and ran into the legs but I felt like– I don’t know how to say– but a burning. Yeah. It was burning pain. It was very, very intense. My friend told me, “Put one leg on the chair and one leg on the floor and balance side to side while a contraction comes.” I made that and that was really, really helpful. I could have a contraction very easily that way. I was telling myself, “My pelvis can open. My baby can know how to birth. Everything is okay. God is with me,” and things like that. That affirmation worked very, very good because it calmed myself and that’s how I passed the contractions all day long. Not the day, only the morning. My daughter, that morning, had a science fair so we decided it was at 8:00 AM so we went. It was the worst time for me having those contractions every seven minutes and very painful. All of the parents were like, “What is happening to her?” Meagan: That’s amazing that you went. Susana: It was because I thought, I’m going to have three days in labor. My midwife had told me that when there’s a labor after so many C-sections, there’s a lot of times that it lasts three, four, or even five days so in my mind, that was my expectation. While I was at the science fair, I said to my husband, “Please take me home. Let’s go home. I am in a lot of pain.” I called my midwife again and she came. She checked me and I was 6 centimeters so for me, I was like, “What? Whoa!” Yeah. She said, “We have to go to the hospital.” Oh, before that, we were planning to rent an AirBnB in the city which is Leon, Mexico to spend with all of the family those days that I was supposed to be in labor. So she said, “Forget about that plan. We will go directly to the hospital.” We called the doctor and the doctor said, “I need to check her with an ultrasound. You need to go to the office with me.” I thought it was useless, but we went to the office. It was the worst travel because I had contractions every 4 minutes and we were traveling in the van, but the good thing was that my midwife was making pressure on my hips and that released the pain. After 1 hour and 20 minutes, we arrived to the doctor. He checked me really fast and he said, “You are 6 centimeters.” Again, I was so disappointed because I thought, “Oh my god. One hour and I’m still a 6.” But my midwife told me, “No, I don’t think so. I think you are maybe a 7 or an 8.”She is very wise. She had a lot of intuition. So we went to the hospital and it was 20 minutes away from the office. We arrived at the hospital at 12:35 PM. When we arrived at the hospital, he wanted to put me in an emergency room, but the doctor arrived immediately and told them, “No. Put her directly in a room because it was going to be a room birth.” I gave birth in a room, not in an operating room, but in a labor and delivery room. Meagan: They had you labor the rest of the way and give birth in the operating room?Susana: Yeah. In Mexico, all of the births happen in the operating room. Actually, it’s not an operating room but it looks like it. It only has that stuff that they put the woman with the legs up. Yeah, I don’t remember the name, sorry. Meagan: Like just the position? Susana: Yeah. Meagan: Okay, gotcha. Susana: So we went to the room. My midwife said, “Do you want to go to the shower?” I said, “Yeah, please.” I went to the shower. At that time, my water broke like a balloon because I felt something really big getting out. It was shocking and I was like, “What? Is that the placenta?” She said, “No, let me see what it is.” It was the amniotic sac almost complete. It was amazing because my midwife told me, “I’ve never seen something like this.” It was amazing. After that, the contractions felt very different with no pain and I started to feel to push. It was very different for me and very scary because I never felt something like that. Meagan: Right. Susana: My midwife told me, “You’re going to birth now. You have to choose your position.” I stayed on my knees on the floor with the arms on the bed and started to push my baby out. I can say I didn’t feel any pain in this moment. I only felt the pressure. I think I had the reflex, the fetal ejection reflex.Meagan: Yeah, mhmm. It’s like where the baby just comes out. Susana: Yeah, because I wasn’t pushing and my body was pushing. It was an amazing feeling but also, I was scared because I didn’t know how to do that. My husband was praying with me and he was very supportive and very loving in that moment. That moment was awesome. I know God was there. I knew all my prayers were answered in this precious moment. I only let my body make its worth. I felt incapable of pushing a baby out. That was an amazing feeling. I don’t know how to say it. It’s like you are here but you are not. Meagan: Yeah. It’s surreal. It’s really– when you realize you’re in that moment of pushing your baby out and I can’t even imagine after five Cesareans, just that moment of, Wait, is this really happening? Susana: Exactly. It was like a dream. My husband was telling me, “Yes. You are so strong. You are telling me the truth. The miracle is done. Come on love. You can do it. You are so close.” I can’t remember exactly but I think it was four or five pushes and baby was out. Baby had two wraps of the cord. Meagan: Double nuchal cord, okay. Susana: Yes. Then the body was out and it was a relieving feeling. It was magical. Everything was done. Every pain, every pressure, and every fear was gone. I felt that very warm and wet body in my arms. It was a magical moment like, I can’t believe this is happening. Praise to God. I was crying. That moment was unlike any other moment in my life. Meagan: I can’t even imagine. Wow. So was everyone very pleased and shocked? That’s not a normal thing. For VBAC after one and two, it’s like, okay. After three, providers are like, “I don’t really know. Risks do go up so we are nervous about this,” so after five, how was your community around you?Susana: Yeah. They were very shocked. Actually, the hospital didn’t allow VBAC after multiple C-sections, but the doctor said because in the lobby, they asked, “How many pregnancies and how many births? All those were natural births?” The doctor said, “Yeah.” Everything was happening very fast. After the baby was born, everyone was screaming, “Vaginal birth after five C-sections here!” The nurses and the doctor and the people in the lobby said, “What?! It’s a miracle.” Everybody was so happy. Everybody was shocked. I don’t know. It was amazing. Meagan: I’m sure they had a lot of feelings. I’m sure they were so happy for you and so shocked and even probably still questioning, “Wait, really did that just happen?” Because even we as a mom pushing in that moment, I think it’s very much for the providers too, “Wait, is this happening?”Susana: Yeah, actually the doctors said the medical community was pretty– I don’t know the word but they were saying, “What did you do? You didn’t do another C-section? What’s wrong with you?” They didn’t do the episiotomy and I didn’t tear at all. Meagan: Amazing. Susana: What else? He said, “It was a perfect birth.” Nothing went wrong. Nothing. So for him, for my doctor, he was very proud. He was not scared of sharing the evidence or the support and my case. Meagan: Right. He wasn’t scared of sharing that he was supportive of you doing that. Susana: Exactly. He put on social media what we did. A lot of people were like, “What?” But he told me, “I only supported you because of your midwife because she is amazing. She is very wise. She has a lot of intuition. She had a good eye to know when it can happen and when not. Meagan: Yeah. Susana: She is awesome. Meagan: I wonder if they work together often now. Susana: Not too often because she usually goes to home births but when a couple wants a hospital or a VBAC, she works with him. Meagan: Oh my gosh. That’s awesome that they can work together and it really truly makes it possible for those who want to. We know that not everybody will and we know that the risk is not acceptable for others. Susana: Right. Right, exactly. Meagan: Something that I love on ACOG, there is a website that is called acog.org so the American College of Obstetricians and Gynecologists so it’s more here in the U.S. but there is a provider called Dr. Angelica Glover. She wrote an article on VBAC and one of the things that I enjoyed about her article was the very end. It says, “One size does not fit all. If you are pregnant and have a previous Cesarean birth, talk through all of these questions with your OB/GYN. Weigh the risks and benefits of each birth option like you would with any important healthcare decision.” I love that. Just like you would with any healthcare decision. It says, “Think of this as an ongoing conversation with your OB that starts early in pregnancy and evolves over time. Your feelings may change and your risk factors could change too. There is no one-size-fits-all answer when it comes to choosing between trying for a VBAC or a repeat Cesarean birth. What matters is that you are comfortable with your decision and you feel supported through your pregnancy and birth.” I love that because really in the end, VBAC after three, four, five, or whatever may not be comfortable for someone else but it may be for someone like you. Then the biggest factor is finding the support and we know that can be really hard so I love hearing that you had two providers who were on board with you, trusted you, and trusted the process. I do love that your midwife talked to you about how it can take time and you made it to 8 centimeters before right? Your body had done it. It just still needed time. It has gone through a lot and there was scar tissue and all of the things. It can take time, but you were allowed that time. You were allowed that time. They trusted you and they trusted themselves even. I am just so happy for you and I appreciate you sharing your story because it is one of those things that is really desired. A lot of people don’t know it’s an option then they find out and they are like, Wait, is this really possible?Yes, it is so it’s really nice to hear a story here and there as they come along to show that yes. Women of Strength, it is possible. Are there risks? Yes. There are risks. Are they more than VBAC after one or two Cesareans? Yeah and honestly, we don’t even know the exact evidence on specifically VBAC after five Cesareans because they are not studied and they are not happening. Susana: No, they are not but I can say that I read a lot. I found very good information from the Royal College of Gynecology and Obstetrics in the United Kingdom and it said that as a provider, you have to let the mom share if they want to try or do the repeat C-section, but always the vaginal birth is less risky than a repeat C-section especially after too many C-sections. Meagan: We do know that there are increased risks with repeat Cesareans as well. We know that is also very much a thing so we want to make sure that we are taking into consideration that as well because we’ve got issues where uterine rupture actually can also happen in a repeat Cesarean and that risk can be there. Bleeding and hysterectomy, there are risks that are sometimes actually higher for a Cesarean than a vaginal birth. It’s just important to know all of the risks. I think sometimes we hyper-focus on the risk of VBAC instead of going through and looking at things. Evidence-Based Birth has such an amazing article and I think it was actually even a podcast episode on VBAC. She talked about how there are a ton of studies within here. She goes through the maternal outcomes here. Susana: That’s awesome. Meagan: Yeah. It shows the maternal outcomes and the newborn outcomes. It says, “Maternal adverse events or bad outcomes were more frequent among women who had a C-section birth after Cesarean,” meaning they attempted a VBAC but it ended up in a Cesarean compared to those who had a VBAC. That’s another risk. We have Cesarean risks. We have VBAC risks and then we have where we are going for a VBAC and it goes into a Cesarean. There is also risk there. We really need to just pause and stop and look at everything. I mean, literally, everything before we make a decision. There are so many times like with your first birth, there was so much going on. You had such an unfortunate event happening with the loss of your loved one and a provider was saying, “Oh, you’re only at 3 centimeters and 60% effaced so this is probably not going to happen,” when in reality, that vaginal birth probably very much would have happened but we just didn’t know. We didn’t know. Susana: Yeah, totally. Yeah. Meagan: It’s so hard because there are so many times where we hear these things from a provider. Me too. I did too. I was like, okay. We trust them and we don’t want to not trust our provider but at the same time, we want to make sure that we do get informed. I’m so proud of you for along the way getting informed and learning about your options and I’m so happy for you that you were able to have your vaginal birth. Susana: Yeah, thank you. Thank you so much. I can say at least here, I think younger OB/GYNs are more open to support VBAC than the older OB/GYNs. I don’t know how it is in the United States, but here, I think that is happening. Meagan: Yeah. I think it takes us all continuing to advocate for ourselves to have these providers stop and change their point of view because I believe that so many times, even if the evidence is there, there are so many times that it takes seeing it to believe it. You can look at a piece of paper and look at the evidence and you can see that, but at the same time, you’re like, Okay, yeah. Sure. That probably can’t happen, even though it’s right there on the form, but seeing it really can change a lot of people’s perspectives and just opinions. I think that is what you probably did to that entire hospital. Like you said, “Vaginal birth after five Cesareans in here!” Yeah. They were all blown away and you really did. You changed their perspective. Susana: Yeah. I am so happy to help another woman, to inspire, to read, to find information, real information. Don’t let the doctors scare you. There is risk in all of pregnancy. It can be risky. Life is risky. Meagan: Life is risky. You’re not wrong there. There is risk everywhere. It’s just important to know the risk and then decide if that risk is acceptable to you. If that risk is acceptable to you, then great. Go for it. If not, that’s okay. Susana: It is worth every moment and every pain. Everything, it was worth it. Meagan: Yeah. Well, I’m so happy for you. Congrats again and thank you for being with us today and sharing a VBAC after five Cesareans story. Susana: Oh, thank you so much. I’m so happy and I hope that a lot of women hear this podcast and are inspired themselves. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
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Episode 333 Shelby's HBAC after Placental Abruption + Faith Over Fear + Defining True Physiological Birth

Episode 333 Shelby's HBAC after Placental Abruption + Faith Over Fear + Defining True Physiological Birth

“My birth stories are my testimony…I have never trusted God more with any situation in my entire life other than with the lives of my children and bringing them into this world.”Shelby’s story is one of faith, trust, and surrendering. Shelby joins us today from Indiana sharing her wildly traumatic Cesarean story due to a placental abruption and her peaceful, healing home birth. Shelby was on vacation at a cabin in New York at 34 weeks when she woke up to regular contractions and heavy bleeding. She rushed to the nearest hospital, was put under general anesthesia for her Cesarean, was transferred via a separate ambulance from her baby to a hospital 3 hours away, and had a 23-day NICU stay in the height of COVID 800 miles away from her family and community.She and her husband were certain they would not have any more children. But as they fought for healing through faith-based counseling, their hearts yearned for another baby and a chance at a healing birth experience. She completely surrendered, found holistic prenatal care, and created a birth space for herself where she knew she felt safe. She was brave and vulnerable, and her second birth was everything she hoped it would be. As Meagan says at the end of this episode, “Get educated. Love yourself. Have faith in you and your body and your baby. You are amazing. You are a true Woman of Strength.”How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Women of Strength, we have our friend, Shelby, here with us today sharing her HBAC story. In addition to her HBAC story, she’s got some other unique things that I think are going to be important for us to talk about today. One is placental abruption. That is something that is definitely a reason for a Cesarean and one of those absolute needed reasons for a Cesarean. We are going to talk a little bit more about that and then we are going to talk about faith and how faith in whatever faith looks like to you, it’s so important to cling onto that. Shelby has some messages about that. Then we really want to talk about physiological birth. We hear it. We see it online. I mean, if you go on Instagram and you go into the birth world, you’re going to see it almost 100% guaranteed but what does that really mean? We’re going to be diving in with that today. Shelby, you are in– where did it say, Indiana? Shelby: Indiana, yeah. Meagan: I have to look at my notes. Indianapolis, Indiana. She’s in Indiana so Women of Strength, if you are coming from her area, definitely listen up as well. Okay, so we have a Review of the week and this is by birthing confident. It says, “Invaluable information. I love this podcast. As a mom planning a VBAC and a VBAC-trained birth doula, the information shared on this podcast is invaluable. I have become so passionate about helping all women know their birth options and avoid unnecessary C-sections. I think this podcast is great for all expectant mothers” and I 100% agree with that. This podcast is for anyone and everyone because like she said we are wanting to help people avoid unnecessary and/or undesired Cesareans. We have a ridiculous Cesarean rate. It is through the roof. I would love to see it start dropping and I don’t know if this podcast truly is going to impact the Cesarean rate the way I would love it to, but I do believe that it’s a starting point. It’s a starting place for you guys to learn your options for birth after Cesarean and to learn how to have a better Cesarean experience if you have one because that’s also a really important factor that I think a lot of people forget about. Not only do we share just VBAC stories, but we do share healing, beautiful CBAC stories and repeat Cesareans. Thank you so much, birthingconfident, for your review. As always, please if you haven’t yet, leave us a review. You can do so on Apple Podcasts. You can message us. You can rate us on Spotify and all of the places that you listen to your podcast. Meagan: Okay, cute Shelby. Welcome to the show. Shelby: Thank you. I’m so excited. Meagan: I am so excited. So let’s dive in. I am actually really excited to talk a little bit more about placental abruption as well and hear about your experience. Shelby: Yeah. I don’t think I even knew it was a thing honestly before it happened to me. I think it’s something that people don’t really talk about and it’s probably a good thing because it’s really scary but also, it would have been good to maybe know what was going on. I know it wouldn’t have changed the outcome, but yeah. I just had no idea that was even something that could happen. With my first pregnancy, it was very run-of-the-mill. Everything was good and I was planning on birthing at a birthing center in Indianapolis so I was still going for that natural, unmedicated birth. I didn’t really know anything that went into that as you do with your first and I feel like you do the typical making the baby registry and doing all of these things that don’t really actually help you with your birth. Not that I would have gotten the chance to even try anyway. I feel like I just definitely didn’t really have much knowledge and I think the problem is that you don’t know what you don’t know which is why I literally recommend this podcast to all of my friends who are even pregnant with their first baby because I’m like, “Just learn the things. Learn all of the things.” We took a very basic birthing course through the birthing center and it was just virtual, like four sessions and it was not super helpful honestly but we also didn’t get to implement it. The pregnancy itself was just very normal. I mean, I have pretty much all of the symptoms which is the worst like really horrible rib pain and nausea and heartburn and all of the things. What was crazy though, this was in 2021 and I actually got COVID while I was pregnant also. Everyone I’ve talked to thinks that’s probably why I had a placental abruption.Meagan: That’s interesting to know. Shelby: Yeah. I had it in about my 5th month of pregnancy in September and I was due in January. It was horrible for a week but then I recovered and I was back to working out. I was totally fine. I didn’t have any blood pressure issues after that. Everything reallly seemed okay. We decided at 33 weeks that we were going to go to New York which is really far away from Indiana on vacation for Thanksgiving to gather with all of my husband’s family. My midwives cleared it. Like I said, I was working out. I was healthy. I was fine. The trip was going super well. I was working out while we were there. I was doing barre obviously so I was doing safe things. Fitness is a really big part of my life but also, it’s not something I added in during pregnancy. It was just normal for me. Meagan: I used to take barre too. I took barre and was teaching barre with my second TOLAC. It’s a very low impact but very, very good for strength and cardio. Shelby: Yeah, and my husband and my father-in-law were doing them with me so we have some really awesome videos of me at 34 weeks pregnant working out with my husband and my father-in-law doing barre. But yeah. Everything was going well and anything that was slightly risky which really even wasn’t, I wasn’t doing. They did this office chair floor hockey where they were pushing each other around in office chairs and playing hockey in a building and I didn’t do it. I sat on the sidelines and observed. I was being really what I feel like was cautious. Meagan: Responsible. Shelby: Right, yeah. We even took family pictures on Saturday and everything, I have pictures of us smiling and laughing and then literally the next day we had a baby which was crazy. I start having Braxton Hicks contractions at 20 weeks. For both of my pregnancies, I just feel like I start having them really early so they are not shocking for me. But that Saturday, I remember several times looking at my husband and being like, “These feel a little stronger than I remember them being,” but with your first, you don’t know anything. I kept mentioning that to him but they weren’t super regular and there were no other signs of anything, just Braxton Hicks contractions. Then that night when we went to bed, I couldn’t really sleep. I was laying there by myself the only one awake. We were all staying in this big cabin together which was great. My husband and I were in our room. At 4:00 AM– this is so funny to me now that I know what labor is actually like. At 4:00 AM, I started timing contractions and they were less than 5 minutes apart when I started timing them. I’m like, What was wrong with me?So after an hour of them being like that, I woke my husband up and I was like, “I think you should go get your mom,” because she is actually a midwife which was good. Meagan: Oh, convenient. Shelby: She was in the room next to us. Yeah. I was like, “I think you should go get your mom because this is not right.” They were not just less than 5 minutes apart. They were pretty uncomfortable. She came over and checked things out. I know now that she definitely knew that something was going on but she was really good at keeping her cool. She was like, “Why don’t you go shower and try to relax?” When I went to go to the bathroom and shower, I started bleeding. Like I said, I knew nothing about labor, so I was like, “Oh, well maybe I am in labor” which was really scary because I was only 34 weeks but it was a lot of bleeding. I was like, “Well, I don’t know what’s normal,” but I know that obviously, my mother-in-law knew what was going on. She was like, “It’s okay. We’ll have Chad (my father-in-law) just go start the car and we’ll go in and get everything checked out.” So we were in the middle of the Adirondacks which is literally nowhere. We had a 25-minute drive to the nearest hospital and this hospital, I mean we were probably the only people there. It was 5:30 in the morning maybe. They didn’t have an OB there. They didn’t have a surgical team there. They were all at home so we come in and the front desk lady is like, “What’s your occupation?” She’s typing like a sloth. I was like, “Girlfriend, I am bleeding and I am in full-on labor. Can we just go inside?” So that was crazy. She’s asking me to sign stuff and I’m telling my husband, “You have to sign.” At this point, contractions were pretty back-to-back and they were super strong. I could tell I was bleeding with every one. I could feel it. They got me back into the ER and the poor nurse. I know that this was probably so scary for her, especially with an OB not even there but she was asking me, “Have you felt her move recently? I can’t find a heartbeat.” I was like, “I don’t know. I’m in labor. I don’t know if she’s moving or not.” Every time I’d have a contraction, she’d just be like, “Oh wow, that’s a lot of blood.” I’m like, “Thank you. I know.” Meagan: You’re like, “I can feel it.” Shelby: Yeah, it was wild. By the time the OB got there, she checked. She said I was fully dilated and effaced. Meagan: Holy cow. Shelby: This was maybe 2 hours. It was not long. Now that I’ve been through a full labor, I’m like, that is crazy. My body had to have just been in panic mode like, We have to get this baby out right now.She checked and something that was kind of cool was I knew that my baby was head down. She had been from 20 weeks. She was perfectly always in the same spot because I could always feel her kicks really high and one of the times the OB checked, she goes, “Oh, and she’s breech so we’re just going to have to go.” I was like, “She’s not breech. Check again. She’s not breech.” She checked again and she was like, “Oh, you’re right.” I was like, “Yeah.” So the nurse brings in all of the scrubs and stuff for my husband to put on and as he’s getting dressed and everything, he’s fully ready to go. He’s all excited because he wasn’t really super scared. Meagan: He didn’t understand what was going on. Shelby: Yeah, but also, he’s like, “I’m going to meet my baby today. This is so cool.” And the literal most gut-wrenching thing of my life was when the OB was like, “No, we don’t have time. It’s going to be under general. You can’t come.” She wheeled me out of the room and I looked back and saw him standing there fully dressed just like yeah. It was awful. In that moment, I wasn’t even worried about myself and I wasn’t worried about the baby. I was just like, He’s going to be traumatized from this. This is horrible. They took me back there and I’m in labor holding onto the top of the bed. I was only in there probably for a minute, but it is scary. The whole room is white and there is somebody over here counting instruments. They stick a mask on your face and you can barely breathe and then the next thing you know you wake up in recovery. I woke up as the only person in this room. There were maybe two guys sitting at the desk but that was it. Nobody else was there. They didn’t say anything to me. Nobody told me if she was okay. I knew nothing. Yeah. I was just laying here. Eventually, my husband came in and he showed me pictures of her. He was like, “She’s okay. She’s on oxygen but she’s doing all right.” But yeah. It was totally crazy. Then they moved me to– I don’t even know. It probably wasn’t actually a postpartum room. I don’t even know if they have those at this hospital. I feel like they probably try to send everybody everywhere else. Then basically, they told me, “Hey, you have 10 minutes if you want to go see her and try to hold her before the ambulances get here to transfer you guys,” because there wasn’t a NICU there and they probably weren’t even– they couldn’t have cared for her. I think as soon as we got there, they must have called Albany Medical Center because it’s 3 hours away. She was born at 7:30 in the morning. I started timing contractions at 4:00 AM. We didn’t leave until after 5:00. The whole thing was so fast. I’m getting ready to get out of bed and get in a wheelchair to go see her and they didn’t warn me how much pain I would be in and they didn’t really help me get out of bed either. As I went to stand up, I leaned back a little and after you’ve had a C-section, I almost passed out. Meagan: Oh my gosh. Oh my gosh. Shelby: Yeah, so I get in this wheelchair and I get in the room where she is. She’s got the oxygen mask on and she’s got all of these tubes and all of the things and you could tell in the pictures I was barely with it. What I remember bothering me the most is I had obviously been intubated so I felt like there was stuff in my throat because it was so swollen. My mouth was all dry and I got to hold her for a couple of minutes but it didn’t even feel real. Then the NICU team got there. She was on one ambulance and I was on a different one and my husband was in a car so we were all separated for 3 hours to Albany. Halfway there, my ambulance– so hers left first, and halfway there, we passed hers pulled over on the side of the road. I started panicking. There was no communication between the two ambulances. Meagan: Oh my heavens. I’m dying right now. Shelby: Yeah. The EMT, bless her heart, was amazing. She was like, “It could be anything. It could be one of the monitors isn’t hooked up right and they’re just stopping to do that or they need to change out an oxygen tank and they can’t do that while driving.” She helped me calm down a little bit. She probably shouldn’t have said this, but we got closer to Albany and she said, “We don’t need to panic.” I don’t remember if she actually said this but she said, “Unless they pass us again going fast.” I kid you not but we were 5 minutes out from the hospital and her ambulance went by us with lights and sirens on. I had maybe seen her for 10 minutes before this and she couldn’t contact the other ambulance. So just traumatizing, all of it. Thankfully, when we pulled into the hospital, the first thing that the guy on the baby’s ambulance did was come over and say, “Everything is okay.” It was just something. They had a lead or something come off so they needed to stop and take care of it so it wasn’t a big deal but it made it feel like a big deal. We are in New York still for all of this. We get in there and I have to get settled in the postpartum section and she has to get settled in the NICU and then finally, hours later, I was still bleeding a lot so they were trying to take care of that. They were doing the fundal rubs and I remember texting my mom and I was like, “If they do it again, I’m going to punch someone in the face,” because it was so awful. They were saying, “It’s because the EMT didn’t do them on the ride over that you are bleeding so much,” so they kept coming over and doing them. It was so awful. So then we had a 23-day NICU stay in New York, just my husband and I because no one else could even visit us because it was 2021 in New York which was pretty bad for COVID. Once I was discharged after 4 days, technically, the only visitors allowed were my husband and I with our NICU bracelets to see her. Even if they had someone come, they couldn’t even come into the hospital. We didn’t really want to leave the hospital because we wanted to be there with her. We were Ubering to Target. We didn’t have a car because we flew there. We are Ubering to Target and thank goodness they had a Ronald McDonald house there so we were staying there and they supplied a lot of dinners and housing which was the biggest blessing in the world. I literally don’t know what we would have done otherwise. Getting discharged without your baby is super horrible and she was only 4 pounds, 10 ounces so she was really little and nursing just never took off for us. I didn’t get to try for a while even because she was being tube-fed and she could barely stay awake because she was so tiny. Every nurse that you’d have would tell you their tips and tricks which is great but not helpful when every 3 hours you are being told something different. We tried so hard and eventually got to the point where it was like, “Let’s just get home. We are 800 miles from home and if it takes a bottle, that’s fine. We just need to get home.” Yeah. After 23 days, my amazing mom drove to New York because we didn’t even have a car seat. It was all at home. She picked us up and drove us back home. Meagan: Oh my gosh. Shelby: Yeah, so then you are coming home with this little 5-pound baby and you are like, “How are we even allowed to do this? She doesn’t even barely fit in the car seat.” It was so crazy. After that, we were really unsure if we’d have more kids. Especially right after, we were like, “I don’t know if we can do that again.” My husband and I always wanted lots of kids and a big family. That has always been something that we wanted so after that first experience– and you do a quick Google search of placental abruption and they say, “Once you’ve had one, it’s 15% more likely that you’ll have another one.”You’re like, I can’t go through that again. That was horrible. I knew that if we got pregnant again, I was like, I’m going to feel like a ticking time bomb. All of these also quick Google searches tell you that it can happen as early as 20 weeks. Thank goodness we made it to 34 but I’m like, If that happens at 20, baby is probably not going to make it. Meagan: That’s a scary thought. That’s a really scary thought. They really have advanced the medical world so much to a point where even when babies are born really, really preemie, there are higher chances than there used to be, but the thought of that in general is just too much to think about. Shelby: Oh yeah, and my mom who drove to New York to get us– which is probably part of the reason they discharged us. She’s a NICU nurse so she actually knew how to feed this litle 5-pound baby who was still causing us feeding issues and all of the things, but I’ve obviously heard from her too the stories of the really early babies. I mean, even 29 weeks and I was like, It’s just too much. But we also knew that we couldn’t stay in that place because we both were not in a good place with it. My husband was obviously so traumatized for different reasons and I was too. It was just a lot. We started seeking out some faith-based counseling basically like spiritual reconciliationing kind of to work through it all because I knew even if we weren’t going to have more kids, I could not just live with that raw the way it was. Meagan: Both of you needed to process that. Shelby: Yeah. We were just praying for the release of that and we even prayed over our poor baby because I was like, She’s probably holding trauma from that too. The losses that I was experiencing were also losses for her. She missed out on the golden hour and a peaceful entry into this world. It would drive me crazy thinking that her first moments in this world were with people she didn’t know and it was bright in the room and being hooked up to machines. I was like, That was probably so scary for her too. We could tell for a long time, probably her first 7 months that she was so sensory. I mean, just screamed and hated the car seat, hated transitions, hated bedtime. I mean, it was basically non-stop screaming for 7 months. I was like, You were supposed to be in the womb for 6 more weeks and instead, you were in the NICU with lights and sounds and all of the things. We just started praying really hard over all of it and speaking to some really trusted friends who worked through trauma with people. I started listening to The VBAC Link. This is probably when it started obsessively. I was doing Amazon deliveries just for fun on the side. I could take the baby with me so I’d put her in her car seat. This was eventually when she stopped screaming in the car seat so it took a while. I would put my AirPods in and while I did all of these deliveries, I would just listen to back to back to back episodes forever and for months. I think honestly that was probably what started getting me thinking even about more kids. I started learning about VBACs and how really the odds of having a VBAC are not that horrible and that it’s really not any riskier than a second C-section and I was like, I really don’t want another C-section because that was– I mean, I couldn’t even roll over in bed by myself. My husband told me, “You don’t usually need me, but that was the one time you actually needed me.” He was like, “Honestly, that was really hard to see you in that much pain and struggling that much.” I was like, “Yeah. I couldn’t even pee by myself.” Meagan: Oh, I remember my husband literally helping with my second. He had to hold me up in the shower. I was like, “I just can’t stand the whole time in the shower. Can you just hold me up and shower me?” I remember feeling so vulnerable and I was frustrated because I’m like, This isn’t my personality. I’m very independent. Why is this happening? Yes. Shelby: Independent and strong. Yes. But also in my fashion, I was walking to the NICU by myself very slowly by day two. I’m like, What was wrong with me? But also, we didn’t have a choice. I was about to be discharged. We had to figure something out. Thankfully, I didn’t need to stay for 4 days, but because I had nowhere else to go, they were like, “You can stay all 4 days if you want.” I was like, “Okay, great.” But yeah, so I just started learning everything and consuming as much information as I could about physiological birth and about VBACs and there really isn’t a ton of information about placental abruption. There are risk factors which I had none other than COVID which no one talks about yet because it had just started, but I didn’t have high blood pressure. I obviously didn’t do drugs. Meagan: You didn’t have multiples. It was a singleton. Yeah. Shelby: It never happened before. My placenta was in a good location. Meagan: Your membranes hadn’t ruptured. Shelby: Yeah, my water never ruptured with her so it was crazy. But around when she was probably 9 or 10 months, I couldn’t even believe it, but I told my husband, “I’m not totally opposed to having another baby.”He was like, “For real?” We talked about it and we prayed about it a lot and I told God over and over again, “If I get pregnant again, this is going to be the biggest test of my trust in You ever because I know that if I try to worry about it, I’m going to go crazy. If I try to control the outcome which I can’t, I’m going to go crazy.” So it basically was like, “If it happens, I’m just going to have to trust you with it fully. No holding back.” Actually, before we were even pregnant, started shopping around for providers. Meagan: That is key. That is so important. Shelby: Yeah. We do have one hospital locally that has midwives and birthing pools. I was like, “Okay, that sounds like a pretty good option for a VBAC.” We went to talk to them– well, I went by myself. I had my list of questions ready. I walked in ready to not take any crap because I also knew a lot about what they were probably going to say and they said, “Yeah.” First of all, they wouldn’t call it a VBAC of course because nobody wants to do that. Meagan: TOLAC.Shelby: That was the first thing. I was like, “No. I’m going to do this.” Yeah, so they were like, “We’ll allow you to try.” I was like, “Okay.” They were boasting about their VBAC rates and it was 60%. It was not very high and I was like, “Umm, okay. That’s not that awesome, but all right.” They started listing off the things you have to do because I had all of these questions ready because I knew. So you have to have an IV hooked up. I was like, That’s annoying. I was like, “Can you at least have the hep lock?” They said, “Yeah, that would be fine.” Then they said, “But you have to have continuous monitoring.” I was like, “Okay. I really, really don’t want continuous monitoring,” and they try to make it sound better like, “Well, it’s waterproof and it’s mobile so you can still move around with it,” but I also knew about the statistics of continuous monitoring and how a lot of times they indicate things that aren’t actually an issue and then especially if you are a VBAC patient, they’re like, “Well, time for another C-section because baby’s heart rate is dropping.” Baby’s heart rate is supposed to fluctuate as they are descending. Meagan: Just like ours. Shelby: There was that and then they also said, “You can labor in the water, but VBACs aren’t allowed to push in the water.” I was like, “Doesn’t that defeat the purpose?” Especially if it’s a VBAC patient, we should be doing everything we can to ease the labor. Why would you make them get out right when they are feeling like they need to push? They were like, “Oh, well it makes the OBs uncomfortable.” I was like, “Well, the OBs aren’t delivering this baby so I don’t really care what makes the OBs uncomfortable.”So they made me schedule out all of my prenatal appointments and I went to one of them but I told my husband, “I just don’t want to have to fight for it. I know I can. I know that I can go in there and say ‘No thank you’ and be confident in myself, but I don’t really want to.” So I had never ever even considered a home birth. I don’t even remember how, but we somehow heard about the only home birth midwife in our area and I scheduled an appointment with her. I didn’t even get established with her until I was 19 weeks. I pushed out the OB care for a really long time when we found out we were pregnant because I knew we didn’t really love them. So I just didn’t go for a long time. I felt like everything was good. I felt like I was pretty in tune with everything. But yeah, I skipped a little bit but when we got pregnant with our second, it was a lot more immediate where I started praying about it all like, Okay God. This is for You because You are the only one who knows how long this baby is going to gestate and you’re the only One who knows if it’s going to end how we hope it does. I started praying. This is something. I started praying really specific prayers. I believe that God cares even about the little things which really aren’t little things in this, but I prayed that my placenta would be in a good spot and I prayed that my placenta would be strong and that it would make it all the way to term and I prayed that this baby would make it all the way to term. Literally every little concern I had, I pretty much sat in the shower every day and just spoke it aloud. I was like, God, I know that You are a God of healing and restoration and I know that You can do that for me. I believed that through this birth, He was going to heal the trauma from our first because I was like, that feels like this is how it has to go at this point. We went and we met this midwife. She didn’t doubt for a second. She didn’t say anything that was like, “I’ll let you try.” She was like, “You sound like a perfect candidate for a VBAC.” I told her that I had COVID and she was like, “Well, that’s probably why your placenta ruptured.” She told me that the placentas she had seen throughout COVID and recently, she was like, “They are not healthy and they are not sustaining a lot of them until the end of pregnancy or if they are, they don’t look good by the time they get there.” She wasn’t surprised. But yeah, she said, “You sound like a perfect candidate. I think you can do this.” At every appointment with her, we’d sit there for an hour and we’d talk and she totally respected all of my wishes. She’d ask me if I wanted to do something. I’d ask her for information and then she’d let me decide either way which was cool too. With our second pregnancy, we didn’t use a Doppler until I was in labor. I could feel her moving first of all so I knew that she was well but we actually started using a fetoscope which was really cool. You can’t start using it until after 20 weeks so we had to wait for a really long time to hear her heartbeat but our toddler would watch us do it too. It was really cute because she would walk around with this fetoscope around her neck and she would go put it on daddy’s belly and say, “I’m listening to Daddy’s baby,” or she’d put it on her belly and it was really sweet. Yeah, we took a full 180 with this pregnancy. I had learned so much at this point that I was so confident in my body and in my instincts and all of it. We didn’t find out the gender which with our first one, we found out at 8 weeks with the blood test. We didn’t find out gender. I didn’t do much prenatal care. We didn’t do genetic screening anyway with the first one either because that didn’t really matter to us. But yeah, I didn’t even do an ultrasound until we were 32 weeks or something. We waited a long time because I had learned a lot about ultrasounds and how we actually don’t know as much about them as we might think we know. Meagan: Might think we know. Yeah. Shelby: I read about how sometimes the techs are like, “Oh, they’re moving away from it,” because they can feel it and I’m like, “We’re not going to do that.” We waited and just had the technician who worked in our midwife’s office which was perfect because we could tell her we wanted a very minimal one just to check basically the heart and vital organs and the brain to make sure everything was okay. She would pause the screen and take the measurement she needed and take the Doppler off and everything so it was very minimal. I was like, “I don’t really care if they have 10 fingers and toes. We’ll figure that out later. Just check the important stuff. Don’t tell us the gender.” We did that and she basically was like, “Everything from as far as I can tell looks good.” That was pretty much all we did. My lifestyle was still very active and I was eating as best as I could. I didn’t really feel like I had anything that was anything of concern which was perfect. I remember at my 30-week appointment, my midwife looked at me. We hadn’t really talked about specific expectations I think for the birth because I didn’t really know what I needed or what I wanted but she looked at me at my 30-week appointment without prompting and said, “I think what you really need from me in this birth is for me to just be there and for you to just do your thing.”Meagan: I love that. Shelby: I was like, “That’s actually perfect. That’s exactly what I want,” because at that point, I had listened to hundreds of birth stories and watched hundreds of birth videos and shown them all to my husband. Everything I was learning, obviously I was soaking it in but if there was anything I felt was pertinent to me, I was showing to him too. He really benefited from that because we went into birth also with him not being afraid. He would watch birth videos with me and he’d be like, “Wow, that’s amazing.” That’s one of my things. Knowledge is power and educate your husbands too or whoever is going to be with you at your birth. Physiological birth especially, they should be comfortable with it. They should know what it looks like and how it progresses and how to best support you in that. That was huge for us. I made him watch a lot of birth videos and he wasn’t even weirded with it by the time it came around. But yeah. She said that and I was like, “Yeah, you know, that sounds great.” We made it all the way to 40 weeks and I just felt completely at peace the whole time. I wasn’t worried and I was like, “She’s going to come when she’s going to come.” Another thing they had told me at the hospital was, “We only let VBACs go to 41 weeks and once you go past 41 weeks, you have to have a C-section.” I was like, “I’m not going to do that. I don’t even know what my typical gestation is because I haven’t made it term.”Meagan: I was going to say, you didn’t even make it to 40 weeks. Shelby: Yeah, so my midwife was like, “Well, if you get to 42 weeks, we’ll do an ultrasound and make sure everything is okay,” but she wasn’t putting a timeline on it which was so great. I did a lot of courses. I stay at home with my daughters so I just listened to a lot of courses. I did the Christian HypnoBirthing one, our midwives did a course. It was really cool. They got us all together at one of their houses and went through a course with us and our spouses with all the moms who were about to have babies. I also did the Free Birth Society course which I was kind of so/so on but I was like, “If I want to know how to home birth, I just want to know about everything. I want to know about the complications that could happen and what you should do in those situations,” so even though I wasn’t planning to free birth, I still wanted to learn all of the things. That was one of the things that I did and I was just listening to constant everything. When we made it to– I guess it was two days before my due date, so July 29, I was having fairly consistent contractions in the evening and so we were all excited. We’re timing them and we were texting our moms but then they stopped the next morning which was a Sunday before church so we were getting ready to go to church but then I lost my mucus plug in the shower. I was like, “Okay, just in case something is going to happen, we should probably watch online.” We stayed home, watched online, and nothing was happening all day. We knew that we shouldn’t get our hopes up but also you make it that far and you’re like, “I’m just ready.” Our church had a picnic that night at a local water park so I was like, “Well, nothing has happened all day. We might as well go because we didn’t go to church.” We went to this picnic and we were doing the mini playground with our 1-year-old at the time who is water crazy. I think I jumped to get into one of the tubes and felt something kind of funny then around 8:30 PM, I had a really strong contraction. I was like, “Okay. That was unusual.” I went to the bathroom and had bloody show so I went back out and got my husband. I was like, “We’ve got to go home.” On the drive home, contractions were 8-10 minutes apart. I showered and we called the midwife and our photographer and my mom and grandma who were coming to get my daughter and the dogs because we didn’t know how it would go so we didn’t want anybody else there who needed care obviously. Meagan: Well and your last labor was actually pretty dang fast. Shelby: Right, yeah so I was like, “I don’t know how this is going to go.” My mom came and helped us clean up the kitchen which is where we were going to put the pool and everything. The midwife and her student arrived at around 10:30 PM. At this point, I was between the coffee table and the couch on my knees holding a comb and my husband was pushing on my back. I labored just in that one position for a long time and that felt as okay as it can feel. Then at around midnight, the midwife heard one of my contractions and was like, “That one sounded a little different. Let’s get in the pool.” So I got into the pool and that was instant relief. I was able to sit between contractions and try to relax then after a little while, I was too afraid to feel. We did zero cervical checks. I didn’t want to know. I was like, I just want to go. After a while, it was so cool how in tune she was with it all. She goes, “Why don’t you see if you can feel your baby’s head?” I was like, “Are you serious?” So I reached up and I could feel her head. I was like, “Okay. That gave me a little bit of encouragement to keep going.” I would say probably about an hour after I got into the water, my body started pushing. I didn’t push voluntarily once. It was wild. I felt something at one point. We were about to change positions again. I had been in the tub for a little while and they were getting the bedroom ready. I was like, “Hold on, something just happened.” I reached down and a big hand-sized bulge of my amniotic sac was sticking out still full of fluid.Meagan: Yeah, I’ve seen that. It’s so cool. Shelby: I told my husband, “Do you want to feel it?” Meagan: It’s like a water balloon sticking out of your vagina. Shelby: Yeah, then the midwife was like, “Okay, we’re not going to move. We’re going to stay here. Obviously this position is good.” I held a comb in my hand the whole time and I had my husband push on my back because with both labors, I have had total back labor. I don’t know why. I just have. I mean, she said I pushed for less than 40 minutes which was crazy. I felt her head come out but we didn’t know it was a girl yet so that was fun and then I tried to slow down because I knew that sometimes you need a push or a contraction between and you don’t want to get pushed too hard and tear but I couldn’t. My body literally just pushed her all the way out in one push. That fetal ejection reflex is definitely a thing. So at 2:14 AM was when she was born and my first contraction was at 8:30 PM. I caught her by myself in the water and pulled her up. She had her cord on like a backpack. It was around both arms and her neck so I had her head out of the water but I could barely get her up. The midwife came over and untangled her and I mean, my husband and I just sat there for probably over 5 minutes before we even checked what the gender was because we were just in awe. We didn’t even care. We were like, “Whatever. It’s fine either way.” So when we finally looked, we saw it was our girl and we already had a name picked out, Elowen Ruth so we got to hold her for a long time but obviously, my midwife could tell that I was bleeding a lot so she had me get out and I had planned not obviously to do Pitocin unless I really needed it especially before baby was born but it was a lot of bleeding. I tried one of our tinctures first and it didn’t really slow it down. So we did some Pitocin. She just did it. I didn’t even notice. I was sitting there holding my baby and I was like, “You can’t make this moment not perfect.” So we did some Pitocin and delivered the placenta. Then we went out and just sat on the couch and my husband made a snack plate and we all– the photographer and the midwife and her student and my husband and I just sat there talking about the birth and eating snacks.Then after a while, my husband got to hold her while I got cleaned up. I did end up having a lot of bleeding.Meagan: I was just going to ask if the bleeding resolved or did it continue?Shelby: I mean, it stopped pretty well. I didn’t end up having to go get checked, but about a week later, my mom and when I took the baby into her first appointment at our nurse practitioner, I wasn’t even there for me and she was like, “We are running iron labs on you because you look super pale.” I was really anemic and we didn’t know so I think that probably was something. Now I know for the future, if I have a lot of bleeding again, I need to get it checked out really fast because I think it really slowed down my healing. Other than the initial pain of a C-section, my vaginal birth recovery was much more difficult. I could barely walk or stand for 4 weeks. I could not believe it. I remember going to my appointment and I was like, “Is this normal?” The birth went so well. I know it was fast but I think it was because my iron was so low. My body just couldn’t heal. I did end up having a little bit of tearing but we didn’t stitch it or anything. It healed pretty well on its own. It was super painful when I would have to pee and all of the things but eventually, it healed up on its own. But yeah. I mean, we got to sleep in our own bed. Well, I mean, the husband and the baby got to sleep. I could not. That high we were on, my midwife told me, she was like, “Okay. She’s probably going to sleep for the next 5 or 6 hours and you should try to also.” I laid there and I was like, “There is no sleeping. There is none.” After that, she’s like, “It’s time to nurse 24/7.” Meagan: Of course. Shelby: She’s 9 months today and we are still breastfeeding which is huge because with my first, I exclusively pumped for 8.5 months and that was so hard. I was so determined. I also took breastfeeding courses leading up to this baby because I was like, “We are going to make this work because I do not want to pump again.” I love nursing. I have to leave for an Army training here in a couple of weeks and I’m planning to take her with me and still nurse her at night time. I’m like, “We’re going to make this go as long as we can.” Yeah, I mean, it was wild but so good. Meagan: Wild but amazing. Shelby: Yeah. Meagan: Did you find it healing? Because sometimes I feel like when you have a harder postpartum where you’re like, “I’m not walking as well and I’m feeling gross with the iron,” that can be defeating and frustrating. But did you find that healing or were you like, “I would still take this over the other?” Shelby: Oh absolutely. I mean, I definitely had times where I would just break down not only because of the hormones but everything else. With my husband, I’d be like, “I did it. Why is this so hard?” I had prepared for postpartum. I made sure we had help lined up for our daughter and for meals and for everything so I was really able to take the time I needed. I think if I hadn’t done that, I don’t know what would have happened honestly because I needed it. I couldn’t even sit on the couch. I had to be laying down in the bed or I was in pain. Meagan: Dang. Shelby: I think preparing for it definitely helped and the birth itself made it all worth it. Now, I’m like, Yeah, that was really hard for a couple of weeks but that experience made up for it for sure. Meagan: Worth it. Shelby: Overall, with the recovery, I’m like, Man, that was really hard with the C-section. it was two really hard days with the C-section but everyday is a little better. With my vaginal birth, I was like, Man, everyday is gettig worse. It’s hurting more. But it was still really good. Meagan: What was it that was in pain? Was it your pelvic floor? Was it your abdomen? Shelby: It was probably my pelvic floor honestly and also because I think I had torn and she came so fast and there was no slow stretching, I mean– Meagan: Fetal ejection. Shelby: From the first one, it was crazy. I think it really was pelvic floor. I remember one of my friends describing it as she just felt heavy. I was like, “Yes. That is what it is.” It just felt heavy and it ached. Yeah. That was hard. I mean, even being in the shower didn’t fix it and that was how my husband and I had planned to bond postpartum was showers together and stuff and I would be in there and I’m like, “I cannot stand up. I have to go back to bed.” Meagan: Too much pressure. Shelby: Yeah, for sure. Meagan: That makes sense. Okay, so let’s talk about faith and getting yourself through a really, really rough first birth and you finding that faith. Do you have any advice for the listeners to gain faith in their ability?Shelby: Yeah. I mean, for me it was just knowing that God created my body to do this. No matter what had already happened, my body knew how to birth. I think what helped was I was like, Okay, it’s already gotten fully dilated and effaced in my first labor. Maybe not gradually or the way it should have, but I was like, I’ve kind of already done it. I didn’t get to the pushing but just knowing that I was designed to do it and through a lot of prayer and speaking and speaking, “God, you created me to do this. You gave me this baby to grow and to birth,” and just the knowledge is the same thing. Learning about how your body was made to do this is just huge and like I said, just praying those specific prayers for me was so important and proclaiming the promises that God has that He is a healer and a redeemer and He cares about our birth stories. He totally does. That was part of His plan from the beginning. I think for me personally, my birth stories are my testimony. I feel like until these two babies, I really was like, Oh, I grew up in the church and I don’t really have a cool story which is fine but also with these babies, I’m like, I have never trusted God more with any situation in my entire life other than with the life of my children and bringing them into this world. For me, that was something I didn’t really realize until recently too. That same friend was like, “I think this is your testimony.” I was like, “You’re so right.” Meagan: That’s cool. Shelby: It totally brought beauty from the whole experience. From the first one, you are like, Why in the world did this happen to me? What good could possibly come of this? We’re traumatized. My baby is having sensory overload and I’m not at home. It was all of these things and then realizing that I shared about my story and I was able to connect with so many other moms who were like, “I had an emergency C-section” or “I had a really scary birth story” and now when I hear that a mom had a baby, my first thought is, How did her birth go and how is she doing? Did it go the way she planned and is she hurting? Those are my first thoughts instead of, Oh, is the baby okay? Okay, the baby is okay. It’s made me really passionate about postpartum moms and at some point, I’d love to do something with that not while I have a 9-month-old and a 2-year-old but just knowing that there can be beauty that comes out of every story because in the moment, it totally did not feel like it with our first baby. Meagan: Right, yeah. That is the case a lot of the time. It feels like there is no beauty at all anywhere in that story and then you go and you listen to these stories and there is beauty in every single story and growth in every single story. There is learning. I think there is just so much to take from these stories. Then I wanted to go over physiological birth. There’s a women and infant’s blog or website and it says, “A normal physiological birth and birth are defined globally by midwife organizations as a birth that is powered by the innate human capacity of the birthing person and fetus.” The innate human capacity. “This means that there are no interventions performed that disrupt the normal physiological process in the absence of complications that warrant interventions supporting the physiological process of labor and birth has the potential to enhance birth outcomes and experiences.”I do believe so wholeheartedly that there are sometimes here. You had a real thing happening, a real medical–Shelby: Right. Thank goodness for the medical system in that situation, you know?Meagan: Yes. Thank goodness for intervention in that situation but that doesn’t mean that we always have to just get all handsy with birth. It does show the benefits of supporting and fostering physiological birth of individuals include reduced Cesareans, increased breastfeeding success, improved birth experience, and reduced cost of care. Now, this world is very cost-minded especially with insurance and all of those things, but in the end, if you look at the reduced amount of money that we are spending when we are not paying for all of the interventions that happen during birth– and they don’t always happen. We know that this is not a blank statement where it’s like, “Every birth ends this way,” but usually when there’s one, there are more. That adds up. Right? In the end, it’s like, is that experience worth another experience? Even if you’re in the hospital, you do not– you can totally have a physiological birth in a hospital. I love that so much. Some people don’t feel safe out of the hospital. Shelby: Right. That’s physiological birth. The key is being where you are safe because your body cannot progress as it needs to if it doesn’t feel safe. I majored in animal science and I think about how animals won’t have their babies if they don’t feel safe. I think that we are mammals and our bodies are the same way. If you feel safest at home, awesome. If you feel safest in the hospital where you know you can get care right away, awesome. Yeah. You definitely just have to make that decision for yourself. Meagan: Yeah. I had a client who really wanted a home birth really, really badly. She decided not to, but decided to labor at home as long as possible and she was laboring and she was laboring and she was laboring and I was like, This labor. Something is off. Something is off. It was going but it wasn’t really going and through chatting with her and doing a fear-clearing and fear-release to see if we could get over to that next stage, she never said, “I want to go to the hospital.” She didn’t say those words but everything else that she was saying to me, that’s what I heard. I said, “Why don’t we go to the hospital? If we end up coming back home, that’s okay but let’s go and let’s just see how things are going.” She was like, “I don’t know,” because she was steering off of her plan in her mind of laboring at home. I said, “Okay, cool. It’s going to be your decision.” About 25 minutes later, she was like, “Yeah, let’s do it.” I’m not kidding you. The second she got into that car, it was a game changer. Shelby: Oh my gosh. Meagan: Because her mind was like, I’m going. She immediately felt better and safe. She didn’t realize that’s where she felt safer. We went. We had a total physiological birth. In fact, we didn’t know if we were going to make it. She had the baby on the bed and the doctor was not there. Shelby: There’s so much mental work that goes into it and everything. For me, knowing that I was going to my house. I hate packing and knowing I didn’t have to leave and go somewhere, that was how I felt safe but I know a lot of people who are like, “No, I want to be in the hospital.” I’m like, “Great. Do it. Just make sure you are informed.” Meagan: Make sure you are informed. That is the ending tidbit here to this story. Be informed. Take a VBAC class. We have our VBAC class online. If you have any questions online, you can always email us on Instagram or in our email at [email protected]. Hire a doula if you can. Hire a provider that you really, really trust to support you. Find that birthing location. Get the information. Learn what is important to you because what’s important to you is going to stand out that day that you are in labor. Get educated. Love yourself. Have faith in you and your body and your baby. You are amazing. You are a true Woman of Strength. Shelby: Yes. So good. Thank you so much. Meagan: Thank you. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
53:2609/09/2024
Episode 332 What The VBAC Link Offers & What is Important to Know with Meagan Heaton, VBAC Link Owner

Episode 332 What The VBAC Link Offers & What is Important to Know with Meagan Heaton, VBAC Link Owner

Women of Strength, so many things are important to know during your VBAC. Meagan Heaton is flying solo today telling you how to get the most out of what The VBAC Link offers. She goes through all of the resources from the Parents’ Course to the Doula Training to The VBAC Link Community and CBAC Community Facebook groups to blogs, newsletter emails, Instagram Q&As, and more. What do you need to know to have a better birth after an unexpected or difficult Cesarean? What is included in The VBAC Link Parents’ Course?While all of the information can be compiled and found through our hundreds of podcast episodes, blogs, and social media posts, the course is concise and comprehensive to have quick access to it all including: The history of Cesarean and VBACPreparing your mind and body for VBACEvidence-based stats on uterine rupture and moreHow to find a supportive provider How to choose between a repeat Cesarean and a VBACVBAC after multiple CesareansCoping tools during labor Family-centered CesareansRisks, benefits, and alternatives of interventionsHow to avoid an unnecessary CesareanWhen a Cesarean is necessaryThe VBAC Link Doula DirectoryThe VBAC Link Community Facebook GroupCBAC Support Facebook GroupHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Doula TrainingFull Transcript under Episode Details Meagan: Hey guys, this is Meagan today and I am solo. I don’t have a VBAC story coming your way today but I wanted to talk a little bit more about VBAC and what we need to know and what we need to do to prepare. If you’ve heard my own personal stories on the episodes a while ago, I think they are number two, go check it out. If you haven’t heard my VBA2C story, go check it out but during my journey, I’ve talked about how I felt alone in my journey. I had a couple of people within my space who were definitely cheering me on and my rocks, but the majority of the people in my life were very, very skeptical or judgmental or honestly just ignored me. That’s what would happen. I could tell people didn’t support or like the idea of me having a vaginal birth so they would just ignore me. Today, I wanted to talk a little bit more about the things that I did and then the things that Julie and I as we were writing our VBAC Prep Course were really truly the most important things that you should know. I want to talk a little bit more about what’s in our course and how you can prepare. I’m going to do that but I am going to share a Review of the Week. It feels weird to not be having somebody come on after but I’m going to share a Review of the Week and then I’m going to go into it a little bit more about what I did to prepare. This review is actually on our ultimate prep course. It says, “This course gave me the knowledge and confidence I needed to move forward with my plan to have an HBAC. When you realize VBAC is just birth and you hear the studies and the insights, they eliminate the myths that invoke a lot of the fear in C-section mamas, you realize you’ve totally got this. I was empowered to find a provider who truly supported me and realized how much my gut was telling me my previous provider was not the way to go. I can’t wait to share my HBAC story when the time comes. Thank you so much for all you do.” Okay, so going right into that, you guys. Like I said, when I was preparing, I did feel really alone. Number one, I think in preparing is finding that provider. Really truly, find that solid provider as soon as you can. We’ve talked about it here on the podcast that I suggest even finding a provider before you become pregnant because there is just this different thing about it where you’re not as vulnerable. You don’t feel as rushed. You feel more confident in your decision earlier on because you’re not feeling that rushed feeling. So sometimes I think we can choose a provider who seems kind of VBAC supportive but maybe isn’t as VBAC supportive as we would like, but we just choose them because we are pregnant and we need to start care. Find a provider for sure but something that we haven’t really talked about is finding your support system within your own circle. If that means that people in your family aren’t supportive, it’s such a hard line because you don’t want to just put your family aside, but at the same time, it’s really not going to benefit you if you have people within your circle bringing negative comments and opinions. I wanted to share one of the experience where I finally felt like I could share my desire. We were at a luncheon with my family members and someone asked me, “Where are you birthing or when are you having your baby?” I just said, “I am looking at possibly birthing out of a hospital.” Someone in my family turned to me and said, “No. You can’t do that.” I immediately felt defensive and adrenaline running through my body. I just wanted to say, “Whoa, whoa. Who are you to tell me I can’t do that?” Because at that point, I had really done so much research and decided that I was pretty comfortable with any risk of giving birth out of the hospital. I also had come up with a plan for if anything were to change to have a hospital plan as well. I felt very confident. I just looked at her and said, “Okay.” I just ignored it. But I quickly realized that that was not the space that I was going to be able to freely talk about my feelings and my desires because people just didn’t support it. Looking back, it really was that they just didn’t know. There are so many people out there even to this day in 2024 when I’m talking to people about birth stories and what I do, they say, “Wait. That’s a thing?” Still, in 2024, people do not know that vaginal birth after Cesarean is an option. That’s where it’s concerning. It’s just that so many people do not know. It is up to us to find that education but I felt like at that moment, I wasn’t in a place that I wanted to try and educate them because they were already coming at me so strongly and they already had their opinion formed. I also had some friends who I think were falling in line of a VBAC-supportive versus VBAC-tolerant or friendly provider where they were like, “Okay, yeah. You go do that Meagan,” but in their minds, they probably thought, “She’s crazy and I don’t think this is going to happen for her.” That was hard because I definitely felt that. I felt that feeling of, “You’re definitely not in my circle either.” Quickly, I really found that I needed to find that support. I encourage you to find that support within your own circle that is filled with people who are going to lift you up, build you up, and really truly support you along your journey. All right. We find the provider. We find our support system. Now we have to educate. What is really, really important or what was really important and is important for us as parents to get the education? We wrote this whole course. It’s over 100 pages in the manual and so amazing. Obviously, I love it to pieces but I wanted to go over a little bit more of what is included because we often do get questions about one, what’s included in your course and two, what do I really need to know? So let’s talk about it. In our parents’ course, the very first section is preparing your mind and body. You guys, we have to prepare our mind and body. I think this really does go into finding that support because as we are preparing, we have to have that support surrounding us and building us up because as we are mentally going through this, there are a lot of back and forth, Should I? Should I not? Should I? Should I not? Is it worth it? Is it not worth it? Mental preparation– we need to mentally prepare ourselves for birth whether you are going medicated, unmedicated, or whatever. Maybe you don’t even know what you want yet. Mentally preparing ourselves is so important. That really starts with honestly processing the past. Let’s process those past births. Even if you don’t think you processed that as a traumatic experience, you never know what may come up that may not be described as traumatic, but less ideal and something that offers tension. We also want to do physical preparation. Physical preparation is something that I am very, very passionate about because with my second baby– so with my first baby that I wanted to have a VBAC with– I really dove headfirst into physical prep. I believe that changed so much for me within my recovery, my pregnancy, and really just everything. Even though I had a C-section, I feel like I was able to “bounce back” both mentally and physically faster. Hydration was huge. I did not hydrate enough with my first. I was borderline preeclamptic. I never tested positive for it but I was swollen beyond swollen and I gained so much weight. I just really wasn’t as healthy. Hydration. Make sure you are hydrating. Watch what you are eating. Be mindful of what you are eating. Really get your protein in and your vegetables. Eat colorful foods and really take those good supplements. I know that there are so many, so many supplements out there and we really truly believe in Needed and their supplements so much. Get on a good prenatal. Make sure you are getting that protein in and if you need extra protein because it is hard to get protein in, get some collagen protein. That will help so much. Try to focus on exercise. If you didn’t exercise before, it doesn’t mean you have to just go an run a marathon. We’ve talked about this with MamasteFit. Just staying active, moving your body, walking, and if you can incorporate lifting weights, that’s great too but really being mindful in our physical and mental prep is so important. And then along the rest of the course, we are going to be going over things like the VBAC and Cesarean history. You guys, that is such a fascinating thing if you haven’t dove into that. It is kind of complex. There’s a lot to it and we really wanted to make sure that we brought it into an easier way to digest but really understanding the history of VBAC and the history of Cesarean and where we are today. We talk about women of color and the reasons for Cesarean and uterine rupture. Repeat Cesareans versus VBAC and what are the pros and cons? Because there are pros and cons to both. We are going to talk about the annoying calculator. Have you ever had a provider come to your visit in your prenatal room and say, “Okay, let’s talk about your previous Cesarean,” then typing things into their computer and tell you, “Oh, you have x% change of having a VBAC?” That’s the VBAC calculator and if you have been with us for a while, you know that we can’t stand it but it’s there and it happens and so we really want to educate you on that calculator because when we are given a percentage, it can impact. Women are told anything just like I was told in my second C-section that he was so glad I didn’t have a VBAC because I for sure would have ruptured. You guys, those things stick with us so when we get these weird numbers, they stick with us and they place doubt and fear. We’re going to talk about special circumstances. We’re going to talk about what ACOG says. That is a U.S.-based recommendation, but we are going to go over it because we really do look at the evidence that ACOG does provide. We’re going to talk about the contraindications of VBAC– when VBAC is safe and when it is not. We’re going to talk about providers and locations and hiring a doula. P.S., if you are looking for a doula, you guys, we have so many incredible doulas. You can go to the www.thevbaclink/findadoula and type in your state and area and it will pull up all of the VBAC doulas near you. We highly suggest a doula and if you can’t hire a doula, that’s okay too but we’re also going to talk about how to essentially get through birth without one as well. We’re going to talk about all of the benefits and risks and alternatives and assessing interventions. We know that there are lots of them.Sometimes there are interventions like stripping our membranes, or the stretch and sweep or scraping our membranes. Everybody calls it something different but even that, sometimes it’s not viewed as an intervention because we’re not putting something in an IV or something like that, but even those are interventions. We’re going to talk about the pros and the cons. We’re going to talk about when you are due. What does that mean? What does that 40-week mark mean? Does it mean you have to have a baby right now? First of all, no. It doesn’t. But we’re going to talk about what that means and what the evidence shows about going over your due date and the chances of even going into labor before your due date or on your due date. We’re going to be talking all about that. We’re also going to be talking about VBAC epidurals. A lot of people contact us saying, “Oh my gosh. I want to have a VBAC. My provider says I have to have an epidural and I don’t really want to because I’m worried about what it’s going to do or if it’s going to impact my labor.” Or we have the opposite where they are like, “I actually want an epidural. I don’t really want to go unmedicated but my provider is saying I can’t have one.” So we’re going to talk about that. We’re going to talk about laboring and positions and coping and tools to have a really amazing, positive experience. We’re going to talk about fetal positioning and how that can impact it. We know that that is one of the biggest reasons why Cesareans happen. Fetal positioning, failure to progress, failure to descend— those all three kind of go hand-in-hand. We want to talk about that more. We want to talk about uterine rupture and the signs of uterine rupture. We’re going to talk about C-sections and how to create a family-centered Cesarean. There are so many people in our community who after learning about VBAC and the risks of both, the VBAC risk is still not acceptable to them and that is okay. Or we know that a lot of people go in and they have a TOLAC or they are going to VBAC and then end in a repeat Cesarean so let’s talk about how to help these Cesareans be better experiences. You guys, and recovery. There are so many things that are so important to know during your VBAC. Then I want to just drop this little note right now that although we are doing all of these amazing things to prepare and understand and to get tools to navigate through our VBAC journey, we have to remember to not forget the postpartum experience. Women of Strength, it’s so important to make sure that we are cared for during postpartum. The way the world works today, it’s just not happening enough. We are getting right back into the busy hustle and bustle. We’ve got multiple kids. Work is not supporting paid time off so we are just getting right back into life, just life, and it is so important to take care of ourselves postpartum.If you haven’t been to thevbaclink.com, if you’ve only been here with us on the podcast, one, I’m so glad that you are here, but two, I highly suggest checking out thevbaclink.com. We have blogs that are amazing. We have so many blogs on so many topics– on ECV, on breech, on VBAC after multiple Cesareans. We have VBAC doulas, stats on VBAC doulas or just doulas in general. We obviously have our Find a VBAC Doula Directory. We have a VBAC Resource page filled with so many things and so much more. I highly, highly suggest checking out thevbaclink.com. Another place where you can find love and support is through our Facebook community at The VBAC Link Community. Answer all of our questions and we’ll get you in there so you can be surrounded by so many like-minded people that are really just wanted to know similar information to you and wanting to feel supported just like you are. We know that our family and our friends sometimes really aren’t those people and that’s okay. We love them, but this group is so solid. It’s so amazing. I can just feel the love every time I’m in it. I’m just blown away. I’m so stinking in love with this group. Check it out at The VBAC Link Community on Facebook. You can also follow us on Instagram. We are constantly giving out tips and suggestions and referrals. We have our Q and A’s every single week so you can check that out. You can go into our highlights and check out the past Q and A’s. We try to make sure to get all of them in there so you can go look at frequently asked questions and the answers as well as all of the sites and recommendations. Women of Strength, I hope that through this podcast, even though it is short and sweet and you just have me today, that you feel like you know more of what The VBAC Link offers and what you can get from us. We love you so much, so, so, so much and we want the best for you. We love to support and love and educate. With all that being said, I’m going to let you go and wish you the best of luck. I will be hoping to see you guys in the community. If you ever have any questions and you’d like to write us personally, you can reach out to us at [email protected]. Again, that is [email protected] and we will make sure to get back to you. Love you all and we’ll see you later. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
20:1304/09/2024
Episode 331 Lauren's 2VBACs + A Frank Breech Vaginal Delivery

Episode 331 Lauren's 2VBACs + A Frank Breech Vaginal Delivery

In this episode of “The VBAC Link Podcast,” Meagan is joined by Lauren from Alabama. Lauren’s first birth was a Cesarean due to breech presentation where she really wasn’t given any alternative options. Her second was a VBAC with a head-down baby, and her third was a breech VBAC with a provider who was not only supportive but advocated on her behalf!Though each of her births had twists and turns including PROM, the urge to push before complete, frequent contractions early on, and NICU time, Lauren is a great example of the power that comes from being an active decision maker in birth. She evaluated pros and cons and assumed the risks she was comfortable with. Thank you, Lauren, for your courage and vulnerability in sharing not only your birth stories with us but also your incredible birth video!Lauren's YouTube ChannelCleveland Clinic Breech ArticleThe VBAC Link Blog: ECV ExplainedNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. If you have ever wondered if a breech vaginal birth or a breech VBAC is possible, let me just tell you right now, the answer is yes and our friend Lauren today is going to share her story to confirm that it is 100% possible. Obviously, we do have some breech VBAC stories on the podcast but they are few and far between. I mean, Lauren, when you were going through it, did you hear a lot of breech births in general let alone VBAC? Did you hear a lot of people having those? Lauren: No. I had heard a few on The VBAC Link but that was really it. I did a lot of research. Meagan: Yes and it’s so unfortunate. This story is a double VBAC story but also a breech VBAC which we know a lot of people seek the stories for this because as she just said, there is not a lot of support out there when it comes to breech birth in general. We have a client right now who was just told that her baby was breech and they’ve already said, “We’re going to try to flip this baby but if not, it’s a C-section.” They didn’t even talk about breech vaginal birth being an option and it makes me so sad. I’m really, really excited to get into your episode. You are in Alabama. Is that correct? Lauren: I am. Meagan: Awesome. So any Alabama mamas, listen up especially if you have a breech VBAC but VBAC in general. If someone is willing to support a breech VBAC, I’m going to guess that they are pretty supportive of VBAC in general. We do have a Review of the Week so we will get into that. This is by sarahinalaska. It says, “HBA2C attempt”. It says, “Thank you, thank you. Your podcast came to me at such an amazing time. You ladies are doing something amazing here. I’m planning on (I’m going to) have an HBAC after two C-sections in February. I look forward to listening to your podcast on repeat to fuel my confidence, ability, and knowledge.” Sarahinalaska, this has been just a minute so if you had your VBAC or just in general, if you are still listening, let us know how things went and congratulations. Late congratulations because this was a couple of years ago. Meagan: Okay, everybody. Lauren, thank you again for being here. Lauren: Thank you for having me. Meagan: Yes, so okay. Obviously, every VBAC journey starts with a C-section so if you want to start right there. Lauren: Yeah. So my first son was about 7 years ago. He was born by C-section. He was also breech. Meagan: Oh, interesting. Okay. Lauren: He was breech through the entire pregnancy. We had talked to my doctor about doing the version but at 36 weeks, my water broke. Meagan: Okay. Lauren: So once your water breaks, you can’t attempt a version. I went to the hospital and they said that it would have to be a C-section at that point. I really didn’t have the knowledge that I do now and basically, it was worded as “I don’t have an option” and that’s just it. So that’s what we did. Meagan: Yeah. It’s so common. Even with non-breech, there are so many times when we come into our birth experience and we are left feeling like we don’t have an option. Lauren: Yeah. Meagan: It’s just so hard to know. Obviously, that’s why we created this podcast so you know all of your options. And then talking about flipping a baby and doing an ECV after your water broke, that is something I’ve only seen one time in 10 years of practicing so most providers will be like, “Nope. I won’t even attempt it.” I was actually floored when my client was actually offered that. Obviously, it’s a more difficult experience and it can be stressful on the baby as well so there’s that to consider. She ended up trying it. He tried it twice and it didn’t happen and then they ended up going into the OR. So okay. Baby was breech. Do you know why baby was breech? Did they say anything about your uterus or any abnormalities there? Lauren: No. They said sometimes it just happens. They knew how badly I wanted to have a vaginal birth and they said, “You are an excellent candidate for a VBAC.” So I was like, “Okay, great.” Meagan: Awesome. Lauren: That’s when I really took a deep dive into birth in general because the stuff that they were saying just didn’t sound right to me. Meagan: They said you were a candidate. So where did your VBAC journey start as you were diving in? How did that begin? Did you do that before pregnancy or after you fell pregnant? Lauren: Before pregnancy. Probably before the time I came home from the hospital with my son, I was already researching. Meagan: Baby was a couple of days old and you’re like, “And let’s figure this out.” Listen, I get that. That’s exactly how I was too with becoming a doula. It was literally two days after I had my C-section. I signed up to become a doula. Okay. You started diving in and what did you find? Lauren: It was very shocking to me how most providers don’t practice evidence-based. I found out the difference between evidence-based versus the standard of care. I was shocked about that too. I was just like, How can you do that as a doctor when you’ve got all this evidence here? But another doctor is practicing this way so it’s okay for you to do that. Meagan: Right. It becomes the norm or it has become the norm. Yeah. Okay. So you get pregnant and you know VBAC is possible. Tell us that VBAC story. Lauren: So that was just a wonderful experience but part of my research, I joined ICAN and I wanted the most VBAC-supportive provider out there. I did switch providers and I switched even before I was pregnant. Right when we were trying, I was like, I need to get in with a provider who is supportive. I found a wonderful provider. The pregnancy was great. I did all the things. I sat on the birth ball instead of on the couches. I made sure to take walks every day. I kept up with my chiropractic care. All of that were just tips that I had seen so I did that. She was head down by 20 weeks so I was super excited about that and she waited until 40+3 which was also a big thing for me because with my first son, they took him to the NICU so I did not want the NICU. The NICU was a horrible experience. I was like, Please, please, please hold on until 37 weeks. 40 would be great.She did. She held on until 40. It was funny too. It was like a switch flipped at that point and I was like, okay. Now I want to get her out. I was eating the spicy food and everything to try to get labor started. But 40+3, my water broke with her as well before labor started. I panicked a little bit because I didn’t want to be on a clock. Although I felt that I was with a good provider, I still hadn’t birthed with her yet and I’ve heard stories about people having this doctor who tells them everything they want to hear and then they get in the birth room and it’s completely different. Meagan: The bait-and-switch, yeah. It’s so hard because they talk about how we have to have this proven pelvis to be considered the best candidate or to have full faith in our ability, but at the same time, I feel like sometimes from us at a patient’s standpoint, they need to prove to us. They need to prove to us that they are supportive throughout. Lauren: Yes. For sure. So pretty quickly after my water broke, I started pumping and while I was pumping, the contractions started so I felt so much better. I was like, Okay, good. Now we’ve got contractions going. I had a doula at that point as well because I felt like having a doula was going to be extremely important for a VBAC. I called her and let her know. She came over and she just hung out a little bit. We did a henna on my belly and we just talked and talked through some fears and excitement and stuff like that. Then she said, “Well, I’m going to go get my stuff. Why don’t you lay down and take a nap and see if once things pick up, we can go to the hospital?” I said, “That sounds great.” This was my first time experiencing labor because with my son, even though my water broke, I never had contractions. They just went straight to the C-section. I went upstairs and I laid down on my left side. Within a minute, I was just like, Whoa, these feel totally different. This is crazy. Probably within 30 minutes or so, I was having contractions every 2-3 minutes. Meagan: Whoa!Lauren: Yeah. I was just like, This just picked up really fast. I think I was supposed to already go in by now. Meagan: Were they intense as well on top of being close or were they not as intense but just close? Lauren: In hindsight, they were not intense but it was my first time having labor and they were more intense than the beginning contractions. “Okay, they are more intense. They are close together. I’ve got to go now.” I was panicking. We made it to the hospital. They checked me and I was 2 centimeters. Meagan: Okay. Lauren: I was like, “You’ve got to be kidding me.” Meagan: Yes. That’s the hardest thing because we are so focused on the time. We are told if they are this close together, it’s time to come in but we sometimes forget about the other factors of intensity and length and what’s the word I’m looking for? I was going to say continuous but they are that pattern always. They are sticking to that pattern. They are consistent. They are consistent, yeah. Okay, so you’re 2 centimeters which is great by the way. It’s still great. Lauren: Yes. Oh, and I forgot to mention too that another that was like, Okay, I probably am with a good provider, I did call her after my water broke and she said, “What are your plans?” I just said, “I’d like to stay home as long as possible and contractions haven’t started yet but I’m going to try to start pumping and get them started.” I said, “I’d like to wait until tomorrow morning to come in if nothing has started.” She was like, “Okay. Sounds like a good plan. Just let me know what you need.” I was like, Wow. She let me go past 24 hours. Meagan: Yeah. I just love that she started out, “What’s your plan?” Lauren: Yes. Meagan: Versus, “This is what you have to do now.” Lauren: Yes. Exactly. She is wonderful and you’ll see through the story how amazing she is too. But anyway, we get to the hospital and I actually started out with a wonderful nurse. The hospital policy is continuous monitoring. Meagan: Yeah, very common. Lauren: But I did not want that. I was so lucky because the nurse who started, she was about to leave. Her shift was about to end but she let me start on intermittent monitoring so I was able to get up, walk around, get on the birth ball just to help things moving. Shortly after that, she left and the next nurse was not so nice about it. She told me, “It’s our policy. Yada yada.” I said, “Look. I’ve been doing the intermittent. I’m fine with the intermittent. That’s what I’m going to stick with.” She said, “You’re going to have to sign a form.” I said, “Bring it on.” Meagan: Yeah. Lauren: I signed the form and I was just like, “That’s fine. I have no problem signing a form to say this is my choice.” Then we labored in the hospital room for several hours and my doula suggested I got in the shower at one point and that was amazing. It was euphoric. It felt so good to get in the hot shower and I was progressing slightly more than a centimeter an hour which I know is what they look for so things just progressed pretty slowly and then that night at around– oh, well actually once I hit 6 centimeters, my body started pushing. Meagan: Oh, yes. That can happen. Lauren: I was terrified when I found out I was only 6 centimeters because they kept saying, “You need to stop pushing or you’re going to the OR.” I was like, “You don’t understand. I’m not pushing. My body is doing it.” It was several hours of working with my doula to try to stop my body from pushing. Every time I had a contraction, and they were still going every 2 minutes–Meagan: Did they give you any tips on how to cope with that or how to avoid pushing like horse lips or things like that?Lauren: The thing that worked best for me was opening my mouth and saying, “Ahhhh.” So that helped a lot but I would still say that 50% of the time I could not stop the pushes. I still remember that nurse saying which was not helpful at all, “Are you pushing? That’s the quickest way to the OR.” Meagan: Ugh. Not very kind. You’re like, “I’m trying not to. Can you see what I’m doing here?”Lauren: Yes. Then my doctor came in around 11:00 that night to check me and she said, “Oh, you’re complete.” I just remember being like, “Thank God.” I said, “Does that mean I can push now?” They’re like, “Yes.” That was the best thing I had heard because that was all I wanted to do was push. I was already in the bed because they had me on the monitor at that point. I was on my back so they just leaned the bed back. I didn’t really want to push on my back but at that point, I was like, “I’m not moving. I’m just going to push how I am.” I pushed. It took about 20 minutes and she just slowly came out. It was– oh, I’m going to get emotional. It was wonderful. My doula was also my birth photographer and she got some pictures. She got a picture of my husband. It’s really sweet. I hope he’s okay with me telling this but she got a picture of him crying. It was when she was almost out. I asked him about it and he said, “I just knew at that point you were going to do it. I knew how important it was to you.” Sorry. Meagan: I’m sure he had that overwhelming flood of emotions like, “I know this is important and I can see it. She’s there. She’s going to do this.” Lauren: Yes. It was wonderful too and then I got to hold her on my chest for a while but they weren’t too thrilled with her breathing so they never took her out of the room but they did take her over to the table and they were suctioning her and stuff like that. I started feeling a little panicky because with my son, what happened was after my C-section, they showed him to me. I got to kiss him and touch him and all that but then they started leaving the room with him. I was like, “Whoa, where are you going?” They were like, “Oh, we’ve got to take him to the NICU because he’s having trouble breathing,” but nobody told me anything. They just started leaving with him. I was panicking thinking that was going to happen with my daughter. I was like, “Please, please, please just give her to me. All she needs is me. She’s going to be fine. Just give her to me.” The nurse was like, “No. She needs suction. We need to do our job,” but my doctor was so wonderful. She came over and said, “What they’re doing right now is suctioning her because they are not happy with her oxygen level.” She sat there and she told me, “Okay, now she’s at 94.1%. Now she’s at 94.2%. Now she’s at 94.3%.” Every time that thing went up, she would tell me. She was just so calm and it was like she got me. She understood. Meagan: She understood what you needed in that moment. Lauren: Yes. Yes. Another thing too which I thought was really interesting is that first off, she did ask before she did anything. We got half of my daughter’s head out but she got a little stuck so the doctor was like, “You know, we really want to get her out.” She said, “I think the vacuum might help or are you okay with me manually helping you?” I said, “What do you mean by that?” She said, “I could just insert my fingers and tilt her chin. I think that will get her out.” I said, “Yeah. Let’s do that one.” So she did. She went in and popped her little chin and then she came out.Meagan: Awesome. Lauren: But it was nice to be asked instead of told what needed to be done. Meagan: Well not even told and just have it done. Lauren: Yeah, just do it. I’ve heard that a lot and it was crazy because that actually was going to happen with my first son. Before my nurses knew I was breech, they came in and they started. They were about to put medicine in my IV and I said, “Whoa, whoa, whoa. What are you doing?” She’s like, “Oh, this is Pitocin. We need to get your contractions started.” I was like, “No, I don’t want Pitocin.” She’s like, “We need to birth him within 24 hours or he’s going to be a C-section.” So it was just crazy the difference in being told what was going to happen and being asked for not only my opinion but my consent. Meagan: Yeah, absolutely. That’s so important. Women of Strength, if you are listening to this, please, please, please I beg of you to help you know. I don’t know how we can let you know even more but you guys have the power to say no and consent is so important. Your consent is so important with anything, even just getting Pitocin drips. If anything is happening to your body, you have the right to say no and you always can question. You can pause and say, “Tell me all of the risks here” or whatever. You don’t just have to have it be done to you. You do not have to. Lauren: Yes. Meagan: It’s hard to say no in that moment. Lauren: It is. It is. Meagan: It’s hard to say no especially when they are coming in and making it sound like something you need. Whether it’s something you need or not, you still deserve to have consent. Lauren: Yes, exactly. Then they throw that at you where it’s like, “Oh, the baby will be in danger.” You’re like, if you’re not knowledgable then you’ll be like, “Okay, then. I don’t want my baby in danger.”Meagan: Exactly. Of course, we don’t. Duh. Of course, we do not want our baby in danger but most of the time rarely is our baby in danger if we are not starting Pitocin right away. Yeah. Awesome. So you had this beautiful vaginal birth with support. It was a way different experience with good, true informed consent even into the postpartum period which should keep continuing anytime you are under care with anyone like this no matter in hospital or out of hospital. This kind of consent should continue. Lauren: Yes, for sure. Meagan: Awesome. Awesome. And then baby number three. Cute little baby. I don’t know if I’m allowed to say his name so I won’t. Lauren: Oh, yeah. You’re fine. Ollie, yeah.Meagan: I was going to say I got to see on the recording just before we got started that he was another breechie. Lauren: Yes, he was. I was just like, Oh my goodness. His pregnancy was so similar to my first son. It was a little freaky. I had a lot of anxiety to work through because of that. I was like, This can’t happen again. He was breech the entire time and basically stayed in the same position. He moved his little head around and that was about it. This time, I was I guess a little more– I don’t know if cocky is the right word but confident that everything would be fine. I was a little more lazy. I didn’t do as many walks as I should have. I sat on the couch a little more than the birth ball and things like that. I was like, Oh, he’ll be fine. So at about 20 weeks when he was still breech, I was like, Maybe it won’t be fine. Maybe I need to get this going. I started trying to do a little more of that stuff. Also, my doula had moved out of state so I was like, Oh no. Meagan: Dang it yeah. Lauren: I know it’s so important and having a doula was definitely important for me. I started the search for a new doula which ended up turning out great. I loved both doulas so I was very pleased but I was very nervous. But yeah. I found my doula while I was pregnant and then I just had so much anxiety about my first son’s birth that I needed a plan ahead of time basically. I talked to my doctor about it and I went in there just nervous to even bring it up. I said, “So he’s still breech. I know that he’s got plenty of time to turn but I am nervous because I have a history of this with my first son. He was breech and I had to have a C-section.” I said, “What are your thoughts on a breech vaginal?” She goes, “Well, I don’t see why we couldn’t.” I was like, “What?”Meagan: You’re like, “I wasn’t expecting that.” Lauren: She’s like, “You’ve already had a VBAC. You did fine. He can’t be sideways. He’s got to be to where he could actually come out breech. It’s just something that we’ll talk about.” She did mention an ECV as well and she was like, “We’ve got a long way away but I don’t have a problem doing a breech VBAC with you.” I immediately just felt so much relief. Meagan: I bet. Lauren: Yes. So we went along the pregnancy like that and then at 37+3 at 5:00 in the morning, my water broke. Meagan: 3 for 3 water breaking, you and I. They say 10% but when you’re 3 for 3, you’re like, “Hmm.”Lauren: That’s what I was thinking and the breech stuff is only 3-4% are breech and I had it twice. It’s like, How is this possible? But yeah, my water broke around 5:00 AM and me running to the bathroom, I woke my son up and he came in. It was really sweet. He got in bed with me and we just cuddled for about an hour and I talked to him about how his baby brother was going to come today. It was just a really nice moment to cuddle with him. Meagan: Oh yeah. Those moments are so precious because you’re like, these are the last moments of just us as a family of 4 and now we’re adding a 5th and these are the last little moments together without little siblings. I’ll always remember that. So we did that. We cuddled for about an hour and then the contractions actually started without me having to pump. This time, I was going to wait a little bit longer before pumping because I wondered if the contractions every 2 hours with my daughter for the whole labor was maybe because of the pumping. Having contractions that close made things really difficult. Meagan: Oh yeah. Not a lot of a break. Every 2 minutes, there’s not a ton of a break especially when they were a minute long. Not a lot there. Lauren: No. So I was like, Maybe that will change. I knew I could handle it but I was like, If I don’t have to, that would be great. They started pretty slow about 6 minutes apart or so really gently. At around 6:00, I went ahead and woke my husband up and let him know. I called my parents. I had texted my doula but I went ahead and called her just to let her know. I called my doctor. She again just asked me, “What are your plans?” I just said, “Stay here to let things pick up and then head to the hospital.” She was like, “Okay, that sounds good.” I just labored at home. My parents live 2 hours away but they were coming to get our older two kids. I was going to try to pack the hospital bag because I had not done that yet. Meagan: Well, at 37 weeks. Lauren: That was the plan for that weekend. I kept having to sit down because of the contractions. My husband said, “Let me do it. Tell me what you need.” I would just give him the instructions as I just bounced on the birth ball. We got that done and my parents showed up. They brought me a big smoothie because I was like, “I want to eat but I don’t want to chew so get me a smoothie.” That was really nice just to have something in my stomach and give me some energy and stuff. They got here at around 9:30 and at around almost 11:00, I was like, “These contractions are starting to feel real.” I had a first birth reference at that point. Meagan: Yeah, like more intense and frequent and strong. Lauren: Exactly. Oh, but I will say by 7:30 again, at 7:30 that morning, I was back at 2 minutes apart. Meagan: Oh man. It’s just something your body does. Lauren: That’s just me, yeah. But they weren’t intense and this time, I knew. I was like, Okay. I know this is not intense. I’m still able to talk through them. I’m able to recover very well, but then right around 11:00, I was like, “Things are getting really intense now so I think we need to go.”We left for the hospital and let my doula know. I called my doctor as well and it was really wonderful talking to her too because she said, “You know, when you go in there, make sure you are confident. Tell them this is the plan. You are going to do a breech VBAC. We have already discussed this.” I think she was worried too. The hospital, I will say, I do not feel was supportive. I think it was mainly that they were scared. I think she knew that too, but having her in my corner was what I needed. Meagan: Yeah, very huge. Lauren: We got to the hospital and she had gone ahead and called them to directly admit me so I didn’t have to do triage and all that. That made it so much quicker. We got there probably around 11:40 or so and we were already in our room and the doctor was coming in by 12:00. She came in and she checked me. She was like, “All right. You’re already at about a 5 or a 6 so you’re doing great.” She’s like, “I’ll be in the hospital for a while so they’ll just call me when you need me. Just do your thing. I was like, “All right. Here we go.” I did get in the bed for a little while so they could do the IVs and stuff like that. I told them I wanted the wireless monitor. They were having trouble working it but they still never made me do any monitors because I told them I can’t do continuous unless it is wireless because I need to be able to move. They didn’t argue with that so that was nice. Once they got all that done, I got on the birth ball. We played some music that I had preplanned and my doula and my husband both helped me work through the contractions then it was 12:58 which was less than an hour when my body started pushing again. I’m like, You’ve got to be kidding me. I can’t do this.They called the nurse in because I was like–Meagan: Last time this happened at 6 centimeters. Please don’t tell me. Lauren: They came to check and she was like, “Oh my gosh, she’s complete and he’s right there.” I was like, “What?” Meagan: Yay!Lauren: Yes. They called my doctor. I was panicking a little bit but she wasn’t there. She was in the hospital but because she wasn’t in my room and I went from a 5 to complete in less than an hour, I’m like, “Is this baby just going to shoot out of me?” I was like, “I need her to be here.” Anyway, she got there very quickly and this time, I knew I didn’t want to be on my back so they had me just try some different positions but I really liked when the bed was sat up and I was facing the back and leaned over it so I was upright. Then I was able to move my pelvis around and just find a comfortable position. I really liked that. I started pushing because I could. He just very, very slowly came out and my doula was recording because I wanted a recording of my last birth but I was just too out of it to even ask for it so I had let my husband and doula ahead of time that I wanted it so my doula took care of that. She was there recording it. Meagan: Awesome. Lauren: Yeah. I was pushing I remember this one hurt a lot more than my daughter. I think they stretch you differently. I remember panicking to my husband, “Oh my gosh. This hurts.” He was just slowly coming out but I couldn’t see what was going on. With my daughter, they rolled out a mirror so I could see what was going on. I felt like I was pushing wine. I didn’t ask him to but my husband stepped in and he was like, “Okay, I see a leg now. Oh, there goes the other leg.” He started just telling me body parts and I was able to get a visual which was so helpful to be able to know how much was coming out. When it got to his chest, it felt like my body was just like, Okay, we’re done. The contractions just stopped and I was like, “What’s going on? They were coming so fast and now they’re just chilling out or whatever.” They were like, “It’s fine. We’ll just wait until the next contraction.” They did start coming back but it didn’t feel as strong and it felt slower. I don’t know what that was about. It could have just been my perception too. He came all the way out up to his neck and then he wasn’t really coming much further after he got to his neck. The doctor was turning him because he had the cord wrapped around his neck twice. He just didn’t seem to be moving like he was supposed to. She said, “I need to check and see if his head is flexed,” and it was not. She had to put both hands inside to flex his head so that it was in the correct position and she had turned him over to try and get some of the cord off as well. It got a little intense there for a minute. She said, “Okay. I need you to get on your hands and knees,” so I did that and that wasn’t working. She said, “Okay, mom. I want to get you to flip over. I just need a different angle to get him out.” I flipped over on my back which I was completely fine with at that point. I wasn’t panicked. I had a little bit of anxiety and fear but I wasn’t really scared because my doctor seemed so confident in that she’s got this. We just need to do something a little different to get him out. We flipped on my back and she got his head exactly where it needed to be. I did two more pushes and he came out. He had gotten stuck longer than they wanted him to so she said, “We’re going to go ahead and cut the cord and get him to the nursery team who was coming in” because they needed to resuscitate him just from the time it took. Meagan: He was shocked Lauren: She said too, “He’s going to be okay. He’s trying to cry but he needs help.” I said, “Okay.” I felt good at that point. I knew that if he was trying to cry that he was still conscious. The NICU team– it was charted wrong how long he was stuck. I think they panicked a little bit because they just went and they intubated him immediately and they said, “Okay, we need to get him to the NICU.” I hadn’t even touched him at that point. I said, “Can I touch him or kiss him or talk to him before you take him?” I asked my doctor that and she said, “Can you bring him over here so she can give him a little pat before you take him?” The nurse looked over and she goes, “She can see him from where she’s at,” and they left with him. Meagan: Oh. Oh. Oh boy. Lauren: To me, it did feel like a punishment for doing a breech. They went back and looked and they charted that he was stuck for 5 minutes. We had a video and he was stuck for a minute and 40 seconds. Huge difference. Meagan: Very big, yeah. Lauren: They went immediately to what they would do with a baby who had been stuck for 5 minutes. They charted his APGAR as 0 but my doctor said, “It can’t be because he whimpered when he got out so he’s got to have at least something.” It was all just a big overreaction at that point. They were supposed to monitor him for 4 hours to make a decision and they immediately just made the decision to admit him to the NICU which meant he was stuck in NICU for at least 3 days. Then within– when I went to go see him, it was within 2 hours. They had already extubated him. He was already breathing on his own with no problems whatsoever. Meagan: He was fine. Lauren: Yeah, he was fine.The next morning, my doctor went and talked to the doctors–Meagan: The pediatricians? Lauren: Yeah. Yeah at the NICU and just let them know, “This is wrong in the chart. This is wrong in the chart,” educating them about breech VBAC. She also did talk to them about the behavior of the nurse and she said, “It was unacceptable.” They talked about that. Oh, because that same nurse, when I finally got up to the NICU to see him, she had her back turned and she didn’t see me coming and I heard her talk. She goes, “Well, you know, he came out the wrong way.” Then she realized that I was behind her and she walked away. I never saw her after that. Meagan: She probably was avoiding you. Lauren: I was like, Oh my goodness. I can’t believe that just happened. Meagan: Seriously. Obviously, she’s got a chip on her shoulder toward people who are doing things that are actually normal, just a different variation. Lauren: After my doctor talked to them that morning, as soon as she left, they called me and they weren’t going to let me breastfeed or hold him or anything like that because he had a central line in his umbilical cord and they said, “It’s too risky. It could fall out.” As soon as she left, they were like, “We’re going to actually let you try to latch and hold him. We’ll just have to be really careful.” Meagan: Good for your doctor for advocating for you guys. Lauren: That was one of my things that I just really love about her. That’s not something that she had to do. She took the time out to review everything that night. I had him on a Saturday so she reviewed everything that night, got up early the next morning, went to the NICU, advocated for me, and I’ll just never forget her for that. She’s my angel.Meagan: Yeah. That’s how it should be. That’s really how it should be. Are you willing to share her name for anyone looking for VBAC support and especially for breech? Lauren: Yeah. Her name is Dr. Robinson and she’s at Alabama Women’s Wellness Center in Huntsville, Alabama. Meagan: Awesome. Lauren: Yes. It’s really hard to find a VBAC-supportive provider in Alabama but breech VBAC? That’s hard anywhere. Meagan: I have Alabama Women’s Wellness Center because we have our supportive provider list that we are working on right now to perfect so everybody can get access to that in a better way and we don’t have her on there so I’ll make sure to add her. Lauren: Yes. Thank you. Yeah. She’s amazing. That’s probably an understatement. Meagan: She sounds absolutely incredible. I’m just so happy for you. I’m so glad that you had that advocate through a provider and it sounds like the second time, it was a little bit more of that informed consent, truly wanting to incorporate you into this experience with a little less of that the second time, but holy cow. Amazing. A minute and 40 seconds, that might feel like an eternity to someone watching, but really, that’s actually pretty quick and your provider knew, “Okay, let’s change positions. Let’s move. Let’s get this going,” and baby’s out. It can be common for babies to come out a little stunned breech or not breech. Sometimes they come out a little stunned and you also had a really fast transition so you went from a 5 to a 10 really fast. There are a lot of things to take into consideration there for sure. Lauren: Yeah. I think she said that they charted from the time his butt came out is what they told her and with a breech, you’re supposed to chart once the shoulders are out. Meagan: Yeah, the shoulders and the neck. That makes sense that they got that mixed up. Well, I wanted to go over the different types of breech. You already said this earlier that it’s kind of crazy that 3-4% of people will have a full-term breech and I know baby number one was 36 weeks but pretty much right there right around the corner of full-term. But 3-4% and you’ve had two so it’s pretty low but we know that breech is happening. It’s just not being supported. I wanted to talk about a couple of different things.There are different types of breech and that is something that I think is important to know. We’ve got frank breech and that’s where the baby’s butt is down into the vaginal canal or down and the legs are sticking right up where the baby’s feet are in front. Do you know if your baby was frank breech? Lauren: Yeah, they were both frank. Meagan: Yeah. That’s typically where a provider, if they are supportive, will allow a vaginal birth, and then complete breech is where the butt is down and both the hips and knees are flexed. Footling is where one or sometimes both– it’s like they are either standing inside or where they are being a flamingo and doing a one-foot thing facing down. Or we know that there is transverse where the baby is sideways. Footling and transverse– I mean, transverse for sure cannot come out vaginally. Footling has some more concerns so most providers will not support that. Anyway, overall, my suggestion is if you have a breech, one, know the options to try to help rotate a baby. If you so choose, there are also risks to ECVs. We have a blog around ECV and we want to make sure it’s in the show notes. We are going to link some more about breech babies as well but know that you have options. You do have options. It’s not like Lauren’s first where she walked in and was felt that she was stripped away of all the options. If you’re looking for a VBAC-supportive provider, something that I always tell my clients and I need to suggest this more on the podcast is while you are asking questions like, “How do you support VBAC?” and all of these questions talk about, one of those questions is “What if my baby’s breech? What does that look like?” I think that’s a really great question to add in there because then you can know, “Okay, not only is this provider VBAC-supportive, but they are even breech-supportive.” We never know. Sometimes babies just flip and sometimes they flip in the very end. It’s very rare but it happens so it’s just really important to know. Add that to your list of questions as you are going through and asking for support for VBAC how they are for breech. Do you have any other things that you would suggest for someone maybe going to have or deciding to have a breech birth in general? Lauren: Just try to be as knowledgeable as you can about it because that gave me a lot of peace just knowing all the facts and just the knowledge. It made me feel a lot more comfortable with it all. Meagan: Absolutely. It sounds like you did. You just told me a stat just barely so it sounds like you are very confident and you know about breech. I would suggest the same thing. Know the pros and the cons of all three– ECV, breech vaginal, and Cesarean. Let’s learn all of them. Well, thank you so much for being here with me today and sharing all of your beautiful birth stories and letting me meet your sweet Ollie via Zoom and sharing these stories to empower other Women of Strength to make the best choice for them. Lauren: Yes. I really appreciate it. I was very excited when you asked me to come on. Meagan: Oh my gosh. We are so happy to have you. Lauren: Thank you. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
49:3602/09/2024
Episode 329 Ashley's VBAC + Inverted T Scar & Extension + “You Will Never Have a Vaginal Birth

Episode 329 Ashley's VBAC + Inverted T Scar & Extension + “You Will Never Have a Vaginal Birth

Women of Strength, we have a truly inspiring story for you today! Ashley joins us from the Liverpool/Sydney area in Australia and shares her VBAC with an inverted T special scar and extension story. During her first Cesarean, Ashley’s OB mentioned that she had only performed that kind of incision one other time in her entire career and that Ashley would never have a vaginal birth.Ashley did not find out the actual circumstances around her first Cesarean until she requested her operative notes during her second pregnancy. In spite of what she was told, her heart longed for a VBAC. She committed to doing all she could to try and find a VBAC-supportive provider as long as it was medically safe to do so. Ashley went into spontaneous labor and utilized the tools available to help her baby rotate from a posterior position. She and her provider both stayed patient, trusted the process, and after pushing for 20 minutes, her baby girl was earthside!Special Scars, Special Hope Facebook GroupThe VBAC Link Blog: Special Scars, Special HopeHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. How are you today? I hope you are doing amazing. We have our friend, Ashley, with us today and you guys, she is from Australia. It has been so crazy. I don’t know why I cannot understand time. We were talking about how we literally had to Google, “What time will it be in Australia if it’s this time in Utah?” It was such a challenge to get this scheduled but I’m so grateful for Ashley for taking the time out of her Monday morning recording with us today so welcome, Ashley. Thank you for being here. Ashley: Thank you so much for having me on. Like I was saying to you before, The VBAC Link was so invaluable to me with all of the research and the statistics and just trying to hear other people’s stories to help me change my mindset to get through it so I’m really excited to add to that with my story as well. Meagan: Me too. Your story has a little extra tidbit to it. Something that we know happens because we’ve got lots of stories on them as well. We actually haven’t had one for a few minutes and yours is a special scar. You had an inverted T with an extension. Do you want to share with our listeners exactly what that means? We’ve had some J scars. There are all different special scars. An extension we know goes past the initial cut or incision. But tell us about the T. Ashley: Yeah, so I actually only found out after the surgery that it was an inverted T but I didn’t know what that entailed so I had to do a bit of my own research especially when I fell pregnant the second time to know what was involved with that. Yeah, it was really scary just to see that I had a vertical cut in the middle. Obviously, you’ve got your normal horizontal cut–Meagan: Low transverse, yep. Ashley: Yeah, that’s right and then through the center going vertically I had a 3-centimeter cut which was obviously riskier. A lot of providers said no to me when I started to look into it when I was pregnant the second time and started to have a look to get somebody to take me on. Even the public hospital that I had originally gone to with my son actually said, “No, you will have to have a Cesarean if you come through us.” In Australia, they can’t really say no to you in a public hospital if that’s what your wishes are, but I wanted somebody who was going to be supportive of me and the whole journey. So yeah. That’s where I come to going private instead and having an obstetrician this time which I know is quite rare with VBACs. You find a lot of people who won’t take you on. I had a really amazing experience if anyone is listening from Sydney. I’m in Liverpool and my provider was Brian Hollis and he’s extremely VBAC friendly. He was amazing. He had actually somebody with an inverted T before. Meagan: Really? Okay, so he had also seen one. Definitely there are so many providers out there who do support VBAC and then they have a special scar patient come in and they are like, “I really like VBAC but I don’t know. I’ve never seen this before.” But we know it exists so I can’t wait for you to share more in your story and about him maybe because we know it’s so hard. It’s so hard to find these providers. It’s hard enough to just find a VBAC-supportive provider in general and then that’s something unique that Australia does that at least here in Utah we don’t do with the private and public. We just have this hospital and then we have the birth centers and then we have the home births. There is not the dramatic difference in the hospital system like in your case. Okay. Oh my gosh. I’m so excited to dive it. I do have a Review of the Week. I’m so excited that I’m talking so fast. I do have a Review of the Week and then we’ll get into those stories. Like you said, you didn’t find out until after. That’s is the case so many times. They don’t even say during. We’ll go into this as well if they went into why but sometimes there’s not even a clear answer to, Okay, I now have this different, unique scar but why? We’re going to get into that. We have this review from xxooxx and it says, “Informative, supportive, and empowering.” It says, “After having a C-section that I certainly did not want and that I did not know was not necessary, I knew nothing about VBACs. I had dove head-first into this podcast and on top of learning so much, I became informed and empowered to get my VBAC which I got. Thank you, Julie and Meagan, for loving your listeners and pouring your knowledge and support into us. What you do matters and I will always recommend The VBAC Link.”Well, thank you, xxooxx, for that amazing review. Congratulations on your VBAC and I couldn’t agree more. This podcast really is so empowering and so informative like you were even just saying. I think a lot of this comes from the storytellers and the moms and the Women of Strength. This is just so amazing. I definitely suggest sharing this podcast to anybody. If they’re not a VBAC mom, if they’re a first-time mom or a second-time mom, I definitely suggest that because I truly believe that the stories on this podcast will help people avoid a Cesarean in general. Meagan: Okay, cute Ashley. You found out after so how did this first birth lead up to this inverted T with an extension? Ashley: Yeah, so I guess my story starts in 2020. I had a low-risk pregnancy and other than being sick the whole time but giving birth in March 2021 with my son and it was super traumatic. It took a long time to heal physically and mentally from it but my waters broke on their own two days before my due date. I had gone into the public hospital I was booked in for. I had seen the same midwife the whole pregnancy which was really fantastic. Midwives are amazing and just empowering telling a first-time mom, “You can do this.” I had no signs that anything would be wrong. So as usual, I went back home and then the contractions started that night. They started to really ramp up and become heavier so that night at about midnight or so, I tried to get some sleep. I wanted to stay home as long as possible. At 3:30 AM, I had to go to the hospital. I was just beyond. The pain in my back was just– yeah. I didn’t know if this was normal but in the end, when I got to the hospital, I was only 3 centimeters dilated. I had used the gas and the TENS to get through the contractions but he was posterior which I was nervous about. I didn’t know as many things as I knew in the second pregnancy in terms of Spinning Babies and trying to get into good positioning. With my son, I don’t know how it happened but he was posterior and the pain was just unbearable. Meagan: And it happens. We learn through pelvic dynamic courses and things that sometimes really truly, babies have to enter in a posterior position before they get into an anterior position and sometimes that means back labor. It is very, very intense. It really is intense. Ashley: Yeah. Yeah, it was. At this point, it went on for a few hours and I just actually couldn’t deal with it anymore so I had the epidural which turned out to be quite a good thing for me. It was relieving of some of that back pain but I still had felt a lot of it through it so it’s almost like it didn’t seem to work as much as I thought it would at that point. The contractions through my back were still there. We tried to do some things before I had the epidural to get into a better position, but it wasn’t working for me. Every contraction, my son’s heart rate would drop and the midwife was really good in just letting me keep going. “Let’s see. Let’s see.” But as soon as the doctor on call knew that it had been quite a few hours came into check me, “You’ve got meconium in your waters. You have to have a Cesarean.” I was just devastated because I had really thought that this was just going to be a great, empowering birth. I was so excited to give birth and to hear that it wasn’t going to go the way that I had intended, I was devastated and crying. But yeah, he was in a compound position as well so he did have his hand up past his head. There were a few things going against me in that time. But despite all of this, they gave me a little bit more time to keep going and I did get to 9 centimeters. I was in a position where they thought, “Okay.” My midwife was pushing, “Let’s try. Let’s try and see if she can continue and maybe we can try some repositioning to get him out,” but the doctor was, “No. Cesarean. There is meconium in the waters. Let’s get him out.” I was so exhausted. It had been 34 hours from the time my waters broke and I just gave in. When I was in that vulnerable position of just so much pain and didn’t know any better, I just said, “Okay, I’ll give in and I’ll have the Cesarean.” During the Cesarean preparing, I heard the surgeon say to her assistant, “She’s 9 centimeters,” and explaining it and the assistant said, “Should we just see? The head is almost there.” There was a little bit of whispering and then it all just stopped. I was just laying there terrified like, What’s going on? They’re talking about how far I’ve progressed and that they were concerned about me having a Cesarean.Meagan: Your baby was so low. Ashley: Yes. I found out later that he was so low that they had to push him back up during the Cesarean. Meagan: Did they push him back up vaginally? Ashley: Yes. Yeah. Meagan: They do that sometimes where they go in vaginally where one doctor is pulling from the other end and one doctor is pushing from the other end vaginally Ashley: Yes. Obviously the recovery is like you gave birth, isn’t it? Meagan: Yeah. Ashley: Yeah. The doctor panicked and I was in such a blur that my husband and I actually debriefed afterward and he said, “I’ve never been so terrified.” A team of doctors just flew in. She was making calls. Obviously, when she started to begin the Cesarean, she saw that she couldn’t grab him. He was too low and that’s why they had to cut vertically but nothing was explained to us. We were just lying there terrified. The tarp was up. Meagan: They were doing their thing. Ashley: Yeah. And with our first child, we didn’t know what to expect anyway but my husband just said there were all of these people who just flew in and there were all of these conversations and whispers. Not long later, he emerged. The tarp wasn’t lowered and he wasn’t breathing. He started breathing once they transferred him to resus, but that time was the longest time. Meagan: Absolutely. It feels like 5 hours. Ashley: Absolutely, yeah. I don’t even know how long it was but it felt like forever. By the time that they placed him on me for the standard amount of time I suppose, I was in just a shock that the spinal block had made me have the shakes. It was just not what I was hoping for. Meagan: Anticipated, yeah. Ashley: Yeah. They wheeled him away with my husband. They went and then I was to go separately into recovery. Before I did that, the doctor then lowered the tarp and said to me, “You will never have a vaginal birth. I’ve only had to do what I just did twice in my career.” Meagan: Oh wow. Ashley: Yeah, and just so brutal. Just the shock of that was like, I didn’t want this either. It was just really hard to hear because I just had this baby not how I had anticipated and to hear that for the future was a big shock to me. Going into recovery and then later on that initial bond with my son, I was just in so much pain that it was hard to hold him. It really took a long time to recover from it. The next day, she did come and talk to me. She said that she had to cut an extension and cut an inverted T incision of 3 centimeters to get him out. She said, “Yeah. I’m so lucky it wasn’t worse.” Meagan: Wow. Ashley: Yeah, then she left and I just had to go home and start my new life as a mum with just this recovery. I could hardly walk. As a Cesarean, it’s already painful, but I had all of this pain and it left me with an awful feeling mentally as well. I just obviously adored my son. I was so happy to be a mum but that lead-up and then just bang. That’s how you’re giving birth, it was just a shock. Yeah, so that’s what happened. The details of it I found out with the second pregnancy. I didn’t know afterward that was our only conversation we had. I didn’t get any discharge notes with that information. It wasn’t until I was pregnant the second time that I requested my hospital notes. Meagan: So important. So important to do. I really encourage anybody whether you were at one, two, different hospitals and all of the things, request your records because you really do learn a lot about what really transpired that day in your op-reports. Ashley: Yeah, definitely. Yeah, so I guess that brings me to now with pregnancy. A lot better, a lot happier result but I fell pregnant in May 2023. Both my pregnancies were normal, and low-risk. I was a little sick and I actually got quite dizzy and things like that but nothing that was going to impact me from giving the VBAC a try. Like I mentioned, I had gone to a few different providers and when I had my pelvic floor checks and things after my first son, I spoke to the doctors there and said, “Would it be possible to have a VBAC here?” They said no. That was something that was a big shock to me. I didn’t expect that I would have to look for somebody. Yeah. That was a big shock. I found out through some of my friends about this OB who was quite VBAC-supportive and I knew I wanted to give it a try and ultimately, if I did have to have the Cesarean, I would be okay with it but I just wanted to try. I heard about this OB and had an appointment with him. My husband and I after the initial appointment were instantly comfortable with him. He was so supportive. He said to me, “Ashley, is this what you want to do?” I said, “Yeah. I really would like to try.” He goes, “Well, that’s what we’re going to do.”Meagan: I love that.Ashley: Yeah. I was just like, “Oh my goodness. He’s so honest about this is how it’s going to be.” “If you want to give it a go, these would be my conditions,” which were to have monitoring which I was fine with. I still was a little bit nervous. I know that some people would rather have no monitoring and just let your body tell you, but with the special scar, I thought if there are any signs of rupture, I really want to know.Meagan: That’s actually a very common request from a provider in a VBAC situation. They usually want continuous monitoring. You can fight not to have continuous monitoring, but that’s a very normal request. On top of VBAC, having a special scar, it’s even more of a normal request for a provider to say, “Yeah, let’s totally do this. I just want to monitor things,” because we do know that one of the signs of uterine rupture is fetal distress. Ashley: Yeah, that’s right. He was just really supportive about, “Let’s put a birth plan together and see what you want to do and I’ll see what is the best thing to do.”During the pregnancy, I tried to do as much listening to podcasts. That’s how I came across your page and Instagram just constantly looking for information. It’s actually a beautiful Facebook group called, Special Scars, Special Hope. Being in Australia, I was just like, this is global. There were so many amazing women on there offering support and advice. There was even information on there– statistics. Yeah. I did a little bit of research but I didn’t want to overwhelm myself. I just wanted to have a really strong mindset. There were times of doubt and, Maybe I’ll just book the Cesarean, but then I thought, No, this is what I want. Let’s give it a try. My OB was really supportive from the beginning about, Let’s just see how we go. He retrieved my notes and he found out that all of those details where they had to push him back up vaginally and they had to do this extension cut and all those kind of things. It was good that he was prepared. He knew and I just tried to stay as active as I could through the pregnancy. I did the dates at the end. I did the raspberry leaf tea and the vitamins. I just was always on the ball. I tried to do as much as I could to prepare myself physically, but yeah.The conditions with my OB were that we said I would be giving birth at the public hospital that is next to the private. It was a different one to before because of any emergencies and that kind of thing. He would have to do some examinations every hour or so which I was also fine about. Obviously, I couldn’t use water. That was one thing I really wanted. I wanted to be able to get into the tub. Meagan: Birth in the water. Ashley: Yeah, or even just use it for pain management. He said, “No, because of the monitoring,” so that was one thing I was ugh about. I thought, When I do go into labor and it starts, I will try and use water at home before I get to the hospital. My husband was so supportive of me and said, “I will help you. Let’s do this. If you want to use the water–” he was a little bit nervous about, “When they start to ramp up, we really need to leave” because the hospital was about 30 minutes away. We just wanted to be at a point that no later than 5 minutes or so apart and they wanted me in. Meagan: Well, and you had already made it to 9 centimeters before so even though you’d be a first-time mom pushing baby out vaginally, your cervix is not as much like a first-time mom. Ashley: Exactly right. That was something that got me through the whole labor. I just kept saying to myself, My body knows how to do this. I’ve gotten here before. I know what to do. That was just something in times of doubt, I would just keep saying. But yes, my OB said at any point that he was concerned, we’d have the discussion and if anything was to go wrong, we’d be calling a C-section straightaway. I was fine about that. I came in at 39 weeks. Sorry, I booked at 39 weeks for a stretch and sweep but I got COVID. Meagan: Oh no. Ashley: My whole family all got COVID and I was just like, “No.” I couldn’t hardly breathe. I was congested and everything. I’m not going into labor like this. I’ve done that much preparation. So I just tried to rest and get better. It was put out until 40 weeks. I had until 41 weeks then he said we would be having a discussion about a Cesarean. He didn’t want me to go too long with the scar. So 40 weeks, my due date. I came in for a stretch and sweep. I came home to relax after, nothing. Nothing at all happened. No pain, nothing. Two days later, I started to have some mild period pains. I carried on the day with my son. I just kept going but I had been attending acupuncture weekly from 36 weeks. I had another session at 6:30 that night and by 9:30, the pain really started to ramp up. I decided to try and sleep but by the time I had a shower, laid down in bed, and at 10:00, they were coming faster, stronger, and I just knew I wanted to stay home as long as possible. I got into the shower then I did some type of positioning that I could get comfortable with the TENS machine on but I knew the pain of the back and I just knew that this baby had to be posterior again because the feeling was just like I had experienced it yesterday. Meagan: Deja vu. Ashley: Yeah. I just said to my husband, “She’s posterior. I just know it.” We left for the hospital at 1:30 in the morning. We got there and I had to walk a really long distance from the car to the birthing unit. It was just so odd. There was no one there, no wheelchairs for me, just no one. Meagan: Huh. Ashley: Yeah, I was so shocked. I was like, What’s going on? I just said, “This is going to help me progress.” Any little obstacle that would come up, I just said, “I’m going to be able to do this.” Helping I think in the end actually helped my labor progress.Meagan: I was thinking that. This is actually probably really good. That’s a lot of movement for the pelvis and good for the baby to rotate. Ashley: I was having these contractions that I had to get on the floor to breathe them out and rock through them. It took us a long time to get from the car to the birthing unit because I had to keep stopping but when I did get there, they were like, “Wow. You are almost 5 centimeters. You have progressed really quickly.” Meagan: Just like you wanted. Ashley: Yeah. The contractions then were so weird. It was like I had to push but it was too early to push. She was posterior. It was confirmed so that pressure was just such an odd labor. I didn’t have that at all even though I was posterior with my son too. This one was like an intense pushing feeling that I couldn’t control. Then yeah. Once I had discovered that she was posterior too, I just tried to get into some good positioning. I had done a lot of research about posterior because I was terrified of it happening again. I got on the ball trying to rock back and forth and my husband was such a great support because we had done a little bit of information reading about this pressure point on the lower back. Meagan: The sacrum?Ashley: Yes, that’s it so anytime I had these contractions, he would just push on there and I swear by that. I have to say more than the TENS machine, more than anything, that got me through that labor. But yeah. At one stage, I sat on the toilet to try and help with the pressure of this pushing and my waters broke. Yeah. That really ramped up from there. I was 6 centimeters at that point and it was unbearable. I couldn’t take it anymore. I asked for the epidural and the midwife was like, “Are you sure you want to do that? You said you didn’t want to.” I just knew that I had to do it. I couldn’t take it any longer. I was at that point where I was asking, “Just wheel me in. I’ll just have the Cesarean.” I didn’t want that. I wanted to keep trying so I had the epidural and I fell asleep. It was just like my body needed that. Meagan: Yeah. Rest and relaxation can really be the best tool in labor. Even in early labor, we are so excited and want to keep going but rest and relaxation. Ashley: I was so tired, yeah. I just relaxed. My body completely relaxed and I fell asleep for about an hour. At that point, my OB came in to see me and measured me and discovered that baby had turned while I was sleeping and I was 10 centimeters. In that hour, I had progressed that quickly. He looked at me and said, “Ashley, you’re having your VBAC.” He said, “You’re going to push this baby out. Within a half hour or so, this baby will be here.” I just was in pure– I’ve got the feeling all over again. I just was so in a pure disbelief. I was just so happy and I just said to my husband, “We’ve done it. This is it. This is the moment that I really wanted.” Yeah. It’s making me emotional all over again. I pushed for about 20 minutes under his guidance. I still had feeling and control in my legs because I didn’t have the epidural at full dose so that really helped and within 20 minutes, my baby girl was born.And just that feeling of pure joy and pure connection, that bond was just immediate. Pride, shock. Meagan: It was just all of it. Ashley: When they laid her on my chest, I will never forget my husband– the pride he had in me. Yeah, it was just beautiful and it was truly empowering. It was a beautiful moment. It’s just something you never forget. She’s 12 weeks now and I just relive that moment over and over. But yeah, it was my healing birth. Yeah, it was beautiful. It was everything that I had hoped for. Just shock, really because it was such a different experience to the emergency that I had with my son. I had that golden hour. She wasn’t taken away from me like my son was. They gave me that time with her and it was just pure disbelief in a beautiful way. Yeah, so that’s it. I recovered so much quicker and I think for me, that chapter of my life closed. It was just a beautiful way to really celebrate what birthing should be like and how I should feel afterward. You know, that bond that you should have. Yeah. That’s me. Meagan: I felt all of the emotions as you were sharing it and I know that I get an extra advantage because I can see your face and I can see you get teary. Oh, just to see it in your face. That moment is amazing when you realize you’ve done it and it is so overwhelming in all of the ways but holy cow, I am so happy for you. I am so glad that you were able to find the support because it’s just so hard. It’s so hard and you were even told– you hadn’t even met your baby yet really and were told, “Just to let you know, you will never have a baby vaginally.” To even be told that in that space, that in itself is so overwhelming and being told, “No. No one here is going to support you. No one.” When you are proof along with so many other Women of Strength who have had special scars and gone on to have a vaginal birth that it is possible and you do not have to but when you’re in that vulnerable state, I can just picture my own C-sections in an OR with the drape up and the bright lights and the beepings and if I were told that I would never have a baby vaginally again, I would already be in that emotional intimate space and vulnerable where I could have and many people could be like, Okay and then just never look past it and that was it. I’ll never deliver vaginally. But that’s where I think this podcast just is so important for people to listen and hear these stories that you may be told something and that may be true. That really may be the best choice in the future, right? It may be medically best or emotionally best but it doesn’t mean it is always what your fate has to be for the rest of your life when having a baby. Ashley: Yeah, and when I was told that and then I fell pregnant, I thought to myself, Okay, if that is what is medically necessary, I will do that. I just want my baby here naturally and safely. If it isn’t the way that I had hoped then that’s okay. At one point, I even looked at the maternal-assisted Cesarean and I had that discussion with my OB. He said, “Yep Ashley, if you decide you’re going to have the Cesarean elective, I’ll do that for you.” He’s like, “I will make it beautiful for you. I can play music you like. I’ll do whatever you like. It will be different from the first.” I said to myself, Okay. That is an option if I just feel that. Meagan: That’s a good plan B. Ashley: Yeah, that’s right. Exactly. He said if we call it early enough and there are no signs of rupturing, “I can still do that for you.” I still felt really comfortable going in that no matter what, this would hopefully be a better experience than what I had. But yeah, you’re right. There’s almost this stigma that C-sections, especially with special scars, that your body failed. I wanted to break the mold on that that bodies aren’t broken. I almost left my first baby coming home with him and I just looked at him and loved him and adored him but I also felt to myself, That’s not how I wanted to bond with you by laying here and I can’t move. I felt like my body was broken or it had let me down and this time around, I just believed in myself. I believed in my body and I said to myself, “Your mindset is everything. Going in, this mindset is how I’m going to birth this baby and get through it.” Birthing is incredible and I feel like we should feel incredible afterward. Meagan: Absolutely. Birth is incredible and it really is incredible no matter what, but the experience really does matter. We hear the whole “safe mom, safe baby” but of course, duh. That experience really, really counts and it sticks with us really for the rest of our lives. I mean, my oldest is going to be 13 in just a few months and I still remember her birth. My other is 10 and I remember her birth and of course, my VBAC baby I remember his birth and those are sticking with me. They are sticking with me and it’s just I love that your provider was like, “Listen. I’m going to support here and if it goes here, I’m still going to support you and no matter what, we are going to make this a better experience for you.” I love that your provider saw the better experience as an important part. Ashley: Yeah. I’m paying for him and his expertise. But I almost felt like he just wanted me to be happy. For him, it was like, “I can see your pain. I want you to be happy this time around.” We felt that from the initial appointment. It was more than just, “I’m paying for you. You have to do this.” It was like, “Help me get a better experience for you. What do you want? What can I do?” That was so important to me so it was wonderful. It was really important to me to acknowledge him as well because he was such an amazing support. Meagan: Yes. I’m so happy for you. I’m so happy for you. I do just want to mention that group again, you guys. Special Scars, Special Hope on Facebook. What kinds of things did you see in your experience in that group?Ashley: It’s just hearing other people’s stories because I would see VBAC stories and I was like, Yes, 100%. I need to do this and I need to do that. It’s got that little bit of a fear factor with it because it is a special scar and not that many people attempt it. So to have a group of women globally who do attempt it and just empower each other like, “Hey, I had an amazing experience. This is what I did,” that was just invaluable to me taking on all of this advice. Quite a lot of these women are in the U.S. and they do talk about how providers can either be for you or against you and just write you off completely. It is similar here too. There were quite a few who said, “No way.” They don’t want that liability so yeah, it was just really great to have that group with such amazing, brave women who are going out there and sharing their story on there because it helps people like me who are like, Look, it can happen. It’s rare, but it’s not impossible. That group is amazing. I encourage anybody who has had all of these different types of scars on there, not just inverted T. There are people who have had inverted J’s and extensions. So anything a little bit special. Meagan: Yes. I was going to go over the C-section incision types. We’ve got the low transverse which is considered the safest way to VBAC having a low, boring, low transverse. But then we have a low vertical which means they cut lower in the abdominal segment and it’s vertical up and down. Then we have classical which is higher and sometimes we have classical scars when maybe a baby is very preterm, very small and the baby can come out that way, multiples, or maybe if a baby is transverse but it’s earlier on or something like that, they may have to go higher. Then there is inverted T and like I said, inverted J’s and then we have extensions on all of these. There have even been low transverse with an extension where it can go further or that’s where it goes into that J. Yeah, there are just so many different types and honestly, the statistics are not that powerful out there. There are not a ton and I don’t know. I would say there’s not a ton of really solid concrete. There are some but they are smaller. Ashley: Yeah, really hard. I didn’t want to overwhelm myself with statistics and things. A lot of people in that group share the rupture risks and the statistics and what they throw at you, these OBs are, “You’ve got a 20% risk of rupturing,” that would turn anybody away. I just knew from women in this group that I had just glanced over seeing that it’s not that high. Don’t let anyone tell you it’s that high. Obviously, there are situations when you need to have the Cesarean because it is unsafe, but in my case, I knew that it wasn’t a 20% rupture risk. I knew that there was definitely less and mine was 3 centimeters. It can be bigger than that obviously, but when I had spoken to my OB, he said, “It is 3 centimeters but in the span of your whole labor progressing, 3 centimeters is not a big deal.”Meagan: That’s pretty small. Ashley: Yeah, it’s pretty small so even just hearing that, it was like, “Wow, you are telling me something different than all of these other people.” It’s good to back yourself up a little bit in your conversations and have just that little bit of research behind you. Meagan: Yes. We are also going to have a bunch of links in the show notes so if you guys want to go check that out, I highly suggest it. Go check out the show notes. We’re also going to have the link to that group because anytime anybody has a special scar, I’m like, This is the group. It’s so empowering over there. It’s so informative. There are not many groups like that. Specialscars.org as well. Ashley: But even most of the people who have had a rupture as well, that group is just a safe space to talk about how you are feeling and there’s a lot of women on there who have become friends really just in sharing their experience. So yeah, it’s a really informative, great group. Meagan: Yep. Awesome. Well, thank you so much again for taking the time out and figuring out the time changes and being here with us just 12 weeks after your VBAC. Ashley: Thank you and thank you for everything you do to help empower women. Obviously, it’s reaching globally and it’s just so informative and supportive. Yeah, it’s amazing so thank you for everything you do. Meagan: Absolutely.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
43:0728/08/2024
Episode 330 Grace's VBAC With the Odds Stacked Against Her

Episode 330 Grace's VBAC With the Odds Stacked Against Her

Grace found The VBAC Link Podcast while still in the hospital after her first unexpected C-section. Her recovery was brutal and she knew she never wanted to experience that again. Grace is a labor and delivery nurse located on the Wisconsin/Illinois border. She shares what it was like preparing for her VBAC while working at a hospital that didn’t support VBAC. Though she found a supportive practice, Grace faced unexpected pressure for interventions at the end of her pregnancy. Ultimately, she advocated her VBAC wishes and they continued to support her.When she contracted a fever and her baby had prolonged heart decels at 10 centimeters, Grace was prepped and wheeled to the OR. She mentally surrendered to the idea of another C-section. But when baby’s heart recovered, she was encouraged to keep pushing! Her baby boy came out in just four pushes and Grace was able to achieve the VBAC she so deeply desired. The VBAC Link Blog: Finding a VBAC-supportive ProviderThe VBAC Link Blog: 10 Signs to Switch Your ProviderThe VBAC Link Blog: VBAC vs Repeat C-sectionHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Women of Strength, we’ve got a VBAC story coming your way today. We’ve got our friend, Grace. Where are you? Illinois? Grace: Yep. I’m right in between Milwaukee and Chicago right on the Wisconsin/Illinois border. Meagan: Okay, awesome. Well welcome to the show and she does have a little babe right now with her. How old is your baby?Grace: He just turned a month old yesterday. Meagan: A month old and this is your VBAC baby. Grace: Yep. There he is. The man himself. Meagan: This is so fresh. Oh my gosh. I love when we get fresh stories. I feel like you’re probably still even processing as you tell your story. Grace: Yep. I am. I practiced a couple times to make sure I didn’t leave out important details. Meagan: Well, we are so excited to have you on the show. We do have a Review of the Week and then we’re going to get into your stories and then we’re going to talk a little bit about when the odds are stacked against you at the end and then spoiler alert, Grace is a labor and delivery nurse so I’m going to ask her some questions about how it is to be a labor and delivery nurse and supporting VBAC in her community. Okay, so we have this review. Its title is, “Tears plus stories plus hope plus joy equals education.” It says, “I discovered these ladies when I was 9 months postpartum from a very traumatic section and was eagerly beginning to research how to heal and build a new birth team for when my second baby came along. Now just a few months later, I’ve listened to almost all of the episodes and I hear the joy and the redemption these mamas have when they are in control of their births. It spurs me on towards my goal of one day having a successful VBAC. I cry when they cry. I feel joy when they feel joy. I feel sadness when they feel sadness and encouragement and elation when they succeed. It’s been quite the therapeutic discovery and I’m so glad Julie and Meagan created this resource. Each time Meagan or Julie directly addresses the audience as Women of Strength, I get goosebumps and I know in my heart I AM and WILL BE that woman of strength. I hope to one day share my version of success within this community.” That just gave me the chills so I’m just going to add tears plus stories plus hope plus joy plus chills equals education to that one. Thank you so much for your review. If you have not done so, as always, we would love them and you never know, you may just be read on the next podcast. Meagan: Okay, cute Grace. Grace: Hello. Meagan: Welcome, welcome. Let’s get going into your stories. Grace: Okay, so first of all, thank you for having me. This is amazing. I’m glad I had a VBAC but it’s even cooler that I get to be on the podcast. For my first pregnancy, I had just missed my first period so I took the test and was positive. I called my doctor and scheduled an appointment. I was about 6 weeks. At this appointment,  my doctor started calculating my due date with his little due date calculator and said, “Okay, it’s about May 26th. I’m going to induce you May 24th,” right off the bat. He decided we were going to be an induction. He said, “Since you are a first-time mom, it will reduce your risk of having to have a C-section if we schedule an induction.” I later found out he was actually just going to be out of town on Memorial Day weekend so he was pre-planning that for himself. But I didn’t know any better. I was like, “Okay, cool. I’ll know when I’m having the baby. I won’t have to worry about going into labor or anything.” Pregnancy went by with no complications. It was nice and smooth. At 39 weeks, he addressed again that we would be going in for an induction but he would just do the Cervadil. I went in that morning and they placed the Cervadil and told me, “Don’t move. Lay as flat as you can. You can only get up to go to the bathroom,” which is not true.Meagan: Hashtag false. Grace: I lay there all day. They take the Cervadil out and it didn’t do much for me. I wasn’t favorable in the first place. I was closed, thick, high, and then he checked me after the Cervadil and said the same thing. Actually, he told me that he’s never done this before but he’s just going to discharge me. He didn’t want to start anything else or doing anything. I appreciate him not just pushing Pitocin when he didn’t think it was going to be a good idea. We left feeling super discouraged because we told everyone we were going to have a baby and then we were going home. He said, “Come in a week later if I don’t go into labor naturally. Just come in and we’ll try again.” So I didn’t. We went in the following week. They put in the Cervadil again. They actually did two rounds of it this time and this time we didn’t tell anybody we were going to the hospital. We just didn’t want the, “Is the baby here yet?” and all of those questions adding to the anxiety of being in labor. So they took the second round of Cervadil out and still didn’t really have any change. I wasn’t contracting or cramping or anything but they just let me stay there. I ended up going into labor naturally which I don’t have the statistic verified but he told me that only 20% of people will go into labor with Cervadil alone. Most people need Pitocin or something else and some other intervention to actually cause labor. But my labor started. Again, he didn’t give me Pitocin which again, I’m grateful for. I was contracting all day. I have a pretty low pain tolerance so I had requested something for pain. They gave me an IV pain medication that I didn’t really like. It worked for a little bit but also made me feel a little strange.The nurses were like, “Okay, instead of getting more of the pain medicine, we recommend that you get the epidural.” This was about 12 hours after the contractions started.” I did get the epidural. I was still only a 1 at this point. They checked me after the epidural and he broke my water without really telling me that that’s what was happening. It just kind of happened. He broke my water and then I pretty much immediately went to 5 centimeters after he did that within the hour. I was like, “Okay, cool. It’s finally happening. I’m at 5 centimeters. I don’t feel any pain from the contractions. I have this epidural that’s working maybe even too good,” because I couldn’t even wiggle my toes but baby’s heart rate started dropping. This was a back and forth, “Are we going to have a C-section? No. Just kidding. You’re fine. You can push later on. You’ll dilate about a centimeter an hour,” is what they told me. But then they also had me come in and sign a consent form for a C-section. They put oxygen on me and repositioned me a little bit then they just called the C-section. We went to the OR that I had not even toured during our hospital tour because I was like, “I don’t need to see that. I won’t need a C-section so I don’t need to see what the OR looks like,” but then I ended up in there. My husband was in the hallway waiting to come in and the anesthesiologist was super supportive. She could tell I was losing it. They brought him in and the procedure itself went fine. There were no complications. Baby came out healthy. She had a cord wrapped around her foot twice which the doctor said he thinks maybe was why she didn’t come down, but I’m not sure. They took her over to the warmer and did all of her checks and everything. It felt like she was over there forever. Then they brought her swaddled over to me. We did the little cheek-to-cheek skin-to-skin. We got our classic C-section family photo on the OR table with our scrub hats on and then my husband and daughter left the room and they finished putting me back together. Then they took me to recovery which I was in there by myself. I had really bad shakes from the hormones or epidural. I’m not sure but I was shaking like crazy. That felt like I was in there forever by myself and then they finally brought her to me. She latched right away so at least I got to breastfeed her but we completely missed our golden hour. Meagan: Yeah, and you were let alone. Grace: Yeah, I was alone. Meagan: In a very scary time. Grace: Yes. The nurse wasn’t really talking to me. She was charting and stuff which I get that you’ve got to chart but I felt very alone in this recovery room. All that being said, everything did go okay. It still did not feel great that I had to have a C-section instead of my planned birth. I had my birth plan and everything. The next morning, the doctor did come in and he told me that for my next baby, I would have to have a C-section. He was like, “You can do all of the research that you want and the statistics are small, but I still would not let you have a trial of labor. You would be an automatic C-section.” Meagan: Did he actually say, “The statistics say this but for you, no.” Grace: No, it wasn’t just me. That’s how he practiced. Meagan: He just doesn’t support VBAC. Grace: Yes and he told me that a friend’s wife tried to VBAC and had some kind of complications. I don’t know how it ended so it also sounded like it was a personal thing. He didn’t do them for personal beliefs. Meagan: Yes. Grace: He left the room and that’s when I found your page. I started searching VBACs and how I could have one. I was so discouraged not being able to deliver vaginally. I was like, I’ve got to at least inform myself and see if I can find a way to do it and how to go about it. Knowledge is power so I wanted to know as much as I could going into it. I had my daughter. You’re busy with a baby so I didn’t do too much research in between. I just saw that it is ideal to wait 9 months before you get pregnant. I did find out I was pregnant at about 13 months postpartum and this was actually two days after I got offered a job as a labor and delivery nurse so I had a little bit of excitement all at once. 13 months postpartum, and the whole time my husband after he saw my recovery was like, “Okay. I will do whatever I can to help you have a VBAC,” because he knew it was very hard on me. I found a doctor. I just was like, I’ll just see doctors and feel them out. My first doctor I saw was super VBAC-supportive. He said that they do them all the time. I’m a great candidate so I was like, Okay. I’ll stick with these guys.My husband did a bunch of research too. He was looking up why people get induced and why you may or may not want to get induced to avoid a C-section and all of these things. He was my biggest cheerleader and came to appointments with me and was making sure our provider was as supportive as we needed him to be to try and make this happen. I also became obsessive. I was listening to the podcast all of the time on my way to work. If work was slow, I’d throw in an AirPod and do laps around the unit to be moving and hear the podcast. I was listening to it in the shower all the time and I found it really helpful just hearing other women’s stories. This pregnancy went by pretty complication-free. I did have some bleeding in the beginning which was just a subchorionic hematoma and they weren’t concerned about it. I actually didn’t tell people at work that I was going to VBAC because our hospital doesn’t allow for VBACs because we don’t have in-house anesthesia or OBs. I didn’t tell them and I didn’t want them to know I was trying. They would even ask me, “Oh, are you scheduling your C-section?” I’m just like, “Oh, I haven’t scheduled it yet.” I just kept working. At 37 weeks, I started anything I read online that could make labor happen. I was doing it. I was having the raspberry leaf tea, pineapples, the dates, walking, evening primrose oil. I was doing everything you could do to get my cervix ready to have a baby. At 39 weeks, we went to an appointment. I did start losing my mucus plug which made me very excited that something was happening on its own. At this appointment, I had a different provider. This practice had multiple doctors that could potentially be on when you deliver so you are supposed to see them all. I saw a different provider this time. He checked me. I was just a fingertip. They were going to maybe do a membrane sweep at this appointment, but he was unable to and then he mentioned, “Okay, if you get to 41 weeks, we’ll talk about scheduling your induction.” I was like, “Whoa. I thought we weren’t doing all that.” They seemed VBAC-supportive during the whole pregnancy and at the end flipped the switch and I felt like I was like, Oh no, I’m stuck. I’ve been seeing them the whole time. Now he’s going to try and push an induction on me. I left that appointment feeling worried. After that, my husband was like, “You should just chill out. Stop obsessing over all the things.” I had a checklist that said, “Eat your dates. Eat your pineapple. Go for a walk.” It was all of the things and it was causing me more stress than actually letting my body do anything on its own. I stopped. I even stopped listening to the podcast. I was just like, Okay. Whatever happens happens. I went on maternity leave too so that no one on work would ask me. I just took my leave early. Then on my due date, I went in. I was dilated to a 1 which was incredible news for me and 50% effaced. I was like, Wow. After all that Cervadil, nothing happened and this time, something is actually happening. He was able to do a sweep at this appointment. We did an NST too. He just said, “It’s protocol. Once you hit your due date, they do NSTs.” I felt great. I contracted and cramped all night. I was like, Maybe it’s happening, but this was just the start of some prodromal labor that went on and off for a while. I went into an appointment on Monday after that Friday and he said, As long as I agree to just keep coming in for NSTs, he said that he would let me go as long as I need to. They weren’t worried about induction. It was a healthy pregnancy. They weren’t worried about his size or anything like that. He did another sweep that Monday. That also caused me to cramp and contract. I was hand expressing as well to try and get my milk supply to come in. I was regularly contracting. I shouldn’t say regularly but it was happening and so I thought that at my next appointment, I’m going to be really dilated because this is all happening. Everything is really happening now. I went into my next appointment. This was a different provider again, a woman. She checked me and I was a 2 which was exciting as well. She said that she wasn’t able to do a sweep because the other doctor already did it and her fingers weren’t long enough so it wouldn’t be effective. Meagan: What? Grace: I was like, “Okay, whatever you say.” Then she sat down and asked, “If you do have to have a C-section, what is your mental state going to be because it is a possibility?” I knew it was but at this point in my pregnancy, I just didn’t want to hear the words “C-section”. I told her I would probably be okay. My eyes are wide open. I know it’s a possibility but I would feel pretty discouraged that I wasn’t able to have a VBAC. She told me if I did have a VBAC, I wouldn’t be able to pick up my daughter for at least two weeks so that really also freaked me out. Meagan: If you did have a VBAC? Grace: Oh no, I’m sorry. If I had the C-section, I would have to wait at least two weeks to pick her up. Meagan: Okay. Like a weight restriction. Grace: I’m sorry, yeah. She was like, “You don’t want to pop your incision,” which makes sense but I’m like, “I’m already bringing a new brother into her life and now I’m not going to pick her up.” That really scared me so I wanted to have my VBAC. So after this appointment, I was 41 weeks when I went to this appointment. That night, I had been contracting starting around 8:00 PM pretty regularly but they were spaced apart 5-7 minutes and then around midnight, the contractions became 3-4 minutes apart. They told me I could go to the hospital when they were 5, but I was worried that it would slow down my labor so I waited a little bit longer. I went in and out of the shower. I took a moment to hold my daughter and lay with her for a little bit thinking, Okay, we’re going to bring a baby home soon. It’s happening.We called my in-laws around 4:00 in the morning to come over because they were regularly 3-4 minutes apart for quite a few hours. They came over at 5:00. We got to the hospital at about 6:00 and it did happen. My labor slowed down. The contractions went to 6 minutes apart. When I got there, I was only 2 centimeters which I was in the office in the morning so I was like, How is this possible? I just contracted for all these hours and nothing happened? I did efface a little bit more. I was 70%. They said, “We’re just going to watch you for a little bit. We’re not going to send you home.” Of course, it started snowing when it had been 70 degrees all week. That’s the midwest. They said, “We’ll just wait. We’ll watch you. Hang out here. It’s snowing. We’ll see what happens.” I was just sitting on the yoga ball already pretty exhausted because I had been up all night. Then at 9:00 AM, the doctor came in and she was like, “Okay, I’m going to break your water.” The nurse was like, “Hold on, we don’t have an IV. We were just watching her. Let’s get some other things in place before you break the water.” Before she did break the water, I was very hesitant about them doing that because I wanted it to happen naturally. I didn’t want them to force anything and then be put on a timer because at our hospital, if your water is broken for x amount of hours, then it becomes, “Okay, we’ve got to get this baby out.” I didn’t want that. She said, “No.” They wouldn’t be worried. They might start worrying if I developed symptoms of infection but that still wouldn’t necessarily mean I would have to have a C-section. They would just treat the infection. I did let her break the water and they checked me six hours later. Again, I didn’t make any change but the contractions had been more intense for me so I ended up getting the epidural about a half hour after that at 3:30. Once I got the epidural, I was feeling good. They told me they wanted to start Pitocin. I was hesitant about that as well because it does increase your risk of uterine rupture not that the percent is that high, but I wanted to avoid it if I could but they told me I would be on a different protocol because I’m a TOLAC patient so they would go low and slow. They would start at a 1 and keep it slow. Anytime they did go over 2 though, baby didn’t like it. His heart rate would drop a little bit so they did end up turning it on and off all day but the contractions still stayed pretty spaced apart. Around 10:00, they did check me and I was a 4. His head was low. I was having some bloody show. They shut off the Pitocin because the contractions were every minute apart. Meagan: Oh, that’s a little close. Grace: Yeah. I don’t know. I couldn’t tell because I had an epidural but they also placed the IUPC and they did an amnioinfusion which we don’t really do much at our hospital so I was pretty unfamiliar with it and she explained that they wanted to just replace my fluid because I had been ruptured for a while and baby needs some fluid to come down and help me dilate so they did that. I feel like I had all of these wires going everywhere. After a little bit, I did end up getting a fever. They gave me some IV antibiotics so with all of these things happening at my hospital, I would have been a C-section for sure. I could tell they were very VBAC-supportive. They came in and repositioned me so frequently because his heart rate would drop. The nurse was in there all night. I was like, This poor nurse is in here every 5 minutes repositioning me or doing something for me. Around 1:00 in the morning, I felt such intense pressure. My epidural had worked really well, but I was feel all that pressure of his head. She didn’t want to check me because she said, “We don’t want to be in there too much because,” Meagan: You already had a fever, yeah. Grace: They waited, but this pain and pressure was pretty intense for me. I was crying through the contractions. It felt like my body was pushing for me. I was like, “Can you please check me? I know that you don’t want to but I’m feeling like something is happening.” I ended up throwing up which could also be baby is getting ready to come out. They did check me at 6:00 in the morning. I was 10 centimeters. She called the doctor to let her know and said– this was also the doctor who I had my last appointment with who didn’t sound super on board with me having a VBAC. Meagan: The short-finger one? Grace: Yeah, little fingers. Meagan: Little fingers. Grace: I was like, I really hope she’s not on. They were like, “She’s on for 24 hours.” I was like, “Okay.” She was the one. She was like, “Let her do a practice push then I’ll be in there soon.At this point, I had been in so much pain from the pressure all night that I was like, “I don’t even think I can push him out.” I’m a first-time mom basically because it’s my first vaginal birth and I could be pushing for 2-3 hours. I was like, “I don’t know if I have it in me.” I said that to my husband. I was like, “I don’t know if I can push.” He was like, “Don’t be discouraged. If you have to have a C-section, you have to have a C-section.” That lit a fire in me. I was like, “No. I did not just go through 31 hours of labor to call it quits. I’m going to at least try to push and see what happens.” I do one practice push and the little guy’s heart rate drops and doesn’t recover for 6 minutes. Everyone is rushing in– the doctor, the hospitalist doctor, all of the nurses. They were like, “Don’t be discouraged. You did everything you could but we’re probably going to have to have a C-section.” The doctor goes, “I think your uterus is rupturing.” I’m like, “Okay, that’s scary. Don’t tell me that.” I’m like, “What is even making you think that?” She’s making a little note in the computer. They are putting in all the orders for me to go into the OR. She said, “But if baby’s heart rate recovers in the OR, we’ll let you push in the OR but we want everyone around to make sure if we do need to have a C-section, we have the whole staff ready to go.” They wheeled me in, were giving me meds in the hallway while I’m on the way in there. The nurses were super comforting though. One of the nurses told me that she tried to TOLAC with her second and ended up having a C-section and that it’s nothing to be ashamed of which it’s not. I just really wanted to do it. I felt like up until that point, I did everything I could. They wheeled me into the OR and the anesthesiologist said he partially blocked me. He gave me ⅓ of the dose that they would give for a C-section but I felt very numb. I could not feel the contractions. I couldn’t feel my legs, nothing. They hooked me up to the monitor and his heart rate recovered miraculously. He was in the 150’s. They said they wanted me to push. I also had already thrown in the white flag mentally and said, “I don’t know if I can push. I’m scared now.” I froze up. I was like, “I don’t want to have a C-section. I don’t want to push. I’m just in this limbo right now of I don’t know how we’re going to get this baby out.” They told me that they wanted to use a vacuum. Initially, I was like, “I don’t really want you to use a vacuum,” but the hospitalist said that it would  help us get baby out faster when I’m pushing. I did finally consent to them using the vacuum. So we’re in there. They nurses had to tell me when I was contracting because I couldn’t tell. They had this audio of my monitor on but they couldn’t see the strip for some reason so they were just palpating my belly to tell when I was contracting. They would say, “Okay, push now.” With four contractions and the help of the vacuum, I did push and got baby out successfully. Meagan: Just four? Grace: Just four. I know I kind of cheated with the vacuum. Meagan: That’s pretty dang fast though. Grace: 10 minutes of pushing and he came out with copious amounts of the fluid that they had replaced. I had said I wanted him to be skin-to-skin if I could. He came out good so they put him on my chest. They actually let me reach down and feel his head while I was pushing and that really motivated me to get him out. The nurses were so helpful and so was the doctor. I don’t think I could have pushed him out as good as I did if they weren’t literally rallying around me like, “You’ve got this. You’re doing great pushes. He’s almost there.” I got him out and I got to hold him then they said, “Let’s just take him to the warmer for a little bit. He swallowed some fluid.” They were reassuring me the whole time then they ended up letting him come back to me. I got to wheel back to the room with him with me which was so exciting for me. I got to breastfeed right away and we went to our postpartum room as a family. I just remember that it was such an emotional rollercoaster at the end. I prepped so much for a VBAC. Okay, just accept the fact that you’re having a C-section. Just kidding, you’re getting your VBAC. I felt like there were so many junctions where it could have been like, “Okay, we’re just giving you a C-section.” We ended up getting lucky and having the baby. I feel like I could not have done it without the nurses and the doctor and all of the information I learned from this podcast so seriously, thank you guys so much for what you do because you make such a big difference in people’s lives. That night, I got to pick up my daughter and lift her up and show her her new brother in the hospital. I was so happy. A month out, I’m able to move. I don’t feel like myself again, but closer than I did when I had my C-section. This all went so great and I’m so glad I got to do it. Meagan: I am so glad too. I am so grateful to you for being here and sharing your story with us. It’s always fun to hear that we were in people’s ears along the way. Man, it’s what we were talking about in the beginning with the odds stacked against you with this happening and it could also go to this or the baby’s heart rate drops and then they do this and then this happens. There are all of the things that could go wrong, but a lot of the way, it seemed like you were making the choices that felt best for you even when it might have been, “Hey, we’re going to come break your water,” and it might not have been exactly what you want but you ultimately felt good about it. So let’s talk about that. When someone comes in or if VBAC isn’t supported in this hospital and maybe that’s your only hospital, that’s a really hard one. In your hospital you work in now, you said, “If that were my hospital, I would have gone in for a C-section and they don’t support it,” so what do people do in your area when your hospital doesn’t support it?Grace: They definitely don’t support it. They would just automatically schedule you for a repeat Cesarean and if we did get a patient in who was in labor, we would probably transfer them or we would have to make sure that the OB who was on is close enough to get there. In my short amount of time that I’ve been there so far, I did see one VBAC. They made an exception for her. The OB stayed overnight. Meagan: Wow. Grace: So did the anesthesiologist. She ended up VBACing and having a big baby and everything. I feel like the odds were kind of stacked against her too but other than that, they don’t try to do it and since they don’t do it, because we don’t have the resources, a lot of the staff there just doesn’t believe in VBACs and they have a lot of– like I said, I didn’t tell anybody I was VBACing but I would hear them talk about VBACs and I’m like, I can’t tell you guys that I’m doing this until I succeed at it then I can be like it is possible. Meagan: What did they say?Grace: They were really glad that I got it how I wanted it. They did know that it was a rough recovery for me and I told them the C-section was really hard on me and our family so they were like, “I’m glad you got to do what you wanted.” Meagan: Yeah. Well, when the odds are stacked against you, and the odds are looking different for everybody. Sometimes it’s advanced maternal age, big baby measuring, over our due date, special scar, VBAC after multiple Cesareans– I mean, there are all of the things that can be stacked against us, but when you are in an area that isn’t supportive, that’s good to know that they would even transfer them and be like, “Actually, we’re going to transfer you to this hospital.” You can transfer hospitals. Of course, you can decide to explore home birth. You can try to find a different provider within that hospital because if that hospital is supportive but that provider isn’t supportive, there are things you can do. I’m going to have a link for a whole bunch of different blogs on ways to find supportive providers, what to do, and also how to decide if a VBAC or a C-section is right for you because I think that can be hard when you find a location that is not supportive. It sometimes is easier to just make the other decision and go along with it. Okay, so labor and delivery nurse. You are relatively new. Grace: Yes. Meagan: But how has it been? How do you feel like birth is in your location?Grace: I feel like it’s good. They do a lot of inductions there. A lot of the patients, they’ll say, “Let’s induce you around 39 weeks.” Initially, my first over a month of orientation, I didn’t see a vaginal birth. I only saw C-sections. It was very common. I don’t know if I was unlucky. I don’t know. Maybe it was the shift I worked because I worked 3:00 in the morning to 3:00 PM. I’m not sure. I was like, “I’d really like to see a vaginal birth because I–”Meagan: Am hoping for one. Grace: Exactly. I was pregnant then and I didn’t tell anybody but it was nice working while I was pregnant and being able to actually learn a lot more while I’m working about labor. I could watch my contraction strip and know what it means. It helped me have more knowledge going into my own situation and then I felt like I was pregnant forever so at the end of my pregnancy, I’m like, They were due after me and they had their baby. Everyone was over there having their babies and I was still pregnant. I was like, I’m just going to grow him as long as I can and when he’s ready, he will come out. Meagan: Yeah. I love that. I love that you’ve been able to learn. I think that’s one of my favorite things too just being a doula. Obviously, I’m not there actually charting those strips or anything like that but it’s been really fun to learn that strip better because we can tell baby’s position sometimes based on those charts. We’ve got coupling contractions sometimes and we know that baby is in a wonky position. Huge congrats to you. Grace: Thank you. Meagan: If you decide to go back to the labor and delivery route, I wish you all of the luck and I’m sure that you’ll be cheering people on and supporting and helping them along the way. Grace: Yes and now I can help them better because I went through a C-section and a vaginal and now I can kind of relate to all of the patients in what they might need. Meagan: Absolutely. Absolutely. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
35:1628/08/2024
Episode 328 Amy's VBAC + Meeting Your Provider in the Middle + Breathing Tips from our VBAC Link Doula Desiree

Episode 328 Amy's VBAC + Meeting Your Provider in the Middle + Breathing Tips from our VBAC Link Doula Desiree

With her first birth, Amy hired a doula and planned to birth at a birth center. During labor, her baby kept having late heart decels which led to transferring to the hospital. At the hospital, Amy stalled at 9.5 centimeters. Baby was having a hard time descending and continued having decels. Amy chose to have a Cesarean and while she was at peace with the experience, she knew she wanted another chance at a vaginal birth. Amy proactively prepared for her VBAC by educating herself and working with her provider to find common ground. Her labor progressed well, Amy coped beautifully, and was able to push out her 10-pound baby! Amy talks about how recovering from birth can be difficult no matter what type of birth you have. Our VBAC Link Doula, Desiree, joins as Meagan’s co-host and touches on the importance of breathwork. As a licensed therapist, Amy also talks about how she uses breathwork with her own clients. “Practice it before you are in labor because then it’s easier to do while you’re in labor.”Desiree's WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome, Women of Strength. It is an amazing day to listen to another VBAC story. We have our friend, Amy, from Massachusetts coming your way sharing her VBAC story with you. Then we have one of our VBAC Link doulas, Desiree, with us as well. Welcome, ladies. Desiree: Hi.Amy: Thank you. Meagan: Hello. Thank you so much for being with me today. We do have that Review of the Week so I’m going to actually turn the time over to Desiree and read that. Desiree: Yeah, so the Review of the Week this week is provided by Ashley on the VBAC Doula course which I am very familiar with. I am so excited to read this one. Ashley says, “TOLAC/VBACs should be treated just like any other birthing person but there is certain preparation and information that needs to be offered to them. Your course covered that. The value is held in your careful recognition of how to best support our clients who are doing a TOLAC. I cannot praise you two enough for the fear-release activity. Honestly, it is something I can apply to even myself before and after birth and even in life in general. Thank you for that. It has already helped three of my VBAC clients.” Meagan: Oh, that’s amazing. That just gave me the chills. I love that. Fear release is so important. Women of Strength, if you are listening, we have that in our course because we truly believe in it. I think fear release in anything in life. We could just be scared to go in and take a test and fear release of that. But when it comes to birth specifically, I don’t know if both of you would agree, but we’ve got to do some fear releases and let go and also process the past, right? Desiree: Absolutely. Yes. I would say it’s good for everybody going into birth, but definitely, if you’re a VBAC or going for a TOLAC because you take your previous birth experiences into the room with you and if you haven’t done the work, then you are just setting yourself up for roadblocks. Meagan: It’s so true. I will admit that I did fear releases and I did lots of processing and I still had little bits of bouts of roadblocks in my VBA2C birth. That was really hard, but I was so grateful for the knowledge of how to do that fear release and work through it in those moments in my labor and because I had already done so much beforehand, the little roadblocks that were there even though they were roadblocks, I was able to get through them so much faster and more efficiently. Okay, Ms. Amy. Thank you so much for joining us. Amy: Sure. Meagan: Yes. We would love to turn the time over to you. Amy: Okay. So I actually gave birth to my two kids and then I gave birth in two different states. My C-section story was from when I lived in Massachusetts then I moved back to Minnesota and had my son which was my VBAC and now we are back in Massachusetts. Yeah, so with my daughter, I hired a doula. I gave birth and wanted to give birth at a birthing center that was outside of the hospital but it was connected to the hospital system but it was run by midwives and more holistic, more of what I was aiming for. Just like with your first births, you have all of the plans and I think partly that is some anxiety mitigation of if I feel like I have a plan then maybe I know what to expect. I worked with a really amazing doula. We didn’t take a birthing class through the hospital. She did that education and I was feeling relatively prepared as much as you can with a first birth. I had a week’s worth of prodromal labor. I always am very cautious. I always call it prodromal labor because I feel like the term false labor is so demoralizing when you’re in it like this isn’t real labor and I’m like, No, it is. It just isn’t progressing the way I want it to. Meagan: Well, but it’s still your body working. I think that’s what a lot of the time we forget. It’s not progressing the way we want but our body is still very much working and making progress behind the scenes whether or not a number of centimeters or a number of effacement is reflecting. We are still doing work and making progress. Amy: Yes, exactly. But my prodromal labor liked to happen only at night so I was going off of probably three or four nights of really not sleeping through the night. Again, as a first-time mom, I didn’t really know. I was up with adrenaline because I didn’t really know 100% what I was experiencing. I did stop going to work. I was going to work up until labor and then I just stopped going to work the last couple of days because I was like, I’m not sleeping. I’m stressed and tired.I went into labor the night before my daughter’s due date and felt the contractions getting a little bit stronger around 10:30. I went to bed. I woke up around 12:30 and told my husband, “Okay, I think this is really actually happening now.” We labored through the night. At 4:00 AM, I called my doula. We met up at the birth center. I was already 6 centimeters. I was obviously so thrilled about that. I was like, “We’re going to have this baby by mid-morning. It’s going to be great.” Then they started checking her heartbeat. From the beginning, she was having a lot of decels and they kept monitoring it, monitoring it, and monitoring it for 20 minutes which again, wasn’t really the plan that I was going to be sitting in bed monitoring her heart rate the whole time. I wanted to be up and moving around but they just couldn’t get her heart rate to stabilize at that point so they moved me over to the hospital then. It’s a birth center but they are across the street from the hospital so they literally put me into a wheelchair and rolled me across the road. That’s when all of the interventions started. From there, I progressed I think to about 8 centimeters but she was having those decels off and on the whole time. Then I think we ended up getting an epidural. I wasn’t planning to but I got an epidural about that time. I don’t know what time of day this was, maybe noon just because it had been a while now. I was tired and they were like, “Maybe if you rest a little bit, we can get her into a better position or something.” Really, what ended up happening was because of her decels, they wanted me to be on continuous monitoring which made it so I couldn’t move around as much because the nurse didn’t know how to apply the wireless ones. That happened so it was just one thing after another and my doula was great. She was really supportive. We did try a few different positions, but it was like every time I got in a position that felt good, they were like, “Oh no, we lost her heartbeat. We have to have you move again.” I think the process was frustrating. I did get the epidural. I got all the way to 9.5 centimeters dilated and then we just sort of stalled. And then of course probably around 5:00, this had been close to 20 hours of labor and they were like, “Yeah, I don’t know. We could try a few more positions but I think this is just going to keep happening and now we are worried that she’s going to get distressed.” So it wasn’t really an emergency C-section at all. They were like, “Here’s what we think. We’ll give you a few minutes to talk about it with your husband and doula and see what you guys think.” It was definitely hard. I was discouraged and frustrated by that but at that point, I just wanted her out. Now that I’ve read, and when I was listening to The VBAC Link and listening to so many other stories where we probably could have given it more time and all of these other things, they did a C-section and they actually found that her umbilical cord was wrapped around her neck twice. She never really descended into the birth canal fully. She never really engaged in my pelvis. Part of me wonders if it was partly that where she had that umbilical cord and that was going to be tough for her through the birth canal. I don’t really know. But she was healthy and everything was good. I honestly didn’t feel super traumatized by that experience but obviously I wish it had gone a different way. That was my first birth and then about two years later, well, my daughter was 2.5 when I got pregnant with my son. I was the middle of the pandemic. It was 2020. Is that when I got pregnant? Yeah. It was the fall of 2020. I definitely started looking into VBAC and found your podcast and was like, I would like to really try for a vaginal birth this time around. I think what was challenging about that and as you are talking about going in with fear is that I felt like even though it was my second baby, I felt like I was going through the process like a first birth because I never pushed. I never got to that point with my daughter so I felt like I had that anxiety almost like I was going into my first birth again. That was hard for me, I think, mentally. But we had moved to Minnesota at that point so unfortunately, I didn’t get to use the same doula that I had before. I found another doula and I think she had a lot of knowledge and I think she did a good job but I think overall, we just didn’t connect as well emotionally. Honestly, I realized that was almost more important to me. Obviously, knowledgeable and certified is good but not feeling like we were always connected, I struggled with that at times. Meagan: Sorry, not to interrupt you but I was just going to say that can impact the way you are feeling and walking into any experience so that connection is really, really key. Amy: Yes. Yeah. I’m a therapist. That’s my job and so obviously, I say that to my clients all the time about therapy too. I never got to the point where I was like, Oh, maybe I should look for somebody else, but I think looking back, sometimes I wish I had. But during the labor and stuff, I think she was great. Yeah. It was different than my first time. So yeah, I did a lot of research about Spinning Babies. My doula helped me with some of those exercises. It was stuff I was aware of before, but I didn’t look into it as much. Then one of the things I was curious around because when I had my C-section, my OB was like, “Oh, well you have a flat pelvis so it is going to be hard for you to ever have a baby vaginally” is what she said to me. My doula was like, “Well, you know. Around pelvis shapes and stuff like that, that’s a very gray area. Generally speaking, we don’t subscribe to that because your pelvis is moving and it isn’t a shape.” But I was curious about that so I looked into that through Spinning Babies and some of those other resources and about how babies engage in your pelvis and how does baby engage to progress labor.Meagan: Yeah, different stages. The baby can be in sometimes different– I mean, we all have different shapes of pelvises so the baby has to come in different positions and sometimes that even means posterior so sometimes we do all the things to avoid posterior babies, and then our babies still go in posterior but that’s actually because of the way our pelvis is shaped or the way it was that day that our babies needed to get into the pelvis in that position. Sometimes they can kind of hang up until we find those positions that can help them navigate down. Amy: Yes. I mentioned that to my doula and we both did some research on it because I think that was part of the issue with my daughter. There wasn’t a consistent engagement. Even though my labor progressed for the most part, I was sort of wondering about that. I also was– I can’t remember when this exactly happened but I think around 32 weeks, I started measuring big. Of course, my OB who I would say was VBAC tolerant. I wouldn’t say she was VBAC-supportive. I did like her quite a bit but she was like, “Okay, your baby is measuring big and because of your history–” she goes through the whole, “here’s your percentage of having a successful VBAC.” I’m 5’9”. I’m larger. I’m not a petite person so even if I had been, I don’t subscribe to that because of listening to VBAC podcasts and stuff, your body can birth a large baby, but also, I wasn’t as worried about it because I know that sometimes those projections are completely off and so it was part of that process of learning to respectfully disagree with a medical professional who I did have respect for and did feel like they had some expertise but to say that we don’t have to agree on everything for me to work with you. That was a huge turning point for me just in my life in general working with medical professionals of, I don’t have to completely throw everything you say out the window but I also don’t have to agree with everything that you say and we can respectfully disagree on that issue. So I was like, “Respectfully, I’m not going to schedule a C-section at that point.” She didn’t pressure me at all. She was like, “I understand. Let’s move forward with the plan.” That’s what we did. I think that was empowering. As we moved closer to my due date, he was big. I was not sure at the time, but I was like, I’m going to go into labor early. That was a mental block for me. Then as it gets closer and closer and closer to my due date, I’m going out of my mind just losing patience. I’m not a good, patient-waiting person as it is so I’m having prodromal labor for the whole week before my due date and at that point, I actually did schedule a C-section for the following week because I needed mentally an out-date. That was what it was in my mind of, Okay. If this goes on for another week, I have an out, even though that’s not what I wanted. I think honestly mentally, it took a weight off my shoulders which is counterintuitive to what you would think when everything in me was working toward this VBAC then I was like, No. A couple of days before he was born, I needed that second date in my mind somewhere. Meagan: Well– oh, sorry. Go ahead, Desiree. Desiree: I was going to say I think it actually makes a lot of sense. You say it’s counterintuitive, but you’re right. We spend so much time and energy thinking about achieving our VBACs and having our babies. Sometimes having– well, even if I don’t do all the things, I can still have my baby and then relaxation happens. That’s when we see labor starting to take off for a lot of people. Amy: Yep. Yeah, I definitely think that was a piece of the puzzle. Yeah, and I think it was helpful.So yeah, I’m trying to think of how this went. Yeah, so we were doing some Spinning Babies things. We did some side-lying releases all throughout the pregnancy and then on June 4th which was actually my son’s due date, having prodromal labor all week and then I felt like there was a little bit more intensity in the contractions I was having that morning so I sent my daughter off to her grandparents’ and was like, Okay. I’m just going to focus today. I’m going to focus on getting my body in gear. It wasn’t that I was in this mindset of, I’m going to make myself go into labor today, it was just this intuition around I needed to be able to focus on what was going on. We had that plan that my daughter would go stay with her grandparents while I go into labor and I thought that maybe she was just going to go earlier than I thought she would because I wasn’t in any kind of active labor. Then I had my doula come over at 10:00 AM and we did more different exercises. I can’t remember all of the ones we did because what would happen was that I would have contractions 15 minutes apart, 15 minutes apart and then they would just stop and that would be the end of it and then the next day, the same thing. Or they would be 10 minutes, 12 minutes, 20 minutes– nothing consistent so what we found was if I laid on my left side in the flying cowgirl position, then my contractions were more intense and more consistent. It was again this think of, in my mind I was like, While I’m in active labor, I’m going to be walking around and trying all of these different positions and all of this different stuff, and what I ended up doing is honestly just laying in bed and watching TV in that position almost all day. So again, it was this thing of that’s not what I’ve heard is helpful or whatever but I just think that was where he needed to be to engage in my pelvis at that stage. Then every hour or so I’d get up. I’d do curb walking. I would just get out, walk around, and be active but it was way more laying down than I ever planned to do. You hear that’s not how you get your body engaged in labor, but that was what worked for me so that was an interesting, Release what you think is going to work for you and do what your body is telling you is working for you. But it was actually kind of nice. It was relaxing. My daughter wasn’t there. It was the summer. We had the air conditioning on in that room. My husband brings me a bubble tea or whatever and I was like, This is actually not so bad. This is okay. Contractions were probably 15, 10 minutes apart that whole day then in the evening is when it ramped up. I turned toward active labor and we called my doula again at 8:00 PM and the contractions were very intense. I was leaning on an exercise ball. My husband was trying to do some counterpressure to get me through it and then she did– and again, this is something where my doula and I were not always on the same page, but I was explaining to her my contractions. “They are about a minute and half long. They were maybe 7-8 minutes apart,” and the first thing she said was, “Oh, well that contraction isn’t long enough to progress you at all,” or something like that. She said something about my labor process and it was so discouraging because I felt like I had taken so long to get to that point that when she said that, I was like, Oh, so all of this was for nothing. I know that’s not what she meant but I remember just feeling very discouraged by that comment. So that was tough. Then she did the abdominal lift and tuck. I do feel like that helped get my son into my pelvis and more engaged in my pelvis because from that point, contractions were two minutes apart. They were very intense. I ended up signaling. I was like, “I’m ready to go to the hospital.” We agreed to labor at home as long as possible, but I was like, “I think this is the time.” Again, my doula was like, “I think we should wait longer.” My contractions were two minutes apart at that point and I was like, “I don’t think we should. I want to go.” I’m glad we did actually because that ended up being the right time. But I remember rolling into the hospital at 12:01 AM and I remember my husband saying, “Well, I guess we’re not going to be having the baby on his due date,” because my daughter was born on her due date. I was in active labor on my son’s due date and then we just missed it. I remember being like, “That’s true. We’re not going to make it but that’s okay.” So yeah, we walk into the hospital and go through triage. My water breaks while we are in triage and of course, they bring out their little testing stick and they’re like, “We’re going to make sure this is actually your water breaking.” I was like, “Okay, but I’ve never wet myself during a pregnancy. This is what it is.” Then we go back in the labor and delivery room and the doctor who is on call is not my doctor. I find out later that this is the most anxious, not-nice-to-work-with OB in that practice. So that was tough. I could tell from the beginning she was just very brusk. She didn’t have a great bedside manner at all. She was like, “I see that he’s measuring big so we’re going to make sure that–” she was really worried about shoulder dystocia. I was very glad again that I had read up on that and that I was not concerned about that. So she was like– they had big birthing tubs there but they don’t let you birth in them. They just let you labor in them. I was in there and feeling like I wanted to push for a while and I remember I went to the bathroom and she comes in the room and she’s like, “Well, let’s get you on the table.” I’m like, “I’m just going to the bathroom.” I don’t know if she thought that I was going to try to have the baby without her or something, I don’t know. Her whole vibe was very anxious. That was hard. That was definitely discouraging. I think at that point, I actually had asked for an epidural. Both times, I asked for an epidural at transition and then once I’m through transition, I’m fine. They didn’t come in time and they checked me and I was already at 10 centimeters so they were like, “Okay, it’s time to push. We don’t have time for the epidural.” I’m like, “Okay, this is what it is.” That was okay and then I pushed for about an hour on my back which was again, not my choice but the OB was like, “No, I need to be able to see what’s going on. I don’t want you in any other position,” because again, she was so worried about shoulder dystocia and him being big. Halfway through pushing, she was like, “Okay, you can try on all fours.” But at that point, I was so exhausted that I couldn’t even imagine myself getting on all fours. I was like, “That ship has sailed.” That was tough because I had planned the whole time to try to push at least for a little while on all fours because again, knowing about big babies and how that can be a really good position for that, but I just didn’t feel like I could advocate for myself. I don’t know. In both of my births, when I get in labor, I go very inward. I think having a doula was great, but both times I don’t think my doula was super outwardly advocating. But again, maybe they were looking for a signal from me and I was just in my own world. It was okay though. I pushed for an hour. He came out just fine. It was that euphoric moment of, Oh my gosh. That just happened. That was crazy. Having only pushed for an hour felt great with my first vaginal birth. They took him out and they weighed him and he was 10 pounds, 4 ounces. Meagan: Yeah!Amy: Yes. It was so funny because the nurses were trying to guess. They were like, “9 pounds. He’s big.” Yes. I felt great and actually, it was funny. The next morning, my OB came in. She was on then. She comes in and she goes, “Well, he was big.” I was like, “And I did get him out, so we were both right.” We were able to laugh about that. Meagan: I love that you said that. Like, “Hey, I was right too.” Amy: Yes. Yes. Yeah, and I felt like it was a good ending. I felt like she was like, “Yep, you’re right. You did.” I did tear. I had two second-degree tears which again was maybe not as bad as I expected with a baby that size, but it was no fun. I think that’s the other thing that I talk about often is either way, with a C-section or with that kind of a birth, I felt like it took me about two weeks to be able to feel like I could even walk normally. I think the difference with the vaginal birth is that I do feel like I made improvements every day where I gradually got better whereas with the C-section, it was really hard for two full weeks and then it was like then I felt better. It was a different recovery but I would say– and I think other people have talked about this here before but either way, it can be a tough recovery. Meagan: For sure. For sure. Amy: It’s hard because my sister had two vaginal births and her second one, she was up and walking. We walked a mile when she was two weeks postpartum and I’m like, gosh. I couldn’t even walk down the block at two weeks postpartum after my son. I think obviously not to compare yourself one or the other but I had a big baby and there was some trauma down there and that takes time as well. But it was a great feeling and I think that obviously, it ended up really good. Yeah. That’s my story. Meagan: I love it. Thank you for sharing it and congratulations. I think that it’s so hard to sometimes have providers who will meet you in the middle. It sounds like you both met in the middle along the way and I think in a perfect world, I just wish that this would happen where providers would meet us a little bit more but there are so many providers who won’t even come in. We talk about it all the time with finding the right provider and if the provider is not right for you and if they are not willing to budge at all and meet you in the middle or be a part of the conversations where you were saying things and she was like, “You know what? Okay. Okay. Let’s go back to the original plan then.” She said her piece. She said her suggestions. You were like, “No. I don’t feel comfortable with this. This is not what I want,” and she was willing to be like, “Okay. Okay. All right. Let’s go back to that original plan.” Look what would have happened if you weren’t able to advocate and stand up for yourself and be like, “Actually–”, it could have been a very different outcome. Amy: Yes. Yes. For sure. Meagan: Desiree, do you have anything to share on that just as a birth worker or anything to share as far as tips go when we’ve got situations like that where maybe it seems like it could get really combative but it doesn’t have to be? Desiree: Yeah. I mean, I just want to commend you, Amy, for being able to voice your opinion in that way because I think that’s really hard for a lot of us to stand up in spaces with doctors who we think are in a position of authority. Yes, they have experience, but no one lives in your body. No one has the lived experience of your body except you. That makes you an equal expert in what’s happening. I think it’s great that providers bring advice and recommendations and they have a plan for what they want to see, but I think a truly great provider does meet you at least halfway. Ideally, you’re right Meagan, they’re coming a little bit more than halfway, but I mean, it’s nice to hear that your provider was willing to listen to you and follow your plan and probably have hers in her back pocket as the fallback. But that’s just great that you were able to advocate for yourself in that way. It doesn’t always have to be combative, right? It can be as simple as, “Thank you for your advice. I appreciate your expertise. This is what I’d like to try and if it doesn’t work, then we can try something else.” Amy: Yeah. I think that I was feeling anxious about that too and this big realization of, I do. I like her. I trust her as a doctor. I feel like we’re on the same page, but that doesn’t mean that I have to agree with everything she says and it also doesn’t mean I have to fire her and find a new provider. Again, there is a happy medium there. You’re right. I was taught that doctors have this authority. They know. They go to years of schooling. Of course, they do. But also keeping in mind that their worldview and perspective might be very different and the lens that they are looking at this through is very different than mine and how do I keep this in mind that they have this medical perspective of what they’ve seen. They’ve seen the worst of the worst medical scenarios but also to keep in mind that there’s this whole other worldview around that so that ws helpful for me. Meagan: Yeah. That was definitely something that stood out to me with your form. It was, “Disagreeing with a provider doesn’t mean that you can’t work with them.” You said it in your story too. That is so, so true. It doesn’t mean we can’t work with them and if it gets to a point where it’s like, “Okay, there is no working with this,” and it is actually not working, then we can make a different choice. We can change things up, find a different provider, look at our VBAC Link provider list, and see if there is someone else. But if you can work with it and everything is feeling good and there are a couple of things but we are working together, that is so great. That is so great. Amy: Yeah. Meagan: Awesome. Well, I just wanted to let Desiree share a couple of tips. I love when we have our VBAC Link doulas come on because it’s so fun to get different tips and different perspectives from other doulas around the world. Desiree is in California with Be_Earth_Mama. Is that right? Desiree: Yeah. My husband gives me a hard time about this all the time because I guess nobody gets it but it’s Birth Mama. Meagan: Oh, I thought it was Be Earth Mama. Desiree: That’s what he says. Meagan: That makes so much sense, so much sense. She is in California. Remind us exactly where in California because California is ginormous. Desiree: California is ginormous. I am in the San Francisco Bay Area so Northern California. Meagan: And you do birth and education. Desiree: I do birth and education primarily. Meagan: You do webinars and all the things, right? Desiree: I do webinars. I do online classes. I teach in-person classes. I’m getting ready to start a prenatal belly dance class that I think is going to be in-person for now but might go to virtual if there is an interest so all things birth preparation essentially. That’s my niche. Meagan: Really, really cool. Awesome. I know there were a couple different topics that you were talking about and I was like, ooh. Breathing and active relaxing. Tell us all the things. Desiree: Yeah, it’s one of my favorite topics and I feel like it’s one that is on the list but it’s low on the list because you think about breathing. Why do you need to practice breathing? You just naturally do it but if you’ve been in labor, you know that when that intensity starts to pick up, breathing is the first thing that goes out the window so having a strong breathing practice is the first step to staying really calm and grounded in labor. But even beyond that, I think having a practice is about the process and I think especially for me in my VBAC journey, it sounds like Amy was sort of like this where contractions start and they stop and they start and you are in this waiting game. Is your body going to do the thing or is it not going to do the thing? What’s wrong? I feel like having the practice to fall back on gives you a way to stay grounded and centered in your body as you are waiting for labor. So it’s two-fold. Keeping your body nice and relaxed while you’re actually working through labor but giving yourself the time to be nourishing yourself in those last precious days and weeks leading up to labor I think is almost more important. Something that I work with all of my clients on is having an established breathing practice. It’s not about the breathing technique because there are so many different ones out there. There is the up breathing. Up breathing is my favorite, breathe in for 4, exhale for 8. There is box breathing where you breathe in for 4, hold for 4, exhale for 4, and hold that for 4 counts. And for some people, it’s just simply breathing as slow and controlled as possible. I think it’s about finding something that feels natural and intuitive to you that you can lean into but it’s about finding time and practicing really dropping into your body and dropping out of everything that’s going on around you and playing into your senses with that. That’s something I like to talk about to my clients is hacking your body. Building muscle memory because it’s so hard to relax and stay calm when you’re going through surges, the contractions are really building, and telling you to stay relaxed is not really going to work. Nobody wants to hear that. But if you have this practice and if you’ve built in sensory cues– I like recommending people to pick a birth scent either an essential oil or a candle or a lotion, picking a song or a sound, it could be even a meditation track and setting aside just 2-3 minutes every day to run through whatever your breathing technique is with your scent or your sound, maybe you have something to hold onto and practice just actively relaxing every single part of your body through the process of breathing when you get into labor, your body is going to remember that once you launch into this breathing routine and you put on your birth scent and you have your sound or your meditation track playing, your body is naturally going to relax because you’ve told it that that’s what this time is for. I think it’s a really special thing that we can do for ourselves to give ourselves this time and this practice where we are just nourishing the deepest parts of us. It’s of course helpful for labor, but I think it’s also a helpful practice to take into postpartum and into parenthood. I can say I’ve been doing this for 5 years. My oldest daughter is 5 years old and I still do it every day. I have to run through my breathing practices. Yeah. I think it’s especially important for VBAC mamas to have this type of self-care routine. Meagan: Yes. Oh my gosh. I love that so much. Like you said, it just becomes intuitive if we can practice this so much and instill this into our lives, it just becomes intuitive in that labor journey. There are going to be times where we were talking about roadblocks and stuff earlier, but those might come in and breathing in itself is something that can get us through those things. When you talked about the box breathing, I’ve done that before and I have this weird thing when I do box breathing. My body moves and I’m creating a square. Desiree: I do too. We don’t have our cameras up, but I have to do the square. Meagan: Same. I do a square. I literally draw a square with my whole body and my torso and everything looks like a tree swaying in the wind and I can just feel it. I literally, the relaxation from head to toe just comes in. Like she said, there’s not any specific way. You don’t have to choose one way. You can use them all. You can use anything, just really, really, really having active relaxation practices before you go into labor is so good. And I think it can help along the way. Even when we have a provider who comes at us with, “Hey, we’re going to meet you in the middle,” it still can be in our head. We can be like, Okay, she said this. I said this. This is what we’re going to do. You’ve just got that whole conversation and it’s just that you’re breathing through that and you’re processing that and you’re going to apply it later on in labor. I don’t know. I just love breathing so much. Desiree: I do too. I think it’s the most important tool that we have that everybody has. It’s the most powerful tool that’s available to us. Meagan: We have to do it to live. Desiree: Mhmm. Meagan: We just have to. It’s intuitive. We have to do it and we talk about intuition here and tuning into our intuition. If we are really, really tuning into our intuition, that breathing is part of that. Then our minds and our bodies can respond. Amy, did you ever do any breathing or anything like that? Have you ever heard about any of the things we are talking about? Amy: Yeah, yeah definitely. It’s something I use in my therapy practice a lot. Meagan: I was wondering if you did. Amy: I work with college students primarily so this is a lot of time for some of them that they are facing some of this but I love what you were saying Desiree about practicing ahead of time because that’s what I’ll say. They’ll be like, “Oh my gosh. I had a panic attack. I practiced your breathing and it didn’t work.” I was like, “Did you practice that ahead of time?” When you’re in crisis, it’s hard to do it then. But if you’ve practiced it before and cued your body to that place, that’s where it is so useful. Ironically, it was something that I didn’t use a ton during my labor process as far as intentional breathing practices. I think I wish I had because I think that would have been useful, but my doula would coach me about some forms of taking deep breaths and sort of how you are breathing through some of the surges and stuff. But yeah, I love that. I love the practice it before you are in labor because then it’s easier to do while you’re in labor. Meagan: Mhmm, absolutely. Such a powerful message. Okay, one more time, Desiree, tell everyone where they can find you. Desiree: Yeah. I’m on Instagram. You can find me at b_earth_mama pronounced “birth mama”. You can find me on my website which is www.b-earth-mama.com and that’s primarily where I’m at. Meagan: Awesome. Well, go give her a follow everybody especially if you are in California and looking for a doula. And Amy, thank you from the bottom of my heart for joining us today and sharing your amazing stories. Amy: Awesome, thanks for having me. It was great. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
42:1221/08/2024
Episode 327 Adriana's HBAC + What Does the Science Say About VBAC?

Episode 327 Adriana's HBAC + What Does the Science Say About VBAC?

Adriana is a scientist and professor at New Mexico State University in Las Cruces, New Mexico. During her first pregnancy, Adriana was faced with the possibility of her baby having a severe genetic disease. She became so involved in researching the details of it that she didn’t consider the need to research her birthing options as intensely. However, after a long and difficult induction process which ultimately ended in a Cesarean, Adriana was left feeling like she failed as a scientist. She was determined to take charge of her next birth and apply her years of research skills to learning everything about VBAC.Adriana went on to have a peaceful home birth surrounded by a big support system and empowered by her research. She also gives listeners tips on how to interpret published articles on VBAC and explains terms like abstracts, confidence levels, and p-values. “I just found the data is so strong in showing that VBAC is super safe for non-high-risk individuals. Again, having a previous Cesarean does not automatically make you high risk…I had three high-risk factors if you will and still, with those factors counted in, I knew that VBAC was really safe for me just based on the data that I found.”Dr. Adriana L. Romero-Olivares' WebsiteNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Women of Strength, we have another amazing VBAC story for you today. This VBAC story follows a C-section that was unplanned which let’s be honest, most of ours are, and it had a lot of interventions. We have our friend– oh my gosh. I can’t speak today. Adriana, hello. Adriana: Hi. I’m so excited to be here. Meagan: Oh my gosh. I’m so excited for you to be here. Tell me. Okay, so you’re currently in Mexico. Where were you when you had your VBAC? Adriana: I’m in New Mexico, so the U.S. Meagan: Oh, you’re in New Mexico. Adriana: Yes, exactly. In New Mexico in the U.S. and I had both my unplanned Cesarean and VBAC here in New Mexico. Meagan: Oh, you did? Very good to know. You guys, she is a scientist and a professor. She spent many years researching microbes which is really cool. Do you say fungi? Is that how you say it? Adriana: You can say it fungi, fungi, fungi. People say it in different ways and they are all correct. Meagan: It’s like fungus, right? And bacteria? Adriana: Yes. Meagan: I have so much interest in that weirdly enough because it is in our gut. I have a really weird interest in gut health right now. Anyway, and how they are impacting the global climate. Something that’s kind of cool about her science journey is it really seems like it was spun after VBAC, right? Adriana: Yeah. I mean, I’ve had an interest in sciences forever, but I guess I had no idea how much science was behind VBAC and getting into this VBAC project that I had for a while, I feel like it really ended up helping me to grow as a scientist which was really cool. Meagan: So cool. We’re going to maybe talk a little bit more about the science of VBAC here in the end so make sure to stick with us. I do have a Review of the Week before she starts sharing her story. This is from eoliver14 and it says, “Love this podcast.” It says, “I’m not one to usually listen to podcasts but ever since I came across this one, I haven’t been able to stop listening. I’m preparing for my VBA2C” so VBAC after two Cesareans “and these stories have been so amazing and helpful.”eoliver14, I hope all went well if you have had a baby since then or if you’re still preparing, I hope that this podcast is still inspiring you. And if just like eoliver14 this podcast is inspiring you and helping you and building you up, please leave us a review. We love them so much and I really truly, truly, truly believe that so do honestly all of the listeners. I think a lot of listeners love these reviews. It’s so fun. You can leave that at Apple Podcasts, Spotify, or really wherever you listen to your podcasts. Even if you Google “The VBAC Link”, you can review us there. Meagan: Let’s get going into this story. So unplanned C-section. Adriana: Yes. I want to give a very brief background of my life just to get into the mindset that I was when I had the unplanned Cesarean. My husband and I have been together for a really long time. We are going to celebrate our 20th anniversary this year. We met our first year of college and then we’ve been together ever since but we only had our first child in 2021. That is because we prioritized our careers for a really long time. We are both scientists. We are both professors so we did our Bachelor’s together then we did our Master’s and then we did our PhD’s together. Then we did long distance for a while because we were doing post-doctoral research which is a thing. Then in 2020, we both landed a job in New Mexico State University where we are right now so in August of 2020, we moved across the country from New Hampshire and from New York City to New Mexico. We sort of started our new life in a new city during the pandemic with a new and very demanding job. In April of 2021, which was just a few months after we moved to– we live in Las Cruces, New Mexico. When we moved here, the biggest surprise of our life happened which was that I was pregnant. It was a surprise pregnancy. The pregnancy was just overall uneventful in the sense that I just didn’t have any sort of discomfort or anything. I was just tired and that’s pretty much it but then when I was around 16 weeks pregnant, I got a phone call out of nowhere. I got the news and this is the way that it was told to me. They were like, “You have a 50% chance of your child having a fragile X chromosome which is a genetic disease.” I was like, “What? What is it? What’s that?” I had never heard about it and I was like, “50% chances? That’s pretty high.” I remember I was in my office and Jovani, my husband, was there when we got that phone call. We were just very confused then when we started to look into it, it’s actually a pretty terrible genetic disease to have so all of a sudden, our whole life shifted. We were very concerned. Since the very beginning of my first pregnancy, there were a lot of interventions just because I was of advanced maternal age. I was 36 at the time and after 35 you are of advanced maternal age. It doesn’t matter if everything looks good but if you are older than 35, that’s it. They were like, “Oh, we recommend this testing and this other testing and this other one” and so on. One of those testings was genetic testing which I think we wanted to do either way just to be prepared in case of anything. So then we started to look into, “What is this genetic disease?” Once again, it was pretty bad. So then yeah, it was 50% chances. That’s pretty terrible. That’s where I brought in my scientist skills. I was like, “Wait a minute.” So then I got in touch with a genetic counselor. I don’t think this is just the way it is for everyone, but the particular genetic counselor that I spoke with wasn’t really helpful even though I told them, “I’m a scientist and I have a pretty strong molecular biology background. I understand DNA and genes very well.” I was looking for very specific information and they were just not really helpful. So then both Jovani and I spent so much time digging into the scientific literature and trying to find information about this disease. That’s how we came about some newer testing that really looks deep into the DNA sequence that they find in your baby and then they’re able to tell very precisely what your chances are of your child having this disease or not based on the genetic sequence. Then we just spent a lot of time looking into that, finding that information, then advocating for my baby to get this genetic testing done because it was not something that my insurance wanted to cover. Long story short, after a few couple months looking into that and making calls and so on, we found a way for that testing to be done. Then when we got the results back, 50% chances were wrong. The information I got was wrong. Meagan: That’s some pretty wrong information to get. Adriana: Yes. It got me thinking how many people are probably given this information with the statistics totally wrong? So then the 50% chances when I looked into it went down to 5% chances and then when we did the additional testing, it went down to 0.1% chances. Essentially, null almost. Meagan: Oh my gosh. Adriana: Yes. Yeah. You know, even though we were very grateful for that, it sort of set this tone in my pregnancy where I was so stressed the whole time. I just didn’t put any time in researching how I have to prepare to give birth. I was just in survival mode if that makes any sense just grateful that I didn’t have to worry about the genetic disease. I think at around week 35, they were like, “Because of advanced maternal age, we recommend an induction at week 39.” I was like, “Okay. They’re recommending this. Let’s just go ahead and do this.” I’m a very tall person and Jovani is tall as well so we make big babies kind of. I knew the date of conception of my baby and I knew that based on that date of conception, I was going to be 40 weeks on December 31st. Then somewhere around 30 weeks, they were like, “No. Because of what your baby is measuring, your due date is actually December 22nd so then that means we–” Meagan: 10 days earlier. Adriana: Exactly. They were like, “That means we would like to induce you on December 15th.” Once again, I was like, “Fine. Yeah, sure.” So then on December 15th, we went into an induction. It is a very long story, but long story short, the induction lasted three days and nothing happened. I was given Cervadil and Cytotec and nothing happened. I didn’t dilate. Nothing. Meagan: Your body was really not ready. Adriana: It was really not ready. I was really desperate. I was like, “What’s going on? Why are things not happening?” No one was giving me any information even though I was asking, “What’s going on?” They were like, “Just relax.” I ended up asking a nurse because the doctor came in and was like, “Well, we tried Cytotec and Cervadil and it’s not working so the next thing to do is Pitocin.” He was like, “Is that what you want?” I was like, “I don’t know. Let me think about it.” I asked a nurse, “What do you think about me getting Pitocin?” The nurse was like, “No. No. They are setting you up for failure. You haven’t dilated at all. No. Just say no.” So then I just was desperate for any advice. I ended up saying no and I was discharged. They were like, “We’re going to discharge you but you have to come back.” It was a Saturday when I was discharged and they were like, “You have to come back on Tuesday for a second induction. But a lot of times after a failed induction, people go home and they come back in labor a few days later.” I wasn’t. On Tuesday, I went back. This was December 21st I think or something. So I went back for a second induction and then when I went in, I was already soft on my cervix. I felt things were advancing really well and I was excited. Then it was almost a three-day induction once again. So they started giving me the same thing. They gave me Cytotec first and they waited for a few hours then I had the Foley bulb inserted. It’s like a blur because there were just so many interventions. People were coming in and out of the room the whole time. I was still sort of having a hangover of the last induction because for three days I was so tired. I was so hurt. They couldn’t find my vein so then I had multiple bruises in my arm. It was just so many things. I felt kind of a hangover if that makes any sense. Meagan: Yeah. Adriana: I started dilating with the Foley bulb. It came out so at the beginning, things seemed to be going well. Meagan: Better. Adriana: Yeah, better. I was like, “Okay.” I think when I– I don’t even know how much I dilated, but at some point, the OB/GYN came in and she was like, “You know, I recommend to you that we rupture your waters just so that things start going.” I was like, “Yeah, sure. Things seem to be going well so let’s do it.” They ruptured the waters and then that was pretty much it. I don’t feel like things started happening or anything. I was getting cervical checks very, very, very often. I think that sort of messed up my head to some level. They hurt me. They are not the most comfortable things to go through. Meagan: Especially early on in labor.Adriana: Exactly. Meagan: Right when your Foley just came out, you probably had a posterior cervix, pretty closed still. Adriana: Exactly, yeah. There was some bleeding going on. It was really terrible. So then a few hours after my membranes were ruptured, I think maybe the doctor could see that I was not relaxed for obvious reasons and she suggested getting an epidural. She was like, “Oh, I suggest you get an epidural because I think that would help you relax. That can speed up things.” I was like, “Okay.” So then I ended up getting an epidural and then I got one and it only worked on half of my body so then I had to get another one later on. After many, many, many hours, things were not happening. I did end up getting contractions after the Pitocin and the contractions, I could feel on half of my body and then eventually, I just couldn’t feel them. I could just feel the pressure. That went on for hours. I mean, I think I got the Pitocin. It started at 8:00 PM maybe or 5:00 PM and then they were increasing the dosage and then around 6:00 AM I think they had gotten to the highest dose that you can get and I was not. They checked me and I was at 5.5 or 6. Then the doctor was like, “Okay, we’re going to stop the Pitocin and let your body do things.” My body didn’t do anything. The contractions completely stopped once the Pitocin was removed and we waited for an hour or two and this time, my waters had been ruptured for over 24 hours so she was like, “You know, there’s nothing else we can do. We’ve tried everything. Nothing is happening. I recommend having a C-section.” I mean, I think when I really felt I had no other option, I was like, This is what needs to happen and what I have to do, so sure. Let’s go ahead and do it. Fortunately, it wasn’t an emergency C-section or anything. We still waited for 4 or 5 hours just sitting there waiting for I guess the team to get their act together. They took me to the OR and my baby was born around noon. Everything went fine. I had no complications. My baby had no complications so it was pretty nice but the recovery was so tough. It was just that something inside me didn’t feel right. I was like, “What just happened? What just happened? Why did I end up having a C-section?” I would just think about it over and over and over at night when I was nursing and when I was alone with my thoughts and so on. I was like, “What happened?” Those sorts of things and why when I asked questions why no one answered the questions. They were just treating me as if I was an uneducated person. They just didn’t want to engage and I think that’s wrong in general to everyone just the way that you are dismissed when you ask questions is pretty terrible. They are on a schedule and they have no time or interest in my opinion or in engaging. Then I started to think about it a little bit more and then in my mind, I was like, Well, I guess if I have another child, I can always do things differently. That was the mindset I was in for a few months. Then when I went to my 6-month follow-up appointment to check me and make sure everything was okay. I asked the doctor, “So, if I have another child, I would like to have this child vaginally so I would want to know why did I end up having a C-section? What happened? I know it was failure to progress according to your notes but what does that mean?” She looked at my chart for 10 seconds and she told me, “You cannot deliver vaginally because your pelvis is too small.” I was like, “What?” I was like, “No. No. That cannot be.” I know that your body doesn’t. You can have your pelvis one way and it doesn’t really mean anything based on your body but I have a pear-shaped body so I was like, “I don’t think my pelvis is too small.” So then I asked her, “How do you know that my pelvis is really small?” She was like, “Because you failed to progress.” She did not want to engage. She did not want to. I just left that room and I was livid. I was so angry that she did not want to engage. She did not want to have a conversation. I didn’t even know if I was going to have another child at that point but I was like, If I ever get pregnant again, I’m just not going to come here. I just kept thinking about it over and over and over. I was like, I just need to reach out to someone who can help me understand this a little bit better. I reached out to a local doula and asked for information about VBAC in general. I didn’t know it was called VBAC at the time. I was like, This happened to me. If this were to happen to me again, can I deliver vaginally? She invited me to a VBAC course and the course was super awesome. They shared a ton of statistics on inductions and VBACs and so on. She also suggested doing a birth story processing which was pretty awesome too. So then 18 months later, I got pregnant with my second child and I knew exactly what I wanted which was not what I had before. I knew that I wanted a VBAC ideally and that I wanted as few interventions as possible. I wanted a provider who would engage with me and I wanted a provider who would follow evidence-based facts and of course, a provider who was VBAC-supportive. I looked for all of those things around my town. We have two hospitals. It’s not a huge city and I asked around. Basically, the information that I got was that they were VBAC tolerant but because I was of advanced maternal age, probably none of them would be comfortable having me as a patient. So then I ended up finding a midwife practice and that was what I ended up choosing because they were all that I wanted. They were amazing and I did end up having the most wonderful experience throughout my pregnancy with them. Throughout my pregnancy, I did a lot of research on my options. I educated myself on physiological birth and I also took classes on a home birth. I did a bunch of other things. I did a fear-release hypnosis. I did the birth story processing which was I think one of the most helpful things that I could do throughout my pregnancy. I didn’t really think that I had trauma related to my past pregnancy or fear of any sort, but then through the birth story processing, I ended up finding out that I did have some birth trauma and I had a lot of fear for this new pregnancy associated to my experience with my last pregnancy. Then I did the Daily Essentials of Spinning Babies every day. I didn’t skip any day just in case position was an issue last time. I ended up getting my documents from my last pregnancy like my records–Meagan: Your op reports. Adriana: Yeah. I ended up getting them actually one week before my VBAC. It was always something that I knew I needed to go get this done but then I kept forgetting. Then before my VBAC, I was like, I need to get this report and I need to read it so I can get some closure. I ended up finding out some really interesting things. This is a parenthesis. They said that my uterus was boggy when they were doing the C-section and they said that they had to take out the uterus and massage it because it was boggy. I was like, What is that? I looked into that a little bit more and I ended up finding out that my uterus was so tired from the Pitocin and the contractions that it was not working. That gave me some closure if that makes sense. I was like, It’s not because my body wasn’t working. It was just overtired. I had listened to the VBAC Link podcasts every day also. I did daily walks and you were my companion throughout those walks and just listening to all of the different stories gave me an idea that birth can go in many different directions and it helped me understand that you really have very little control over your birth experience. You can prepare all you want but then at some point, you have to let go because you can’t really control the situation. As a scientist, that is very frustrating because we are always in control of our experiments. But in a way, we can never control the outcome of the experiment so in a way, I was like, Okay, this is one more experiment. Yes. I did have spotting on week 18 of my pregnancy and I was diagnosed with marginal placenta previa and possible accreta so for a few weeks I was like, Well, maybe this is just not meant to be and that is okay. But then it ended up resolving by week 28 so I was cleared for VBAC. Throughout the pregnancy, I kept my plans secret from almost everyone including my parents and my in-laws. I told Jovani, “You are forbidden to talk about this with anyone.” As you start getting closer to your due date, people start asking questions which to me is like, why do they want to know such specific information like where are you giving birth? I never ask that but some people really want to get all the details. I just told him, “Just lie and tell them that it’s going to be at a hospital. Just say whatever you want. I don’t care. I just don’t want people asking questions and just getting reactions over my birthing plans and decisions.” Exactly. I don’t want to give explanations to anyone. I don’t have the energy to educate anyone at the moment. I know that I am making the right decision for me and that’s pretty much it. So that was really difficult keeping that information from some friends but as my due date got closer of course, we shared the information with my parents and just our families in general and our in-laws. I did share my plans with a few very, very close friends of mine. Most of them were supportive. Some of them– I guess I had to deal with some anxiety on their side. My doula helped me a lot with that because I was getting almost angry that they were anxious. My doula was like, “You have to remember that they love you and they love your baby. They are scared for you and your baby so try to understand them.” It gave me that perspective like, yeah. If I didn’t know, if I wasn’t educated enough on facts, I would probably be anxious too. Especially around week 35, their anxiety passed on to me and I started to have a lot of doubts about my decision. I was like, Is this the right decision? Is this really what I want? By then, I was so soaked on data and stats because I just put so much time into researching all of that, that it was how I calmed myself down. It was like, You know the data. You know the stats. You know the chances of things going wrong. Of course, there are chances of things going wrong, but the chances are so low that it’s almost impossible for this to happen. If something were to happen, okay. You were one of those improbable chances, but it was a chance that I was willing to take based on the statistics. Once again, that really helped me deal with the anxiety and if I would have had energy at the time, I would have been more than happy to share all the data and stats with friends and family. This is also how my husband ended up being convinced that I wanted a VBAC and that I wanted a home birth as well. I remember this one day, I think there was some sort of miscommunication between him and I at the beginning. At first, he wasn’t super happy that I was going with a midwifery practice but then I was like, “They are trained professionals. It’s not like Call the Midwife where she shows up with a tissue.” I was like, “No. These people come with equipment. That’s how it is.” So that calmed him down but I think he thought I was going to give birth at the hospital so then one day I was watching, I don’t know if you hear of this terrible thing that could happen with an uncertified midwife where the baby was footling breech and it was a really terrible story. I was watching something on YouTube and it came up and Jovani was like, “I don’t understand these crazy people who want to give birth at home.” I was like, “Hello, I’m planning to give birth at home.” He was like, “What?” So I told him, “Yes, Jovani. I am planning to give birth at home. This has been the plan the whole time.” He was like, “No, I thought it was going to be at the hospital.” I was like, “No. It’s going to be at home.” He was really, really, really nervous for a while so once again, I shared statistics and data with him. The midwives also were like, “Bring him in. Have him bring all the questions that he wants and we will answer them. We are here to help.” All of a sudden after a couple weeks after having that conversation, I shared a lot of resources with him. I told him, “Do you want to come with me to the midwife’s appointment so you can ask any questions you want?” He was like, “No, it’s okay.” I was like, “Oh, so you’re cool with me having a home birth?” He was like, “Yeah, if that’s what you want. I respect that. I respect your choices. I trust you as an individual and the choices that you make so that’s totally fine.” Giving him resources so that he could see the data I feel like really, really helped him. Then with some of my family members like my brother, for example, he was like, “Why do you want to do this? Why don’t you just, why? Why do you want to do this that isn’t the norm?” I explained to him my rationale and he was like, “Okay.” I had some other conversations. I have a family member and she is a physician and she was also like, “Why would you want to do this? Cesareans are so easy especially if they are scheduled. You just go in. You don’t suffer and then you just come out with a baby.” I was like, “Have you had a Cesarean?” Of course, she hasn’t. I was like, “It’s not really that easy. The recovery is really, really, really tough and there can be some very serious complications. If it’s needed then that’s wonderful,” but I know that I did not need one for my first pregnancy and I know that I did not need one right now. So then at 39 weeks, I started to feel very anxious because nothing was happening and I was very worried that I was not going to go into labor on my own because I never went into labor last time even though I know I was early. But I was still worried that, What if I never go into labor on my own? I’m going to start getting very nervous if I go past 40 weeks. Then at 39+5, I had prodromal labor at night so I felt excited to experience real contractions I guess for the first time. I was also very worried that I was not going to be able to go unmedicated because the prodromal labor was quite intense and I got thinking about all of these people who have shared their stories that they had prodromal labor for weeks. I was like, Oh my gosh. That’s horrible. I reached out to my doula and I was like, “Okay, I had prodromal labor last night. I’m very worried about not being able to handle the unmedicated birth that I want to do.” She suggested we do a welcome baby hypnosis session and to focus on relaxation so I guess once again, as a scientist, I never thought that I would be into hypnosis. It just ended up being this wonderful resource that helped me a lot during my pregnancy and during labor. On my due date exactly, so I woke up and noticed that I had lost what looked like pieces of my mucus plug and then within a few hours, I started having some mild contractions around 1:00 PM and then the contractions continued to get more intense throughout the afternoon and the evening. At midnight, my contractions were super intense but they were not consistent. I couldn’t get any sleep because of the intensity of the contractions but I did try to rest as much as possible. Around 4:00 PM, my doula checked in and she was like, “What’s going on?” I was like, “I’ve been having these contractions on and off.” I felt the contractions where you feel period cramps and they were more in my abdomen. They were so intense in that area but just according to what people said, they were like, “We could feel them in my whole belly.” I was like, “These are just weird. I don’t know. Are they real contractions or not?” Just because they were not consistent, I would get them every 3 minutes, every 5 minutes, every 7 minutes. Sometimes they would last a minute but sometimes less and sometimes more so I was just super, super, super confused and my doula told me, “You’re probably having prodromal labor again.” I was like, “Oh my gosh. No. This cannot be. It cannot be because I’m not going to be able to withstand this for much longer.” It had been 15 hours or so at that point. So I was tired and I hadn’t slept at all. This was around 4:00 AM so then my doula once again suggested I reach out to the midwives and ask them if I could have a cervical check. She was like, “That’s going to give you an idea of if this is actual labor or if this is prodromal labor. I was like, “Okay.” So then I texted my midwife. I didn’t want to call them because I didn’t want to bother them at 4:00 AM so I texted them and I was like, “Can I go to your office?” even though I don’t know why I suggested that because it would have been horrible to get in my car and drive to their office. I was like, “Can I go to your office in the morning so that I can get a cervical check?” They replied and they were like, “Yeah, sure. You can come to our office. We will see you there at 8:00 AM.” At this point, it was 4:30 AM and I think it was at 7:00. I was like, “I just don’t think I can do this for one more hour.” I texted them again and I was like, “Can I go to your office now? The pain is pretty intense. Can I go now?” Then one of them replied and she was like, “Actually, we can go to your house. We can go to your home and we can check you there. Are you okay with that?” I was like, “Yes, yes.” They ended up coming at 8:00 AM and they checked me. She was like, “You’re 6 centimeters dilated.” I was like, “Oh my gosh. Thank you.” I was so excited. I was like, “Oh my gosh. Yes. I knew this could not be prodromal labor for so long.” She was like, “You’re 6 centimeters dilated.” I was also leaking some amniotic fluid so she was like, “Things are about to get more intense now.” She offered some pain medication. I don’t remember what it was but she was like, “This is the pain medication that I can give you. Yes. It’s going to reduce the pain but it’s also probably going to slow down things. Are you okay with that?” I was like, “No. Don’t give me anything. I just want to get this over with.” I knew understanding– I feel like the first part of labor was very confusing. I was like, “Are these contractions? Are these not? Am I dilating? Am I not?” But understanding physiological birth, I knew very well that after 6 centimeters, things are about to get really intense but they are also going to be faster ideally. I guess I sort of trusted that. I was like, “Things are about to get more intense. I know that for sure and ideally, they’re going to get faster so I think I can keep doing this for a few more hours so no pain medication, thank you.”She was like, “Okay. I’m going to check in again with you at 11:00 AM.” It was 8:00 AM at this point. She was like, “If anything happens, just let me know.” She left and I think as soon as she left, things got really intense. I lost my mucus plug and then I had bloody show and I continued to labor peacefully at home. I was just in my room quietly. My mom and my dad were here because they live out of town and I asked them to please come to support me and to help with my son, my toddler. They were here but they were in the living room so it was only Jovani and I in the room. I sort of continued to ride the wave. That was my main coping mechanism. I was like, “Okay. A contraction is about to happen and then I would just count and Jovani helped me with back pressure.” Sort of the next few hours are a blur again. I think I was just so focused on coping with the pain, I was just counting over and over and over. I used a comb for a little bit but just was counting and riding the wave is what helped me the most. At some point, my doula and her student showed up. I think Jovani texted them. I don’t know. Meagan: 4-1-1, come!Adriana: Yes. They came in and they helped me. They did some massage and helped with back pressure as well. That made a huge difference. I got into the shower at some point. Huge relief to get some hot water on my belly. That really helped. Also, at some point, I had two midwives and one student midwife. At some point, they showed up as well. They started setting up the birth pool and then at some point, I noticed my contractions were not as back-to-back as they were a few minutes before. Once again, understanding physiological birth, I was like, “I’m getting close. I know my contractions are not back to back anymore so I know I’m getting close to being done.” My midwife– I had asked some questions to her before and I was like, “How do you know? I don’t want constant cervical checks so how do I know that I’m about to be done?” I remember she told me, “We know. We are trained to listen to the birthing person and we can tell when they are getting close.” So I guess they could tell and around that time, she was like, “Okay, I think it’s time for you to jump into the pool.” I think this was around 11:30 or something. I was on my knees and my arms were on my bed. That was the position that I felt most comfortable laboring in so when I stood up, I felt something coming out. I was like, “Oh my gosh. Something is coming out.” I went into the pool and within a few minutes, I started to feel very strong contractions in my whole abdomen finally. Up to this point, the contractions were only on my lower belly. My body started to push and after two pushes, the head of my baby came out and on the third push, all of him came out. I don’t know how long that took. It short of felt like forever to me but they told me it was pretty quick so I don’t know, maybe 15 minutes. I have no idea. It’s really funny how you lose sense of time. Meagan: Mhmm, yeah. Adriana: During that time. There were so many people in the room at that point. It was the two midwives, the student midwife, the doula, the student doula, my mom, and Jovani but it was pretty interesting because the ambiance was so quiet. Everyone was really quiet the whole time. It was really, really peaceful and then when baby came out, everybody was clapping and so on. My dad was outside the room and he was like, “It was so quiet. I was getting worried then all of a sudden, I could hear excitement and clapping.” I was able to catch him and we did immediate skin-to-skin. I couldn’t believe it. I was like, “Oh my gosh.” I couldn’t believe it. I got a shot of Pitocin and then birthed the placenta within a few minutes. My midwives tucked me into my bed. My baby was still attached to the placenta. My doula brought me a donut. Jovani got me coffee. My mom brought me a sandwich. Meagan: Oh my gosh. I love it. Adriana: Yes. It was one of the best meals I’ve had in my life. I was so happy and so excited. I had a very small tear so I didn’t need any stitches or anything and the recovery was so easy. It was nothing compared to recovering from a Cesarean in my experience after a long induction. Then it was really nice too because in the next days and weeks, my midwives visited me in my home. The checkups and everything were at home so that was pretty wonderful. I guess throughout this whole process once again, understanding, it was really interesting to me how– I don’t want to call it a project but I guess it was a project and like an experiment, like the things we do in the lab. You look for background information. You prepare everything. You inform yourself with data and what other people have found. You look at statistics so it was really interesting to me how this VBAC journey helped me grow as a scientist. That was one of the nice outcomes. Something I forgot to say is that after my Cesarean and when I did the birth story processing– because you give a bunch of information to the person who is doing the processing for you and one of the things that I couldn’t point out was why I was so bothered with the experience. If everything had gone well, what was it that was bothering me? She was the one who brought it up because one of the things I kept bringing up was, “I do research for a living. This is what I do. This is what I do every day. I research. I look at data. I look at stats. I read the literature. This is what I do. Why didn’t I do any research for my first pregnancy? Why didn’t I prepare myself? Why didn’t I second-guess what the medical doctors were suggesting me to do? If I’m always second-guessing what everyone says, especially in science, you are always like, where is the evidence? Can I see the data? Why didn’t I do that?”It was really interesting that she brought this up. She was like, “It seems like you feel like you failed as a scientist with your first birth experience. It seems like you feel like you failed as a scientist.” I was like, “Yes. That is exactly how I feel. Yeah. I feel like I failed as a scientist. Why didn’t I put any work in researching one of the most important events of my life? Why didn’t I do that?” I think a way to cope with that in my second pregnancy was doing the opposite and really doing all of the research, looking at all of the data and all of the stats. At some point, I was like, I’ve done all of the work so whatever the outcome is, it’s not on me.Meagan: It’s out of your hands. It’s out of your hands. Adriana: Exactly. It’s out of my hands. So that was something that really helped me throughout my pregnancy and throughout labor. I’m happy that I had the outcome I wanted but I think at some point, especially in the last weeks of pregnancy, I was like, Whatever the outcome is, I’ve made peace with it because I’ve done all I can to prepare and that’s it.Meagan: Yeah, that’s such a great message to share because in the end, just like you said, I actually love how you said it. I prepare. I gather. I do the experiment and not that birth is an experiment, but in the science lab, and then the outcome is really unknown. Adriana: Yeah. Meagan: It’s really unknown. Sometimes you can control it by adding whatever into it and sometimes you can’t. It’s like labor. Sometimes we go to the hospital and we can control it with Pitocin or an epidural or whatever and sometimes we still have these outcomes. Such a great message. Just in the end, it’s so hard for the not-average scientist, the average person, not the scientist, to really decode all of the literature out there. Do you have any tips for the listeners on how they can go about taking the preparation like what you did? Obviously, we have blogs and our VBAC course and all of the things to try and help break these things down into English because sometimes they are very hard to understand. Adriana: Don’t get me started. Meagan: Yeah, but what suggestions would you give to any of the listeners? Adriana: Yeah, I have a few. The scientific literature– I feel so annoyed having to write the findings of my experiments in that type of language, but I guess that is sort of how things are done. One of the things that I recommend people doing is not one that a lot of people think of, but you can reach out to the authors of the papers. I get so excited when someone reaches out to me and they are like, “I saw this paper. Can you explain to me what it means?” Most scientists are just going to be so excited to have people reach out to them and tell them, “Can you help me understand this?” Most of them are going to be so excited about that. That’s one thing you can do if you feel like reaching out to someone.Maybe sometimes they are not going to reply, but I would say most scientists–Meagan: Worth a shot. Adriana: Exactly. It’s definitely worth a shot and most scientists are going to be so excited that you are reaching out to them. The other thing is that most papers come with a short summary at the beginning. It’s usually called “summary” or “abstract” and in that summary, they summarize the findings in a way that is way easier to understand than if you look at the results in the discussion because sometimes also the plots are impossible to understand, the statistics are very difficult to understand if you are not trained in statistics, so reading the abstract and the summary, especially toward the end, there is usually one to three sentences with the main outcome of the experiment. They are not going to give you statistics or anything, but they are going to tell you what they have found. You will see that most scientists are really conservative on what they conclude from their study. Even if their data and stats are really strong, they are usually very conservative on the way that they conclude and then sometimes that conclusion gets lost somewhere when the information is given to you by your OB/GYN for example so I would really encourage folks to look at those last few sentences to really understand, Okay. My OB/GYN brought up this scientific article. Let me go and see what is actually written there and what they are actually saying. By reading those one to three sentences, you’re going to get a better understanding of what the scientist actually found. Meagan: Overall, with VBAC, what was the overall finding? Obviously, I kind of know a lot of the overall findings, but what was the overall finding that you found in your own research when it comes to VBAC and the safety of it? Adriana: Yeah. I just found the data is so strong in showing that VBAC is super safe for non-high-risk individuals. Again, having a previous Cesarean does not automatically make you high-risk and I guess if you think about it, I was “high-risk” because I had a previous Cesarean. I am of advanced maternal age and I also have a higher than average BMI so I had three high-risk factors if you will and still, with those factors counted in, I knew that VBAC was really safe for me just based on the data that I found. Then if you add in too the reduction of interventions, that makes the chances of VBAC really high. Meagan: VBAC high, rupture risk is lower. Adriana: Exactly. If you keep adding things, I found especially when researching for home birth, the data is really messy out there. It’s not desegregated and by this, I mean that when they show you the statistics for home birth, they show you the statistics of everything together like people who had unplanned home births for example. The outcomes of those can be very different than that of a planned home birth and they also add people who end up having spontaneous abortions at home and that’s included as a home birth. That is ridiculous so we really need desegregated data so sometimes when you go into the scientific literature, you can get the desegregated data in the scientific paper. Once again, I know that is not in an available format for people who don’t have the training but again, you can reach out to the authors of the paper and to the scientists for them to explain to you what is the actual finding or read the abstract so that you can see. Most of those papers are like, “We need more research on planned home births.” Meagan: Right. Oh, such great information. I know we have so little time but I have one more random question because in a lot of these articles, they say, “Confidence level blah-blah-blah.” Can you describe what that means as someone who is reading that? What does that mean when an author says that?Adriana: When an author says that, they are taking percentages as their confidence level. When they say 95% confidence, it’s that they mean that out of say 100 individuals, the chances of this occurring is less than 5% when there is a 95% confidence interval. Once again, it could mean depending on the type of data that out of 100 people, 95 people we know for sure backed up by statistics that 95% out of 100 individuals are going to have this outcome. That’s basically it. They are just giving you a percentage so that it is a little bit easier to understand and we also use this same thing with P-values. P-values are something that you see all the time in scientific literature. It is the exact same thing. We consider P-values smaller than 0.05 as significant so essentially, this means that there is a less than 5% chance that whatever you are studying is happening out of chance. Essentially, it’s telling you there are 95% chances that what you are seeing is actually happening and it’s not something that is happening out of chance if that makes sense. Meagan: That totally makes sense. Adriana: Yeah. Meagan: Oh my gosh. We could probably talk about this for a long time, but I will not keep you any longer. I appreciate you so much. Congratulations on your birth. Thank you so much for sharing with us and have a wonderful day. Adriana: Thank you for inviting me. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
57:1919/08/2024
Episode 326 Jolie's HBA2C + Finding the Right Provider + Surprise Big Baby

Episode 326 Jolie's HBA2C + Finding the Right Provider + Surprise Big Baby

“I leaned back in the tub and I think what I said was just, ‘I’ve never held one of my babies after they were born before.’It was interesting how there was an element that was sort of mundane about it but I liked that. It was just the normalcy of it all that shocked me if that makes sense.” Since her only experiences with her previous births were in a sterile, surgical, hospital environment, the simplicity and freedom of a home birth felt shockingly normal in all the best ways!Jolie shares her first C-section, her planned home birth turned CBAC, followed by a 15-hour home birth at 43 weeks to an almost 11-pound baby with her third. She gives invaluable advice on how to REALLY know if you have the right provider for you and how it may not always be the VBAC-supportive provider everyone recommends. Jolie's Photography and Coaching Contact InfoTransforming BirthNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. It’s Meagan here. We have another VBAC story for you today and we have our friend, Jolie. Hello, Jolie. Jolie: Hey, Meagan. Meagan: How are you today? Jolie: I’m good. How are you? Meagan: I am so great. I am so excited to record your story. There were a whole bunch of little snippets through your story that I’m like, Oh, I want to talk about that. But I wanted to tell everybody that I’ve been starting to do this. I don’t know if you’ve been noticing but we get a lot of emails of, Hey, where was this person located? What state was that? I’m curious if it was my state so I can try to find that provider. We are going to have her providers and stuff tagged in today’s post but you say you are in North Georgia, correct? Jolie: Yes. Meagan: Is that just where your VBAC was or is that where you are residing now? Jolie: Nope, this is where my VBAC was, in North Georgia. Meagan: Okay, so North Georgia people, listen up. This is going to be a great story. I’ll tell you guys a little bit more. Okay, so you’re a birth worker and a photographer. Are you a doula? Jolie: Yes. Yep. I was trained as a doula in 2020 but I’m exploring different ways to support people in the birth community because, with three young children, I’m just trying to navigate the on-call life and doing things. But yes, I do have experience being a doula. Meagan: Awesome. So cool. Like she said, she has three kiddos. She is a Christian wife to a Biblical counselor. That’s awesome. I love how you guys said that you have a vision of a multi-generational team on a mission to God’s kingdom. I just love that so much. I am so excited to record your story here in just a few seconds. I do of course have a Review of the Week as always. We always have reviews and just a reminder, if you haven’t left a review yet, we would love them. They really do help the show. They help other Women of Strength find these amazing stories and honestly, they just put a ginormous smile on my face. This review says, “Love these ladies and this podcast.” It says, “I love listening to your podcast. I listen almost every day in the car. So often that my oldest son knows you both by name. The stories shared here have inspired me so much. I wish I had all of this information with my first baby. I have had two C-sections. I’m not pregnant at the moment and still have to get my husband on board for a third, but I am so excited to start planning for a VBAC after two C-sections when the time comes. Thank you, Julie and Megan, for creating this amazing VBAC community. I’m so thankful for the education and support.” Okay, seriously, I love that. We keep hearing this. I love that other kids know who we are because they are just so used to listening to the podcast because this is what I love even more than just they know who they are. They are learning. These kids are sponges. We know that. They are always taking stuff in that we are saying and if they’re listening to these stories, they are learning. So hopefully if your kiddos are learning and listening, they are going to have a different outcome in their future for their future births if they so choose to because they’re going to know, right? They’re going to know all of these stories. Anyway, that makes my heart smile. Jolie: That’s awesome. Meagan: All right, girl. Are you ready? Let’s do this. Jolie: All right. Meagan: All right. Let’s turn the time over. Jolie: Okay, so yes. I had a home birth in November, November 5th. That was a home birth after two Cesareans so an HBA2C. I’ll just do a small synopsis of the first two births because I feel like that always helps preface the background of where I’m coming from. I think everybody’s journey to their VBAC is totally different. Meagan: Yeah, totally different and at the same time, there are so many listening who are like, Oh my gosh, this is just like me. I think sometimes we hold on to those past experiences even if we’ve processed them. We know that was our past so sometimes we even doubt ourselves because of that so hearing someone’s story who is pretty similar to yours and then hearing them go on to have a VBAC is pretty impactful. Jolie: Yeah, absolutely. I can relate to that as well with listening to podcasts and finding those stories of women’s journeys to their VBACs. I definitely clung onto the ones I related to. With my first baby, our daughter, she was born in 2019 and I mean, that was like so many, a typical cascade of interventions situation where I was aware of home birth and natural childbirth. I knew that I wanted that, but I also was just young and didn’t know and wasn’t aware of the resources I had. It’s pretty much what I chaulked that up to. I just was getting into birth and eyes wide open and reading what I could but I didn’t really know obviously what the future was going to hold for me. I didn’t know all what was available to me either. I was seeing a traditional OB group and was planning a hospital birth but wanted just a natural childbirth with no interventions at all. I just wanted in in the hospital. I ended up getting fear-mongered to just put it simply out there. Fearmongered into an induction at 41 weeks and yeah. Quite frankly, it just didn’t work. My body was not ready. I was not open at all and I was so determined. I stayed in that hospital working with an induction for a whole week before I had my C-section. I was trying to go slow and steady and I was going a little stir crazy there at the end of that week. I obviously was confused and just downcast and so just sad about what was happening. I was shocked that I was there in that situation. I remember reading Ina May’s book and skipping the C-section chapter because I was like, That’s not going to be me. Why do I need to read this? Meagan: That’s really normal. Even here with the CBAC stories, I think it’s really common to be like, I don’t want to listen to that CBAC story because that’s not going to be me. But at the same time, I think it’s good too. Jolie: Yeah. Yeah. There’s definitely a balance to that. I found myself at the end of that week pushing 42 and was kind of again just had fear within me and had fear coming from my providers of, “You’ve been at this for a week. You’re not in labor. Your options are to leave or have a C-section.” I was just like, “Leave? I’ve been here for a week. I’m not going to leave here without a baby.” We opted for the C-section and she was fine. We handled that whole week together perfectly fine. There were no emergencies or hiccups in the road. It was just like, “All right. This is just what we do next,” kind of at this point. She was born at 32 to the day via Cesarean and yeah. That was that. I definitely processed the birth very traumatically because any trauma is how you process what’s going on. I know there are births out there that could look like that and people handle it differently. So anyway, for me, I processed it with a sense of trauma. I spent that next year just working through that sorrow and trauma. I started seeing a Biblical counselor which is why I included in my little bio that my husband is one because I saw one and the change that he saw in me is what spurred him on and encouraged him to become one. That was a really cool moment in our family where I was going to this wonderful woman for help and just handling my birth. Anyway, that was really helpful for me in growing and changing the way I was looking at my birth. I was very determined to have a VBAC. My husband I have always said that we want however many children the Lord would give us. I assumed that wouldn’t be just one. I wanted another one so I was very determined for a VBAC for my second pregnancy. We conceived my second when my daughter turned one. It was a year later and I was just– the way this pregnancy and birth happened which was a repeat Cesarean, I just put my blinders on and put my head down and was like, I just need to hire a home birth midwife and she’s going to give me my VBAC. That was my attitude. Surely if I plan a home birth, I’m not leaving my house. There’s no way it will end in a C-section. I was very– I don’t know if stubborn was the right word, but there was a sense that I was covering up all that I went through with this first birth to just have the VBAC, have the VBAC. It was almost like that was going to fix the first one. That was how I felt. In hindsight, I see that now. In the moment, I probably did not recognize that that was how I was operating. I hired a home birth midwife who came recommended to me. I knew friends who used her. So then here we are towards the end approaching 41 weeks like the last time and my water broke on 41 weeks. It was the first sign of labor and I had no signs of labor with my first child so that was so exciting. I was kind of scared too. I was surprised. My water broke at 41 and I was talking to my midwife and whatnot. I had some little pitter-patter contractions that night and then nothing the next day. That was on a Sunday. My son ended up being born that Thursday via Cesarean. What happened within that week or a little less than a week was not the funnest of times. I pretty much realized there at the very end when I was needing– you’re here at the end and you’re like, What’s going to happen next? I realized, I hired the wrong midwife, but what do I do now? Meagan: No way. Jolie: Yeah. Like I said, I’m not going to speak ill, but I believe that every care provider is not the right fit for everyone. So just because I heard wonderful reviews, that’s not negating the fact that she was wonderful for some people, but looking back, this is pairing it where my head was down and my blinders were on. Now I can see in hindsight the red flags that were coming up. I was like, Oh, she’s just tired. Maybe she just got back from a birth and that’s why she seems grumpy. She’s been doing this for a long time. I was just giving reasons to why she was the way she was. It was nothing more than that we just didn’t click well. After my water broke, she took on this fearful attitude. She was very concerned and just didn’t know what to do. She really fed into fears that I had and new ones in my head. I was just like, This is not helping. What’s going on? All that to say, I think she wanted me to have a biophysical profile done since my water had broken and I was 41 and labor hadn’t begun. Obviously, the profile came back that there was low fluid which I knew because my water had broken but there was nothing else concerning with my son. But because of that report, she transferred me to the hospital. She transferred care and she called my husband after the report came back to her and said, “Y’all need to go to the hospital. I’m not going to be able to support you. Just go.” That moment from the report to the hospital was scary for me but on the way there, I had this peace come over me because I was going back to the hospital that my daughter was born at and before this birth, I was very much even just seeing the hospital– I would just not look at it by the side of the road. I had all of this emotion attached to this place. I knew a few people who worked there in the labor and delivery ward. I had their numbers so I messaged them. I was like, “Is there any chance y’all are here?” Long story short, I’m coming. I don’t want to be here, but I’m coming. They were. I had a friend come and she prayed with me and I had seen another nurse there who was there when I had my daughter and she remembered me. It was just this very healing moment in the sense of I was respected. People totally were not judging me for coming in as a home birth transfer. I was worried about that that I would get a side-eye or judgment because I was a home birth mom. I was actually going to the hospital and I didn’t have a provider there. But no, they were all so very much like, “We are so sorry that you are here because we know that you don’t want to be here but we are taking care of you. We understand that this is hard for you to process everything that’s going on right now.” That was healing in itself. That healed my emotional attachments to the hospital that were negative. He was fine. They monitored him for a few minutes when we got there. He was fine, but they also– I did tell my husband when we were on the way, “I just know that it’s going to be another C-section because I don’t even have a doctor here. My water’s broken. I’m already a VBAC.” I kind of had accepted that outcome before even getting there and decided to opt for it again. The doctor there was also very respectful with all of that just like the nurses were. He was born at 41 and 5. He was fine even though the water had been broken for some time. So that was that. In processing that birth, it was a little bit different than my first. I definitely felt like I was at a fork in the road though because here I am. I’ve just had two. I was technically a home birth transfer. I was determined to get this VBAC. What in the world happened that time? I just realized that I had taken any sort of trust and responsibility in the medical community or within myself and just put it in the hands of this midwife and put her up on this pedestal of, You’re going to give me the birth that I want. I misplaced that into the whole home birth community. I was like, I can’t do that again. But then that is some deep internal work then. If I am realizing that I am making all of these other people responsible for my birth and my outcome and it’s not working out great, I need to figure out what the root of this is and really work on it. That began the year journey of just doing some more internal work and more counseling and therapy and stuff like that. I remember it might have been this podcast episode that I listened to or it could have been another birth podcast. It was honestly a lightbulb going off. I didn’t realize I could do this. I can’t remember. I think it was your podcast but one of y’all said, “I interviewed seven providers before I became pregnant again to pick one out.” Meagan: Yeah. I actually interviewed 12. Jolie: Yes, okay. I wrote that down. I heard that and I was like, Wait a minute. How am I going to do that if I’m pregnant and scrambling to find the perfect provider? I heard you say that and it was almost like, Whoa. I didn’t realize I could interview people when I’m not pregnant, but why couldn’t I? So that helped me. Meagan: It sounds weird. Why would you go talk to a doctor if you’re not pregnant? Jolie: Yeah, but that gave me so much peace and confidence. It was a clear path of, Oh. I’m not pregnant. I’ve got time. I started. I didn’t want to figure this all out until my son turned 1 so I was just like, You need to take a breath. Everybody talks about your next baby right after you had one and I’m always like, Can you just slow down? I just had a baby and I’m going to enjoy this time. So I waited a year not to get pregnant the third time but a year to go after my provider, find my plan, and really do the deep work again. So I did. I started interviewing all of these people. I found my midwife a little over a year before I conceived my third baby. I found her early when I wasn’t pregnant. It was just such a God-ordained, perfect experience where my husband and I went and had a conversation with her. She just aligned with us on a biological level, on a spiritual level. That was something I didn’t realize how important it was going to be to me to find a fellow Christian who really walked out their life with the Lord and she did. I developed a close friendship with her actually even before I was pregnant. Being in the birth world, I would work with her. I had attended some births with her before I became pregnant so I really just saw her live it out and I knew she was amazing. What’s so funny, just the way the mind and body and spirit are connected was when I first met her and did the interview with my husband, I hadn’t started my cycle back. I was telling her, “I’m just looking. I need a VBAC. I want a VBAC. I’m not pregnant yet, but I haven’t started my cycle either so I have no idea when.” The very next day, I got my period. For me, I felt like it was my body coming into alignment with the fact that I just found somebody who was going to be amazing for my birth. Meagan: You’re ready. Jolie: I emailed her, “This is so weird but I literally just started my cycle.” Anyway, that was just a really cool moment for me to recognize that connection.That was when I found my midwife and that was such a key part to my VBAC. Then it was about a year later when I got pregnant with my third. I hired her and we were just so excited. Okay, so one of my big things with interviewing people for my third was, “Okay, I have had two pregnancies and two Cesareans. Historically, I have gone postdates with both of them. I need to know what your deal is with due dates and the whole ‘let me’ language and all of that.” I was trying to figure out what I aligned with in that regard and what they would support me with. So here I am approaching 42 weeks. She was very much like, “Whatever. We’ll check on you more when you’re past your due date if you want and we’ll obviously take care of you but I have no cutoff or whatever.” Yeah. So I was 42 weeks and I started losing a little bit of my mucus plug. That was exciting but then another pretty much week went by and here I am a couple days before 43 and I have two nights of prodromal labor where the contractions would wake me up in the night but then I’d go back to sleep. That was the first night on a Thursday night I would have those contractions. Friday rolls around. I am so pregnant and so tired. It was definitely emotionally very challenging that last month. But Friday night comes around. They pick up again and that night, I really couldn’t sleep so I would be on the birth ball. I would get in the bathtub and yeah. I knew I was going to need some support on Saturday because of my other children so it did fizzle out Saturday morning, but I had a friend come and play with my kids. We just all hung out together on Saturday. I did have some contractions that were strong every 30 minutes to an hour during the day on Saturday. I was pretty much– that Saturday I was 43 weeks I think. Either Saturday or Friday I was 43 weeks. That evening it started picking up a little bit more and my birth team, so my midwife and her assistant who was going to come to the birth and my husband. They came over around 10:30 Saturday morning and then 30 minutes later– so they got to my house at 10:30-11:00 PM. My kids were asleep so that was fine. I wasn’t really sure if I was going to have them around or not. I was going to play it by ear because I wasn’t sure what kind of support I’d need from my husband and how they were going to handle it. Through the night they slept which was great and I was laboring that Saturday night. My water broke at 11:00 PM Saturday night 30 minutes after my birth team got there and that was something that I was having to really work with in my mind because of the second birth having my water break as the first sign of labor and then not have the baby for several days. I was really wanting to not have my water break early. Meagan: Yeah. Jolie: But my water breaking actually when it broke at 11:00, I was in labor before then. That was a different situation and I just had this wave of peace come over me again because I knew I was finally in labor and my birth team was going to stay. It wasn’t going to be, “Oh, nevermind. We’re going to go home now.” They were here and the water was clear. I had no worries. I was actually really excited after my water broke because I thought I wasn’t going to be because of my second birth but I was so thankful. Pretty much from there on, it started picking up pretty intensely. The nighttime was a blur. I just did squats and walked around and swayed and just clung to door frames I feel like. I was just sort of, yeah. I definitely struggled with holding tension in my body in the contractions. I did labor pretty much all night on Saturday and then later in the night maybe around 4:00 or 5:00 AM, I finally found a great place to relax and just a position. It was actually just laying in the bed reclined is what did it for me. I was able to melt into the contractions and I could tell that I was opening and progressing. I just slept around 4:00 or 5:00 until 7:00 AM so early into Sunday morning now. I was definitely still laboring intensely but I was sleeping. To somebody on the outside, you would just think, Oh, she’s just taking a nap. I was in transition actually. I did not think I would want a cervical exam because of my previous two births– never dilating, all of that. I had to move past that whole belief that my body was not going to open and things like that so I wasn’t sure how I was going to do with exams and stuff. But at that time, being a doula and hearing so many birth stories, I was already pregnant for so long, I was just like, I need to know if I have a whole other day of this. I don’t want to hear a number but I want her to check me and at least tell me if my energy needs to be hunkered down, conserved, you’re not that far, or is it okay, let’s pick it up. You’re almost there? I did want her to check me but I didn’t want to hear a number. I just wanted her to give me a general frame of, “Here’s where you need to be in your headspace with this information I’ve just received.” It was 7:00 AM maybe. She checked me. She was like, “Are you sure you don’t want to hear a number?” I could just tell the way she asked that question. I was like, Okay, she knows I’m going to like the number I’m going to hear. I was like, “Okay, go ahead and tell me.” She was like, “You’re an 8 and I can stretch you completely open very easily.” I was like, “What? Oh wow, this is amazing. Okay.” She was like, “I think all it’s going to take is some different positions. We’re going to do a circuit to get the baby’s head lined up just a little bit more straight and that will open you up all the way if we just move the baby just a little bit.” I was like, “Okay, let’s do it.” I did two circuits of excruciating positions. Side-lying was not the most fun thing I’ve ever done but I was very much just like, “Tell me what to do and I’ll do it.” We did side-lying, knees to chest, and dip the hip where I was standing and I would swap and turn. I don’t know how to explain the sensation, but it was probably just the baby moving through my pelvis. It was pretty intense. I did two circuits of that and I was just like, “I need to feel some comfort again and not do this circuit again.” So I was like, “I think I want to get in the birth pool.” I had the birth pool set up. I had tried to get in earlier in labor but got right back out. It was just not for me. I was like, “Maybe I’ll try the birth pool.” I stepped in and was like, “Nope. I don’t want to do that.” The second time now, this was around 11:30 AM. I was like, “I think I want to get in the pool.” I got in and I was like, “I’m not 100% sure but I kind of think I feel pushy.” It was just one of those things that in a lot of ways I felt like a first-time mom having this labor where I never had a pushing phase with the others. I was just sort of doubting myself a little bit, but the assistant was like, “Well, we can’t tell you if you feel pushy.” I was like, “Okay. I know. I know.” Meagan: We can’t tell you. Jolie: Yeah. Meagan: That’s hilarious. Jolie: I was like, “Okay. Well, I’ll just be in this for a few more contractions and see if whatever sensation I’m feeling stays or gets stronger. I think I’ll be confident when I am ready to push or if it changes and whatever.” I just was trying to figure out again where I needed to be. So I did feel that pushing sensation and started to in the water. That was definitely such a switch in the way I was experiencing the sensations of labor because the contractions were painful to me, but when I started pushing, it was like relief and very relieving. I felt like, Oh, I’m doing something. This is different. I’m not just getting through this. I’m moving through it in a way where I have this sort of control over it. I really enjoyed pushing and I was in the tub and again, reclining on my back. I never thought I would be in this position for birth because it’s usually the hospital stereotype of on your back on the bed but that’s where I felt relief and got through transition on my bed so in the birth pool, that’s actually how I pushed was kind of reclined back. I was just able to do it better that way. I had 5 minutes between each contraction so that was really nice because I ended up pushing for about 2 hours. That’s kind of a long time. I think from start to finish my labor was 15 hours so it was those last 2. I never felt exhausted as in, I can’t do this, but I do remember I wasn’t really aware of the time. I knew it was Sunday afternoon. I got in the pool at 11:30 and my son was born at 2:05. I was pushing but I had those 5 minutes of breaks so I was able to doze off and float in the water. I genuinely enjoyed those 2 hours. It was just peaceful but I felt myself getting sort of impatient because I didn’t know what time it was, but I was just like, Okay. The water is kind of cool. I know I’ve been in here for a while so I don’t know. I really wish this was over now. So finally, there was a candid moment where I saw my midwife getting baby stuff together and I was just like, “Oh, what are you doing?” She was like, “You’re pushing. I’m getting the baby stuff out. You’re doing this. It’s actually happening.” I was just like, “Oh wow. Okay. I guess so.” It was so funny. I don’t know. I think there is just this part of where I was just so zoned into what I was doing and what I was feeling that I wasn’t really processing it, Oh, this is happening. This is happening. As she told me, I could feel my baby’s head and that was mind-blowing. Once I could reach out and feel his head, which we didn’t know at the time it was a boy. We were waiting to find out. That definitely brought me into a sense of reality when I could feel the baby’s head. It was just like, Whoa, okay. This is happening. There was a slight burn when his head crowned, but there was so much adrenaline when his body was coming out that I don’t even really recall that being painful just kind of a burning sensation. His head crowned. I changed positions after his head was born. I was still in the water, but I sort of think I was on my back. I moved up a little bit onto my hands and knees and stayed in the water. My midwife ended up guiding his head and shoulders down and then his body came out. She handed him to me and I just remember knowing it was a boy even though I hadn’t seen yet. I leaned back in the tub and I think what I said was just, “I’ve never held one of my babies after they were born before.” That feeling of an immediate, My baby came out and they are in my arms. That was just so surreal but at the same time it was almost so seamless and intuitive that I was just like, Okay. I just gave birth and it’s just a normal day. Everybody around me– I think I had thought built it up in my mind to be this incredible experience which it was. I don’t want to say, It wasn’t all that, but in a way, birth is so natural and normal that after it happened, it was just like, I’m in my bed and the birds are chirping outside and the day is going on, where before I was in the hospital and it felt like this whole different world. It was interesting how there was an element that was sort of mundane about it but I like that. I don’t know. It was just the normalcy of it all that shocked me if that makes sense. Meagan: Yeah. No, I really actually can totally relate. I remember after I had my VBAC after two C-section baby, I was at a birth center. I was in the bathroom on the floor when I gave birth and they were like, “All right, let’s get you up and move you to the room.” I was like, “Okay.” I just remember going in there and laying down and starting to feed my baby and just looking around almost like, Did that really just happen? But at the same time, it was like, Yeah, it just happened and now I’m just feeding my baby. Jolie: Yeah, that was it. Meagan: It was so weird. It was so weird. There was a slight disconnect in my brain that what had just transpired transpired. Jolie: Yes. Meagan: So yeah. I really can relate to that so much. Then about how you were saying, “I was pushing for a really long time and I just looked over and realized my midwife was putting the baby stuff together and getting stuff ready,” and you were like, “Oh, yeah. Yeah.” I had that moment too where I was just laboring on the toilet and then all of a sudden, my midwife was just coming in here guiding me to the stool and I was like, Wait, what? She was like, “Let’s come have a baby.” I’m like, “What, really?” I couldn’t believe that what was happening was happening but I was so zoned into doing this birth, having this VBAC, and then all of a sudden, I realized I was doing that. I was actually doing that. Jolie: Yeah. I think when you have C-sections and when you have any sort of difficulties in your births, your mind clings onto those phrases that people say like, “Oh, your baby is too big. You’re not going to open.” Meagan: Oh yeah. Oh yeah. Jolie: It makes you feel like this miraculous thing must happen for me to give birth because it didn’t work the other times so how in the world? Trumpets need to be blaring and some crazy thing has to happen for this to work but it doesn’t and it was just like, Oh. That was it. Meagan: This is normal. Jolie: Yeah, the thing that didn’t feel normal was actually the surgical births but the thing that felt normal was the VBAC so it was very interesting but after he came out, they were like, “That’s a big baby.” He pooped twice before we got out of the tub like pretty big poops so then by the time my midwife weighed him, she knew that he had already pooped, but I think he weighed 10, 14 so she was like, “He totally was 11 pounds coming out. If I weighed him before he took those ginormous poops.” That was shocking and not expected at all. Meagan: Yeah girl! Jolie: That was really cool that it was not even a part of it because I didn’t get any late-term ultrasounds. Looking back, people definitely kept asking me if I was having twins. They were like, “Wow. You look really big.” I just was like, “Ha, ha. I get it. I’m pregnant.” You know the things people say. I’m like, Maybe I actually did look larger than normal because this child could pass for two babies as twins. Yeah. He was almost 11 pounds. I did have one tear that I chose for her to not suture, but that was it. That was the birth. Meagan: Wow, and a surprise big baby. Think about how there are a lot of times in the provider’s world of the hospital where they see someone who is a larger baby and they are wanting to do those third-trimester ultrasounds and growth scans and they are like, “What?” When really you didn’t need any of those things, you just needed time. And a 43-week baby. I had one of my beginning doula clients and she was 43 weeks and 1 day as well. I mean, it was a 10-pound baby as well. It was 10,12 I think. That girl just powerhoused that baby out but she was getting pressure to get induced at 39 weeks. She was feeling all of that pressure. “Oh, your baby is looking big. You look so big. You are small. I don’t know if this is going to be possible.” Then she switched at I think 41 weeks then she went to 43 and 1 and just had a beautiful, vaginal birth. I love that. Okay, so there are so many things. Something that I caught in your story was with your second midwife or with your second provider with your second baby. Everyone said, “This midwife, this midwife,” so you went with this midwife then you realized it wasn’t the midwife for me. I think that is something that is important to note especially when we have our supportive provider list, right? We have this list and we’re providing these names where people will rant and rave for days and days and days about some of these providers so you’re like, Yeah, great. The whole community is going to this provider or whatever. Then you’re in that situation and you just take that word for it, but then you get into that situation of birthing and you’re realizing, Oh crap. This isn’t right. There were red flags and I didn’t recognize them because I was just going off of what everybody else said. I just think it’s important to note that even though everybody or people might say this provider is the only provider or the best provider that it doesn’t mean they are the best provider for you. It really comes back down to what that provider is looking like for you in your mind. Close your eyes. Envision your birth. Think about what they are saying, what they are doing, how they are caring for you. Think about the questions you want to ask them and go and really ask these people these questions that are really something for you. I love that you talked about that with your third midwife how you were like, “These are the qualities I was looking for.” It took you a while to find it but you found it. I love also that you pointed that out. Really you guys, I can’t say it enough. Finding a provider when you are not pregnant is night and day from finding a provider when you are. Jolie: Yeah. There was no pressure. I felt like I could be so much more confident in saying no because I didn’t feel like I had to say yes. Meagan: Yeah and honestly, our minds are in a different space. Even Dr. Fox a few episodes back talked about that how that is a really great thing to do because we are emotional. We feel pressure. There’s time. Our baby is growing and each week matters to find that provider. It’s a very different thing. It’s a very different thing. Okay and then in your form, we talked about this a little bit before but you talked about radical responsibility and the word radical just stands out to me now because of our radical acceptance episodes that Julie and I have done. We’ve done two of them so if you guys haven’t listened to those, go back and listen. There is a part one and a part two. How would you describe radical responsibility or finding radical responsibility to our audience? Jolie: Yeah. I think that it comes with a lot of coming face-to-face with some core beliefs because for me, when I was realizing was that we all day, “You are the one that cares the most about your baby and your body.” Okay. I think most people can agree that’s true. But then how do you actually walk that out when you are pregnant? Because what can happen is you can be subconsciously deciding that this person over here is going to make sure I’m safe, is going to make sure my baby is safe, and is going to do all of these things for me when in reality, I believe that nobody outside of you can guarantee that safety. As a Christian, I believe that I don’t even hold the keys to life and death. If that’s what we’re going to talk about, at the core of all of this stuff, people when they are pregnant, you want your baby after you are born and that’s a thing. So that’s kind of your basic line. I had to come to grips with even just the reality at its deepest core of, Okay. So if I’m pregnant and I have this baby growing inside of me and I want to birth this way for these reasons, I need to own this. If my midwife recommends I eat this way or do it. She’s not going to come over and feed me. She’s not going to text me everyday and ask if I took my supplements or went on a walk.That’s goes into something else I’d like to mention if we have time of just handling all the things in birth. But with the responsibility aspect, it’s hard to pin down but I think that it just boils down to realizing where you have control and where you don’t have control and are you giving any control to someone else or are they just there to support you? There was an element where I was at where I wasn’t wanting to do a free birth. I know there are very strong opinions for that or with unassisted– different terms and all of these things– but I did glean a lot from books I was reading about unassisted birth because I wanted to feel like I could make decisions with my midwife’s support and not the other way around. It wasn’t her making the decision and making sure I was on board with it. It was more like, This is what I want to do and I’m going to work with you because I did hire you and I actually hired you more for the essence of womanly support. Midwife means “with women” so I wanted this relationship. The relationship I cultivated with midwife was more of a sisterhood/friendship where I was like, “I need you in my birth. I hired you because I know you have incredible skills and I know that you can use these skills if something arises where I need to do something different in my birth, but more than that, I know that you know that you’re not responsible for certain things and I’m not responsible for certain things but we are working together and you are there for me on an emotional level.” That was more important to me. Meagan: I love that. Jolie: Not everybody is going to be there for our births but I think if you’re listening and that resonates with you like, I’ve taken some power and put it in other people or I’m holding my provider responsible for x, y, z at the end of the day, I would just work through that and base those thoughts and beliefs and see if you think there needs to be a change in your perception on responsibility and what we control or don’t control. We have to surrender which is incredibly difficult. Meagan: Yes. It is but I love that you are talking about that. We have to walk in. We have to own it but we also have to work together. I like that you said, “I don’t want her to have to convince me of this. I want to know what I’m talking about and work with her with this situation.” A lot of the time we have to do that with providers where we need to come in and work together and not be patient versus provider. It just needs to be a collaboration but at the same time, we have to take ownership into everything that we can. Okay, so we were talking about this and you mentioned that you wanted to talk about all the things. We talked about getting enough food, making sure we get the right supplements which we know here at The VBAC Link, I’m very passionate about getting the right supplements and then finding the right provider and figuring out what to do with the kids. There are so many things. Jolie: There are so many things. Yeah, I can talk about that for a minute because I think there are so many things that you can obsess over or shut down over. So one of the things that this goes into my tips of if you are going for a VBAC, here are some tips. A holistic approach– when I say holistic, I mean body, mind, and spirit. There are a lot of things we can do for our bodies when we are pregnant– the nutrition, the walks, the exercises, the Spinning Babies gymnastics. There are all of these body-focused things but you also need to be working on your mind and how you are doing in your mind which was huge for me. I found a birth course and worked with this incredible group of people. They are called Mind Change, but her birth course I think I sent you is called Transforming Birth. It’s all about subconscious stuff and rewiring your brain to have different pathways for your birth. Anyway, that’s my plug for that. But going into it, prepare your mind for birth. Actually think about what you do want and not what you don’t want. Think about what you don’t want. Have a plan. You need to have a plan for your provider. Of course, that’s responsible. But put that away and spend the real-time immersing yourself in what you want it to look like. And then just your spirit. You could make a whole list of all the things you need to do, but the key is in how you approach it because I remember in one of my previous births, one of them that was a C-section, somebody had said one time– it might have just been on social media, “Oh, I went to the chiropractor every week for my birth and I got this wonderful, fast labor and I know it is because of the chiropractor.” I thought to myself, I went to the chiropractor every week. Why didn’t I have a vaginal birth? It’s not in the things. That’s my main point which is so simple. You might hear that and be like, Duh. But it’s in how you approach them. Going to the chiropractor regularly is great for your health but if you are doing it from a place of stress and control like, If I miss an appointment or if I don’t hit 3 miles today, then actually, that’s not helping you anymore and you should probably not do that and not go on that walk if you are feeling stressed out about having to go on the walk. Don’t do it. Approach it from a place of peace and joy and acceptance going back to your radial acceptance. All of the things that can help you in your pregnancy are wonderful, but take them one at a time and make sure that when you’re going on your walk, when you have your supplements, you’re taking them from a place of peace and acceptance and then it can be helpful for you. One of the– I’ll just share one small example of how I did this with my third pregnancy that I didn’t really have this frame of mind with my previous two. There was a certain supplement. I can’t remember what it was called. It was a combination of herbs that helped ripen your cervix. A lot of people recommend it for VBACs at the end. Meagan: Like Birth Prep? Jolie: It wasn’t Birth Prep. It was 5 weeks or something. It had something to do with 5 or 7. There was a number in it and it’s like a holistic supplement that has supportive herbs in it for ripening your cervix so I remember coming across this information while I was pregnant and just thinking, Okay. I looked it up. It was all sold out on line and I was like, I feel like in my mind I’m thinking I have to do this to get the VBAC. This is going to help me. If I don’t get it, then what’s going to happen?  I ended up talking to my midwife about it and she actually had some. She was like, “Oh yeah, I do love this supplement. I have some and they are all sold out right now.” I was like, “I’ll take it. I’m going to let you know if I’m going to start taking it. Please ask me if I’m taking it out of a stressful, controlling way or if I’m taking it from a place of peace because depending on the way I answer, I need accountability to not actually do it,” because I wanted to be able to receive it in a way of support in general. That’s what she told me. “It’s not going to hurt you. They are wonderful herbs that will just strengthen and tone your uterus so you can take it,” but I knew I needed to be in a frame of mind where it wasn’t like, this is going to be the thing. This is just a small example of how I embodied that reality of if this is going to stress me out, even if it’s a good thing, I’m not going to do it. Meagan: Yeah, okay. I love that so much within our own community and other communities where it’s like, You guys, I have 5 days to get this baby out or they’re going to make me have a C-section, so then we have this stressful overreaction to do anything we can to get that baby out and actually what it’s doing is creating more stress in our body which is not going to help our cervix. I love that message. I do not know what you’re talking about exactly like what they used. Herbs are great, but I love that. Do things with intent and purpose. Don’t do things out of fear or out of worry or out of pressure. Do things because you think they are right and because you think this is what you need to be doing, not because you’re stressed about something. I’m just going to leave that right there because I love that message so much. Thank you so much again for sharing your stories and congrats on your HBAC after two C-sections. Jolie: Thank you, yeah. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
51:2014/08/2024
Episode 325 Failure to Progress: What It Isn’t and What It Is...

Episode 325 Failure to Progress: What It Isn’t and What It Is...

Women of Strength, how many of you have “failure to progress” on your operative report as the reason for your Cesarean(s)? Meagan and Julie talk ALL about failure to progress today– how it led to their own Cesareans and how after breaking it down, they both realized that neither of them actually qualified for that label. When is it failure to progress and when is it failure to wait? What does failure to progress actually mean? This is an episode you will want to listen to over and over again. From learning all of the ways a cervix changes other than just dilation to all of the possible positions you can try during a lull in labor, Meagan and Julie share invaluable current research and personal experiences on this hot topic! ACOG Article: Limiting Interventions During Labor and BirthAJOG Article: Safe Prevention of a Primary Cesarean DeliveryThe Journal of Perinatal Education: Preventing a Primary CesareanOBG Project ArticleThe VBAC Link Blog: Failure to ProgressHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello. I am with Julie today and we are going to be talking about failure to progress. If you have been diagnosed with failure to progress– and I say diagnosed because they actually put them on our op reports like it’s a diagnosis of failure of progress meaning our cervix does not know what to do. It cannot make it to 10 centimeters or it hasn’t or it will not in the future, then I am telling you right now that this is definitely a great episode for you. Even if you haven’t been told, it’s going to be a great episode because we are going to talk about some other great things in the end about what to do in labor position-wise and all of the things. So we’re going to get going, but Julie apparently has a Review of the Week. We weren’t going to do one, but she says she has a Review of the Week. So, Julie? I will turn the time over to you. Julie: This is my review. Are you ready? Meagan: I’m actually really curious. Julie: “I’m so excited. Thank you so much, Meagan and Julie. I love The VBAC Link!” Signed, lots of people everywhere. Meagan: I love it. Julie: We don’t have a Review of the Week so I just made one up. Boom. There. Signed, AnonymousMeagan: All right, you guys. Failure to progress: what it is and what it isn’t. Let’s talk about what it is. What does it mean? Essentially, it means that your provider believes that your cervix did not progress in an adequate amount of time and there’s also failure to progress as in your body may have gone into or you are going in for an induction and then they couldn’t even get labor going which we all know is usually not the case that your body really couldn’t do it, but failure to progress is when your cervix does not continually dilate in an adequate amount of time. Would you change anything about that, Julie, or add anything to that? Julie: Sorry, I didn’t hear half of that. I was just going through it. I was going through the things just to make sure that we are 100% accurate on what we are about to say. Whatever you said, yeah. That sounds great. Yeah. Let’s go with it. Meagan: Failure to progress– the cervix is not dilating in an adequate amount of time. Julie: Basically, yeah. Your cervix isn’t changing so you’ve got to do a C-section because it’s not working basically. Meagan: Okay, so what it isn’t– do you want to talk about what it isn’t? Julie: What it isn’t? It isn’t– sorry, I’m trying to say it. Meagan: It isn’t true most of the time. Julie: Most of the time it’s not true. It isn’t what we think it is and if it is, it’s not a sign that your body is broken. It’s not exclusion. It’s not a reason to exclude you from trying for a VBAC. It’s not your fault. It usually is a failure from the system where people are in a rush or in a hurry and just not knowing how to move past a stall in labor or not understanding the true flow of how some labors take. I mean, I was diagnosed with failure to progress. You were diagnosed with failure to progress and I know that both of our literal clinical outlook at the time we were diagnosed with failure to progress was not true failure to progress. Meagan: Mhmm. Julie: According to what the actual guidelines and requirements are. So I always say, yeah. What you said, it is not true. Meagan: It is not true.Julie: We joke about that and use it loosely. Sometimes it is true. I’ve seen one true failure to progress diagnosis in over 100 births, but I feel like most of us listening and most of us who have C-sections have them because of failure to progress. Now, mine when I was in labor, I was not told failure to progress. I was told fetal heart tones, but that’s another topic for another episode– what we are told versus what is in our op reports. So yeah, let’s do a little plug-in about getting your op report. Find out what is actually in the notes that say why your C-section was called because it’s not uncommon for what it was written down to be different than what you were told in the moment. I feel like having an accurate clinical understanding of what your Cesarean looks like on paper to another doctor who is reviewing your birth is super important. Meagan: Absolutely. I agree and also, I think that it’s important to note that if you have been told this and you have doubt in your body, that it is normal to have doubt because we have been told that we can’t do something and that our body can’t dilate, but I also want to plug-in that really try not to believe that. Try your hardest. Do whatever you can to not believe that. It’s going to help you. Believe the opposite. Believe that your body can do it. Believe that you were most likely set up in a less-ideal circumstance that created that result, right? Like an induction– it was a failure to descend, not progress, but I just recorded a story the other day where her water was broken at 6 centimeters, baby came down wonky. They couldn’t get baby out and they diagnosed her with CPD. There are these things that are happening a lot of the time where we are walking in to be induced way too early or really any time we are being induced could be too early especially if it’s just an elective. It can definitely be too early and our body is not ready so our body is not responding or our body is overwhelmed because it’s been given so much so fast and it doesn’t know what to do so it doesn’t react the way a provider wants it to by our cervix dilating. It almost is reacting in the reverse way where it’s tense and tight and like, No. I’m not ready and I’m not letting this baby out. Don’t you feel like you’ve seen that? Julie: Yeah. We’ve seen lots of things. I feel like that’s the tricky thing. We as doulas and birth photographers really do get to see the whole gamut of everything from home to birth center to hospital and everything. I feel like we have such a unique perspective on how labor is managed in and out of hospitals and how stalls or lulls in labor are managed in both places. Let me tell you, it’s often way smoother and in my opinion way better outcomes when you are out of the hospital and that happens. Meagan: Mhmm. Labor at home as long as you can. Yeah. I mean, one of the stories that I just recorded was an accidental home birth. It was not her plan, not even close, and it will for sure come across that way when she is telling the story, but there were so many things that she did within that labor like movement from the shower to the toilet to walking down the stairs to moving back to the toilet. There was all of this movement that sometimes doesn’t happen in a hospital or we’ve got, like I said, “Let’s break your water. Let’s do these things.” We’ve got these interventions that may help, but doesn’t always. It may also cause problems. Okay, so we have some updates for you on the safe prevention of a primary Cesarean delivery that Julie has found and then we also want to talk about what is adequate labor too? What does that mean and where do we decide or where does a provider decide if labor is not adequate? Julie, do you want to talk about this for a minute on what you found from the OB/GYN Project? Julie: That’s just a really nice summary. I really like it because it is all laid out really nicely. I am seeking out different pieces of information because there is updated information so I’m just looking for that. I’m not quite 100% certain I can speak to when it came out. Evidence-Based Birth has some great information. They did a podcast episode on the Friedman’s curve. We know that dilating 1 centimeter an hour is based on the study that Friedman did. That’s incredibly flawed but there is new updated, more evidence-based information that has come out. I’m trying to find out when it came out actually because the Friedman curve was established I think in 1956 and let’s see. In the 2010’s there were big shifts in the evidence. In 2014, ACOG had a study. Maternal Fetal Medicine published new guidelines on labor progress. Okay, so 2014 it looks like which is actually not that new anymore because it’s 10 years later. That was, I think– I don’t think it’s actually shifted that much at all. I’m just trying to figure that out right now. I’m sorry. Let’s see. The Practice Bulletin– yeah. You go. Safe Prevention of the Primary Cesarean Delivery. Meagan: I think we are looking at approaches to limit interventions during labor and birth, but we know that a lot of the time when we are introducing interventions, that is where we often will receive a failure to progress diagnosis because we are really introducing things, like I said earlier, when the body is not quite ready or the baby is not quite ready. Maybe the baby was already too high and was trying to make their way around and into the pelvis but now we’ve got an asynclitic baby or a transverse baby or an OP baby.This one, Number 766 which we will have in today’s show notes actually originally replaced the committee of 687 in February 2017. The 766 was in 2019 and reaffirmed in 2021. Something that I like that it goes through is recommendations for women who are at term and spontaneous labor it happening. It talks about admission upon labor. It talks about premature rupture of membrane or rupturing of membranes which I think is a big one. Really, through my own experience but also doula experience, I’ve seen so many people go through membrane rupturing whether artificially or spontaneously and then nothing is happening so we go in and we get induced. Or we are told the second our water breaks that we have to go in, then labor has not started yet so we are intervening. One of the things it says is, “When membranes rupture at term before the onset of labor, approximately 77-79% of women will go into labor spontaneously within 12 hours. 95% will start labor within 24-28 hours.” I just had this experience with a VBAC client just the other day. Her water broke and within about 9 hours, she was starting to contract and within less than that, she actually progressed really quickly. Baby was born. That was really great but then there are situations like myself where it takes forever for labor to even start. It took 18 hours for my very first contraction with my second baby to even start and then by 24-28 hours, I was in a repeat C-section because my body didn’t progress fast enough according to my provider.It says that, “The median time to delivery for women managed expectantly is 33 hours and 95% had delivered by 94-107 hours after rupture of membranes.” I think that is something also really important to note that if your water breaks, it doesn’t mean we’re just having a baby right away. It doesn’t mean that our body is failing because we haven’t started labor. 94-107 hours after the rupture of membranes is when the baby had been born. That’s some time. We need to allow for the time. Julie: That’s why I hate it when hospitals say, “If your water breaks, come in right now.” No. Meagan: I know. My provider did that too because it makes sense in our heads. They’re saying, “Oh, just come in because we have to monitor baby because of infection and all of this stuff.” But we also have to take a step back and realize that once we go into that environment, one, that’s a new environment. We’re not familiar with that. All of those germs in that environment, we’re not accustomed to. We’re not immune to them. And then two, we know that the second we go into labor and delivery units, what happens? They want to check our cervix which means–Julie: Bacteria. Meagan: There is bacteria that is possibly being exposed to the vaginal canal, right? Even if it’s a sterile glove, that still raises chances. Julie: Yeah, sterile gloves really are not as sterile as people think. Meagan: There are these things to keep in mind, but it’s so hard because for me, I had premature rupture of membranes. My body didn’t start labor, but I was told failure to progress after 12 hours for only reaching 3 centimeters. I was told failure to progress. I just really liked that. I mean, I like a whole bunch of this but I really liked that part of the rupture of membranes because I think so often we are told, “Oh, your water is broken. You’re not progressing. You are a failure to progress.” Or we are not progressing so we have to break our water to try and speed our labor up and then that doesn’t happen and then we are failure to progress. Can you see the problem here? Julie: Total problem. Meagan: It’s a problem. Julie: It is a problem. So many problems. It’s fine. I just dropped two different links to the updated guidelines because it’s really funny. I’ve been going down the rabbit hole now while you’ve been talking so if I’m repeating things like I tend to do on you sometimes, please forgive me. I just think it’s interesting. There is starting to be a shift in pulling away from Friedman’s curve and going into a different way to consider an actual progression of labor which is a really cool, nice little shifty-shift here. I feel like maybe let’s talk about what failure to progress really is. What are the guidelines for it? What is real failure to progress versus what you’ve probably been told about it? First of all, let’s just talk about– nothing. Meagan: Can we use my own birth example just as a starting point to what this evidence is showing us or what the guidelines are? My water had broken spontaneously. It took a little bit to start labor. Within 12 hours, I was 3 centimeters and was told that my pelvis was too small and that I was failure to progress. Water broken, I was 3 centimeters 12 hours into labor. all right, Julie. What am I? Am I real, true failure to progress or not? Julie: No, you’re not. Absolutely not, are you kidding me? Because you were still in the first stage of labor. That is the number one thing. According to clinical guidelines, it is not failure to progress until you’re in the second stage of labor which is at least 6 centimeters dilated. So guess what, friends? If you got called failure to progress before you were 6 centimeters dilated– mine was labeled failure to progress at 4 centimeters so that rules me out. I mean, there are lots of things that rule me out and Meagan. But if you are less than 6 centimeters, it is not failure to progress. Meagan: Yeah, it even says right here. “Active phase arrest is defined as a woman at or beyond 6 centimeters dilation with ruptured of membranes who fails to progress despite 4 hours of adequate uterine activity or at least 6 hours of oxytocin administration with an adequate uterine activity and no cervical change.” Can we talk about that too? Adequate uterine activity. You guys, at 3 centimeters with my water broken, I was still not in an active pattern to progress. It takes time. Our uterus doesn’t just start contracting regularly and adequately. It takes time. Then at that, I was only on oxytocin for 2 hours. Julie: Pitocin. You were on Pitocin. Meagan: Sorry. That’s what I meant. Pitocin. I’m looking at the word oxytocin administration. Pitocin. Julie: We all know the truth. Meagan: We all know that Pitocin is not oxytocin. Julie: That is a soapbox for another day. Meagan: I was only on Pitocin for 2 hours. 2 hours. At the top, it says, “Slow but progressive labor in the first stage of labor should not be an indication for a Cesarean. With a few exceptions, prolonged late phase greater than 20 hours in a first-time mother and greater than 14 hours in a multi (so a mom who is not a first-time mom) should not be an indication for Cesarean as long. As the mother and the baby are doing well, cervical dilation of 6 centimeters should be the threshold of an active phase of labor.”Julie: Exactly. That’s it too. Later on after this, we’re going to talk about all the different ways a cervix can change because can I just tell you what? Someone says, “I’m 5 centimeters. I’m still 5 centimeters, great. Cool. What else has your cervix been doing? We’re going to talk about that in just a second.” But yes, that’s the thing. It’s not failure to progress before 6 centimeters. It has to be 4 hours of adequate uterine activity which means strong, consistent contractions. Contractions that are strong enough. We could talk about the Montevideo units which is another measurement of the strength of contractions. We’re not going to talk about that because we just don’t have time, but are your uterine contractions strong enough? Yes? Then it’s got to be at least 4 hours without cervical change. No? Then great. Let’s do Pitocin and the inadequate amount of uterine activity. It says 6 hours or more of Pitocin without adequate uterine activity. If you’ve been on Pitocin for 6 hours and your contractions– which has caused that adequate contractions– and there is still no cervical change, then you are failure to progress Let’s talk about cervical change though because the cervix goes through so many things. When I was doula-ing, I talked about this a lot in our second prenatal visit about how a lot of times you’ll be like, Oh, cervical change. Yeah, dilation. Am I 4, 5, 6, 7, 8? But listen. The cervix goes through changes in 6 different ways. It moves forward so from posterior pointing backward toward to your spine. It straightens out to a more downward position. It softens so it goes from hard like your forehead to hard like your nose to softer like your chin. It softens. It effaces which means it thins out so it starts thick. It thins out which is effacement. It dilates obviously which is the opening and then baby’s station like where baby is in the pelvis. Baby drops down, rotates, and descends. If you were 3 centimeters at your last cervical check and 60% effaced and 2 hours later at your next cervical check, you are 3 centimeters and 80% effaced, your cervix has thinned by 20% which is a good amount of cervical change. Meagan: Good change, yeah. Julie: If you were 6 centimeters and your baby was at a -2 station and at your next cervical check, you are 6 centimeters and your baby is -1 station which means your baby is lower in the pelvis, that is a cervical change. All of these things are shifting so I feel like it’s important that when we are talking about failure to progress or when we are talking about labor progress that we consider all of the things the cervix does.I was just at a birth yesterday– not yesterday, two days ago. I don’t know. It was all night and it was long for me. All night is long. It doesn’t matter if i was there for 6 hours or 20 hours. If it was all night, I’m going to call it long as I’m getting older. The client was still 4-5 centimeters but the cervix was a lot softer or stretchier I think at the one before this. Oh yeah, your cervix is super stretchy now. Those are all great cervical changes even though the dilation number hasn’t changed. Meagan: Yeah, so coming forward, thinning out, really softening up, baby dropping– all of these things are signs of progression and so it’s something to keep in mind if a provider is like, “Well, you’ve been sitting at 6.5 centimeters now for 9 hours,” or whatever, but at the same time, your cervix went from 40% to 80% thinned and it went from super posterior to more mid-line and baby went from -3 to a 0. These are changes. These are absolutely changes and there are so many things that go into that. If a baby is high and not well-applied because they are trying to work their way down to the pelvis and our cervix is working on coming forward, there is so much that goes into that where now we’re going to have a baby. If that change was made, now maybe we can have a baby that was well-applied to the cervix creating good pressure. Uterine activity is getting stronger. Things are progressing in the right way.So in the ACOG thing, it does say that in contrast to the prior suggested threshold of 4 centimeters which we know is very outdated, the onset of active labor–Julie: Right, that was according to the Friedman’s curve. Friedman’s curve called active labor at 4 centimeters but now we are getting all of this new information that yeah, it’s probably at 6. I feel like when you and me started as doulas 9-10 years ago, it was 4 centimeters, but a couple years after that, everything started shifting into 6. So it’s actually not that new, but kind of new. Sorry, keep going. Meagan: Yeah. I want to get into our positions really quickly, but it does say even in here, the onset of labor for many women may not occur until 5-6 centimeters. May not occur until then and then we know that sometimes around 6 centimeters, it takes some time. We’re going to make sure all of these links here are in the show notes so you can check it out. Meagan: But we only have a few minutes left so I really want to talk about positions, okay? So positions in my opinion can truly change failure to progress. Julie: Yes. If there is a lull in labor, they’re getting close to calling a C-section, what can we do about that? Nobody wants to hang out at 4 centimeters forever. Nobody does so what can we do about that? Yes, Meagan? Sorry, go ahead. Meagan: Movement. If you do not have an epidural, obviously movement is a lot more free. Moving around, just walking. Just flat-out walking. If we’ve got a higher baby and we’re trying to get a baby down, really think about that femur rotation turning out. You can walk and sometimes I’ve had my clients do this little step dance thing where you step really wide and out and then left and right and left and right. We are doing this weird-looking dance thing, but you’re grooving. Julie: You’re grooving. Meagan: That can really help. Or thinking about really big asymmetrical movements so put your leg up on the bed or on a stool or on a whatever and leaning over. Bigger movements and outward movements. If you have an epidural at this point, same thing. Rotate on your side and really open those knees up really, really wide. Try to keep those movements consistent. If you’re exhausted and you have an epidural because you need sleep, I really, really believe in sleep and I think it’s very powerful. Find a good position. Sleep in that position and when you wake up, get going. Get active. But every 5 or so contractions, if you can, if not, make it 8, make some changes. It doesn’t have to be too dramatic. It sounds weird, but if you are at home, crawling up your stairs. Crawling up your stairs on your hands and knees is weird but it works or standing up and down going from the side– one side going down, standing back up, turning and walking back up, turning around, doing the other side down and coming back up. Those things are going to help. Doing big figure 8’s or hip dips. As the baby gets lower, all of those things are really still important. We are going to be less focused on big open wide because now we’re going to want to get baby in and then down. So if you think about a pelvis, when the femur rotation goes out, the bottom goes in. Femur rotation in, bottom goes out. Thinking about these movements as you’re laboring and as you’re working through these things, as you’re in these positions. Think about our hips, our pelvis, and even doing some cat-cows in labor is really good. We know there is the flying cowgirl. That is a really good one in labor too to get baby down and in. Julie: Walcher’s. Meagan: Walcher’s is not as fun, but it can be very good. Julie: It is magical. I’ve seen it push labor through so well. I had a doctor once at the U come in. I had a client who was 5 centimeters. Baby wasn’t looking too great. She had been 5 centimeters for a while and we were doing Walcher’s. They came in because the heart rate– Walcher’s sometimes makes it hard to get a fetal heart rate so the nurses come in. They were talking about C-section and they were prepping, bringing in all of the C-section stuff for her partner to get ready. They were like, “You can’t do this. Baby’s heart rate is not tolerating it.” I’m like, “No. It’s just not picking up the heart rate.” I’m like, “Okay, just one more contraction.” One more contraction later, she comes up and starts pushing 2 minutes later and her baby is born. the doctors are freaking out because, “Oh my gosh, the bed’s not designed to labor like this.” Not everyone, sorry, but those are a little couple of pushbacks I’ve gotten sometimes. Meagan: It’s weird-looking. It’s funky. It’s uncomfortable. Julie: Yeah. It’s curious and some staff at hospitals do not– if they see something new and they don’t know about it, they automatically assume it’s not good because they need to keep everything in line and to the protocol and all of those things. But yeah, it’s just really a magical thing. Meagan: There’s also the abdominal lift. You can abdominal lift. I think actively moving through the contraction which can get really hard in that active phase, but through the contraction can actually help. Hands and knees, sacrum, and all of those things. Holy cow, there are so many positions. Julie: Yeah, can I just touch back? When you said about the epidural, I love when you’re not resting, I think sometimes it’s easy to get discouraged if you want an epidural but you also want to move during labor. I want to expound on that a little bit because you can move with an epidural still and here’s how you do it. My favorite labor position with an epidural is sitting up in the throne. You lay the head of the bed all the way up, drop the feet down, then you crisscross your legs. Put the peanut ball under your right leg. Five contractions later, peanut ball under your left leg. Five contractions later, criss-cross your legs again or stretch them out straight and then repeat. Do you know what? There are so many magical ways that that helps. It keeps your pelvis moving and shifting and growing. I swear that is the most magical position for laboring with an epidural because you are upright. Baby is going to move down. The pelvis is moving and shifting so it creates lots of movement and space and I have seen that progress labors relatively quickly to how they have been going before we set up the throne so many times. I love that. I will swear. I will die on that hill. If you are failure to progress and things aren’t moving, sit up, drop your legs, get the peanut ball. It doesn’t even have to be the peanut ball. Maybe you don’t have one in your hospital but stack a couple of pillows but put one leg up. Put your foot flat on the bed so your knee is making a triangle. I don’t know how to describe it the right way and then drop it and put the other leg up and then criss-cross your legs then stick them out straight like two little sticks. Meagan: Every five. Every five, have subtle changes. Every five, subtle changes. Keep that in mind when you are laboring. Women of Strength, know that failure to progress is rarely truly failure to progress. We get it. We’ve been told the same thing. We see it all of the time as doulas. There’s more. There’s more and don’t feel like you have to say, “Okay” to a Cesarean if your cervix hasn’t dilated to a certain amount that the provider is wanting. Assuming you and baby are doing well, you can always ask for more time. Okay, we are on a soapbox. We could probably continue for a whole while longer, but Julie, thank you for joining me today and talking about failure to progress and what it is and what it isn’t. Julie: You’re welcome. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
34:1512/08/2024
Episode 324 Hannah's VBAC with Thrombocytopenia + Partial Placenta Previa + Marginal Cord Insertion

Episode 324 Hannah's VBAC with Thrombocytopenia + Partial Placenta Previa + Marginal Cord Insertion

Hannah is a VBAC mom and doula with Ebb and Flow Birth Co. located in Indiana. Hannah’s first labor began very intensely. Her platelet levels were high enough for her to be able to get an epidural which she requested right away. She dilated to complete quickly, but after about 4 hours of pushing, baby just kept coming down and going back up with no progress. Hannah was exhausted and consented to a Cesarean. Unfortunately, her very effective epidural was not as effective during her surgery. It was painful. She required higher doses of medicine, hemorrhaged, and was so out of it that she remembers very little about her baby’s actual birth.After the birth of her son, Hannah researched birth options and did all she could do ensure she’d never have another Cesarean. Her VBAC pregnancy included thrombocytopenia again, partial placenta previa (which completely resolved!), marginal cord insertion, and she was GBS+. With a great team and supportive provider, Hannah was able to stay focused on her VBAC goal even with the curveballs thrown at her. She went into labor spontaneously, progressed quickly, and though her pushing stage mimicked the same patterns, with the help of her doula’s tips and freedom to move without an epidural, baby was able to descend and come right out!Hannah's Doula WebsiteWhat is Thrombocytopenia? ACH PublicationsPlatelet Transfusions ArticleNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome, welcome. I hope you guys are having an incredible day. We have a guest today who has a VBAC story with a whole bunch of different things added to her journey. She has thrombocytopenia. Thrombocytopenia, I always say that wrong, which means low platelet count. That is definitely something that is more unique. It’s a little bit more rare, but if you’ve ever been told that you have low platelet counts or thrombocytopenia, this is definitely going to be an episode for you to listen to. She also had partial placenta previa and even marginal cord insertion. I am so excited for her to be sharing her story today. We do have a Review of the Week so I’m going to dive right into that and then we are going to get into her beautiful story. This review was just left on Apple Podcasts recently and it said, “I recently discovered this amazing VBAC podcast and I’m absolutely hooked. The host is incredibly knowledgeable and passionate about all things related to pregnancy, childbirth, and postpartum care. Each episode is packed with insightful information, personal stories, and practical tips for expectant mothers and families. I love how they bring on guests and experts to cover a wide range of topics making each episode engaging and informative. Whether you’re a first-time mom or a seasoned parent, this podcast is a valuable resource and empowers and educates. I highly recommend tuning in and soaking up all the wisdom shared on The VBAC Link Podcast.” I love this review and as always, I love them all. I love every single review, you guys. It is so amazing to get a notification in our inbox that a review has been left, so if you haven’t had a chance yet, please do so. Please leave us a review. Tell us what you think about The VBAC Link Podcast. You can do it on Apple Podcasts. You can rate us on Spotify or really wherever you listen to your podcasts. Or even Google– you can Google “The VBAC Link” and leave us a review there. As I always say, these reviews truly warm my heart but they actually really help your community and these other Women of Strength find this podcast and these stories. I encourage you to leave a review and tell us what you think so someone else can find this episode as well. Meagan: Well, welcome Hannah. Thank you so much for joining us. Seriously, you guys, I can’t tell you guys enough. Every time I have someone recording, I’m like, “Thank you for being here with me” because it takes a village and without all of your guys’ stories, this podcast wouldn’t be a thing. So thank you for being here, Hannah, and yeah. Feel free to share your stories. Tell the world what you feel like they need to know. Hannah: Yeah. Thank you so much for having me. I really appreciate the opportunity to share my story because both stories, I could talk about all day but also, I listened to your podcast consistently, constantly throughout the postpartum after I had my C-section and also during my VBAC pregnancy. With our first, I didn’t really have a different plan other than what my friends and family had done. I had planned to go to the highly recommended hospital in my area with a random OB that I just chose. The only real decision I knew I wanted specifically was that I knew I wanted to go unmedicated for my birth but I didn’t do anything other than general childbirth classes to actually prepare to birth unmedicated. I just assumed, “I’m going to go in and have a baby unmedicated and everything will be fine.” I didn’t do anything to prepare for that and my pregnancy was pretty uneventful. I was sick the entire time. I had borderline hyperemesis– not officially diagnosed, but I was very, very sick. The only other weird thing I guess that I wasn’t aware of before pregnancy was I had gestational thrombocytopenia where your blood platelet count gets lower. Meagan: Yes. We just heard about this on a recent story and I had never even heard of that before. Hannah: Yeah, I’ve had it with both of my pregnancies so I think my body just does that when I’m pregnant. The only thing that they had mentioned about that was there was a potential that you won’t be able to get an epidural if your platelets fall too low. I had wanted to go without an epidural anyway so I wasn’t really concerned about that, but again, I didn’t do much to prepare. At the end of my third trimester, around that 36-week mark, they had brought up, “Well, your baby is measuring potentially big.” They estimated him weighing 11 pounds. They were like, “If you want to schedule an induction at 39 weeks, you can. If not, that’s fine. It’s up to you.” My OB was really great about just presenting options and not forcing things to happen. She did say, “You can schedule one of you want to but you don’t have to.” I did schedule an induction for 39+5 or something like that. At 38 weeks and 39 weeks, I decided to get membrane sweeps. I got one at 38 weeks exactly and 39 weeks exactly. The day after I got my membrane sweep at 39 weeks, at 39+1, I went into labor. This was before my induction. I didn’t have to end up being induced, but my contractions that morning had started so fast and so hard that I was really thrown off. I was shocked because when I had talked to people, they said, “They’ll gradually build and they’ll gradually get closer together and stronger in intensity over a few days or whatever it may be.”Mine started. It just hit me like a train. It was really bad so I called my husband. He was already at work that morning and I said, “We need to go to the hospital now. I need to get an epidural right away.” Because they were so intense, I just thought, I’m really far into labor, clearly. We got to the hospital and we got into triage. They checked me and they were like, “Well, you’re about 3 centimeters.” I was just so annoyed. I was like, Okay. I’m only 3 centimeters. Whatever. We can stay because I’m obviously not coping well. I got an epidural right away as soon as we got back to be admitted. Thankfully my platelets were within range to get the epidural. Meagan: That’s awesome. Did you get platelet transfusions at all during pregnancy? Hannah: Nope. They just monitored them. They continued to decrease, but they didn’t drop below that epidural safety level but they were continually decreasing throughout my whole pregnancy. Meagan: Got it. I was curious. I’m always wondering what people with low platelets do if they do transfusions or not. Do you remember what the low number was, like the safety number?Hannah: Yeah, it kind of depends on the anesthesiologist, but for epidural specifically, they said anything below 100. I don’t remember the units. It’s like 100 something per milliliter or something like that. Anything below 100 would be considered not okay to have an epidural. Anything below 70 or 80 would risk people out of home birth which is another thing to consider. But yeah. Mine didn’t drop below that level. It was 105 when I checked into the hospital. Meagan: Awesome. What’s crazy is that less than 1% of people even have this condition. Hannah: Yeah, it’s very rare. Meagan: Yeah. Yeah. Well, good. So you’re 105. You’re getting good. You’re clear to get an epidural. Hannah: Yep. I get my epidural right away when we get back there and essentially, I just nap. My husband was really confused. He was like, “Well, I thought I was going to be doing more. I’m just sitting here,” because I just napped with a peanut ball between my legs. I progressed very, very quickly especially for a first-time mom and around 9 centimeters, I had been stuck at 9 centimeters basically not really long, but longer than I was for how fast I was progressing. When my OB came in, she said, “If you want, we can break your water just to get you to that complete state so we can start pushing.” I was like, “Yeah, fine.” I didn’t really know a difference so she broke my water and then I got to 10 really, really quickly but I labored down for quite a while just because my OB was back and forth between seeing patients in clinic and then coming to see me because she comes to your birth whether she’s on call or not which is nice. I labored down for a while and then started doing practice pushes or whatever with the nurse. My epidural was so strong. I felt absolutely nothing. I didn’t feel a sensation to push, an urge to push. I didn’t feel pressure– absolutely nothing. Me trying to push was not effective whatsoever. I pushed for about 4 hours before we ended up opting for a C-section because my son was just coming down and then going back up, coming down and going back up and of course, I was in that semi-reclined, pretty much on my back position so gravity wasn’t really helping me at all. He just was not coming out. The nurse and my doctor had mentioned, “We think he’s asynclitic,” where his head was tilted to the side and he just wasn’t coming out. I was just exhausted and annoyed so we opted to have the C-section. That was really shocking to me. I was a little thrown off because C-section was never on my radar. It’s not something I really prepared for or thought about. I just thought, C-sections happen in emergencies. I was fine. My baby was fine. We were both stable and had no problems. It was just that I had been pushing for a long time so I felt really confused on why it was happening. But the hard part for me was once the C-section started is when things really took a bad turn for me emotionally and physically. My epidural like I mentioned was super, super strong, but when the C-section started, I could feel a lot. I felt a lot of pain, not just the pressure they had mentioned. I was really, really in pain. I had told my husband, “There’s something wrong. I can feel way more than I believe I should be feeling.” He told the anesthesiologist and they gave me some additional medication. I don’t know exactly what it was, but whatever they gave me, I fell asleep for a little bit. I wasn’t under general but I dozed off. Meagan: Yeah, it made you sleepy. Hannah: Yeah. I don’t remember when my son was born or meeting him or hearing him cry because I was just so out of it. When I woke up however long that was, time was just not in my mind at that moment, but I remember my husband saying, “Babe, it’s a boy,” because we didn’t know if we were having a boy or a girl. That’s all I really remember from the OR itself. Then in recovery, in the recovery room, my blood pressure dropped. I was going hypotensive. I apparently had hemorrhaged more than they would have liked for a C-section which is understandable with low platelet counts so they were trying to get me stable because I was essentially on the verge of passing out. Everything was blurry and my main concern while all of this was happening was having my son breastfeed. I told my husband, “They’re going to work on me. Just get him to nurse,” so he was holding my son to my chest so he could nurse while they were trying to stabilize me. It took them quite a while to get my blood pressure back up and to get everything fine, but thankfully, I didn’t need any transfusions or anything like that. The whole postpartum experience, everything from C-section on was just really difficult to deal with and process at that point but that’s kind of how everything ended up with that one. Then I knew from then on if I had any other kids, this can’t happen again. I have to do something different. Meagan: Did they talk to you about anything like, “Okay, for your next birth, if you choose to have one, you can have a VBAC”? Did they counsel you at all after that? I’m always curious if providers do. Hannah: Yeah, so my OB specifically– I told her, I was like, “If I have more kids–”, because I had never heard the term VBAC. I didn’t know that was a thing. I just thought, Oh, you can have a C-section but you can go on to have kids vaginally later. I didn’t realize it was such a big deal until I started looking into it and asking around about it. At my postpartum appointment, I talked to my OB about it and she was like, “Well, yeah. That’s fine. There are no issues with that. You would be a great candidate for it.” It was like, okay. That’s what’s going to happen if I have more kids. From postpartum on, I started researching. Meagan: Awesome. So what did you find in your research? Hannah: The first thing I did was look up obviously what VBAC was. I didn’t really know then I started listening to podcasts and reading and reading book and listening to stories. I came across your guys’ podcast which I honestly don’t know how I found it. It was 5 weeks postpartum and I had never really listened to podcasts before. I found it and I found several others and started listening. Then one of the big things I looked at was, okay. What happened in my birth that potentially contributed to this? How can I avoid this in the future or make it a better experience? One of the big things was that I got my hospital notes and my op report and everything from when we were in the hospital just to understand fully what happened because they don’t explain every single detail of what’s happening to you unfortunately in most circumstances. So I wanted to see all of the notes and everything that happened down to the minute that was in my chart which really helped me understand what happened, process it, and heal that. Then for me, when I was looking at why I had my C-section and all of that, when I was looking at things about VBAC, it was like if these things happen to you like a failure to progress or the baby wouldn’t come out like CPD, the cephalic pelvis disproportion, then the chance of you having a VBAC are not great. I was like, Well, that’s discouraging. Then the more I got to the research, the more I realized that my birth specifically was likely a cascade of interventions starting with my epidural for me. That’s how I personally feel. Some people would say that’s not the case but that’s how I personally feel. I knew going into my next pregnancy that I would do things drastically differently to set myself up for the best possible chances of having that VBAC. Meagan: Yeah. I love that. It sounds like you were starting in all of the right places. Hannah: Yep. Meagan: So baby number two– Hannah: Yeah. We decided. 8 months postpartum, I was like, “Let’s have another baby.” I feel like with both my pregnancies and both my postpartum, around that time, I just get baby fever and then I am thankful that I don’t get pregnant at that time. We got pregnant with my daughter about 20ish months after I had my son. That wasn’t specifically chosen for VBAC intervals or anything like that. We just weren’t ready to have another kid yet. So I got pregnant with her and I had interviewed doulas before we even conceived because in my area, they book up really, really fast, especially the more experienced ones. I specifically looked for a doula who had a lot of experience supporting VBAC. Then I also looked into different birth location options. I had first looked into a birth center and out-of-hospital birth center, but where I am in Indiana, it’s illegal and against the law to have a VBAC in a free-standing birth center. I was upset about that at first, but then I looked into some home birth midwives as well as hospital providers. Home birth midwives– the only one I could find in my general close area was about two hours away and the ones who were closer to me wouldn’t support a primary VBAC so if you had never had a vaginal birth either before your C-section or had a VBAC before, they wouldn’t support you which was really discouraging. With how fast my labor progressed the first time around, I just didn’t want to travel that far for appointments or having my midwife have to travel that far for the birth because you just never know how fast it’s going to be. The thing about my first birth, my OB was amazing. She was not the type of OB who would try to coerce you to do anything. She was always very supportive of whatever I decided to do. She was very supportive of VBAC but I did also interview some hospital providers, some midwives, some other OBs and ultimately, I decided to stay with my OB because I felt really comfortable with her. I felt confident in her. She had no stipulations surrounding VBAC at all. The only other OB I did interview was an OB who would do vaginal breech birth because that’s one thing my OB would not do and I was like, If I have a breech baby, I’m not having a C-section so I’ll go to this other OB if that ends up being the case. Meagan: Okay, you’re in Indiana.Hannah: The Indianapolis area. Meagan: Did you find it hard to find that provider? Hannah: Yes and no. Yes because he’s the only one in our area who supports vaginal breech and no because my doula and a network of doulas who I converse with now all recommended him because they know that he’s the only one in the area who would do it. Meagan: Do you care to share his name just in case we have someone breech listening? Hannah: Yes, so his name is Dr. James Webb and he’s on the verge of retiring. Meagan: No! That’s the problem. Hannah: Yeah. He is very particular about what hospitals he’ll deliver at and all of that, but he is the only one currently in our area who will do it so if he doesn’t happen to be retired at the time of this episode coming out, you can look into him as an option. Meagan: Yeah, awesome. That is the hardest part is we are seeing so many people who do supportive breech VBAC or just breech in general are retiring. They are closing doors and that’s the hardest part. Okay, sorry. So you did an interview with him. Hannah: Yes. I had him as a backup just in case baby did end up being breech. Then my pregnancy again in general was fine. I had gestational thrombocytopenia again. I was not as sick the second time around which I was very, very thankful for. The only other weird things that came up were I was GBS+. I was negative for my first pregnancy and then I had a partial placenta previa at one point which at first concerned me but then once I realized that they usually resolve as your uterus grows, then I wasn’t too concerned about ending up with another C-section because of that. I also, my baby was breech at one point. Meagan: Oh my goodness. Hannah: I know. I was like, All of the things that could happen did happen. But I didn’t let it discourage me. I just kept going on and doing what I needed to do. The big difference in my preparation that I did the second time around because I knew for my VBAC I wanted to be as low intervention as possible. I knew I wanted to go unmedicated. I had my doula so I took a program called HypnoBabies which is a type of hypnobirth for those who may not know. It’s a medical-grade hypnosis so I consistently practiced with that throughout my whole pregnancy. I did some breathwork and progressive relaxation videos and stuff like that to make sure I was really mentally prepared to go unmedicated because I feel like that aspect of birth is so much more mental than it is physical. That’s where I really wanted to be prepared for that part. Meagan: Mhmm, nice job. Hypnobirthing is really common here in Utah. I wouldn’t even say common but a favorite education course and we actually have a blog about it because so many people love it. It really can put you in such a great head space. Hannah: Yeah. I know it doesn’t work for everyone, but what was more beneficial for me was that I didn’t just go through the course in the last 6 weeks of pregnancy or something like that. I consistently practiced throughout my entire pregnancy to make sure it became a habit or something that I was normally used to doing. I did that primarily to prepare for birthing unmedicated and then I also did pelvic floor therapy to help with my C-section scar and my ability to push because pushing was such a difficult time for me the first time around. I really wanted to know what muscles to use and how to actively engage and push if I needed to. Meagan: Awesome. Hannah: I did a lot of different things to prepare the second time around. But then at the end of pregnancy, I did not get any cervical checks. I didn’t get any sweeps because I knew it would just mess with my head space. It would discourage me if I was dilated or wasn’t dilated and I knew that my dilation wouldn’t determine when I was going into labor. I didn’t schedule an induction either. I was just going to wait for my baby to come when they wanted to come and my OB was fine with that which was great. The only thing I did do was– I didn’t have to end up doing this, but if I went past 41 weeks, I was going to get non-stress tests. But we were find waiting for things to happen. I went into labor spontaneously at 40+2 and– oh, I forgot to mention. Sorry, I’ll back up. I did have a marginal cord insertion with this baby too so all of the things where the cord was on the side of the placenta instead of the center. The issue there could potentially be a lack of blood and nutrient flow to the baby which could cause growth issues. Meagan: IUGR, yeah. Hannah: We did monitor that a little bit more, but there were no issues with her growth or her percentile or anything like that so that was never a concern of her being too small or too big or anything like that. But I went into labor the morning of 40+2 and it didn’t start how I expected or anything like my first labor. I had excessive bleeding and no contractions. I was really confused. I was like, Why am I bleeding so much? It was more blood than I felt comfortable with. A lot of times you have a bloody show or something like that with your mucus plug, but this was filling pads. I called my doula. I called my doctor and they were both like, “Yes, just go in.” My plan was to labor at home as long as possible, but because it started that way, I was like, Okay, I’m going to the hospital. Meagan: Mhmm, and the previa had completely resolved? Hannah: Yes. Yes. It was still low-lying, but it wasn’t covering the cervix at all. With the amount of blood, I was like, Well, this is a little concerning. I did go into the hospital right away and went to triage because their main concern was a placental abruption with how much I was bleeding. Meagan: That’s one of the things I was thinking too. Could it be a placenta thing? Hannah: They put the monitors on us. They checked everything and we were both fine. There were no issues. The bleeding ended up resolving and they couldn’t exactly tell where it was coming from. At the time, I was about 4 centimeters dilated when we got to triage and I had planned because we were both fine, I was like, Well, I’m going to go back home then, but we had to stay to be monitored for about an hour just to make sure nothing else came up or things didn’t take a turn or something like that. Within that hour, I had already began to dilate more. I was already 5 centimeters and at that time, I started feeling contractions so I decided, Okay, we’ll just stay. We’re already here. With the bleeding, I felt a little bit more concerned so we just stayed. I told my doula I would just text her and keep her updated. We got back to be admitted and because I was GBS+, I did choose to get the antibiotics. I got that round of antibiotics and then had them unhook the IV because I wanted to be as mobile and as free as possible. Thankfully, my hospital had wireless monitors so I was able to move around. I didn’t have to tote around a monitor or be stuck to the bed or anything like that. After the antibiotics went through, I was going to lay down and listen to my Hypnobabies tracks and just rest because my contractions weren’t intense or anything like that. I was super, super uncomfortable laying down. I needed to be up and moving. I tried and I was just annoyed with my headphones and annoyed with the tracks and everything. I was like, I need to be up and moving. At that point, I was getting ready to get up and my water broke on its own which was different for me because it did not break on its own with my previous birth. My water broke and again, I was around 5 or 6 centimeters at this time. It was definitely my water and they made sure. It was gushing out so it was definitely my water. After that point, I just felt like I needed to be on the toilet. I went to the bathroom and sat on the toilet and my husband got me cool washcloths and was wrapping my shoulders. I was just swaying back and forth on the toilet. Quickly, within 30 minutes, I was getting hot and sweaty. I was shaking. I was doing the horse-lip breathing and my doula wasn’t there yet. I had texted her right before I went to the bathroom to tell her, “Things are getting more intense. You should probably head this way.” I hadn’t been there more than 2 hours so she was like, “Okay, yes. Okay, things are picking up. I’ll be on my way.” When I was on the toilet and I was starting to sweat and shake, I was clearly in transition. I knew that in my mind. My nurse knew that. My husband realized that. At that time, I was like, “I need an epidural.” I told my husband that and he was like, “But you’re doing so well. Let’s wait for Julie (my doula) to get there and see what she suggests.” I just felt like I couldn’t do it. Then my nurse was really great about just leaving us alone and letting us do our thing. She came into the bathroom to check on us like I said about 30 minutes later. I told her, “I think I need an epidural.” At this time, I did not have an IV hooked up. She had mentioned, “Well, it’s at least going to take 20 minutes to get the fluids in you to even be able to do an epidural.” She knew and she was clearly trying to stall me. Meagan: Yeah, I was going to say, I think that nurse knew something you didn’t know. Hannah: Yes. Looking back in my mind, I knew but I was just in denial. I didn’t really want the epidural but at that moment when you are in transition, you’re just like, I can’t do this. Two minutes later, my doula walks in and I told her the same thing, “I think I need the epidural.” She was like, “How long have you been on the toilet? Have you switched positions lately?” I said, “Well, now I’ve been here about 30-45 minutes.” She said, “Let’s try getting in the shower and see if that just helps things ease up or change or whatever.” I was so reluctant to get off the toilet because I was so comfortable and in my zone but I did. I got in the shower and as soon as I stood up and got in the shower, I was bearing down and pushing. I was hanging onto my husband’s neck and my doula was putting water on my back and the nurse heard me grunting and bearing down and she came in and was like, “Are you complete? We need to make sure you’re complete just to make sure you’re not pushing against a not complete cervix.” That was one of my concerns too. I was unmedicated so I felt the urge to push obviously, but I didn’t want to be in that case where my cervix would swell or something like that. But I was complete and I had just a slight lip or whatever. My doula just suggested maybe we get on hands and knees to help relieve that lip or get in a different position to even everything out. I got on the bed and got on hands and knees. At this point, I’m just pushing. My body is pushing. I have no control over it. It’s happening regardless of whether my cervix is complete or not. I was on hands and knees sitting on the back of the bed. My husband was cooling me down with washcloths and rubbing my back. My doula was doing the same and taking pictures and watching me push to see how baby’s movement was. I pushed on hands and knees for about 10 minutes and again, my baby was coming down and coming back up and coming down and coming back up which was discouraging because that’s what happened the last time. Then my doula said, “How about we try a squat to see if that helps with gravity working in getting your baby out?” I was so tired at this time. I was like, “There’s no way I can hold myself up in a squat. This is not going to happen.” But we got the squat bar. I got in the squat. My doula and my husband were both supporting me. Within 5 minutes, probably two or three pushes, my baby was out. We didn’t know again if it was a girl or a boy. She came out so fast and my doula was trying to get me to do the blow breathing to control and slow the pushing but I was not. I was like, “Get this baby out,” because I knew pushing was going to be the hard part for me to get past because it was four hours with my C-section baby. My doula knew that as well so she was trying to give me that extra support to make pushing a good experience. I let it fly and I was like, “Nope. This baby is coming out now. I don’t care how fast she comes out. I don’t care if I tear or whatever. I just need to get her out.” So she did. She came out and it was so funny because I had the squat bar and I was trying to pull her to my chest. My doula had even mentioned this in our prenatal prep. If you use the squat bar, the umbilical cord is still going to be attached so go under the bar and not over the bar. I tried to go over the bar of course. They were trying to get me all untangled and stuff but I was so happy she had come out that I didn’t even look to see if she was a boy or a girl. I just forgot to check. She was a girl and we were so, so happy and so excited. I was just in disbelief that I had done it. It happened so fast that I didn’t really have time to process what was happening. It was 4.5 hours total. Meagan: Oh my gosh. Hannah: Yeah. From the first contraction I felt– so not when the bleeding started, but from the first contractions I felt to when she was born was 4.5 hours. Meagan: Holy smokes. Hannah: Yeah, that’s almost a precipitous birth and I don’t know what just happened. It was just a rollercoaster and intense with no breaks whatsoever. But we were so excited. So excited. Meagan: I bet. Oh my gosh. When you said almost precipitous labor, to me, that is still very precipitous. 4 hours really from the start to the end, that is so fast. I have had a couple of clients like that. Sometimes I’m just like, “How does your cervix just do that?” Because from a mom who had a 42-hour long labor, it’s like, what? We envy a lot of you precipitous birthers, however, I will point out that when precipitous birth happens, it’s typically super intense. Hannah: Yes and you don’t have a break. It’s just constant intensity. Meagan: Yes. It’s so hard because people have said, “Oh, I’d rather have a fast labor than a long labor.” It goes both ways. They want a fast labor, but I’m like, you have to know that it is very, very, very intense. It usually starts right out of the gate. When I say right out of the gate, I can picture a rodeo with a cowboy on a bull and the second the gate opens, the bull is just bucking, right? Hannah: Yes, because as soon as–Meagan: That is what reminds me of precipitous labor. Hannah: As soon as I felt contractions, I went from feeling nothing that morning to feeling like my whole body was contracting. It was just very intense so I don’t know. I think both have their pros and cons, long labors and short labors. Meagan: Absolutely. Absolutely. Yeah. I’m glad. Precipitous labor for a first baby is common from what I have seen in the doula world of supporting hundreds of babies and lots of moms with precipitous labor. It is common to happen the next time. So even if you didn’t have bleeding, you probably would have gone in sooner rather than later too. Hannah: Or I would have ended up with a car baby because if I hadn’t been bleeding, I would not have gone to the hospital. I would have been fine. My plan was to labor at home as long as possible. Meagan: So you could have had a car baby or a front door baby. Hannah: Yeah, or just somewhere that is not in the hospital baby because it was too fast. Meagan: Yes. Oh my gosh. You are amazing and it is interesting. I’m so curious. Did the doctors say why they think that you developed low platelets? Do you have that normally? Hannah: No, I don’t. Meagan: You said gestational so I’m like, She must be meaning just during pregnancy. Hannah: Yes. Some people have it in general without being pregnant. Other people develop it just when they are pregnant. They don’t really know exactly why. I think there are things you can do to help that and help increase those platelet levels other than getting transfusions or whatever, but they didn’t really know why. I mean, I’ll be interested to see if I have a third to see if I have it again, but I think it’s just what my body chooses to do. Meagan: Yeah. Interesting. Well, I’m so happy for you. Huge congratulations. Hannah: Thank you. Meagan: I don’t know if you’re going to have a third, but I assume you’ll probably have a wild ride as well and you’ll have to let us know how it goes if you decide in the future to have one. Hannah: Yeah. It will probably be the wildcard. Meagan: I know. You know, that does happen. I swear baby number three– in fact actually, it was my very first doula client that I attended. I was shadowing a birth doula because I was brand new and this mom had precipitous labors and baby number three took 15 hours. She was like, “No. No. No. Why is this happening? What is going on here? No.” The whole labor, she was like, “I don’t like this. This keeps going.” So you never know. Baby number three also could be a labor wildcard. You never know. Well, thank you so much for sharing your story today. Hannah: Yes. Thank you so much for having me. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
38:0207/08/2024
Episode 323 Lauren's 2VBAC + Special J Scar

Episode 323 Lauren's 2VBAC + Special J Scar

Lauren has had three very different births. She had a peaceful C-section due to breech presentation with a difficult recovery, a wild, unmedicated VBAC, and a calm, medicated 2VBAC. Due to her baby’s large size, she had to have an extra incision made during her Cesarean leaving her with a special J scar. Though her provider was hesitant to support a TOLAC with a special scar, Lauren advocated for herself by creating a special relationship with her OB and they were able to move forward together to help Lauren achieve both of her VBACs. Lauren talks about the importance of having an open mind toward interventions as she was firmly against many of the things that ended up making her second VBAC the most redemptive and healing experience of all. How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hey, hey everybody. Guess what? We have our friend Lauren and her 11-day-old baby. Is that right? Lauren: Yeah. Meagan: 11 days old. You guys, I actually didn’t even know that this baby existed until we popped up on the Zoom and she was holding this precious little newborn. She was like, “Surprise! I had another VBAC.” So we will be sharing, well she will be sharing her two VBACs so 2VBAC and something kind of unique about Lauren is that she has a special scar, a special J scar, correct? Lauren: Yep. Meagan: Yeah, so that happened in her first C-section. If you are listening and you have a special scar or have been told that you have a special scar, this is definitely an episode that you are going to want to put on repeat and save because I know that there are so many people out there who are told that they have a special scar and that they should never or can never VBAC again. I know we’re not even getting into the story quite yet, Lauren, but did you have any flack with that? Did anyone talk about your special scar at all? Lauren: Yes. Advocating for the VBAC is probably the overarching theme of my VBAC because I really had to go to bat for myself for that without switching providers. Meagan: Yeah. We know that’s so common. We see it a lot in our community just in general trying to get a VBAC let alone a VBAC with a special scar. We are going to get into her story but I have a review and I didn’t even know that this was a review. It was left in a Baby Bump Canada group on Reddit actually so that was kind of fun to find. It’s really nice. It says, “Seriously, I’m addicted. I find them so healing. I had an unplanned and very much unwanted C-section and I have been unknowingly carrying around all of these emotions and trauma about it since. I thought I was empowered going into my first birth, but I wasn’t strong enough to stop the medical staff with all of their interventions. Don’t get me wrong, I believe interventions are necessary in some instances. But looking back now, I realize those interventions were put in place to make things easier involved in delivering my baby. Anyway, I won’t get into all of that here, maybe in a separate post. The point of my post is checking out The VBAC Link podcast. I listen to them all day now while caring for my babe. They also have a course you can take focusing on preparing for VBACs. Even if you just like birth stories, they have CBAC stories I believe as well. On the podcast, a guest also pointed out that what do you want for a VBAC birth– peace, redemption, etc.? She talked about how you can still feel those things if you need a Cesarean.” I love that point of view right there that you can still have peace and redemption even if you have a scheduled C-section or if your VBAC ends in a Cesarean. It says, “Another mom pointed out when she was feeling hesitant about saying okay to a C-section, her midwife said, ‘You have permission to get a C-section,’ not in a way that a midwife was giving her permission, but telling this mom, ‘C-section is okay and you shouldn’t feel like having one is wrong.’ My baby is 8.5 months and we aren’t going to try for a baby until they’re about 18-24 months mostly to increase my chances of VBAC, but I really love these podcasts.” Then she says, “Okay, I’ll stop raving now.” I love that. Her title is, “If you’re considering a VBAC, I highly recommend The VBAC Link.” Thank you so much to– I don’t actually know what your name is. Catasuperawesome on this Baby Bump Canada group. Just thank you so much for your review. As always, these reviews brighten our day here at The VBAC Link but most importantly, they help other Women of Strength find these stories like what we are going to be sharing today with Lauren’s story. They help people feel empowered and educated and motivated and even first-time moms. They are really truly helping people learn how to avoid unnecessary Cesareans. I truly believe that from the bottom of my heart. Meagan: Okay, Lauren. As you are rocking your sweet, precious babe, I would love to turn the time over to you to share your stories. Lauren: Awesome, thank you. It’s so nice to be here finally. I’m so excited because this podcast truly is the reason why I had my VBAC. I am kind of weirdly unique in that I didn’t really feel like I had any mothering instincts. My husband and I had been married for 6.5 years before we decided to get pregnant because I always swore off children. I said, “It’s not for me. I’m never going to have children. I want to travel and I want to do all of these things and children are for other people. I can’t imagine myself as a mom.” My husband said, “Well, let’s wait until we are 30,” because we got married really young. He was like, “Let’s just wait until we are 30 and we will revisit the discussion.” I always find it kind of nice when I hear stories of women who feel similarly to the way I did because it’s so relatable and I feel like we are very few and far between. That’s another reason I wanted to share my story because I know there are other women out there like me. So anyway, it just so happened that at this time, my sister was pregnant. My brother was pregnant. My husband’s brother was pregnant. We were like, “You know, we’re almost 30. We’ve waited a long time. If we’re going to have kids, we might as well have a kid when he or she is going to have all of these cousins.” My husband was like, “Let’s start trying.” I’m like, “Great. I’m going to give it two months and if we don’t get pregnant, we’re not going forward with this. I’m going to say I tried and I can tell everyone I tried and that it didn’t work.” Well, God has a sense of humor because two weeks later, I had a positive pregnancy test. Meagan: Two weeks later? Lauren: Yes. Meagan: So you were already pregnant when you had this conversation. Lauren: I was already taking birth control. I was multiple days into the pack. I just threw it in the trash and was like, “Let’s just see what happens.” I guess when you do that, you can get pregnant. I don’t know. I didn’t really have a cycle. I got pregnant. I was so naive about how it all worked. I’m like, “Okay. The test is positive. I’m pregnant. It is what it is. I’m very much pregnant.” I had not doubt. I had no worry about miscarriage, nothing because I had a positive pregnancy test. That’s sort of how I went through my pregnancy, kind of disconnected, very naive, and a little bit in denial that I was actually pregnant all the way up until the end. I read one book and it was called The Girlfriend’s Guide to Pregnancy and it’s this really sarcastic, funny book. She’s very flippant about pregnancy and very straightforward with my sense of humor. I liked it because I felt the same way. I wasn’t mushy or emotional. I had no connection to the pregnancy. I am pregnant. That’s a fact. Anyway, at 26 weeks, my doctor was like, “You know, I think he’s breech.” I was like, “Okay.” I knew what breech was, but I’m like, “Okay, what does that mean?” She was like, “Well, I would start doing some Spinning Babies exercises. Let’s just keep an eye on it. I was going to a chiropractor this whole time. This is important for people to know. I was going to a chiropractor before I even got pregnant regularly. This chiropractor was seeing me. I told her that the baby was breech. “Can you help me flip him? Can we do some bodywork?” I continued to see her. I don’t know if it was once or twice a week but it was often. 36 weeks rolls around and I see the midwife in the practice. She is not finding the heartbeat where it should be. She finds it up higher and she goes, “Lauren, I think your baby is still breech.” I thought there was no way. I had been seeing a chiropractor. I had been doing body work and stuff. She was like, “Well, why don’t you go see the chiropractor that our practice recommends?” I’m like, “Okay.” I call this chiropractor on the phone. I leave her a message and I’m like, “I’ve been seeing another chiropractor, but my baby is breech.” She immediately called me right back and she was like, “What has the chiropractor been doing?” I’m like, “It feels like a normal adjustment like nothing different from before I was pregnant.” She was like, “So you’ve been on your side and she’s been twisting your back and your pelvis away from each other?” You know how they do those kinds of adjustments? I said, “Yes.” She was like, “Oh my gosh.” She’s like, “How soon can you come see me?” I started seeing her. My OB actually also recommended moxibustion. She got me set up with an acupuncturist in the area which I thought was really cool that she was like, “Some people say they swear by this. You need to do more Spinning Babies. I want you to go to acupuncture.” I saw this chiropractor and she was like, “What that chiropractor is doing to you is not pregnancy-safe. She’s not Webster-certified and you needed to be seeing a Webster-certified chiropractor.” That’s one of my regrets because I feel like had I known, obviously, I can’t say I blame her 100%. I was also working out a ton because I’m like, “I don’t want this pregnancy to change my body. I’m going to be skinny.” That’s all I cared about so I’m sure I was holding my abdominal muscles way too tight too. I’m sure I contributed to it as well, but just knowing that probably was a major contributor to what ended up happening to this day irritates me. But anyway, he never flipped. He was solidly in my ribcage. He never moved. I would push on his head and he would not even budge an inch. My doctor was like, “You know, I would normally recommend an ECV, but he seems very wedged in your rib cage. He’s stargazing,” which means his head is tilted up. His chin is pointed up. She said, “You are on the low end of normal for amniotic fluid.” She was like, “You have these three strikes against you basically. We can try it if you want to try it, but I’m going to say it’s probably not going to work.” I had to wrestle with that. I ended up calling my husband’s aunt who is a labor and delivery nurse for 30 years. I asked her for her opinion. I’m like, “Have you ever been in on an ECV? Tell me about it.” Naively, I went with her advice. She said, “If your doctor is not confident, then that means it’s not going to work.” She’s like, “I’ve seen so many births and I believe that every baby should be delivered via C-section because birth is dangerous and it's scary.” I’m like, “Okay, okay. I’m just going to move forward with the C-section. I’m so glad I talked to you.” Meagan: Whoa. Lauren: We scheduled the C-section and you know what? It really wasn’t that big of a deal. My friend’s husband was actually my anesthesiologist. My doctor was there. It was very happy. It was very pleasant. I had gone out to dinner with my friends the night before. If you could plan the perfect C-section, it was the perfect C-section. I just talked to my friend’s husband the whole time. Again, not connected to this pregnancy at all. It was very much like, “Okay, a baby is going to come out. What is this going to be like?” I remember the doctor held him up over the curtain. I made eye contact with him and I was like, “Oh my gosh. I’m a mom.” The nurse was like, “Do you want to do skin-to-skin?” I was like, “What’s that? Sure.” “Do you want to breastfeed?” “I think so. Sure.” Very naive. What ended up happening was that the recovery was just really tough. The surgery was great, but I did not expect the recovery to be so tough. I feel like the way people speak of C-sections is so casual. “Oh, just have a C-section. I had C-sections for all my babies. It’s no big deal. It’s a cakewalk.” That’s the mindset I went into it with. Same with my husband because I reassured him, “It’s no big deal. We’re just going with the flow.” No. It’s awful. It’s major surgery. I’m allergic to– I think a lot of people are– the duramorph that they put in the spinal so I had the most severe, horrible itching for 24 hours to the point that they basically overdosed me on Benadryl because I could not cope and my vitals were crashing. I was barely having any respiration. They had to shake me awake and put cold washcloths on my head. They were like, “Hello,” because I was having such a hard time with the itching. Not only that, but the pain. It’s painful. In my surgery, backing up a little bit, the doctor said, “Wow. He’s really wedged in there and he’s a lot bigger than I expected. I thought he was going to be maybe 7.5-7.25 pounds.” She goes, “He tore your incision coming out because he was so big.” She was like, “You have a J incision now so your incision goes horizontal and then vertically up.” She said, “Unfortunately, that means you’ll never be able to have a VBAC. You’re just going to be a C-section mama.” I was just lying there like, “Whatever. You’re asking me what skin-to-skin is and breastfeeding and no vaginal births.” It was just a lot of information to process and take in and make decisions about. He ended up being 9 pounds. He was a good-sized baby. Anyway, that was my c-section experience. I know I’m probably one of the lucky few who could say that their C-section was so peaceful, really no trauma from it. I just thought, “I’m fine with that.” I watched my sister have a failed TOLAC and it looked kind of traumatizing and she was still traumatized from it just a couple months before my C-section so I’m like, “It’s fine. I’ll just be a C-section mom, but that recovery was terrible so I’ll have one more baby and that’s it.” I’m not going to have any more kids. I don’t want to experience that again. That was May 2019. Fast forward to COVID times. We were thinking about getting pregnant before my son turned one but COVID hit so we were like, “Let’s just give it a couple of months and see what shakes up with this pandemic.” The world stopped. I’m in real estate so for a while, we weren’t allowed to show any property or do anything so I just was sitting at home doing nothing. I remember one night, I was just sitting there doing a puzzle bored as heck and I’m like, “I’m going to go listen to a podcast while I do this.” My phone suggested The Birth Hour. I hope I’m allowed to say that. Meagan: I love The Birth Hour, yes. Lauren: I was scrolling through the episodes and there was one on VBAC. I’m like, “Okay, I’m going to listen to this.” The interviewee mentioned The VBAC Link so I was like, Okay, I should check that podcast out. I was like, Why am I even listening to this? This is so not my wheelhouse, childbirth. I still didn’t care about it, but listening to these podcasts opened up a whole new world for me. I’m so glad I found it all before I got pregnant. I started listening to all of those podcasts then I think I found through your podcast. I don’t think it was The Birth Hour. Someone mentioned Dr. Stu so I started listening to his podcast and man, that guy set fire. He had so much great information. I listened to every podcast pretty much that he had done, especially the ones on VBAC because he talks about VBAC a lot and just how it really shouldn’t be a big deal or shouldn’t make you high risk and all of that. At the time, he was still graciously reviewing people’s op-reports for them and now he doesn’t do that. I think you have to pay for it, but I emailed him. I reached out to him and I emailed him my op report and I just said, “If you could look at this, my provider told me I wasn’t a VBAC candidate but I want your opinion.” He got right back to me and he was like, “There’s no reason you can’t have a VBAC. This scar is really not that big of a deal. Yes, it’s a special scar, but it shouldn’t take away from your opportunity to TOLAC.” I ended up getting pregnant in the fall of 2020 and I went to my first appointment and my OB was like, “What do you want to do for your birth this time?” I’m like, “Did she forget what she told me? She must have forgotten.” I was like, “I want a VBAC.” She was like, “Okay, I’ll give you my VBAC consent form and we can talk about it as your pregnancy progresses.” I’m like, “Okay, cool.” I saw her again at 12 weeks and she was like, “I’m having some hesitations because you had such a big baby and your scar is not normal. I think we need to talk about this a little bit more but let’s not worry abou tit now. We can put it off and worry about it later.” I was like, “Okay.” I was so bummed because I love my OB. Funny story, I met my OB when I was worked for a home design company called Pottery Barn and I met her one day just helping her buy pillows. I’m like, “What do you do for work?” She was like, “I’m an OB.” I’m like, “Cool. I need an OB.” I had just moved to the area so I just started seeing her. I think I was one of her first patients so she knew me. It wasn’t like she was a friend and a provider I only saw once a year, but we always picked up where we left off. We had a good relationship. I really did not want to change providers. I don’t want this to sound like I was being manipulative, but I was like, I’m just going to really lean into this good relationship we have and just try to win her over. As the pregnancy progressed, at the next appointment I think I saw a midwife. I talked to the midwife about the VBAC and my OB’s opinion and she was like, “I’ve seen a lot of women VBAC with a J scar at my old practice. I don’t think it’s a big deal, but I’ll talk to the doctor for you and hopefully, we can figure this out.” I was like, “Okay.” Then I want to say I went to my 20-week appointment and they told me, “Okay, your baby is gigantic.” They said, “He is going to be between 9 and 10 pounds,” because he was measuring two weeks ahead. They said, “But the other concern we have is that you have marginal cord insertion and that could make for a small baby.” I’m like, “Okay, so is he big, or is he small?” Clearly that marginal cord insertion is helping him not being 12 pounds? What are you trying to tell me? They’re like, “Either way, we suggest that you come back at 32 weeks. We have concerns about his size. He might be a tiny peanut. He might be enormous.” I’m like, “I think I’m good. Thanks, but no thanks.” Thanks to you guys, you push advocation so much that I’m like, “This doesn’t add up. You can’t tell me that he’s too big and too small. I’m just going to go with fundal height and palpation if my doctor has a concern, we’ll come back.” I never scheduled that growth scan. I was very protective of this pregnancy. I didn’t want any outside opinions. I was so afraid that if I went and had this growth scan, I would be pushed to do a C-section. I wanted an unmedicated birth. I was terrified of the hospital. I was listening to so many podcasts all day every day. It was like an obsession so then I told Meagan before we were recording is that I felt like I was almost idolizing the VBAC. It was all I could think about. It was all I could talk about and it became this unhealthy obsession. Right around 25-26 weeks, I decided to hire a doula and move forward with the VBAC. It didn’t matter to me what the doctor said. Right around that time, I was having some hesitations. Just getting that pushback from my doctor and knowing he was big, I started to let the fear creep in. I told my husband, “You know what? Maybe we should just do a C-section. I think I’m overanalyzing this so much. I’m just going to push aside this research I have done because clearly I’m obsessed and it’s consuming me.” Meagan: Yeah, which is easy to do. Just to let you know, it really is easy to let it consume you. Lauren: It totally is. I think that we have to take a step back sometimes, come back to reality, and if you let the information override your instincts which I think is really easy to do, I think you can get too wound up or too set on something that might not be meant for you. Speaking of instincts, that night, I still remember. I had told my husband, “I’m just going to have a C-section.” I went to bed and I had a dream. I was in the hospital in the dream and I was holding my baby and my dad walked in. I have a really great relationship with my parents but especially my dad. I love my dad. He comes in the room and he’s like, “How did it go?” He was meeting the baby for the first time and I burst into tears in the dream. I said, “Dad, I didn’t even give myself the opportunity to VBAC. I just went in for a C-section. I just have so much regret about it and what could have happened if I had tried to have a VBAC.” Meagan: That just gave me the chills. Lauren: Yes. It was so weird. I have never really had a dream like that before. I woke up and I was like, “There’s my answer. I have to move forward with this.” Having that dream gave me this peace that there is the instinct I need to follow. Yes, I have all of this information that is consuming me, but it was like, Keep going. I hired a doula which I found through The VBAC Link Facebook page. I put it out there, “Does anyone know a doula in my area?” Julie commented and it happened to be her really good friend who had just moved back to my area. I called her and it turned out that we had mutual friends. We connected really fast. I think, like I said, it was about 26 weeks. I go to my OB again and we had more of a pow-wow like a back-and-forth on the VBAC option. She was like, “I’m just worried about it. A C-section is not that big of a deal. We could just tie your tubes and then you won’t have pelvic floor issues.” False. I said, “I got a second opinion from another doctor.” I didn’t say it was Dr. Stu. I didn’t say it was some guy with a podcast in LA. I said, “I got a second opinion and I feel like I just want the opportunity.” We didn’t really land on anything solid, but she got up to leave the room and she got to the door and she turns around. She came back over to me and she gave me this big hug. She said, “I don’t want to disappoint you. I want you to be happy, but let’s keep talking about this.” I was like, “Okay.” That gave me a little bit of reassurance that I was leaning into that relationship I had built with her over the years because it had been 6 or 7 years of seeing her. I would also bring her flowers. I would always try to talk to her about her life and making a social connection with someone. If you let your doctor intimidate you just from the standpoint of being a stranger, I feel like that can really change the course of your care. But if you try to get to know people, and that’s not necessarily a manipulative thing, but I think it’s important. It should be important in your relationship with your doctor. If you don’t feel like you can connect with them, there is issue number one, but I really felt like I could connect with her. I leaned into that. I have a cookie business on the side. She loved my cookies. We just had some other things to talk about other than my healthcare and I feel like it set this foundation of mutual respect. What doctor comes over, gives you a hug, and tells you, “I want you to love your birth”? So fast forward again, I see her again the next time and she said, “Look. I brought your case to my team and because we support moms who have had two C-sections, we felt like your risk is similar to theirs and that it shouldn’t risk you out of a TOLAC so I’m going to support you if this is what you want.” I had given her this analogy that I think was Julie’s analogy. She said, “If you needed heart surgery and you were told that you had a 98% chance of success–” because I think my risk of rupture was 2% or maybe a little bit lower, maybe 1.5. I told her this. I’m like, “If you told me I needed heart surgery and I had a 98 or 99% chance of success, we would do it. There would be no question. I have this 1% risk of rupture. I’m coming to the hospital. What gives? I should at least be able to try.” The problem is, I’m sure some people are like, “Why didn’t you just switch providers?” We have three hospitals in my area. One is 20 minutes from me and two are one hour away. One of them which is an hour away is the only place where I can VBAC and there isn’t a VBAC ban. There is maybe a handful of providers who deliver there. I knew my provider was VBAC-supportive sort of. She had the most experience of a lot of the providers around me so that’s why I didn’t switch. I had very minimal options for care. I couldn’t go to LA or I couldn’t go somewhere further away. It would be a four-hour drive either way. We are in an isolated area. I felt like that was a huge win. We are set to go. I remember I told Katrina. Katrina was so happy for me, my doula. I just soldiered on. I started taking Dr. Christopher’s Birth Prep at 36 weeks. I was doing my dates and I was really busy in real estate. That’s part of my story. I was so busy working super hard and I was getting to the end of my pregnancy. At 38 weeks, I went in and I had clients lined up showings coming up. I was like, “I can’t have a baby anytime soon.” I was talking to my provider about it. “Maybe at 40 weeks, we can talk about a membrane sweep or something. I have so much on my plate. I can’t have a baby this week.” My husband is a firefighter and his shift that he was going to be taking off was starting maybe the following week. I’m like, “He’s not even going to be home. He’s going to be gone most of this week. This is a horrible week to have a baby.” I let her check my cervix because I’m like, “I want to see if my birth prep or my dates are doing anything.” At the same time, I still had this fear of, What if I do all of this work and I don’t even dilate? That was kind of what happened with my sister so I had that fear in the back of my mind. She checks me and she was like, “You are 2 centimeters dilated, 50% effaced. You’re going to make it to your due date no problem. We’re not even going to talk about an induction until 41 weeks.” She was like, “I’m just not worried about it. He doesn’t feel that big to me. He doesn’t feel small. He doesn’t feel too big. He feels like a great size.” I said, “I know. I feel really confident that he’s going to be 8 pounds, 2 ounces.” I spoke that out. I said, “That’s my gut feeling. I just have so much confidence and peace about this birth. I just know it’s going to work out.” I go on my merry little way from that appointment. I’m walking around. We had gone down to the beach. We were walking around and I’m like, “Man, I’m so crampy. For some reason, that check made me so, so crampy.” This was 38 weeks exactly. We go back home and I have prodromal labor that night. I’m telling Katrina about it. She goes, “You know, I bet the check irritated your uterus.” The next day, I start having some bloody discharge. I’m like, “What is this? What does this mean?” I told Katrina and she said, “It could mean nothing. It could mean labor is coming soon. We’ll just have to see.” I hadn’t slept the whole night before. She was like, “You need to get a good night's sleep.” I had to show property all day. I met these clients for the first time. I showed four or five houses to them and meanwhile, I’m like, “Gosh, I’m so sore and tired and crampy.” I told them, “I’m very obviously pregnant, but my due date is not until the end of the month.” This was June 10th and my due date was June 23rd. I said, “We have time. If you need to see houses, it shouldn’t be a big deal. I don’t want my pregnancy to scare you away.”That night, I get home and I’m like, “I’m going to bed. It’s 8:00. I’m going to bed. I’m going to take Benadryl and I’m going to get the best night’s sleep.” They call me at 9:00 PM and they’re like, “Lauren, we saw this house online. It’s brand new on the market. We have to see it.” They lived a couple of hours away so I’m like, “I’ll go and I’ll Facetime you from the house. I’ll go tomorrow.” Tomorrow being June 11th. I’m like, “We’ll make it happen. I promise I will get you a showing on this house.”I texted Katrina and I’m like, “Oh my gosh. I feel so crampy and so sore. Something might be going on, but I have to work tomorrow. I’ll keep you posted.” I wake up the next morning. It’s now June 11th and I lose my mucus plug immediately first thing. There was some blood. It was basically bloody show. I told Katrina and she’s like, “Okay, just keep me posted. I have a feeling he’s going to come this weekend. It was a Friday. I’m like, “Well, he can’t because my husband works Saturday, Sunday, Monday. I don’t have time to have a baby.” We go to the showing. I’m finally alone without my toddler and my husband. I’m in the car and I’m like, “Man, my lower back hurts. It’s just coming and going but nothing to write home about, just a little bit of cramping.” Of course, I never went into labor with my first so I did not know what to expect. I get to the showing and this house had a really steep staircase. I’m Facetiming my clients and I’m going up the stairs. It was probably at noon and I’m thinking to myself, Man, it’s really hard to go up these stairs. Why do I feel so funny? I finish up the showing and they’re like, “We want the house. This is the house for us.” I get back in the car. I’m getting all of their information. I’m talking to the other agent. I start the offer and I’m like, “I’m just going to drive home and get in my bed because I don’t feel good. I’m just going to write this offer from my bed and everything will be fine.” I get home and I tell my husband at 2:30, “I’m just going to sit in our bed and get this offer sent off.” Mind you, I had a work event, a big awards event that night for my whole office and we were going to have to leave at 4:00 PM. My in-laws were going to come get my son and take him to sleep over. It’s 2:30. I’m writing this offer and I’m like, “I don’t feel good.” My partner calls me. I tell her, “Listen, I don’t know if I’m in labor, but I don’t feel well. Maybe I have a stomach bug. I’m going to write this offer. I’m going to give you my clients’ information and I want you to take over for me a little bit. They know I’m really pregnant, but this could just be a sickness but either way if something happens, I want them to have the best care and be taken care of if we are going to send this offer off.” I send the offer off. It’s 3:30 at this point. I close my computer and I’m waiting for them to DocuSign. I text my husband, “There’s no way I’m going tonight. I don’t feel well. Something is up. I’m not sure what.” He didn’t see my text for a little while. He comes in the room at 4:00 and he starts to talk to me. I literally fall to the ground with my first contraction. I’m in active labor.I don’t know it yet, but I’m in active labor. I’m just like, “It feels like there’s a wave crashing in my body.” That was the best way I could describe it. I’m like, “I feel this building. It’s an ebb and flow,” but it reminded me of playing in the waves as a kid because I grew up in Orange County at the beach and just that feeling of the waves hitting you when you are playing in the surf. I’m like, “This is really intense. What is going on?” I’m like, “I’m certain it’s a stomach bug.” I told him, “I have gas or something.” I was just like, “I’m going to give myself an enema and this will all go away.” I did that and sitting down on the toilet, I was like, “Oh my gosh.” It made everything so much more intense. I texted Katrina, “Something is going on. I’m not really sure it is.” She’s like, “Well, why don’t you try timing some contractions for me and let me know?” I crawl into my closet. I can hear my son and my husband getting ready. My son was 2 so of course, 2-year-olds are not always behaving. I can hear them interacting. I crawl into my closet and I’m lying on the floor in the dark. The contractions are 3.5-4 minutes apart lasting a minute. I was like, “I’m still pretty sure this is a stomach thing that is happening every 3-4 minutes.” I call Katrina and I’m like, “I don’t know. I think I’m in labor. This is the length of my contractions. It’s probably just prodromal.” I had so much prodromal.She was like, “Um, it doesn’t really sound like prodromal labor, but I’ll let you just figure it out. You let me know when you are ready for support. Make sure you are eating anything. Have you eaten anything today?” “No.” “Have you had any water?” “Not really.” “Okay. Please eat something. Please drink some water and keep me posted.” She goes, “Can you talk through the contractions?” I said, “I can cry.” She’s like, “Okay. I’m ready to go as soon as you tell me.” Then the next thing I know, literally, this is probably an hour later so at 4:00 I had my first contraction. Now it’s 5:00 and I’m like, “The contractions are 3 minutes apart and lasting a minute.” I said, “Maybe you should come over. I think Sean (my husband) is getting a little nervous.” We were still so naive. We didn’t know what labor looked like and what was going on. We were like, “If we’re not going to the event, why don’t we just keep August (my son) at home? I’ll just make him dinner and I’m going to make you dinner.” He starts prepping dinner and I’m like, “I don’t think either of us really know what’s going on.” Of course, Katrina knew what was going on and probably thought I was a crazy person but I was very much in denial. We texted her to come over and she gets there. I’m lying in my bed and she’s like, “Okay, yeah. They’re coming 2.5-3 minutes apart. If you’re ready to go to the hospital, I’m ready to go with you.” I’m mooing through these contractions, vocalizing everything. I’m like, “It just feels good to vocalize and I just really keep having to use the bathroom. It’s probably just my stomach.” She’s like, “No.” I can hear her outside my bathroom telling my husband, “I think we should go. She’s really vocalizing a lot and that usually means it’s pretty substantial, active labor.” Meanwhile, all I can think about is, “I’ve got to get this offer in for my clients.” I’m waiting on DocuSign, checking my email. Finally, it comes through. This is 6:00, maybe 6:30. I see it come in. I send it off and I’m standing at my kitchen counter with my computer on, mooing, doing this freaking offer. I go to cross my legs as I’m leaning over and I’m like, “I can’t cross my legs, Katrina. I feel like my bones are separating.” She’s like, “Yeah, baby is probably descending into your pelvis. I think we should get going if you’re okay with going.” We have a 45 to an hour drive depending on traffic and the time of day. It’s a Friday night so basically where I live, there’s not a ton of traffic but we get in the car. She’s following us and we get to the hospital. It’s probably 7:15-7:30 or something like that. I’m telling my husband as I’m mooing through these contractions, “This really isn’t that bad. If this is labor, it’s intense and it feels like there’s an earthquake in my body, but I would not tell you that I’m in any pain right now.” He’s like, “Okay, whatever you say lady.” We ended up having to walk across the whole hospital parking lot to the ER because the regular hospital entrance was closed. As soon as we walked in the hospital, the hormones changed. The adrenaline kicks in. I start feeling pain. I start feeling a little bit panicky and it starts getting harder to cope through these contractions. I’m on the floor of the triage room crying into a trash can and everyone is staring at me. Katrina’s like, “They need to stop staring!” She was trying to defend me while my husband is answering all of their dumb questions like, “What’s your favorite color? What city is your mom born in?” They’re like, “Let’s just put you in a wheelchair and get you up there.” I’m like, “I can’t sit.” Anytime I tried to sit, the contractions were a minute apart and they were so intense. I get there and I was so protective of this birth and outside interventions, I just was like, “Everything is evil. Cervical checks are evil. The epidural is evil. Everything is going to make me have a C-section.” I was like, “I don’t want to know how dilated I am. I don’t want anyone in this room to know except the nurse. That’s who is allowed to know how dilated I am.” She checks me and the doctor comes in. It was the hospitalist and of all the providers in my area, it was miraculous that I got this hospitalist because he has so much experience. He is so calm, so kind, so supportive. He just said, “Hi, Lauren. I’m Dr. so-and-so and you’re in labor. Happy laboring.” No concerns about my TOLAC, nothing. He didn’t even bring it up. He didn’t ask to check, nothing. Just, “Happy laboring,” and he left the room. I’m like, “Okay. Clearly I’m in active labor.” So then they were getting the tub ready because my room had a tub and as we were waiting for it to warm up, I’m sitting on the ball. I’m having all this bloody show. The nurse asked to check me again before I get in the tub. Unknowingly, I had been 5 centimeters when we arrived. I was 7 now when we got in the tub an hour later. I get in the tub and I wouldn’t say it provided me any relief. Honestly, I was so in my head and not necessarily in pain, just so mentally unaware of everything going on, in labor land, but also very overwhelmed by the intensity of it. I told Katrina, “George Washington could have been sitting in the corner watching me labor. I would not have known.” I barely opened my eyes. I had a nurse who was there sitting with us because I had to have a one-on-one nurse for being high-risk and I had to have continuous fetal monitoring. Because I was in the water, she needed to sit there and make sure the monitors didn’t move. I couldn’t have told you what she looked like, nothing. I didn’t speak to her. I was in another world. I think I maybe was in the tub for 30 minutes to an hour. It’s probably 9:00 or 10:00. I can’t even remember the timeline of it but it wasn’t that long of a labor. My water breaks and I start grunting. They’re like, “Let’s get you out of the tub. Let’s get you out of the tub.” I think I was 9 centimeters at this point. We arrived at 7:30. This is probably 10:00 PM or something like that. I’m like, “Okay. I’m just going to lean over the back of this bed and just moo and make noises.” Me being who I am and not super emotional, I’m making jokes about how I sound. I’m like, “You guys, I sound like Dory in Finding Nemo. I’m so embarrassed. Please don’t look at my butthole.” I was naked. I’m making all these jokes and coping, I would say pretty well in terms of pain but just very overwhelmed by the intensity of it. They come in and check me and they’re like, “Okay, you’re complete.” This is at 11:00 PM maybe or 10:30, something like that. But she was like, “You have a little bit of a cervical lip.” It was a provider I hadn’t met before at my OB’s office but they were like, “We will just let you do your thing. You sound pushy but please don’t push because you have a lip. Let’s just let him descend.” I could feel his head inside of myself. I could feel his head coming down. I was like, “I want it to be over. I want it to be over.” I’m still in denial of this whole thing this entire time. Are we sure it’s not poop? I know there’s a baby coming out. Once my water broke, I’m like, “Okay, I guess I’m having a baby.” That was really, truly the first time that I was like, “Okay, this is really happening.”Maybe 30 minutes later, the hospitalist peeks his head in the room and he’s like, “Lauren, why don’t you try laying on your side?” I tried and it was too painful. I flip over on my back and three pushes later, he comes flopping out. I screamed him out and it was super painful. I was so overwhelmed by how painful it was. I just screamed like a crazy, wild woman. He’s on my chest and he’s screaming and I’m in all this pain and then she’s like, “I’ve got to give you lidocaine. You tore a little bit. I’m going to stitch you up.” It was just all this pain happening at once, but I was like, “I got my VBAC. That’s all that matters. No one touched me and I got my VBAC. I don’t care about anything else.” Anyway, it was great. I would not change it for the world because I never had a ton of pain. I never really thought I needed an epidural, but it was a little bit mentally overwhelming. Meagan: Mhmm, sure. Lauren: Anyway, that was my first VBAC. The doctor said, “You pushed so primally. That was the most amazing thing I’ve ever seen.” The hospitalist was like, “That was incredible to watch. You are a badass.” I was like, “That was such a compliment because I didn’t know what I was doing and you’re this doctor with all the experience.” Anyway, fast forward to my third pregnancy. This is now the summer of 2023. We decide we’re going to have one more baby. I of course had no issues with the VBAC this time because I had a successful TOLAC with my second. I made it to 20 weeks. I had COVID, RSV, and the flu all right around then so they were telling me, “Your baby is measuring totally normal.” I’m like, “Yeah, because I’ve been sick as a dog for 6 weeks.” I’m like, “Maybe I’m going to get this newborn who is a normal size,” because my son was born at 38 and 2, the second one, and he was 8 pounds, 3 ounces. I had told my doctor 8 pounds, 2 ounces. I was one ounce off. I was like, “Maybe I’ll get this little peanut baby and it’s going to be so great. I’ll finally have a newborn who fits in a diaper for more than two days.” Then I hit 33 weeks and I got huge. I just exploded inside. I go to my OB and I’m like, “I don’t feel good. I’m too big. This baby is too big. Something is wrong.” She’s like, “No, Lauren. I really just think you make big babies and he just went through a growth spurt. Let’s not worry. I’m not going to have you do an ultrasound or anything like that. If he continues to measure 2-3 weeks ahead,” because I was measuring 36 weeks at 33 weeks, “then we can talk about it, but I don’t want to worry about it.” I was like, “Okay.” I was having all of this round ligament pain more than I had with my others and prodromal labor was so painful. I remember telling Katrina who I hired again, “I feel like something is wrong with my muscles. I just am so uncomfortable. But I don’t want to make any rash decisions based on it. I might get an epidural if this keeps up because this doesn’t feel normal. “She was like, “Okay, whatever works.” So I get to my 38-week appointment and I’m thinking, I’m going to have this baby at 38 weeks just like I had my second baby. I had everything ready. Everything was good to go at my house and then day by day, it ticks on. Baby is not coming. Baby is not coming. I was due April 6th. This was just this year, 2024. I get to 38 weeks. I tell my doctor, “Just strip my membranes. I don’t even care.” She was like, “Okay, I guess if that’s what you want.” She did. Nothing happened. 39 weeks rolls around. She strips my membranes again. Nothing really happens and then the night of Easter, I had this strange experience where I woke up in the middle of the night and I had this contraction that wouldn’t end. I couldn’t feel the baby move and it freaked me out. I did everything I could to get him to move. I was in the shower. I was eating. I was drinking and doing all of these things. Finally, I called Katrina at 2:00 in the morning. I’m like, “My baby’s dead. I’m 100% sure he’s gone. What do I do?” She’s like, “Lauren, just relax. Lie on your side and drink something sweet.” We were ready to go to the hospital. I remember we had a stethoscope. I got the stethoscope and I put it right where I knew his heartbeat was and I heard a heartbeat. I burst into tears. It was the first time I’ve ever cried with any of my babies even being put on my chest. I just felt this relief because I had so much anxiety about him with my size being so big and the pain I was having. I was like, “I just want this baby out.” I never really felt that way, but it was this desperate anxiety. A couple of days passed and I’m now in week 39. I’m like, “My uterus is silent like a little church mouse. She’s not doing a thing. She’s not cramping. She’s not contracting. No discharge, nothing.” I’m like, “This baby is never going to come.” I tell my doctor at my 39-week appointment, “If this baby hasn’t come by Friday, I’m back here and I want another membrane sweep.” I felt kind of crazy because I’m like, “This is technically an induction, like a natural and I’m intervening.” Me who never wanted anyone to touch me and now I’m like, “Please touch me and pull this baby out of my body.” She goes to check me and she’s like, “Lauren, I think he’s coming tonight. Your body contracted around my hand when I tried to sweep you. I just wouldn’t be surprised. Don’t worry.” I’m like, “Okay, well you’re breaking my water on Monday.” I was 3 or 4 centimeters dilated and I’m like, “We’re waiting until Monday but I want you to break my water because I’m over it.” She’s like, “That’s a good idea. Let’s threaten this baby and he’ll come right out.” This was early in the morning on Friday, the 5th. Anyway, I had all of this anxiety and I just felt like he needed to come out. I couldn’t get any peace until I knew he was alive and happy and healthy and on my chest. Friday afternoon, I felt crampy just a little bit the whole day and then at 4:30 PM, I feel this gush and I’m like, “Okay. Is that my water or is it my pee?” because his head felt like it was on my bladder. I didn’t say anything to anyone. Then 6:00 rolls around. I text Katrina. I’m like, “Listen, I felt a little gush and I keep feeling it. I put a pad on and it doesn’t seem to be urine. I’m not really sure what’s happening. I’m just going to do some Miles Circuit and I’ll update you.”At 7:30, I’m cleaning my kitchen and all of a sudden, I’m hit with an active labor contraction. I’m like, “Not again. I want labor to start normally so I know what’s happening.” No. Baby’s like, “I’m ready.” At 7:30, I tell her, “Okay, I’m feeling contractions. I’m getting in the shower to see if it will stop. It might be prodromal. Let’s give it an hour. I’m going to text you, but they are 2.5 minutes apart.” She’s like, “I’m at dinner. I’m getting boxes. Just let me know.” I was like, “Okay. It might stop though so I wouldn’t worry about it.” No, it did not stop. She gets to my house at 9:00 and my car is already running. I’m like, “We’re going.” I am mooing through these contractions. I’m going to pop this baby out right now. I had thankfully put some chux pads in the back of my car. I’m on all fours in the back of my car. Mind you, we have to drive an hour to the hospital. I peed all over the chux pad. I just was like, “He’s on my bladder. He’s on my bladder.” It was so painful and I couldn’t control anything. I’m like, “Is this water? Is this pee? I don’t even know what’s happening.” We get to the hospital. He did not come in the car, thank God, but we did have to go to the ER again and the ER was taking forever. It took a half hour to get me up to labor and delivery as I’m actively mooing in front of the hospital. I was like, “I’m not going in,” because there was a little girl sitting in the waiting room and some convict sitting with a police officer. I’m like, “I’m not having my labor in front of these people!” Even the police officer came out and he was like, “I don’t understand what is taking so long. You are clearly about to have this baby. I will bust open these doors for you and walk you up to L&D myself if that’s what it takes.” Finally, they got me up there. I arrived. I told Katrina and my husband, “You guys, I’m getting an epidural.” I said, “I have had so much anxiety and so much pain. This does not feel like my previous labor. This feels like I’m suffering.” I said, “I just want to smile. I just want to smile. I want to smile this baby out.” We get up there. I’m 8 centimters dilated. This was the part of the story that I feel like it comes back to advocating for myself. I go in there and I’m like, “I don’t care what you need from me. I just need the epidural and stat.” The nurses are scrambling and this doctor walks in. I am on all fours on the bed just staring at the ground, actively transitioning. I see this doctor walk in. I see his feet and he had his shoelaces untied. Immediately, I’m just like, “No. It’s a no.” I don’t know why. I just was like, “Your shoes are dirty and they are untied. You seem like a hot mess. I’m already a hot mess. I want someone to come in and just be like clean-cut and normal.” He starts asking me all these questions. He’s asking me my whole health history, everything about my grandparents, my parents, all of this stuff. I’m in transition then he goes, “You’re aware of the risk of TOLAC, right?” I said, “Yes.” He goes, “That your uterus could burst wide open?” I literally saw red. I’m in a contraction and I just screamed like a wild lady. I was like, “Get out.” I wanted to add on some expletives and tell him to get out of the room. I just said, “Get food.” He was like, “I’m  just saying.” He ended up leaving and my nurse peeks her head under. I look over and I see this nurse peeking her head right into my face and it’s the same nurse who was there with my first VBAC. She goes, “You don’t have to accept care from him.” She goes, “Your doctor is actually the backup on-call doctor tonight.” She goes, “If you refuse care, we can call her and she can come in.” I was like, “Oh my gosh. This is a miracle.” We get the epidural. I’m like, “We’ve got to slow this thing down. I don’t want to have this baby and have this crazy man who I cannot stand anywhere near my body parts, anywhere in this room.” We get the epidural and everything slowed down. I labored down. My doctor ended up coming in and she checked me. She was like, “Your bag is bulging. It feels like rubber. It’s so thick.” She was like, “I think that’s why he’s not coming out.” We got to the hospital at 9:30-9:45. By the time we got in the room, 11:00 by the time I got the epidural, and the anesthesiologist was like, “You’re going to have this baby in 30 minutes. I’m certain of it.” To slow it down, I’m closing my legs and doing all of these things to slow it down.My doctor comes in. She breaks my water and fluid goes everywhere. It floods the floor. She goes, “I don’t remember any time I’ve ever seen this much water come out of someone without polyhydramnios. Maybe you had it. I don’t know but this is an insane amount of water.” She breaks my water and then my epidural was a pretty low dose because he thought I was having the baby in 30 minutes. It’s now 2:30 in the morning and I haven’t had the baby yet. I’m getting up on my knees. I’m leaning over the back of the bed and I feel him descending. Then my doctor comes in an hour later and she’s like, “Let’s get this baby out.” It was 3:30 in the morning and she’s like, “Let’s go.” She feels me. She’s like, “You’re complete. I feel his head right here. You just need to push and you can’t feel that his head is right here.” So I just get on my back, in lithotomy with the freaking stirrups like I said I would never do with the epidural I said I would never get and I pushed him out in three pushes. He was 9 pounds, 7 ounces. I am so glad I got that epidural. No regrets there because that’s a really freaking huge baby. His head was in the 100th percentile or something like gigantic. I tore a little bit again, but I feel like the tradeoff was this peaceful, happy birth. I was making jokes. I had this nurse that I loved and knew. I had my doctor I loved and knew. I had Katrina and I had my husband who were the only people in the room and we laughed our way into this birth. I laughed my baby out basically. I was making jokes the whole time and I just had this peaceful experience. I told my husband, “I know I railed on the epidural my whole pregnancy and I said I would never get it,” but it’s a tool ultimately. It’s a tool. If you use it wisely, I was very far along. I said, “I don’t think it’s going to stop my labor.” I felt really confident in my decision. I didn’t feel like anything was pushed on me. I made the decision. I’m happy I did it that way. Would I do it again that way? I don’t know. I think with every birth, you should be open-minded to the possibilities and your needs. I hear so many stories where women are like, “And then I got the epidural. I had to.” I’m like, “It’s okay. Own that decision. You’re no worse off for getting it and it doesn’t make you any less of a mom or any less of a good person for getting it. It’s okay to not feel every single pain of labor if it’s overclouding your ability to be in the moment.” Meagan: Yeah.Lauren: So anyway, that was my second VBAC story. Honestly, it was so redemptive because there was no trauma from the pain of having this wild, chaotic, primal birth. It was just peaceful and happy with all of the people. If I could have dreamt up a list of people who could have been with me, that’s who it would have been. Meagan: Good. Oh, I love that you pointed that out. Well, I am so happy for you. Congrats again, 11 days ago and right now I want to thank you again so much for sharing your story. Lauren: Thank you for having me. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
59:5905/08/2024
Episode 322 Emily's 2VBA2C With an Induction

Episode 322 Emily's 2VBA2C With an Induction

During her first labor, Emily experienced a hyperactive uterus where she had constant squeezing with no breaks and minimal dilation. She was at a birth center but after exhausting all coping options decided to transfer to the hospital. After receiving an epidural and Pitocin, then detecting meconium, Emily was ready to consent to a Cesarean. Emily’s second birth was a planned Cesarean, then her third and fourth births were both VBACs. Emily describes how even though her provider was the same for both vaginal deliveries, her experiences were so different. With her third, Emily had a beautiful pushing stage and easy recovery. However, pushing with her fourth felt rushed and she experienced a fourth-degree tear. Meagan and Emily share the importance of making your preferences known in every aspect of labor and delivery so your support team can speak up when you are not able to. Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. We have a 2VBA2C story for you today. We were just talking about it before we started recording all of the acronyms. I was like, “Oh, you’re a VBAC after two C-sections story.” And your baby is 8– wait, did I see that right? 8 months? Emily: He’s 9 months now. Meagan: 9 months. Emily: He’s almost a year. 8 months, 9 months, 10 months, somewhere around there. Meagan: Still very little, still very fresh so I’m excited for you to share his story and your other babies’ stories. We have Emily by the way. This is Emily. Hello, Emily. Emily: Hi. Meagan: Remind me. Where are you located? Emily: I’m in Texas. Meagan: Okay, you’re in Texas. Awesome. Okay you guys, we’re going to share her stories. We do have a Review of the Week so I want to hurry and get into that and then we’ll jump into Emily’s stories. This Review is from Rachel and it says, “Thanks for giving me the confidence to have a VBAC. I am glad I found this amazing podcast when I was newly pregnant with baby number two. After a long, traumatic experience that ended in a C-section, I was cautiously hopeful that I would have a VBAC. Using information that I learned from hearing other people’s stories on The VBAC Link, I felt confident and prepared for the birth of my son. On October 9, 2020” so that was four years ago, “I had a beautifully redemptive VBAC and welcomed our boy into the world. Thank you so much for helping me achieve my dream.” Women of Strength, that review is for you. You and your stories and your participation in the community and on Instagram and all the places is seriously what builds this community up and helps these other Women of Strength find the courage just like she said and find the education.I’m so excited for you, Rachel. Congrats and as always, if you have time to leave a review, please do so. It helps other Women of Strength find stories. Meagan: Okay, Ms. Emily. Let’s get into this. So you have four babies now. Emily: Yes. My oldest is about to be 7 and my youngest is 8 months or so. Meagan: Okay, so you were having your first C-section as I was pregnant with my VBA2C baby. Emily: Yeah, it was 2017. Meagan: When you had him? Emily: When I had her. I had three girls and then my youngest is a boy. Meagan: Yes. My VBA2C was in 2016 so just right before, yeah. Awesome. Okay, well I’m going to turn the time over to you. Emily: Sure. So my first pregnancy, I actually found out I was pregnant on my honeymoon when we were in Mexico. Meagan: Oh my gosh. Emily: Yeah. I was stressed out and working out a bunch and all of this planning the wedding. I expected my period to come while we were there so I’m like, “Oh, it’s going to be the worst. I have all of these white clothes and I’m going to be on the beach and I’m going to have my period.” It just didn’t come so it was right at the start of our honeymoon. I was like, “Let’s take a test. I don’t want to be drinking margaritas for the rest of the week,” then of course, I was. We came back from the honeymoon with another big announcement. I feel like a lot of people’s stories is that you didn’t know any better and you just showed up at the hospital and you did what the doctor said. I was the exact opposite at that point. I was reading all of the things. I read the Ina May book. I had a midwife at a birth center and I was going to the chiropractor constantly. I was doing all of the things to be ready to give birth at the birth center without medication and all of that. That’s just not how it ended up. I think I was around 36 weeks and she was breech. I was going to the chiropractor all of the time trying to get her to turn. I was doing Spinning Babies. I was doing acupuncture. I was going upside down all of the time. I was finding swimming pools to do handstands and all of the things. I did moxibustion where you smoke–Meagan: Uh-huh, on your Bladder 6. Emily: She was still breech so my midwife set me up with the breech guy. People come to him from all over to do breech vaginal deliveries so I started seeing him. This was when we were living in Houston so I started seeing him and we did all of the things to try and get her to turn and ended up having a version. I went in. I had an epidural. They manually turned her and then afterward, they were monitoring me in the room and the nurses were like, “Okay, well do you want to be induced now?” I was like, “Nope. I’ve got a plan. I’m going home.” So I left the hospital after that. She stayed head down and then I went to 42 weeks and at about 42 weeks, I went into labor but my labor was weird. I was getting contractions but there was no break between them. It was just constant, squeezing pressure. I was texting my midwife asking, “I don’t know what to do. I can’t time them. There is no in-between.” It was mostly my back and after, I think it was 3 hours and I was like, “I can’t do this. This is too weird.” I didn’t have any guidance for what to do if you’re not able to– they weren’t broken up at all. Meagan: Were you dehydrated at all? Emily: No, I don’t think so. I’m not sure. We finally went into the birthing center and it stayed that way for a really long time. We were there throughout the night. I was on a birthing ball and my husband was just elbow into my back for hours. I couldn’t sleep because it was just constant pain. I tried the Rebozo scarf. We did all kinds of things while I was there. I will say though, I should have had a doula because my midwife kind of just left the room and was gone. She was somewhere in the center probably sleeping. I don’t know. She would come in every once in a while and we were really just left to our own devices in there. We had done I think it was a six-week class. We went in every week trying to prepare. Yeah, we were just in this room together in the middle of the night really tired and in a lot of pain not knowing what to do to get this going. At one point, I was on an IV. She had given me all of the pain stuff that they can give you. At one point, she was like, “I’ve done all of my–” I wish I could remember. Meagan: I’ve exhausted all my tools type thing. Emily: Yeah, I’ve given you as many doses as I can in a time period. We did the catheter. That came out at some point. I think it was Monday when I went in there and then Wednesday when I ended up leaving there. At one point, she was checking to see. She was looking at my cervix and my water broke. There was a bunch of meconium and it was green crazy. She just looked at me and was like, “I think it’s probably time for you to go.” I got back in the car in rush-hour traffic in Houston and headed to the hospital. There was a nurse in the back seat with me holding my IV bag. My husband drove us there. She had called the doctor who did my version so I had already met him and known him and known that he was pretty progressive as well doing breech vaginal deliveries and I know he did breech twin deliveries. He was a very cool guy so I felt good about that. We went. He was like, “All right. Let’s do an epidural. You can sleep. You can relax and all these things.” That’s what we did. I think I had the epidural for 8 hours and I was at 6 centimeters. They were like, “Okay, what about Pitocin?” I feel like they did give me a lot of time and I hate the saying “give me” but they gave me a lot of time and by the end of it, I was exhausted. I was done and ready to get her out. I only made it to 6 centimeters after all of that. It was 3 days of labor. By that time, just get her out of there. She was almost 10 pounds. She was big. Yeah. The C-section, that all went fine. I found recovery to be especially hard. My body was already so tired. Meagan: Exhausted. Emily: Exhausted. I wasn’t prepared for it. I didn’t expect it to be as painful as it was, but yeah. I know some people kind of just pop right up after and are moving around. That was not my experience. That was my first. I feel like I had 10 experiences in one. I did the midwife birth center thing. They tried to get my labor going with an epidural. I had already been there for an epidural once so by the time I was getting the second one, it was whatever, and then the C-section also all in that one pregnancy. Yeah. I feel like it was three births in one.But yeah, then we got pregnant with my second. I talked to my midwife again. She was like, “I don’t do VBACs,” so the first person I called was the guy who did my C-section and my version. I said, “I want to do a VBAC.” He was like, “All right.” He was very cool about it and awesome. It was another really easy pregnancy. I got to the end. I was 41 weeks. Meagan: So you carry longer. Emily: Yes. I was 41 weeks with her and I went in for an appointment and they did a sonogram and I was like, “Please can you check my cervix? I just have to know where I’m at.” Yeah, I hadn’t dilated at all and he was like, “Well, your sonogram’s estimating that she’s going to be 10 pounds also.” My mom had been in town at that point. They were trying to be there for the birth and helping me with my toddler and she had to leave the next day because my sister was being induced in Dallas. She had been staying with me for that whole last two weeks and it was like a now or never she’s going to be gone. I’m already 41 weeks. I was also teaching and so every day, I was walking into work so pregnant. 1000 comments like, “You’re still here? You’re still pregnant?” It just felt like I was sick of it. Then hearing the 10 pounds, I was like, “All right. Let’s just have a C-section I guess.” He left that up to me. I feel like he would have if I said. He wasn’t even doing cervical checks at that point. It was me who asked for it. He left it up to me and he agreed when I said, “Okay. I guess we’ll just do a C-section.” That one was different because it was scheduled. We went in the next morning. It was easy, breezy, and a little bit better of a recovery since I wasn’t already so exhausted at that point. But yeah. I had a newborn and a toddler and a C-section again. It was rough. It kept opening because I was picking up my toddler. I went back to work I think when my second was six weeks old. Yeah. It was a lot. Those were my first two C-sections. Very different experiences for both of them with the same doctor. Then COVID happened and I finished the school year teaching online when COVID happened and my husband was working in oil and gas. We decided we were going to move to my parents’ ranch. I finished the school year online from there and he was working with my dad. My dad does custom home building so that was something he wanted to get into. It was kind of the perfect segue out of there. Meagan: Mhmm. So where were your first two babies born? Emily: Houston. Meagan: In Houston. For people who are interested in breech, are you willing to share that provider’s name? Emily: Yes. His name is Dr. Alfredo Gei. Meagan: Okay. Emily: Yeah. I mean, he was great. I don’t know if he’s still working or not down there, but he was awesome. He was a very, very cool guy. He was very calm, very respectful, friendly, and all of the things. Meagan: Yeah. Yes, good. Emily: Yeah. We moved up to my parents’ ranch in Glen Rose, Texas. I finished the school year online. I decided I would stay home with my two kids. I think by the end of that summer, we were ready to have our third. It was perfect timing. I was staying home. We had my parents there. My husband had an easier work obligation working with my dad and all of that so I got pregnant with my third. That pregnancy was wild. We had a lot going on. I guess it was my first experience having a pregnancy that didn’t go super smoothly and whatever test and all of the normal things you do like blood testing if you choose to do that. Everything came back weird so I’d have to go in and retest. I think at one point in the beginning, they thought she might have Down Syndrome so it was like, “Well, you can do the amnio to find out or you can wait until that anatomy scan.” I spent that time just waiting until 20 weeks to find out if she had Down Syndrome or not. I tried to do the gender test, one of those home ones. My first two were a surprise and with her, I just wanted to know. I needed something. I wanted to know what was going on in there. We did one of those gender tests and it came back inconclusive. Whatever could go wrong was going wrong with the pregnancy. I had found an OB/GYN who was VBAC-friendly who worked with a group of midwives so it was him and a bunch of midwives. I started seeing him and them because I thought– oh, I didn’t even mention. When I had my second baby, they predicted her to be 10 pounds. She was 7 pounds. It made me so mad. It made me so mad. Meagan: Okay, so now I have a question for you because we talk about third-trimester ultrasounds. At 41 weeks, that is normal because they do non-stress tests and all of those things. Would you have chosen a different situation or would the scenario be the same because of your mom and convenience and all of that? Emily: That’s a good question. I would like to say that I would have at least given myself a couple more days at that point, just a couple more days to see maybe. I always think, What if I had gone into labor in that next couple of days instead of the C-section? Would she have come out easier being 7 pounds and not 10 pounds? Of course, I thought, Maybe it’s my pelvis. Big baby, small pelvis, and all of these things. I don’t know. It’s hard to say. I was really ready to have her. Meagan: Absolutely and you were given an opportunity. That goes to speak where you are in your pregnancy. That’s a vulnerable state. That’s a very vulnerable state. But you had her and it was an okay C-section and your mom was there and all sorts of things. Emily: Yeah. She came out and then they brought me back to the room and my mom was there. She got to meet the baby then drove all the way back up to Dallas and my sister had hers. They are a day apart. Meagan: Aww, that is so fun. Emily: Anyway, with my third, I was seeing him and I had some weird blood testing results and weird stuff happening at the beginning. It was the end of COVID sort of so COVID started around spring break. I got pregnant around that summer and by the next spring, it had been quite a while but hospitals and stuff still had all of those weird rules in place about people being in the room and all of the things. It was the tail end of that. My husband got to come in for the anatomy scan. He was there with me in the room when she did all of the scanning and everything and then he had to leave when the doctor came in. He went and waited outside in the car and the doctor came in and my first question obviously was, “Did you see any Down Syndrome markers?” They said, “No.” They didn’t see that, but her head circumference and her cerebellum were measuring in the first percentile. The normal range is 1-100 and she was right there on the cusp of being abnormally small. He dropped that bomb on me while I was in there by myself. He waited until my husband had left. He told me that I was going to need to go and see a maternal-fetal medicine specialist and then I could come back after that. I left that appointment just in shambles not knowing what was going on or what to expect or what that meant and then I had to wait for an appointment to see a maternal-fetal medicine specialist. At that point, I just threw the whole VBAC idea out the window. It was all about what was going on with the baby and keeping the baby healthy and all of those things. My mom is a NICU nurse so I was like, “Well, I’m going to give birth at the hospital that she works with because if my baby goes into the NICU, I want her to be there, and all of these women that I had known her working with for 30 years.” I went to see a maternal-fetal medicine specialist. I switched providers and hospitals and I went to where my mom was working. I went in and they measured her cerebellum for the rest of my pregnancy. It was every other week or so I would go in and they measured. She stayed on that very tail end the entire time. I want to say that she might have reached the 6th percentile by the end in growth so it was still pretty precarious not really knowing what the deal was there. But by all accounts, she was healthy. They weren’t giving me any kind of diagnosis or suspicions about anything. She kept falling in the normal range which meant they weren’t going to do any further testing. They could have done an MRI or something on my stomach at one point but they didn’t do any of that. I think around 34 weeks, I had an appointment and I was just like, “You know, if we’re good to have a VBAC, I still want to do that.” I just looked at my provider and was like, “This was my plan. I don’t see why it still can’t be my plan. I’ve got two toddlers at home. I really can’t have another surgery. I don’t want to do that.” She was like, “Okay. Awesome.” I was expecting a fight. Meagan: You’re like, you do. You really, really do. You expect this, “No” or “But, well–”. Those are the things that you automatically assume so when you have a provider who’s like, “Okay, cool,” you’re like, wait what? It throws you off. Emily: Yeah. I left there with a skip in my step. Meagan: I bet you did. Emily: Right after that, I contacted a friend of mine who is a doula and I started working with her. She shared your podcast with me so I was listening, listening, listening to as many episodes as I could in those couple of weeks and it was very helpful. I’m not a confrontational person or even a person who previously was good at advocating so I was mostly listening. I already knew what the hospital situation looked like. I already knew what a C-section looked like so I was really listening for how do these conversations happen with doctors and what does that look like when you’re advocating for yourself? What are the words that I need to use? I listened for a lot of those kinds of examples of this is what I can say if she says this. This is what I can come back with or suggest if this happens. So that was very helpful for me to just go in and can we do a Foley? Can we do a Cook’s? Meagan: To feel prepared to have that conversation. Emily: Yeah. I know at one point, they wanted to schedule an induction and I said, “Well, what if I just don’t come?” She was like, “Well, we can’t drive to your house and bring you,” kind of response. “What if I don’t want to do Pitocin and all of this? Can you do a Foley or a Cook’s?” I really came into those appointments with more of a two-sided conversation and not just “We’re going to do this. We’re going to do this. We’re going to do this.” I remember I got there at my 36-week appointment and my nurse was like, “Okay, go get undressed.” I didn’t get undressed. I just sat there with all my clothes. She came back in and I was like, “I don’t want that. I don’t want my cervix checked.” Meagan: Good job. Emily: Yeah, she didn’t know what to do with that. She was like, “I think she’s going to want to look.” I was like, “Well, why?” Meagan: I don’t want it. Emily: “I don’t want to know. It’s going to get me in my head. What’s going to change if I’m 36 weeks?” Obviously, that was the norm there to start doing that at that point. What happens if I’m 1 centimeter? What happens if I’m 3? I’m still going to go home. I remember that was the first time I did something out of the norm there. I didn’t even say the whole doula thing since it was the end of COVID. They were still working out who was allowed in so I asked for a doula and they didn’t know if they could even have them so we were asking the hospital for hospital policies and calling up there asking all kinds of questions. By the time we did show up, everybody there was like, “She’s here. She’s here.” My mom worked there too so it felt a little bit like maybe everyone else was walking on eggshells with me because– Meagan: Because of your mom too. Emily: Well, my mom too. She was working that day so I probably couldn’t have had her if she had come in as an extra person with us, but she was working and so she just showed up in our room in her scrubs and everything. I went into labor. Meagan: What gestation on this one?Emily: I was 37 weeks. Meagan: Whoa! So way earlier. Emily: Yes, way earlier. It was Easter. I started having contractions during the whole Easter thing. I’m hiding eggs struggling around the yard and I went to bed that night thinking, This feels like it’s it. They were not painful but they were stronger than the regular Braxton Hicks so I went to bed and I think at 3:00 or so in the morning, they started waking me up. I tried to keep sleeping until 6:00 in the morning. I woke my husband up and was like, “You’ve got to figure out getting the kids to school and stuff. We’re going to be going into the hospital.” It was about an hour drive. So I got in the bath. My doula told me to get in the bath and she gave me some different positions and stuff to do so I did all of that and that sped things along a whole lot. I did some curb walking and then yeah, I showed up at the hospital ready to have her and I want to say I was in labor there for three or four hours. I asked to speak to the– is it the anesthesiologist who does the epidurals and stuff? Meagan: Yep. Emily: I told her that I wanted a walking epidural. A lot of people don’t know that there is a range. You can have it on full blast or you can have just a little bit. She gave me a very light epidural. I was able to still move in the bed and get in different positions. They had the bar over the bed at one point. They wanted to do an internal monitor at some point because my heartbeat and the baby’s heartbeat, they could not figure out where to put the strap. I declined that. The nurse really just had to stay in there with it pressed to my stomach for hours. Yeah, that’s what we did. I moved around. There was a peanut ball at some point and then yeah. They checked my cervix and my water broke. I don’t know if that was on purpose or not, but I then had another water break at a cervical check and things went pretty quickly after that. I think I pushed through three contractions. Right before I started pushing, my OB came in and said she was leaving and that another doctor would be coming in. I was like, “Does he know? Is he cool?” I was so confused. But yeah, he came in and he was great. He asked if I wanted a mirror. I know that he was using oil and he had a hot compress and whatever. Meagan: That’s awesome. Emily: He let me pull her out so I reached down and I grabbed her. It was all very cool. We were blasting Enya’s Sail Away. It was a whole vibe. Meagan: I love that. Oh my gosh, I can just picture it all. Emily: It was very easy. Hardest pregnancy, easiest labor and birth. Yeah, she came out. I would say she slid out, but pushing wasn’t hard. I could see what was happening. I don’t know. I felt very comfortable. Meagan: Good. Emily: I felt ready. Meagan: Good. At the end, was anything going on with her? Emily: Yes. That’s another whole long story. She didn’t pass her newborn hearing screening so when they do the hearing test, it’s a couple of days after you have the baby. She didn’t pass and they thought, Oh, she might have fluid in her ears and this and that. You’ll have to go back and do it again in a week or so. We went back and did it again and she didn’t pass again. We had to go to the Children’s Hospital and they did another type of hearing test and we found out that she was deaf. Yeah, we went down the whole hearing aid route and that. Healthwise besides her hearing, she was having a really hard time holding her head up. I think we started having a PT come when she was 4 weeks because her head was just flopping all over. I guess she was diagnosed with a gross motor delay and so we did PT until she started walking at 2.5. We had the option of doing genetic testing and all of that to find out the reason for the hearing loss and we just kind of thought, What’s it going to change? She’s still not going to be hearing after all of these tests so whatever. We will just deal with what we’ve got going on right now. She got hearing aids at 4 months. We were going in and they would do all kinds of tests and stuff. She still wasn’t responding to any sound so they wanted to do cochlear implants and in order to do that, you have to have an MRI. They look at everything structurally to make sure you are a good candidate for cochlear implants. They look at the nerve and the ear canal and all of those things. They came back and they said, “She can get them. She’s a good candidate for that, but here’s what we saw with her brain on the MRI.” She had white matter abnormalities which are just when they go in and they look, if you have all of these white spots, they indicate inactivity so she had a bunch of that that they couldn’t explain and she had a cyst somewhere in there on some groove. I have forgotten all of the lingo at this point. They wanted to find out what the cause of all of those things were. They also didn’t want to give her cochlear implants if they thought that these areas were going to grow so then we started doing all of the genetic and DNA testing. They wanted us to wait a year to do her next MRI and the cochlear implants to make sure in that year time period they didn’t grow at all. We were just like, “We can’t do that. One, we can’t wait a year to find out if our child has this thing that’s taking over her brain and two, it’s a critical time for learning language and speech and all of those things.” We settled with 6 months so we waited another 6 months. We did another MRI. They checked. Nothing grew. She was still making growths and learned to crawl and all of those things. She just did everything about a year behind. Yeah, we did cochlear implants and we all learned sign language and that’s how we communicate. Yeah, it’s been 3 years now. She just started the deaf preschool last week. Meagan: Awesome. Emily: And now bringing it home with baby number four. Meagan: Baby number four who is 9 months old? Emily: Yes. He was a surprise. We had a lot going on with my third daughter. I’ve got Eloise who is 7, Violet who is 5, and Matilda who just turned 3. We thought, Maybe we’ll have another. Let’s see what’s going on with her. Let’s get her into kindergarten. Let’s get her speaking and signing and all of these things. Then we had surprise baby number four. He ended up being a boy so that was fun. He was born in July of last year. Meagan: Okay. Emily: During all of that, our insurance had changed so I couldn’t go back to the same OB/GYN and I went to another one at that same hospital. After I had my third, my hormones were just so wild and crazy and I had a lot of anxiety and obviously stress from all that was going on with her. I went in and I was like, “I just want to figure out what’s going on with my hormones.” I remember the doctor asked me about my previous pregnancies and births and stuff. I told her, “I actually had a VBAC with Dr. So and so at this hospital.” She said, “Oh, if you want to do that again, you’ve got to go somewhere else because we don’t do that here.” Meagan: But you’re like, “But I did do it here.” Emily: I was like, “Don’t worry about it because I don’t want to have another one.” Of course, a few months after that, I ended up getting pregnant again so our insurance had changed yet again. If you have a baby who has special needs, you’ve got to get the insurance thing figured out all the time. We changed again. I was able to go back to the same doctor so when I was pregnant with him, I saw her and she was like, “I’m guessing you’re going to want another VBAC.” I said, “You’re right.” Same thing. I didn’t let them check my cervix. I didn’t have a late-term sonogram. I went into labor with him. I got induced. That’s right. I got induced with him. Yeah, yeah. I was 41 weeks again. Meagan: Okay. Emily: I was so expecting another early one and then I got to 41 weeks and we started talking about inductions and stuff. I said, “If I come in and do this, I’m going to want to do Foley or something again.” So that’s what we did. That put me into labor right away. I think I was 1 centimeter so they were able to put that in and it just went from there. I will say this about the fourth with the same provider. I specifically in my birth plan said, “No students.” I feel like I had already done all of that. I had already allowed all of them. I had paid my dues to society by letting them in. I had a student who did my epidural with my second. I was done. I was done with that. I didn’t want a bunch of people in the room. When it was time to put in the Foley, she wasn’t available so they were like, “Do you mind if a resident does it?” I’m like, “That’s fine.” The question was raised about breaking my water. I think I was over 6 centimeters at that point when they were asking about breaking my water and I was like, “Eh.” I talked to my doula. She was there again. I talked to my doula about it and we decided that was okay to get things moving along. They said, “Oh, well she’s not available still. Can a resident come in and do that?” I was like, “Okay.” Then it was time to push and deliver and a whole team of people came in. I was in the thick of it. I had another really low-dose epidural so I was still feeling a lot. I also thing one thing about the low-dose epidural managing pain and staying on top of pain is a real thing and you can reach a certain point where there’s not much you can do about it where you are too far. That’s where I got with that. Even though I had the epidural, I was too far along at that point for it to do much. I was like, “Turn it up. Turn it up.” It wasn’t making any difference so just know that’s something that does happen. When it was time to push, my doctor on her wheelie stool just scooted out of the way and someone else showed up. Meagan: What? Again? Emily: From the background and it was like, “Push, push, push!” The vibes were very different. I’m not sure why that happened because as far as I’m concerned, nothing was happening with me medically and nothing was happening with him medically to necessitate me to push vigorously. I had not been pushing for hours. I got him out in under 30 minutes. It felt like there was this need for me to get him out of there and get him out quickly. I’m not sure why that happened. So I guess it was a resident who was down there. There was no oil this time. There was no hot compress this time. There was more pulling during the pushing part and I ended up tearing fourth degree all the way. It was awful. Same provider, different experience. She’s retired now. I wouldn’t go as far to say that I’d recommend her to other people having a VBAC. I think she was more– what’s the word? Not VBAC-friendly. Meagan: Tolerant. Emily: Tolerant. I think she didn’t think I was going to get there so she said yes thinking that’s not how it was going to go and we’d never get to that point where I was in labor there ready to push. That’s what happened both times so it was thrust upon her also. She’s not a bad doctor or anything. That’s my one takeaway from that one. You’re pushing and there’s a lot of people in the room and there’s a lot going on and you’re very much focused. I wish that I or someone else in the room had said, “Oh wait, what’s happening down there? Why is this person coming in? Why are we doing this so quickly? What’s this need to rush?” Yeah. That’s my takeaway from that one. At the end of the day, I had an easy pregnancy and an easy delivery. I did have another vaginal, but it also came with some bad as well. It was a bad recovery for me for sure. Meagan: You know, I think that’s something to note. Like you said, you got your vaginal birth and everything, but not every vaginal birth always ends with an easy recovery or an easy experience or even a positive experience so it does help to have that support team but here you go. Still even then at the last second, you got switched out on like you did last time too. That’s weird. I’m like, was she not confident in delivering babies or what? That’s interesting. Emily: I don’t know. I’m not sure. Of course, afterward, I’m like, If she had stayed sitting there, would I have torn as much? Meagan: Exactly, yeah. Emily: If I was pressured to go so quickly, would I have torn as much? I left that one feeling, What just happened? I talked to my doula afterward about it and she was like, “You know, I wish I had said something,” but unless we had talked about it before, for her to stop a doctor in the middle of what they are doing without me having already told her, “Hey, I don’t want this,” it’s weird. Meagan: It’s a really tricky situation. As a doula, I will say it’s very tricky when you’re like, I don’t like what I’m seeing, but she’s not saying anything and didn’t say anything to me before this. I would assume she doesn’t like this, but at the same time, yeah. Like you said, it’s tricky. You don’t want to step on people’s toes. You don’t want to change the atmosphere. It doesn’t sound like the atmosphere was exactly peaceful either, but yeah. Gosh. That’s hard. Emily: Yeah. It was another unexpected thing. I hadn’t prepared for that scenario. I had it in my birth plan that I didn’t want students, but then I had said yes to them for these things, so I can see how we got there, but yeah. For those wondering, I pushed him out to Shania Twain’s Man I Feel Like a Woman. There were some good vibes in there. Meagan: I’m loving all of your music choices. That is amazing. Oh my gosh. Well, I’m sorry that it was that type of an ending. I am happy for you that you were able to have both of your vaginal births. But it’s such a good takeaway and a great note. Women of Strength, think about those things too even with pushing, what you are wanting. Talk about this to your team. “If nothing’s wrong, if nothing is emergent, I need it to be this way,” because that is for sure tricky. I wanted to talk about way into the first birth. I wanted to give a couple of suggestions for people who are having a hyperactive uterus where the uterus is just too active. It’s not releasing. Sometimes that can be a baby’s position working through and trying to get into the right position and the uterus is trying to help but a lot of the time it can be due to things like dehydration or I know that sometimes if there’s a UTI or an infection or something like that, that can cause a hyperactive uterus. Sometimes people just have hyperactive uteruses but with a uterus that is just not letting go like yours, something that a midwife a long time ago within my doula career suggested to a client of mine was called cramp bark. Cramp bark, yeah. It’s a tincture and you can take it. It can try to help relax the uterus so if you are having really long prodromal labor or like Emily where her uterus just wouldn’t give up and it was just constant– and you said it was in your back. Emily: I had that wrap-around experience. It was like, I’m in a whole lot of pain but it’s right here in my back. It never eased up. No, and then I wasn’t dilating at the same time after all of this time of being like that. I think it was definitely her positioning. She was sunny-side up by the time the C-section did happen. Meagan: That’s what I was thinking. Were you dehydrated or was it a positional thing? A positional factor can do that. Sometimes the uterus needs to relax so we can work with position. I know you were working with position but your uterus wasn’t giving up. Sometimes you can increase your hydration, but cramp bark and always, always, always ask your provider about it, but it was actually something that a midwife and I think Julie took it with one of her babies with her prodromal labor too and it helped her as well. I just wanted to bring back that note of if you’re having that hyperactive uterus, there could be a few things like hydration, position, maybe it’s an infection that is undetected or maybe you’ve just got a great uterus that likes to keep squeezing. Thank you so much for sharing all of your beautiful stories. I’m so happy for you and congratulations. Emily: Thank you for having me. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
49:1831/07/2024
Episode 321 Jacqueline's VBAC with FSHD Muscular Dystrophy

Episode 321 Jacqueline's VBAC with FSHD Muscular Dystrophy

Jacqueline’s symptoms of FSHD muscular dystrophy began at 16 years old. She shares with us today how she manages chronic pain and what that looked like throughout her pregnancy and birth journeys. Jacqueline is also a sexual violence trauma survivor and went through three pregnancy losses. Through her nonprofit organization and as a birth doula, she is a strong advocate for trauma-informed care for all women. Jacqueline shares inspiration and advice throughout the episode for women who also have a history of trauma as well as those who are trying to navigate birth with a neuromuscular condition. Her proactive approach to caring for her body and heart allowed Jacqueline to have a beautiful, empowering, and healing VBAC, especially after enduring so much.  Anesthetic Management for Dystrophy ArticleNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. Today’s episode is a VBAC episode, but it has an extra topic that is a first for the entire podcast life. In 320-something episodes, we have never talked about this specific topic. The other day on social media, I had a couple of spots so I reached out and I am so grateful for Jacqueline. Are you in Canada? Jacqueline: Yes. Meagan: Yes. She’s from Canada and she reached out and was like, “Hey, this is something about my story.” And I was like, “Yes, let’s do that because this would be amazing.” One of the things that we are going to be talking about today is FSHD muscular dystrophy. Jacqueline: Dystrophy. Dystrophy. Meagan: Okay, yes. We are going to be talking about that a little bit more and the challenges that you have had to go through with all of this. If you wouldn’t mind before we get to the review, will you tell us a little bit more about FSHD and one, what is it? Two, what are the things that we are told because you have it and how you had to birth if you were told?Jacqueline: Yeah, absolutely. FSHD is a form of muscular dystrophy. It’s quite rare and it essentially affects the muscles in my shoulders and in my facial muscles as well. For everyone with FSHD, your symptoms present quite differently. Of all of the types of muscular dystrophy, it is one of the more common forms, but in the big scheme of conditions that you can live with, it definitely is still considered to be rare. I was diagnosed in 2018 officially though I had symptoms starting from the age of 16 and I gave birth to my first child when I was 21 years old. I didn’t have too many symptoms at that time. Going into my twenties, I started to have more atrophy in my shoulders, my lower back, and sometimes in my feet. My second and third processes were a little bit different, but overall, in terms of pregnancy and birth, my specialist always shared that you’re able to carry a baby and you’re able to give birth. The atrophy that we experience doesn’t necessarily affect that process thankfully, but I’ve always been someone who is very proactive in terms of minimizing my pain and trying to do different types of therapies to minimize the chronic pain that I live with so I’m very focused on that during pregnancy especially. In my most recent birth which happened 5 weeks ago now, I really focused on making sure that my body was very strong and at its optimal comfort level that I possibly could be while pregnant in order to achieve a successful VBAC. Meagan: Oh my gosh, thank you for sharing and we’re definitely going to go in through your journies and I’m sure it’s going to come up. We’re going to learn more about how you did that, how you made sure your body was at its most comfortable spot that it could be while growing a baby and how it’s impacted your life. Thank you for sharing. I do want to share a Review of the Week before we get too far into today’s episodes. This is by Rachel Thornton and it says, “Thanks for giving me the confidence to have a VBAC.” It says, “I am so glad I found this amazing podcast when I was newly pregnant with baby number two. After a long and traumatic first birth experience that ended in a C-section, I cautiously hoped that I could have a VBAC. Using this information that I learned from hearing other people’s stories on The VBAC Link, I felt confident and prepared for the birth of my son. On October 9, 2020, I had a beautiful, redemptive VBAC and welcomed our boy into the world. Thank you so much for helping me achieve this dream.” Girl, Rachel, you are amazing. Congratulations and thank you for sharing the story of your dream. I am so happy for you that you got your VBAC and as always, if you have opinions about The VBAC Link, please share them. Rate us. Give us a review and let us know what you think and maybe how we’re changing your dream as well. Meagan: Okay, Jacqueline. Okay, so you have three babies. Jacqueline: Yes. Meagan: One is 5 weeks old. 5 weeks? Jacqueline: Yes. Meagan: Itty bitty, bitty. Wow. Thank you so much for taking the time 5 weeks postpartum and you could be taking a nap right now and you are here with us sharing your story. I’m going to turn the time over to you and let you share away. Jacqueline: Great. As mentioned, I have three kids but this was actually my 8th pregnancy so I am quite well versed on pregnancy and birth and I am actually a doula myself. I went through the training process after I experienced three consecutive losses when I was trying to get pregnant with my husband. This was back in 2020. With that, I sort of had a new sense of knowledge coming into pregnancy and birth. That was following the birth of my daughter. I had her when I was 21 years old and that process was very different than my other two pregnancies and birth stories. Unfortunately, when I was pregnant with her I was in an abusive relationship. It’s a very unique story I guess you can say. I was living abroad at the time so most of my pregnancy care actually took place in Kenya where I was doing work with my nonprofit organization and then I moved back to Canada when I was 6 months pregnant and lived with my family at the time. They really supported me and just came to a level of peace before giving birth and mentally preparing for becoming a parent at a very young age and as a single mom. But going into that birth process, I really did no preparation at all. I found myself during this pregnancy and as I was preparing for the birth of my second son which happened just 5 weeks ago, I really found myself reflecting on my pregnancy and birth experience with my daughter. With her birth, I had no foundational knowledge aside from what I had seen in movies really and because of that, at 39 weeks, I ended up getting induced. It was a very long birth process. I was already in a very traumatized state because of what I was going through at the time and I had my mother and my grandmother there with me when I gave birth but my mother had also gone through inductions because my brother and I stayed locked in there until well over 42 weeks actually for both of my mom’s pregnancies. She had never experienced anything different. I didn’t think twice about experiencing an induction and to summarize that birth story really, I ended up giving birth vaginally after over 24 hours of laboring. I had a failed epidural which I got just before she was born about an hour and a half prior to her being born and I had no movement throughout the entire process. I quite literally just moved from one side of the bed to the other. I was watching Ugly Betty throughout my entire labor and delivery. That I do remember. It was my comfort show at the time. I largely just wanted the process to be over so that I could be with my baby and there were a lot of things that happened throughout that labor process that I didn’t even reflect on as unnecessary interventions again until this pregnancy. Jacqueline: 7 years later, when my husband and I decided that we wanted to start the process of expanding our family, we were really conscious about making sure that I didn’t have that same experience. I really opened up to him about how I was just in a state of survival with my daughter’s birth and how I didn’t want to go through that again. Again, at this time, I also was a doula as well. After we had experienced our losses, it was really important to me to just expand my knowledge and I felt really called to get that training because of the insensitivity that I experienced when I was navigating loss. Coming into the process of now having a rainbow baby and wanting for it to be a really redeeming birth as well, I tried to make sure again that my body was very strong coming into labor. One thing that I think stands out as a person living with a disability with FSHD muscular dystrophy is that often with conditions that are rare, you have providers who when they hear that you have a rare condition, they immediately want to turn you away. Meagan: Yeah, they get scared. Jacqueline: Exactly. I reached out to the midwives’ team in my community. At the time we were living in Northern Ontario in Canada which is more rural and remote so we only had one midwife team in our area. When I put in my form stating that I had a form of muscular dystrophy, I was immediately turned away and that was a little bit deterring so I reached out to a friend of mine who was a midwifery student. She encouraged me to just call the practice and explain what my condition actually was and how it did not affect my ability to give birth at all. I was not high risk. In doing that, they changed my status in their system and put me on the waitlist. Within our community, you essentially have to call the midwives at 5-6 weeks pregnant if you want to get in. It’s very unfortunate because they provide such incredible trauma-informed care and support, but it’s something that is very heavily regulated and they are only allowed a certain amount of clients each month.Because of that, a lot of women who are giving birth don’t get to access those services. Fortunately, I received a call about 2 months into my pregnancy that I was now able to be accepted as a patient. I was paired up with an incredible team. I’ll give a shoutout to them, Meredith and Sara from Sudbury Community Midwives. They really helped change the way I viewed being pregnant. During my first pregnancy, I absolutely hated the process. I am the first to admit that. I was going through so many hardships on a personal level and I just really felt that I didn’t have any sense of control or agency over my body at that time. That really translated into my birth experience as well. They really helped me to navigate through that and really connect with my body and feel empowered through the process. I really loved as well just in general with midwifery care that they allowed me to have the space to ask questions. I never felt rushed and I never felt that because I had a disability that I had to have a certain type of birth where I wasn’t in control. I think sometimes for folks who have disabilities, that’s often what you are made to feel like has to be the process. Obviously, everyone has a different background, but often that isn’t the case. Often, you can still decide what outcomes you will encounter both in your pregnancy and in your birthing experience. Jacqueline: With that, I decided that I wanted to have a home birth. We did everything humanly possible to prepare for that process. I was going to a chiropractor quite regularly. I was seeing a naturopathic doctor. I had gone to my specialist to make sure that my body was ready for birthing and everyone was getting me into the best possible shape I could be in to give birth. The midwives’ team were very aligned with what we wanted for our home birth as well.I really wanted my daughter to be a part of that process and again, being my birth following three consecutive losses and the first birth after a baby after having my daughter and not really getting to fully even embrace that first year of her life largely because I was navigating through so much trauma myself after leaving my abuser, I really just thought that would be a meaningful experience for us as well. But my son had other plans. At 39 weeks, I remember it so vividly. I was in the bath and I quite literally watched him flip from head down which he had been for weeks to transverse breech. I thankfully had a midwife appointment the next day and said to them, “I’m fairly certain that my son has turned.”They said, “There is no way. Statistically, this is so unlikely. You are so far along in your pregnancy. Don’t stress. I’m sure you are mistaken.” Of course, very quickly, we learned that he had flipped. I think that too really speaks to as someone with a disability you are so in tune with your body. You feel every little change. You are so used to having discomfort and pain on a daily basis. I knew the minute that he had flipped so I advocated for myself in those moments and said, “Can we have an ultrasound to confirm it?” We did. Even in that process, I really made sure that I stayed a part of my birth. I had a strong feeling that I would probably be having a C-section. It wasn’t what I planned for, but going into everything, I think my doula training did help in this regard. I was ready for whatever may happen. I had sort of a plan A and a plan B. Plan A obviously was that I would be able to have my home birth if by some miracle he flipped back, but plan B was that I would be involved in the decision-making process for a C-section. I spoke with my midwife team and we found one OB/GYN in my community who was willing to try and do an inversion, so to try and manually move him back into the head-down position. We did a consult at our hospital. This OB/GYN and I actually had a history. He had supported me through two of my losses and was actually part of helping us successfully get pregnant with my son. It was actually very full circle that he would then be a part of my birth. I felt comfortable in his care as well. He knew my history. Part of my story as well is that I am a survivor of sexual violence. That’s actually what I do professionally with my work. He knew that a lot of elements of birth are very triggering for me as well so he really wanted to ensure that we would be as minimally invasive and as trauma-informed as possible. Unfortunately, our ultrasound showed that I had a limited amount of fluid. He was still willing to try and do the inversion, but he said, “To be totally transparent with you Jacqueline, this is going to be incredibly traumatic for you. I refuse to do it unless you get an epidural because it’s going to hurt and you’ve gone through so many losses. This is the baby that you’ve been waiting for. Make an informed decision of what you think would be best for you, but I just want you to know everything going in.” I really appreciated that as well that he spoke to me from a very personable standpoint knowing my background and our history and ultimately, we decided that a C-section would be what was best for us. Jacqueline: Everything went smoothly with the C-section, thank goodness and I welcomed my son in a very powerful way. I still think because I was very involved in the decision-making process, I felt very at peace with the fact that I had to have a C-section. My midwives were still in the OR with us when we were going through that process and they were still with us for the continuation of care and I also had the connection with my OB. He made sure that he really congratulated us in welcoming our son and highlighted that it was really special that he was here now after he had seen our journey. It felt very good, but the recovery was just so incredibly difficult as someone who lives with a neuromuscular condition. I think no one at the hospital was really aware of the fact that I needed a different timeline in terms of when to get up and get moving in comparison to other moms who don’t have the condition that I live with. Everything was very rushed. I literally left the hospital 24 hours after having a C-section which is the standard of care where we live. Meagan: 24 hours? I didn’t know that. Jacqueline: 24 hours. It’s appalling in my opinion. Meagan: Very quickly. Jacqueline: It’s something that I don’t think should be encouraged, but I returned home and really just wasn’t prepared for what was to come. I didn’t feel like I had even a full range of mobility for probably 6-8 months. It was just traumatic in that sense that I hear so many people around me sharing that after a few months, they felt that sense of normalcy again and reconnection with their body to some extent. For me, my timeline was just very different. For anyone who is going through the process of giving birth and lives with a condition like a neuromuscular condition or something similar, I think it’s important to have in the back of your mind that your timeline will be different and that is okay. If it is possible for you to give birth vaginally or to try and go for a VBAC or try and avoid a C-section if not medically necessary, do everything in your power to try and make that possible because often even the care instructions that I was provided with in postpartum were not aligned with the realities of what I face as a person with a neuromuscular condition.Because it’s so underresearched, my OB/GYN for example did not know what kind of recommendations to give me in terms of what to expect and how to prepare myself so I think that’s just something to keep in the back of your mind if you are trying to make informed decisions about what to expect if you are someone who lives with a neuromuscular disease. Jacqueline: That being said, when my son was 2, or I guess we actually got pregnant 18 months postpartum so exactly at the time you are recommended to start trying again. This was not something that we necessarily planned for and we did not think it was possible to have another child without planning so we just took that as an unexpected blessing and my pregnancy with my second son went very smoothly. I did notice though with my pregnancy with my first son, I didn’t seek chiropractic care and other services like massage as much as I probably should have. I also wasn’t as active prior to giving birth as I probably should have been in order to help myself with mobility and also with my postpartum healing. So I was very proactive during this pregnancy. We had just moved from northern Ontario to southern Ontario for my husband’s work so we were now about a 5 ½-hour drive from the majority of our family and support system. One of the first things that I did when we moved to the community was find a sort of new care team to help with FSHD– just the regular symptoms, not even pregnancy-connected. I found The Wellness Hub which is located in Hamilton, Ontario for anyone who is in the area. They are a practice that primarily specializes in women’s health and so I just felt very at home immediately when I entered their clinic and I found an amazing chiropractor there who supported me from the very beginning of my pregnancy and then when I reached 20 weeks, I decided that I wanted to start going more frequently so I was going for weekly chiro visits. I made sure that I also did massage at least once a month up until 30 weeks and then I was going bi-weekly from 30 weeks onward. I think that’s also very important for anyone who is living with a neuromuscular condition or something similar. Prioritize your care and don’t put yourself in the back corner preparing for your baby to arrive. Really make sure that you focus on your care and healing as well. So to fast forward a little bit, everything went well with my midwife care team in this community as well and as we neared our 35-week mark, I said, “Hey, we should probably start talking about labor and delivery.” so they were actually quite slow to start having that conversation. I don’t even think it came up until 36 weeks for us because I had always gone past 39 weeks. They thought I would have time. They didn’t think I would go into labor early. I didn’t, but I still thought we should be having those conversations. My husband is a pilot so he’s actually gone every 2 weeks and so because I didn’t have family close by and because I knew I may potentially not have my husband at home either, I hired a doula team. I also did this during my second pregnancy, well my second birth as well, but unfortunately at that time, it was COVID so we couldn’t have doulas in the hospital. But she did support me mostly in preparing my husband for what to expect, but she had a background in kinesiology as well so she also helped prepare my body physically for the birthing process. She had studied with a training called the Body Ready Method. I really wanted to find a doula who had the same training background because I found it very beneficial. I did some research and found a doula team, Leanne and Roseanne, who are in the Hamilton area with Hamilton family doulas and they worked with me from around the 35-week mark as well to get ready for my birth. Largely because I had the knowledge background as a doula myself, they didn’t have to go through too much about what to expect in your birth. We largely just discussed the different types of movement I would want to be doing in early labor and also really helped me to prepare for what I had hoped going in would be an unmedicated birth but also talked about the different options that we may have with a really strong focus on having a VBAC. That was my number-one priority even in selecting gmy provider. I really made sure that I called around and fortunately, in my area, every midwife practice I spoke to is very aligned with me having a VBAC. Meagan: Awesome. Jacqueline: Ultimately, the providers I chose, my team, Sara and Emily, were really aligned with making sure that I was very comfortable, that I wouldn’t be moved around too much after giving birth. I really emphasized as well that I wanted to try and avoid giving birth on my back because I knew that any additional pressure on my hips and lower back would probably lead to a longer postpartum healing for myself just because of my condition. Everyone seemed very aligned. As we neared closer to 39 weeks, that’s when we started to have discussions about induction and things of that nature. One thing that is standard practice where I live is that you would have a consult with an OB and an anesthesiologist from 20 weeks which I thought was crazy. At the time, I said, “I don’t want to have an epidural. I don’t want to have an OB involved in my birth process at all. I don’t want a C-section. I’m not even meeting with these folks because I want to manifest the birth that I want.” So they were a little caught off guard by this. They did try and schedule me again. I believe it was around 30 weeks and I just declined again so being informed about what my options actually were in terms of what I can accept or say, “No thank you” to was very important and for anyone who is going through the process as someone who is living with a disability, I think you really need to make sure you do educate yourself on what you can say no to because you have that extra layer that people can always fall back on to say that you are kind of treading the high-risk zone. You can push back on that politely and say that you are not high-risk. That’s why you are here and that you prefer to just stay with your current providers and your current care plan. Meagan: I was going to say too that Julie mentioned this on a previous episode that I loved and is sticking with me too. You can say, “How will my care change if I do this? If I meet with these people or if I have these extra visits?” You can say, “How is this going to change?” If they say, “Oh, it’s just to let you know who they are,” then you’re like, “I don’t care.” Jacqueline: That’s essentially what I did in person was saying, “Why do I need to meet with an OB?” They said, “It’s standard practice here.” I said, “I really would prefer not to. I am working on a huge project right now with my professional career. I have two other kids. I just don’t have the time or capacity to be having meetings with someone who probably won’t even be on shift when I give birth anyway. So respectfully, no thank you.” At the 39-week mark, we discussed what would be our next steps if I did go over 41 weeks which in my province is sort of your cutoff time from when you can give birth without induction for a VBAC. So within my community, VBAC anywhere other than a hospital was just not even discussed. Because of my condition, I did agree that I would do a hospital birth. Now, if I ever had another child, I would probably actually want to try for a home birth. But yeah, I went into the process trying to keep an open mind, trying not to be too judgmental going into a hospital environment. I spoke about this a lot with my doula team. I got to hear a little bit about their experiences within this hospital because they had supported clients there to give birth. I had a friend who is a nurse there in the labor and delivery department as well. Ultimately, everyone gave me very positive reviews which put me at ease. I think it’s important as well to do a little bit of research about the care team that you select and the hospital that they have privileges in. If the hospital where they have privileges isn’t necessarily VBAC friendly, then maybe it’s a good idea to get a different care team. That may be something that is very Canadian-specific, but our midwife teams only have privileges in certain hospitals, so you have to make sure that you do that extra little step of research. I also spoke to a lot of moms in a community called Mamaraderie here in Hamilton, Ontario. I hope I’m pronouncing that correctly. A lot of the moms shared very positive VBAC stories. I was actually referred to the podcast several times by moms who I spoke to which was great to hear as well. Yeah, basically from that time forward, the talk was really just how do we ensure that I have a successful VBAC with my midwives? They didn’t really speak to me too much from their end about induction. They recommended that I have a consult with an OB at the hospital. I went in and I spoke with a resident. I believe she was a fourth-year resident. To be quite frank, the experience was terrible. She essentially told me that if I needed to be induced, my care with the midwives would end until my baby was born and that they would not be there with me when I was laboring because their care was redundant which I found to be incredibly insulting. Meagan: Yeah. Jacqueline: I was just floored that she would state that. She did emphasize that the decision if I wanted to be induced or I wanted to wait out labor was my decision. She spoke to me about C-section even though I expressed that I did not want it. She said, “Let me just cover my bases and tell you what your options are.” I respect that. It’s probably what she was trained to to but it definitely put my guards up because I explained in detail why as a person with FSHD, it is not in my best interest to have a C-section, then when she provided all of my different options, and I was also big on hearing the statistical options if I waited to go into labor naturally or if I was induced in a more controlled environment type of situation what the best outcome would be, I had heard all of these statistics through the podcast but I didn’t listen to one specific episode talking about induction yet so after I had a major breakdown after leaving the hospital, I spoke to another friend of mine who is also a doula and she recommended listening to the episodes specifically on induction. That helped a lot more than speaking with the resident to bring some clarity in terms of what the best outcomes will likely be if I were to wait versus if I were to go down the induction route again. I already knew from my birth with my daughter that induction using oxytocin doesn’t even really necessarily work very quickly for my body. I wasn’t really convinced that it would speed up the process. If anything, I remembered it being a 10 pain from the beginning with very minimal dilation and an incredibly long process. I knew that in my area as well, if I’m birthing in the hospital environment and I’m induced, I need to be monitored 24/7 and that meant that I wouldn’t be able to move around. It meant my plan to have early labor in the bath would no longer be an option. It also meant that if I went over the 24-hour mark, I wouldn’t even have a choice. They would just tell me that I would need to have a C-section per their policies. I said, “Okay. I’m going to give myself more time.” From 38 weeks, I had been going to chiro again weekly. I’d been doing massage weekly. I started doing acupuncture once a week and I also started doing things like the Miles Circuit and things of that nature to try and induce labor. One thing around the 39-week that started was that I was having contractions that would stop after a certain number of hours. Even if I did movement, I would take baths trying to check if they were Braxton Hicks. I’m still not entirely sure what they were because they felt a little bit stronger than when I had Braxton Hicks but they would just stop. Meagan: Like prodromal labor. Jacqueline: Yes, starting from pretty well the 39-week mark. Then there would be days at a time where I would have nothing. In week 40 I knew, Okay. my deadline is next week. I need to amp this up a bit. My entire care team at The Wellness Hub were all fixated like I was on my having a VBAC. Now at this point, when I would come into my appointments, everyone would be waiting at the door because that would mean I’m going into labor. I felt like I had a very supportive team around me and we started to do acupuncture twice a week during my 40th week. I also was going to chiro twice a week and doing massage as well. I think even in my 40th week, I did massage twice in that week. I took one of their cancellations. Meagan: Yay, good for you. Jacqueline: We did everything humanly possible to try and induce labor naturally. Because I had never experienced a sensation of natural labor, I didn’t know what to expect in terms of the sensations. My doulas didn’t necessarily describe it or know how to describe it either in terms of what was not labor and what was. We were all just waiting around. Every time I would have contractions start and stop, they would be like, “Okay, maybe it’s going to happen but it’s probably not because it’s been many days of it starting and stopping.” Jacqueline: On March 7th around 1:00 AM, I started to feeling contractions again but much like my doulas, I said, “Oh, I’ll sleep through it.” They started to intensity and get more close together, but my first son was a terrible sleeper and so he used to wake up about every half hour to an hour so from a sleep perspective, I’m very used to waking up often. So when my contractions started getting closer together, I didn’t really think too much of it. My son came into my room around 2:30 that morning and I realized, “Oh my goodness. My contractions are 5-7 minutes apart at this point for the last hour.” He came into bed with my husband and I tried to stay in bed, but they were just too strong so I went into the bath. I realized I had lost my mucus plug.I got in. I was trying to remain comfortable in the bath. This time, they were just intensifying so I had a feeling that this was early labor. Meagan: Yep. Jacqueline: I remember my daughter came into the room. Initially, I asked her to be my mini doula before I called in my doulas and she saw me in pain and I could tell by the look on her face that she was not going to be my mini doula because she was terrified. She said, “Are you okay?” She stayed with me for some time and eventually, she went back to bed. I stayed in the bath for about an hour just breathing through contractions. I think it was 45 minutes in when I started to time them using an app just to know if I should contact my doulas and say, “Things are starting to happen.” The week prior, I did my first cervical check. I was less than 1 centimeter dilated. I knew my body. I knew that I don’t dilate easily. I remembered that from my first birth so I just mentally prepared myself for what could be a long labor. My contractions around 5:00 AM were about 5 minutes apart. I live about a half hour away from my hospital so I knew that I should probably contact my midwives to just let them know that contractions were 5 minutes apart. When I gave them a call, they said to come in around 6:30-7:00 AM unless things really intensified then come in immediately. I woke up my husband. My dad had actually driven down from northern Ontario to come and stay at our home just because I had a feeling. I gave birth on a Friday and on the Wednesday I told him that he should probably come. I just knew that I probably wouldn’t even last until the weekend when he anticipated to come. So he came and took my son. Yeah, things just got more and more intense. By the time we got to the hospital, I was breathing through contractions about every 4 minutes. Sometimes they were a little bit closer together so we went up to labor and delivery. We saw our midwife and she told me that I was still 1 centimeter dilated and that it would probably be a long process. She recommended that we come back home which we did. I didn’t feel too disappointed at that time because she recommended I return home because she knew that I wanted to have more ability for movement. She knew that would help with my condition and she also knew that I wanted to be able to be in the water. I really appreciated that she had that recommendation. I let my doulas know that that was what was going on. Initially, when we went in, we called one of our doulas to give them a heads-up that we were headed into the hospital. We ended up staying at home for about 2-3 hours where I really tried to move around. I would recommend to anyone who has this type of condition as well that movement really is your best friend.Even though it feels like it won’t be comfortable, in your postpartum recovery, you will be grateful that you moved around and didn’t stay stagnant in one position. We were only there for about 2.5 hours. My mom had driven down that morning as well and she just watched me trying to get some rest in bed. My contractions were about 2-3 minutes apart at that point. I said, “I don’t feel like he’s descending so I’m not worried about that,” but she said, “Your contractions are so close together. I’m worried you are going to give birth in this bed at any minute.” I knew that we were not there because I could feel that we weren’t there. They were very close together and they were intensifying so we did go back in. From there, things went pretty quickly. Well, it felt pretty quickly but it was not pretty quickly. We got in and I had a replacement midwife so she wasn’t someone from my initial care team. My midwife actually was feeling unwell between when I saw her in the morning and when I got into the hospital. But oddly enough, this midwife, Elizabeth, reminded me so much of my mother’s best friend. She looked like her physically. She sounded like her so I felt like it was someone close to me even though I had never met her before. She surprisingly recommended the internal monitoring to me several times which I declined and I will say for anyone who has a midwife, often we don’t anticipate that anything will be recommended by a midwife that maybe we are not comfortable with, but if that happens and even if you have the best relationship with your provider and you fully trust them, you are still allowed to decline an intervention if it’s not medically necessary. Meagan: Yes. Jacqueline: So I did do that very respectfully as well. I was monitored 24/7 throughout my process of being in the hospital. When I initially came in, my son’s heart rate was not accelerating at the rate that my midwife thought we should be seeing so with that, she admitted us. Initially, she had just started out with the monitoring and was going to send us back home because I was only 2 centimeters dilated but she decided to keep us there. The OBs that she consulted with when she saw the heart rate acceleration was not where they typically like it to be, they weren’t concerned which also put me at ease because they obviously were not providers who were trying to rush me into a C-section. She had explained to them what my background was and how I really wanted to avoid it and they already seemed to be aligned with that. That brought me a lot of ease too. We went through that labor process of again lots of movement. My doula came in. She had me doing as much as she could to help me ease my pain. Around 9:00 PM, I decided that I wanted to get an epidural. Largely to be honest and transparent, it was because I found that cervical checks which are often aligned with a VBAC in our province anyway. You have to have that monitoring. I found it to be very triggering and I felt my body tensing up and becoming less and less open and comfortable every time I had to have one done. I did try and delay them as much as I possibly could, but I also understood why they needed to happen to see how I was progressing because I had been in labor for several days at that point. I had essentially started having the prodromal labor 3 days prior. I knew that my baby was going through that. I was also a little bit more accepting to going outside of what I originally thought my birth plan would be. I was exhausted at this point too so I wanted to try and have a little bit of rest. When the anesthesiologist came in– and this is where I would actually recommend for any folks who have a neuromuscular disease or anyone with a similar condition to do that initial anesthesiologist visit which I initially declined. I regret doing that now because when I did need to get an epidural done, the anesthesiologist had done a lot of research so it took her about an hour just to come and give me my epidural. She explained it was because she was actually researching my condition to make sure that she wouldn’t do it incorrectly and make sure that I would actually have a successful epidural. Meagan: If you had done the consult, would someone have already done the research and put that in the notes? Jacqueline: Yes. Yes. She also told me something that I had never heard before as well that within labor and delivery specifically, there is one drug that can be sometimes given for pain management that a person with muscular dystrophy is not supposed to have so she said she wrote in my chart that I was allergic to that type of medication just to ensure I’m never given it. She said that she doesn’t anticipate that it would affect someone with my type of muscular dystrophy because my lungs aren’t necessarily affected but for some folks who have other forms of muscular dystrophy, it can be fatal. She said just for the future if I ever needed to have any type of sedation that I should try and do a consult earlier. That is a good recommendation that I would have for any folks even if you’re thinking you’re not going to have an epidural in your birth plan, I would say to still go for that specific appointment just so they can get your health history and have it in your chart, in your notes, get to know you, and make sure that they are advocating for you when you are in the hospital. Part of my recommendation as well would just be to put your pride aside sometimes. I myself thought that I was protecting myself in not going to those appointments and doing the best form of advocacy that I could but I was actually hindering myself to an extent. Meagan: Yeah, but at the same time, they didn’t say anything like that. “This is the reason why we would like to meet with you.” Jacqueline: Yeah. I did explain that to my midwife team afterward as well and said, “Please share widely throughout the community because I think for anyone with a neuromuscular condition, we can give birth successfully. We are not high risk, but this element should be noted and you should explain that in this way so that even if a mom is not wanting to have an epidural, in the case of an emergency, she is not given a drug that can be fatal for her.” Meagan: Right, yeah. Jacqueline: So it was that piece of advocacy. After I had the epidural, we had the OB come in for a consultation because I had been laboring near the 24-hour mark at this point. We started talking about the potential of having oxytocin. I wasn’t explicitly against any forms of induction because again, I had been laboring for 3 days off and on but I just wanted to try and hold off as long as possible. It was an OB resident who I spoke to. Her name was Dr. Tam. She’s fantastic. She just explained why this process would be beneficial to start now. She said she would need to do a cervical check just to see where I was at from my previous check about an hour prior. They said they typically like to see dilation by 1 centimeter each hour when you are a VBAC patient who’s admitted. So at one hour prior, I was 4 centimeters and when she checked me, this would be close to 10:30ish, I was a 6. There was progress and I said if I’ve gone more than 1 centimeter within the last hour, do I even need the oxytocin now? She spoke with her attending who said, “They could hold off,” but if I wanted to prevent myself from having a C-section, it might be a good idea just because I had been in labor for several days. At that point, I understood and we had also seen some heart dips a few times which were easily resolved through movement, but they said, “We really want to support you in not having an emergency C-section and have the VBAC that you’re wanting. You decide, but we’ll have the conversation again in an hour if you don’t want it.” I decided that I was okay with it just to see if things would progress with having one dose of oxytocin. I did express that if after one hour that we didn’t see any change that I wanted to be off the drip essentially and just let things progress naturally. They were comfortable with that. We tried it and at that time as well, my doula put me into a certain positioning which I felt to be very beneficial for my progression. That was the flying cowgirl position. Meagan: Yeah, with the peanut ball. Jacqueline: Yes. One of the nurses had recommended a different position, but Leanne stepped in and said, “I think we should put her in this position.” At the time, my midwife was still there. She said, “Yep. I agree. Let’s do it.” They got me into that position. I was in that position for about 15 minutes and then I felt an insane urge that I needed to poop. This is kind of a funny story that moms will relate to and probably laugh at but I just kept saying to the nurses and at this time, my midwife said, “It’s going to take you a few hours. I’m going to take a rest and come back.” I said bye to her but then I was talking to the nurse and said, “Look. I haven’t pooped in a few days. I’m realizing now I need to do that. I have an epidural so I can’t go to the bathroom. What do I do?” The nurse just told me, “You don’t actually have to go. It’ll happen probably when you’re pushing. It happens to everyone. Don’t worry about it.” I was trying to articulate that no, I have to do it. Meagan: I actually have to. Jacqueline: I’m going to do it on this bed if you don’t get something to put under me. She wasn’t listening to me and I was just going back and forth with her. My husband later told me that he thought I was loopy from whatever drugs they gave me, but long story short, I cleared space for the baby. My doula supported me in cleaning myself up and the nurses cleared everything away. They were actually surprised because they did not think that I actually had to go but I said, “I know my body even though I don’t have 100% of my feeling. I know that I had to do this.” Then from that point, I kid you not. It was maybe 15 minutes later. I was told that I was 10 centimeters. They had gotten me back ito the flying cowgirl position after I cleared out everything and I just felt like I needed to go again. I said, “I feel a lot of pressure.” At this point, actually my epidural had stopped working. I started out feeling some contractions on the left side of my leg which spread and I could feel everything pretty well. I wasn’t mad at it because I wanted to be able to feel my contractions when I was pushing anyway so it was kind of the best of both worlds. I had gotten about an hour and a half to rest and let my body regain some energy then I could feel everything again. It ended up being what I wanted. I was telling my doula, feeling this pressure again, feeling like I had to poop, and the nurses got this look on her face like, “Is she crazy and does she have to go again or is this the real deal?”One of them looked and I declined a cervical check again. I said, “I’m sure if it’s happening, you’ll see a head.” They said, “Okay, we need Dr. Tam to come back in.” She came and she said, “I need to do a cervical check again.” I said, “No. I don’t want one.” I was feeling contractions fully at this point. I said, “I’m feeling too much pain. I don’t want a cervical exam. I’m not doing it.” She stood there and waited for about 15 minutes and she was like, “I really need to check you because I can see that things are progressing and I think you’re in transition.” I just huffed, “Okay, fine.” I let her do a cervical check and she said, “You’re 10 centimeters and it’s time to start pushing.” I said, “I’m not ready to start pushing.” I did not feel like he was in the position to start pushing yet. They all just sat there. They called my midwife back in. She fortunately was just at her car about to leave. She ran back inside. By the time I felt ready, she was on one side and my doula was on the other side of me. They asked me what position I wanted to be in. I tried with side-lying. My OB was also very supportive of that and I think if you’re a person with a disability advocating for the position that you’re most comfortable with is very important. The only piece of advice I would have for anyone who planned for an unmedicated birth is to have your plan B if your plan does change in the moment and you decide you want an epidural. That was the one thing and as a doula, I should have known better, that I did not do was prepare other positions that would be aligned with an epidural. I really only in the moment could think of side-lying. When it wasn’t as effective as they wanted to see after a few pushes, they recommended, “Okay, let’s try on your back.” Because I was just in the zone, I agreed. I had my doula on one side and my midwife on the other side then Dr. Tam was in front of me and my husband came and joined me on the side. I really just focused on my breathing. I initially started out holding his hand. At some point, I let go and hung on to the sides of the bed which gave me some momentum. I found it gave me also that sense of control as well which I found very beneficial as a survivor and also as someone who wanted to feel in control of their birth. I didn’t really listen to what anyone was saying in terms of, “Okay, keep pushing. Push, push, push,” or timing things out. I just pushed when I felt like I had the sensation to push and stopped when I felt like I need to take a break. My midwife was telling me when I needed to soften my legs and my doula was on the other side. She was going through deep breathing and I was following her in those deep breaths. I had my eyes closed the entire time and Dr. Tam and her attending came in at some point and was another voice I had never heard before but my eyes were shut. I was just focused. They were all being very encouraging and they shared with me when his head came out. He was much bigger than anyone had told me. I did a scan at 37 weeks and was told that he would be around 6 pounds. He ended up being 8 pounds, 11 ounces so they were a little off, but everyone in those final moments helped really guide me through that process in a very empowering environment and we had very minimal interventions to get him out. He came out all on his own and it was just a beautiful experience getting through that last chapter of my birth. Yeah. We had him placed right on my chest and it was just a very, very empowering, beautiful VBAC which was exactly what I was hoping for. Meagan: Aw, thank you so much for sharing that. Huge congrats. Jacqueline: Thank you. Meagan: Oh my gosh. I’m so glad that you were able to advocate for yourself through that journey too. Through every journey, you were advocating for yourself and even in some moments when you were like, “Okay, I’ll do that.” I think that really speaks to sometimes how labor is. You don’t have to ever say, “Okay” if you don’t want to, but getting the education, feeling comfortable, and sometimes saying no a few times, then maybe later you are okay with it. It’s really important to know that your opinion can change as long as it’s your opinion that is changing. Jacqueline: Exactly. As long as you come into it from an informed perspective and not being afraid of asking your providers why something needs to be done is very key as well. For someone who is living with a disability, I’d say that when it comes to your birth, envision what you want for your postpartum experience as well and allow your birth to inform that next chapter. In my birth process, I wasn’t necessarily thinking, Healthy mom, healthy baby throughout the entire experience. Of course, that’s obviously what you want, but I was also thinking, How will this next step influence what my postpartum experience will be like? I think that’s very important. Meagan: Yeah, very, very important. How will this answer or next step impact me moving forward? I love that you talked about postpartum specifically too because you have a prolonged postpartum. How was this postpartum? Did you bounce back a little faster? How did it differ? Jacqueline: It was so different. Even far better than I could have imagined for myself. Largely, I think that was due to the chiropractic care that I was receiving, going for the acupuncture, and going for the massage. My body was just so ready to not only give birth but also to support me in my postpartum journey. I did feel the effects of pushing on my back. My pelvis locked up very intensely after but I didn’t freak out or panic. I just called my team at The Wellness Hub and explained that I would need a very gentle assessment and they had me in within the first few days of returning home so I would have more mobility and that really helped with my postpartum experience as well was having that mobility back. Build your care team that will not only support you in your pregnancy but also in your postpartum as well. That goes for everyone and not only moms with a disability. Meagan: Yes, absolutely. I really think that when it comes to birth, investing in ourselves and our birth and our postpartum experience can be hard naturally sometimes as moms. We put ourselves last because we are taking care of kids and partners and all of the things, but doing those things like chiropractic care, acupuncture, massage, pelvic floor therapy, and all of these things– hiring a doula, hiring a birth team– these are things that may have a cost but really, you deserve it. You deserve it. In the end, are you regretting anything that you did? Jacqueline: No. I was doing all of the things to try and induce my labor which afterward, I thought, I spent all of this money. It took so long. Then I stopped myself from those negative, intrusive thoughts and thought, Do you know what? You got your natural labor that you wanted. You had your VBAC. Your body has quite literally- it took me about one week to start feeling like myself. I had no tearing either. I just felt like all that preparation was not for nothing. I think if you invest in your knowledge and your physical being, it’s never a waste. You can’t take care of anyone unless you take care of yourself. Meagan: 100%. It always comes back to the airplane analogy for me where they are like, “Hey, you have to put your own oxygen mask on before you take care of other people if the plane is crashing. You really do. You have to invest in yourself and take care of yourself.” Really quickly, I just want everyone to know that I have a PDF that we‘re going to include in the show notes. It’s called “Practical Notes for Anesthetic Management for a Dystrophy Patient”. I’m going to put that pdf here in the show notes. If you do have a muscular dystrophy– oh my gosh. Jacqueline: Dystrophy. Meagan: I feel like I’m saying it funny. Dystrophy condition whether it’s more severe or less severe or whatever, it might be something that helps you and take that note. If you’re going to need an epidural, make sure they know so you can talk over what’s okay and what’s not okay. I’ll have that in the show notes for you. It’s a PDF easily readable and it’s got all of the stats and studies noted along the way. Okay, thank you so much again for sharing your story. I’m so grateful for you and for reaching out. Congrats again. Jacqueline: Thank you so much for having me. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
01:10:3729/07/2024
Episode 320 Cord Blood Banking with Diane from Cryo-Cell

Episode 320 Cord Blood Banking with Diane from Cryo-Cell

“With cord blood, hope really knows no bounds.”Diane Paradise is living proof that cord blood transplants cure the incurable. Diagnosed with a rare form of Hodgkin Lymphoma at only 24 years old, Diane fought an extremely hard fight as it returned five more times before age 42. It had now become stage 4B and metastasized to her bone marrow. With no other options, Diane was given hope through a clinical trial. She eradicated all of her sick marrow through aggressive chemotherapy and then was given a new blood type through a cord blood transplant from two different donors. 24 days later, after almost two decades, Diane was cured. She has just celebrated her 10th year of being cancer-free and has committed her life’s work to spreading education about the hope behind what banking your baby’s cord blood after birth can do for your family. Meagan and Diane talk about what cord blood banking is, how to enroll, how much it costs, and where you can find all of the information you need about this lifesaving procedure. July is Cord Blood Awareness Month and Cryo-Cell is offering a free seminar on Wednesday, July 31 2024 at 1:00 PM EST. Register at https://lp.cryo-cell.com/fuller-paradise-seminar. Cryo-Cell's WebsiteNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hey, hey everybody. Today’s episode is a little different from the norm. We are actually going to be talking about cord blood banking. We have my friend Diane on the podcast. Hello, Diane. Diane: Hello, hello. Meagan: It’s so good to see you again. She and I met for the first time actually in January of this year, 2024 at a doula retreat and she was there speaking at this retreat about cord blood banking. Cord blood banking for me wasn’t actually a new topic because I had spoken to another company a little while ago about it but there was something extra unique and extra special about Diane and Cryo-Cell is the company that she works with that I was like, We need to share more about this. First of all, her story which I’m sure she’ll share a little bit more about, is incredible. So today, we actually normally would do a review, but I really want to soak up the time with Diane because I know her time is so precious. After the intro, we are going to dive right into what this is even about. Meagan: Okay, you guys. Like I said, we have our friend Diane. Diane is a 29-year, six-time cancer survivor. After fighting a rare and uncurable Hodgkin Lymphoma for nearly two decades, a cord stem cell transplant saved her life. You guys, when she was sharing her story at this retreat, it was so insanely amazing and heartbreaking at the same time. So many things that she’s been through. It says, “This past December, she celebrated her 10th transplant re-birthday. For many years, Diane was a survivorship educator helping women living with cancer and chronic illness. Today she is spending time on the side of the cure educating expectant parents, birth workers, and obstetricians on providing the potential of cord blood for Cryo-Cell International, the world’s first cord blood bank.” Diane, welcome to the show. Seriously, I am so excited for you to talk more about this with our listeners because we do have expectant parents. We do have OB/GYNs and midwives and birth workers and this really is a unique thing and it’s something that is so powerful. I know because I’ve heard your story so I’m just going to turn the time over to you. Diane: Thank you so much, Meagan. First of all, I know your audience is varied but for the expectant moms out there, I just want to say congratulations. I can only imagine the mix of emotions they are feeling right now and one of them is probably a profound sense of hope and anticipation. So for me, hope was two units of cord blood stem cells hanging on an IV pole on December 3, 2013. So let me step back a bit just so everybody can understand. I was diagnosed at 24 years old with that rare, incurable form of Hodgkin Lymphoma. It was back in 1994. I think about that. Wow, I’m aging and I love it. The alternative wasn’t great. Meagan: But you’re still so young. Diane: I am. I am.I was told that this was incurable and that it would keep coming back. It would be more and more aggressive. The chemo would become less effective over time and the intervals between when it came back would get shorter. That’s exactly what happened. It came back at ages 31, 35, and 38. It became really aggressive at age 40. What I mean by that is that it went from stage 2B to 4B. It had metastasized into my bone marrow. I couldn’t walk. I couldn’t drive. I couldn’t take care of myself. I couldn’t even take care of myself alone. Thankfully, I went back into remission around the spring of 41, but it came back a year later at age 42. I spent about a year and a half going through different types of chemotherapy trying to get it back into remission and that’s when the idea of a transplant came up because quite honestly, it was my last chance. It was my last hope. It was in my bone marrow. It was time to either going to heal or it wasn’t. So I ended up in a major hospital and we originally had started looking at bone marrow transplant. We were looking at what they call a half-match and they were going to use my sibling. Now, my siblings aren’t ideal donors. They are older than I am and the ideal donor is 18-35. At that point, I was 43 so I was a year and a half into it. I was 43 so that tells you how much out of the ideal age range my siblings were. Then they called me and said, “Oh hey, we have a clinical trial going where we are going to be comparing the side effects of cord blood versus bone marrow and the effectiveness.” I was like, “I don’t understand. What’s the difference?” They said, “Bone marrow is educated stem cells. They are educated stem cells. They’ve been exposed so any virus that your donor has or has had, when you receive that donation as your own stem cells, you will have been exposed to that whereas cord blood which is taken after the umbilical cord is clamped and cut is pure and uneducated. It has a higher rate of engraftment. It has a lower rate of graft versus host disease which is where your body thinks the stem cells are the enemy. Then it really doesn’t have much of a chance of a virus being there, a latent virus.” I went ahead and said, “Yes. Hello, I’ll take that pure, uneducated. I’ve had a failing immune system for 19 years at this point. Yes. I’ll take that clean, clear, beautiful, pristine cord blood stem cells.” So I went to the hospital. It was around November and I had to do a lot of the pretesting. I went through six days of really intense chemotherapy and one day of radiation to eradicate my own bone marrow, the sick bone marrow. Then I received on December 3, 2013, two donor stem cells. One was from Germany and one was from Michigan. About, it was a few weeks later. It was a few weeks later when they pull a blood test to see where are you on the engraftment. Is there a little bit of one of the donors? And I want to step back. The reason that there were two donors– if I were a child, I would only need one donor, but I’m an adult. That’s a lot of bone marrow that has to go in and graft and replicate in order to ingraft for an adult basically. That’s why I had two of them. It kind of creates a survivor of the fittest. It creates an environment for faster cell engraftment. So then I had the blood test done 24 days later. After 19 years of battling incurable cancer, I was 100% grafted to the Michigan baby in just those 24 days. Meagan: Isn’t that incredible? Diane: It really is. I was cured by cord blood in 24 days. Meagan: 24 days after years and years. Diane: Almost two decades. Meagan: Yes. Diane: Yes. So think about this. I want you to really think about this. What is often tossed as medical waste is what saved my life. Meagan: I encapsulate placentas, the actual placenta itself and there will be so many times where people are like, “Why would you do that? That is garbage.” They literally say that. They think that. Placentas are garbage, but look at what it’s done. It saved your life. Diane: Well, the cord blood did, yes. Meagan: The cord blood which I understand they can throw the placenta away after they get the cord blood out. Is that correct? Diane: So what we do with cord blood is that after it is clamped and cut, they actually insert a needle and draw the rest of the cord blood out because the placenta continues to pulse as if the baby is there for up to 30 minutes. That’s the stem cells that we are collecting. Now, if we were to collect the cord tissue that’s after the placenta has been delivered, we will cut and collect the cord tissue if that’s something that the parent is interested in, yes. Meagan: Gotcha. Diane: Yes. So I ended up with a new blood type, just so you know. Meagan: Oh yes, I remember you saying that. Diane: Remember? I remember you liked that comment a lot when we talked about it. Meagan: A whole new blood type. The fascinating thing is even your immune system we talked about how it started over. Diane: Yeah, I had new baby immunizations. I’m 43 years old and 44 years old and getting immunizations as if I never had them. Meagan: Yeah. Diane: I just find that so fascinating. Meagan: It is so fascinating. Diane: So fascinating. Meagan: It is. Okay, so cord blood isn’t being used a ton. Diane: It is. It is. Meagan: Sorry, it is being used a ton. Diane: A lot more than people know, a lot more than people know. Meagan: This is my thing is that it’s not being talked about. Diane: Bingo, ding ding ding. There you go. Meagan: Let’s go into that. Diane: Yes. It’s funny because even I found a transplant video from the day of the transplant where I did a vlog to my family and friends and I talked to them about these two women who selflessly donated their cord blood and how it would potentially save my life or potentially could save my life. I was like, “I don’t even know how they do that.” The video was really funny. What I realized was once I got done with it, I went down this rabbit hole of, I need to know more. Once it cured me, I wanted to know everything. Meagan: I’m sure. Diane: What I found was there was a lot of information out there and it’s being used in a lot of ways but there’s also misinformation. You had mentioned that I was a survivorship coach leading up to this and I was until I moved to Tennessee and I just decided I didn’t want to continue that and I wanted to be on the side of the cure and for me, that was cord blood. Fast forward to today, I am working for Cryo-Cell International and now, I can recognize and help people with the misinformation and myths surrounding cord blood banking. You talked about it not being used. That is simply not true. We just don’t know about it. It is actually an FDA-approved treatment for nearly 80 different diseases including blood cancers, and anemias– we have a whole list on our website but there have been 50,000 transplants worldwide and there are 175 active clinical trials for things like autism, multiple sclerosis, cerebral palsy, adult stroke, Alzheimer’s, dementia, Type 1 diabetes, Parkinson’s– because what it is, cord blood is rich. I don’t want this to be a big science class lesson, but it’s good for people to understand because we have two different things here. We have cord blood and we have cord tissue. Cord blood is what is called a metapoetic stem cell and that is what creates all of the cells in your blood and immune system which is why it was able to replace my stem cells with my donor’s. They are a perfect match for the baby. They are a 50-75% chance of a match for a sibling and there are a lot of sibling transplants and an acceptable match for parents. Now, the other side of it, the cord tissue, is a different type of stem cell which is the mesenchymal stem cell. They do something a little bit different. That’s in the Wharton’s Jelly so they are capable of becoming structural and connective tissues like bone, fat, and cartilage, and they can modify immune functions to help treat autoimmune diseases such as arthritis and diabetes. I recently listened to a doctor out of UC Davis. Her name is Dr. Farmer and she used the stem cells from cord tissue on the spine of a baby with spina bifida in utero. She did the surgery in utero and closed up the opening where the spinal cord was exposed and the baby came out wiggling their toes and moving legs. Pretty amazing. Meagan: Wow. Diane: Yeah. And there’s a lot being done with this. There are over 100 active clinical trials for ALS, rheumatoid arthritis, lupus, Type 1 diabetes again, MS, Crohn’s, and spinal cord injuries– I mean, there are just so many active clinical trials for different diseases out there. It is being used. Cord blood is being used and cord tissue is in active clinical trials as well. Meagan: Wow. So especially for our pregnant mamas and expectant parents or even birth workers wanting to share this information with their clients, what is the process to do this? We know a lot of the benefits right here. We just went through so many of these benefits. What is the process of getting started? What I think is pretty cool about Cryo-Cell is that they can send the kit to you. I saw the kit you have brought as an example. Can you walk listeners through what it’s like in case they are interested in doing it both physically on what the steps are and even financially if we can talk a little bit about that? Diane: We can.Meagan: Then storage-wise, how long? There are so many questions. Can we talk about that process? Diane: Absolutely. Absolutely. Okay. I’m trying to think of where we should start with this. There are so many questions you just asked me there. Meagan: Sorry, I just threw a lot at you. Diane: Like, hmm. Where do I begin? Another myth– so if somebody wants to save for themselves, one of the myths we hear is that it’s expensive. 10 years ago it was. Now, it’s more affordable and Cryo-Cell has, first of all, we have the most amazing kit. You mentioned it. I will repeat that. We have a kit that has a handle on it. It comes to you. You open it up and it has everything right there, the forms for you to fill out, the information for you to give the delivery physician. All of that is right there. When you enroll, you get the collection kit, the shipping, the medical courier, the processing, and testing because after processing, once it arrives back to us, it has to be processed and tested as well as the first year is storage. That price because it has that initial fee in it ranges from $800-2000 whether it is cord blood or cord blood and cord tissue. However, we have a risk-free enrollment so nothing is charged at the time that you enroll. If you decide not to collect, call us and ship the kit back within two weeks and it will be no cost to the expectant parent. Then after that, if they do enroll and we get all of it and it’s processed, the annual storage fee runs between $185 and $370. It’s $185 for cord blood and then $370 for cord blood and cord tissue. We offer flexed payment plans. We offer monthly specials. There are discounts for returning clients and families with multiple children. We have military discounts for retired and active and also medical professionals. If your friends and family want to purchase gift certificates for you, they can do that as well. We have that ability. The thing that I like the most is that we have a refer-a-friend program. If you are having a baby, your friends are probably having them too. If you refer your friend to us and they become a client, you get a free year of storage and you can get unlimited years of storage using that program. I do want to just take a quick step back with the kit because our kit is like I said, it’s special. It has everything in it that you need. We have these– I’m trying to think of what they are called right now. Vacuum packs, they’re not vacuum packs. They’re insulated packs because it has to stay at a certain temperature. If it’s too hot out, those packs will cool the collection down as it’s being shipped. If it's too cold out, it will warm them up. It’s pretty special. It is definitely a kit and then it also protects up to 30 times longer because of that. Meagan: Yeah. Which I think is a really unique thing about their kit for sure. Diane: Yes. Yes. Meagan: So they’ve got it no matter what part of the world or what time your baby is born. If it’s in wintertime or summertime– Diane: Yes. It’s taken care of. Meagan: It’s taken care of. You can rest assured. Okay, so they can enroll to be a member. If you do and decide to donate, it gets sent. There’s an initial fee but then there is an annual fee which you can easily get for free by referring friends. We talked about it being shared and it can help siblings and things like that. It is there if you need it. For your instance, is it possible to be a match to somebody then does someone call? How does that work? Diane: No, so my donations came from a public bank. Mine were unrelated donors. Meagan: Okay, because that was a clinical thing too, right? Was yours a trial? Diane: It was a trial, but they already knew that cord blood transplants worked. They were just trying to compare the side effects of each– which has lower, graft versus host. Meagan: So it was just being donated from a bank. Diane: Yes, from a public bank. If someone can’t afford to private bank for their family, there is the option to donate like what saved me. Meagan: That’s where I was getting at. This is perfect. Diane: That is free and that is anonymous. You can give someone a chance at life whether it be through a transplant like I received or through research. Cryo-Cell has public donation sites in Florida, Arizona, and California. If there isn’t one in someone’s area who is listening, I’m sure you’ll put out my contact information and they can contact me directly and I may be able to help them find a way for them to donate. Now, there’s a couple of things that I want people to understand about the public donation option. If you can’t afford to private bank, this is a great option because the only other option is for it to be medical waste. Let these be the only two options for you and that’s why I’m like, contact me. I might be able to help. I want you to understand that I did have two donors. Only one of them was from the United States. They had to go out of the States to Germany to find me a second match. Whether it’s bone marrow or cord blood, it isn’t easy to find any match when it comes to that type of transplant. If there is a family history of any of the diseases that I mentioned earlier, I really urge people to consider private banking to safeguard your family’s health because when you donate, sometimes people think, Well, I’ll just donate and it’ll be there if I need it. Well, 8 out of 10 units that are donated go to medical waste anyway because of family health history or low collection volume and they are being used daily. The ones that are there are being used daily so most likely, you won’t find it if you need the cord blood for your family. Meagan: Right and your family is more likely to be a perfect match, right? Diane: With the matches, it is a perfect match for the baby. It’s a 50-75% acceptable match for a sibling and an acceptable match for the parents as well. Meagan: Right, yeah. So pretty awesome chances. Diane: Yes. Yes. Because of the audience, I want everybody to understand because this is probably the #1 myth that I get from parents that I hear a lot. That is that, Well, I want to delay cord clamp so I can’t save the cord blood. I want you to know that you can. 10 years ago, that was probably true. Today, if they follow the ACOG recommendation of a 30-60-second delay, you can delay and save. It may yield a smaller collection so basically what that means is it’s really crucial to select the best processing method. For instance, our PrepaCyte processing method is more advanced. It provides a cleaner yield and that is what makes it beneficial for delayed cord clamping and saving the cord blood. So if that is truly what they want to do, here’s the other thing to know. Remember how I said that you have a risk-free enrollment if you enroll then decide not to collect? If you enroll and you collect and it gets to us and it has suboptimal results, we pick up the phone and call you and talk to you about it. You can decide one way or another if you want to move forward with banking that cord blood. Meagan: Continue. Diane: Yes. And you did ask about how long does this stuff last? Cord blood is living medicine. It is collected. It is processed and it is stored in this amazing five-compartment chamber so you can get multiple uses out of it if maybe it’s a treatment protocol and it’s not one big transplant necessarily which I think is going to become more and more the way of doing things with cord blood. That’s my personal opinion. That’s not necessarily the opinion of Cryo-Cell, but I do see that with all of the reading that I’ve done. Did I answer all of those questions you threw at me? I’m not sure, but I tried. Meagan: Yes, yes. I think you did. You nailed it. Diane: Yes. Meagan: Yes. Yes. Okay, so obviously you chose to work for Cryo-Cell for a reason and you’re telling us all of the things about why but is there anything else that you are like, this is literally why I choose Cryo-Cell and why I suggest them? Diane: Yes. When I was doing all of my research, I looked into all of the cord blood banks, but for me, because I was cured by cord blood. This was why I am still standing here. I wanted to work for a company who did more than just banked cord blood. So when I went looking for that and I found Cryo-Cell, I realized that they focus on cord blood education and also cord blood advancement. They are embedded in every facet of the cord blood industry. They have private which is also called family banking. They have public donation sites. They are always seeking out the best technology for our kids and for our storage. I mentioned those temperature packs. I mentioned the five-chamber storage bag and then our premium processing, the PrepaCyte. So we are the world’s first cord blood bank, but we don’t ever rest on our laurels. Thank you. There’s the word. They never rest on their laurels, so to speak. Why do I keep trying to say that word? That’s hilarious. They are constantly trying to advance research. They are advancing research. In 2021, Cryo-Cell entered into an exclusive license agreement with Duke University and what that does is it grants us the right to propriety processes and regulatory data related to cord blood and cord tissue development at Duke. This year, I love this. This year, we are opening our first infusion clinic where it will be a site for future clinical trials investigating cerebral palsy, autism, and other neurological conditions. This is what I mean. We don’t just collect the cord blood and cryo-preserve it. We are constantly looking for how that can be used. How can it be used to protect the families who have trusted us with their baby’s cord blood? And not just us, but they’ve trusted us and we want to do what’s right for them. Cord blood is all we do. We aren’t part of a larger business model and that’s what makes our quality and our level of customer service unmatched. I knew Cryo-Cell was who I wanted to work for and I’ll be honest with you. The story behind how this all happened was honestly the stars aligning and I happened to be in the same room with someone who worked there. I had a conversation and a few months later, this is where I ended up. I couldn’t be happier. This company is– Meagan: Life-changing, literally. Diane: Yes. Life saving. Meagan: Lifesaving, yeah. Okay, so tell everybody where they can enroll and find more information because on the website, there’s a lot of really great information. There’s more on why, pricing, they go into the cord tissue. They talk about private versus public so all of the things that you’ve been touching on. They’ve got all of these things, a Q&A. There is a really, really great amount of information. Where can they find you? Where can they find the website? How can they enroll and all of the things? Diane: If they want to know more or are ready to enroll, they can go to our website which is cryo-cell.com and they can either chat with one of our incredible cord blood educators. They can click to enroll. Like you said, everything that they are curious about is there. If they want to reach out to me personally, I have an Instagram account for Cryo-Cell which is called @curedbycordblood. I have all of my contact information there. Meagan: Okay. I’m going to write that down right now so we can make sure to have it in the show notes. You guys, it’s super easy in case you forget anything. Just scroll in the show notes. Click the link and you can go read more about how you can definitely start cord blood banking for yourself or like she said, even donate to the public. Diane: Yes. Yes, or for research. Can I just end with one thing for these expectant parents? Meagan: Yes, of course. Diane: Banking cord blood is a once in your baby’s lifetime opportunity. You don’t want to miss it. If you have questions, call us. When I tell you we have the greatest educators in the industry, I mean it. Every bit of it, I mean it. They can answer all of your questions. All I ask is that no matter what you decide, please don’t let it go to medical waste because, with cord blood, hope really knows no bounds. Meagan: Thank you so stinking much for joining us today and sharing this seriously invaluable information. It is so important and it can really benefit so many people. So thank you so much.  Diane: Thank you for having me.  ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
33:5624/07/2024
Episode 319 Caylee's 2VBACs with Preterm Inductions + Cholestasis

Episode 319 Caylee's 2VBACs with Preterm Inductions + Cholestasis

Caylee joins us from Canada sharing her experience with two VBACs after a twin Cesarean birth. She also shares what it was like having cholestasis in all three pregnancies. Cholestasis is a liver condition that slows or stalls the flow of bile. Meagan and Caylee discuss in greater detail what cholestasis means during pregnancy, what symptoms can look like, and how it is diagnosed. One of Caylee’s most intense symptoms was incessant itching. She talks about how it affected her not only physically but mentally as well. While all three of her pregnancies were preterm births and her two VBACs were medically necessary inductions, Caylee advocated throughout her entire labors and was able to stay the course to achieve the vaginal births she knew she was capable of. Cleveland Clinic Article: Cholestasis of PregnancyAmerican Journal of Obstetrics and Gynecology Article: Risk of Stillbirth in U.S. Patients with CholestasisHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Welcome to the show. We have our friend, Caylee, with us and her little wee, tiny little newborn. Caylee: Hi everyone. Meagan: Oh my gosh. Welcome to the show. How old is your baby? Caylee: He just turned 3 months. He was born a month early though. Meagan: Okay, 3 months and a month early. We are going to talk about why he was born a month early. You guys, today we are going to be sharing some stores and talking a little bit about cholestasis. This is something that we actually don’t have a lot about on the show. When you were listening, Caylee, did you? Caylee: I don’t think I’ve heard a single episode, yeah. Meagan: Did you hear about it in general on other platforms? Was it talked about?Caylee: Not really, no. I found it online on Facebook. I’m in the ICP Care Facebook group and that’s super helpful. They are amazing in there and super knowledgeable, but yeah. It’s not very common. It’s quite rare. I think it’s 1 in 1000 women who end up getting it. Meagan: Yeah. Caylee: So yeah. It’s not very well known about and even with providers, providers don’t know about it very well either. Meagan: Yeah. I think that can be part of the problem, right? Because we’ve got providers who don’t know a lot about it and then it can cause a little bit of a panic and then a lot of the times, it can cause Cesareans or lead, I should say, to Cesarean. We’re going to be talking about that today and sharing her stories. Review of the WeekMeagan: But I do have a Review of the Week so I’m going to get into that and then turn the time over to cute Caylee. This is from Cori and it doesn’t say where it’s from. Somewhere in the universe, it is from. It says, “The VBAC Link is gold.” It says, “Of all of the things I did to prepare in pursuing for a VBAC after two C-sections, I think is one of the most important is that I was listening to this podcast. Hearing these stories and information from Meagan and Julie made the dive into learning about VBAC and birth in general so much easier. I was blessed with my VBA2C” so VBAC after two C-sections “with my sweet Brynne Lynn and I sincerely believe I wouldn’t have gotten to that point without this resource and the community. Thank you guys for all that you do.” Oh, that just makes me smile so much because this community– oh my gosh. I mean, Caylee and I were kind of just talking about this. Yes, Julie and I are here, but there is this community, this absolutely incredible community and all of the people coming forth to share their stories. And Caylee, you just said it yourself when you were like,  it’s like all of these people who came and shared these stories impacted you. Caylee: Yeah, totally. Meagan: Yeah, they are the reason. You are the reason right here. Caylee, you are the reason why what Cori said in this review is possible by sharing your stories, by coming in the community on Facebook and on Instagram and having these conversations and learning and also being vulnerable. There are so many times where I see posts where it’s the most vulnerable, genuine post and I can’t explain to you the outpouring of love that I see come in for this person from this community. The VBAC Link Community, just the VBAC community in general, oh my gosh. You are all amazing. Thank you so much and yes, if you want to join that community, check us out on Facebook at The VBAC Link Community. It is a private group. You do have to answer the questions to get in so just keep that in mind. If you are not answering questions, you might not be allowed in. And on Instagram, and of course, if you want to have a review that I could share for the Review of the Week, please do so. We would love that.  Symptoms of Cholestasis Meagan: Okay, Caylee. Are you ready? I’m so ready. Caylee: I am ready, yes. Meagan: Awesome, I would love to turn over the time. Caylee: I don’t know where to start. Should we start by talking a little bit about cholestasis so that they understand the risks? Meagan: Yeah, I think that– well yeah, the risks, the symptoms, and then also how it can be missed and then how it can sometimes– well it kind of goes with the risk, but there are other things that can come in I should say from cholestasis and I actually even had a client myself, a VBAC client after two C-sections. She had cholestasis, preeclampsia, VBAC after two Cesareans, and was induced. Caylee: Wow, good for her. Meagan: Yeah, but preeclampsia, right? Okay, let’s talk about the things. So what are the symptoms that you one, may be experiencing, and two, that there may be that someone might not experience? Caylee: Yeah, so for me, it was intense itching mainly on the bottom of my feet and on the palm of my hands but I had it everywhere. I have scars on my ankles, up my arms, on my belly just from scratching. Meagan: From scratching? Caylee: Yes, incessantly. It’s an itch that you can’t really scratch. It’s in your blood that is making you so itchy so you can scratch all you want and it’s temporary relief but as soon as you stop, it’s like, oh. I broke down in tears so many times and had ice packs on my feet and on my hands while I was trying to sleep. Another symptom is darker urine output and some upper right quadrant pain. Meagan: Yes. Yeah. Caylee: Those are very common and some people also experience jaundice. Meagan: I was going to say yellowing, jaundice. Decreased appetite. Caylee: Yeah. You’re more likely to get preeclampsia and gestational diabetes. Yeah. Meagan: Mhmm, yeah. So nausea, feeling unwell, dark urine, lack of urine output which a lot of the time, dark urine is the beginning of that. Your kidneys are warning you and then you stop. Yeah. I had a client, not the one I was telling you about, but another client. She said that her bowels like her poop smelled really weird, like abnormal. Caylee: Yeah, I’ve heard that before too. Meagan: Yeah. That’s the first time when she was like– that was actually one of her first symptoms that she noticed. Thinking back, she was like, “Yeah, I guess I was kind of itchy, but I wasn’t itchy-itchy until later.” But that was one of the things where she was like, “I just thought I ate something weird.” Caylee: Yeah. Meagan: A decreased appetite. Pain in your belly and your quadrants, jaundice, and of course, itching. Those are the main signs. Caylee: Itching. And the severity of the itching can vary greatly between cases so the first time, it was quite mild and then it progressively got worse throughout my pregnancies. That’s different for everyone who experiences that so if you have any itching, you should ask for LST’s and bile acid tests from your provider. Itching can also precede the bile acids rising and the elevated bile acids is what’s dangerous for the baby. It increases the risks in the baby where they might pass meconium before birth and also stillbirth risk goes up a lot if the bile acids are above 40. Meagan: Too high, yeah. So when you are pregnant, if you are having symptoms, definitely go in and get checked like she said. Get these tests. Then if you have cholestasis, if you test positive and things are looking like you have it, it is something that may increase extra testing and extra visits because you do want to keep a close eye on this. Again, like she said in the beginning, it’s really rare. Even right here, it shows on this link that I’m going to put in the show notes, it’s from the Cleveland Clinic, but it shows 1-2 in 1000 people during pregnancy will experience this. It’s pretty low, but it can be a serious thing. Also, I was going to ask you because I know my clients have in the past. They’ve been given some things to try and control, to minimize, to control, to lower things to try and continue pregnancy to a good, safe term stage. Were you given anything like that? Caylee: Yeah. I was put on a medication called Ursodiol. It helps lower bile acids to make it a little bit safer for the baby so you can continue. With my last pregnancy, they were very severe levels. They were over 100 so it was kind of touch and go there whether we could get him to 36 weeks or not. They were talking about inducing me at 34 weeks. We ended up opting for non-stress tests and biophysical profile ultrasounds just to keep an eye on him. Meagan: And he did well? Caylee: He was doing well. He had already passed meconium sometime before I was induced though at 36 weeks. It was time for him to come out. He was already in distress so it was good that we did end up taking him out at 36 weeks, but he did great. Really great. Meagan: Good. Good. That’s another thing I would like to drop in and note that if you do have cholestasis, it may be something that brings you to something like an induction that is earlier than expected. Obviously here, we’re going to share this story in just a second about VBAC and induction. It’s possible and totally doable, but that is a thing. Cause of CholestasisMeagan: She’s mentioning bile. It is in the liver, right? Am I correct? It’s in the liver. Caylee: Yeah. Meagan: We don’t really know why. I don’t know why. Do we know exactly why it happens?Caylee: They don’t. They think it’s something to do with pregnancy hormones and the placenta, but they don’t know for sure. It’s some sort of genetic factor as well, but no woman in my family who I know has had it. So I think it’s just something that can happen sometimes. Meagan: Yeah. I have heard the hormones like estrogen and progesterone can be too much in the body. So just to circle back around again, if you have had any of these symptoms or if you are having any of these symptoms, it’s okay. Don’t hesitate and go in and get checked out. Caylee: And if you go in and get a negative result and still have symptoms, ask your provider to keep testing you. Meagan: Yes. Go back and check again. Okay, so baby number one? First pregnancy: TwinsCaylee: Twins. Meagan: Twins! Caylee: Baby one and two, my first pregnancy. Meagan: So twins. You had symptoms? Caylee: I did, yes. I got it pretty early on and they tested me and it was negative. They just put me on Ursodiol before anything came back positive. They didn’t do anymore testing or anything. I didn’t have any itching. The medication must have made it go away somewhat. Yeah. I was only 21 when I was pregnant with the twins so I was pretty young. I didn’t know much of anything. I knew I wanted a vaginal birth. I had actually switched providers in my third trimester to somebody who was comfortable with vaginal birth with twins and they ended up being breech when they decided they needed to take them out. Preterm Cesarean at 36 weeks due to breech presentation and IUGRIt wasn’t due to cholestasis, but I did have them at 36 weeks because one of the twins had stopped growing so they took them out. Meagan: IUGR? Caylee: Yeah. Yeah. He was quite significantly smaller than his brother. Meagan: Okay. That can happen with twins too, I know. Caylee: Yeah, totally. Yeah. My twin A was 6 pounds, 7 ounces, and twin B was 4 pounds, 4 so it was quite a big difference. Meagan: Mhmm. Caylee: Yeah, so it was a C-section with them. We were in the NICU for two weeks. Second pregnancyCaylee: I ended up getting pregnant again when the twins were 16 or 17 months old. I knew I did not want to do that again, having a C-section so I found supportive midwives and got on with them. Unfortunately, I don’t know if it’s in Canada, but they don’t allow home birth for your first VBAC for some reason. Maybe it was just those midwives, I don’t know, but I really wanted a home birth and they were like, “No, let’s do hospital. It’s safer.” I was like, “Okay, as long as I can still have my VBAC. I’ll just do that.” The pregnancy went well. I thought I wasn’t going to get it again. No itching, then I hit 34 weeks and the dreaded itching started again. I kind of had a feeling that I had it during my first pregnancy too from my own research. I had mentioned it to my midwives beforehand so we were looking for it seeing if it would happen. They sent me for testing right away at 34 weeks. It came back negative so they ended up testing me again weekly and then at 36 weeks, they tested me and my liver function tests were very high. My liver was basically failing and they didn’t even wait for the bile acids to come back. They just brought me in for an induction. Meagan: What week again? Caylee: I was 36 weeks and 2 days when they started my induction.Meagan: Okay, so technically preterm. Caylee: Yes, yes. InductionCaylee: When I went in, they started with a Foley balloon to help dilate my cervix and that was awful. It’s like a torture device, I swear. But it was effective I guess. It dilated me and then it fell out and I don’t know if they didn’t have a nurse for me or something, but I was waiting 8 hours for them to continue my induction. The OB came in and he wanted to break my water. I said, “No. Let’s start low Pitocin.” He was like, “Well, it’s not really going to do anything if you’re not going to break your water too.” I said, “Okay, let’s see how it goes.” Meagan: Yes. Caylee: We did that. Labor was going smoothly. I loved being in the shower. It was amazing. Then they made me get out because his heart rate was dipping really high so they wanted to get me out and be able to monitor him a little bit better. That’s when things got really intense and I felt like I wasn’t able to cope as well after I got out of the shower. I think in the back of my mind, I was still pretty young with him too for my first VBAC. I was only 24 and I know that uterine rupture risk is very low, but for some reason, I just couldn’t get that out of my mind and every contraction I’d have, I’d just feel like I was being ripped open and was so scared that I was having a uterine rupture. I ended up– it was 32 hours into my induction and I still was at 4 centimeters just because I wasn’t letting my body relax and do the work. I was tensing and fighting every contractions because I was terrified. I ended up getting an epidural at 1:00 AM and 5 hours later, I woke up and was fully dilated and pushed for 15 minutes and he came out. Meagan: 15?! 1-5? Caylee: Yeah, 1-5. Meagan: Oh my goodness. Caylee: As he was coming out, I pulled him up to my chest and it was just this amazing feeling like, Oh my god, I did it. The high that comes with that is unbelievable. Meagan: Yeah. Caylee: I just kept looking at everyone saying, “I did it. I did it.” Meagan: Absolutely. Caylee: It’s an amazing feeling. Meagan: It really is. Caylee: I fought with the OB who was on call a little bit, the one who wanted to break my water. He kept saying, “Does she want to do this? Let’s just go for a C-section.” I’m like, “Yeah, I can do this all night long and he can stay out of my room until I’m pushing. My midwives have got this, thanks.”Unfortunately, because I had to be induced, I had to be overseen by an OB so my midwife ran the show and was able to be with me and do everything, but he had to be there in case anything went wrong I guess. Meagan: That’s kind of normal. A lot of the times, when there is a hospital midwife, there are OBs who oversee them. Caylee: Yeah. Yeah. So yeah, that was my first VBAC, first induced VBAC. Second Induced VBACCaylee: I just recently had another induced VBAC. With this one, my levels went up high. I think it was 28 weeks that I tested positive so it was sooner. Meagan: Significantly sooner. Caylee: Yeah. They went from 0 to 100 within a matter of days. They put me on Ursodiol immediately as soon as it came back positive. I was being monitored weekly with NSTs, non-stress tests, and they were sending me for biophysical profiles as well weekly which is an ultrasound to check on the baby’s well-being. He was doing well so they just were keeping going with that and unfortunately, the Ursodiol did not help my itching this time around. It was so severe. I was in tears pretty much daily from the severity of the itching. Yeah. It was really bad this time. The mental health aspect of having that incessant itching I don’t think is talked about a lot either. It really gets to you. It’s depressing. Meagan: Oh, I would not do well with that. I would find myself getting very anxious probably and out of control. Caylee: Even now, if I get an itch, I get PTSD. It’s like, Oh my god. It’s not going to stop. I freak myself out and work myself up. I remember that after my second pregnancy as well. It was like I’d get a bug bite and I’d just have to itch and itch and itch until it was bleeding. Oh, it was just bad. I don’t know how to leave itching alone now. His levels were very severe, or my levels I guess. My liver function tests were some of the worst that my OB had ever seen. Meagan: Interesting. Caylee: So yeah, it was just really bad. Caylee: I had actually applied for midwives. We had just moved from Alberta for BC pretty much as soon as we found out we were pregnant with Henley here. I applied pretty much as soon as I found out I was pregnant for the midwives here. I ended up hearing back from the midwives in Edmonton which is an hour and a half away that they could see me up there but once I got the itching and cholestasis, I was like, “Just transfer me to an OB where I live. It’s just easier for me then all of my appointments will be out here and I don’t have to drive 1.5-2 hours to appointments in the middle of winter.” Yeah, so they scheduled my induction for exactly 36 weeks because of the high levels. They didn’t want me going past that because with levels over 100 bile acids, the stillbirth risk goes up very high after 37 weeks. Meagan: Did they give you a percentage or anything like that? Caylee: Yeah, I think it’s upwards of 15% with very severe levels. Meagan: Oh wow. Caylee: If levels stay under 40, your risk of stillbirth is around the same as anyone else's. They go up 3% over 40 and over 100, it’s even more. So it was a bit touch and go there. They were talking about inducing at 34 weeks and we were able to get to 36. Still preterm, but a higher likelihood that he wouldn’t need additional support. InductionCaylee: I was induced at exactly 36 weeks. I actually had influenza B when I had to be induced. Meagan: That’s miserable. Caylee: As if labor isn’t hard enough alone, I had to have influenza B. It was great. Meagan: Miserable. Yes. Caylee: Yeah, one perk though was that we got a private room right away. I didn’t have to labor in triage until I was far enough along to get my delivery room or whatever. They put me right in there. I was able to get set up and feel like it was my space and get more comfortable. So yeah, they started with the Foley balloon again to open the cervix. They can’t do Cervadil or a few of the other cervical ripening– Meagan: Cytotec. Caylee: Yeah, because it really does increase the risk of uterine rupture with induction, but the Foley balloon is a safer option and it works. Within an hour and a half this time, my cervix was 4 centimeters. Meagan: Wow. Caylee: From barely a 1. It was kind of funny. I was standing there talking to my husband and I took a step toward the bathroom and it just flopped out and there was this line of blood up and down the floor. It was like a total bloody show. Meagan: Mucus. Caylee: In a perfect line. Meagan: Oh my gosh. Caylee: Because they attach the tube to your leg. They tape it to your leg so when it falls out, it makes a long, smooth line. My husband pulled the nurse call button and she’s laughing. She ended up cleaning me up. Things picked up pretty quickly from there this time. I felt it was much more manageable though. I don’t know if the nurses were nicer this time and they were doing the Pitocin a bit slower because I remember with my first VBAC, the contractions just felt back to back like I wasn’t getting a break at all and it was really mentally wearing me out after 32 hours. I hadn’t slept. I ended up getting the epidural but this time, it felt like more of a natural progression. I don’t know. I’ve never had natural labor, but for me, I was able to handle it a lot better. Maybe that’s because I knew what to expect this time so it wasn’t as scary. Meagan: It could be. Caylee: Yeah, I don’t know. Or I’ve heard too that with cholestasis that the bile acids or something make Pitocin more effective so maybe I didn’t need as much of it this time because my levels were higher. I don’t know but it was much more peaceful this time and I knew what to expect even though I was sick. I labored in the shower for a little bit with the mobile monitor because with inductions, they want to be able to monitor the baby constantly which I know is talked about a lot on here as something that is not ideal. Meagan: Yeah. Even if no induction with VBAC, it’s really, really common if not 100% that your hospital is going to want that monitoring. Caylee: Yeah. And having that mobile monitor though is so helpful if your hospital has one of those. Definitely ask because oh my gosh, it’s so nice to be able to get up and walk around and move and shower. Unfortunately, because of the flu, we were battling a fever. I had a fever so as soon as my Tylenol would wear off, my fever would spike and then his heart rate would go up. I had an anterior placenta so it was kind of in the way of the monitoring and it was hard to get him constantly so they ended up wanting to do the electrode. Meagan: The IUPC and the FSC? Caylee: Yeah, I think so. It’s the one that they put on the scalp. Meagan: Okay, that’s an FSC, fetal scalp electrode. Caylee: Yeah, that unfortunately didn’t work very well. I was bed-bound but I was so sick that I didn’t even really care. I was just switching sides laboring through, using the gas. I loved the gas this time.Yeah. I ended up getting to an 8, 8 centimeters and the OB unfortunately was not the OB who I had through my pregnancy. She had gone on vacation for my induction, unfortunately. I was really sad about that, but the OB on call came in and he was like, “You know, this is taking pretty long. I think it’s time that we start thinking about a C-section. I’m getting worried about your scar.” I’m like, “I’ve done this before and it took longer last time. I am not having a C-section.” Meagan: Good for you. Caylee: I don’t think he really liked that though because he was like, “Well, then you’re getting an epidural because at least if you have the epidural and something happens, we can rush you in and open you up faster,” and blah, blah, blah. I’m like, “It has to be at least 24 hours and it’s only been maybe 12 hours of hard, active labor here. My C-section scar is strong. It’s been over 7 years since my first C-section. We are both doing well. Yes, I’m sick. Yes, his heart rate keeps going up when we have a fever but when the Tylenol kicks in, his heart is going back down and his tracing is normal. Why would I have a C-section?” Meagan: The fact that you’re having a fever is more likely to the fact that you are sick versus that you have an infection.Caylee: Yeah, exactly. They tested me when I got there and they knew that I had influenza B and I tested for Group B strep so I was just having to fight with another OB again which is really frustrating, but yeah. He ended up leaving the room and my doula and my nurse were both like, “Wow, you’re amazing. I’m actually so impressed with you saying no to him.” I guess a lot of people just go with what the doctor says. Meagan: Well, I guess. Caylee: That is why there are so many unneeded C-sections. Meagan: Well, we’ve talked about it on the show where it’s like, I didn’t go to years and years of medical school, so okay, I guess. Same thing with me, I was like, Okay, and went down and had a C-section when I completely did not need a C-section. Caylee: You hope that doctors are saying that when it is actually medically necessary and not when it’s convenient for them. I think he was getting like, It’s been 24 hours. I’m almost off-shift. I don’t know, but I was not having it. It was actually funny. When he texted me, he was like, Oh, you’re 8 centimeters, but he’s -2 position and not coming down. He was like, It’s probably time to do a C-section. I was like, “No, it’s not actually.” Meagan: Oh my gosh. He really wanted to do a C-section. Caylee: Yeah, so I was like, “No, I’m not having a C-section.” He ended up leaving the room and pretty much immediately, I had a super strong contraction. I jumped off the bed trying to get away from it because apparently, that can help. I kind of grabbed my nurse’s shoulders, the poor thing. She is this tiny, little 20-something nurse. I grabbed her shoulders and my body was pushing. I was farting and things were moving down there. Meagan: I bet that baby was coming down quickly too. Caylee: Yeah, that quick movement. Popping up just brought him down and she was like, “Are you pushing?” My doula was like, “Well, that’s a good sign.” I was like, “I don’t think so.” But my body was just doing it and then I barely made it back on the bed before his head was out. Meagan: Oh my gosh. So was the provider even in there? Caylee: No. Nope, he was just leaving the room telling me that I needed a C-section because I wasn’t progressing. Meagan: I know that he had left but I didn’t know if she was beeping him back in like, “Come back in!”Caylee: I guess he was down the hallway at that point and his head was out. I made it back onto the bed thankfully. My nurse was down there taking the fetal electrode out of his scalp panicking a little bit being a nurse. She was like, “You need to keep pushing.” I’m like thinking in my mind, No, I need to rest for a second. His head’s out. He’s fine. I knew in my soul that he was okay. I took half of a second to rest and then my body was pushing again and he was out. Meagan: Oh my gosh. Caylee: He had the umbilical cord wrapped around his neck and his armpit. I thought that maybe was why he wasn’t coming down. Meagan: It could be. Caylee: Maybe he was tangled up in there a little bit and couldn’t come down fully but maybe that quick movement that I did to pop out of bed was just enough to let him come down. It was so quick. I was looking around. My doula ended up riding out into the hallway to call my OB back and my nurse was frantic. She was like, “This was my first baby I caught!”Meagan: Aw, and it was a VBAC. Caylee: Yeah, yeah. I’m looking around the room like, “Whoa. What just happened?” I went from 5 minutes ago being told it was time for a C-section to my baby on my chest. Meagan: Yes. Oh, that is amazing. You know, maybe that person needed to leave to also relieve some stress so baby could come down. That’s another thought I had. Caylee: Yeah, I think that was it and maybe my baby was like, Yeah, we’re not going for surgery, mom. Let’s show this OB what’s up. Meagan: Yeah, seriously. It reminds me– is it the tiger or the lion? I can’t remember the thing, but when you are being chased or when you are in a hostile environment, you either tense up or you run or whatever. We’ve got all of these senses and you could have been like, Nope. I am not having this baby with you in this room. I’ve had enough of your C-section talk. So cool. So after, with all of the babies, but especially with this one because your levels were so bad, were there any complications? Caylee: I guess I did touch on this a little bit before. I forgot though during my birth story there, when they broke my water, because I did allow it earlier this time because I felt with my first VBAC that that actually helped speed things up a little bit. I did allow them to break my water and start Pitocin at the same time this time. When they broke my water, it was full of meconium. They weren’t too worried about it. Thankfully, that OB seemed pretty C-section happy and he was still like, “Oh, no big deal. We’ll just monitor him. It’s okay. There is a risk there for aspiration, but it’s not a total risk that that will happen.” So they were just monitoring that. When he came out, he was fine for being 36 weeks. He was breathing good. They wiped his face because there was the meconium on his face, but no. He was great. It was more me that I was worried. I was like, “Is he okay?” They were like, “He’s fine.” Meagan: Good. That’s so good to know. I was just curious because he was early, high levels, induction, fevers, all the things so that’s so good to hear that he was really great. Caylee: Mhmm, yeah. Even my twins were 36 weeks, 2 days when I had my C-section. They were in the NICU for 2 weeks and that was just for feeding and growing. They didn’t know how to suck and then with my now 5-year-old, he was totally healthy when he came out too. He was 36+4 at the time he was born because my induction took so long with him, but yeah. He was healthy. He did have jaundice quite badly though so he needed the bilirubin lights and then with my baby now, he also had jaundice but he was able to stay off of the lights. He was just under that level for needing phototherapy. That’s pretty common with early babies anyway. I don’t know if that had anything to do with cholestasis in general or if that was just them being early that it was more likely to happen.Meagan: Yeah, that makes sense. Oh, well thank you so much for sharing your story and talking more about cholestasis with us. Like you said, there is not a lot out there. It is not very common so it makes sense that it is not talked about that often. However, uterine rupture isn’t very common but it is talked about all the time. Caylee: Yeah. Meagan: So you know, but it’s good. It’s good to be aware. It’s good to understand the symptoms and what’s going on and why so I’m so grateful that you shared your stories. I’m so grateful that everyone is healthy and happy and wonderful and you are smiling and have some good birth experiences and maybe some healing birth experiences. Caylee: Yeah, totally. Meagan: You showed yourself that you could stand up to pressuring doctors. Caylee: Yes. I honestly thank my doula for being there for my last birth because I don’t know if I would have had the confidence to be that firm with such a pushy, “this is what’s going to happen” doctor. We had talked about it previously that she can’t say anything for me but that she will be there to support and give me the power to advocate for myself. I totally felt that power from her. She was amazing. I’d like to shout her out to Little Loves Doula in Red Deer. She was amazing. Stephanie, she’s great. If anyone is in Red Deer, Alberta, definitely contact Stephanie from Little Loves. Meagan: Well, you know that we love doulas here and always encourage checking out a doula. We do have VBAC Link-certified doulas. She’s got her doula. Yeah. Caylee: I think she was also VBAC Link certified. Meagan: Was she or is she? Caylee: Yeah. Meagan: That’s so awesome. You can check out The VBAC Link doulas at vbaclink.com/findadoula. Let me tell you, it’s so fun to see all of the doulas in all of the different states. We are growing within the States. And if you have a doula in mind who is not on the VBAC list, send them the link. We would love to have them and have them support our VBAC clients and our VBAC community. Thank you so much again. Caylee: Thank you. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
41:5722/07/2024
Episode 318 BadassMotherBirther + How to Make Change

Episode 318 BadassMotherBirther + How to Make Change

“Let’s change the narrative.” From how to be an active participate in your care to how to help get your partner on board with your birth goals, Flor Cruz and Meagan talk about it all. Flor Cruz is the founder of BadassMotherBirther and a long-time friend of The VBAC Link. A two-time VBAC mom herself, Flor is passionate about equipping all moms with the education they need to feel empowered in their birth space. Meagan and Flor share the importance of paying attention to red flags and how to recognize them even within your body. They talk about how feeling safe in your birth environment and being able to acclimate can literally change your birth outcome. These two ladies have been where you are. They know how overwhelming it can be trying to prepare for an empowering and healing birth after tough ones. But Women of Strength, you are not alone. Together, we truly can make birth after Cesarean better. Flor’s WebsiteNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Welcome to The VBAC Link. Today’s episode is with one of my absolute favorite people. Even though I actually haven’t met her personally, I’ve been following her forever and we’ve been doing things and connecting back and forth for years. I am just so stinking excited to have the one and only Flor Cruz from BadassMotherBirther on the show today. We’re going to get into the nitty gritty and really talk about some feelings so be prepared for that. If you don’t know who Flor Cruz is yet, I highly suggest checking out BadassMotherBirther. She is the creator of BadassMotherBirther. She is a doula, a birth and human rights advocate, a childbirth educator, and also a mom of 5 and two-time VBACer. You guys, I’m so stinking excited to have her on the show. We do have a Review of the Week and then we are going to jump right into our episode. Today’s review is by mamaofboys0326. It says, “The Best Podcast About Birth and VBACs”. It says, “I had my first baby after a very unexpected C-section. I had done everything right to try and have a natural birth and things did not go as planned. When I got pregnant again only 6 months after him, I knew I wanted a VBAC but didn’t know where to go for information and support. This podcast was exactly what I needed. The birth stories and education, information, and inspiration that is provided is amazing. It helped me know the facts about VBAC and be inspired to be a Woman of Strength. I am here to say I just had a successful VBAC and I am so thankful for the inspiration that this podcast has provided for me through the whole journey.”Oh my goodness. Mamaofboys0326, thank you so much for your review and congratulations on your VBAC. We love you. All right, let’s get into today’s show.Meagan: Okay, so we’re just going to dive right in because the conversation we were having before we started pressing record was exactly what I feel like I want to talk about today and everybody, right before we were pushing record, we are going to talk about doulas. We are birth workers. We are VBAC moms. We see a lot of stuff and we’ve also been through a lot of stuff so we understand you. We get you. We hear you. We see you. We see it every day in all of the VBAC communities even not in the VBAC communities. I’m seeing so much of the same questions and comments and things. I just wanted to talk a lot about some of those things. One of them was a doula and how we can’t expect them to save us as VBAC birthers, right? I was telling her about a situation with a client who unfortunately came with a lot of question and doubt in what she was being told, but then in the end, the decision that was made which is not my decision to make or judge or anything, but it was a decision that was made that unfortunately turned into the cascade that a lot of us see. The hardest part is that person was pretty upset with us. That was hard. That was hard for me so what she posted a post. I think it was actually this month maybe. I think it was this month and she just said, “The birth plan will not save you. The doula will not save you,” because we hear a lot of people say, “I hired the doula. I did the birth plan. I did this. I did that and it still didn’t work out in the way.” I love what you were just saying about insurance. Can you tell them about that? Flor: Yeah, so I think when a lot of people hire doulas and they take the classes and they do the things and the birth plan, a lot of those things you have to utilize them well. Okay? We are tools. Doulas themselves are interventions. We are interventions for the system. We are an intervention for you, right? Interventions can also create good outcomes. You can get insurance for your vehicle, but if you are not following the rules of the road and you are not utilizing your car the way you are supposed to, then the insurance is going to be garbage. It’s really not going to mean anything. This is the part that people need to realize when they are hiring outside people to come in and help them. There is a certain layer of work that you need to be doing that your doulas cannot do for you. I can’t make you not be scared. I can’t make you participate in your care. I can’t make you make informed decisions. I can’t make you have conversations with your provider and ask them to do their due diligence with you. We can’t force those things. We can suggest things and we can give you information, but at the end of the day, those decisions are your own and when you make those decisions, they come with benefits and risks. The doulas don’t have the magic wand to fix those consequences of certain decisions. We just don’t. I think people have that expectation that the doula is going to come in with this cape and everything is going to be good no matter what decisions are made. That’s just not how it goes. Then there are people who really do the work. They release the fears. They see the chiropractor. They hire the best provider that they can. They are doing all of the things. They are participating in their care. They are asking the questions. They are doing all of those things. They are staying home as long as they can and then sometimes they still have a C-section. Right? Meagan: Mhmm. It’s frustrating. Flor: It’s frustrating but it’s also a reality of birth that some people just do need C-sections. Sometimes you just don’t know why. You don’t know why. Sometimes we walk away going, “Fuck. I don’t know what the hell happened.” Everything was aligned so great, but we still had a C-section and sometimes it’s just a matter of the mammal of their home. I know that is a really hard pill to swallow for a lot of people, but we need to understand that mammals are not inherently built to leave their homes in the middle of labor to go give birth somewhere else in a building with strangers and lights and sounds. Sometimes no matter what you have done, the mammal will not give birth in that environment. Meagan: Mhmm. Flor: It’s not going to give birth within the standard practice that are within those systems. They want to see the baby out within a certain timeframe. There is a lot that is happening. Meagan: Yeah, a lot. We’ve talked about this on the podcast before. When we choose to birth in the hospital which is fine, there is this sense of acclimation that has to happen and sometimes, we don’t acclimate properly. It’s so weird that sometimes I think about the situation too like when I remodeled my house and my wood flooring had to acclimate well and there was a certain part, there was an actual box. For some reason, it was something weird and it didn’t acclimate and it rejected the space. It didn’t lay correctly. It didn’t work. Sometimes our bodies go in and we don’t know why. Sometimes we are tense or whatever and we don’t acclimate well or we finally start to acclimate but all of these interventions start to come in and these other people so then our body freaks out again and then it’s just a mess. It’s just a mess. We can do our best as doulas or birth workers to encourage and motivate, but we really cannot be the deciding factor of you getting induced or not induced or you doing an IUPC or not doing that IUPC. We can’t be that deciding factor so if you’re listening and you haven’t hired a doula or you have a doula, just know that we absolutely want to be there and we love you and we want to help you have a better outcome. We really, really do, wholeheartedly. There have been births where I have walked away bawling actually because I was like, What the hell happened? Then I start questioning what I have done or what I could have done better. That’s so hard and that’s a whole other conversation for birth workers processing that. In the end, we have to make sure as VBAC parents that we really are willing to put all the work in and accept what’s going on and take charge of what’s going on. Flor: Mhmm, mhmm. Yeah and also VBAC parents are probably more showing up with the extra layer of fear. We’re showing up with so much fear and different layers than someone who hasn’t gone through something that was potentially traumatic or a past experience to that degree so there is more, right? This isn’t to shit on hospital births. It’s not about that because I’ve also seen plenty of home births go way south. It’s not about that. It’s about so many things that are not being unraveled. Too many people are showing up to the spaces that don’t know what they are doing that are not practicing evidence-based care that are not upholding autonomy, that are not being compassionate, that are not being vulnerable with someone, that are not staying in the moment with the birth, that are doing everything in a medically defensive manner. Everything is judged by risk and that’s how we are going to move forward. We see midwives do that all of the time. It’s not just the hospitals, right? It’s not always just leaving your home. Someone coming into your home with all of their fucking medical equipment and assistance and charts and cell phones and iPads. That’s all disturbing too. It’s not just the hospitals. There’s so much shit that needs to be unraveled here but at the end of it, one person, your doula, cannot save you from all of that. They cannot. They can make some outcomes better. Yes, the research shows us that.But if you think we are going to show up and 100% save you from so many things, that’s just not the reality. It’s not. Meagan: Yeah, like you said earlier, it can be a hard pill to swallow. Even as a VBAC mom myself, I put a lot of faith and I put my doulas and my midwife on this totem pole over here that was like, “I’ve got this because they’ve got me.” That wasn’t necessarily the right attitude. It wasn’t the right way to enter my birth space. I think I had to process that for a really long time in my 42-hour-long labor and accept that and realize, this is me. This is me. We have to take charge of our birth. But what I think as a doula, one of my biggest messages is that we want to see change. We want to see change in this birth world. There are a lot of things to unravel and change and just fix in this birth world but we are not seeing them happen. So why are we not seeing them happen? Because we are not making the change. That sounds like a lot of pressure on us as birthers, but it is. It is up to us to make the change and until we get out of the status quo and the normal path of what the system wants no matter home birth or not, we’re not going to see change. We have to educate ourselves. Flor: Yes. This isn’t a thing to shame parents to tell them they are not doing enough or they are not making good decisions. Nobody should ever have to step into figuring out how they are going to birth their baby with having to figure out who is the best provider. You should be able to show up anywhere and be able to have 100% support. Already, that’s the problem. We’re showing up to these spaces and not getting what we need. Also, what people need to realize is that the things we have now in the birth space like pushing in the positions that you want, talking about physiological birth, and skin-to-skin contact. Those are the things that were stripped from us through the industrialized medical system and we as the people fought for those things back. Meagan: And still have to. Flor: And still have to. Those are not things that, Oh, it’s great. They’re coming along and giving us all of these things. Everything we have now, you guys, we had to fight back for. It’s going to be the same concepts when you are looking to have a VBAC. It’s going to be the same concept. You have to participate in your care and I get it. Culture grooms us to just listen to our doctors. That’s where the seed is in our foundation. You just listen to the doctor. You are not smarter than them. You don’t have a degree. They are the professional and if you don’t listen, you don’t love your baby enough. Meagan: Yeah, exactly. You don’t love your baby enough or you are putting yourself and your baby at risk by making these choices when intuitively, for years, we were birthing off of intuition. We were truly, I believe, birthing from our intuition many, many, many, years ago and we have lost it. It’s like someone has stripped our ability to tune into that intuition because like she said, we are so groomed to trust this other area. We lose our intuition but it’s so much there. You have it. You have it in your heart and your soul. Your intuition exists. You just have to listen. Sometimes that means going into a quiet place and tuning into what your heart is saying versus what the outside world is saying and burdening in fear. I think that is the biggest part in trying to figure out intuition is, Is this fear or is this my heart saying this? What is right? A lot of people will steer away from home birth when their heart is like, This is where I need to be. My heart is in my home. But for some reason, someone said something so their fear creeps in and now they confuse that with their intuition. Flor: Absolutely. What’s the easiest way to get someone to comply? To tell them that they are endangering their baby. That is the quickest and easiest way to get anybody to comply is to give them the threat of their baby dying. Meagan: That’s what my second provider told my husband. My second provider used my husband. Don’t get me wrong, he’s a great guy. It was a really super dumb thing that he did but he was really smart. He used my husband against me because that’s all I had was my husband with my second, my VBAC attempt, my TOLAC or my CBAC. Yeah. He used him against me. He was like, “Listen. Your wife is not being smart right now. This is not okay. Your baby is at risk.” So what did my husband do? Freak the hell out. “We need to go down and do a C-section. We need to.”But then I didn’t have anybody with me. I had everyone against me because that fear, that one comment of, “This isn’t good for your baby,” that was it. That was it. That was all that needed to be said. Flor: That’s generally all it really takes. But I think if we get to that point with our providers, then the next step needs to be one, stay calm. You need to stay calm. You need to not make that fear a reality in your brain. Your provider has the responsibility to show you the burden of proof. Meagan: That’s a powerful message right there. Flor: That’s your provider’s responsibility right there. They are not supposed to be talking to you without giving you actual, real numbers. By the way, that’s what you need to be asking providers when they’re saying some shit that is real left field is, “Can you show me the burden of proof? Can you show me the real numbers and evidence to this? That’s what I’m looking for.”When we walk into these spaces and we want to say, “I trust my providers,” I think that that’s great that you trust your provider, but that doesn’t mean that you fail to participate in your care, that you fail to ask the questions, that you fail to make informed decisions, that you fail to say, “Let me see the numbers on that. You’re telling me that my rupture rate is 15%. Can you please show me that on paper? And can you please show me out of that 15% rate of rupture how much of that is actually catastrophic which means that me or my baby will die from that?” They will not be able to produce any of those papers because it’s not real. It’s not real. I always tell people this. Put the same energy into finding out who your partner’s exes are. You’re figuring out their Facebook. You’re looking at their pictures. You found their cousins. You found all this information about your partner’s exes. Put that same energy into your providers. Put that same energy into their care. Right? Meagan: You deserve it. Flor: You deserve it. You deserve to have someone on your team who is knowledgeable, isn’t going to lie to you, and is continuing to learn and do the research because that is also another big fault of providers is they are not keeping up with the research. They are still doing the same shit they were doing 20 years ago. Meagan: You know, I even think that sometimes when providers see research, it’s there. They are given it. It’s like, “Well, that’s not how it really is,” because that’s not how they are practicing. So it’s not like, “Wow, I need to make some adjustments in my care.” They just keep going so that’s why we have this crazy lack of change. That’s why some countries are 10 years ahead of us because we for some reason aren’t willing to make change when the facts are provided. Flor: Right. I think especially in the United States, we really glorify licenses and degrees. We glorify people who have this sense of authority over us. It makes us feel warm and fuzzy inside, but why is that? Why is it that we don’t feel smart enough to be the head of our own care? Why? Meagan: Why do you think? Flor: It shouldn’t be that way. Meagan: No. No. It shouldn’t, but it is so easily that way. We just don’t. We just don’t. Flor: We just don’t and I know sometimes it’s a cultural difference. Both of my parents are immigrants from Nicaragua so for them to come to the United States and have access to healthcare and have access to get seen by a doctor and to get antibiotics and get help and get x-rays, that’s amazing to people who come from a country where they don’t have access to stuff like that. I was raised with, “This is amazing. We have doctors here. You should just do what they are telling you because we are just so grateful to have access to this care,” that we are just blindly following what they are saying. I’m the first person in the family to question, “Well, what if this person is wrong?” Meagan: You’re the first person in your family? Flor: What if this person is wrong? I’m the first person to really fully participate in my healthcare. That is not in the norm in my family because of the culture that we are immigrants so there is also that layer of where our family’s are from and is this new to us? Is having access to healthcare new to your generation in your family? Because that’s a whole other layer that you’ve got to uncover now too. Meagan: Yeah, I actually didn’t even think of that. Flor: Yes. Absolutely. Meagan: Wow, yeah. Flor: We’re getting ready to have these babies so it’s like, you’re going to have this brand new little human that you are now going to have to advocate for. Getting on that wheel of participating and advocating prenatally during your pregnancy, your labor, your postpartum, that’s all gearing up for you to get ready to advocate for a new human for the rest of your life. If you think you’re not going to end up in an ER at some point in time with that child and you’re going to have to advocate, you are dead-ass wrong. At some point, you will end up in the ER and have to really ask the questions and not just hand your child over and just do whatever you want type situation. We have to realize that starts now. Meagan: With us being able to advocate and take charge of our own care. You know, I know. I definitely have had the personality in the past and it’s still in me. It’s still very much in me where I’m like, oh I’m a people pleaser. I’m like, “Sure. Okay fine. It’s probably not that big of a deal. Obviously you seem very passionate about that so we will just go along with that.” We’re going to say breaking water for instance. A provider comes in and says they want to break your water and you’re like, “I didn’t want that. I know I didn’t want that. That was something I knew I didn’t want. It’s on my birth plan. I didn’t want to break my water, but this provider is saying it. They seem really passionate about it, so I guess I will just back down on that and let it go even though I’m really passionate about it. Sure, go ahead. Break my water.” Flor: Yes. Meagan: Right? But why? Why are we allowing that if it’s something that we really, really, really, really don’t want, why do we just back down so easily? Flor: There are a few things that are going on here and I think for women in particular, we are raised to people please. We are raised to take care of everybody’s needs around us but women in general to people please. Women are raised to not ruffle anybody’s feathers, not make anybody upset, give people what they want, and that’s our only job so when someone comes into the room and says they need you to x, y, and z, our brains are calculating that as there is a need that has to be fulfilled and I have to fulfill that. But the other thing that is happening here too is that we do have mammalian mechanisms in place to protect us and to help us survive within the wild. So if we have someone coming in who is looking like they are this sense of authority who could potentially feel like a source of threat like a predator to us, the mammal will give in to the predator’s demands to avoid further harm. There are layers of mammal instinct that are happening here as well. It’s happening on a subconscious level. So this is where a doula will help. The doula is the person who is outside of that who can step in to say, “Hey, I understand that this wasn’t part of your plan. Is there any medical reason why this should be happening? Just to speed up the labor isn’t a medical reason so I just want to remind you that your birth plan is pretty ironclad so if this is not something that you want to do, I fully support you doing that.” Right? Then we give the benefits, the risks, the information, and then let the parent decide what they want to do. But ultimately, this is a lot of the time what ends up happening. The parent does what the provider says. Meagan: Yeah.Flor: The doula is not going to save you from that. Meagan: No. Flor: We can’t. Meagan: It’s hard, you guys. Women of Strength, we want to protect you. We want to help you get your birth plan and have that amazing experience that you do deserve and that you have worked hard for, but like she said, we can give you everything as doulas, but then it really is up to you or us as parents to make that ultimate decision and if we do that and just back down because we want to meet that person’s need, we then have to deal with what happens after that. We have to accept that. I don’t like the work deal. We are going to accept that because that was the choice we made. Flor: Yes. It’s the choice that we are doing. Meagan: If we are going to go into a store and steal something, we have to understand that there are repercussions from stealing that item. Whether or not you get caught and you are just feeling guilt or whatever, there are going to be feelings so if we do something just because someone wants us to, then we sit down and we’re like, Oh crap. Or if it goes awry, then there’s no one else to blame and that’s the hardest part as a VBAC parent and a VBAC doula from those two standpoints. It’s a hard thing. Flor: It’s a really hard thing. As much as we’re asking our providers to give us that information and to give us the burden of proof and ask them, “Why are you suggesting this intervention?” It’s also important that you have that conversation with yourself. Why am I not choosing to do this or to do this? You also need to ask yourself that because if you are saying yes or no to something, are we saying yes or no out of fear? The thing I see a lot of the time too is that people are completely fucking exhausted. The system has completely dragged them through hell and back just to get to that moment and people are fucking tired. Meagan: Yes. All people, but especially with VBAC. There is this extra layer of pressure to have our baby by certain dates and you have to be a certain centimeter or they won’t induce. Or guess what? If you do hit this date, I won’t even induce you. You have to have a C-section so we have all of this extra pressure and stress and angst. We’re going out and we’re trying to self-induce and we’re trying to do all of these things. We are so stressed that we are not even able to get our head into a space of relaxing, calm, and willing to hear what our true intuition says because we are so wound up. Flor: We see it all the time in these VBAC groups. I stay in those VBAC groups heavily because I’ll tell you what, providers act so fucking wild when nobody’s around. When they think nobody’s around to watch them, the shit that they say and do, they act so differently then these people come to these Facebook groups and tell us how their prenatal visit went and I’m fucking blown away by the things that they are saying and the things that they are doing and the things that are happening. And also really sad that people don’t have the courage to stand up to their providers and to ask the questions and participate in their care. It’s really sad to see that this is the place that we are at. I’m always, always seeing, “I have to be in labor by 39 weeks” or “I have to have an induction or I have to have a C-section”. That’s the thing I see all the time. All the time. Meagan: You don’t have to do anything. Or I see the “Let me”. “They will let me. They will let me.” Women of Strength, if you are this person and you’re like, Oh crap. Yep. That’s me. That’s me saying that. Yep. My provider said they would let me, let’s make a change. Let’s make a change together. We have to do this as a community together and we deserve it as individuals to take better charge of our care and of our outcomes. Flor: Yeah, this is what this conversation is about. It’s about trying to get to a place where we are more participating in our care and getting that better type of care and just asking the simple questions. And even asking for space. If you are just feeling really overwhelmed in the moment and you are feeling like you are about to comply simply out of fear or being stressed, that is the perfect time to say, “I need time to think about this.” Meagan: Yep and your doula can be there for you. If you have a doula, they can be there for you to help hold that space and talk about those things and navigate through what is really being felt and thought in your head. Right? Flor: Absolutely. Meagan: There are so many times and I never want to shame providers or shame anyone. That’s not my goal ever in life. I don’t like to shame, but at the same time, it drives me nuts when I see a provider come in and they say– it’s like they are placing these seeds and then they are watering it with MiracleGro so it grows really thick and hard and then they are coming back in and they are dousing it with MiracleGro again. They come in and say weird things about breaking your water or whatever. You’re like, “Maybe. I’ll think about it.” You’re like, “Yeah. I said no. I pushed it off and put it aside. We’re not going to do it right now.” But then they come back in an hour later and are like, “Well, we really want to break your water.” Or now it’s the nurse, “Well, the doctor really wants to come in and break your water.” Here’s that second pour of MiracleGro so it’s growing thicker and harder to resist that root and that seed so you’re like, “Oh, no. I still think I want to wait. I really still think I want to wait.” But then the third time they come in and they are like, “Okay, we really think it’s best to break your water. You’re still hanging out around 6 centimeters. It’s probably going to help speed up your labor and get this baby out. You don’t want to do this forever. You’re going to tire out your uterus.” Then they douse it again and you’re like, “Fine. Sounds good.” We can’t say no three times, but you can. You can. If that still doesn’t feel right that third time, you can still say no. So I think here we are talking about all of the situations but how do we find that confidence? How do you think that we find this confidence to hold our rod and push through and not let it crack? Flor: Mhmm. For once, that starts prenatally. You cannot figure out who the fuck your provider is on the day you give birth. Meagan: You really can’t. Flor: You need to participate prenatally. Even just any single little prenatal test. “Can you explain to me why you are suggesting this? What are the benefits? What are the risks? Can you show me the evidence on this?” Any little thing. I don’t care if it is a urine exam. Your provider needs to see you participating all the way through and through so they know what to expect from you and what type of client you are actually going to be. That also gives you a good sense of, is this person willing for me to participate? Meagan: Yeah. Flor: Because you’re either going to get a provider who goes, “I love that you’re asking all of these questions and you’re participating in your care and you’re gaining knowledge. I love this.” A good provider will understand that that limits their liability if you are knowledgeable. The provider who does not like you asking questions is already a red flag. Meagan: Huge red flag. Flor: Huge. There are lots of times where you will find out who someone is very early on if you start participating there. Meagan: Yeah. Yeah. Flor: Then once we move to the actual labor, there is a decreased chance of you getting someone who you don’t want at your birth. Now, if it keeps getting pressed of this issue of we need to intervene. We need to intervene. We need to intervene and at some point if you’ve had enough, you say, “Hey, can you put it in my medical chart that I have at multiple occasions made the decision to refuse this intervention and you are continuing to come in here and coerce me? Can you please write that on my medical chart?” Meagan: Yeah, what do you think they’re going to do? Flor: They’re not going to want to. As much as they use that medical chart for their own liability and their own benefit, you also need to be using that as your own tool. Meagan: Yeah. Flor: Hey, I don’t want to discuss this again. Can you please write it in my chart that I’m not willing to discuss this any further? If you have anybody on your team who is just not listening, get rid of them. Why are we so scared to tell someone, “Hey, can you bring me another nurse who is on the staff please?” Meagan: Yeah. We are so vulnerable when we are in labor that we can’t seem to find this space of advocating for ourselves to that extent of, Okay, every time this nurse comes in, my blood pressure goes through the roof. I’m clearly feeling a fight-or-flight experience. This is not going to help me or my labor or my baby and definitely not going to help me leave this experience feeling joyful or will cherish for the rest of my life. So if that person is in your space making you feel those things and your body is responding that way– because let me tell you. Our body is a huge factor in what happens and it’s a response. We need to listen to it. Flor: It’s so smart. Meagan: It is so smart. Flor: So smart. Meagan: If you get the chills every time someone comes in or you can feel your heart race every time someone comes in, that is a flag that someone shouldn’t be in your space. That is okay. It is okay. We talked about this with Dr. Fox too with providers. No provider wants to be in a battle either. So if they are not going to be in that space of support and willingness to meet you and let you be a real– and “let” like not fight you against being an advocate for your own birth and being a participant in your own experience, that’s not the right provider. And guess what? They probably don’t want you as a patient either. And that’s okay to say, “You know what? Thank you so much for all you have done and where you have brought me today. I’m going to discontinue care.” Or you can just leave and transfer your records. You do not have to stay or you can say to that nurse or to another nurse or whatever, “I would like to request a new person.” Flor: Yeah. Meagan: Please do not return to my room. We had this a long time ago. I think it was even before COVID, probably in 2018. We had a preeclamptic mom who was already really struggling with blood pressure. She was on magnesium. She felt like garbage. It was her fourth or fifth baby. I can’t remember. It was a very stressful time. She was being induced and that was not what she wanted. She did have this nurse who came in. I’ll tell you, she made my skin crawl. Everything, just the way she walked in. She didn’t have to say a word and you could just feel that negative energy from her body. When she would speak to her and when she was touching her and maneuvering, it was just very aggressive and it was just ick. A lot of ick. I watched her blood pressure. I physically watched her blood pressure because she had to be on blood pressure the whole time. They were taking it every 15 minutes and I watched her vitals go up and then they would still go down and be high but they were clearly down. I started noticing that and I talked to her husband and I said, “Have you noticed this?” He’s like, “Yeah.” I’ve noticed everything about her. She gets anxious. I was like, “Yeah.” We went over and we talked to her and she was like, “I hate her.” She’s like, “I do not want her.” I said, “Then let’s get rid of her. That’s okay.” She said, “Wait, wait, wait. We can do that?” I said, “Yeah.” I went out to the desk and I just said, “Hey, is there any way we can get another nurse to come in here and chat?” She was like, “Yeah,” so she sent another nurse in and the patient was like, “I would really like to request a different nurse. I’m feeling really anxious when this nurse is in here. This is not what I’m needing. This is not the experience I want.” And they were like, “No problem.” We never saw her again, never. I didn’t even see her out in the hall. Never. Her birth experience dramatically changed in a positive way in a really crappy situation that she didn’t want, but it was a dramatic change and she was so happy. So happy. Flor: Yes. The environment and the vibes in there have to be immaculate. I think that’s a part that people don’t understand is if you’re also having to fight through and through and through throughout the whole labor, I wouldn’t expect a baby to want to be born into that environment. You cannot keep thinking of your body as this robot and as this mechanical thing. It is connected to your brain, to your emotion, to the environment, to your partner, the support system, and everything that is happening within the room. Our bodies are not going to release these tiny, little, precious, vulnerable mammals into the wild when the body feels that there are too many predators around and the environment is not safe. I see what happens here sometimes is that someone is fighting a lot throughout the whole labor and then they end up in a C-section and they go, “I just should have had the C-section to begin with because clearly my body doesn’t work.” It’s like, well no. You weren’t even given a fair shot at having a VBAC would be having support through and through. That would be a fair shot, but when you are having someone who is putting you in fight or flight, adrenaline overload, cortisol overload, your pelvic floor is going to tighten up. It is going to go woooop. Meagan: Hold that baby in. Flor: The baby is not going to have the room to navigate, to rotate, to descend. Your body is so smart. I don’t think people realize that your body is so smart and intelligent and works so well that it will hold your baby in when your body feels it is not a safe environment to be born. It’s not a failure. It’s a testament to how well your body actually works. Right? Meagan: Yes. Yes. Yeah, and the medical system really treats us in a way that we failed. Our body failed. Whatever. That’s just not the case. It’s not the case. It’s that our body was brilliant and was responding to a really not awesome experience. Flor: Absolutely. Meagan: It is up to us to continue to advocate so keep doing that, Women of Strength. Advocate for yourself. Push through. Listen. Read the room too. Read your body. If you are feeling anxious, make change. That is where it is up to us to– I hate the word, but at the same time, we can’t fail ourselves by not doing anything. If we do nothing, we are failing ourselves. We do not get the education. If we do not put forth the work and the effort, we’re not giving ourselves an opportunity. Flor: You’re not going to be able to change the outcome that the system is already curating for you. There is already this curation that is happening throughout this whole thing and is expected to end a certain way and you have to be the person that disrupts that curation and to build it to go a whole different direction. It shouldn’t be that way. It shouldn’t be our responsibility. We shouldn’t have to go in there and advocate so fucking much. It shouldn’t be that way but it’s clear right now in 2024 that the system is not doing anything to improve these outcomes. None at all. Zero. So by default, it lands in the parents’ lap. By default. Meagan: We’re already doing so much so I know that you might even be overwhelmed listening to this episode and be like, Oh my gosh. Now I have to do this too? But you deserve it. Yes. Right now, it’s unfortunate that we have to go in and we have to take charge of our own care but we can do it. You can do it. Even if you’re a people pleaser, you can do it. You really, really can. Flor: You guys, always remember that the squeaky wheel gets the grease. Meagan: I love that. Flor: The squeaky wheel gets the grease so be as loud as you need to. Advocate as much as you need to. Participate as much as you need to because that’s the person who’s going to get the grease, not the person who is sitting in compliance. Meagan: Yeah. Yep. Women of Strength, thank you for listening with us today. I hope that you enjoyed this conversation. We are very passionate. If you cannot tell, we are very passionate. We want things to be better for you. We want to see change. We as doulas want to advocate for that. We want to help you. We really, really want to help you, but in the end, it’s in our laps. We have to push up. We have to keep going. I do think that it’s going to take time. Unfortunately, it’s probably going to take longer than we want it to, but if we keep advocating for this change and if we keep pushing forward and taking care of ourselves and our babies and all of this, we will slowly see change. We’ll see it. It will come. Flor: Yes. You’re not just advocating for yourself. You’re advocating for all of the people behind you as well. If you’re looking at it in the bigger picture as, “Okay, when I’m speaking up for myself, I’m speaking up for thousands of other families,” if you look at it like that, you will have the courage to speak up. Meagan: Yes. There is a listener, she was a VBAC after multiple Cesareans, more than three and everyone was shooting her down. No, no, no, no, no, no. She was like, “Nope. I’m going to do this.” She found the research and decided to go for it and did. She had a beautiful birth and a beautiful experience. Something I told her was, “You just changed that provider’s world. You just changed anyone coming in in the future with VBAC after multiple Cesareans because that provider said, ‘You’re not going to do this. It’s not going to happen. Sure, I’m going to let you try, but it’s just not going to happen. It’s not possible,’” and then she showed her it was. Providers do hold onto experiences. They do. Sometimes they have to see enough experiences to change their mindest but if we keep pushing forward and showing that this is really okay– just with breech birth. Good golly. Let’s get some more breech birth. Let’s show these providers that breech is just a variation of normal. We just have to keep going. We have to keep going and it does. It’s just bull crap that it’s in our laps and we have to do it but we do. Flor: Yeah, it’s all of us working together collectively quite honestly. It’s all of us together doing our part even if it just feels so minute and so little to you. If every single one of us just did a tiny little spec of work, it’s a huge fucking mountain that we are moving together. Meagan: I was just going to say think about how many people are in our communities alone let alone all of the people in the world. It’s powerful so believe in yourself. Believe in yourself. You deserve it. You are strong. You are completely capable. Do the work. Do the work. That is something that we do have to do. Do the work. Let’s see, what else? What other final message? Flor: Always ask for the burden of proof. Meagan: Yes. Always ask. Flor: I say it all the time, burden of proof. Show me the burden of proof. I want it on paper so I can make an informed decision. Always know that you legally have the right to make those decisions no matter what even if you are saying no to an intervention that could put you or your baby at risk. You still have the choice to say no even when real risk is at the front of your face. Risk is always subjective. That changes from person to person. You have the right to be treated like an actual human and not just a vessel. You matter too. Meagan: Yes. Ask questions. It’s okay. It’s okay to ask questions. You’re not a problem for asking questions just to let you know. It’s not a problem if you ask questions. That is something that in my opinion shows strength. If we are willing to ask a question, and it’s okay to doubt too. It’s okay to doubt. It’s okay to be like, “I don’t know if I believe that,” and then ask that question or “I’ve never heard of that. Can you show me the proof or can you show me what the outcomes are for this result?” Ask the questions. Flor: Not just tell me, show me. Meagan: Show me. Flor: I think another leg that people aren’t paying attention to is when an intervention is being suggested, really pay attention to if your provider is telling you the benefits and risks of the other side. Meagan: And the alternatives. Flor: Because if they are just telling you one side of the coin, well that’s coercive care. That’s coercive information. They should be telling you the benefits and risks to each side and the alternatives and then letting you choose. That is competent care. Meagan: Yeah. If they’re coming in and they are just telling you the risk of VBAC, we’ve talked about this. If they’re just telling you all the risks about VBAC and they’re not even talking about Cesarean, that is a problem right there. We talked about this. It starts prenatally, but I really– if you are not pregnant yet, I encourage you and you’re like, Okay, I really want a VBAC, I encourage you to start right now. Flor: 100%Meagan: Find a provider right now. Start getting the education right now. You are in a whole different mind frame than you are going to be when you are pregnant. It’s okay if you are starting when you are pregnant. Don’t ever not start. But if you are not pregnant right now and it’s like, Oh, I’m going to listen. I’m going to get these notes and I’ll start when I’m pregnant because I’m not ready yet, I actually think it is a great time to start now. Get the VBAC education. Find the provider. Understand what you are wanting. Understand your rights because it really is a different ball game. Flor: It’s a whole different ball game. When you have the luxury of time, take it. Do it because I feel like a lot of people go to get educated right at the end in the last trimester and I want you guys to know something. Your brain functionality starts to decrease at the end of pregnancy. Meagan: You’re overwhelmed. Flor: You’re not supposed to be using a lot of brain function at the end of pregnancy because your primal birth brain is trying to take over. You trying to learn at a time where your brain function is decreased is not optimal. It is not. You need to get educated absolutely now even if you’re like, I’m just not sure if I want to have another baby, get educated. What is the risk to you getting educated? Meagan: Well, and honestly, it’s just going to help the next person even if you don’t have that baby and your best friend gets pregnant, you’re going to help them and you’re going to guide them in the right direction to help them get educated. You’re going to help change. It’s those minute changes that we are doing in life that are going to make a huge impact. Flor: Huge impact. Absolutely. Make sure that your partners are showing up with you because it is not going to be doable if your partner is showing up just to sit in the corner and be fearful and not understand things, not be educated, not know how to advocate, not know what questions to ask, they will not be of any help to you. You need someone who is going to show up in that same brain capacity and be able to hand it over to them essentially because you shouldn’t be doing any type of fucking thinking during the labor. Meagan: Right? I mean, look at what happened to me. It went straight on to my husband and he was like, “I don’t know,” and it was just like, “No, we’ve got to go. We’ve got to go.” It was awful. It was awful. It was really, really hard and it was something that I made sure was not going to happen again. We are not going to do that again. We are going to make sure that you are okay with this and that you understand so when someone just comes in and says this one little fear tactic, you don’t just crumble to the floor. Flor: Absolutely. Absolutely. These partners have got to start showing up in a different way. They just cannot leave all of these childbearing things up to the person who is pregnant. One, it’s not fair. Two, it’s not adequate enough. Meagan: We can’t. Flor: It’s not adequate enough. I can’t tell you how many times people are like, “I ended up in a C-section and I feel like it wsa all my partner’s fault. They pushed me to do it. They didn’t help me at all. They didn’t advocate. They didn’t even show up to the classes and I just feel like it’s all their fault or they wanted me to hurry up and get it over with.” Meagan: I mean, I love my husband to absolute pieces. I told this story before how when I told him I wanted a VBAC after two C-sections, he was like, “What? What? No. Let’s just go unzip you.” He said that word, you guys. He said that word. He said, “Let’s just go unzip ya.” That is not okay. He was so far away from understanding and I had to really reel him in. We get it. These partners are also scared. They are scared. They don’t know. They are vulnerable too. It’s not just you. It’s also their baby that they care about. They hear the negative things out there in the world and they see the word “uterine rupture” and they’re like, “Oh my gosh, no. I can’t.” Or they’re like, “We’re out here. We’re providing. We can’t do that childbirth education. We can’t do those VBAC courses,” but really, it’s so important because they have to be there with you. They are your rock too. They are your rock. You have to have them. I’m going to tell you. In labor, you can’t always be 100% in your mind. Flor: You shouldn’t be either. Meagan: Yeah, well because we are laboring. We need to focus on getting a baby here and we can’t be thinking about all of the things that we need to be asking the next time the provider comes in. That is where a doula can help and can help encourage your partner. “Hey, these are some things to ask next time,” and help but it helps even more if they have done the work and they are with you. They are with you in this journey. Flor: Yes, they have to be with you and understanding that you and the baby are a diad. You are one. You are not separate from each other. When you do well, the baby does well. When you don’t do well, the baby doesn’t do well. It’s one person. You are one unit. They are not separate from each other. Partners really need to understand that and also really think about what type of energy you are putting into these statistics and the numbers because if a provider is telling you, “You have a 0.7% chance of rupturing,” okay. So there’s a 99% chance I’m not going to. How different does that sound? Meagan: Let’s flip that. We talk about that on the podcast too. Let’s flip it. Let’s start focusing on those little tiny numbers on the chance that you do, it’s important to know that, but let’s flip it and look at it like, “Okay, so I have a 98-99% chance of not rupturing.” Flor: Right. Meagan: Okay. Okay. That feels good. I think that’s a good risk right there. I’ll take that. Flor: Exactly. Exactly. Obviously, it’s not up to us to be in charge of pulling our partners out of that fear. That shouldn’t be our responsibility, but it’s okay to look your partner in the face and say, “This is what I’m needing from you. This is what I’m wanting and these are the reasons why and I’m the person who has to give birth to this baby and I’m the person who has to recover for the rest of my life with how this birth turns out. Me.”Right? When I showed up for my VBAC, I went in thinking my husband was going to fight me on it so I showed up like, “Listen. We’re going to have a fucking VBAC. I don’t give a shit what you’re going to say.” I showed up ready to fight. Meagan: We actually did get in a fight at a restaurant because I was like, “This is what’s going to happen. We’re going to have this many people and by the way, I’m actually not going to birth in the hospital either.” He was like, “What the hell?” I was like, “It’s going to happen.” I was like, “You’re going to have to meet me right up here. I’m not coming down here. You’re going to have to meet me up here.” And I’m so grateful that he did. I really am so grateful and honestly, it changed him. It changed his perspective. It changed his narrative of birth. He was like, “Oh wait, yeah no. We would never do it any other way. That was amazing.” Flor: Right? Luckily for me, my husband didn’t fight me. I went in guns blazing thinking he was going to but he was like, “Look. You’re the one who’s pregnant. You’re the one who has to give birth. Whatever you choose, I’m on board. I will support you and I trust whatever decision you make. I can’t tell you what to do,” so then I felt like a jerk after. Meagan: My husband was too. He did put his two cents in of, “Oh, so you’re just going to choose the most expensive option?” That was what he said in the end, but in the end he was like, “Okay, cool. We’re going.” We know. We know. We see it. I’ve done so many consultations with people where they are like, “My husband is just not on board and I don’t know what to do. I don’t know what to do.” I think one of the very first things that I suggest is to educate them because they are usually making those quick no’s and they’re very against it because they are just uneducated and they are scared. Flor: Yeah. That’s generally where it’s coming from is a lack of education and following that thread of fear. Those shouldn’t be the places where someone is making that decision. Someone should get educated and then we’ll discuss what you think and what your opinion is. Know that it’s just that. It’s an opinion and it’s not going to be the detour of what I’m going to do with my birth. It just shouldn’t be that way. Meagan: Yeah. Yeah. Flor: We already live in such a patriarchal system as it is. I’ve seen lots of partners saying no to doulas being on board. Meagan: Oh yeah. Oh yeah. Flor: Why? Meagan: My husband was one of those. My husband was one of those. He was so anti-doula and his reason was, “Well, I don’t want to be replaced.” I was like, “It’s not like that,” with my second. It is not like that at all. It just was so hard and we didn’t have a doula and we ended up in a repeat Cesarean. I’m not saying I ended up in a repeat Cesearean because I didn’t have a doula but I definitely wish I had some of that extra support when things were turned on me and someone to help him understand too but there are so many other things with that birth. I was with the wrong provider. That’s what it was. I just didn’t make the full change for myself. Flor: The thing with that too is that a lot of men do not show up for women fully 100% because there’s really not a lot of opportunities where they do show up to be 100% there for their partners. Birth is one of those spaces where they need to do that and they’re not used to that. They’re not used to showing up to that capacity of really not centering themselves. Meagan: Yep. Flor: What is this doula going to take away from me? What is being at home going to take away from me? What is this going to require? That is someone centering themselves instead of looking at the situation and saying, “What is it that you need from me? How can I help you? How can I help you be most comfortable? I want you to be as happy as possible in this situation.” That’s the type of energy that we need people to show up to the birth for. Stop centering yourself. It’s not about you. When it’s your turn to give birth, then we will do whatever you want to do, but until that time comes, it’s about me. Meagan: You’ve got to come up here. Yeah. Flor: It’s about me. Meagan: It is about you, Women of Strength. We love you. We love you. Like I said in the beginning, we see you. We hear you. We feel you. Literally, from one VBAC mom, two VBAC moms to another, we understand. We are with you in this journey. We are cheering you on. This message today is to hopefully motivate you, educate you, plant a seed or whatever you want to take it as, give you the motivation or the oomph to do what’s best for you truly. Truly do what’s best for you and let’s change the narrative. Flor: Yep. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
01:02:4617/07/2024
Episode 317 Brittany's HBA2C + VBAC Education, Big Babies, Provider Support, Preterm Birth & More

Episode 317 Brittany's HBA2C + VBAC Education, Big Babies, Provider Support, Preterm Birth & More

“The 9 lb 2 oz baby that they said I could never push out and could never have had her vaginally– I ended up going on to have a 10 lb 10 oz baby girl.”Brittany first gave birth to twins via Cesarean at 34 weeks and 1 day. She didn’t get to meet her babies until 36 hours after delivery and they had to stay in the NICU for 10 days. While Brittany was so thankful it was not a longer NICU stay and the babies got to come home at the same time, she grieved the introduction into motherhood that she thought she would have. Brittany’s next birth ended in a difficult CBAC under general anesthesia. Once again, she was not able to hold her baby right after birth like she so badly wanted. Her physical and mental recoveries were intense and tough. Not long after her third baby was born, Brittany felt called to understand more about her births. She wanted to learn why things happened to her the way they did and if there was a way to help prevent other women from going through the same things. She became a doula with Joyful Beginnings Doula Care and absolutely loves it!With her fourth baby, home birth was on Brittany’s heart. With the education from doula work and her own births, Brittany set herself up for success by surrounding herself with a beautifully supportive birth team. Her HBA2C was quick, uncomplicated, redemptive, and empowering!Brittany’s WebsiteThe VBAC Link Blog: Preterm CesareansTVL Blog: Everything You Need For Your HBACTVL Blog: Provider Red FlagsTVL Blog: VBAC/HBAC PreparationTVL Blog: VBAC MidwifeTVL Blog: Big BabiesHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. We have our friend, Brittany, today with us sharing her HBAC. If you have not been with us very long or are still unsure about all of the crazy terms in the VBAC world, HBAC is home birth after Cesarean but she is a home birth after two Cesareans so HBA2C so similar to what I am. I am a VBAC but I was in a birth center, not a home. I’m so excited to share– well, I’m not going to be sharing it, but she is sharing it today so welcome, Brittany. Thank you so much for being here with us. Brittany: Thank you so much for having me. I’m excited to get to share my story. Meagan: Absolutely. Me too. We will get right into that. I’m just going to do a quick review then we will do our intro and we will dive right in. This review was left by Brianna Moody and this was left in 2023 and it says, “So binge-worthy.” Okay seriously, I could not agree already with her because I feel like this is the type of podcast that when you are looking for your options for birth after Cesarean, you just want to hear every story and I get into those binges especially with podcasts so I could not agree more. I believe that this podcast is bingeworthy. It says, “I found The VBAC Link Podcast in my second trimester after my midwife suggested that I start listening to positive stories to get in a good headspace as I prepared for my VBAC.” Okay, I also love that her midwife is suggesting that. I 100% agree there as well. It says, “What I didn’t expect was to hear so many different types of birth stories in one place. I was floored by the amount of information in each episode and by how much these stories impacted me. I found that I love listening to all of the different stories, even the CBAC stories. Honestly, I think those helped me process some of my fear about potentially having a CBAC.” Okay CBAC, Cesarean birth after a Cesarean, just want to make sure we know what that means. It says, “--as could be something that could still be beautiful and empowering. I tell everyone I know about the podcast, even first-time moms because there is truly something that could benefit every birthing mama on here. I am so happy to say that I had my VBAC baby in January.” Ah, so amazing. Congratulations, Brianna Moody. It says, “--in January and it was the most beautiful experience. I still cannot believe I really did it. I took so many things from the podcast that helped make it possible. Thank you so much for sharing your heart and passion for VBAC with the world.”Okay, I’m obsessed with this review. So many amazing things right here. Yes, binge the podcast. You’re going to learn so many incredible things, like so many. Every story, just like she said, has its similarities but also it’s very different. That’s something that I love about birth then I love that she pointed out that CBAC could even be viewed as beautiful and empowering. I love that because I want you to know, Women of Strength, VBAC doesn’t have to be the right answer. If it’s not feeling right for you, that’s okay. You can go and have a Cesarean birth and it can be absolutely beautiful. Know that it’s an option to do both and you can still have a beautiful, empowering experience. Okay, all right. I’m going to let you guys go. We’re going to get to the intro and then we’re going to dive into Brittany’s HBAC after two Cesareans. Meagan: All right, Brittany. A long intro. It’s time for you to share with us your beautiful stories. Brittany: Yes, thank you. Okay. So I’m going to start at the beginning and give a little brief overview of my history and kind of what led me to pursuing an HBAC after two C-sections. In 2019, I had my first pregnancy and I was actually pregnant with twins so that was a big, exciting thing for us. It was very unexpected and overall, I had a pretty normal pregnancy. I didn’t really have a whole lot of issues until the end. My blood pressure started to creep up here and there and then at 33 weeks, I went in for an appointment and I was diagnosed with preeclampsia. That was very overwhelming. I did not have a lot of knowledge about birth really in general. I was one of those who went in and just trusted everything my OB said. I just rolled with it and they looked at us and they said, “We need to admit you. Your blood pressure is too high. You have protein in your urine.” So my husband and I went over to the hospital immediately following and realized that we were going to be staying there for a little bit. They were able to manage my blood pressure for about a week and then I needed to deliver the twins at about 34 and 1. So it was actually July 5th, so it was right after the 4th of July and it was hard. It was definitely a hard, all of a sudden transition that we weren’t expecting. We were thrown into the hospital. My husband had to come out of work and things just continued to get worse. At 34+1, we did another ultrasound and both were breech like they had been the entire pregnancy so we really were not given any options besides a scheduled C-section. I didn’t really think twice about that. I just thought, “Okay. This is what you do. We have breech babies. We need to do it.” So at 34+1 on July 5th, I went in for my scheduled C-section. I had the twins and obviously, being born early, they were taken to the NICU so it was a very abnormal experience in the sense that I had these babies. My body knew I had just had babies, but the babies were taken from me. They were instantly taken from me and I had to go back on magnesium for my blood pressure post-C-section so I actually did not even get to see my babies, hold my babies, or touch my babies until about 36 hours later. So it was just a very abnormal experience, especially for a first-time mom. I got wheeled to recovery and they were like, “Here’s a breast pump. You need to start pumping.” It was all of these things that I just wasn’t prepared for and I hadn’t done before. It was such a new experience. Thankfully, they were only in the NICU for 10 days, but as you can imagine, recovering from a C-section, going back and forth to the hospital, trying to figure out pumping and how often to pump. It was just a lot. It was a lot and it was very unnatural. It is just not a natural experience to be separated from your baby or babies after they are born, but we made it and we got through that trial. We were very, very, very lucky that they got to come home together 10 days after being born. Meagan: Wow, 10 days? Brittany: Yes. A miracle within itself. Meagan: That is very fast. Yeah, that’s great. Brittany: It was very fast. They were doing great. They were just considered those eaters and growers. They really didn’t have any major issues. My son was on CPAP for maybe 48 hours but after that, they were just learning how to eat and grow and they got to come home together which is also very rare for twins. Meagan: That’s awesome. Brittany: Yes. We were very thankful for that. Following that pregnancy, we got pregnant again unexpectedly when the twins were only 9 months old. As you can imagine, that is a lot. That was in 2020 and it was right in the thick of COVID. Things were different. Things were crazy. They weren’t even really, at least at the practice I was at, allowing women to come in for appointments until the second trimester. Just all of these different things. It was a lot. It was a lot to process that I was pregnant again. I was wondering if I was pregnant with twins again. There were so many questions that I had and I just was not getting any answers or any support during that beginning period.So at about 13ish weeks, they finally allowed me to come in person and be seen in person. We were pregnant with just one which we were thankful for. It would have been a lot to have twins back to back. But I didn’t have a significant amount more knowledge at this time. I knew a little bit more about birth. I knew I didn’t want to have another C-section. I knew that there was something called a VBAC. I was hoping to be able to do that. I didn’t want to have to go the same route, but I really didn’t have much education. So we kind of just went with the flow. We were at a smaller hospital closer to us this time around and looking back, I would 100% say that my provider was VBAC tolerant, not VBAC supportive. I don’t think that I could identify that at the time not having the knowledge and the resources, but definitely now, I can tell that they were very just VBAC tolerant. Meagan: Sorry to interrupt you, now looking back–Brittany: No, go ahead. meagan: I was going to say that at the time you weren’t able to identify which is very, very, very common but now looking back, what were some of those very first signs? Is that what you were going into? brittany: Yes. We kept having conversations about can I have a VBAC. Do I have to have another C-section? It was like, We’ll see. When we get closer, we’ll see. We don’t want to risk anything. It was a lot of the nonchalant I’m going to beat around the bush, but really, I’m probably going to pull the rug out from underneath you at the end. There were a couple of appointments where I left really discouraged and in tears like, I feel like this isn’t going to happen. I don’t understand. But again, I just didn’t have the knowledge to really be able to question what they were saying. I just assumed that if this isn’t going to work out, it’s not going to work out because it’s not safe or x, y, and z reasons. My pregnancy went on and of course, in the back of my mind, there was the concern of preeclampsia again because I had it with the twins, but I had no blood pressure issues. I had no issues with that pregnancy. Obviously, carrying a singleton compared to twins is very different and so we got towards the end and at about 38 weeks, they started talking about wanting to induce me. I was like, “Why are we doing this?” But again, I just didn’t have the knowledge to really question their reasoning behind it. So they had actually scheduled me for an induction at 39 weeks. My husband and I left that appointment and we knew enough to know that we didn’t feel good about it. We were like, “This just doesn’t feel right. Something feels off about this. Why are we brushing this?” So when the time came, we actually canceled that induction and didn’t show up. We went to just another regular appointment that following week and I was getting ready to go into my 40th week. They were okay with the fact that I had not done the induction, but they were really, really pressing an induction for 40 weeks which was a couple of days after. meagan: Which is also another red flag. brittany: Yes. Yes, very much so. Again, something I couldn’t identify at the time besides the fact that I felt insecure about it. So we decided to do the 40-week induction and when we got there, we were going to start with a Foley bulb but it ended up that I was already 3 centimeters dilated. My body had made some good progress. I was already effaced, so they jumped right to the Pitocin induction. Because this was in the thick of COVID, there were no doulas allowed. I did have a discussion with my husband about potentially hiring a doula. I knew of doulas. I was like, I think this would probably be going for trying for a VBAC, but that was not an option. You had one support person allowed. That was it. My mom couldn’t be there. Nobody could be there. No doulas could be there. It was just a really, really hard time in the hospital system. We did the best we could to prepare for what was to come but just did not have the education and the support that we needed going into the situation that we were going into. To make a very long story short, it was intervention after intervention after intervention after intervention. It was basically the definition of the cascade of interventions from Pitocin to epidurals to just everything in between.Thankfully, by morning, the induction started at about 6:00 PM, and by 9:00 PM, they were like, “Oh, we’re going to have a baby. This is going to be before lunch.” I was almost 10 centimeters dilated so we were really excited about that We got to the pushing phase and things just didn’t move. I mean, I was making very little progress and knowing and having the knowledge that I have now, I look back and realize there was very much a disconnect happening with my mind and body which I’ve seen happen in some other women sometimes when having epidurals. We pushed. I pushed for a total of about 5 hours. meagan: Wow. brittany: We did have some breaks in between. Yes. There was actually not an OB on the floor so it was with a nurse. She left to go home and the one that I was going to have was in the office, so they basically just let me keep at it and the nurse did try. I will give her credit in that she tried to get me into some different positions, but we just could not make any progress with her and we did know when my water broke that there was some meconium in my fluid so we knew that that was there and that we needed to be aware of it.But after about 5 hours, we were exhausted. It was like, “What is going on? Do we need to make some decisions? Why can’t we get an OB over here?” So finally, the OB I guess had finished her shift across the way in the office and made her way over. At that point, it was about 6:00 PM. It had been a very, very long afternoon and she came in and she did an assessment and she said, “There is a lot of meconium, so we need to make a decision. We either need to get this baby out with a vacuum or we take you back for a C-section.”I was like, “Well, what’s a vacuum?” We had no knowledge of what that was or what the pros and the cons were. They literally brought in a pamphlet and were like, “Here’s a pamphlet to read about it.” meagan: They didn’t just tell you all of the pros and cons right there? brittany: No. meagan: They gave you a pamphlet after 5 hours of pushing and feeling exhausted? brittany: Yes. They gave one to us. meagan: I’m sorry, but that’s silly. brittany: It’s terrible. Yeah, it’s terrible because I was in no head space. I was just beyond exhausted. She said, “I’m going to give you about 30 minutes and we are going to prep the OR. When I come back, let me know what you want to do and we can try the vacuum or we can go back for a C-section.” I was like, “Okay.” My husband and I are talking through this and really have no idea what to do. Reading a pamphlet in that time and place is just not okay and not adequate. So she came back in and she gave me another assessment and she said, “Okay, I’m really sorry but we need to go back for a C-section right now. Meconium is very thick and this is becoming very problematic.” She took the vacuum option off the table and said, “We need to go and we need to go now.” So we went back for what I consider more of just an urgent C-section, not an emergent C-section and it was an experience. About halfway through, I started to feel what I felt like was way too much. They actually did end up putting me to sleep fully after she was born. meagan: After she was born?  brittany: She came out, and she actually– after she was born. So when she was born, she didn’t cry. I panicked about that and my husband was like, “It’s okay. It’s okay,” and we found out that she did have a lot of meconium and she did need to be resuscitated. She actually had an APGAR score of 2 which was much, much less than my twins who were born at 34 weeks so thankfully, they got that addressed very quickly and by that 5-minute mark, the APGAR score was back up to an 8, but at that point, I told them, “I am feeling way too much of what you are doing to sew me back up.” I started to really panic. My pain level was very high so I saw her briefly and then they took her to the NICU and then they actually ended up just putting me to sleep because I woke up back in recovery following. She was a 9-pound, 2-ounce baby. They very much threw the label of big baby, this is why you couldn’t push her out. She was stuck, and things of that nature. She was sent to the NICU again. She was my third NICU baby. This is my third baby that I haven’t held or touched post-delivery. Just a weird, weird experience. So this C-section was much, much more challenging for me than my first. Obviously, I had labored down for many hours. I had pushed for many hours and then went into a C-section which makes a huge difference but I also had an infection post-birth which one of the OBs said was probably from the numerous amount of cervical checks that they gave me after my water broke. So I just had a really, really hard time. I went into postpartum already struggling. I was struggling before I even had left the hospital. Thankfully, our little girl only had to stay in the NICU one night. She was able to be with me the second night and then was able to come home with us, but still, it was just a very abnormal situation where you wake up from the surgery. You just had a baby. Your hormones are all over the place but your baby is not there. You are in pain. It was just a very unnatural situation. I really went into postpartum already a few steps behind. I just was really struggling physically. I dealt with a lot more pain this go around and mentally, I struggled a lot emotionally. I didn’t know it until later on, but I really believe that it’s healthy to grieve a birth that doesn’t go the way that you had maybe envisioned or planned and that’s such a healthy thing to do. It felt so silly to me at the time. You’re like, Okay. My baby’s healthy. My baby’s here. Why can’t I get this together? But really, it’s so much more than that. I know so many people will say, “But we have a healthy baby,” which is what you want and is so great. It is not the only thing that matters though and I think so many people, so many women don’t realize that. People mean so well. Family and friends come in and say, “Oh, but thank God the baby’s okay.” Yes, of course, thank God the baby is okay, but it’s not the only thing that matters. You essentially have a grieving mom in the thick of postpartum who also just had a major surgery, so it was a lot. It was a lot. It was honestly a really miserable postpartum recovery for me and I also had twins who were 17 months old. It was just a lot. So at my 6-week visit, the OB who did my C-section said, “Okay. That’s it. It will be C-sections from here on out. VBAC is off the table. You just need to know that.” I left that appointment and I actually remember texting my cousin just about it and I was like, “Okay, I guess that makes sense. I’ve had two C-sections.” Then weeks following, I just was more and more unsettled with that. I really was grieving the whole situation. I was grieving the fact that I had three babies and somehow hadn’t gotten to hold one of them after delivery. It was all of these emotions that I was trying to process and through that, I became very obsessed with birth like, I need to understand. I need to know. I need to educate myself and I want to know as best I can what happened in Lyla’s birth. How did we end up here? I really began to educate myself. I delved into all of the things. A few months later, I really felt the Lord calling me to pursue becoming a doula. I mean, we had three kids under two-years-old, so it was crazy to think about taking anything else on, but I remember it was that following July, I went to my husband and I was like, “Listen. I know this is crazy. I know we have so much on our plate, but I really, really feel like the Lord is calling me to pursue becoming a doula so that I can help educate and empower other women and hopefully help them avoid being in the same situation that I was.” He, being the man that he is, was like, “I think you would be great.” He was like, “I’m totally supportive. I’m totally on board.” So then that started my journey of becoming a doula and it was about a year where I went through my program. I worked with those first initial moms. I did all of those things and I really, really loved it. Then I found out I was pregnant again and that was January of 2022. I knew for sure I needed and wanted a different situation. I could not walk through the same scenario that I walked through, especially with my second daughter and I wanted things to be different. I really had home birth on my heart and where I live, I live near Charlotte, North Carolina, there was actually only one hospital that would allow you to pursue a VBAC after two C-sections. meagan: Really? brittany: All of the other hospitals will not, yes. So I started to pursue home birth but then also thought, Maybe I’ll do co-care because then I will have something lined up if something does go wrong, blah blah blah. So I tried to get into that hospital with their OB/GYNs and at all three of their locations, they were not accepting new patients. Initially, I was very discouraged. I remember crying that day, texting my husband, What are we going to do? This is the only hospital that will even allow this and that will even potentially let me come in and try. He very simply said, “The Lord closed that door to co-care. Focus on home birth. That’s where your heart has been.” At the time, that overwhelmed me, but looking back, it was one of the best decisions and I’m so thankful for it. I do believe there is a time and place for co-care for certain women, absolutely, who want to do home birth but want to have that co-care piece, but for me, looking back, I think co-care would have destroyed me mentally just with all of the appointments, all of the extra things being said even though I knew and had that VBAC knowledge. It’s hard when you are constantly getting little bugs in your ear of, “You shouldn’t do this. We need to induce,” or things like that so in the end I was very thankful for that. I simply pursued home birth. I interviewed a lot of midwives and I ended up with, I’m very biased but, who I think is just the best midwife ever. She’s really, really awesome and received just such amazing care. My visits were an hour long. It was very proactive care trying to stay ahead of things that could come up just with nutrition and supplements and things like that. So I hired my team, my midwife. I hired a doula because I told my husband, I said, “I know I am a doula but I also know what happens when you are in labor.” I said, “Everything goes out the window and you go to labor land.” I said, “I want somebody there who I know can be my brain and can help me with all of the things when I can’t think straight.” He was super supportive of that and I hired a really awesome doula. So once I had my team in place, I felt really, really good about it moving forward. My husband was so extremely supportive. He’s one of those where anybody who is a doula, their husband is extra educated at birth. I feel like he has to listen to all of my stuff all of the time, but he was so supportive. At that point, I had a really standard pregnancy. The biggest things that I did were to continue, I used The VBAC Link a lot just whenever that doubt crept in my mind of Am I making the right choice? Is VBAC after two C-sections really safe?” I would go back to some of those resources that you guys put out. That knowledge that I had just to read through again to give myself that sense of peace that I made again. I listened to every VBAC after multiple C-section podcast that you have and really tried to focus on those positive birth stories. The biggest thing I did was that I really made the effort to protect my mental health meaning we kept the decision we made very, very private from family and friends which was hard because everybody, especially after my last experience was like, “Where are you giving birth? What is the plan?” But I knew that I didn’t need the opinions of everybody. I didn’t have the time or energy to educate everybody around me in the decision that I had made. My husband, myself, and our birth team were confident in the decision that I had made in moving forward so we just kept it very private. My best friend and my sister-in-law knew and they were my support throughout then once we got toward the end and I reached that full-term mark of 37 weeks, we did tell all of our parents because we wanted our parents to know. My mom was going to be there and his mom was going to come at some point. Thankfully, our family was very supportive. My mom used to be a labor and delivery nurse so she had a lot of questions, but my midwife sat down with her and let her ask all of them. So our family was on board, but I really just made the point to protect my mental health and only view and read things that were positive and only talk to people who I knew were going to be encouraging and positive about it. That was truly one of the best decisions I made throughout my pregnancy. Fast forward, we get to 39 weeks and 4 days. I thought for sure that I was going to go over 40. With that doula mindset, I always tell my clients, “Prepare to go over 40 weeks so that mentally you’re not distraught when 40 weeks comes.” Oh man, I was like, “It’s going to be over 40.” I was so secure in that that when it happened, I was not ready almost. I was a little overwhelmed like, “Oh my gosh. I’m not 40 weeks yet though.” I’m 39 and 4. We had actually went out with some friends that morning. We took our kids somewhere and my mom was there. I remember my mom putting us back in the car. She got all emotional and she was like, “I just feel like it’s going to be so soon.” I was so frustrated I remember because I was like, “No, mom. I’m not 40 weeks. It’s fine.” She’s like, “Call me as soon as something happens.” I’m like, “Mom, we have time.” Little did I know I was going to have a baby that night. Later that afternoon, I decided, I need to go to Costco. I need to stock up. My best friend was like, “You are crazy to go to Costco on a Saturday. That is going to put you into labor.” Sure enough, that is exactly what it did. I went to Costco and got everything I needed. I ran into Target and my first contraction started. I had Braxton Hicks most of my third trimester so I was very aware that this was different the first time it happened. But again, that doula mind, I was like, This could be nothing. I’m just going to ignore it. We’re going to continue on. They kept coming as I finished my shopping about every 10-15 minutes apart so when I left, I decided to text my husband and say, “Hey, this could be nothing but just so you know, I’ve had some contractions. They are about 10-15 minutes apart. We’ll see what happens.” They had started at 6:00 PM when I was out. I finished up getting when I needed, came home. My girls were already asleep on the couch and my husband put them to bed. We ate dinner. My son hung out with us for a little bit and things continued to pick up. I was like, Okay, this is definitely happening I think. At about 7:00, I alerted my midwife just to let her know, “Hey, it’s probably going to be a long night, but I’m definitely having contractions.” I let my doula know and our photographer. I got everybody in the loop. After I ate, I was like, “I’m going to get in the bath with some Epsom salt and try and relax. See if I can relax these contractions enough to maybe get some rest.” In my mind, I was like, This is going to be an all-night thing. Let’s see if I can get some sleep. But that is not what happened. I got in the bath for maybe 10 minutes. I had a few contractions and was like, I cannot sit like this. This is not comfortable. I called my mom and I was like, “Hey, I’m having contractions. Don’t worry about coming over yet though. We’ve still got plenty of time.” Thankfully, she ignored me because she was about 50 minutes away at the time. She ignored me and got in the car and came anyway which was a huge blessing because things continued to pick up really quickly. My husband continued to set our room up and the birth pool up but also tried to support me through contractions. Thankfully, all of our kiddos at this point were asleep upstairs which was something we had just prayed about because I wanted them close by, but I also knew that I just needed my space especially with them being so young. So that was such a blessing. They were all asleep. It was just me and my husband. So around 9:00 PM, my mom thankfully arrived which was a blessing because moments before, I was like, “Okay, you need to tell my mom to come,” because things were just moving really, really quickly. I particularly found a lot of relief in one position and that was the position I wanted to stay in. I was on all fours on the ground rocking back and forth on my yoga ball and everybody said, “Hey, try this. Try this.” I was like, “Nope. This is what’s working for me. I just want to continue doing this,” so that’s what I did for a long while. Shortly after my mom got there, we called my doula to tell her to go ahead and come because she was about 45-50 minutes away as well. With that phone call, she was able to tell because I had prior talked to her as well that things had definitely picked up. We were definitely probably in full-blown active labor. She had told my husband, “Go ahead and start filling the birth pool,” because anybody who has had a birth pool knows that it can take some time. He went ahead and started to fill the birth pool while my mom stayed by me, helped support me, and my doula left and was on her way. Shortly after that, my water broke. A lot of pressure, a lot of pressure, then my water broke. I remember being so panicked telling my mom, “Please check for meconium,” because I just kept thinking about Lyla and the situation that I had with my prior daughter. I said, “Check for meconium. Check for meconium.” She looked and everything looked fine. Following my water breaking, I moved right into transition. It was game on at that point. My husband called my midwife. He said, “Okay. We definitely need you to leave and come.” Thankfully, he had gotten the pool all ready so the pool was ready. Warm water was in. I was able to get in and that was about 10:45 PM. I was able to labor through transition in the water which was a huge blessing. I’m one of those who loves to be in the water. I love to be in the bath. I find it to be very relaxing. I remember at this point telling my mom, “I feel like I’m getting no breaks.” I still at the time did not know I was in transition. Looking back, I was very easily able to identify the phases, but when you are in it, even having that knowledge, you’re like, “No. There’s no way. This is going to go all night. How am I going to do this? I’m not getting any breaks.” But I had so much great support and my doula arrived not long after I got in the pool. She was doing some counterpressure and giving my husband some things to do to help. I have a lot of tension in my face so giving him some suggestions of things he could do. Not long after getting in the pool, that fetal ejection reflex definitely kicked in. I had heard obviously people talking about it. I had studied it in my work becoming a doula, but until you really experience it, you’re like, Wow, this is no joke. People are like, “How am I going to know when to push?” Oh, you will know. Your body is going to do it whether or not you want it. That is exactly what happened. My body was doing these little pushes without me even doing anything. Soon after, I started to really lean into that and continue with that pushing. I remember feeling such relief when I got to the pushing phase because it was very challenging. It was giving me that purpose through contractions and something I could focus on. I actually got a little bit of relief when I was doing some of the pushing. I remember being really thankful for that. My photographer arrived. My mother-in-law arrived during that time and my midwife team got there at about 11:15. I already started pushing a little bit, but I remember although yes, it’s challenging to not have an epidural, it was also so amazing because having had the experience of Lyla where I pushed for 5 hours and they were like, “Well, she’s not moving. She’s in a bad position. She’s stuck.” I could feel nothing. I could feel everything. I could feel the progress of my baby being moved down frequently during pushes. I could feel her in the birth canal. I could almost feel the progress I was making at different times with her which was so motivating and so helpful for me. That was just such a night and day experience from my prior experience pushing with Lyla and then after about an hour and 15 minutes give or take a little bit, my daughter, Charlie, made her way into the world. It was about 12:25 AM and it was a beautiful, beautiful, beautiful experience. She was born in the water. Literally, my overwhelm of emotions following was like nothing I could ever really articulate in words. The oxytocin was on full blast. I was on this birth high and having had prior C-sections, one of the downfalls of a C-section is that you are on so much medication and so many pain meds that I always felt like when I came out, I was in a haze like I didn’t really know where I was and things like that so to be so present and to literally feel my hormones doing what they were designed to do was such an overwhelming experience. I remember talking to my husband about that days later and I was like, “It was just such a high after she was born.” This was obviously my first experience getting to hold the baby post-birth so that was very emotional for me getting to pull her up to me and have her right there and just be able to hold her. My husband was there and people who we loved most were just surrounding us. It was a very, very beautiful, overwhelmingly positive experience. One of the benefits of home birth is that you get to move from the pool or wherever you gave birth to get comfortable in your bed. So that was just awesome. I remember when they got me comfortable in my bed, I was looking at my birth affirmations wall. I had a bunch of stuff hanging up by the pool and I remember thinking, “Oh my gosh. Thank God that’s done. that was the hardest thing I’ve ever done,” then a minute later, I was like, “I feel like I’m going to have to do this again.” I was so overwhelmed with the experience and the emotions. My husband and I got to lay in bed. We got to cuddle our girl and pray over her. Everybody was so great. They were cleaning everything up. My mother-in-law was making food for everybody. It was just such a beautiful experience. Then about an hour into it, we decided to do just her newborn checks and have the midwife look her over, weigh her, and stuff. We knew she was big. There was no denying it when she came out, but never once did I look at her and be like, “Gosh, she’s a giant baby. She’s so much bigger than Lyla,” or anything like that.We weighed her and everybody made their guesses. She ended up being 10 pounds, 10 ounces, and 22 inches long. The 9-pound, 2-ounce baby that they said I could never push out and could never have had her vaginally, I ended up going on to have a 10-pound, 10-ounce baby girl. She also had a nuchal hand. Her hand was up at her face when she was born which can make things a little bit more challenging, but I delivered her and I had no tearing. It was just such an amazing redemptive story after being told, “You never could have birthed this 9-pound baby. You’re never going to have a vaginal birth. The door is closed for you,” and really have the exact opposite happen. I went on to have a much larger baby and she was great. She was healthy and had no issues. My children were just thrilled the next morning to wake up and come and meet her. To this day, they will still bring it up. “Do you remember when Gigi brought us downstairs and we had a new baby?” It was such a beautiful, redeeming story for all of us, my husband included. I think sometimes we forget how much of an emotional experience it can be for the dads and especially to see their wives go through so much so it was just so healing for both of us. It was just such a beautiful experience. I feel like I could go on and on about it. I had the best postpartum care. For those who aren’t familiar, with a home birth, your midwife comes to see you multiple times. Mine came to see me six times. She came at 24 hours, 48 hours, 72 hours, one week, and two weeks, so she was constantly there checking on me, checking on my baby girl, and it was just care like no other. All I had known was I had major abdominal surgery then 6 months later, they brought me in and were like, “You’re cleared for everything.” It was so overwhelming and this go around, I had somebody who was like, “How are you doing mentally? How are your emotions? How are things healing? How is your nutrition? Are you resting?” All of these things are so, so important for postpartum, and I think so many women don’t even realize these things about what postpartum should really look like. I will forever be thankful for that care as well. That was just unlike anything I had prior experienced obviously as well. So yeah. I mean, overall, it was such a beautiful experience. I’m so thankful for how it played out. The Lord had answered so many of our prayers throughout and I’m so, so thankful to my midwife who believed in me and in my body’s ability to birth my baby no matter the size and that team of people who I had, I will forever be grateful. Meagan: Are you willing to share your midwife with those in your area who might be feeling restricted because of the lack of support in your area?Brittany: Yes. I will say I had a certified professional midwife. I live in North Carolina. I live outside the Charlotte area in Monroe. We are very lucky. We have such a fantastic group of midwives in the Charlotte area of certified professional midwives. There are truly multiple great midwives. My midwife’s name is Brooke. She is just the best of the best. She is a dear friend of mine and I have been really lucky as a doula to get to work with some of her clients and still see her at births and things following. If you are in the Charlotte area and you are considering home birth, things can be a little bit hairy because we do have some restrictions in regards to certified nurse midwives compared to certified professional midwives, but feel free. I think in the show notes, my information will be there. I would be so, so happy to help guide anybody in this area and give you a list of names of some really, really great providers who support VBAC or VBAC after multiple Cesareans because it can be a hard world to navigate whether you are in the hospital system or planning a home birth. It still can be really hard to navigate if you don’t know where to look. Meagan: And can people find you somewhere if they have any questions they can write you to on your own doula page? Brittany: Yes. Yes. You can find me at Joyful Beginnings Doula Care. You can find me on Facebook and Instagram. I also have a website at joyfulbeginningsdoulacare.com. Please feel free. I love nothing more than helping guide moms in finding that right support and then also obviously, I love working with VBAC moms as a doula. But you can find me there. Feel free to reach out. I love doing whatever I can to just help other women have more positive experiences especially when it comes to VBAC because that’s really, really hard sometimes. Meagan: Absolutely. It is. It’s hard and it’s frustrating that it’s hard so it really takes a village to find the right support. Let me tell you. I’ve been taking little notes along the journey of your story and there are so many things.One, you had a preterm Cesarean so that’s a thing and we don’t even have time to go through all of these things so while she was sharing, I was like, “Ope, we have a link for that. Oh, we have a blog for that.” We have so many blogs. We have all of it. I already sent it off to our amazing transcriber, Paige, who will make sure that this is all in the show notes. But preterm Cesarean, then a close duration between Cesarean and her TOLAC that ended in a CBAC. Talking about red flags in finding the right provider, processing the birth, and co-care– I wanted to explain for anyone who didn’t know what co-care means. I love that you pointed out to the fact that it’s really, really great for some people and it’s not great for others. I think that if you’re interested in co-care or if you are interested in it, you need to tap into you as an individual and the type of place that you’re in because co-care can be amazing and it can be tricky because of what Brittany said where you can go and you can be getting this information from a hospital and then this information from your home birth midwife or your birth center midwife and they are not the same. They can pull your mind out of a very positive space and start putting a lot of doubt and questions. So if you’re going to do co-care, I think it’s super important no matter what, but you really, really need to know your facts because it’s going to be important and it will likely come into play where someone might say something and it’s the opposite of what the other professional is saying so you need to know what the evidence is. Big baby– I’m going to include a blog about big baby if you are being told that you have a big baby or if like Brittany, you were told that you would never, ever get a baby out of your pelvis because your babies are too large and it was a whole pound plus bigger baby for her VBAC. Oh my gosh, what else? I love that you also talked about something that is so unique to home birth in my opinion and I just wanted to touch on it really fast. That is the care after. Here in the U.S. and I know that if you are not listening from the U.S., it’s very different outside of the U.S. Here in the U.S., it is very standard to have the type of care like what Brittany described even with a Cesarean. It’s an abdominal surgery. It’s a pretty big deal to have surgery or to have a baby vaginally and to not be seen, called, or asked anything for six weeks. Six weeks– let me tell you how much can happen in six weeks. A lot can happen. I love the uniqueness that home birth does offer and I love that you even felt that and that you saw it yourself. You saw the difference of 24 hours, 72 hours. You’re getting those mental checks. You’re getting, “How are you sleeping? How are you eating? Where are you at? What are you doing?” We’re getting those check-ins. It is so important. It is so important. So if you are birthing at a hospital and you are likely going to be in the traditional line of the six-week follow-up, I highly suggest with checking in with a postpartum doula or getting someone who is a professional that can check in on you– a therapist even if you have gone through therapy. Have a 72-hour checkup with your therapist after birth. If that means you just talk and you’re like, “All things are peachy. Great.” There are things in the U.S. that we have to do where we, unfortunately, have to take it upon ourselves to take care of our mental health because it’s just not the way the standard care is. I’m going to leave it at that. Brittany is shaking her head. She’s like, “Mhmm, yeah.” Do you have anything to add to that? Brittany: The only thing I would add to piggyback off of that especially if you are a VBAC mom, take the time. Do the research. Reach out to a local doula who you know is VBAC supportive if you need extra help doing this but take the time to find a provider who is supportive and not tolerant because your providers and your birth team, the people you are allowing into your birth space, can truly make or break your birth experience. I have witnessed it. I have experienced it so do your due diligence on the front end. It is not always easy, especially navigating the hospital system, but there are people out there. A lot of local doulas do know, “Hey, I’ve had a lot of great experiences with this OB/GYN when it comes to VBAC”, or “Hey, stay away from this practice.” Do your due diligence. Find a team who really believes in your body’s ability to birth your baby vaginally. They need to believe in it as much as you do and just take the time to educate yourself. I believe that education is the key to empowerment. That’s such a big piece of the work that I do with my moms leading up to birth with both birth and postpartum but take that time. Educate yourself. Find a team who believes as much as you do in your VBAC. Meagan: I am just going to leave it right there because I think that is a nice way to zip it right up and complete this beautiful episode. Thank you so much for sharing. Congratulations. I love so much that your kids still talk about, “Remember how she brought us downstairs?” So awesome. I’m so happy for all of you and congrats again. Brittany: Thank you so much for having me. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
53:1615/07/2024
Episode 316 Lynn Schulte Returns Talking About the Pelvic Floor and More

Episode 316 Lynn Schulte Returns Talking About the Pelvic Floor and More

Lynn Schulte, the founder of the Institute for Birth Healing, was featured on The VBAC Link Podcast Episode 123 back in 2020 and today she is back! So many of you loved her information about Cesarean scar massage and know her insight about pelvic assessment, movement restriction, and balancing uterine ligaments will be just as valuable to you. Lynn gives tips on how to tell during pregnancy if you need pelvic assessment and also the three signs to watch for to know if scar tissue is interfering with your quality of life. Through the Institute of Birth Healing, Lynn has trained hundreds of practitioners all over the world to be able to assess more women for pelvic restriction and to know just what to do about it. She shares how to find one of her practitioners in your area. While pelvic floor physical therapy may require investing more in yourself both from your time and finances, the benefits can last for years to come and are so, so worth it.  Lynn's Educational PlatformClinical Practice WebsiteInstitute for Birth Healing DirectoryBlog: Preparing the Pregnant BodyBlog: Supporting Pregnant ClientsYouTube: How to Massage Your C-section ScarLynn's Live Course ScheduleInstitute for Birth Healing: All CoursesNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. We have a returning guest with us today and her name is Lynn Schulte. She is with the Institute for Birth Healing and she was with us, I don’t know, 3 or 4 years ago talking about scar massage, and today she is going to be talking with us more about pelvic floor health and the cervix and failure to progress and so much more. Today, I am so excited to share with you guys again Lynn. Before we get started, I wanted to tell you a little bit more about her. Lynn Schulte is a Pelvic Health Physical Therapist for over 30 years. She is the principle instructor and founder of the Institute for Birth Healing. She has successfully healed thousands of women from all the issues women experience after birth and is now teaching courses to bodyworkers to help them do the same. She found a common birth pattern that shows up in the pelvis after birth and knows how to effectively release these patterns. Knowing we are more than just our bodies, Lynn works on all levels, physically, energetically, and spiritually with women to help them access their full potential. She also teaches bodyworkers how to work with the energy of the body and how to access and use your intuition in your bodywork sessions. She offers a certification process to help birth professionals become Birth Healing Practitioners. Lynn holds a Bachelor of Science in Physical Therapy from St. Louis University in St. Louis, Missouri and I am seriously so excited to have her back on today. Before we get going on this amazing episode, I did want to share a Review of the Week and this is on our Parent’s Course. It’s from Jenna and she says, “I just started but already have learned so much. After two C-sections and one where my doctor made me think it was very risky, I was terrified to try again. With this course, not only have I learned the truth about VBAC, but I’m also excited to attempt mine in August.” Sending you all the love Jenna and seriously, let us know how things go. If you guys are looking to dive more into what VBAC looks like, what the history of Cesarean looks like, what the evidence is on VBAC and how to increase your chances of having a VBAC, check out theVBAClink.com. We have courses for both parents and doulas wanting to learn more about supporting birth couples around you. Meagan: Okay, so Lynn, I am so excited to dive in today again with you. It’s so cool that you have been on before. We were just talking about it before we started recording– a long time ago it feels like and now we are circling back and I was telling her you guys, I actually found her very, very first– I actually didn’t even know about pelvic floor therapy or any of that really like pelvic floor health or anything and do you want to know how sad it is? By the time I found Lynn and her YouTube page back in 2019 probably, I had three babies. I had three babies. Lynn: Yep. Meagan: That to me right there is a problem. Lynn: Totally. Totally. Yeah, let me tell you what that problem is in my world, okay Meagan? We do a wonderful job in our country here in the States of taking care of mom and baby and making sure mom stays alive and baby stays alive. Where we fail pregnant people is where nobody is assessing or treating what I like to call the birth door. The birth door is that passageway. The pelvis and the pelvic floor muscles are the birth door. I’ve just seen way too many times in my practice where women have issues. One client came to me because she wanted a vbac and she had 42 hours of labor. I went to assess her and her tailbone was sticking straight up into the pelvic outlet so the baby’s head was hammering it for 42 hours and why? My heart broke for her because I was like, “Why did nobody assess this?” Meagan: Right? Lynn: It blows my mind that doctor’s aren’t aware to check that the pelvis is capable of birthing a baby. Now, I don’t want to give moms the wrong feeling here because most pelvises, a large majority of pelvises, are able to get a baby out when the baby comes into the pelvis in an appropriate manner. Where we are failing moms is that the doctors are not as concerned about the position of the baby, about the balance of the baby and the way the baby is entering into the pelvis. It’s like they don’t even understand that component. Nobody is assessing to see is anything in the way? Is anything going to be in the way of my baby coming through my pelvis? That’s where a pelvic health PT can come in and do that assessment for you. If you see one of the pelvic practitioners who I’ve trained, they know exactly what to look for and not only look for but what to do about it when they do find things. Meagan: Yeah, so I was going to say that we find it. We recognize it, then is there something to do? A to-do? And the answer is yes? Lynn: For the most part. For that one client whose tailbone was sticking straight up, it was fused in that position. Meagan: Was it? Lynn: It was so there was no mobility of that tailbone to be able to move out of the way so what I love about my work is working with a pregnant person and really getting a chance to evaluate what her pelvic bones are doing and the position of them and trying to treat what we can but when we can’t make effective change, I like giving the information to the birth team to say, “Hey, if labor stalls, you might want to push here.” Sometimes I will get a marker out. I get a Sharpie out and I put a big X on a person’s sacrum because the sacrum needs to be nice and even for a baby to come on out. The sacrum needs to be able to move backwards and forwards to allow the baby’s passage through the pelvis. If that sacrum should be as even as possible to make that movement happen as easily as possible, but sometimes it can be in a torqued position and if it’s in a torqued position in there in the pelvis, usually there is some dysfunction or back pain. Another problem is that most OB providers, you go in complaining of back pain and they go, “Well, you’re pregnant. Live with it.” In my world, that pain and that dysfunction could be a problem that you’re going to bring into your birth then. Why not optimize our bodies the best we can for birth prior to going into birth? Meagan: Prior. Key word: prior. Lynn: Prior, everybody. Meagan: Prior. Prior. You know, I think that’s what a lot of us don’t think is that we need to do this prior to going into birth. It’s just that so many people especially I’m going to call us out as C-section mamas. Pelvic floor or anything like that or thinking about it down there doesn’t even cross our minds sometimes because we didn’t have stuff happening down there. Lynn: Right. Typically, right? Meagan: Typically. Lynn: Yes. When we are pregnant, we are all consumed about baby growing and is baby going to be okay? But what I would love to help see shifting is okay, the difference between a smooth birth and a birth that has complications is really what a person brings in their body to that birth. So it’s these falls and impacts on your tailbone or your buttocks or it could be surgery so appendectomies– anytime in your lifetime creates scar tissue. Your appendix is in the right lower quadrant of your belly and if you’ve had your appendix taken out even as a child, there is scar tissue that forms and that scar tissue is in the area of the uterus. It will pull that uterus to the right side. Meagan: Interesting. Lynn: 100% all the time, all my mamas who’ve had appendectomies, I find their uterus is off to the right hand side and cannot move to the left. Meagan: Really? Lynn: They don’t know it. They don’t realize. I had this one mama come to me and I always look at the baby in the belly and look at the belly. You can see. If your baby is only inhabiting one side of the belly, there’s a problem there but most practitioners don’t notice it, don’t ask about it, and don’t know what to do about it. Really, if we could help educate OBs and help them understand the importance of helping to get baby into the best position possible to come on out, that’s going to decrease our C-section rate. Meagan: I was going to say, that is probably going to completely decrease that because we know that failure to progress which can be positional, and failure to descend or fetal position are three really serious things that are happening and causing Cesareans. Lynn: And all three of those are things that can be addressed in the structural tissues, in the soft tissues, in the uterine ligaments, in the pelvic bones, in the pelvic floor muscles, in our hip muscles, in our rib cage. Everything is influencing it. Baby goes where there is space. Meagan: It makes sense. I would too. I did. I did, 35 years ago. Lynn: Yes. Baby goes where there is space so baby tells us where there is tension in your body. Either they are avoiding tension or there is so much tension on one side that they can’t get away from it. That’s what we can assess and we can move that belly so anybody who is pregnant listening into this, you can take your hands on either side of your belly and you should be able to push that baby as far to one side as you are to the other side. It should be even. If you only go halfway one way and double the other way, that’s a restriction in your uterine ligaments and that’s an indicator that you might want to think about going and getting some work done because people who know how to work with the uterine ligaments can help release them and get even mobility. It’s amazing. I have some blog posts that I’ve just recently posted on my website, instituteforbirthhealing.com where I’ve done some talk on pregnancy. There are before and after pictures of treating someone and the baby. In several of the first pictures, the baby looks like it’s almost going side to side and those babies have round, right ligament tension. We all have those ligament pulls and those twinges and that’s your round ligament. That’s your round ligament, but if it’s only on one side, that’s a ligament that has an issue. If there’s a little twinge here and a little twinge there that alternates, but really, we should be able to carry a baby without any pain period. If we are having pains and discomforts, that’s telling us that things are in dysfunction and it would behoove you to try and get support so that you can release those dysfunctions to help you have a smoother birth. It’s interesting. If you guys check out those blog posts, the position of the baby is straight up and down. The belly, the shape of the belly, changes dramatically after you release the ligaments. Meagan: We will make sure to put those blog posts in the show notes so they are very easily found as well. If you are wanting to check out these photos, check out the show notes after this episode. Lynn: Yeah. It’s just so fun as a practitioner to see these drastic changes. Meagan: Oh, I’m sure. Lynn: Right? And to feel those. We talked about the belly and the uterine ligaments. We talked about the pelvis and the pelvic bones, but the pelvic floor muscles are the stoplight for birth. If you have too much tone and tension in your pelvic floor muscles, that baby is not coming through. Meagan: It’s going to be hard, yeah. Lynn: You could have a yellow-light tone which is going to make it a lot harder but what we want is a green-light tone where it’s nice and bouncy and springy and you press down and it gives and it releases and it comes back up but if there are breaks in there, that baby is going to have a hard time because those pelvic floor muscles need to lengthen for baby to come on out. I really encourage everybody. I know this is The VBAC Link and I hope for those listening in who want to have a vaginal birth after a Cesarean, please go get all of this stuff checked out. Please go work with a practitioner who can help you figure out how to push effectively. Meagan: Yes, yes. Lynn: I can’t tell you the number of people I see in my practice and I go, “Okay, can you push?” I do intravaginal work. I just use fingers in the muscles and work with the tissues vaginally, no speculums, and I’ll just put my fingers on those pelvic floor muscles and I’ll say, “Can you push my fingers out?” I can’t tell you the number of times that people contract and pull up and in. Meagan: Interesting. Lynn: So then if it’s like, “Push my fingers out,” and you’re contracting, now you’re pushing but you’re tightening at the same time and your baby is not going anywhere. Meagan: Mhmm, and we have failure to descend. Lynn: Yes, yes. There are so many things that can cause failure to progress, failure to descend, asynclitic babies, and OP babies. All of that is stuff that can be dealt with prior to the labor. It should be. Meagan: That keyword again: prior. Lynn: Yes. Meagan: I’m loving this because it is something that like I said, I didn’t even know about until three babies were already born and I was one of those people who was told that my pelvis was too small. You mentioned that this tailbone was physically fused so maybe it was broken in the past and fused kind of funky or something like that. I actually had a client who had that situation and her tailbone actually did break during birth but her first was a C-section. She was going for a VBAC and there was all of this restriction in the first one and it did break which is one of the wildest experiences I’ve ever had during birth. She was actually good with it. She was like, “That’s great. My baby came out vaginally,” but then she wanted to learn how to heal it properly and things like that. There are situations where like you said maybe the pelvis isn’t working with us in our favor, but I was told my pelvis was too small and that I would never get a baby out and I had failure to progress and that my body didn’t know how to get to 10 centimeters. So I think really a lot of people are told that so I wanted to know after someone who has been told that their cervix maybe didn’t dilate or wouldn’t dilate, we know that there are lot of factors that could play into this especially too early of an induction or things like that, but what can we do prior to labor if this was a diagnosis of ours and we are wanting a vbac or even not wanting to have more kids and we’re having back pain or we’re having weird things like maybe incontinence or pain during intercourse or things like this. What can PT do for our cervix to maybe help that and what could be wrong? I say wrong loosely, but what could be less ideal with our cervix at that time? Lynn: So the most common answer for everything that you just talked about there is the uterosacral ligament. Meagan: Okay. Lynn: The uterosacral ligament is the ligament that attaches the posterior/inferior aspect of the uterus near the cervix to the sacrum. Well, some to the sacrum, some to the sacrotuberous ligament, some to the spinous processes. So the attachment point to the pelvis varies in different women. Meagan: Wow, okay. Lynn: So depending on any restriction and one of the biggest issues is that the uterosacral ligament helps to drain the cervix. If the uterosacral ligament is restricted, it may cause the cervix to swell. Meagan: Interesting, which we have seen. Lynn: Yep. Yep. So the uterosacral ligament being restricted can cause the cervix to swell and then not be able to open up fully so then you don’t get full dilation and things. Uterosacral ligament will be the first place that I would look. I just had a client a couple of weeks ago who was pregnant with her fourth and all three times, she was getting ready to push, but then she was told, “Oh, you have a cervical lip so don’t push. Don’t push. Don’t push,” and it was a swollen part of her cervix. I went to assess her and her right uterosacral ligament was restricted. Meagan: Interesting. Lynn: She’s like, “This time I’m just going to go for it. I’m not going to let them tell me to not push,” because that’s traumatic in and of itself. Meagan: Yes, especially when your body is just intuitively doing it. Lynn: How do you stop a poo coming out of your anus mid-stream? You can’t. So to tell someone to stop that is just traumatic and not a great thing. But the uterosacral ligament is where I would first look. That is one of the main ligaments that I work with in my clients is just to make sure that there is nice balance and that it can work evenly. Some people are saying scar tissue on the cervix could cause some inability for it to open fully. I like to work with cervixes when clients come to see me and they’ve had the biopsies or they’ve had anything where the cervix tore or something during birth. I just want to give that scar tissue some love and just see if we can’t soften it because scar tissue can be very hard and it’s not as flexible as normal tissue so I want to just see what can I do to help soften it. Most, I don’t tend to do that during pregnancy. I would like to see someone who has any scar tissue prior to even getting pregnant though. Meagan: Prior prior. Prior to even getting pregnant and conceiving. Lynn: Right. We have to plan ahead ahead here guys ideally because I don’t like messing with the cervix once someone is pregnant. Meagan: Understandable. Lynn: I will around 39-40 weeks and especially if someone is overdue, I will go give some love to that cervix and make sure it is feeling okay and soft and mushy all around. We want that. It’s very interesting to feel some cervixes. Some cervixes feel like a duck’s bill. The cervix is really long on half of it and then it’s shorter on the other half like it got dragged out as the baby came out. I mean, I’ve felt all kinds of different cervixes in their afterbirth and if someone does have any type of scar tissue, ideally, let’s work with it in the postpartum period when you are healing so that it can be nice and happy and healthy and then maybe even right before you get pregnant again to get some work done on that beforehand and then I would leave it alone until baby is well-cooked in there. Meagan: Right. And those things can help those lack of dilation, those cervical lips. It’s interesting that you said that because I have a client, she is actually a VBAC client, she shared her story on this podcast and she just had another baby where I was with her and same dang thing is that cervical lip. It happened. It’s so interesting but she labors, she labors, and that cervical lip just does not let go and then she ends up getting an epidural at the very end, and then within 15 minutes, it’s gone which is interesting so what is it? Is it possible that the epidural or maybe she is struggling and she is extra tense? Lynn: Yeah, that could be it. Meagan: Maybe she’s intuitively feeling like she needs to push but can’t because she has this lip. I’m trying to relate to what you said. I’m going to text her after this and be like, “Hey girl, you should go check this out.” Lynn: I’m not quite sure what the epidural is doing for the drainage. Like you said, the epidural bypasses the muscles so it takes the muscles out of the picture so it must be doing something for that uterosacral ligament to help it to relax as well. Meagan: Interesting. Lynn: So that it can now drain for things. That’s really what is helping to drain the cervix is the uterosacral ligament so if there is a dysfunction– well, if the pelvic floor muscles are tight and pulling the bones out of position, that can put strain on the ligaments so it’s possible that indirectly, the epidural is causing that to not be as tense. Yeah. Yeah. Meagan: Yeah, it’s really interesting because she’s like, “I don’t want the epidural,” but right at the 9.5 centimeters, she goes for a while then yeah. I’m just curious. I never even knew about this drainage. There are so many births in my head that I’m connecting this with where I’m like, “Oh, this could have been that.” Okay, so we did talk about cervical scarring, working it out prior to getting pregnant and doing PT during. Do you want to add anything else to the cervix? Lynn: I do because the cervix on an energetic level is the blackbox recorder of the pelvic history. Meagan: Okay. Lynn: Meaning that the cervix energetically is actually holding onto everything that has happened in that vaginal space kind of like the history of it. So tuning into the cervix and helping the cervix to realize that it can let go of whatever is no longer serving you and just asking that cervix to energetically release– Meagan: Let go. Lynn: Let go of what’s no longer serving you can just relax it. When I tune into a cervix, I just love to give it love and gratitude for all that it has done for my clients and just offer it that gratitude. It’s just so amazing. You can feel it just melt in your finger when it’s respected and when it can sense that love and that connection. It just softens. Meagan: Wow. Our bodies are incredible. I mean, I’ve said this before. I’ve said this before, but holy cow. They are incredible. Lynn: They are. They are so fun to work with. They are so fun to work with. I totally agree. Meagan: Oh yeah. Yeah. Okay, so can we talk about someone who has never had a vaginal birth and has maybe had one, two, multiple Cesareans or even just one and how can– okay. We just talked about getting an appendix removed. A Cesarean is a major deal to our body. As you mentioned, we get scar tissue and scar tissue can be tough sometimes. We’ve got a lot of scar tissue usually with a Cesarean but what type of things can someone if they are fresh out of a Cesarean specifically do with pelvic PT? What would that look like? I just had my Cesarean and I’m coming to you. Lynn: Right. If it was just a planned Cesarean where we didn’t go into labor, then we really just want to work on that scar tissue and get greater mobility in that scar tissue. I used to think that maybe we were getting rid of scar tissue until I saw what scar tissue looks like in the body. I observed a surgery and I’m like, “Oh man, we are not getting rid of it.” Meagan: Yeah, because it’s really thick. Lynn: It can be. It can be. What we are doing is increasing its flexibility and how to help it best lay down because scar tissue lays down very haphazardly and all of the fibers lay in all different types of directions trying to create stability and close up the tissues and help the tissues to be strong. It isn’t until it learns how to lay down. So say if you got a scar on your arm and if you bend it and flex your arm back and forth, it teaches the scar tissue how to lay down properly to work that arm. Meagan: Okay. Lynn: In the abdomen, we are more 3D so it’s harder. The tissue doesn’t figure out how to lay down so it’s still in there very criss-crossed everywhere until we get in there and massage it and teach it how to move effectively. That’s where I do have that YouTube video of how to massage your C-section scar. That’s how you found me in the first place. Meagan: Yes, that’s how I found you and we actually have a whole episode. I think it was 123, right? Is that what I said in the beginning? It’s 123 with Lynn and we’re talking about scar massage and scar care. Lynn: Yes. Yeah. That helps it to learn how to lay down properly. I think in that episode we also talked about the three main issues that people can have when people have too much scar tissue or when the scar tissue is inhibiting things and that’s bladder frequency, deep thrusting pain with intercourse, and back pain. Meagan: Yeah, that’s one of the things I was searching for because I had this back pain that just didn’t go away. Lynn: Yeah, because the back is not the problem. The pain is hardly ever where the problem is in the body and you’ve got to understand where that pain might be coming from. It’s usually from a restriction somewhere else in the body that is creating that pain. So releasing that scar tissue and getting it as flexible as possible prior to getting pregnant again would be ideal. Now, not a lot of people know how to do that so then they get pregnant and they’re like, “Oh,” you may have some pulling. You may get some tension in there. I like to work around the C-section scar when someone is pregnant especially newly pregnant. I don’t like messing around with anybody in that first trimester. We don’t know if it’s a viable pregnancy. We don’t want to be moving it around and working it too hard and if they do miscarry, then I might get blamed that you created that. Well, it might have not been a viable pregnancy to begin with, so I just want to be really, really careful in that first trimester. As the uterus grows though, it actually is stretching out that scar tissue. Becoming pregnant is actually a beautiful thing because it does help the tissue learn to lay down. However, what I thought then after someone who has had a C-section, they get pregnant again, no matter how they deliver, I thought the C-section scar especially if they did have a VBAC, that the scar tissue would be nice and loose and it’s not. It definitely tightens up again after the uterus shrinks back down. It’s almost like it gets reactivated. So it needs more scar tissue. It needs more massaging of that scar tissue. We don’t really know how long scar tissue forms in the body so there are other body workers who have had C-sections are like, “Oh no, you need to work on that the rest of your life,” so it could always potentially be causing those three issues– the bladder frequency, deep thrusting pain with intercourse, and back pain. So if you ever get any of that, massage your C-section scar. Meagan: Yeah, I was going to say that after I found your video, I started doing that and then I’d be like, “Oh, I’m doing really good,” then all of a sudden, I’d be like, “It’s back,” then I’d massage again and be like, “Oh, it’s really good,” then my old partner Julie was like, “I’ve never even heard of this. I’ve never touched my scar like that.” I’m like, “You should try it. It’s amazing.” With C-section moms, do you ever work internally with them as well? Is there possible trauma within the pelvic floor or cervix or anything internally? Lynn: Yes. After any birth, no matter how the baby comes out, I can find the cervix anywhere internally. Ideally, the cervix is right in the midline and I have to just reach up right in the middle of the vagina to find it but after birth, it can be off to the left or to the right. It can be pulled backward. It can be poking up into your bladder which is going to cause a lot of bladder frequency so we need to help bring that back and get that cervix balanced in there again and help it to find its mobility. The analogy is the cervix needs to be like a pinata in vaginally. It needs to be able to move 360 and up and down. The C-section scar tissue is what keeps it from being able to move up. That’s what creates that thrusting pain so releasing the scar tissue and getting down to the level of the uterus and getting the uterus to move side to side and rotating inside, those are all mobilizations I do to check the mobility of the uterus and then treat whatever it can’t do and that really does help. But internally, so once I get the cervix in its proper place, I also want to release and pull that. There’s a pubo-cervical fascia which is the fascia where on the inside of that fascia is the bladder so I just like to call it the bladder. I like to make sure that the bladder and the cervix have as much disconnect as possible because that scar tissue can glue them together. Meagan: That is what we determined when I went in is that I can’t remember if they said my uterus or my bladder. I don’t remember but they said that they were adhering together. Lynn: Yeah. The uterus lays over the bladder and underneath is where they cut so when it lays down on that bladder, it can inhibit the two and like you said, fuse them together. Well internally, I like to get in between those and pull the bladder off of the cervix of the uterus and just make sure there is good mobility between those two. I do it both internally and externally. Meagan: Okay. This is something that like I said even for those moms who are maybe done having babies now and it ended in a Cesarean or vaginal birth, could benefit really from and like you said, we don’t know how long scar tissue can keep going. I don’t know, maybe for the rest of our life so maybe we start years down the road like you said in your video that I found originally. This woman was much older than her 20s having babies. She was much past that and having this pain and it was related to her Cesarean scar. Women of Strength, if you are having symptoms like any of this, don’t shy away from caring for yourself and taking care of yourself. Go find a practitioner, a pelvic floor practitioner who can work with you and help you. You don’t have to suffer. You don’t have to deal. You don’t have to just say, “It’s normal. I had babies,” or whatever. Lynn: It’s not. It’s common, but not normal. Meagan: Common but not normal and I’m wondering if it’s more common because of the lack of support that we are getting after we have babies and even before. It really should be part of our prenatal care. Lynn: Absolutely. Meagan: We go every 4 weeks then we go every 2 weeks then we go every week and somewhere in the middle of that or the whole time, we should be seeking this care as part of our prenatal care I truly believe and even more in our postpartum too because so many people do have a lot of complications and we’re not healing well because we weren’t getting the support and then we are going in and we’re having 41-hour long labors with posterior babies and a cervix that doesn’t want to progress if you have ever heard my story, this is it to a T. Yeah. That can be hard and long and exhausting. Okay, so tell us more about one, where to find you and tell us anything else that you would like to say and how to find your practitioners and all of the things. Lynn: Okay, so one other thing that I just want to throw in here because I just want to help those who have this understand it. There are a lot of people after you have a C-section who cannot touch their scar. Meagan: Oh yes. Lynn: That to me is a sign of trauma that the incident and the event was too overwhelming for your system and it created this avoidance or this trauma freeze response in the body. Please know that that is something that can be worked with. You don’t have to just keep avoiding it. I do. My colleague and I both do Zoom sessions. We can help you with any of the birth trauma that you’ve had so that’s really effective. I just want to put that out there that trauma can be held in your tissue and the scar tissue when there’s trauma in there is way more painful and it’s larger. When you release the emotion that’s being held in that scar, the tissue instantly becomes smaller. Meagan: Yeah. I mean, just like what you were saying earlier with the cervix, the dervix holds this past trauma and everything and boom. Yeah. Lynn: Yeah. You give it permission. Meagan: Absolutely and we’ve talked about this in the past too about that like loving your scar, appreciating your scar– Lynn: It’s a lot easier to do when you’re not traumatized about it. Meagan: Yes. I do think though that in my opinion, from my experience, it was really part of my healing and acceptance of an undesired Cesarean. I did not desire my Cesarean. I did find out that it was likely unnecessary which was really frustrating. I could have looked at that and harbored a lot of negative but it was really interesting because I have grown to just love it and appreciate it. Lynn: Yeah. Meagan: And respect it. You kind of talked about this earlier like giving the cervix love and appreciating the cervix and when it receives love, it can give you love. It melts and it is appreciative. I think that goes a lot with a Cesarean scar. If we can give it love and appreciate it for what it did for us and what that represents, I think that can be really healing.I love that you guys offer that trauma release processing because I think that’s a really great first step to a huge step forward. Lynn: Yes. Yeah. It just makes it easier and in my view, If you’re struggling, if it’s hard, if it’s challenging, there’s a reason why and when you get to the reason why, then things can be effortless and easier for you. So I just want to throw that out there to help people understand that there may be something deeper at play here that when you heal or you look at what is happening at that deeper level, then being able to love your scar or touch your scar is easy. So just know that. Know that that is something that you can get to. Meagan: Absolutely. Lynn: Yeah. So my business name, there are two websites that I run. One is thecenterforbirthhealing.com and that is my clinical practice so if any of you listening in would like some of that healing support with your birth, please reach out. We can do a Zoom session from anywhere that you are at and then the other website is instituteforbirthhealing.com and that is my clinical educational practice or educational platform teaching other body workers how to support pregnant and postpartum clients and on that website, there are additional resources at the top of the menu. Click on that and then at the bottom is a directory. We only have 200 of my students currently in that directory. We are going to be revamping then I’m just going to be putting everybody who has completed a course in there so that people can find practitioners because we are just finding practitioners are already busy and they are not getting their listing down. I just want moms to find support. I know that when people combine forces, they know how to best support you. They are different than a regular physical therapist. They are way different from a pelvic health physical therapist. They have a much broader range of techniques and skills to be able to better support your healing. I highly recommend one of my practitioners and just know that my directory will be changing here in the next couple of months too. Meagan: Yeah, because you’ve got your summit. You have so many things going on. You guys, she’s got a podcast. She’s got a blog. I’m here. I literally just wrote on the director and just typed in “Salt Lake City” because that’s where I’m at and right there we’ve got two really, really close. It’s really awesome to see. This reminds me so much of our Find A Doula. We are the same.Are you still in Colorado? Lynn: Yes. Yep. Still in the Boulder area. Meagan: Okay, yeah. She’s just one person in one state. This just makes me so happy and smile because it is the same concept with our doulas where we can’t change the world alone. We can’t help every single person out there so why not train these people to do what you do which is amazing work and help people all over find the support that they deserve? Lynn: Yes. That’s my goal. I want mamas to heal more completely after birth. I don’t like the care we are receiving in pregnancy and postpartum. When I started this, gosh. I started this in 2016. I had been working with postpartum women even before then so almost 10. Meagan: We’re in 2024. So 18 years? Lynn: Yeah, 18 years. There was hardly anything on the internet about postpartum healing. Meagan: 100%. I know. Lynn: I am just thrilled to see the influx of information and education going out on the social media and helping moms understand that this is a thing and I just really hope that someday every pregnant person is seen by someone who really understands how to assess their body and make sure it’s ready for birth and then really being supported more holistically in that postpartum period as well. Meagan: Absolutely. And this is just my own little side note. I don’t know if any of your practitioners take insurances or things like that, but I want to tell you Women of Strength, if you are listening right now, there are a lot of things in birth that are not covered by insurance. I think it’s B.S. I’m just going to say it. I understand the availability– not the availability. What’s the word? It’s nice to have insurance accept it but I have learned at least here in Utah that insurance doesn’t think that pelvic floor is a big deal. So most of the providers I know in my area are not taking insurance. A lot of the time, we can look at that and be like, “Oh, so expensive” or this or that. Let me tell you, Women of Strength, it is worth it. It is worth it. Put value in you and your body and your birth and your postpartum recovery. The value is there and I’m going to tell you this right now. 10 years down the road, you’re done having your babies. You’re not having pain. You’re not having incontinence. You’ve had better birth experiences and better postpartum experiences. Let me tell you that whatever you paid at those visits, you’re not even going to bat an eye. In fact, you’ll say, “I would have paid $15,000 more.” Not literally. But do you know what I mean? Lynn: 100%, Meagan. Meagan: It’s so worth it and I understand that in the time, it’s really, really hard so if you are having a hard time paying for things or you’re really wanting a pelvic PT throughout pregnancy and you’re really wanting a doula or a photographer or all of the things that come with birth that insurance doesn’t cover, register for those things. Lynn: Yes. Yes. Meagan: Get people to help. When people say, “Hey, can I bring you meals after?” Be like, “You could, or” whatever. Whatever that means, but I promise you that it’s 150% worth it to invest in yourself. Lynn: I just want people to understand that the practitioners who take insurance are working in a practice that can only see you for 30, maybe 40 minutes tops. Meagan: They are limited. They are completely limited. Lynn: Yeah, and a lot of them are younger physical therapists so they are not as experienced and those who are paying and have their own private practices and they choose to do cash pay, they are the experienced ones. They are the ones who are going to get you better faster. If you’re a new mom, I see people 1-3 times and other practitioners are 6-10 times so yes, I might be a little bit more expensive but what’s more expensive, your time and the effort and energy getting to and from me? Or do you want results? Meagan: Yeah. Lynn: There’s value in paying for your own services. You take it way more seriously. You show up more fully for it because you’re investing in yourself. Meagan: Yeah. Lynn: It’s so worth it. It’s so important. Meagan, I’m so glad you said that. Thank you. Meagan: Yeah. Yeah. I thought about the word that was coming to my brain. It’s convenient. Going with a provider who takes insurance is more convenient because it’s usually easier sometimes. Lynn: It is financially, but like I said, time and energy and effort. Meagan: That’s what I was going to say, but is it really convenient? I just want to put it out there because I know money is a thing. I know it is tight out there but I fully believe in investing in yourself and your health and your well-being and hopefully one day, the world will change and it will be more accepted on the insurance side. But if it’s not, don’t let it turn you away. Lynn: Amen. Amen, sister. Meagan: All right. Lynn: You preach it. Meagan: I know. I feel a little passionate about this. Lynn: I can tell and I love it. I love it. Meagan: Oh my goodness. Well, thank you again so much for having us and like I said you guys listening, we’re going to have those blogs with the pictures. We’re going to have her podcast, her website, both of the websites so you can find a practitioner near you. If you don’t see a practitioner near you at the very moment you are listening, give it a sec and check back because like she said, it’s going to be updating. Lynn: I also have a Facebook community group that has over 10,000 practitioners and moms in it so you can reach out. The Facebook community group is Institute For Birth Healing Community so if you go on Facebook and check out that group and join it, you could ask in there and see if anyone has trained with me in there.Meagan: Awesome. Lynn: Yeah, thank you. Thank you so much for this. Meagan: Oh my gosh. Thank you again. I think you are amazing. I’m so grateful I found you in 2017. I think it was 2017 when I found you, maybe 2018. Just keep changing the world, girl. You are killing it. I’m so happy for you and all of your support and all of your practitioners. Lynn: Thank you. Thanks so much, Meagan.  ClosingWould you like to be a guest on the podcast? Tell us about your experience at theVBAClink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to theVBAClink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
50:0710/07/2024
Episode 315 Emmy's Empowering HBAC After Failure to Descend

Episode 315 Emmy's Empowering HBAC After Failure to Descend

“It was perfect. It really was. I would do it again and I would do it the exact same way. I felt safe and I felt respected and I felt like there was never a moment in it that I was scared.”Emmy’s first birth was a medicated hospital birth turned C-section after two hours of unsuccessful pushing. Her greatest trauma was being so out of it that her first thoughts after her baby was born were, “I don’t care.” Her multiple failed epidural/spinal placements caused intense postpartum spinal headaches. Overall, Emmy’s difficult experiences were a recipe for postpartum depression and anxiety.After finding The VBAC Link, Julie and Meagan became Emmy’s virtual friends helping her through tough postpartum days. When she became pregnant again, Emmy knew that Julie Francom needed to be on her team. Emmy shares how she made the choice to switch from planning a hospital VBAC to an HBAC and how home birth relates to cows! Her birth was powerful, intuitive, and healing.After her husband caught their baby and Emmy pulled her up to her chest, she shares the most healing moment of all. “I wasn’t thinking in my head, ‘I don’t care’. I was thinking that I had this beautiful little baby in my arms. It was what I had dreamed of. “CDC ArticleThe VBAC Link Doula DirectoryThe VBAC Link Facebook CommunityDown to Birth PodcastDr. Stu's WebsiteThe VBAC Link Blog: Choosing Between Home Birth or VBACBirth Becomes You Birth Photographer DirectoryHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Julie: Hello, hello. Surprise! It’s Julie here and I’m super excited to be here with you guys today. I always love coming on the podcast with Meagan you guys know. I love to get a little bit salty and a little bit straight-up talk on the podcast. I quite enjoy my time here but I am a little extra excited and a little bit less spicy and salty because I have a client of mine. Her name is Emmy and she just had a VBAC about 3 weeks or 4 weeks ago. Has it already been 4 weeks? Oh shoot, I owe you your gallery already. It’ll be done in a few days. But I photographed her birth and she is incredible. It is super exciting because she is going to tell you more about this. She actually reached out to me 2 years ago when I was still doing doula work at the beginning of her journey after her C-section baby and it’s just super fun to be here full circle with her and have her share her story. I want to hear it from her perspective. I haven’t heard it from her perspective yet. We are just going to have lots of fun chit-chatting. You guys are going to come to love Emmy just like I do. But before we do that, Meagan has a Review of the Week for us. Wait, did I say it’s Julie? Did I introduce myself? Meagan: Yes, you did. Julie: I feel like some people don’t know. You have been doing solo episodes for a really long time and I feel like some people don’t know who I am anymore which feels kind of weird to me. Meagan: You are the famous Julie. Julie: The famous Julie. Anyways, Julie Francom, co-founder of The VBAC Link. I separated a couple of years ago but pop in every once in a while to get a little bit salty. If you know, you know. Anyway, here’s Meagan. Meagan has a Review of the Week for us and I’m going let her do the rest of the things. Meagan: If you know, you know. Okay, we have a review. It’s from lar23 and it’s titled “Love Your Podcast”. It says, “Hi Meagan. I love your podcast so much. I always end up crying at the end of them. So happy for these moms who get their VBAC. Thank you for creating this podcast. It’s so inspiring to hear these stories. I’m 38 weeks pregnant currently and hoping to get my VBAC here soon. Keep doing what you’re doing. You’re helping so many people and doing so well to achieve their birth dreams knowing that we are not alone. Thank you for that.” That was left on Apple Podcasts and that was actually just about a year ago so lar23, if you are still listening, we always love to know how things went so maybe write us in at [email protected]. If you haven’t left us a review yet, please do. We love them. They make us smile and guess what? I actually even still share them with Julie today. Julie: It’s true. I love getting a good screenshot of a review. It makes my heart happy still. Meagan: Right? They do. Every single time they come in, my smile immediately grows from ear to ear. Okay, are we ready? Julie: Yeah. Meagan: Julie, Emmy, let’s do this. Let’s hear this amazing birth story. I was reading a little bit of her bio part and can I just tell you that there is one little thing that stuck out? It all stuck out, but there was one little thing. “I found a doula I loved. I hired Julie Francom as my birth photographer. You bet I felt starstruck.” It says, “I interviewed multiple midwives before choosing one. Originally, I planned a hospital birth, but the more research I did and after listening to the podcast with Dr. Stu, I felt very strongly that a home birth was right for me. I was just as shocked as the guy that I told the next day that I felt that way.” Can I just say that stood out to me? You hired the doula. You found an amazing photographer who is also a doula. You interviewed multiple people. All right. I’m just going to leave that right there for the intro to your second story and let’s cue the first story. Julie: Let’s go. I’m excited. “I felt starstruck”. It’s still weird to me when people are like, Oh my gosh. I don’t know if that’s what you were like, but it’s just so funny. Anyway, sorry. Go ahead, Emmy. Emmy: Yeah, we’ll start with the first one and then I’ll talk about my starstruck interview with Julie. Yeah. It was 3 years ago almost exactly because I had my kids a day apart 3 years apart– March 14th and March 15th so it was 3 years ago, I was teaching 6th grade and it was a new subject and a new school so that was my focus. I did zero prep, but I was so optimistic. I’m like, Everyone goes in and has a baby. We did nothing. Suddenly when my water at 39 and a few days started to leak, we were like, Okay, we go straight to the hospital. My water hadn’t even broken. It was just a leak. Meagan: That’s what you’re told a lot of the time. If your water breaks, you go in. Emmy: Yeah, so you’d sit down and a little gush would happen. We high-tailed straight over to the hospital. I was feeling Braxton Hicks contractions. They weren’t even painful yet. They checked me and to quote, I was maybe a half-centimeter dilated. I said, “Great. When can I get the epidural?” She was like, “You can get it right now.” I’m like, “Fantastic. This is greater than my wildest dreams right now,” because at that moment, I had done no prep so my fear was of the pain. The fact that I was getting this epidural before I even felt pain was amazing in my head. I get the epidural at maybe a half-centimeter dilated and I lay on my back on a bed for 30 hours. I did do the peanut ball a little bit back and forth. There was some movement there, but as far as any other real movement, there was nothing. Little did I know, he was OP and now I’ve done a lot more research on OP babies and learned a lot about how OP babies need movement. I read a whole article from Rachel Reed that was just talking about how the most important thing for an OP baby was movement and I did not move. It was probably no surprise now looking back that I started to have really horrible back labor having an OP baby which if you’ve had back labor, it’s not like a normal contraction where you have a 60-second contraction and then you have a 10-minute break. It is continuous and it is awful. Meagan: Not great. It’s not great. Emmy: Excruciating and it goes all the way up your back. I’m numb from the waist down but it was going all the way up my back to my neck and it was continuous. I was just in excruciating pain for hours and hours. I was just holding on to the side of the bed just dying.Meagan: I can already relate so much. I was holding. I’m like, Help me. Do something. Emmy: That’s so funny. Do something. I was dying. I finally get to complete and I pushed for 2 hours and I remember the OB pretty vividly. I remember him being like, “Okay. You’ve pushed for 2 hours. When I went to school, they said to let a mom push for 4 hours and now they say to let a mom push for however long she wants.” She was like, “You can either keep pushing or you can just go in for a C-section and we can get this over with.” I mean, I was done. I was like, “Cut him out.” Meagan: Sure. Yeah. And if you are given that, it’s like the golden ticket. You could have your baby right now and not continue this. Sign me up. Yeah. Emmy: So I was like, “Yep, please cut him out.” So they wheeled me into the OR and sorry. While I was pushing, I guess from the hours of back labor, my back had seized. I could not bend it. While I was in that pushing phase, he kept saying, “Okay, do a crunch. Sit up in a C formation.” I was like, “My back is not moving. It is unresponsive. It’s not that I won’t. It’s that I can’t.”Then they wheeled me into the OR and I’m getting a spinal block and they are telling me, “Your epidural needs to be a C position.” I’m like, “My back is not moving. I’ve never experienced this before. It is unresponsive right now.” He tried three times to get the spinal block in. Two times it came out and the needle was bent because it was just hitting. Meagan: Oh my gosh. Emmy: Third time’s the charm. So I had five. Three times from the spinal block and then it had taken the epidural twice to get it in so I had five punctures which makes more sense when I talk about my spinal headache later on. They finally get the spinal block in and they lay me flat on my back. It went from the back labor had been agonizing, but for some reason when they laid me on my back, it was intolerable. I started thrashing. I was like, “My back, my back!” I started thrashing. I’m under the impression that he gave me morphine, but whatever he gave me, I went warm. My whole body went warm and numb. I couldn’t move anything and in my head, I’m like, Thank heavens. I don’t care what he just gave me but I’m so grateful right now that this pain has gone away. But then like I said, I believe it was morphine. It moved up into my lungs and my breath started getting shallower and shallower and shallower. I’m like, I’m suffocating right now. My breath was getting more and more shallow and I started to panic more and more. Meagan: Scary. Emmy: I turned to the anesthesiologist to say, “I can’t breathe.” Nothing came out. The morphine had also affected my vocal cords and so I’m looking at him, I’m like, I can’t breathe. I’m just mouthing the words and he’s not looking at me. So then I look over at my husband who is also not looking at me. I’m like, “I can’t breathe.” I’m looking between these people like, I’m going to die on this table and nobody is going to even know because they are not looking at me and I can’t talk right now. Meagan: Oh my gosh. Emmy: Yeah, finally my husband looked at me and he’s like, “She says she can’t breathe.” He looked at my stats. He’s like, “No, her oxygen levels look fine. She’s fine.” In my head, I’m like, No, I’m dying. He put an oxygen mask on me and in that moment, I closed my eyes and I’m like, I’m just going to focus on breathing because right now I’m in a complete panic attack that I’m dying. They got him out. I heard him cry. They took him to the NICU and for however long they were gone, I remember a nurse saying to me, “Do you want to meet your baby?” In that moment, in my head, I was just like, I don’t care. I don’t care. Colin comes walking in with a swaddled baby with tears rolling down his face. Colin is my husband, sorry. Colin comes in with tears running down his face holding a swaddled baby and I could have truly cared less. Out of all the traumatic things that have happened to me in my birth up to that moment, that is the moment that sticks with me the most where it’s like that is the moment you dream of as you are preparing especially for this first child to come into the world. It’s that moment when you get to hold your baby for the first time and for me that first moment in my head was, I don’t care. That really slingshotted my passion for this next birth. It was going to be amazing and I’m going to make sure of it. I heard a quote recently that was like, “Passion a lot of the time stems from trauma.” I felt that so deeply in my bones at that moment. I was like, I look back at the last 2 years and some months since I’ve had the baby and I’ve been so passionate about it. It definitely stemmed from my trauma from my first birth. Julie: Oh my gosh, yes. I relate to that too. That is why I’m so salty dang it. Meagan: I know. It’s hard. It’s hard when you do have that passion and then you are seeing people going in the direction that we were going that created that passion and possibly trauma. It’s hard because you are like, No, no, no, no! Don’t go there. Come over here. We want to help and save and yeah, do whatever we can do, right? Emmy: Yeah, and unfortunately, my postpartum experience wasn’t really that much better. I really struggled with postpartum as I not only was recovering from a C-section but a few days later, I developed a spinal headache which is where they have punctured the membrane around your spinal cord so it starts leaking fluid. You’ll sit up and it starts leaking fluid and it’s an immediate migraine. You’re trying to go to the bathroom. You’re trying to feed your baby and you are dying from a migraine. It’s kind of a peculiar thing because the moment you lay down, the moment your head hits the pillow, it goes away. When you sit up, it’s leaking this fluid but when you are lying down, you’re not leaking the spinal fluid and it goes away. I called my sister and she was like, “Oh, I’ve heard of that. It’s a spinal headache.” I called my OB and told him my symptoms. He was like, “Yeah, you can either go into the hospital and get a blood patch or it’ll go away in two weeks.” I’m like, Two weeks? I’m not waiting two weeks for this to go away. I can’t even sit up to try and feed my baby let alone function. Meagan: Oh, so did you go get the blood patch? How was that? For someone who may have experienced this or if they experience it, can you explain the process of that? Emmy: Yeah. I mean, it’s uncomfortable and kind of painful. You go in but it’s also pretty amazing too. You go in and lie down. They pull quite a bit of blood from your arm. They numb the spot that is leaking which was where I had five dots from all of the different needles and they put that blood into that spot and so the blood goes in and it clots where it is leaking and you lay there for about a half hour and you sit up and it’s gone. It was pretty amazing. I sat up and I was scared and it was immediately gone, but you add so much blood into that area that it is filled with pressure for three days so it’s like you can’t really bend your back. That’s kind of the theme of my story I guess is I can never bend my back. For three days, I couldn’t bend my back or it would spasm from that spot. But it did get away from the spinal headache and if I had another spinal headache, I would do it again. Meagan: Okay, good to know. Emmy: But yeah, so I did go in and get the blood patch. It fixed the problem, but I recovered from a C-section. I had this blood patch. I really struggled with breastfeeding. I know now that I had a lactation specialist, an IBCLC come to my house after my second birth. She looked at his tongue and she was like, “Oh, he’s got a heart-shaped tongue. That’s a severe tongue tie.” I didn’t know that at the time. I know about tongue ties now but I didn’t know about it then. I was just really struggling with breastfeeding and the pain from it. I was like, Something has to go and the only thing I have control over right now is breastfeeding. I chose to exclusively pump which comes with a whole other host of pros and cons but I chose to exclusively pump because I was like, Something needs to go pain-wise here and breastfeeding is the only one I can let go.Looking back, I really had a recipe for postpartum depression and anxiety. I had a traumatic birth and recovery from a C-section. Breastfeeding wasn’t going well and he was a terrible sleeper for 3 months. I was extremely sleep-deprived and I didn’t really plan my postpartum care well. I got one week that my mom and my husband were home at the same time and then they were gone but I still needed care after that for at least another week or two. My nutrition was poor because I was worrying about my nursery and cute clothes and my baby shower and stuff. I hadn’t really thought about postpartum care with freezer meals and snacks and things like that so I was just starving which I’m sure didn’t add to helping with postpartum depression and anxiety when your nutrition is poor. I was still worrying about work and had to go back to work 6 weeks later which was a stressor. Isolation is a big contributing factor to depression and anxiety and I just hadn’t found a group of mom friends yet too. I was just giving out so I was home all day for the first 6 months. For the first 6 months, I really struggled with postpartum depression but I learned what a VBAC was the first week post C-section. I was like, What is this? What is this VBAC they speak of? Then I found The VBAC Link about the same time because I was Googling VBAC and I found your website which led me to the podcast. I was taking multiple walks a day at that time because I was just bored and I was just devouring The VBAC Link. Julie and Meagan were my best friends for the first– they were my only friends for the first 6 months. Meagan: Aww. Julie: I love that but it’s also kind of sad but I also kind of love it. Emmy: Yeah. I was listening to your guys’ voices. You were the people I talked to the most each day for a while. I just devoured it and I went from believing my C-section was necessary to seeing how one thing probably led to another and led to the cascade of interventions and just being like, Oh, I actually think I really could have done this if I had done things differently and prepared differently. I think I actually would have been able to do this the right way. Then listening to people talk about having this redemptive second birth, I’m like, Wow. People have births and like their births. I thought everybody just hates birth. I’m like, No. People are actually having births and enjoying their births. How do I get that? So it really spawned into this passion which came out of trauma but turned into a really great thing and about a year postpartum, I reached out to Julie because I was anticipating getting pregnant probably in the next year. I was like, I know I’m going to build the greatest team that I can in this area. In my vision, Julie is on that team. I reached out to her and you said in that first interview, you were like, “Okay, I am still doing doula work but I am starting to switch over to photography but I will honor your request for a birth doula.” I was like, “Great! Do you know any hospitals or midwife groups in-hospital who are VBAC friendly?” That was still in my head was that I was going to end up in a hospital. Julie gave me some midwife groups and some hospitals that she had good experiences with for VBACs and that was my plan moving forward. It wasn’t until a year and 3 months later that I ended up getting pregnant and by that time, Julie was like, “I’m really just doing photography.” Julie: I told the Universe that this is the thing and Katie, your doula, will attest to this. I struggled going back and forth where my passion was and where my heart lay. I was like, Okay, I will do doula and photography for a little while. I told the Universe 16 times that I was only doing photography and then I felt like I had to stay committed to it and I really thought that you would be best served by a fully dedicated doula. In the end looking back, I think that was super the right choice. Anyway, yeah. That’s kind of where that was. Emmy: Yeah, I’m really just doing photography now but I have a really great friend who has done the VBAC Link course and I’d love to do your photography. At the time, photography was not in the realm of my birth vision at all. It was actually something that was kind of weird to me. I thought, People photograph their births? But Julie was such a core keystone part of my birth that I was like, I don’t care if you are there to be my massage therapist for this. You will be there. I ended up hiring a photographer because I wanted Julie to be there so badly. I wanted her knowledge there and then it ended up in the end being that I am so glad I have photos of this. This is so cool. I think all around we made the best choices having Katie. Shoutout to Katie who is the doula that Julie recommended. Meagan: She is amazing. Emmy: Yeah, she was not a bad recommendation at all. It was amazing. So I think in the end it turned out great to have Katie there and have Julie there. Everyone was in their right place. But yeah, when I reached out to Julie, I hadn’t even thought about home birth. Home birth to me was woo-woo. I didn’t have an interest in natural birth but I actually ended up listening to Dr. Stu who I know you have had on your podcast, but the first time I heard him was actually on the Down to Birth podcast, episode 111 if anyone is interested where he talks about his journey from being a regular OB/GYN to being a home birth OB/GYN. He dispelled the fears around home birth and the questions that everybody asks like, “What if things go wrong?” In those 45 minutes, I literally went from, I’m only having a hospital birth to I’m going to have a home birth. It spoke to my heart and I immediately was like, This is what I need to do. I felt really strongly. It was really bizarre. I’ve never had a full shift in what I was thinking before. I just felt very inspired that that was what I needed to do. I was a little worried about convincing my husband, Colin, but I showed him that podcast and he seemed immediately on board. He’s a dairy farmer actually and listening to the podcast, there were a few things where he would pause it and say, “That’s very interesting. I actually see this in cows.” I was like, “Great. I’m glad that you feel really connected to this.” Meagan: I love that. Emmy: Yeah. Julie: Okay, but seriously now, we have all these animals in the wild giving birth in these natural ways and nobody thinks to interfere but we humans need all of this help. It doesn’t make any sense. Emmy: Yeah, like for example, Dr. Stu said a woman will be home laboring and the labor–what’s the word I’m looking for? The contractions are coming regularly. Let’s say it that way. The contractions are coming regularly and she comes into a hospital which is an unfamiliar environment with people she doesn’t know who are touching her bits and stuff and it’s really not common for your labor to slow down or completely stall. He’s like, “We are mammals. If a mammal in the wild comes into an unfamiliar place or feels that there is a predator or feels nervous or anxious, the labor is going to stop until she feels safe again.” Colin was like, “I see that with cows. You see a cow in a pasture laboring great and the legs are poking out. We bring them and we bring them into the barn where we have fresh straw. She’ll be by herself. In our heads, we think we are helping her but we have just done an intervention and her labor will stall. She’ll sit there for hours without any progress. We see that with cows.” Meagan: You know what? We as doulas see that too. We are laboring at home. We are laboring at home. Things are going really well and then we transition to the hospital or a birthing center or that other location. Even just that move that makes you think you would be more comfortable and this is where I wanted to give birth, you still have to acclimate to that space. Like you said, it’s an intervention. Emmy: Yeah, so he trusted my gut and I”m going to be forever grateful for that because he was very trusting so the prep really began once I got pregnant, it was like, Okay. We’ve got Julie and my number-one priority was building a strong team. I interviewed Julie in person and went out to lunch with Katie who became my doula and felt really connected to her right off the bat. Julie also gave me a list of home birth midwives in the area. I probably interviewed 5 or 6 midwives and for me, I wanted somebody who was really experienced, had a lot of years, had seen the good, the bad, the ugly, and had a good, calm energy because I have a lot of energy. I was like, I feel like in my birth, I just need calmness. So after interviewing them, I picked a midwife who I thought was the best for me and had the most experience. She truly was amazing in the birth and I think I made the right choice for sure. Midwife care is so different than OB/GYN care as well. You have a 5-minute appointment with an OB/GYN but you have an hour long appointment with a midwife where you do the same things but more. They sit and talk to you about any symptoms that you have. I really, really liked the midwife care. I was really impressed. I didn’t know what I was stepping into but it is leaps and bounds better care than I had at an OB/GYN office. That was my first priority. I felt like I built a great team from the get-go then it was all about educating myself and preparing for postpartum. That was a big part. One thing I did was instead of having a baby shower, I did a mother’s shower. I had all of these people come and we made freezer meals. It was really fun. I planned better postpartum care. Colin came for a week. My mom came after that for 10 days so I just did a lot better focusing on my postpartum care which has made a huge difference. Colin and I took a Bradley Method class which ws intense but I’m so grateful that we did because really, Colin was my doula for the next birth for the 23 of the 26 hours and he was doing hip squeezes, counterpressure, acupressure, talking me through each of the contractions, massage techniques– he was amazing and it really came down to us preparing really well. He was my little doula for 23 of those 26 hours and I will never forget that. It was very bonding for us and special. I guess for my second birth which was a much better experience, the contractions started at about 3:00 AM and they were about 10 minutes apart. My labor was 26 hours and interestingly enough, until I hit transition at 23 hours, my contractions did not get closer together than 10 minutes apart the whole time even though the intensity increased. I had a 60-second contraction 10 minutes apart the whole day. I texted Julie and Katie at 8:00 AM, “Contractions have started guys! I’ll let you know.” 4 hours went past and I’d be like, “What’s the update?” Julie: “Are you doing okay? How are things going?”Emmy: Then I’d be like, “Yeah, sorry nothing.” Then four hours later, they’d be like, “Are you good?” I’m like, “Yep. Still contracting 10 minutes apart, guys. Sorry.” So yeah. I contacted them. I had a chiropractor appointment already just by coincidence at 10:00 AM. I went to that. It didn’t really seem to kickstart anything like I hoped but I just figured it couldn’t hurt to get in. I think Meagan, didn’t you go to the chiropractor? Meagan: I sure did. I actually did twice during labor. Emmy: Wow. Meagan: One in early, early labor and then one in that middle stage. Well, a little bit less. It was early, early and late early labor. I got adjusted and I swear to you that even though like you said that it didn’t kickstart or dramatically change one contraction to another, I know that it changed the outcome for me. I fully believe that it helped change the outcome by helping me balance out my pelvis. Emmy: Okay, yeah. My doula, Katie, felt very strongly about it too that she felt like going to chiropractic in labor was very helpful for her too. She said that her contractions immediately changed afterward. Meagan: Yeah, and I have seen that happen. Emmy: I didn’t feel like for me that was the case and I still didn’t have her until 15 hours later, but still being aligned and having things be in the right place was probably still very helpful. It just wasn’t immediate. So we labored and we had fun. We watched Survivor while he was helping me and I was laboring all around the house which I didn’t think I would care that I was in my own house, but I actually in the end really loved being in my own shower and being in my own bed, being on my own toilet and laboring in my own environment actually ended up being really helpful for me and I enjoyed that. It wasn’t until I did the Miles Circuit at 11:30 at night. I was like, I’m going to do the Miles Circuit. When I was doing lunges on our stairs, that’s when my contractions were 10 minutes, 9 minutes, 8 minutes, 7 minutes– immediately they just started boom, boom, boom, boom getting closer together and I started to shake. I called my midwife, “Can you come check me? I think I’m getting closer now and it’s really intense.” She showed up at about 12:30 AM and she checked me. She said, “Okay, you’re dilated at about a 6 with a bulging bag and I think you’re in transition right now. You’re shaking.” So she stayed and then it was like the parade came in. Kate shows up. Julie shows up. Another midwife shows up and it was go time at that point. I really felt like they all came at the right time becuase I was really struggling through those last contractions for the last few hours. Between Katie doing hip squeezes and everyone, I remember laboring on the toilet because they say that’s the labor station, right? What do they call that?Julie and Meagan: Dilation station. Julie: I got there when you were on the toilet and Katie says I got there right at the time when things were really picking up but I just remember because it was a 40-minute drive for me and when she said that you had a bulging bag and were 6 centimeters, every time I go to a birth, I have a heart attack that I’m going to miss it because 2 years ago, I missed three births in a row because things went so fast. Two of them were VBACs. I’m just like, Oh my gosh. I’m praying, like, Please, Jesus. Let me get there before this baby is born. This would not be fair if I miss it because I have had this relationship for 2 years. I’m begging. I think we got there right at the right time. Maybe a little sooner would have been better, but really, I think that I’m just so glad everyone arrived for you when they did. Emmy: Yeah. I thought they were like, “Why don’t we try the toilet?” I honestly thought that was where I was going to die. I thought that was a cruel, cruel joke that you guys played on me. Those contractions were no joke on that toilet. So I was like, “Get me out of here.” That was the first time that I think I was like, “I can’t do this.” You were like, “Yes, you can.” Just that resounding– all of the women in the room were like, “Yes, you can. You’re doing it.” It was amazing. Julie: It’s this weird diad between seeing a woman– I don’t want to say in pain but I don’t know what other word to use. But because all of us look at each other and smile whenever someone is like, “I feel like I’m going to throw up,” everyone in the room just looks at each other with this knowing look. We smile and we are like, “Yes! I’m so excited that you are going to throw up,” because it means that things are getting closer. We have seen this so many times. We know that it just means labor is progressing well and you are doing great even though that feels like the moment where you are really going to die. It’s really good that you feel that way. Emmy: Yeah. Yeah, I was like, “I can’t do this.” You were just like, “Yes, you can.” We labored on the bed a little bit after that and I started to have the urge to push. We moved to the tub which we had set up in the living room and Colin took his place in front of me holding my hands and then the doula and the midwife both did counterpressure on me and I started to push and that was intense. I think that was the only time. I didn’t make a lot of noise besides breathing, but that was where I started to feel like the animal grunting. I also had this outside perspective in that moment of, I know this sounds weird probably to Colin in his face, but I was like, This is working. I was feeling pretty powerful at that time that I was going to be able to push this baby out. My water broke while I was pushing in the tub and I mean, it felt like a half an hour. I remember they told me afterward that it was an hour and a half of pushing. I think that was the most suprrising part of my birth was how long everything still took. It was 26 hours with an hour and a half of pushing. I was surprised at that but I also now look back and am like, Man, had I gone to the hospital, because I still felt like even with an epidural, without an epidural, going natural and pushing, I still felt like it took me a minute and took me a while to figure out the pushing and to feel like I was being fully effective. I was like, Man, if I was in the hospital with an epidural on my back, I bet the same thing would happen to me again. It still took me an hour and a half with no pain meidcation to figure out how to push and push this baby out. What would have happened on my back in the hospital? Quite possible, the same thing. They may have gotten to 2 hours and been like, “Do you want to keep pushing or do you want to call this?” It might have ended up in a C-section again. I’m really grateful that I feel like this is how it was meant to be because I pushed for an hour and a half which was really intense and hard. I was on all fours and then I ended up on more of a squatting pushing. It was just like, “Get her out!” Everyone was just encouraging me all the way around. Colin, once I was in the squatting position, was behind me and it was really special to me. When she was about to come out, Colin was like, “Colin, come switch me places.” He came up to my knees and he was able to be the one who pulled her out and hold her for the first time and bring her up to my chest. Well, bring her up to my chest, I was the first one to hold her, but he pulled her out and brought her up to my chest. We were just able to have that moment of holding this baby and I wasn’t thinking in my head, I don’t care. I was thinking that I had this beautiful little baby in my arms. It was what I had dreamed of. It was 3 years. It was exactly 3 years in the making of this very moment right now and this is what I knew it could be. Then we went to the bed and got to have that golden hour– not hour, golden hours– with her. It was perfect. It really was. I would do it again and I would do it the exact same way. I felt safe and I felt respected and I felt like there was never a moment in it that I was scared. I remember that there was one moment where I was like, Oh my gosh. I’m having a VBAC right now. Do I feel any scar pain right now? Nope, I feel great. Then I never thought about it again. It was wonderful. I am so grateful for this podcast and for the prep work that I did, the team that I built and to be able to have done that with Colin. It was very special and bonding for us. Julie: First of all, you are amazing. Second of all, are you going to do it again? Because sign me up for it.  I’m inviting myself. Third of all, yes. We need shirts this time. I can’t believe we didn’t order three amigo shirts. That was a missed opportunity. Emmy: We will not forget that this time. Julie: Fourth of all, I want everyone to know that this is probably the coolest trade for services I have ever done. I literally traded– I don’t know how many pounds of natural, grass-fed, antibiotic-free beef. Half of my payment, I feel like I got a quarter of a cow or half of a cow maybe. It’s cool. We are still eating it. It’s the best beef ever. My husband, every time I make some of it for dinner or we go to a restaurant– we were at Zion National Park for spring break and he had a steak or something for dinner and he was like, “This steak is awful compared to the stuff we cook ourselves.” Meagan: Amazing. Emmy: That’s right. Julie: If you want, next time, you obviously should have whoever you want, but I am fully open to trade for more cow. It was seriously the coolest trade ever and the fourth thing is that first of all, I can’t believe it’s been 4 weeks. I feel like so much h as happened since then that it also feels like last week for real. I have been sitting here just polling through your photos as you are telling your story and reliving all of these moments as you are telling them and I am just so inspired by you first of all hearing your story and second of all, just being able to look through these. I will have your gallery to you by this weekend for sure. I like to say 3-4 weeks turnaround and I’ve been just a titch behind in the last few galleries. I’m off my groove or something. I cannot wait for you to see them. I remember after I sent– I don’t know. I was talking to Katie about this the other night at the positive birth group. Sorry, I’m not trying to center this around me. I promise. It might seem like it’s going a little bit that way. Anyway, Katie hosts a positive birth circle for expecting parents and things like that because I love hanging around pregnant people. We were talking at the end and I was like, “I sent Emmy her gallery,” and her first words were, “Those are some real rough photos of me.” I was like, “I hope she liked them,” and Katie was like, “Actually, I talked to her about that at her first postpartum visit,” and the thing is that me and Katie go through all of these pictures and I love seeing that rawness and that vulnerability and your power and your strength and those are the ones I am naturally drawn to. I see all of that and yes, I guess even the one on the toilet which I think is so cool. It’s super cool. There is so much power and strength, and the one of your husband catching the baby as he is coming out in this beautiful white birth pool in your beautiful white house. Those power ones are the ones I am super attracted to and Katie was like, “I think she maybe would have liked just a couple of just her and the baby holding the baby softly after the birth.” I was like, “Oh. Oh. Okay, yes. I’ve got to be more mindful of that when I send these sneak peeks to people sometimes.” Because it’s true. I feel like as birth workers, we are drawn to that rawness and that vulnerability and that space. It is super cool. Especially you not quite being super 100% on board with birth photography ahead of time, I feel like yeah. Maybe I should have thought about that. I’m sorry. I’ve edited a few more that you can use. I sent them to you. Emmy: They were wonderful. Julie: There are plenty of those. It’s interesting the relationship of your birth photos and how it evolves over time when you first get them, you will feel completely different about them in a year or in 2 years or in 5 years. My kids are 6, 7, 9, and 11 now. We go through all of their birth photos and their videos from their birth every year and it’s so exciting and the emotions are just so different as we look at them over time. I feel like they get more valuable the farther away I get. I’m super excited for you to see those. I also recorded a full video for you so if you ever want a video, let me know because I have all of it. I record video at every birth. Meagan: And you can share it with this community. Julie: I have specific instructions for what I’m allowed to share or not and we are going to go over all of the ones I want to share after I deliver her gallery, but yes. I just think it is so cool because when I tell people I am a birth photographer– see, now I am centering this around me. I’m sorry. When I tell people I’m a birth photographer, I get one of three reactions. People are like, “Ew, why would you want photos of that?” Or people are like, “What’s that like?” Or people will be like, “Oh my gosh. That is so exciting. I had a birth photographer. I love looking at birth photos.” I think that people who have that disconnected reactions are the people who really don’t know the true power that the imagery holds especially for the birther so I think it’s really cool to just listen to your transition or your transformation around that and have it evolve. I seriously am going through all of these. You are going to have 400 pictures I think. Okay, so my camera was in lower light. Sometimes it struggles to focus so I shot a little bit more than I usually would because I was scared of missing focus and normally I shoot about 600-800 photos at a birth and go through them and narrow them to about 150 roughly in that range. At your birth, I shot 1276. Emmy: Oh my gosh. Julie: I’m going through and– Emmy: Not a moment missed. Julie: No. Not a moment missed. I’m super excited. You’ll probably get between 150-200 final photos but seriously, I’m like, “Yes. That hands picture and that hands picture. Oh yes. I see everybody squeezing her hips right now. That’s super awesome. Colin is right in front of you squeezing your hands.” I don’t know. I think it’s just priceless to be able to relive these moments through the imagery. I think it’s so cool and so powerful to see how awesome you are if you didn’t know. I have photo and video evidence. Meagan: You are awesome. I love your journey. I love your journey from– I don’t love that someone has a bad experience, but I love that someone can grow from a bad experience and truly, hearing you transform into the person you are now, I mean, I feel like for me, I changed as an individual after my birth. We talked about that earlier with the passion and stuff, but it’s more than the passion. There was something inside of me that changed. It’s amazing to hear when we have these stories. You can hear the shift. If you are listening, Women of Strength, keep going through these episodes and you can hear this shift. It is just so cool. It’s so cool. It’s actually one of my favorite things about being a doula. There’s a CDC National Vital Statistics report that was sent out in 2022 and it shows that the percentage of U.S. home births rose from 1.26 in 2020 to 1.41 in 2021 which is a 12% increase since around the 1990s. It’s kind of an interesting thing and there is so much more about home birth. That’s just a really quick CDC stat, but it’s really cool to see that people can feel comfortable at home. Like you said, in your own bed, on your own toilet, in your own shower, in your own kitchen, kneeling on your own floor. I just think there is something cool about that and home birth. So if you are exploring home birth listening to this, definitely go listen to all of our other HBAC stories and go listen to Down to Birth– what did you say it was? Emmy: Oh, 111. Meagan: 111 with Dr. Stu. Go check out our episodes with Dr. Stu or just go even listen to him and Blyss talk about home birth on their own podcast because home birth can be a safe, reasonable, and amazing experience and something that, like Emmy said, shocked her too. It shocked her as well. I think that you never know until you explore the option and get the facts. We also have a home birth blog and all of those things. We are going to have all of those links in the show notes. I’m going to find the Down to Birth podcast and link it in the show notes so it is easy to find. Thank you so much, Emmy. Your energy is just so fun. I am so happy for you and I hope that I get to see some more of these photos and if you decide to share a video, I love videos and it was honestly one of my biggest regrets. I was so focused on my VBAC that I forgot about the photography aspect. I’m so glad that you got looped into that because Julie became just a photographer because still to this day, like Julie said, my son actually just turned 8 this month so I tend to look at those images at those year marks and I really still to this day cherish it and look at it differently every time. I’m so glad that you have them and obviously for anyone listening, if you want a birth photographer, check it out. It is worth it. Emmy: It is. It is worth it. Julie: I think we should put a plug-in. To find a great doula, build the right birth team obviously. You can find a list of supportive VBAC providers on the community on Facebook in the documents and you can a VBAC doula at thevbaclink.com/findadoula and if you are looking for a birth photographer which I obviously think you should, there’s a really good group called Birth Becomes You. It’s kind of like The VBAC Link but for birth photography. You can follow them on Instagram. You can follow them on Facebook, but they have a database just like we do for VBAC doulas for birth photographers all over the world. You can find their search database at birthbecomesyou.com/find-a-photographer. That will be linked in the show notes too. I’m putting Paige to work here. Obviously, if you want to reach out to anyone of us, me or Meagan, to support you in your birth, we are happy to do that as well. If you need to find out information about Katie, she is in The VBAC Link Doula Directory as well. I am super excited that there are so many resources available. I feel like it’s even way better than when I was having babies. There is just so much more information available and it wasn’t even that long ago. It’s just so cool that there are all of these resources that we have to help parents find the right support team for them no matter what that looks like. I don’t know. I think it’s really amazing. Meagan: Absolutely. Okay, well thank you again so much, Emmy, and have a wonderful day. Emmy: You too. Thank you so much for having me on. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
50:4008/07/2024
Episode 314 Amanda's Joyful VBAC + Building a Team with The VBAC Link's Resources

Episode 314 Amanda's Joyful VBAC + Building a Team with The VBAC Link's Resources

“It was just such a redemptive, wonderful experience. I am so grateful to The VBAC Link for seeing me through it, for giving me the information, and just the inspiration to even take this on because if I had never found you, I don’t know for sure if I ever would have gone through with it. So, thank you so much for that.”Amanda’s episode will warm your heart, give you chills, and bring tears to your eyes. Her birth stories include a rough induction at 36 weeks due to preeclampsia with an 11-day NICU stay and not getting to hold her baby for 32 hours. When she found The VBAC Link, Amanda was given hope that she could have another baby and that her experience could be very different. Equipped with information and drive, she was able to do just that. Amanda’s VBAC birth was spiritual and powerful!Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Episode Topics:Review of the WeekAmanda’s storiesMonitoring for preeclampsiaCervadil, Magnesium, and CytotecConsenting to a CesareanThrowing up during the C-sectionWaiting 32 hours to hold her babyFinding The VBAC LinkPraying for a babyScared or scarredSigns of wavering provider supportPhysical and mental preparationContractions beginAdvocating during laborThe night nurse“It is done.” Importance of lactation supportMeagan: Hello, everybody. How are you doing? I hope you are doing great. Right now, I can just tell you that my face is already hurting from smiling just from talking to our guest for 5 seconds. We have our friend, Amanda. Hello, Amanda. Amanda: Hello. Meagan: Oh my goodness. She has just been the sweetest thing just pouring on the sugar and sweetening me up. I mean really, she is saying just the nicest things about The VBAC Link and it has just been so fun to hear how The VBAC Link was part of her life. You guys, I love this so much. Thank you for supporting this podcast. Thank you for supporting us on Instagram and Facebook and all of the places. I truly from the bottom of my heart love you. I know I haven’t always met you but I love you and I love this community and I love what we are doing here. I am so grateful for the opportunity. I just wanted to say that it really wouldn’t happen without all of you so really from the bottom of my heart, thank you. Review of the WeekMeagan: We do have a Review of the Week so I want to jump into that and then we are going to get into Amanda’s stories and maybe even some other things. We will see what this episode transpires to. Okay, so this is from Liz Judd and it doesn’t say where it was from, but it says, “Empowering”. It says, “I found this podcast around week 30 of my second pregnancy by searching for ‘VBAC’. I had a traumatic C-section in 2019 and I knew I did not want to go through that again. It was helpful for me to learn the evidence on VBAC, how to advocate for myself, and healing to listen to other’s stories. I just had my second child by VBAC and I thank you for the role you played in that.” Seriously, it warms my heart and you just said the same thing. You carried me through my whole pregnancy, and then this was back when Julie and I took a big 10-month break and you were like, “Oh no, they’re gone!” But here we are. We are back and I hope that we are carrying someone else or many other people through their pregnancy journeys as well. Amanda: I’m sure that you are and that review could not have related more to my story so I can’t wait to get started for you. Amanda’s storiesMeagan: Okay, well without further ado, let’s do it. Let’s get started.Amanda: Here we go. My husband I met in 2004 which yes, was 20 years ago. We got married in 2009 and we were just living our best lives. We were traveling, doing all of the things. I had lost 129 pounds and I said, “I want to run a marathon and have a baby.” Meagan: Dang, yeah. Amanda: I was even a group exercise instructor at the time. Life was good. I ran the Marine Corps Marathon in 2015 in October and in 2015 December, I got pregnant. What was really special about that was we got engaged on Christmas Eve so on the 10th anniversary of our engagement, I got to share the news with my husband that we were expecting. Meagan: Yay! That’s so awesome. Amanda: It was really special but other than that, I really had no knowledge at all about pregnancy and birth. I just knew that I wanted an unmedicated birth. Where I came up with that, I’m not sure, but I just was going to trust my doctor. That’s where my brain was at. I went to my normal OB who I had always gone to and it was a very small practice. There were three doctors and a nurse practitioner and up until this point, I had always seen the nurse practitioner. She confirmed my pregnancy and she advised that I limit my exercise from what I was currently doing and to only maybe just walk and do some light cycling. Meagan: Oh my gosh. My OB said the same thing. I was wanting to run a half marathon and he was like, “Oh no, you’re having too much round ligament pain. Just go for a walk.” I was like, “What? Okay,” so I stopped working out. Amanda: Right. That’s exactly what happened to me. Now I know that was the first red flag of this practice, but I didn’t know at the time. I was just like, Okay. Listen to what the doctor says. So I just kept going to my appointments and I generally felt okay but at my appointment check-ins, my blood pressure started to be high. They would put me into the room and I would lay down on my left side and they would have me do the whole appointment that way and then they would check my blood pressure at the end and it would be okay so they would have me come back in a couple of days for a re-check and it would be okay. We just continued on that way until I circled through all of the doctors and back to the nurse practitioner. She was really the only one who seemed a little more concerned than everybody else about what was going on. Monitoring for preeclampsiaAmanda: I got back to her and she sent me to the hospital for a blood pressure monitor. It wasn’t super high so they sent me home, but they told me to do a 24-hour urine collection. I did that and my protein in that came back at 299 and she said, “Well, 300 is preeclampsia so we are just going to keep monitoring it.” Meagan: Mhmm, okay. Amanda: Okay. That’s exactly what I said. Meanwhile, I’m not exercising. I’m just taking my prenatal and going to these appointments. I didn’t have any preeclampsia symptoms either. I had no headaches, no spots, no swelling. I just felt yucky. I just chalked it up to pregnancy. I thought, Okay, I’m pregnant. This is what I should feel like. Meanwhile, people around me are pregnant and they are like, “I feel fabulous. I love this.” I was like, I don’t love this. This is not great. I’m excited to have a baby but I don’t love it. I also got carpal tunnel. Meagan: That is a thing by the way during pregnancy that people don’t talk about. Amanda: They don’t and I didn’t know about it. My doctors were just like, “It’ll go away when the baby is born. It will go away when the baby is born.” I’m like, “But I’m really in pain. My poor husband has to cut my food. I can’t function here.” Finally, one of the doctors said, “Well, if it hurts that badly then you can go to a hand and wrist doctor.” Okay, so I did and I ended up getting a cortisone shot because it was unmanageable. I had the braces. I was doing night braces and day braces so that did help a lot. A high blood pressure and getting admitted to the hospitalAmanda: In the meantime though, we moved from an apartment to a house. I was the matron of honor in a wedding and then we moved into our house on July 17th. I had a surprise baby shower on August 6th and August 8th which was my 36th week, I had a non-stress test at the hospital. I went into the hospital for the non-stress test. They took my blood pressure. The nurse didn’t say anything. She was like, “I’m just going to take it when it’s over,” which is something I had heard the entire time. I do the non-stress test. She takes my blood pressure again. She says, “You know, the doctor wants to talk to you.” I was like, “Okay. That’s fine.” I go into this little room and the doctor starts saying things like, “Not going home” and “Going into triage” and “Keep you pregnant as long as possible”, so I was like, What? I just couldn’t even process those things. Meagan: And there wasn’t any extra talk of, this is why. Amanda: No. Meagan: Yeah, okay. Amanda: No. I called my husband. I was like, “Listen, you might want to come be with me because I’m not sure what’s going on.” So I go over to triage which was right around the corner and I’m waiting in that waiting room for over an hour. I’m still not thinking there is any type of emergency. They take me into triage and they take my blood pressure which was 214/111. Meagan: Okay. Amanda: Yeah. Meagan: Okay, well that’s high. Amanda: Yeah, so then everyone starts going a little bit crazy. They start giving me medicine. They have me only lay down. I’m not allowed to get out of the bed and they start talking. I start hearing words like, “Possible seizure” and I’m like, “What is happening here?” A nurse finally comes over and says, “We are going to admit you. We just don’t know yet if it’s to labor and delivery or high-risk OB.” I looked at my husband. I was like, “Are we having a baby right now? Are we having a baby?” Then at that point though, that’s when all of the things started happening to me and I was not a part of any of these decisions. Cervadil, Magnesium, and CytotecAmanda: I realize that that was a very high blood pressure and I didn’t really check it after that, but they do take me up to labor and delivery where the doctor starts with Cervadil. This is on a Monday night. She inserts the Cervadil but I had zero dilation. They also put me on magnesium and when they did the magnesium, they also wanted to give me a catheter because they didn’t want me to move. I said, “I don’t really want that.” At this point, I still felt fine and nobody was really explaining to me–Meagan: The severity of things and what was really happening, yeah. Amanda: Right, right, right. So then they were giving me the saline. It was just so much fluid so I had to use the bathroom a lot. They were just letting me use the bedpan and teh nurses were so irritated by me. They would just stand there and watch me. I just felt horrible. It just was a very uncomfortable experience. Then there was the magnesium which–Meagan: Bleh. Thumbs down. Amanda: Yes. It was awful. I just felt terrible. They also gave me a shot for lung development because I was only 36 weeks. Yeah. My water broke on its own but that is the only part of labor that I experienced at all with him. After my water broke, they gave me a dose of Cytotec, and literally nothing happened. Not one thing. My blood pressure was still unstable. The magnesium made me feel awful and then I felt decreased movements. I just kept telling the nurses, “I can’t feel the baby moving. I can’t feel the baby moving.” I was scared. At one point, we knew nothing was happening. My husband and I actually called the doctor and said, “Should we have a C-section? Is this what is going to be happening?” They said, “No. Let’s just see how this plays out.”Looking back, I’m shocked that that was the answer they gave me because of everything else that was going on. They just kept doing cervical checks and they were very uncomfortable because I had zero dilation and I didn’t know I could say no. In fact, one doctor came in. This was actually the doctor who ended up delivering him. She said, “Do you want an epidural?” I said, “No. I don’t even have any pain.” She said, “Well then, you need to let me check you.” Meagan: Wait, because you didn’t want an epidural then you had to let her– what? Amanda: Right. I think she was saying this because I was acting like it was uncomfortable. I mean, it was uncomfortable. I wasn’t acting. Then they gave me another dose of Cytotec. Nothing is happening. Now this is late Tuesday night. My blood pressure is all over the place. They keep giving me different doses of medication. I was on fire from the magnesium. I just kept saying, “This room is so hot.” They said, “But it’s the coldest room in the wing.” “I don’t care. I’m burning up.” Meagan: You’re like, “My skin feels like it’s on fire.” Amanda: So they gave me a fan. That was their accommodation for that. Consenting to a CesareanAmanda: It was around 12:45 so now this is Wednesday morning at 12:45 AM. The doctor comes in and she is just sitting on the end of my bed. I was in and out of awareness. I remember having her be there, but the magnesium is terrible. They just kept taking my blood pressure and she just kept giving me medication. All of a sudden, she stands up and she says, “We need to do a C-section right now.” I still don’t know to this day if it was a decel. I don’t know if it was his heart. I don’t know if it was my blood pressure. I don’t know what happened that made her stand up, but I just remember watching that happen and the look on her face. They were laying me down. They were giving my husband scrubs. I’m signing all kinds of consent forms laying down and then they gave me this awful drink for nausea and wheeled me into the OR. Because I had the magnesium, they were lifting me. I wasn’t allowed to do anything by myself and I forgot to mention that since I wasn’t exercising or doing anything, I gained 90 pounds during this pregnancy which was terrible but I didn’t know. I wasn’t small and they were moving me around. I get a spinal. As soon as I got the spinal, I said, “Oh my goodness. I’m going to be sick.” I just felt so nauseous and I remember the anesthesiologist behind me saying, “It’s okay. We’re ready,” and other people saying, “Lay her down. Lay her down.” They immediately lay me down and then I vomit into the bucket. Meagan: Oh yeah, that’s the most miserable feeling. Amanda: It was terrible. He was ready. He did have a bucket. He wasn’t lying, but then they squirted something on my stomach and I just remember saying, “I can feel that. I can feel that.” The doctor says, “Yeah, but is it cold?” I said, “No.” She says, “Starting incision.” She just is going. Throwing up during the C-sectionAmanda: Literally every time they pushed on my stomach, I was throwing up. Every single push and shove they did, it was awful. It was awful. But at 1:38 AM, our first son was born and there was one squeaky little cry and then he stopped and the NICU team got to work on him. They were about to take him up to the NICU and God bless my husband. He stops in front of the door and says, “Can she at least give him a kiss first?” They brought him over really quickly. I got a kiss and then they took him away. All was quiet. I was still nauseous and I just remember the anesthesiologist saying, “They’re just putting you back together. Why don’t you try to take a nap?” I was like, “Um–”Meagan: Okay. Amanda: Right. Needless to say, the bedside manner all the way through was not great. Meagan: Not great, no.Amanda: But once I got into recovery, I was just holding onto the fact that they said I could see my baby in 24 hours. I was like, Okay. I just have to make it 24 hours and they will take me to see him. I set an alarm on my phone. I am pumping. They gave me the pump. I am pumping. Any colostrum I am getting, I am sending up to the NICU. My blood pressure is still not settling down. Waiting 32 hours to hold her babyAmanda: 24 hours goes by. I call the nurse. I’m like, “It’s 24 hours. Take me up to see my baby. Please take me up to see my baby.” She’s like, “Well first, we have to take your blood pressure.” It was not good. She was like, “Wait 2 more hours and then we will check.” I was like, “I just waited 24 hours and now I have to wait 2 more.” They take my blood pressure again and it was fine. I was like, “Yes. I’m going to go see my baby.” They were like, “Well actually, you have to walk and go sit in this chair first and then we can take you up. We have to take your blood pressure from this chair.” I sit in the chair. My blood pressure is not good. “Oh, you have to get back in bed. We can’t take you up.” At that point, I just lost it. I was like, “I can’t.” I told my husband, I was like, “You have to tell people to stop texting and stop calling. I cannot do this. I just don’t understand what’s going on here.” I did not know it at the time, but after they got me back in bed, my husband went back into the hallway. He told the nurses. He was like, “You have to take her up there. You have to take her up. She has to see that baby.” Sorry. Finally, the nurse came in and she checked my blood pressure and it wasn’t great but she thankfully had I guess fewer patients so she came up to the NICU with me. She did take me up there and after 32 hours, I finally got to meet him and hold him but as soon as we were together, both of our health’s dramatically improved. My husband knew that that’s what we needed. I’m so grateful that he did that. Meagan: Absolutely. Amanda: I ended up staying admitted for 5 days because they just couldn’t get my blood pressure situated and then our son Jeffery David came home after 11 days. Physically, my healing was okay because I had 11 days of sitting. Meagan: Hanging out in the hospital not doing much. Amanda: Yeah, and you know, God bless my family and friends who drove me to the hospital every day to go see him. Some of them sat with me for hours and hours and hours just because I was by myself but my mental healing was not great. Because of everything that happened, I had just closed the chapter on kids. We were apparently one and done. I told my husband, “I am not doing that again.” I mean, I was on blood pressure medicine for 2 years after that. Meagan: Wow. Amanda: Yeah. It was bad. I just said that I always wanted more kids, but I’m not going to do that again. That was terrible. Finding The VBAC LinkAmanda: So my son was about 2 and I was listening to a different podcast. They were interviewing these two doulas who had VBACs and I was like, Who are these women? Then obviously, it was you guys. Meagan: That’s awesome. Amanda: I went over and I found The VBAC Link. I was like, Oh my gosh. I didn’t even know a VBAC existed up until this point. I was listening to your podcast and I listened to all of the episodes and then I finally said to my husband, “Listen, I found this information. It’s really inspiring and really informative and if we ever had another baby, this is what I want to do.” He is the most supportive person that exists. He is my biggest fan and biggest cheerleader. He was like, “Okay. That’s fine.” With a list of questions from your website, I went and found a new OB who I interviewed and I decided that they were supportive because aside from answering all of those things positively, she could also tell me the nearest provider who delivered VBAC twins and the nearest provider who did VBAC breech births. Meagan: Wow, that’s awesome. Amanda: She said, “It’s not here, but these are the two places that you could go.” I was like, Okay, I feel like this practice will work. It was also much, much bigger. They had two midwives on staff which I was very interested in because I’m definitely more of a midwifery mindset. In the meantime, I also went to pelvic floor therapy and while she fixed a lot of internal things, she also did a scar release which was very intense but very, very needed. I didn’t know that until I had it and then I was like, Oh my gosh. I didn’t realize how uncomfortable I was just living my life all of the time. It was amazing. Meagan: How game-changing it really is. Yeah. Not even just for birth, but for life like you said. Amanda: Yes. I couldn’t even sit criss-cross applesauce just because I had so much tension in my hips and everything. It fixed so much. Praying for a babyAmanda: Then my son is approaching 4 years old and then one night we were saying our prayers just he and I at night and he says, “I pray for a baby in mommy’s belly.” Meagan: Aww. Amanda: I was like, “What?” Meagan: “What did you just say?”Amanda: Yeah. There was no one pregnant around us at the time. I didn’t even know at that time that he knew that babies in bellies were a thing. That continued for weeks. I never once reminded him. Every single night, he would pray for a baby in Mama’s belly. I talked to my husband. I was like, “We need to address this one way or another. We either need to tell him that that is not happening or we need to have a serious discussion.” So since I’m here, you know what we decided on. Meagan: Spoiler alert. Amanda: We were blessed with a second pregnancy. Now, the day I took that pregnancy test, I went on The VBAC Link website. I looked up your doulas and I found doulas in my area. I just kept scrolling back to this one profile that just kept speaking to me. Her name was Mallory. I sent an email to her which was “Seeking doula, have questions”. She wrote back to me and that is actually who I ended up having as my doula. She was literally with me from day one. But I started this pregnancy at advanced maternal age because I was 35 at the time. I was plus-sized so while I wasn’t 90 pounds heavier, I had lost some weight, but I still had a higher BMI. I also consistently worked out 4-5 times a week and I was loaded with information. I had a new OB and I instantly became their worst nightmare. I know it because–Meagan: Because you had all of the information. Let me just tell you. Providers, I think it catches them off guard when people come in and have information and they are like, “Oh, wow. This lady knows what she is talking about.” That’s how it should be. We should know what we are talking about. Amanda: I agree. I always say that I wish there was a second-time mom the first time because I just went in armed with so much information that I never would have gotten if I didn’t have such an awful experience the first time. I started taking a baby aspirin every day just because of the blood pressure issues before. Scared or scarredAmanda: This is a much larger practice. Like I said, they had two midwives and as I rotated through those doctors, I realized that some were supportive, some were tolerant, and some were scared. Meagan: Oh yeah. I like that you say that. Scared. Because I think that’s the case with a lot of the “unsupportive providers”. I think they are scared or scarred. Amanda: That’s a good point. Yeah. That’s a good point. Meagan: They just haven’t had a great experience. Amanda: Right. So along with all of this medical information, I also am very strong in my faith and I was having a hard time. I was having an internal struggle because I had all of this information and I wanted this so badly but I was struggling with the fact of what if this wasn’t God’s plan? I was fighting for all of this stuff and what if it wasn’t His plan? I shared that with my doula, Mallory, and she actually said to pray then if this is not Your wish, then take the desire away. Meagan: That just gave me the chills. Amanda: Yeah. I wanted to share that because it changed me so much. I prayed it every single day of my pregnancy and the desire never went away. I felt like it was okay. Because I was able to pray that and the desire was never going okay, I just felt so strongly and continued going along in this happy, healthy fast pregnancy. There were no physical issues. I had no carpal tunnel. I gained a total of 16 pounds. Total. I mean, I worked out up until 39 weeks. At my 39-weeks, I was doing body pump. I lifted the weights over my head. The instructor was like, “How long are you going to do this for?” I was like, “Actually, I’m all done today.” Meagan: Today is the last day. Amanda: If I knew though that I was going to go to 41 weeks, I probably would have kept going but I just wanted to some time to be done with the gym and just get in the right mental space. Signs of wavering provider supportAmanda: At 30 weeks though is when the support started to waver a little bit. There were more questions about heart decels and reminding me of the continuous monitoring. At 32 weeks, I was having a scan to make sure baby was head down and I had been going to the chiropractor this whole time. This baby liked to hang out transverse. Before my 32-week appointment, the night before, I went to the chiropractor and I was like, “Listen. I know you have been doing Webster the whole time. I have an appointment tomorrow. They are checking to see if he’s head down. What can you do?” He’s like, “I got you.” So I don’t know what he did, but I was driving home from the chiropractor and it felt like I was on a rollercoaster. You know how your belly does that flip? It was so intense at one point that I actually pulled over and chilled for a minute. It was just so much movement happening. The next morning, I went to my 32-week appointment and he was head down. Meagan: Awesome. Amanda: That was pretty cool. Then at 36 weeks, they started to pull the big baby card. Meagan: Oh yeah. Amanda: They gave me an ultrasound and they said that the baby was measuring 11 pounds. Meagan: Whoa. Amanda: I said, “That is impossible.” First of all, I gained 16. There’s no way 11 of that is him. Then they were like, “Well, you do have a high BMI.” I was like, “That does not mean that he is going to be a big baby.” I had the article that I brought with me about all of the evidence and I declined a re-scan. That blew the receptionist’s mind. I said, “No. I’m not.” She said, “Well, the doctor said you have to.” I said, “I don’t have to though so I’ll make my next appointment, but it’s not going to be for an ultrasound.” That night, I actually got a phone call from a doctor who was like, “Why did you decline the scan?” I said, “My baby is not 11 pounds. He’s not.” We had a big conversation and we agreed on a different type of scan. Now, I can’t actually remember. I apologize. I can’t remember what kind it was. They took different measurements but at that one, he measured 6 pounds. Meagan: What? That’s a dramatic difference. Amanda: I know. Where I thought, that’s where I thought he was going to be in my head so then I was given the green light to proceed with the way I wanted to. This whole time, I just had such amazing support from my husband but also from my doula. She would check in before every appointment. She just was amazing. I would be in the parking lot and the text would appear, “How are you feeling about this?” Then when I would come out, she would check in with me. In fact, even before recording this podcast, I got a text from her, “How are you feeling about this?” I was like, She is a gem. But I got the green light. Meagan: We should have had her on. Amanda: I know. I did think about that. I feel so bad. Meagan: That’s okay. That’s okay. Amanda: She’s got a new newborn of her own. I know, it’s wonderful. At 36 weeks, I also started to get the on-call schedule of all the doctors. I would say, “Who is working this week?” I would keep it in my phone so I knew who would be working because there was one doctor who at an appointment told me directly that she is terrified of VBACs. I knew that I should avoid her at all costs because I just knew that if I had her, she would find some reason to deem it C-section worthy. Physical and mental preparationAmanda: Throughout this pregnancy, I’m doing chiropractic care. I’m drinking raspberry leaf tea. I’m eating the dates when I was supposed to eat the dates. I also went back to pelvic floor therapy and told them that I want to have a VBAC. Help me prepare for that. That was wonderful. I became so passionate about this whole thing. Everybody knew. My poor coworkers had to listen but if there was anybody around me who was getting a C-section, I had to tell myself, “They didn’t ask you. They didn’t ask you. They don’t want a VBAC.” Meagan: I know. Amanda: I also got acupuncture because I was just trying all of the things. Also, in The VBAC Link Facebook group. I found someone was Catholic affirmations that they had made. She shared that file with me so I had them all printed out. I was ready to go and then my due date comes and my due date goes. Meagan: Hello, goodbye. Amanda: Yes. I had never been pregnant past 36 weeks before so I was like, Well, this is pretty awesome, but I felt incredible. I still was coming to work. I came to work on my due date and my principal was like, “I did not expect you to be here today.” I thought, Don’t underestimate me just like those doctors. I’m here. Contractions beginSo on a Monday, I was 40+3 and I had an appointment. I saw a midwife at the practice who was actually a VBAC mama herself. She and I just had this vibe and I was like, Yes. I love her. I knew at that appointment at 40+3 that I was going to ask for a membrane sweep. So I did and she tried but I wasn’t dilated at all. She was really giving it her best shot, but she couldn’t do it. I felt fine. I was fine with it, but I was also a little disheartened because I knew that pressure was going to start coming from the providers. This is where my BMI came in handy because I could qualify for an early induction because of that because like I said, I had the work schedule and that doctor who was terrified of VBACs was working on Friday. Meagan: So just a couple of days later. Amanda: Yes. Yeah. This was Monday at this point, so I scheduled an induction for Wednesday. I was like, Okay. Let me give myself a couple of days to see what I can do, but I also knew I didn’t really want to go too far past 41 weeks because I know at 42, the risks go up and I knew time was of the essence. After that appointment, I go back to school and I’m standing on the playground with my partner. There are all kindergarteners running around and running around. I felt this intense squeeze in my belly. I looked at my partner who has had three babies and I was like, “Oh my god, what does a contraction feel like?” I was like, “I think I just had my first contraction.” We were just cheering out there and they continued every 10-12 minutes all the way through Tuesday. I come to work on Tuesday. I was still having contractions but they weren’t increasing in intensity so it was okay. Meagan: Yeah, just happening. Amanda: Yeah, but Tuesday, I did decide to leave work early. I just checked in with my principal and I said, “I think I’m going to go home. I think being in a better headspace knowing I’m home and relaxed might help.” As I was leaving, one of my coworkers who had a C-section several years ago came up to me and she said, “There are a lot of women who would love to be in your shoes so good luck.” I thought that was really special. Meagan: Mhmm. Amanda: I appreciated that. I knew. I was like, Yes, I’m doing this for me and for a lot of people. So anyway, sorry. I was in constant contact with my doula. I go home. My contractions are increasing to 7-10 minutes apart. They are more intense at night. Now they are 5-10 minutes apart but I still decided to go to the hospital on Wednesday morning for the induction because I know my body. With my first baby needing the NICU, I knew that as much as I would dream of a home birth, I know that I was afraid in case intervention was needed and I knew that my body would just relax when I knew I was in the place where the interventions could be if I needed them. Advocating during laborAmanda: I send my son to preschool and I go into the hospital with my birth plan and all of the things. I tell the doctor I want Foley but no Pitocin. He was like, “Uh,” and then he watched me have a contraction and then he said, “Are you having contractions?” I said, “I am.” He said, “Okay, we can do it then.”I got the Foley and he also when I was talking with him about my birth plan said, “Listen. We all read it and we want this for you.” I just thought that was a cool thing for him to say. Meagan: Validating. Amanda: Yes. So I’m in New Jersey and here, VBAC after two C-sections is not a thing. I knew that this was really my chance and I also knew that really, two was enough for me. I knew I wanted two children to make our family complete and that was it. One of the things for a VBAC here in the hospital and with the practice is continuous monitoring. Trust me, I tried to not have them do that. Meagan: It’s a real fight if you decide to try to fight it and that’s really common everywhere. Continuous fetal monitoring is usually pushed really hard and it’s one of those things where it’s like, is it worth fighting for to you? You have to weigh it out because you really do have to put up a fight. Amanda: I tried, but like you said, I wanted the VBAC more so I was like, Okay, fine. We can do this. They did thankfully have a portable monitor because I really wanted to labor in the shower. They had a portable monitor. It could go in there. I was like, “Good. We’re golden.” But then my baby did not want to be on the monitor so he kept falling off but there was no decel. There was never a concern. Meagan: Just loss of heart rate because baby moved away. Amanda: Because the monitors fell off. Yeah, so at one point, one of the midwives– not the VBAC midwife, the other midwife– comes in and says, “We’re just going to put an internal monitor in.” I remember my doula looked at me and she said, “Do you know how they do that?” I said, “No,” so then she explained that to me and I declined. Meagan: Yeah because they do have to break your water to do that. Amanda: Oh, I’m sorry. My water did break. Meagan: Oh, your water did break. Amanda: I apologize. I missed that. Gosh darn it. Meagan: I might have missed that. Amanda: No, I missed it. I missed it. But I didn’t want the internal monitor. I just didn’t feel like that was right for me. I was like, “I’ll just keep struggling with this. He is safe and happy and comfortable. I’ll be fine.” The night nurseAmanda: Everything was going fine. My body was doing it. I didn’t need Pitocin and I was loving labor. Everything that I had practiced and done and just my head space was good and I had listened to some fear-release meditation prior to this and it was just wonderful. I was living in labor land. It was wonderful. Then shift change happened and the night nurse came. The night nurse was very, very intense. My day nurse would let that monitor ride a little bit without being on. This night nurse was not having it. Continuous monitoring meant continuous monitoring and she felt that she needed to do that 3 inches from my face with her hands just pressing and touching me and I really was feeling very overwhelmed by her. Meagan: Yeah. Amanda: I was trying to ignore her and they brought in the bar and I was laboring on the bar. It was wonderful but I still remember that I could smell her breath through her mask. It was too much. She was too much. I said, “Please can I labor in the shower and then we can get together?” She was like, “Okay, as long as baby stays on the monitor." I was like, Please baby, stay on the monitor. So I get in the shower and I was like, Okay. We’re fine. Life is good. This is wonderful. I feel great. I’m rocking. It’s great. Then I hear the bathroom open and I turn around and she is standing there in a full raincoat. She’s got a head cover. Meagan: A raincoat? Amanda: She’s got a plastic gown on, plastic shoes, and she comes in the shower with me and is trying to adjust this monitor. Meagan: Oh dear. Amanda: I lost my mind. I don’t remember what I said but all I remember is screaming at her and her leaving but telling me I had to come out of the shower. So she leaves and I walk out and my husband and my doula are just snickering because I just kicked her out. But I was like, “Why is she in the shower with me?” I get dried. I get redressed. I’m back in the bed and she’s back. Then my blood pressure starts spiking and I start hearing, “High blood pressure, high blood pressure.” I’m like, Oh my god, it’s happening. Meagan: It’s her. It’s her. Amanda: Right, but I got scared because of what happened before. Meagan: Of course. Amanda: I was like, “I can’t have this.” I remember Mallory looked at me and she said, “Do you want an epidural?” I didn’t initially want one because I wanted to feel this. I wanted to feel all of this. She said, “It would just be a tool to reach your ultimate goal.” Now, I knew two things at that time. It was one, an epidural would help keep me still which was going to help keep this monitor one and two, it’s known for bringing blood pressure down. So I agreed. I was kind of sad about it, but I knew ultimately that I was going for the VBAC. That’s what I wanted so I had to keep that in my sights. In my head, I didn’t say this out loud, but I said, “Okay. If I am a 6 or less, I will get an epidural.” I had a doctor come in and check and I was a 6. I get the epidural and obviously, it doesn’t work so I get a second epidural. Meagan: Oh my gosh. Amanda: It was lovely, but that one did work. That brought my blood pressure back to normal and I was still, but then man. Between my husband was helping my doula and she had the peanut ball and she was still moving me. She was holding that monitor on. She was watching that monitor for me. It was just amazing but the problem was that the epidural stopped my contractions. Meagan: That is a downfall that can happen.Amanda: Yeah, so then I did consent to Pitocin at that point because everything stopped. “It is done.” Amanda: I had the epidural. I had the Pitocin. Things were progressing. I was dilating. We were moving me as much as you can with the epidural and then around 4:00 PM, my epidural wore off and I felt it wear off. I was like, Oh my gosh. At 4:45, the midwife came in and she checked me. She said, “Oh, you are 9 centimeters. This is wonderful. I’ll be back in a few hours.” I’m thinking, A few hours, I don’t feel like I have a few hours here. I felt my body start pushing all by itself. I was like, Oh my gosh. This is amazing, but I was like, “You have to get her back here. I know she said I was just 9, but you have to get her back here.” She came back and she said, “Oh, you’re 10 already. Let’s do a practice push.” I was like, “Wait. I need the mirror. Where’s the mirror? I want to get the mirror.” There was a full-length mirror that they brought in and I thought there was going to be a little hand mirror situation so I was really happy with the full-length mirror that came in. She said, “Let’s do a practice push,” and she was like, “Oh, you are an excellent pusher. You’ve got this.” I’m watching in the mirror and I hear from the hallway, “Don’t let her push until I get in here!” And it was the doctor that I originally interviewed. She came in. She said, “I want to see this through.”Now, meanwhile, I had not seen her throughout my entire pregnancy as one of my providers but I thought that was so cool that she remembered that and came in for this. It was the midwife, not the VBAC midwife but another midwife and her were there with me and as I started to push him and his head came out, the midwife said, “Oh, do you want to feel his head?” Before I could even answer yes, the doctor said, “Oh, she does,” and takes my hand and I feel him. I’m pushing. I’m watching. My doula is taking pictures and all of a sudden, the midwife is blocking the mirror. I’m like, looking at her and I’m like, “I can’t see.” I’m hearing her say, “Amanda, Amanda, Amanda.” Finally, I look over and she’s blocking the mirror because she is holding my baby in front of me. Meagan: Oh my gosh! No way. Amanda: I was like, “Oh my gosh!” Then I’m looking at him and then there is a bright light behind him and I feel this moment of peace and I feel in my heart and I hear, “It is done.” I just know that God was there with me the entire time and I’m so grateful for that. My husband got to cut the cord and I got to hold him immediately– well, we didn’t cut the cord until it stopped pulsing. he was so cute. He was like, “She told me to wait until it’s white. Is it white? Is it white? Is it white?” It was just wonderful and he cut the cord. I got immediate skin to skin and I got to do his first latch right then and there which was so different. It was so different than my son. It was just such a redemptive, wonderful experience. I just am so grateful to The VBAC Link for seeing me through it and for giving me the information and just the inspiration to even take this on because if I had never found you, I don’t know for sure if I ever would have gone through with it. So, thank you so much for that. Meagan: Oh my gosh. You are so welcome and thank you for sharing this beautiful story. I’m looking at your photo right now and oh my heck. I don’t know who took it–Amanda: My doula, she took it. Meagan: Mallory?Amanda: Mallory. Meagan: Mallory killed it with this photo. I mean, seriously it is beautiful. Amanda: Thank you. Thank you. Meagan: I highly suggest if you are listening right now, head over to Instagram or Facebook and check out this absolutely empowering photo. The emotion, oh. Congratulations. I’m so stinking happy for you. Amanda: Thank you. Thank you. Thank you. It was quite a journey. Importance of lactation supportAmanda: I just wanted to add one more thing if I could. Meagan: Yes. Amanda: I got to nurse Jeffrey David eventually, my first baby once he left the NICU but it was a rough time and then with Charlie, my second, I got to latch him right away and I am still nursing him now. He’ll be 3 in June. I just want to say just like you get doula support for your birth, get yourself some lactation support if breastfeeding is the way you want to feed your baby. Meagan: 100%. 100%. Amanda: Yeah, so I used my friend, Lauren. She is from Cozy Latch Counseling and she has seen me through this entire process. I went back to work. I was able to pump and provide milk and now like I said, he’s almost 3 and I’m still able to do that. If I hadn’t had that lactation support from the very beginning, I don’t know if that journey would have been as successful as it was. Meagan: Yeah. I mean, I full-on believe having lactation support even before the baby is here to talk about it. Talk about your plan. Discuss what you are wanting, your desires, your needs, and then getting that help right away even if it’s your second, third, fourth, or fifth baby. Everyone is so different and I love that you brought that up because definitely, we are passionate about that for sure as you know or if you have been listening. We love The Lactation Network. We absolutely 100% would agree with you on that. Oh my gosh, well my face is just so happy. Can you just see my face right now? Amanda: I can. Meagan: I’m just smiling so big. My cheeks are throbbing a little bit, but that’s a good thing. I’m just so grateful for you. This is such an amazing episode and congratulations again.  ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
46:2603/07/2024
Episode 313 Happy Birthday to Meagan’s VBA2C Babe + Walking Down Memory Lane with her Husband, Ric

Episode 313 Happy Birthday to Meagan’s VBA2C Babe + Walking Down Memory Lane with her Husband, Ric

“Trust your partner. Trust the mom. They know things better than you do.”Meagan’s husband, Ric, joins the podcast today as they celebrate their VBA2C baby’s 8th birthday! Ric gives the perspective from the partner’s side of things as they both share details of Webster’s birth story. He talks about some not-so-proud moments and is the first to admit how little he knew about how to support a VBA2C labor– especially one that went over 40 hours! But through it all, Ric came to understand the importance of doulas and how magical it can be to have not one but five doulas! He agrees that the births of each of their children ultimately was a special journey and brought the two of them closer together. Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:17 Review of the Week04:10 Deciding to birth out of the hospital06:35 Agreeing on a birth center10:57 PROM for the third time15:05 Laboring loudly20:23 Relying on the doulas28:33 Navigating doubt and transition on the toilet34:25 Pushing Webb out in three pushes37:08 Passing out after birth40:37 It takes a village42:45 Ric’s advice to other dadsMeagan: Today is my VBAC baby’s birthday. I cannot believe that it has been 8 years since that little boy joined our family and today I wanted to share or reshare his story. I know I’ve done it in the past, but I invited my husband, Ric, to share the story again for you and maybe I might just give him a couple of questions and see how he felt about it from his perspective. When we were going through pregnancy and preparing for me, it was just like, This is what I want to do. This is what I want to do. I would always go and say, “Hey, these are my thoughts”, and to be honest, I don’t know if I even gave him a ton of opportunity to share his exact thoughts because I was so driven and just wanted to get this.We are going to dive more into his thoughts and his perspective on the birth because we know so many dads out there are also a little hesitant when it comes to the idea of VBAC because the world as we know it talks about VBAC in a very poor manner and it can be a very scary thought. So we will be diving into that today in just one moment.01:17 Review of the WeekMeagan: We have a Review of the Week so I wanted to get to that before we get into Webster’s birth story. This is from Katiewarren11. It says, “I wish I would have found this sooner.” It says, “I love the show. I wish I would have heard these before my last baby. I was planning for a VBAC 7 years after my first baby and just thought it would happen. I didn’t realize I might have to fight for it.” That just gave me the chills. It says, “I got to the week of my due date and my body didn’t seem at all ready. Then they were estimating her to be 9 pounds, 12 ounces, and the doctor told me, ‘No option. You are getting a C-section.’ After listening to these stories, I now know that there were other options.”Thank you, Katiewarren11, for sharing your review. I want you to know that you are not alone. There are so many of us who get to the point at the end of our due date. We are being told that our babies are too big or our bodies aren’t working because they are not dilated yet or whatever it may be. There are lots of scenarios that people are told, but there are options. You have options and that is definitely what this podcast is about is helping you learn and grow and know your options. So thank you, Kate, again, and as always, if you have one moment, we would love to hear your review of the show. It really does help the show grow. It helps other Women of Strength find these stories and help them know their options as well. You can do that on Apple Podcasts. You can even Google “The VBAC Link” and leave us a review there or if you would like, you can email us a review and let us know what your thoughts are. We always throw those into our spreadsheet as well. Thank you so much. 04:10 Deciding to birth out of the hospitalMeagan: Okay, you guys. As I mentioned, I have my husband, Ric. Hey, hon. Ric:  Hello, everyone. Meagan: I’m sure he is just so excited that he is here. But really, I wanted to go through the experience from your perspective on VBAC and not only just the birth but also before and us deciding to birth out of the hospital. I was already kind of a crazy pants when we were trying to conceive because we really wanted a boy so I was really dialed into that. Then once we found out we were pregnant, I really, really just wanted to find someone to help me through the journey of VBAC. I interviewed many, many, many providers in fact, even before I was pregnant. We know on the show, I have talked about it, that it is really important to interview and look for providers before you are pregnant if you can but I ended up finding a provider actually just right after I found out I was pregnant or right before I found out I was pregnant. We went in and it seemed like a really great fit. Ric, you seemed like you were pretty on board with the provider shift at that point. ric: Yeah, I mean those who know Meagan know that when she is passionate about something, it is very unlikely that she will be turned away. Meagan: Convinced otherwise. Ric: Convinced otherwise so I just kind of went with the flow. But yeah, the provider seemed great. You seemed happy which was most important. Meagan: Yeah. And just kind of a quick little back summary, how did you feel about the C-sections? Did they bug you at all? Did they affect you at all? Did they just seem normal?Ric: Yeah, I mean, I didn’t know anything other than the C-sections so it was normal. It was just that you were very unhappy with them which was hard for me. It was hard because I was stoked that we had the babies and you were upset with yourself, with the provider, and I didn’t share those feelings because I didn’t know. Meagan: Yeah, It was hard because like you said, we were so happy that we had our baby but I was in this cloud of doom and just and unsettled cloud. Ric: Dissatisfied. Meagan: Yeah, I was dissatisfied. 06:35 Agreeing on a birth centerMeagan: Okay, so we found this provider and everything is going really great. This provider at the time was the VBAC provider in Utah. Everybody went to him and he was amazing. He flat-out said after reviewing my op-reports that my pelvis was too small and my baby would probably never come out of my pelvis and that my body didn’t know how to dilate, he really agreed that I probably just wasn’t given a fair chance and he didn’t understand why we wouldn’t be able to go forward.But at 24 weeks, I attended a birth just before that with a midwife out of the hospital that blew me away. I immediately knew that I wanted to go talk to her which was kind of interesting because we never really discussed birthing outside of the hospital, but I went and met with her and I told you, “Hey, I want to birth out of the hospital.” Now, you knew nothing but C-sections. You were okay with me finding a provider, but how did you feel about the idea of birthing outside of the hospital?Ric: I don’t think I was that excited about it. I was okay switching providers, but not being in the hospital was worrisome. I actually think, didn’t you broach the subject on birthing from home? Meagan: I think I did. Ric: I immediately put the kibosh on that. Meagan: You were like, “No.” Ric: So I think when you initially discussed birthing outside of a hospital, you gave a couple of options of a birth center or a birth from home so I completely– that was too big of a jump for me from hospital to home so we went and did we go to multiple birth centers or just one? Meagan: We just went to one and we interviewed with a different provider than the one I met, but it was at the same birth center that the provider I met would have birthed at so we met with another midwife at the birth center. Ric: Right. It was awesome. Meagan: It was awesome.Ric: No, the midwife was cool too. She was great. Meagan: Yeah, she was really awesome. Yeah. So as we were there, did you feel like, Oh, okay. Once you saw it, did you feel more comfortable? Ric: Yeah, because it seemed more medical. I don’t know the word for it, but it just seemed like, Oh, hey. Things looked sterile which was a big deal for me and it just made it seem like, Yeah, it’s not the hospital, but– can I swear on the podcast? Meagan: Yeah, sure. Ric: –if shit hit the fan, then we were in a better circumstance than trying to find gauze and stuff at our home. Meagan: At our home, yeah. Which for those who are birthing at home, typically your midwives would bring all of that to the birth but we didn’t even get there for me to explain that. Ric: I don’t need to know if I would have even let you. Meagan: Get to that point? Ric: Yeah. Meagan: Okay, so then fast forward. Labor begins. Actually, we hired a doula. Ric: A doula? Meagan: Multiple doulas.Ric: You had these two mentors in the doula community here and you said, “I definitely want to hire them,” so we did. Those two mentors were in a group of three. Not only that, your really good buddy who became a doula at about the same time and had gone through the doula course with you wanted to attend, and then your cousin who is about as much of a doula as you can be without being a doula– Meagan: Seriously, yeah. Ric: Also had to attend the birth. Plus the midwife–Meagan: And the assistant. Ric: And the assistant. There were a lot of people in the room. Meagan: There were a lot of people in the room.Ric: Initially when you said, “Hey, look. We are going to hire a doula,” because you were doing the stuff, I was totally on board. I had no idea how many doulas would actually show up. Meagan: Yeah. Ric: But they did and it was fine. Meagan: It was great. And rewinding back, remember back with Lyla when I asked you if we could hire a doula or bridge that, you weren’t super keen on that idea. Ric: I don’t remember that conversation.Meagan: You don’t. Ric: But I remember our nurse being a doula. Meagan: Yes. Ric: And she was awesome. Meagan: She was fantastic. Ric: And that solidified your desire to be a doula. Yeah. Meagan: Absolutely. 10:57 PROM for the third timeMeagan: Okay, so with all three of our kids, I for some reason have PROM. If you don’t know what PROM means, that’s the premature rupture of membranes. My water broke with each kiddo and my body took its sweet old time to kick into labor. They say only 10% of women will experience that, but we are 3 for 3. Ric: Do they know the story about where I was when your water broke with Lyla? Meagan: No, I don’t know. That was another reason why I wish we had a doula. So going back to Lyla’s birth, my second C-section–Ric: Kind of just showing the progress of where Meagan began as a, “Hey, look. I trust my doctors. I’m going to do everything that they say on the first birth.” The second birth opened my eyes as to how Meagan was going to control the situation as much as she possibly could. So yeah, tell them where I was when your water broke. Meagan: So you were in Texas when my water broke with Lyla. As he mentioned, my cousin is pretty much a doula without the doula training and she just is so loving and caring. She was really excited because we wanted this VBAC. I wanted this VBAC really, really badly. So yeah. Ric was out of town and my water broke. I was like, “Uh, you should probably come home.” Nothing was really happening at all really. I was just leaking. Yeah. You got home probably 6-7 hours later. Ric: No, it was about 10. Meagan: Was it about 10? Ric: Yes and I assumed you were going to go to the hospital. Meagan: Yeah, you were not happy when I was not at the hospital when you got home. Ric: I walked in and you were sitting there naked in the bathtub and I’m like, “What in the world are you doing? You are supposed to be in the hospital. Your water broke.” Because for me, your water breaks, you go to the hospital. For Meagan, that’s not necessarily the case. Meagan: Well, yeah. I think going back to what you were saying, a lot of providers actually say, “If your water breaks, come right in,” even if labor is not going on. Through my research with Lyla and the VBAC, I realized that I didn’t necessarily need to just run right into the hospital. I checked my vitals. All was well. Everything was good, so we stayed and labored at home. Plus, I was waiting for you to get in town. Ric: Yeah, but it kind of prepped me for what the next birth was going to look like. Obviously, that birth ended up in another C-section and you were really disappointed after that one. You worked really, really hard. Meagan: I was, yeah. Ric: Then with the next one, when you were going through options of birth centers, doulas, and midwives, that instance where I flew home in an emergency fashion as quickly as I could and came home to find you in the bathtub realizing, Meagan is going to do what Meagan wants to do. Meagan: Yeah, so when I told you, “Hey, let’s birth out of the hospital”, did you feel like, She is going to do whatever she wants to do anyway? Or were you more comfortable with the birth centers? Were you okay with that? Ric: Yeah. It’s hard to tell you no, but when we went to the birth center, I did feel significantly better about having a birth there. Meagan: Yeah. What had you heard about or had you heard anything about VBAC just in general? Ric: Nothing. Meagan: So you didn’t really hear a ton. Ric: Other than what I heard from you. Meagan: So you didn’t hear anything scary. Ric: No. Meagan: Okay, because a lot of dads out there do hear when they say, “Oh, my wife wants to VBAC,” people are like, “Oh my gosh. It’s so scary.” I think that can be really hard especially if their partner is saying, “Hey. I want to birth out of hospital.”15:05 Laboring loudlyMeagan: Okay, so my water broke with Webb at 3:00 AM or something like that. Yeah, what do you remember about that? My water broke in the middle of the night. I don’t even think I told you until I woke up. Do you remember anything about that?Ric: With Web, that was where you labored forever, right?Meagan: Yeah, 42 hours. Ric: I don’t remember that first morning. I remember the next night. Meagan: Yeah. Ric: Didn’t Hillary– Hillary is her cousin, everyone. Hillary showed up at 6:00 in the morning and you guys went out and walked around the neighborhood. Meagan: Yeah, so the night–Ric: The first night?Meagan: No, that was the second morning, yes. My water broke and again, I had PROM so I was so frustrated. I was 40 weeks and 3 days or 4 days. I had him at 40 weeks and 5 days. We had a visit with Danielle and my water had broken. I was sort of contracting a little bit here and there. I asked if you would come up to Park City with me. We went up to Park City and I went in and I did my regular visit and then she said, “You’re going to Christine.” Christine, at the time, was my chiropractor so we went to the chiropractor. You got me a Jamba and we drove back down the mountain and came home. My body just really wasn’t going into labor. It was taking its time so I went and I took a nap which is really hard to do when you are in labor because your mind is so excited and you just want to have a baby, but I needed to nap so I went in and I napped. It’s weird. I can even picture exactly how our room was set up that day. I took a snooze and woke up and I was sort of starting to contract. I actually went out into the driveway and threw a tantrum. Do you remember me throwing a tantrum in the driveway?Ric: No. Was I working? Was I at home?Meagan: You were at home. I threw a tantrum that my water broke. I was triggered. I was like, “This is going to be the same. I’m going to have another C-section.” I was just so upset. I remember our next-door neighbor had this big pine tree and they were watching me throw this insane tantrum in our driveway. But yeah, so then that night, that’s when you said you started remembering. My cousin came over for a little bit and actually, my doula came over and was doing some rebozo work and some things, but then they left and I really wanted to labor in my son’s room, in our baby’s room. Ric: Yeah, but wasn’t Hillary there at that time? Meagan: She was for a little bit, uh-huh. You ended up going to sleep because you were super tired and again, labor wasn’t super happening. I had Hillary there. We were just hanging out. That’s when you came in with a pillow. Ric: Guys, so I mean, it’s not a big house but we’ve got enough space where you can spread out so you don’t have to wake everybody up with your– can I say moaning? Meagan: I was moaning. I was moaning to cope through. At that point, I was contracting. Ric: Yeah, so there were three bedrooms right next to each other, but we had a whole family room on the other side of the house and she could have done that and not woken everybody up, but instead– Meagan: I just woke you up. Ric: You were so loud though. You were so loud and can I make the noise? Can I pretend? Meagan: Oh my gosh, sure. But you are going to be dramatizing it. Ric: No. No. You exaggerate pain so much. Meagan: I don’t think so. Ric: You think you are great at handling it but–Meagan: I am. Ric: You obviously are enough, but the way you are great at it is by being really loud. Meagan: Posterior baby, everybody just to let you know. Ric: I don’t know what that means. But you were contracting every 5 minutes or so– Meagan: Yeah, every 5-8. Oh my gosh. Ric: That’s exactly how it was and it was loud and you were in the room right next door to our two little girls and right across the hall from me so I was super frustrated because I was exhausted and I couldn’t sleep and of all of the places you decided to labor, it was right next to everyone so I came in with a pillow and threw it in your face and said, “Muffle yourself.” Meagan: Oh my gosh. This was not the brightest moment. Ric: This is why you hire a doula because sometimes dads just don’t get it. Meagan: Just don’t get it. And you were tired. It was really late. Ric: You don’t need to excuse me. I was being a complete jerk. Meagan: But this is why I love that it is from your perspective because in my perspective, I was not that loud. I was moaning for sure. I was coping. Oh my gosh. I had so much back labor, but yeah. It was so funny. 20:23 Relying on the doulasMeagan: You throw the pillow at my face. You walk out and you leave and Hillary, my cousin, was like, “Oh no he didn’t.” She was laughing. So we continued. We definitely were just quieter. I don’t know. Ric: No, you didn’t leave the room. Meagan: No, we didn’t. Ric: You were so stubborn. You were so stubborn. You probably were louder after that because you were so mad. Meagan: When you find a space where you want to labor and are coping really well, you stay. Then the next morning came around and one of my doulas was up in the canyon so she was not even getting a ton of messages and didn’t have service. She was coming down and obviously the texts were blowing up so she started texting me and said, “Why don’t we call the midwife and see? Maybe we should plan on heading there.” Like Ric said, my cousin and I decided to go walk. It was 6:00 in the morning and my cousin and I decided to go walk around the block. Man, my labor totally picked up after walking. We were doing curb walks. You go up and down the curbs. We were just walking and it was such a beautiful morning, absolutely beautiful. The birds were chirping. It was July 1st. It was such a great time of year. We actually had gone to the birth center the night before to go get checked. I don’t remember if you remember that and they placed a Foley balloon which is a catheter that they can fill up with saline that pushes pressure on the cervix to try and help dilate so I think it was 1 centimeter or something like that. But it popped on the way, so nothing really happened. The next morning, we went in. It was 9:00 AM and we met everybody there. My cousin had left at this point. Maybe she had stayed for a little bit actually, and then my doulas were there so like Ric said, there were just so many people there. Do you remember arriving and anything about that?Ric: No, I don’t actually. The part that I do remember is hanging out outside of the birth center with Robin who is my favorite and just watching her. She just had her hands on your belly and was just calming you down. Meagan: Yeah. Yeah. I’m going to rewind a little bit. We get to the birth center. She does. She did do a cervical exam and she said, “All right. We’re going to stay. Let’s go upstairs.” So we go upstairs. At that point, she didn’t tell me what I was dilated to but I knew I was dilated enough to stay. For me, dilation was a big mental block because I had never made it past 3 before. I had never made it past 70% effaced either. I was told on my op reports. I don’t know if you remember that day that I got the op reports and I was just crying and so upset, but I was told on those op reports that I was failure to progress and that my pelvis was too small. I was just worried about dilating but at the same time, it gave me some oomph because she said, “Let’s go. Let’s go upstairs.” So we went upstairs. I later learned that I was 4 centimeters which was huge and yeah. My baby just really was posterior and really having a hard time turning. We did the stairs. We walked up and down the stairs and like Ric said, we went outside and we went underneath this beautiful tree. I sat on a peanut ball or I sat on a ball and my one doula was behind me holding my belly. You were there and then I had another doula keeping me hydrated. It was just a beautiful time. It was a beautiful time. I really liked it. Yeah, then we went in and I feel like that’s from the point we went in, it started getting a little bit more serious but you hadn’t eaten. It was like, Okay if we are going to take a turn, we need to get Ric food because we are going to have a baby soon. Do you remember that you left for a little while? Do you remember leaving? Ric: I don’t. No, I do remember leaving because that’s when I came back and everybody had shown up. Everybody had shown up. Meagan: Everybody was there, everybody. Yeah, so you left which was nice that you were able to leave and decompress and maybe reset. Did it feel good to be able to leave? Did you feel nervous leaving?Ric: No, again, the benefit of having Robin there. Robin was kind of the main doula for me. She was always the one who would talk to me and make sure that I was doing okay which I was. Meagan: Which is good to know because I think that hours and hours and hours into labor, you could have easily been freaking out. Ric: Yeah, I don’t know why. It was just calming. Meagan: It felt calming. Ric: It just seemed we had a bunch of hands on deck that could have handled any situation that presented itself. So yeah, I remember coming back. Did you move to the room with the bed? Meagan: Mhmm. I had. I was getting counterpressure. Ric: I walked in and there was Courtney, Robin, Hillary, Angie, Danielle– there were five. Yeah. Meagan: You said Courtney, yeah. Ric: There were five women there. Meagan: Surrounding. Ric: I walked in and there was such a relief. I didn’t have to do a thing. I was like, I can just sit. Because I think I brought my food. I just sat and ate and watched as you were getting pampered. You were getting attended to by these amazing women. Meagan: Such a princess. Really, there was a point where all of them like you said, all hands were on deck. They were all giving me counterpressure. They were all doing something. After you ate, do you remember when I was like, “I need Ric”?Ric: Yeah, for some reason I’ve got magic fists. Meagan: You have strength. Ric: I basically punched my wife in the lower back over and over and over again. Just as hard and as much pressure as possible. For some reason, it worked for her. Those women are way stronger than a man. Meagan: They are so incredible. Ric: Yeah, but I remember we would go between there and the bathroom that had the bathtub. I remember for a second we filled up the bathtub. You hung out in the bathtub for a while. Meagan: Yeah. Ric: And just kind of sat there. You obviously kept working yourself up because the progress wasn’t quick enough. Baby wasn’t coming fast enough. You were obviously uncomfortable. Meagan: Yeah, it had been at least 35 hours at this point of being in that tub. Ric: Yeah, so you just kept trying to find the spot where you felt would trigger things for the labor and get the labor going. Meagan: Yeah, I was really trying to get that baby to rotate. I was trying to move. Every five contractions, I would re-position myself in that tub. Eventually, I got out. Ric: Yeah, we went back into the bedroom and that’s when Robin pulled me aside– or maybe it was Danielle– I think it was Robin who pulled me aside and she was like, “Hey, you were very much in your own head and starting to doubt yourself.” Meagan: I was, yeah. 28:33 Navigating doubt and transition on the toiletRic: Robin said, “Hey, I think we need to leave.” Meagan: We might need to leave, yeah. Ric: No, no, no, no, no. Meagan: Oh, I don’t know. I shouldn’t correct you. Ric: She was saying that the girls needed to leave like all of the women needed to leave and it just needed to be me and you. So we hung out for a little bit longer. We went back into the bathroom. Do you remember fainting on the toilet? Meagan: That was after the birth, but yes. Ric: That was after birth. Meagan: So it was just you and I. What happened was you all went out and Danielle and I were in the bathroom and she did an NST on me. She was just checking on the baby to make sure he was doing okay and  he was doing fantastic. Ric: What’s an NST? Meagan: A non-stress test. They did a non-stress test on him and he was doing great. Everything was great. We weren’t having issues. I didn’t have any fever because again, it had been many hours since my water had broken and I’m assuming that’s when you were being talked to and then I remember Danielle taking the machine out, going out and you coming in. It was just you and me. I was on the toilet. I was facing backward– the dilation station– and I was really hot. That position is a really good one though. It really opens the hips. It just helps. So I was there and I had a backpack– or not a backpack. I had a pillow. Ric: You had everything. Meagan: Yeah, I had a pillow and then you were keeping me cool with rags and stuff. There were some pictures of you even touching me and just your touch was so amazing and did so much for me. I remember just absolutely loving it. I think that’s even more of why I was like, “I need Ric,” for counterpressure. Yes, your counterpressure was incredible, but I just needed your touch too. Anyway, but yeah, we were in the bathroom for a bit. It felt like a little bit. Ric: Yeah, and you really started doubting yourself. Meagan: I really was getting down. She had just done an NST and she said the NST was great, but I was thinking, Whatever. They’re going to transfer me. I’m going to have a C-section. Ric: The one lady had come in and said that you should transfer so a midwife who wasn’t our midwife who was at the center–Meagan: With another mom.Ric: I think she was frustrated that we were taking so long. Meagan: She was. Ric: But she had mentioned the hospital word and that really set you off. Meagan: That really impacted me. Ric: You immediately started feeling doubt in yourself. Up until this point, I don’t think you had. Meagan: In my head, I was like, Oh my gosh. This is taking forever and it’s getting really strong but we’re not getting anywhere. I was thinking that, but when she said the word– I remember she wasn’t very great. Her bedside manner was not very great. She checked me and I was 6 centimeters which was great, but I had been just lagging. She was like, “I think it’s time to go to the hospital,” or something like that. I think that’s when she told the midwife and the midwife came in and did the NST. But we were in there and one of our other doulas came in, Angie. I turned to her and said, “Are they going to transfer me?” She just said honestly which I really appreciated, and I really encourage doulas if you are listening, to be honest with your clients. Honesty is so important. She just said, “They are looking at things. It’s one of the things they may consider.” I was like, “Okay. We’ve got to do something here.” Ric: No, that’s not what you did. Meagan: In my head, that was what I was thinking. Ric: You got really down on yourself. Meagan: I did. Ric: This is when I turned into super-Meagan. I was like, “No. You can do this. You’ve got this. You worked so hard. You’ve done everything in your power to have the baby here. Let’s have the baby here. You keep doing what you are doing and it will happen.” That was the one time when I think I was the one who was pushing more for having the VBAC than you were and was it 5 minutes later when Danielle came in and said, “All right, we’re good.” Meagan: Well, yeah. She came in. She had me turn around. Ric: You had been checked. Sorry, let’s go back a little bit. Right before it was just you and I in the bathroom, you had been checked and you were like an 8.5 or a 9. Meagan: Oh, yes. I was a 6 when the other midwife checked. She had checked me right before. Ric: Probably a half hour past. Meagan: Yeah. Ric: Then right before we were left alone in the bathroom, Danielle came in and checked you and you were like a 9. I don’t know what everything else means, but I don’t think that Webb was in a great position though. Meagan: He wasn’t. I don’t know if you remember, but first of all, I was already having back labor. Now my baby was really low. I was dilated pretty far and I wanted to push. I don’t know if you remember. I was trying to push, but they were like, “You’re not dilated.”Ric: You thought you were going to go to the bathroom. Meagan: Yeah, so I was living on the toilet then she came in and I think that they had been listening. It really wasn’t that long. Yeah. She checked me and what she did was she kind of advanced my cervix. I was 9 centimeters. My baby was posterior and she stretched my cervix over his head. Ric: Yeah. Meagan: She manually brought me to a 10. Ric: She assisted. 34:25 Pushing Webb out in three pushesMeagan: As soon as she did that, it was like, Oh my gosh. This baby is coming. Everybody flooded. Ric: She brought in the stool. Meagan: Yeah, she brought in the stool and everybody flooded in the bathroom. It was insane. There were so many people in this small bathroom. Yeah. I sat on the stool and you were right behind me. I think I put at least one of my feet on someone’s shoulder. Ric: Courtney. Meagan: Maybe. Courtney was taking pictures. Ric: I don’t know. Meagan: Yeah. I don’t know either but yeah. I put my foot on someone and I started pushing. She was like, “Let’s have a baby.” I still in that moment was like, No. It’s not going to happen. This isn’t happening. How am I pushing a baby out now? It was so– I don’t know if it’s euphoric but it was really weird. Ric: It was exciting. Meagan: It was super exciting but I didn’t believe it. I didn’t believe that what was happening was happening. Ric: I did. I remember they asked me if I wanted to catch the baby and then they asked if you wanted to catch the baby which because of where you were at on the stool, you weren’t able to. Meagan: Yeah. Yeah. I pushed and within one push, he made really great progress. He had rotated. He had rotated because I did not give birth to him posterior. He had rotated and yeah. It was one push with major movement. The second push had major movement then I just remember I was sitting there. It was really quiet and there was another mom in the next room also pushing. She was a VBAC and I was like, I’m going to have this baby before her. I made it a competition a little bit. It seemed like we were kind of on and off. When I was pushing, she was not. When she was pushing, I wasn’t. With the next contraction, Danielle looked at me. I remember her eyes and I was like, It’s going to happen. I felt it. I felt a lot of pressure, a lot of pressure. I pushed him out, pulled him up, put him on my chest, and I don’t know. Were you crying? Ric: No. You were. Meagan: I was bawling. Everybody else I feel like was bawling, just all of the women in the room who had just gone through this whole experience with me, not just the labor but the journey of wanting the VBAC and then also as a doula watching me want this VBAC. So anyway, we were all crying and then you’ll have to say. I don’t know what happened. 37:08 Passing out after birthRic: Yeah, you passed out. I was behind you with my arms around you and the baby. You had been crying and with the emotion, with all of the hard work, you suddenly just went limp. So I had just told one of the doulas, “Hey, can one of you guys grab the kid because Meagan just passed out and we need to wake her up?” They grabbed Webb and–Meagan: Gave him to you, right? Ric: No. Meagan: Oh, really? Ric: No, I hung out with you while they had the baby. Meagan: Oh, I didn’t know that. Ric: You came to and did they start? I remember they cut the umbilical cord. Meagan: Yeah, because they took the baby. They cut the umbilical cord. I saw pictures of you holding the baby and me on the ground. Ric: I was just focused on you because you had passed out. Meagan: I just assumed they handed the baby to you. Ric: Eventually. Meagan: Okay, yeah. So yeah. I don’t know. I woke up pretty quickly. It was pretty quick it seemed like. Ric: Yeah. Meagan: But yeah, then I was just on the floor and I was just beaming and laughing and just so stinking happy. And then we went into the bedroom and I nursed for a while and was doing really, really well. They were like, “Okay. Let’s get you to the bathroom and showered and then you can go home.” What happened?Ric: You passed out again. Meagan: I passed out again. Ric: Yep. You woke up on the floor. You had just sat up on the side of the bed and you passed out. This is when I did have Webb in my hands at this time and you passed out. Luckily, another doula had come so we had a fresh one, Rachel. You woke up laughing. You were like, “Oh, I’m on the floor again.” Meagan: I was like, “Why does this keep happening?” Ric: But you really wanted to go to the bathroom so we went. You and I just went to the bathroom. You sat down on the potty and you passed out again. Meagan: Yeah, and Robin came in. I remember waking up and you and Robin were right there. Ric: Yeah. We had to pick you up so we hung out in the birth center a lot longer than we would have. Meagan: Than normal.Ric: I think you ended up going to sleep. Meagan: I did. Ric: Because I was next to you and then Webb was between us. I was super worried about rolling over on him or you rolling over on him, but I think we hung out there for a couple of hours. They checked on him. They checked on you and then I just remember how amazing it was to go home that night. Meagan: Yeah. Ric: I mean, it was later. I think it was 11:00 at night. Meagan: He was born at 5:30 and it was like 11:00 that we were finally stable enough to go home. Ric: It was so odd to be told, “Hey, look. You can go home now.” He didn’t have to wait in the nursery. He didn’t have to do any of that. We were just able to go home. We came home. We had the crib in our room. We put him in the crib and we slept great that night. Meagan: Yeah, we did. Ric: He did too. He did awesome. I think he woke up once or twice to feed, but he was so calm. 40:37 It takes a villageRic: From my perspective, seeing you accomplish what you wanted and for those of you who are unaware, I told Meagan unequivocally that this was our last child, so this was her last opportunity. She wouldn’t have had another opportunity after this. So it was really fun to see you accomplish what you had wanted to accomplish. It truly did. It took a village. You had so much help. We had so much help. I had no idea what I was doing and it was awesome because I had no idea what I was doing and everybody else who was there knew exactly what they were doing and they did such a good job. Meagan: Yeah, so obviously you would advocate for a doula. Ric: Oh, 100%. When people come up to me and ask what a doula is, I tell them it’s what the perfect partner would be and how they would act and how they would treat their partner during birth. Meagan: Mhmm. Ric: So yeah, they were fantastic. Again, being able to leave and come back knowing that you were 100% taken care of– obviously, I had my spot there. I don’t feel like I was minimized or my role was minimized at all. There were a bunch of times where you would have me step in when I needed to get in there and help, but I was able to focus on being there for you and they were able to show me, “Hey, look Ric. Here’s where she wants you to push.” I remember that. You had showed and I think Robin or Angie said, “Hey, this is the spot where you need to push.” I remember when we were out under the tree, I was able to look at you because Robin was holding you from behind and that was a big deal because I remember Robin was obviously there and it was just serene having her with us, but it very much felt like a moment between just you and I because we were able to just sit there and be with each other and talk to each other. Meagan: Yeah. Yeah. It just helped the connection and the bond and everything. I just love doulas so much. I love you and I am so grateful that we were able to have this journey together. 42:45 Ric’s advice to other dadsMeagan: Do you have any advice to a dad who may be in the spot that I put you in? Ric: Yeah, I’m sorry. First and foremost, I apologize to you because that’s rough. It’s a rough spot to be in. No, honestly, trust your partner. Trust the mom. They know things better than you do and again, for us, it’s really easy because you get your way 99% of the time in our marriage but seeing how things ended and how everything happened, it just showed me that yeah, I can trust her and I know that she’s listening to her body and she’ll know what needs to happen. Meagan: I love that you point out that I was listening to my body. I think that can be a hard thing for any dad or partner to understand because there is this weird, innate thing inside of us. It just felt so right to birth vaginally after two C-sections and then it also felt right to birth out of the hospital. So thank you for supporting me through all of that and for being there. I can’t believe our baby boy is 8 years old today so happy birthday, Webster. We love you so stinking much. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
44:3801/07/2024
Episode 312 VBAC Basics with Meagan & Julie

Episode 312 VBAC Basics with Meagan & Julie

This episode goes back to the basics and is a great place to start on your VBAC journey! Julie joins Meagan today as they talk about many common questions beginning with reasons why providers tell women they can’t go for a VBAC. Topics today include: Nuchal cordsBig babiesSmall pelvisesArrest of descentThird-trimester ultrasounds Cervical dilationInductionDue datesThe ARRIVE TrialWhy there is so much contradicting VBAC infoPregnancy intervals EpiduralsMeagan and Julie also reflect on how their perspective toward each of these topics have changed over the years. Allowing for nuance is so necessary when approaching birth. Know that you always have options and never feel pressured to make a decision that doesn’t feel right for you.The VBAC Link Blog: Pregnancy IntervalsNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 04:24 Review of the Week07:48 Intro to the basics09:53 Nuchal cords13:30 Big babies, small pelvises, fluid levels, and third-trimester ultrasounds17:08 How will this change my care?18:47 Cervical dilation25:54 Due dates28:18 Vulnerability and the ARRIVE trial30:44 Inducing a VBAC36:15 Julie’s social media story38:29 Contradicting information41:36 Pregnancy intervals46:38 Epidurals54:13 Allowing for nuanceMeagan: What’s up, everybody? This is Meagan. We have Ms. Julie with us today and we are going to be talking to you about what we need you to know about VBAC. We obviously like to talk about different topics but Julie and I decided this morning as we were getting ready to record that we need to do an episode on just the basics again. Don’t you feel like it’s the basics? It’s not to shame anyone for not knowing the information. It’s honestly to– I don’t even want to say the word shame– but providers are not educating their patients. They are just not. We see it time and time and time again where people just don’t know. We saw a post, I don’t know, maybe a month or so ago. I think maybe Julie sent it to me. It was just saying, “Hey, so can you have a VBAC no matter what reason the C-section was for?” Someone said, “Well, it depends because if it’s something like a cord wrapped around the baby’s neck, if that was the reason you had your previous C-section and if your last baby had its cord wrapped around their neck and was having struggle, yes. You have you have a C-section.” Julie: I am getting a little salty. I feel like maybe salty is not the right word, but direct. I jumped in and I’m like, “That’s actually not true. The cord wrapped around a baby’s neck preventing them from descending is a perfect VBAC candidate because it’s not anything to do with the pelvis or labor stalling or anything like that.” Anyways. Meagan: Even with that said, even with that said– Julie: People still argued with me. Meagan: Well, but even if it was due to someone being told that their pelvis was too small or their baby didn’t descend– Julie: That’s also false. Meagan: That’s also false. Julie: I mean with actual pelvis trauma where it’s actual CPD and is legitimately diagnosed and that type of thing. Honestly, most people are good candidates for VBAC but we are going to talk about that. Meagan: Yeah, we’re going to talk about that today because it’s obviously something that we are really passionate about and it’s something that we want you guys to know so let’s talk about it. 04:24 Review of the WeekMeagan: We do have a Review of the Week. You guys, it’s a really long one and I might have specifically been waiting for Julie to come on with me so she can read it because she’s a lot better at reading long reviews sometimes. I’m just going to pass the time over to Julie to read this amazing review. Julie: Now I feel pressure, man. Meagan: Don’t mess up. Julie: The pressure’s on. Are you ready for this? This review says, “This is such a tremendous resource for VBAC mamas.” See? There I go. I knew it. I’m going to start BBAC mamas. Try and translate that, Paige. Anyway, okay. It’s fine. I’m going to circle back around. “This is such a tremendous resource for VBAC mamas. I sadly only discovered your podcast after my VBAC in April 2022 but having caught the birth bug during my prep for that birth, I still listened to each episode as if I’m preparing for my VBAC all over again. I think having a special place for this very unique scenario helps those planning and hoping for a successful VBAC feel less alone, more supported, and very well-informed. “The balance of evidence-based information with the age-old practice of sharing birth stories makes this one of the best birth resources out there. I only wish I had this when I was planning my VBAC but maybe someday I’ll get to share my own story and help inspire a fellow Woman of Strength. “Prepping for and achieving the unmedicated birth of my daughter absolutely flipped a switch in me and I feel determined to become a birth worker one day.” I feel like all of us go through that, right? “Knowing that this podcast team also has a course for prospective doulas like me thrills me to my core. I want to be there for other anxious, hopeful VBAC mamas like me and the amazing work that you are doing is changing birth and lives everywhere. Keep it up. It is so needed and appreciated. Adrianne.” I love that so much. I feel like that’s all of us like you and me. We all go through this journey like, Hey, I had a really bad birth experience or I had a really bad one and then an empowering one and I want to be part of this change so that other people don’t have to suffer like I did. I love that and I feel like almost all birth workers’ stories start like that. I know mine did and yours too, Meagan. We all are there at some point. Meagan: We are. Yeah. I couldn’t agree more. I definitely have been there. 07:48 Intro to the basicsMeagan: Okay, all right. Let’s talk about the basics. What basic do you want to talk about first? We were talking about just a second ago where we were like, Hey, this was being told to you and you are being told you may not get to have a VBAC. So maybe we just start with reasons people are told that they have to have a C-section and they can’t have a VBAC. Julie: My gosh. I want to speak to a couple of different points in that direction. I have a couple of different ideas in my head. First of all, I feel like it’s important to acknowledge that we are all ignorant to things at some point. Right? We all have to learn that VBAC is an option at some point or maybe we always knew. For me, I feel like I never was like, Oh, I can have a vaginal birth? I just always thought I could have one, but I also feel like the age-old “once a C-section, always a C-section” thing is so ingrained in some parts of our culture that you really do have to have that awakening that, Oh, I can do this. It is safe.So I just want to acknowledge that. Sometimes, even for me, I’m scrolling through Facebook and I see this post about something or the ARRIVE trial with induction at 39 weeks is safer and it’s really easy to eye roll or it’s really easy to be like, Oh my gosh, how come you don’t know this? But I feel like let’s circle back when I see these things and remember that we all start somewhere. Not all of us have access to supportive providers, supportive hospital systems, supportive families, supportive providers. We don’t all have access to those things. If you’re advanced in your VBAC thoughts or thinking or whatever, I encourage you to still stay on the episode because you never know when you’re going to learn something new. You never know when something is going to click right for you and you never know when you’re going to gain the perspective that you need. If you are a seasoned VBAC pro, please also stick along with us. 09:53 Nuchal cordsJulie: I feel like I hear a new reason why someone is told they can’t have a vaginal birth every day. Not every day, that’s a little dramatic. Meagan: But a lot. Julie: It still surprises me. I’ve been a doula in the birth scene for 9 years now and I still get that cord prolapse one. I have never heard that as a reason why someone would have a repeat C-section. I mean, I had a VBAC client. She was trying for a VBAC at home and it ended up in a hospital transfer. The baby’s cord was wrapped around her neck four times. They had to cut the cord in four places to get the baby out via C-section. Meagan: I remember you saying that. Julie: Yeah, that baby was stuck so tightly in there. In those circumstances, that C-section was necessary. That baby was not coming out, but that doesn’t mean she can’t try for another VBAC. I think she is done having kids, but that is completely circumstantial and specific to that pregnancy. So I feel like that’s a really important thing to note is that most things are circumstantial. Even stalled labor or arrest of dilation or failure to progress or a big baby or whatever these things are circumstantial. The cord around the neck preventing baby from coming down– totally circumstantial. I feel like even the American Pregnancy Association– did I say that right?-- says that 90% of women who have had C-sections are good candidates for VBAC. I think that’s important to note is that if you’re being told that you are not a good candidate for a VBAC, I would really question why because most of the time, you are a good candidate. Big baby, sure. That’s one. We can throw these around. People say, “Oh, your baby is too big. You have to have a C-section.” That is not evidence-based. Even ACOG says that big babies are not a reason for either induction or automatic C-sections. Meagan: Suspected big babies. julie; Right, suspected big babies. Meagan: Let’s just say that they’re not always big. Julie: They are not always big and we know this is something we automatically know like, everybody knows this but not everybody does. Your ultrasound measurements can be off by 1-2 pounds in either direction. They can measure small or big. The only accurate way to determine how big your baby is is to weigh it after it is born. Meagan: To birth your baby. Right, to birth your baby. Julie: Not only that, but big babies come through petite pelvises all the time. Babies’ heads mold and squish through pelvises that flex and open and move to work together. The baby and the pelvis are this really cool diad where they have this great relationship of working together and the pelvis opens and the baby’s head smooshes together. Anyway, I feel like that’s probably the biggest thing that I’m hearing lately, “My baby’s too big and my provider won’t let me.” Or there was a post in the community today that Meagan shared with me and she said, “Is it really possible to have a VBAC after a C-section? Because I feel like you always have to have C-sections. Is it really possible to have a vaginal birth after a C-section?” We need to remember that we live in a country and in a world where many people still have this way of thought. Many people don’t question their options and many people, most people go in and just automatically schedule a C-section because that’s what their provider says, that’s what’s most convenient, and they don’t take the initiative to learn and ask questions. 13:30 Big babies, small pelvises, fluid levels, and third-trimester ultrasoundsJulie: it’s a failure in the system. We were just talking about this before. Meagan, go ahead. Meagan: Yeah, I was just going to circle back around with the size thing. What I’m seeing more is people doubting their ability because we have people saying, “Well, your baby is this size,” but the reason why they are even saying that is because I’m seeing an increase in third-trimester ultrasounds. Julie: Yes. Third-trimester ultrasounds are trouble. Meagan: They are trouble. Julie: Just routine to check on baby’s size and check fluids– no. Just say no to third-trimester ultrasounds unless there is a valid concern for baby. Meagan: Yeah. Yeah. It is getting me. It is getting me that I’m seeing it so often. It’s just getting me irked a little bit. Julie: Gosh, Meagan, I swear though. The reason you are getting irked is because we have seen these things go south so many times. Guess what happens? They go in for a third-trimester ultrasound and there are no published statistics for this. I don’t know. I haven’t looked. But I feel like people go in and they get their third-trimester ultrasound and then they are like, “Well, my baby is measuring big,” and then they start to get worried like, “I don’t know if I can have a big baby,” because their provider is like, “Oh, your provider is measuring big.” Their provider is saying it like that. It casts doubt. It casts that doubt in their mind and that little seed of doubt gets planted. That little seed of doubt gets nourished like, “We will let you try for a VBAC but your baby is kind of big so we will just have to see how it goes,” and then these parents get set up for wanting to have an earlier induction for big baby because they don’t want their baby to get too big or just scheduling a repeat Cesarean because they are terrified of a bigger baby and the problems that a big baby could have which are not actually that many. The risk of shoulder dystocia I feel like doesn’t increase significantly more with big babies. We just think it does. Smaller babies get shoulder dystocia just like bigger babies do. Or, “Oh, my fluids are too big or too little,” and those ultrasound measurements are just so inaccurate first of all, but most of what they find isn’t evidence-based either. You’re walking into a situation where your provider will cast doubt on you whether intentionally or not. I don’t want to villainize providers because most providers I don’t think have ill intentions. They are just doing what they know and doing what they are comfortable with. But that happens nonetheless. So if your provider is recommending a third-trimester ultrasound, here is something that I encourage people. Ask them, first of all, why. If they will be like, “Oh, just to check on baby and check the size.” I feel like you can politely decline unless you want to. It’s fun to see your baby and things like that, but what would change? This is what you can ask your provider. “What will change in my plan of care based on what we find in the ultrasound?” What will change? What direction would shift? What answers are we looking for? What will change in my care based on what we find in the ultrasound? If your provider says, “Well, we just want to make sure that your baby is not too big,” that’s a red flag. Right? Meagan: Yes. Julie: “We want to make sure your waters are okay,” which could be a legitimate reason. If you are measuring more than 10 weeks ahead or behind, it’s probably a good idea to get your fluids checked by ultrasound but if you are only measuring 3 or 4 weeks ahead or behind, that’s not necessarily an evidence-based reason to do that. I would just ask that. I mean, that’s a good question to ask for any type of intervention or checks or whatever.17:08 How will this change my care?Julie: “You want a cervical check at 36 weeks? Okay. What would change in my care? What are we looking for? What would change in my care plan if this happens and if that happens?” because most of the time, cervical checks before labor– actually cervical checks during labor too– don’t tell us anything. They don’t tell us anything. I just missed a birth a month ago or about three weeks ago because a first-time mom went from 3 centimeters– she was at 3 centimeters for 12 hours and went from 3 centimeters to baby in less than an hour and a half. Cervical checks tell us nothing. Anyway, before I get off on a little more of a soapbox there. Sorry, I’ve been rambling. Meagan: You’re just fine. I absolutely love that you pointed that out and that you specifically said that it can really apply to anything in your care. What does this thing do or how does it change my care? I just think everybody should take that nugget from this episode right now and just hold onto it tightly. Put it right in your pocket and keep that because you nailed it right there. How does this change my care? If you’re getting things like she said, yeah. That’s dumb. It’s silly. Or with a cervical exam, it’s like, “Oh, we just want to see what your BISHOP score is. We just wanted to see if you’re progressing.” Why? At 36 weeks? First of all, that’s preterm. Second of all, to actually be, especially if we never made it to 10 centimeters before in our first labor, the chances of us being very dilated at 36 weeks–18:47 Cervical dilationMeagan: Okay. This is going to lead me to the next thing that we see all of the time. The chances of you being dilated at 36 weeks is pretty low actually. This is something else I see that breaks my heart actually in our community and not even just in our community, in other communities, and honestly even in consults I’ve had people talk about this. “Oh, I’m 37 weeks or 38 weeks and I’m not dilated so my doctor is telling me that it’s probably not going to happen.” Do you see this all the time, Julie? “Oh, guys. I’m so sad because I’m 38 weeks and my provider is telling me that I’m not dilated so I probably need to schedule a C-section the next week.” Women of Strength, if you are not dilated at 36, 37, 38, 39 or even 40, even 41 weeks honestly, that’s okay. Your body will do it. Some bodies don’t do it until they are in labor. They just don’t. Julie: Yeah, and honestly at 36 or 37 weeks, anytime before labor starts and you’re not dilated, guess what? Your cervix is doing exactly what it’s supposed to do which is keeping your baby safe and keeping your baby in until it’s ready to come out. I can’t reiterate that enough. You’re not supposed to be dilated before it’s time for the baby to come out. I say supposed because some bodies shift and change a little bit sooner and that’s okay. But whenever I was a doula, I mean I don’t get to talk to people prenatally as much anymore since I’m just doing birth photography, but I would always say, “You know what? If you want a cervical check, that is totally fine. You get to decide. You get to make the choice about whether you get a cervical check or not.” But if having a cervical check, if you go in and you have a cervical check and you know that if you’re not dilated at all that it is going to make you depressed and frustrated, then don’t do it. If you go in and you’re like, “Hey, I’m prepared to be low, hard, and closed and I just want the information because I love information,” and you are not going to be sad if you hear that you are low, hard, and closed, then sure. Get one if you want. But just know that anything beyond being low, hard, and closed is just– Meagan: Lucky, great, awesome. Julie: Lucky, sure, great and awesome, but it’s also not an indicator because guess what? I’ve also had a client, a first-time mom, walk around at 4 centimeters dilated for 10 days and then she went into labor and had a 24-hour labor at home and ended up in a hospital transfer and a C-section. I swear. Your cervix is not telling you anything before labor and during labor most of the time, it’s not telling you anything. It’s telling you that you have progressed this far. It’s doesn’t tell you how anything is going to go in the future. It doesn’t tell you how anything is going to look moving forward. It just doesn’t. Meagan: Yeah. So if you are having someone tell you, “You’re not dilated” or “Oh, it’s probably not going to happen. You should probably schedule a C-section–”Julie: Just say, “Julie Francom said–” Meagan: If you want that, do that. But if it’s not what you want, don’t let someone bully you into believing that your body is not working when it’s actually doing exactly what it’s supposed to be doing. Julie: Exactly. that’s the thing too. Sometimes at the end of pregnancy, it is hard. Being pregnant is hard. Being close to your due date is hard. Everybody is asking you, “Have you had your baby yet? What are you going to do? What are your plans for induction?” We’ve all been there and it is really, really hard to stay strong. I feel like some people could just benefit by just saying no. Just saying no because it’s so easy if your baby is measuring big or if you feel like your cervix is hard and closed. Be like, “Aw, flip man. I’m going to be pregnant forever and my baby is going to be big and it’s going to have a hard time coming out so I might as well schedule a C-section.” If you feel like you could be easily swayed by those things which a lot of people are. It’s so easy to be swayed by those things, especially at the end of pregnancy. Then maybe just say no. Obviously there is nuance here so if there is a true medical need and there is some medical concern for baby or if there is some worry for your cervix being in preterm labor or things like that, obviously those are valid reasons but if it’s a just because, I’m not a big fan of doing medical things just because. Meagan: Just because I agree. Yeah. Exactly. If there’s no real reason, then just because doesn’t. Unless you want it. Unless that’s really what you want. 25:54 Due datesMeagan: Okay, so we talked about babies. We talked about dilation before due dates and can we also talk about due dates? Julie: Ew. Meagan: Ew. Julie: Yeah, just kidding. That was weird. I don’t know why I said that. I’m a weirdo sometimes. Meagan: Well, due dates are hard. Due dates are a really hard topic because especially after the ARRIVE trial which Julie Francom herself wrote the blog about the ARRIVE trial if I recall. I don’t think I did. I think you did.Julie: I’m pretty sure I did. Meagan: I think you did. I feel like since the ARRIVE trial, we really have seen a major shift in due dates. Julie: You mean induction? A major shift in interventions? Meagan: Well, sorry. Induction because of due dates. Julie: Right. Gotcha. Meagan: We see people at 38 weeks being checked, not dilated, being told that they either like I said, have to have a C-section or have to be induced in the next week because they are 39 weeks but really, do we have to? We do not. We do not have to. A lot of bodies do go over that 40-week mark. I think it’s important to know when you are approaching your due date that you may start getting an influx of pressure to do those things, to sweep your membranes, to induce, to schedule a C-section, and I think that is something that I find frustrating. I mean, you guys, obviously as a doula, I work with a lot of pregnant people and Julie even being a photographer now, I’m sure you have situations where you are like, Oh, this person is being induced now, and now you’re planning and induction. We’ll get to induction in a second. But the pressure that starts coming at people at 38 or 39 weeks for induction or a scheduled C-section is unreal to me when sometimes we just need to let the body be. Julie: Yep. Meagan: Right? 28:18 Vulnerability and the ARRIVE trialJulie: I agree so much. It’s so funny because we all know that induction is safe and we’re going to talk about that in just a minute. It’s safe for VBAC when it’s necessary. it does slightly increase the risk of uterine rupture and a couple of other things, but it’s frustrating when we have providers taking advantage of this vulnerable group of people. Meagan: Very vulnerable. Julie: By offering induction at 39 weeks and who doesn’t not want to be pregnant anymore at 39 weeks? I think everybody. There’s a small group of people who just like being pregnant and that’s totally fine. I like being pregnant but by my last one, I was like, Get this baby out! I was content for baby to pick their birthdate every time, but with the last one, I was like, Get this baby out! Anyway, I feel like most providers don’t think they are taking advantage of these people when they are offering 39-week inductions, but it really is. It’s taking advantage of a woman in a vulnerable position and could skew their birth plans in ways that they don’t want. It’s hard to say no when you are that pregnant and unless you have a super strong resolve which even the strongest resolve can weaken in that type of emotional and hormonal state. It’s really frustrating because we have this ARRIVE trial that was published in– what was it? It wasn’t 2020. Meagan: 2019. Julie: In 2019 and the medical world jumped on that so fast. They were like, Yes. Let’s induce at 39 weeks. Meagan: It was a leech situation. Julie: Yes. And then now that multiple studies have proved it invalid and it has been picked apart and even ACOG doesn’t recommend that anymore. It doesn’t stand by the validation of the ARRIVE trial, there have been multiple studies showing otherwise since then, but guess what? Oh my gosh. This is so frustrating. It normally takes 10-15 years for the medical community to catch on to updated information, but this one took on so fast and now it is going to take 10-15 years to undo that. Meagan: To go back. I agree. Julie: Yeah. It’s frustrating. Meagan: It is. It’s so frustrating. 30:44 Inducing a VBACMeagan: It’s hard to see so many people, like you said, in a vulnerable state feel that pressure of induction. I think where I even struggle more is seeing people in the last weeks of their pregnancy which can be hard because they are uncomfortable and Julie wanted to get that baby out. They actually can be some of the most precious times with your other kids before your family grows and your husband before you have a baby and you are a family of three or your partner. They can be really great spaces and a place where we can really get our head in the space for labor and delivery and for birth. But we have so many people out there being scared that they are going to have to have a scheduled C-section. We know that even though evidence shows induction for VBAC is safe and reasonable, there are many people and many providers out there all over the world who absolutely refuse to induce a VBAC. They refuse and induction. It’s either a scheduled C-section, spontaneous labor, or that’s it. Those are your options. We see so many people out there spending these last few weeks that could be so amazing and getting ourselves in that positive headspace in frantic mode because they are trying to induce themselves. They are trying to do all of the things. Julie: Yeah, they are like, Oh my gosh. My provider is going to schedule a C-section at 40 weeks or induction at 39. Meagan: What can I do to get this baby out? Julie: Yep. Meagan: It makes my heart hurt because it just really isn’t where you deserve to be in your last weeks of pregnancy. Let me tell you one thing, when you are so hyper-focused on getting your baby out, tension and cortisol is high in the body and when we are stressed, that’s typically not a space where we can let our cervix go and have a baby. So when we are doing those things, we are entering a space full of tension and we are already setting ourselves up for a harder experience. Julie: Mhmm, it’s true. You go in there ready to fight then your cortisol levels are high and cortisol is the opposite of oxytocin which gets baby out. Your stress hormones are fighting your baby coming out and it’s not optimal. Can it happen? Yeah, sure. People do it. But it’s going to be harder. Meagan: It is. Julie: It’s just going to be harder. Meagan: It is. Like I said, back to the head space, it really puts us in the wrong head space. It just is not optimal. Know that if you are receiving pressure to have a baby because you’re not being supported in an induction that you should just change your provider. No, really. You need to take a step back and decide if that provider is the right choice for you and if that’s the right space for you to be birthing in and if what you are doing in your mind and to your body because a lot of people do some crazy things, is really what is going to be the best for your labor journey. Julie: And sometimes, people don’t have that much of a choice too. Sometimes, that’s the only choice you have. Sometimes, home birth is illegal in your state for VBAC even and– Meagan: You have no providers in your area. Julie: You have one hospital within 6 hours and sometimes that’s going to be your only choice and it sucks that people have to choose between that and an unassisted birth at home which I feel like if you are going to have an unassisted birth at home, that’s a whole other topic. You should do it because you are educated and informed and that’s what you want not because you don’t want to have this horrible hospital birth where you are going to have to fight the whole time. Meagan: Yeah. It’s a tricky spot. To Julie’s point, we understand that. There are so many people who are just flat-out restricted and they feel like they are walking in with their hands tied behind their back and just have no choice. But there are other options too. There are other options. But laboring at home a little longer or just saying no. Just saying no which is really hard. Julie: Yeah, it is really hard especially when you are in labor. Especially, maybe you have this resolve and your partner doesn’t have that resolve. Maybe you can’t find a doula in your area. You can’t afford one. It really sucks to be your own biggest supporter and believer in birth. You have to have other people in the room who are just as resolved and want this for you as much as you do if you are birthing in that type of environment. 36:15 Julie’s social media storyJulie: Okay, back to basics. What are we doing next? Oh, let me tell this story about induction. I think this is so funny because there are so many people who think that induction isn’t safe and they think that induction isn’t safe for a VBAC to go past 40 weeks so you have a provider who won’t induce you and won’t let you go past 40 weeks so what are you supposed to do? It’s really interesting because I hired someone recently to post on my social media recently for my birth photography. She is a birth photographer and doula and has attended many births before. She just recently shifted over to social media and website management for birth photographers. She knows that I’m really passionate about VBAC so I want one post a week to be about VBAC. She’ll write up posts for me to approve and one of the things that she wrote up for me about VBAC was things you can do to– I think it was things you can do to increase your chances of having a VBAC or something like that. In her post, she even made the comment and I’m glad I read through these all in detail because she said something that, “We know that induction isn’t safe for VBAC because it increases the chance of uterine rupture.” She said in my post that is on my page that is supposed to be written in my words that induction isn’t safe. I deleted it. I shot her a little message to be like, Hey, VBAC induction is safe. Does it slightly increase the risk of uterine rupture? Yeah, it does, but as long as it’s managed well, the increased risks are very, very small. Meagan: Still pretty low. Julie: Yeah. It was just so funny that someone who has been in the birth world still for so long operating on more of an evidence-based side of things has that view still. I don’t know. It’s just interesting. We all have things that we need to learn still. Meagan: We do. We are always learning and we are even still learning here at The VBAC Link. It’s just important to know that if you see information and you’re like, Oh, I already know that, you still need to check it out and see if there is something new to that. 38:29 Contradicting informationMeagan: Okay, so back to the basics. We’ve talked about the pelvis. We’ve talked about induction. We’re talking about due dates. We are talking about the cervix dilating. We’ve talked about baby sizes. What else do we have? Julie: Epidurals. Meagan: Oh yeah. Epidurals. Julie: This is so funny. The opposites. It’s the same thing about the opposite. VBAC has to be induced before 40 weeks. I will not induce VBAC at all. You have to have a C-section by 40 weeks. All of these things. Epidurals are the same way. You have to have an epidural placed in order to do a VBAC and then we also have you cannot have a VBAC with an epidural. Meagan: Yeah. Yes. I’ve seen that. Julie: Isn’t that so stupid? I’m sorry. I just think it’s so stupid, all of these polarizing things. It’s so funny because sorry, time out. I will let you talk about that. I promise I will let you talk about that. I think it’s so funny because we know that Facebook can do so much good and it can also do so much bad. There will be a post like, “Hey, my provider said I have to have an epidural with a VBAC,” and there will be 50 comments on there and every comment will be different like, “Oh, yeah. You absolutely have to. It’s safest in case you have to have an emergency C-section.” Then the next comment will say, “No, you don’t. You can’t because then you won’t notice the signs of uterine rupture.” Everyone says something different and it’s really funny because it’s the same thing about the length between pregnancies or C-sections to VBAC. People will be like, “My doctor said it has to be 18 months from birth to birth. My doctor said that you can’t get pregnant within a year of having a C-section. My doctor said–” or they say. I love it when people say, “They say 18 months birth to birth is best. They say don’t get pregnant within 9 months. They say 2 years between births is the best.” Who is they, first of all? Who is they? Whenever someone says they, I say, “Who is they?” Because there are so many sources and everybody is so resolute in their answers. “My doctor said this. They said that this is the right answer. 6 months, 9 months, 12 months, 24 months, 3 years.”Everyone is so firm in their answers. How freaking confusing is that? Meagan: Very. Julie: P.S. the optimal range for births actually hasn’t had any definitve say yet because there are different studies that show different lengths, some as short as 6 months between pregnancies. Some are as long as 24 months between births. Is it between births? Is it between pregnancies? I just laugh every time I get on Facebook and see these people who all say, “They say” in their resolve. I don’t know. I just think it is so interesting and can be so overwhelming and confusing which is why we started The VBAC Link so we can bring you the evidence so that you know. Sorry, go ahead and let’s talk about epidurals. I had to go on that tangent. Meagan: Well, you just brought that up and that’s another big basic. When can I get pregnant? 41:36 Pregnancy intervalsMeagan: When can someone get pregnant? We’ll buzz back to epidurals. Julie: Yeah, luckily we wrote a blog. We will link it in the show notes with the studies cited. Meagan: A lot of people are confused. Is it birth to birth? Is it birth to conception? Right? Julie: Yeah. Yeah. Meagan: Do you want to talk about that? I’m going to sneeze. Hold on. Julie: Yeah. It’s really interesting because you are getting these different numbers– 6 months, 9 months, 24 months, 15 months. You’re getting all of these different numbers then you are also getting these different ranges. Between birth to birth, so between the time when your C-section baby is born to when your VBAC or your attempted VBAC baby is born is different than from the time you have your C-section to the time you conceive the baby. 18 months birth to birth is 9 months pregnancy to pregnancy so 6 months pregnancy to pregnancy is 15 months birth to birth. Of course, everyone is confused. That’s all I have to say about that. What do you want to add, Meagan? Meagan: It is confusing. It is absolutely so confusing and I think when you are talking to a provider, it’s important to talk to them about their view on intervals because there are different views. People, like she said, do have different views. People will say, “If you are pregnant before 15 months from birth to conception” or not before 15, before 24 months even sometimes or before 18 months, that’s not okay when it really might be from birth to birth. We do have a blog about it. We’re going to link it so you can see the studies and how they view it, but I also want to point out that if you are being told you absolutely can’t VBAC because you have a shorter interval, say from birth to conception is whatever, 15 months. You conceived 15 months after your C-section and providers are saying, “No, it’s too close,” there are studies that show and talk about an increased risk of uterine rupture but I also want to point out that a lot of people do it with no complications. Julie: A lot of people do it. What it all comes down to is what is the acceptable level of risk to you and can you find a provider who is willing to take on that risk with you? In our blog, I’m just remembering off the top of my head. It might not be 100% true but one of our studies showed that a 6-month pregnancy interval so after you have your C-section, you get pregnant 6 months or beyond, there is no increased risk of uterine rupture. Within that 6 months, there is an increased risk of uterine rupture. I think it is 2.4% up from 0.5%. Now, a 2.4% risk, I think it’s that. I think it’s 2.4%. You’ll have to look at the blog. I’ll send you on a treasure hunt for the blog. But that level of risk might be acceptable for some parents and providers and it might not for other parents. For me, I would go totally try it. I would do it because that means I have a 97.5% chance of not having a uterine rupture. Heck yeah. That’s pretty solid to me, but it might not be solid to you. That’s what matters. The other one showed that an 18-month pregnancy interval is optimal. 24 months birth to birth, I think, was the other one. We are having a bunch of different ranges and all three studies that were cited the blog are credible studies. The real answer to that pregnancy interval question is we don’t know what is the optimal pregnancy interval. We just don’t know. They say, they will tell you– I feel like most people and most providers are about on the 18 months birth to birth side. Some providers want 12 months between pregnancies. Meagan: Yeah. I see a lot of people saying that. I even see 12-24 months or 12-18 months before conception. I see a lot of conception as well. It’s just important to talk to your provider about that and when you are looking at the studies and you see a 15-month, see what it is talking about. Is it talking about C-section to VBAC or to birth or to conception? Julie: Yeah. 46:38 EpiduralsMeagan: Okay, epidurals. We were talking about it a minute ago where so many providers say, “Yes, you have to have an epidural. No, you can’t have an epidural.” I think I’ve shared this story before. The only uterine rupture I have ever witnessed in my life was with an epidural. I’m going to guess that she probably had a delayed feeling because I’m assuming she would have felt it sooner and this pain. She felt it later on and when she felt it, it was above where the epidural site numbed so up in her rib area, up below the breast. That was where she felt it with an epidural. There weren’t any heart decels or anything like that. There were other signs of things like a stalled dilation and things like that but she still felt it with an epidural. A lot of providers are telling people that they can’t have an epidural. I think that this scares a lot of people. Julie: Mhmm. Meagan: Birth unmedicated can scare someone who doesn’t want to birth unmedicated so the thought of going unmedicated can scare someone to the point where they are like, I’ll just schedule a C-section. My point in sharing this story is that even with an epidural, you can often still feel a uterine rupture happening and there are usually other signs that are happening even before that that are pointing things out. There is a pretty, I think it’s a debate in the medical world, on if epidurals actually increase Cesarean. Have you seen the blogs and different things? Julie: I absolutely do think they do. I’ve seen it. My gosh. Meagan: I know. I know. A lot of the evidence out there or a lot of the opinions out there on the blogs and the National Institute of Health publications and things like that show that maybe not, but then there are things that show actually it does seem like it can. Julie: I think it’s how you act when you have the epidural. If you have a nurse in there who is content on changing your positions every 30 minutes or whatever, I don’t know. Maybe not. Keep the pelvis moving. But if you are flat on your back for 20 hours, then yeah. It probably increased that risk. Meagan: Yeah. There’s not a lot of evidence showing that it for sure does increase the risk of Cesareans but as doulas and people who have gone into a lot of births– obviously, there are a lot of providers who have gone to way more births than we have as doulas. I don’t know if it’s a cause, but it does seem to correlate. It can correlate and there are a lot of different things. We see an epidural come into play and I actually have seen moms dilate really fast. I have seen an epidural be the best tool–Julie: That’s true. That’s true. Meagan: –for a laborer to get a vaginal birth. I really, really, really have seen this, and not even just vaginal birth after Cesarean, just vaginal birth. Julie: That’s true. There is a lot of nuance there for sure. Meagan: But to what you are saying, a lot of the time it really does depend on what comes after the epidural. A lot of the time after an epidural comes in, we know that there are two things for sure that have a higher chance of happening. One, you have a higher chance of sitting and doing nothing. Just hanging out like Julie said. Not really moving, working with the pelvic dynamics, and getting baby out and down. And two, we know that PItocin often comes into play after an epidural because a lot of the time, it can stall labor. We want to get labor going again and sometimes instead of just waiting and letting the body– I use the body acclimate a lot, but really, the body has to acclimate so much in labor. We are going from home to a hospital. We have to acclimate from that place to the car to the hospital and then we are getting there and we are not even just acclimating to that space. We are acclimating to new voices. Julie: Mhmm, new smells, new sensations, new temperature, new germs– that’s probably not really a thing. Meagan: Yeah. It’s not even just being in a different place. It’s all of the things that come with the different place. So we get an epidural and our body is like, Oh, cool. I can rest. This is my opinion, okay? I don’t have any research to show this. But my opinion is that when an epidural is placed and a body “stalls”, that is our body saying, “Thank you. I’m going to take this opportunity to rest.” Can it continue laboring at some point? Yes. Will it always? Maybe not. Maybe Pitocin does need to come into play at that point because it has decreased our bodies’ ability to register and acclimate, but sometimes I feel like with getting the epidural, we need to just acclimate to that and see what happens versus just immediately starting Pitocin and acclimate to new ways to change. But yeah, did you want to say anything, Julie?Julie: It’s interesting because I like that and I feel like sometimes that is exactly what a body needs maybe not necessarily for the body as much as for the psyche to just be able to rest and relax and let go because a tense body and a tense mind sometimes isn’t going to be very efficient at laboring because of that. Again, we talked about this before with the cortisol levels so if you can get someone to relax easier and let the body take over what it is supposed to do intuitively or instinctually– and it doesn’t always and it’s okay if it doesn’t and it’s okay if we need other things to help us, but sometimes just that rest and relaxation and that 30-minute power nap is exactly what the body needs to continue on throughout the rest of it. I think a lot of people when they are going for a VBAC think they need to go unmedicated to have their best chances. While yeah, that may or may not be true, it just is completely dependent on the person and the labor and how things go and how long it is and all of those types of things. I just think about the cascade of interventions. 54:13 Allowing for nuanceJulie: I was going off on a daydream over here when you were talking about the cascade of interventions because we always demonize that a little bit or villainize it like, Oh, the cascade of interventions as soon as you get to the hospital or as soon as you get the epidural or as soon as you whatever. You know, it’s true. We’ve seen it a dozen times, but I’ve also seen the cascade of interventions help parents have the exact birth that they wanted as well. So like with all things in birth, there is that nuance there. I’ve used the word nuance a lot and I feel like maybe it’s a thing for my life lately and everything that we have to allow for the nuance and we can’t be super rigid in our thinking. I think maybe at the beginning of The VBAC Link, Meagan, you and I did a lot of that villainizing of the cascade of interventions. But as we have grown and talked more to people and had more experience as doulas and in the birth space, I feel like we are allowing ourselves to be a little more fluid in that thinking and allow for that nuance to come into play. Meagan: Yes. Yes. 100%. Julie: But I will say this. I will say this with 200% certainty, okay? There is no nuance allowed here. People who tell you that you have to have an epidural for a VBAC are 100% full of crap. This is why. Because the reason why they say you have to have, and I say “they say”, I’m saying they like your provider or anyone who says that. The reason why is because in case of a uterine rupture, the epidural is already placed and they can get you back for a C-section faster and not have to put you under general anesthesia which is riskier. That is true. General anesthesia is riskier than an epidural. That is 100% true. It is safer overall to have an epidural for your C-section than it is to go under general anesthesia. Now, here is where I call B.S. because even with an epidural placed and dosed, when you have an epidural going, it is not at the strength it needs to be in order to do a C-section without feeling any pain. Meagan: It’s not enough. Julie: From the moment the epidural is dosed up, now keep in mind it takes time for the anesthesiologist to come in and everything like that too, you’re looking at a minimum of 12 minutes if the anesthesiologist is there and pushing the bolus. 12 minutes for the epidural to take effect enough to have surgery. Now, listen to me. If it is a true emergency and a catastrophic uterine rupture, you do not have 12 minutes to save the baby. You will be put under general anesthesia because minutes matter. Seconds matter in those true emergent situations. So, Karen, if you have an epidural placed and it’s a true emergency, then you will have to be put under general anesthesia. If it’s not a true emergency, then guess what? You have enough time for a spinal block which takes effect in about 3-5 minutes. Go into the OR. You can still have your baby out in 15 minutes or more but usually what we see called an emergency C-section, they’re like, “All right. Baby’s heart rate is not looking good. Let’s get the doctor in here. Let’s have you put your scrubs on. Oh, look Dad. Let’s get your scrubs on.” You get dressed and you are getting wheeled in the OR 45 minutes later, that’s not an emergency. Having an epidural placed when you don’t want one or need one– some people need one and some people want one and that’s fine. Having an epidural placed is preparing you for surgery. It’s preparing you for surgery. That’s why I say there is no room for nuance because you just can’t magically make an epidural surgical strength in minutes. You just can’t. There’s no nuance there. It doesn’t happen. Meagan: Okay. We’ll just end right there. You guys, there are so many things but hopefully, we covered a lot of the basics. Know that you always have options even if you feel like sometimes you don’t have options, there probably is another option there. It’s crazy, but there really is so keep looking at your options. Look at your blog. Look at the show notes. We’ll create and leave the links today. Check out our How to VBAC course. It’s going to cover a lot of information and help you hopefully find the right stats and evidence-based information so when you see posts on Facebook or TikTok or anything like that that are saying things like, “If your baby’s cord was wrapped around their neck the first time, you can’t have a VBAC the second time,” or if you are told that your pelvis was too small the first time and you can’t have a VBAC or going on and on, that you will be able to know the evidence-based information. All right, okay. All right. Julie: Yeah. Meagan: See you guys later. Julie: Bye! ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
59:4926/06/2024
Episode 311 Sami's VBAC After an Unexpected Breech Cesarean

Episode 311 Sami's VBAC After an Unexpected Breech Cesarean

Upon arriving at the hospital during her first labor, Sami was told that her baby’s heart rate wasn’t stable, Pitocin was necessary, and a C-section was most likely going to be the safest mode of delivery. After laboring for a while, she was wheeled to the OR but the anesthesiologist was running behind schedule. Sami was checked and discovered she was complete! She pushed like her life depended on it and with the assistance of a vacuum and forceps, was able to vaginally deliver her baby in the OR. Sami was thankful to have had a vaginal delivery, but it wasn’t the empowering experience she hoped for and she knew she wanted something different the next time around. But when her second baby flipped breech during labor, Sami unexpectedly consented to a Cesarean. During her third pregnancy, Sami did everything in her power to set herself up for a VBAC. She found out her baby was breech and exhausted all options to try to flip her. A few weeks after a successful ECV, Sami had a precipitous VBAC, pushing her baby out within one hour of arriving at the hospital!Sami's Fitness AccountHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:23 Review of the Week04:26 Sami’s first pregnancy06:41 A vaginal birth in the OR07:55 Second pregnancy and switching providers11:00 Flipping breech during labor13:10 Sami’s C-section and feeling invalidated16:50 Third pregnancy24:19 A successful ECV29:38 Going into labor32:38 Pushing her baby out within one hour of arriving at the hospitalMeagan: Hey, hey everybody. We have another VBAC story for you today from our friend, Sami. She is actually local to me here in Utah. Hi, how are you?Sami: Hi, I’m good. I’m so excited to be here. Meagan: So excited to share these stories. I was going over your story and it’s just crazy to think how things can twist and turn and the unexpected can happen. I love that about stories sometimes and then I don’t love that it happens but I also love the uniqueness of that. Does that make sense? Sami: Yeah. Yeah. I feel like literally and figuratively, my babies twist and turns happen. Meagan: Yes. It’s important to know that going into birth even though we are planning one way, sometimes twists and turns can happen and then it’s up to us to figure out how to navigate through that space and it’s not always easy. It’s okay to not always have it be easy and then sometimes it is easy. That’s another thing I wanted to talk about too is pointing out that to some, a twist and a turn might be no big deal to someone and then to some, it rocks their world. We are all in different spaces here and you definitely like you said both figuratively and actually have some twists and turns. 01:23 Review of the WeekMeagan: We’re going to share her story in just a minute but of course, we do have a Review of the Week and I just wanted to quickly share it. This is by– okay, I’m probably going to butcher this. It is mitaywa. I’m so sorry if you are listening and you are like, You are telling this so wrong. It says, “I hope this plays over the speaker in every OB/GYN office.” I love that. That’s a cool subject. It says, “I cannot even begin to describe what encouragement these podcasts have been for me. I have completely binged on these the past few weeks and they have grown my confidence for my up-and-coming VBAC baby. I cannot stop sharing everything I’m learning and even help encourage first-time moms to educate themselves on how to avoid a Cesarean in the first place. Thank you so much for this no B.S., truth-declaring and empowering platform that I know has encouraged so many more than just myself. Keep being amazing. I can’t wait to share our story in just a few short months. All of my love.” Aw, that’s such a great review. I love that so much. I hope that you got your VBAC and that all went well. I’m so excited to hear that this podcast is doing exactly what we intended it to do– empower, educate, inform, and inspire people to know their options for birth after a Cesarean and like you said, how to avoid a Cesarean in the first place. 04:26 Sami’s first pregnancyMeagan: Okay, cute Sami. I’m excited to hear these stories. Thank you for joining us today. Sami: Yeah, thank you so much for having me. It’s a really cool full-circle moment to be here after binging on the podcast for months and months and months so I’m excited to be here. Meagan: All right, well every birth story starts with baby number one, and your first baby actually wasn’t a C-section, right?Sami: Yeah, with my first baby, I got pregnant in 2017 and had him in 2018. I feel like as so many other people on the podcast, I felt like I was pretty informed going into the birth. I mean, I read two books. To me, I’m like, I am so informed. I took a HypnoBirthing class but I had a provider who had just been my OB/GYN for a long time so I decided to stay with her. Even though I didn’t have a C-section with that first delivery and pregnancy, it definitely wasn’t what I was hoping to get out of it. I went to 40 weeks and thought that I would have my baby right then and there. I didn’t have a doula. I hadn’t talked to a lot of people but I was planning on going unmedicated in my delivery and then the days kept going on. I got to 40 and 5 and finally started to go into labor. I was really excited because my OB had scheduled an induction for me I think the next day actually. I got to the hospital and everything changed. We got there. We were excited and fresh-faced. We were having our baby today. The minute we got there, they were picking up a lot of heart decels. They didn’t feel like the baby’s heart rate was doing well. They told me that I needed to get on Pitocin immediately and that I would be really lucky to not have a C-section so my hopes for an unmedicated delivery went out the window immediately. My OB came in and told me, “I really do think that a C-section is going to be the best course of action for us but let’s give you a couple of hours and see how things do with Pitocin, get you an epidural just in case,” and after a few hours, came in and said, “I really think we need to go to the OR right now. We need to get your baby out for his safety.” 06:41 A vaginal birth in the ORSami: We scrubbed up, my husband and I. She took us back to the OR. I was a wreck. I was crying and just so upset because no one had prepared me for that. In my HypnoBirthing class, all of the stories that were shared were really positive. We didn’t really talk about what would happen in this type of situation. Like I said, I didn’t have a doula. We got to the OR and the anesthesiologist was actually running behind. He was doing another C-section and they didn’t have another one on call I guess. She was like, “You’re dilated to a 10 so if you can get this baby out right now, I’ll let you push and try.” So I pushed like my life depended on it trying to get this baby out. He was sunny-side up so she did end up using forceps and a vacuum. We got him out in that timeframe. It was so cool honestly after having this experience that felt really scary and just not what I was wanting, I was riding the high of my life to have still been able to deliver him. So I didn’t get my unmedicated delivery, but I was just really happy to have him there with me. Meagan: Yeah, yeah. 07:55 Second pregnancy and switching providersSami: So fast forward to my second pregnancy, I got pregnant in 2019 and had him during the pandemic in 2020. I decided to switch providers just because I felt like after going through that experience with her, it wasn’t a bad experience, it just wasn’t what I was wanting. To get there and have her immediately pushing a C-section– Meagan: That’s kind of unique. Did she ever tell you exactly? It was just the heart rate? “You’re heart rate is wonky. Let’s put you on Pitocin.” Those two things often don’t match. And then it’s like, “Oh, you’ll probably end up there anyway but we’ll let you keep going.”Sami: It was so bizarre. Looking back at it for me, I do feel like there were signs that she just wasn’t going to be a supportive provider of an unmedicated delivery all along. I told her I didn’t want to have an epidural and she said, “Well, good luck. You’ll probably change your mind, but I support you doing whatever you want to do.” We found out after he was delivered that the cord was wrapped around his neck twice. That was what was causing the decels to happen, but that was what was hard for us to understand too. We were like, “If it’s emergent, why aren’t we being taken back right now?” Yeah. It just felt like she wanted to get the baby out. I was over 40 weeks. I felt like even though I had a great experience postpartum and I was fine, I couldn’t trust her anymore. I didn’t feel like she was a safe person or someone who would honor my wishes during birth. Meagan: Right. Sami: I had heard of a doctor locally. A few of my friends had just raved about him. He is pretty popular in my neighborhood. I feel like a lot of different people go to him, but it’s Dr. Thackeray and INC. Meagan: Oh yeah. Sami: Yeah, so I switched over to him for that second pregnancy and immediately just really liked him. He was warm. He took a lot of time talking over everything, getting to know us in a way that most OBs don’t in the hospital setting and I let go of my hopes of having an unmedicated delivery. It just felt like with my first birth and postpartum, everything that could have happened did happen. I had this plan. I had the birth plan. I wanted to have that unmedicated labor and it all went out the window the minute that we got there. I felt like, What’s the point in even trying to go unmedicated? There are so many unexpected things that can come up in birth. I went forward with that pregnancy. It was a pretty normal pregnancy. Honestly, I felt great. I’m one of those weird people who enjoys being pregnant. I just soaked up the time with my oldest son. We were having another boy, but when the pandemic really started to get serious, we were terrified. We were being told every week that things were changing. You could have people come with you and support you. You couldn’t. My birth partner may not be able to be there with me. We were a little nervous about that. 11:00 Flipping breech during laborSami: I got to 40 weeks exactly and went into labor again. I was so excited. It’s really funny because my husband and I took pictures outside of the hospital. We were both really excited to hopefully have a more normal experience of being able to deliver in the delivery room without all of those interventions. We got checked into the hospital. They checked the baby’s position and they told me that he was head-down. Then shortly after that, my water actually broke. They called my OB to come in and just check on how things were progressing. When he came in, he checked me and he was like, “I don’t think that I’m feeling the baby’s head. I think I’m feeling the baby’s bum.”They did an ultrasound. Meagan: So breech? Sami: He was breech but he wasn’t even just complete breech. Meagan: Like sideways? Sami: Yeah. He was transverse. It brought up a lot of anxiety and emotions from that first delivery. I’m like, “No. I avoided a C-section. I really don’t want to go back to the OR. I don’t want to have forceps. I don’t want to have all of these things happen.” They tried to perform an ECV. They actually tried for 45 minutes to get him to flip but because– Meagan: Which is also impressive just to say for a provider to do that during labor. That’s impressive. Sami: Yeah, he was. He brought in one of his partners. I could tell that they were trying really, really hard but he would not budge. They told us that because my water had broken, it was just likely that there wasn’t enough fluid in there to get him to flip back. Meagan: Rotate. Sami: Yeah. We don’t know at this point. The nurses who checked us in told me that he was head down, but we don’t know if he flipped when my water broke or if he had been sitting breech for a long time. In any case, he wasn’t flipping. My husband and I asked for some time just to think about our options, but his foot became prolapsed and they told us, “This is an emergent situation. We need to get him out right now. If the cord prolapses, it could be pretty risky.” 13:10 Sami’s C-section and feeling invalidatedSami: They rolled us back to the OR. It was kind of like Dejavu from my first delivery. I’m sobbing. I’m like, Oh, I don’t want to have a C-section. I’ve got a baby at home to think about this time around. I told him I’d be back in two days. Just a lot of emotions were brought up. They took us to the OR and kept having to give me medication after medication. They lay you down obviously. So many people listening to this story are going to be able to relate to what it’s like in there, but it’s freezing cold. They laid me down and strapped me onto the bed. I was shaking. I felt like I was going to vomit. They just kept giving me all of these medications. They finally started to perform the C-section and I just had tears rolling down my face. The anesthesiologist bent down and was like, “Don’t worry. My wife had to have C-sections with all of our babies and she’s fine.” It was just the weirdest situation. Meagan: Yeah, probably out of the goodness of his heart of, “You’re going to be okay. My wife was okay,” but it’s not really what you say to someone in that moment either. Sami: Yeah. It just felt kind of invalidating that I was having a hard moment. Meagan: Yeah.Sami: Ultimately, they got my son out. They took him and cleaned him off and when they brought him over to me, I can barely remember what it was like but I couldn’t hold him. I was shaking. It was a really hard moment to not be able to have that immediate connection with him. We got back to the recovery room and things went fine for the most part. I did have a pretty bad hemorrhage and they kept having to come in. They were going to open me back up at one point, but all in all, it was fine. My son was healthy and I was really grateful for that. I think the hardest part for me was just like I said with the anesthesiologist just feeling really invalidated in how hard the situation was. I wanted to get back to see my son. I’m pretty into fitness and health like I talked about and hadn’t really wanted to have this really long recovery from all of that. People just kept saying, “Well, your baby is healthy. That’s what matters. At least your baby is healthy.” I think that’s a really hard thing sometimes for moms to hear because as the mom of the baby, I want them to be healthy more than anyone. Meagan: It’s a no-duh situation. Sami: Yeah, that’s my number one goal. Funny enough, I found The VBAC Link in the hospital while I was lying in my hospital bed those three days just feeding him and spending time with my baby and I started listening to the podcast then. I just thought, If I ever go down this road again and have another baby, I really want to have a different experience from these first two deliveries. I want to be able to hold my baby the minute that they are born, not be so drugged up that I’m having to come out of being groggy and things. To make a really long story a little bit shorter, my postpartum situation with my son– the recovery was okay but it was really hard. It brought up a lot of postpartum anxiety for me, a lot of different things with the pandemic. We weren’t able to have visitors, not be able to be outside or move around the way I wanted to immediately. The podcast really helped me get through a lot of that. 16:50 Third pregnancySami: Fast forward to 2023 and I got pregnant for a third time, I was just excited to hopefully do things differently this go-around. We had two boys and found out that we were expecting a girl. I’m a pretty type-A person so I devoured all of the information that I could about VBAC and realized that I really hadn’t known that much going into my first birth. I thought that HypnoBirthing class was enough and it really wasn’t. I hired a doula who was local here to me in Salt Lake. She is amazing. Her name is Jamie Kowalk. A friend had referred her to me. I just got to work on a lot of different things. I did chiropractic. I worked with a pelvic floor PT. I actually worked with a therapist too to go through some of the postpartum anxiety that I had experienced after the second time around and hopefully have someone in my corner in case I had that going on again. But once we found out that we were pregnant, I did consider switching providers again. I just thought, Can I go through another delivery with the provider who did my C-section? I did interview a couple of other providers. We met with a midwife pretty early on and had a weird experience. I don’t blame her. I don’t fault her or anything, but she was the first person to give me an ultrasound when I was pregnant and she had thought that we were having twins so she gave me the ultrasound and said, “You know, I’m kind of seeing two babies here. I don’t see two heartbeats. I think it’s likely that you lost a baby fairly early.” When we went to get an ultrasound after that that she recommended, the tech was like, “That’s not two babies. That is a yolk sac. This is just the baby. This is the yolk sac. You’re only pregnant with one.” Yeah. It was a surprising experience but what I realized from that was that I had wanted to call my old OB the whole time and just verify everything that she was saying with him. I just didn’t think that I could fully trust her because I already had a pretty strong relationship developed with him. I did choose to stay with my same provider. I had some friends who had known him and shared stories of him doing VBACs that they had heard of. I talked to him about it. The one thing that was kind of hard was that he was really VBAC-supportive when I shared my plans to hopefully have a VBAC, but he wasn’t a huge cheerleader. He wasn’t like, “I’m going to get you your VBAC. We’re going to go in and do this.” It was really realistic. “We’ll try to do everything that we can and see how it goes.” Meagan: Right. Sami: I appreciated that ultimately. I had a fairly normal beginning part of my pregnancy. I found out we were expecting a girl which was shocking to us after having two boys and then I got to the gestational diabetes screen which was something I had never worried about. Like I said, I’m pretty involved in health and fitness at a high level. I watch my diet really closely. I failed the screening pretty badly, like pretty terribly. Sami: I ended up going on to pass the 3-hour test which was good but after that, I really felt pretty excited about the VBAC. I felt this hope that I could do it. I feel like meeting with my doula was really powerful because we went through not only my ideal situation and scenario of what would happen but also what things could look like if I did have to have another C-section. I think that was one of my favorite parts of the process of working with her was just planning with her when there weren’t emotions at stake in it and not trying to make decisions in the heat of the moment in labor but making them far ahead of time. Meagan: Yes. It’s so important. Sami: Yeah, it’s a total game-changer. But then we got to about 36 weeks and I had been doing, when I say all of the things, I really had been doing everything in my power to hope for an optimal positioning with the baby. Like I said, the chiropractor, the Spinning Babies, and everything, but I asked my provider for an ultrasound that they don’t usually give at 36 weeks unless there is some type of indication that it’s necessary. He had been feeling the baby externally and thought that she was head down, but I just didn’t want to go into the delivery with any unknowns or surprises. We got that ultrasound and went in. The minute that the tech touched my stomach, they were like, “This is a really breech baby. This baby is completely breech.” Yeah. That brought up a lot of emotion for me from my previous deliveries like, What am I going to do? We haven’t had a baby in a good position yet. I’ve already been doing all of the things to hope to get her in an optimal position. When I met with the nurse right outside the room, she was like, “Well, it’s fine. You can always have a C-section. It’s not a big deal. We just did a couple today.” Meagan: You’re like, “Again, not what I’m wanting though.” Sami: A lot of my hopes and dreams and everything went out the window. From there, I got to work on all of the things that I could do to get baby to flip. I was reading forums. I was Googling. It was honestly so exhausting. I look back on that time and for anyone else who has had a breech baby and tried to get them to turn, it is an emotional rollercoaster. Meagan: Oh yeah. Sami: Yeah. We did acupuncture. I did moxibustion. I did the Spinning Babies “Flip a Breech Baby.” It is so funny, but I downloaded this hypnosis track to try to get your baby to flip. I was doing hypnosis. I went to the pool and I attempted to do handstands in the pool at 37 weeks pregnant. I was not successful. How anyone can do that, I have no idea. But I was lying upside down on an ironing board trying to encourage her to flip. I put ice packs on the top of my stomach. It was completely exhausting. In hindsight, I wouldn’t change the effort that I put into hoping to get her to move, but it’s hard to be in that space where you are so far along pregnant and then trying to do that and being unsuccessful. Meagan: It’s consuming. It consumes you because you are like, I want this so bad. It’s sort of within our control, but a lot of it is out of our control. Sami: Totally, yeah. Yeah. I actually ended up posting in the Facebook group and just asked if anyone had recommendations local to me for a provider who would consider delivering a breech baby. Someone recommended Dr. Silver at the University of Utah. We actually did meet with him when I was 38 weeks pregnant. That may be wrong. It may have been 37. 24:19 A successful ECVSami: We went and met with him. He told me, “This baby is breech and if you want to try to deliver her, I’ll do it but I think that you should have an ECV first and exhaust all of your options.” I was a little hesitant to go into another ECV after having one that didn’t work. I didn’t have high hopes. I went and met with Dr. Thackery and he did perform an ECV. I didn’t use an epidural or any medications but she actually flipped really easily. Meagan: Good. Sami: It was super quick. Yeah. It was really cool. I think something that I didn’t share, but leading up to that, I was working with my therapist a lot just on my mindset. I was pretty devastated when I found out that she was breech. I had to come to terms with the fact before we even went into the ECV or met with Dr. Silver or any of these things that I’m trying to control all of these different variables. I’ve done this with all of my births and it hasn’t really gone the way that I wanted to. With my first baby, I thought it was going to be fine to do unmedicated. My second baby, I was like, I don’t care what we do as long as I don’t have a C-section, then it ended in a C-section. Then to have her be breech, I was exhausted from all of those things that I was doing, but I just had to realize that, I can show up and I can try to flip this baby on my own and I can try to get an ECV and I can try to hypnotize myself all day, but if that’s not what’s best for her and if that’s not in the cards, there is a level that is outside of your control when it comes to birth. I feel like that was one of my biggest lessons. When I was lying there as he was performing the ECV, I was just talking to myself and visualizing her flipping but I was talking to her and just saying, If there is a reason why you can’t flip, if this is not going to be safe for you or if this is not what’s best for you, that’s okay. I’m going to do whatever you need me to do in order for you to get here healthy. It was only an ECV but that was actually a really powerful moment for me in my third pregnancy in just letting go and letting the outcome be whatever it was going to be. Meagan: Yeah. Sami: She did flip like I said then after that, I was doing deep squats every day. Meagan: Get that baby engaged. Sami: Yes. Get her engaged in my pelvis. I had a few more appointments with my provider and every time would ask him to do a scan just because I didn’t believe that she would stay head down, but she did. I felt like we had overcome our last hurdle. I was utilizing HypnoBirthing tracks again. I don’t think I mentioned it, but I did want to try to go for an unmedicated this go-around just because I found that every time I would get the epidural or get Pitocin or get anything, that’s when everything would go wrong. I was trying to prepare for all of that. We found out that our provider was going to be out of town a few days after my due date. He got asked to go on a last-minute family vacation and said yes. A lot of the other providers in his office are VBAC-supportive, but I didn’t really feel comfortable with anyone else being the one to deliver my baby. I had to just again let go. I’m like, Okay. We’ve almost had gestational diabetes. You’ve been breech. We did the ECV. Now if we can just deliver this baby, it will hopefully all go well. Yeah, I just kept doing those things the last couple of weeks of pregnancy and on the Fourth of July, I started to go into labor. I was so excited. I started to feel those familiar contraction pains and didn’t tell anyone. We went to a barbecue with some friends. I didn’t say anything and then I decided to stay up all night on the Fourth of July because after you’ve had two babies, who would stay up when they are in labor? I’m like, what was I even thinking? But I stayed up all night watching TV and timing my contractions, getting excited. I didn’t want to wake my husband up or anything. But in the morning, they kind of fizzled out. There wasn’t a lot happening. I had an appointment with my doctor later that day. I should say at that point, I was 39 weeks and 3 days, 39 and 4. I went to that appointment. My husband ended up driving me and we brought our two kids with us because we didn’t have any sitters lined up at that point. He said, “I think that things are going to pick up in the next day or so. I think that you’re going to have this baby.” We were going to do a membrane sweep that day. That was something I felt comfortable doing but we ended up not doing it. We drove back home because we live about 45 minutes from the hospital that we were delivering at. I decided to make dinner and give my youngest a bath. By the time I had that bath water halfway filled, I couldn’t even do it. I was just laying on the floor trying to breathe through contractions, but not able to do anything. 29:38 Going into laborSami: I’m yelling at my husband in between, “Please come upstairs. Give Harvey a bath.” We had not packed anything. I feel like we were the worst third-time parents. We were not ready to go. I think there was so much pressure getting her ready to flip and trying to prepare for all of these other things that I think it would almost jinx it to be super ready for the delivery. We were throwing things into a bag. We had my mom come over because she was going to watch our two boys while we went to the hospital. We just turned around and essentially went back. It was really funny because when we went to go get checked in, they brought us back to a room. I was like, “Are you guys going to check me? Are you going to triage me?” They were like, “No, you seem pretty serious. We’re just going to admit you and you can stay.” Meagan: Awesome. Sami: Yeah. We were really excited about that. Again, I wanted to be really excited like I was in my second birth with taking pictures and everything. I have a friend who uses the term “cautious optimism”. I think about that a lot. I was optimistic but also cautious because of everything that had happened in those prior experiences. We did get checked in and we called our doula who decided to come in and meet us, but we didn’t get a nurse for 10-15 minutes. I felt like my contractions were really picking up. I remember I opened the door and was looking around like, This hospital is dead. Where are all of the nurses? Why is no one coming to do anything?She finally showed up and it was pretty clear. My doula got there about that same time that our nurse was not super unmedicated supportive. She also didn’t seem super VBAC supportive. The minute that Jamie walked in, I was just like, Okay. Now I can breathe. I have someone here who can advocate for us and be an ear to bounce things off of. She started to check me in and go through all of the paperwork, the insurance stuff, and I remember just being on the birth ball. We were trying a couple of different things because I felt like my contractions were pretty strong. Probably 15-20 minutes after Jamie had gotten there and our nurse had come in, I just started screaming, “I can’t do this. I can’t do this. I can’t do this,” at the top of my lungs. I remember it feeling almost like an out-of-body experience. I didn’t feel like I was screaming anything. I didn’t feel like I was saying anything, but there were just words coming out of me. My nurse said, “I think that we need to check you.” 32:38 Pushing her baby out within one hour of arriving at the hospitalSami: They checked me and I was complete. Meagan: Whew!Sami: Yeah, it was wild. We had not been there long. They started to get everything ready to go and I thought from doing HypnoBirthing and preparing and hypnosis and meditation and all of these different things that I would be able to be calm and present and that was not my experience at all. For a long time, I should say afterward, I felt embarrassed. You hear these stories or you watch Christian HypnoBirthing in these different cities of these people smiling and singing and they are quiet as they are having their babies. That was not me. Now I can look back on that and I’m like, That’s okay. I was just loud. I was roaring through birth. It all was happening so fast. I felt really comfortable being on all fours. I was in that position trying to start to push, but when my doctor came in, they actually did have me flip to lying on my back which is something looking back I wish that that wouldn’t have happened, but yeah. I flipped over and probably had her within 20 more minutes. When we look at the timeframe, it was an hour after we got to the hospital that she was born. It was just the most amazing, incredible moment of my life. I think one of the coolest things about the whole thing was after she came out, they just handed her to me and put her on my chest and they were like, “Do you want us to wipe her off? Should we go clean her off? Do you want us to put a diaper on her?” I was like, “No. No one touch her. Just leave her right here.” Yeah. We got to snuggle and cuddle and had that golden hour. It was incredible. Meagan: You got that experience that you were waiting for. That minute where you were like, Okay, I did this. It’s all over. I don’t have to question anything anymore. That happened. She’s here on my chest. I love that. I remember having that feeling. It was just utter joy feeling that human right on top of you. I feel like your photo is exactly that. It just says it all. It says it all exactly how you were feeling. Sami: Yes. Meagan: Just pure joy, amazingness and I am so happy for you. I am happy that even with the curves along the way with this baby, she was able to flip really easily, you were able to go through and show the efforts that you were able to do yourself and truly have this better experience. That is so fast. An hour after getting there and not really having too much going on from being at your visit to going home. That’s quick. Sami: Oh, it was shocking. It was really shocking. I feel like for me that was part of the reason why I was so loud. It was hard to believe that it was happening so fast. Meagan: Oh yeah, that transition. Sami: I told my doula, “I want to do the rebozo. I want to try all of these different positions,” and we didn’t really get to do very much. Meagan: You didn’t need it. You didn’t need it either. 35:56 Fitbliss FitnessMeagan: That is so awesome. I know you had mentioned in your summary that you are a personal trainer, right? I would love to talk about that too and all of the things that you did during pregnancy that you would suggest to anyone checking it out. I know physical abilities are always different in pregnancy, but can you tell us about that too? Sami: Yeah, absolutely. I am a personal trainer and a coach with a team here. We actually started local to Salt Lake called Fitbliss Fitness. I’m a coach and I’m also our COO. We coach women in bodybuilding, powerlifting, strength athletes, and macro coaching but primarily I’d say the bulk of my clientele are women who want to get stronger, feel empowered, and change their body composition in a lasting way that is not just a 6-week shred or a quick fix. It’s all about creating sustainable habits and then getting strong while you do it. For all three of my pregnancies, a huge part of that has been resistance training at a high level and it’s been different throughout each one. I was actually, it’s a sport called powerlifting. I don’t know if you are familiar with that, but it’s essentially bench presses, squats, and deadlifts where you compete to try to get your best number or PR, a personal record. I power lifted throughout that whole entire first pregnancy. Meagan: Nice. Sami: There has been some research to support easier, quicker, labor and delivery when you are familiar with resistance training and that’s something that you are doing consistently. The second and third, I think I did go a little bit easier not in the sense that I wasn’t still training. I trained 4-5 days a week, some weeks 3 throughout my entire pregnancy but just listened to my body more and not feeling like I had to prove anything or be as strong as maybe I once was. Yeah, so the big things that I focused on during pregnancy was resistance training specifically. Still doing movements like squats and core work that is important for a pregnant person– not things like crunches or obliques or twisting but things like pall-off press, side planks, and there are a lot of different movements that you can still safely do working on transverse abdominal breathing throughout my pregnancy. Then the other thing that I focused on the other side of the coin there was just my nutrition at a high level so a lot of protein intake. Protein is huge. Fiber in my diet throughout, a lot of veggies, fruits, getting in really good sleep each night, sun exposure, and just a lot of different things to take care of your body during a time when it’s doing so many different things. It’s not only filling you but also your baby and if you are depleted, that’s not going to be ideal for either of you. Meagan: Right. Absolutely. I feel like with my first, I kind of started doing the running. I was like, “I’m going to train for a half marathon,” then my provider was like, “Oh, you have round ligament pain. You can just stop. Stay walking.” That was such a bummer to me that I did that and that I stopped. Then I didn’t focus on my nutrition at all. I mean, seriously my husband worked 2:00-10:00 and I was eating Chinese food all of the time. My protein was probably not even close to 50g a day. It was really, really, really bad and I think that’s another one of the reasons why I feel so passionate about good nutrients and physical activity because yeah, I ended up training and becoming a Barre coach and stuff but really dialing in on that. I really do believe what you were saying that studies have shown. I had a better postpartum. I had a better labor along the way because I was able to focus on that. One, I love that you did it and two, I love that you help people do it and break it down and understand. If someone wanted to check you out, do you do only online? Do you do just in person? What does that look like? Sami: Yeah. I used to be a personal trainer in a gym here locally alongside my clients but now ever since COVID, it’s fully online. We have a website that is fitblissfitness.com and I’m on Instagram at sami.g.fit. Yeah, it’s really cool. There are a lot of stereotypes out there about what women can and can’t do when they’re pregnant and oftentimes, it’s not the advice that we need to hear. I remember someone in my first pregnancy saying, “Oh, don’t move that chair over. You’re pregnant. You wouldn’t want to hurt yourself.” You can still lift and be strong. You can enjoy foods that you like still too while eating enough protein and giving your body what it needs. Meagan: Getting the right nutrients, yeah. That helps you and your baby as well. Okay, I love it. We will make sure to tag you so everyone can go find you and we’ll put it in the show notes. Thank you so much for sharing your stories and I’m so stinking happy for you. Sami: Thank you. Thanks for having me. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
41:4924/06/2024
Episode 310 Kristen's Healing VBAC with a Special Scar

Episode 310 Kristen's Healing VBAC with a Special Scar

Every pregnancy and birth experience is different. That is true for everyone, but especially for Kristen. Kristen joins us from Provo, Utah, and shares her experiences with an initial vaginal birth, a diagnosis of omphacele with a Cesarean and infant loss with her second that left her with a special scar, an induced, medicated hospital VBAC with her third, and she is currently expecting twins!Kristen’s journey has not been easy, but she has learned and grown so much. She talks about how a safe and supportive birth team truly makes all the difference. Your intuition will help guide you to the best provider for you. When you know, you know!Meagan concludes the episode by touching on some myths and facts about doulas. The VBAC Link Blog: Myths and Facts About DoulasThe VBAC Link Blog: Special ScarsSpecial Scars, Special HopeNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:50 Review of the Week04:02 Kristen’s first vaginal birth09:41 Coping with grief and hospital communication issues15:17 A low transverse incision with a J extension19:59 Finding VBAC support in Salt Lake23:10 Foley induction at 41.5 weeks29:29 Changing plans30:37 Myths about doulas38:55 Facts about doulas41:05 Kristen’s advice to other women with special scars43:26 Listening to your intuition when choosing a providerMeagan: Hello, Women of Strength. Thank you for joining us for another amazing episode here at The VBAC Link. Today’s story is from someone who is local to me which I think is always kind of fun to have someone who when they are telling the story, I know the birthing place, I know the provider, and here I even know the doula so that is super exciting. Welcome, Kristen to the show. Kristen: Thank you, Meagan. Meagan: Thank you so much for being here and I’m excited for you to share your stories. I would like to get into a review really quickly so then we can do that. Kristen: Sure. 01:50 Review of the WeekMeagan: Okay, we have a reviewer from Apple Podcasts and it says louuuuuhuuuu. I think that’s how it is and it says, “Very Inspirational.” It says, “I knew I wanted a VBAC with my third pregnancy, but I wasn’t sure if it was possible. However, I knew I didn’t like being flat-out told no at my first appointment. Listening to the podcast was definitely the start of me really researching birth and looking into my options. I ended up with a successful HBAC” which is home birth after two Cesareans, actually HBA2C, “and I definitely don’t think I would have had the courage or believed it was possible without the podcast. Thank you, Meagan, for all of the work that you do to provide this information.” And thank you, louuuuuhuuuu. I don’t know how to say it. I’m just butchering your name. If you are still listening, thank you so much for your review, and as always, we love your reviews. They really do help the podcast. They help Women of Strength find these incredible stories and information just like she was able to receive. You can drop that review at Apple Podcasts or Google or wherever you listen to your podcasts. 04:02 Kristen’s first vaginal birth, Cesarean, and infant loss experienceMeagan: Okay, Kristen. Thank you again so much for joining us. I would love to turn the time over to you to share your stories. Kristen: Well, thank you. It’s hard to know where to start. There are a lot of details to mine. We had our first little boy in April of 2018. That was its own experience. That was a vaginal birth honestly. That was as hard as it was as a first-time mom and a first-time pregnancy/birth. It had its own set of interesting details to go along with that but we soon found ourselves unexpectedly pregnant with our second one just four months later after he was born. Meagan: Really soon. Kristen: Yeah, they would have been 11 months apart. I say would have been because my daughter who I had via Cesarean ended up passing away a few hours after she was born. She had a few congenital defects and when we got our first ultrasound, we found out she had a condition called omphalocele which means she had some of her organs on the outside of her body in a little protective sac. It was mostly her liver. I saw the ultrasound. I looked at it and I was like, That doesn’t look normal. It was one of those moments where the ultrasound tech was like, “I’m going to get the doctor.” Your heart sinks and your heart drops. At the time, it wasn’t a big deal after the doctor came to us and talked to us and said, “She’ll be fine. You can deliver safely. It would most likely be a scheduled C-section.” I was expecting that from the very beginning because it wasn’t just, “Oh, this is going to be a big baby. This is going to be a big baby with a large–”Meagan: 100% necessary Cesarean. Kristen: Exactly. 100% necessary. Meagan: Yes. Kristen: That was to be expected even though I was like, Darn. I don’t want that, but obviously, I wanted her to be her in the best and safest way possible because this is just such a crazy anomaly. That was around 18 weeks and then around 24 weeks, we were at Maternal-Fetal Medicine at our local hospital down here where I live in Provo, Utah and they discovered something else which is a lot more serious. She had a diaphragmatic hernia which means her diaphragm didn’t really develop all of the way and allowed some of her other internal organs to be pushed up into her chest cavity. Meagan: Oh wow. Kristen: Whatever was left in her abdomen was pushed up. I think some of her spleen was in there and pushed. They essentially squished her lungs so they couldn’t develop all of the way which is essentially what happened at the end of her life. That’s not something– we’ve grieved and healed a lot from that but it’s also something that I consider one of those things that now I can be there for somebody else now who has gone through infant loss in whatever way that means. I can be a sounding board for anybody else who has been there. Meagan: Yeah. It’s crazy how sometimes we have some of the most unfortunate or horrific experiences that we could ever imagine going through and life-jarring and after we get through them, we are still super there but we are also stronger in a weird way where you can be that support for other people and you can relate. It’s just this weird but most amazing thing that there are people like you who are like, I went through this really not great experience, but now I’m here and I want to support those who need it. Kristen: Yeah, totally. It took a long time to get there. Meagan: I’m sure. Kristen: She was born on March 25, 2019 and so she would have turned 5 this year. We celebrate her birthday as a family every year. Meagan: Good, yes. Kristen: My 6-year-old is excited because we always release a balloon up for her and he said, “I’m so excited. My sister’s going to get this balloon.” It’s still very innocent and sweet. We love being able to do that as a family because she is very much still to us a part of our family. Meagan: Absolutely. That just gave me the chills thinking about your little boy doing that. That’s so awesome. Kristen: He’s very tender-hearted and sweet. It’s one of those things that means a lot to him. Even though he was barely one when this happened, he wouldn’t have remembered her at all. Anyway, with those things going on, her outlook from the very beginning was bleak. That was a hard piece of the puzzle to deal with, but it also plays into what happens later. Although this was a scheduled Cesarean and absolutely necessary, we wanted to give her every possible chance just in case she could beat the odds or whatever. Me as mom, I’m like, There is still a 20% chance this could be okay. That’s something. It’s not nothing. Meagan: Exactly, yeah. Kristen: You’ve got to hold onto something and that’s what I did. 09:41 Coping with grief and hospital communication issuesKristen: The Cesarean itself was fine. The process in the hospital for me, nothing went overly wrong with me physically. But afterward, that was where it gets a little complicated. We had to leave the hospital with just my husband and myself which was obviously very hard but we also had a few different things that left me baffled and confused but really frustrated. Anyway, the first thing was that after our daughter had passed and while I was recovering, the hospital staff didn’t seem to be on the same page with a lot of things. First being their communication. I remember it was the anesthesiologist who came in the day after my daughter had passed and they asked, “Oh, how are you? How is your baby?” Did you not read the notes? Is there not a sign on the door that says she’s not with us anymore? I had to clarify. Of course, he was very apologetic. “I’m so sorry.” Okay. That seemed like one of those things where it’s like, okay. You should have been informed. I don’t know why. After that, we had the resident doctor and the doctors in training at the time. He comes in and says, “We had to do a mid-transverse incision on your uterus and so you should plan on Cesareans from here on out. It’s not safe and don’t plan on having a vaginal birth.” It’s like, “Okay, no one told me that was happening.” I felt like there was again that lack of communication and just that misstep between doctors and the other providers and stuff. I was told that in the hospital as I was recovering so that was another blow of course because I was very much expecting, Okay, I know I can have a vaginal birth after a Cesarean. That’s totally a possibility. I go in with that strand of hope again for myself thinking that I could totally do this later. I’ve heard it’s possible. I’ve just got to find somebody who can help me with it. I’m fine, then someone tells you like your reviewer today. I hate it when someone tells me no. Don’t tell me no. Don’t do it because I will literally make it my life’s work to prove you wrong. That was really hard to hear, of course, in that setting and in that moment. It’s really deflating to hear that. But I was like, Okay. If that’s what they think, that’s fine. I’m going to prove them wrong later. Whatever. I’ll do it.Then we ended up going home. I ended up calling back the doctor’s office saying, “Okay. You said mid-transverse. What does that actually mean?” I was trying to clarify things. Meagan: It’s higher up. Kristen: Yeah. The nurse who answered said, “Well, we had to do a mid-transverse incision. We had to make more room for your baby to get out.” I was kind of expecting that they might have to do that. They did forewarn us that it may be a possibility but no one ever said that was what happened in the hospital when we were delivering her. Anyway, they never told us that happened until I called back and said, “Hey, what actually happened?” She said, the nurse I remember was like– it still makes me baffled why you would say something like this– but she goes, “We had to show a mid-transverse incision with a double-J extension,” so one on either side. Meagan: On each side? Wow. Kristen: Yeah. That’s what she told me. She said, “Think of it like a smiley face on your uterus.” It’s like, why would I ever think of it like that? It was just the weirdest verbiage. Why would you say that to somebody? I don’t know. I was like, Okay. That was weird. Why would you say that to me? Then it gets even better. You can request your op-notes. Meagan: Yes. Kristen: I did that. I requested them. I feel like people are just going to be doing the facepalm like, Oh my gosh, seriously? What were these people thinking? On my op-notes, they have little bullet points. The first one says, “Uterine incision”. The uterine incision they told me they had on there said “classical”. Meagan: Oh. Kristen: Which is wrong, totally wrong. Immediately beneath that, it says, “Detailed C-section notes”. Then it says, “Mid-transverse incision. Patient should not labor in the future.” That was the note. First it says classical. Then it says mid-transverse incision. Then they tell me I have a mid-transverse incision with a J extension or double J’s. What do I have? What did you do? Meagan: Yeah. Yeah. 15:17 A low transverse incision with a J extensionMeagan: That’s frustrating. Kristen: Yeah, so fast forward to when I have my new provider. We’re pregnant with our third now or we were at the time. He was a wonderful, wonderful guy and a wonderful provider. He said, “Do you know what? I’m going to go off of the actual written notes from the person who says they were watching the procedure.” It’s like, oh that’s really smart. They said I have a low transverse incision with a single J extension to my right side. Meagan: Wait, so different again? Kristen: Different again. So I was like, Oh my goodness. Where does this end? It stopped there, thank goodness. Yeah, he said, “I’m trusting more the person who was basically looking and saying, I was here in the moment taking physical notes and this is what was done. I’m trusting this more than somebody’s bullet points.” Meagan: Everybody’s bullet points, yeah. Kristen: Exactly. Meagan: And the nurses who are just randomly saying what they did. Okay. Kristen: Yeah, exactly. Exactly. Meagan: Wow. Kristen: So I was like, “Thank goodness I have you to translate for me,” because I was like, What did they do to me? I have no idea. Probably any other doctor who wasn’t super VBAC-friendly would be like, “Well, this is too risky. I don’t want to take any chances.” Meagan: So technically you have a special scar. Kristen: I do. I have a special scar. Meagan: Low-transverse with a J. Kristen: With a J. In those op-notes, I actually did notice just the other day when I was reading them again, it said that they extended it bi-laterally which in my mind, I didn’t call and ask obviously, but in my mind, that would translate to making the low transverse incision just a little bit longer. Again, I don’t know. But at least at the bare minimum, I have a low transverse incision with a J extension. So yes, I have a special scar. It was one of those crazy things like, Oh, now I’ve got to look this up. Again, I’m gung-ho at this point about, I can do this with a special scar. I’ve listened to the podcast. So many women have done it. I can do it too. I’ve just got to find somebody who is willing to meet me in the middle. Meagan: Support you. Kristen: Yeah and like I said, luckily I did up in Salt Lake where it’s not too far of a drive from where we are from. It was definitely worth it. He said, “It shouldn’t be a problem from what I’m reading. We’ll just go with it and if anything changes, I’ll keep you posted.” He was just supportive from day one which was super awesome. Meagan: He’s wonderful. Kristen: Anyway, so yeah. That’s the complication from my fun story. Hope that all makes sense. Hope we are all able to piece that together. Sorry. Meagan: Well, that’s so hard because it’s like, I’m being told this and this and this so what is it? All of these things impact my decision or maybe it doesn’t. But you want to take all things into consideration so it’s frustrating to not know what you have. Kristen: Right, totally because yeah, like you said, it could totally impact somebody’s decision. Meagan: It could affect somebody’s decision, yeah. 19:59 Finding VBAC support in Salt LakeMeagan: Okay, so you found out it was a low transverse extension J special scar. You found a provider up here in Salt Lake that was like, “Yep, okay. We’re going to do this.” How did that go? Kristen: That was really good. Honestly, it was one of those things where you start looking online first and then go from there. I just found his name. At the time, unfortunately he doesn’t practice that anymore, but he had his own little personal video posted about that. I was like, I feel this. I’m getting really good vibes from this guy and I really like it. So I called his office. I scheduled myself in. Great. Okay. Then yeah, it was really comfortable from day one. I told him. I said, “I’ve got some weird things going but at the same time, I am really motivated. I’m really determined to do this.” He was like, “Okay. I’m with you.” Meagan: There was something about him that brought this overwhelming sense of calm when he was with you. Kristen: Mhmm. Meagan: Fun little side note, I was actually under his care as well for my VBAC. Kristen: Oh cool. Meagan: For a little while until I decided to go out-of-hospital. Kristen: Yeah. Meagan: Yeah. He’s just awesome. Kristen: Yeah. I completely agree 100%. Meagan: He transformed the VBAC community here in Utah. They just flocked to him because there was just something about him that wasn’t anywhere else here in Utah. Kristen: Yeah. Now you’re giving me chills. I’m going to get emotional about it because I feel like it’s so true. Meagan: Yeah. Yeah. He’s a special OB for sure. Kristen: Yep. It does. It makes you sad that he’s not doing that anymore but at the same time, I’m sure he is one of those doctors who will refer you to somebody who he trusts and you can be like, Well, if he trusts them then I can feel safe about it.Meagan: Yeah. Yeah. And you hired a doula. Kristen: I did. I hired a doula. Meagan: Who was one of my clients. Crazy, huh? Kristen: She’s one of my good friends. I was like,  You know what? I’m going to do a total 180 on this one. It was the best thing ever and the best decision ever. It happened to work out super nicely because my husband was there, yes. He is the best– she calls them daddy doulas. He’s the best daddy doula, but he had to take some breaks too and having that other person there was like, If you weren’t here, I don’t know what I would do because I feel like my husband needs a break and I have to do this by myself, but no. I wasn’t left by myself. It was one of those things that helped with the whole VBAC process go so much more smoothly especially because it ended up being an induction. Meagan: Oh, okay. Kristen: Yeah, so just add more to my docket here of fun things that I chose to do. 23:10 Foley induction at 41.5 weeksKristen: We ended up going to 41.5 weeks with my daughter and at that point, I think this is probably biased but I feel like a lot of OBs, not matter how supportive they are, they are like, “Well, we could go this far if you wanted to, but it’s getting to that point.” It’s like, Okay, fine. It was my choice obviously to do it. We went in for the induction. I chose to use the Foley bulb. I had never done that before. That was hands-down so much better because my son was an induction as well and about the same time. My babies just go late. They are just 41+ weeks and they are still just cozy. So with him, it was not the same. They tried to push me in and out with a much faster style of induction. I was not a fan. The one, I was like, Okay. This is going to be different. Like I said, a 180. With her, it was a very slow, gentle induction and yeah. She arrived and it was pretty awesome just to feel at the end of the day like, Yeah, maybe an induction wasn’t exactly how I pictured this to happen, but my thoughts and feelings that I put out there into the universe was just that, I want a VBAC and I want it to go well. And it did. She’s here. She’s 3 now. It was one of those things that gave me that really big sense of accomplishment and that “ha” moment like, “I told you I could do it.” Meagan: I understand that “ah-ha” feeling so much. I definitely did that when my son came out as well. 25:10 Pitocin, epidural, and pushing for 10 minutesMeagan: You mentioned it was a lot slower of an induction and things like that. A lot of people don’t think that it’s really possible to do a low and slow induction. You started with a Foley then what happened from there? Did they start with Pitocin right after that? Kristen: They did. They started with Pitocin and we had to have some conversations with the nurses too. It was another reason I was glad I brought my doula. They started going a little bit faster than I wanted. I remember being a little bit earlier on and I was like, These contractions should not be on top of each other like this already. They were again, really good about backing off and letting me do it. Again, like I said, there are still things I would change but I feel like we all maybe have this ideal, I want it this way, especially for me. I’m very much like, I want this and this and this to happen. I have to be realistic. It’s not going to go exactly how I want it to. There are some things I can tweak and change along the way, but having a realistic viewpoint of how things might go is good. Meagan: Yeah. Kristen: Yeah. They ended up starting Pitocin and I was trying to go as natural as I could for as long as I could. I think I got to about 5 or 6 dilation and then I was like, Okay. I think I’m ready to just get a little relief. So yeah. I got an epidural. Again, then my brain switches over to how my induction births were different. With my son, I was cranking that thing up to 10 as high as it would go. It was my first time doing it. I didn’t know how it works. I ended up with him being flat on my back. I couldn’t feel my legs but with her, I was like, I don’t need to do that this time. So I was a lot more, that education. It helps having prior experience. But yes, it was as low as I could bear. I could still move around. I could sit up. I think I was even on my hands and knees for a little bit with it too. Meagan: Awesome. Kristen: Yeah. Having my doula there, she was wonderful helping. We were doing rebozo and stuff like that. Again, it was all of the good, natural stuff that I was looking forward to. Meagan: Yes. Kristen: Yeah, so I got myself to a 5 or a 6 and then I had a little help, but yeah it didn’t really take much longer after that. It’s hard to remember all of the details but once I got to a good place, they ended up breaking my water which was fine. After that, it only took a couple of hours to get her down and out. I pushed for 10 minutes and she’s here. Meagan: Nice. Kristen: She’s our biggest one, 8 pounds, 14 ounces. Well within normal range. Meagan: Yes. Kristen: But still it’s just so funny how the nurses react, “Oh my gosh. She’s big.” Not really. For you, maybe. I don’t know. Meagan: I swear. Anytime the babies are over 7 pounds, they are like, “This baby is huge.” I’m like, “No, the baby is not that big. It’s perfect.” Kristen: Right? I know. She had a full head of hair. That was their biggest comment. “Look at all of that hair.” It was so funny. Meagan: I love that.Kristen: But yeah, she was much more alert than my son was when he was born. Again, just different vibes, a different environment and a different style. Meagan: It probably wasn’t as long so he didn’t have as much in his system too. Yeah. Kristen: Exactly. Yeah, but it was one of those things where she came and then it was like, oh my gosh, that sense of relief. It went off without a hitch. In my mind, I was like, This was just perfect. 29:29 Changing plansMeagan: I love that you mentioned things along the way like change with induction. There are things within our labors and things that may not go exactly as we envisioned or wrote down on paper, but there are so often times where we can sit back and decide, Okay, yes. I’ll go for an induction. Okay, yes. Let’s try a Foley this time. Okay, I’ll actually go for that epidural. We’re changing plans or making decisions and in the end if we were part of that decision, it really resonates differently for our minds. We feel better about the experience even if it wasn’t exactly how we would have put it on paper. Kristen: Yeah, exactly. Meagan: I love hearing that you were like, Yes. This was a good experience and I got my doula and I had my provider and honestly, you were in a really great hospital. I really, really like them. 30:37 Myths about doulasMeagan: I wanted to share a little bit about doulas because obviously, I love them. Kristen: Sure, yes. Meagan: I am a doula and so maybe that is biased, but I really had a long labor myself and was able to truly benefit from doula support. Like you mentioned, my husband was exhausted and he got to a point where he was starving. He needed food and I remember he actually left the birth. He full-on left the birth to go get food. He felt very confident that I was in good hands and I was being supported. I love that so much, but there are a lot of things that people think about doulas that aren’t necessarily true. I wanted to go over some myths and then some really good pros and facts about doulas. Number one is that doulas are expensive. Now, doulas– Kristen: False. Meagan: It’s so funny because after services with our clients, a lot of the time they will be like, “You are worth your weight in gold. You need to charge more.” Kristen: Right. Meagan: When you see a doula who ranges from $800-$2000, that is a lot of money. That is a lot of money, but then when you break it down and look at really what a doula offers–Kristen: Totally, from start to finish, correct me if I’m wrong, you can hire them as early as you want and then, especially for me, it was the postpartum support that was a really big deal so it’s not just, “Okay, I was here. I helped you while you had your baby. See ya. Good luck. Let me know if you need anything.” No, “I’m going to bring you supplies.” Of course, my doula is a little bit more special because she was one of my friends. Meagan: But she is amazing. Kristen: She is. She is wonderful. Meagan: Her natural ability to care and help you feel supported, she–Kristen: Mhmm. She has this way of connecting with people that is quite rare, I think. Meagan: Yes. I love that. And myth number two is that doulas replace the birth partner. Kristen: Like we just both said, nope. They don’t. Meagan: I think that they help the birth partner. A lot of people don’t realize that doulas are there for our partners as well. It’s definitely more focused on mom because mom is giving birth, but there is a lot that partners go through during childbirth that really is important to be loved because you are in a very vulnerable state. You are watching someone who you love so much go through a very big event and they are also bringing another human into this world who is yours. There is a lot of fear and uncertainty and desire to help but again, uncertain as to how and needing rest and things like that. As doulas, we are never there to replace a birth partner ever unless that is something specifically where you are like, “Hey, my partner is not going to be here. I would like you to replace and be there in place of that.” But no, we definitely don’t do that. Myth number three, doulas are the same as midwives. Just before we started recording, I was telling Kristen how even to this day in 2024, people are like, “What do you do?” I’m like, “I’m a birth doula.” They’re like, “Oh you catch babies?” I’m like, “No. I don’t.” “Oh, you do this?” I’m like, “No, I don’t do any of that.”We’re not midwives. We are doulas. We are there for loving, educational support and information and all of those things, but we are definitely not trained midwives. We work with midwives and OBs. Another one is that doulas are only for the mother which is kind of what I was just saying a second ago. No, we are not only there for the mother. Doulas are hippies who chant and sacrifice chickens during birth. Kristen: That is quite the specific myth. Meagan: That is very specific. This is something that was on our blog, but it was something that someone said and we are like, Oh, yeah. Okay. This is perfect. We are putting this as Myth #5. Kristen: That’s hilarious, yep. Meagan: But really, we are hippy. We are hippy. Kristen: That’s funny. Meagan: Okay, maybe. Maybe doulas are a little bit more natural-minded. That’s true, but just because someone wants an epidural or even a scheduled C-section or doesn’t want to go in and do weird sacrificing of chickens apparently, I don’t know, that doesn’t mean it’s true. We don’t. We are there to support you and we are going to be there in the way that you want us to be there. Doulas only support home or unmedicated births. This is a big myth. So many people when I start telling them about what I do, they are like, “Oh, so you just only do home births.” I’m like, “Actually, it’s a rarity. It’s more rare to do a home birth than a hospital.” I would say that 97% of our births are in-hospital. As far as medicated go, we don’t support them, that is B.S. Kristen, you are living proof that that is not true.You guys, it is not for us to judge anybody on the way they birth. We are there to love and support them. If that means that they choose the epidural route, that means they choose the epidural route and that is great. We support them. So, no. If you are wanting to get an epidural and you don’t know if you want to hire a doula because you want an epidural, let me tell you. We as doulas do a lot actually with epidurals. Sometimes when there are epidurals at play, we actually have to work differently. It’s more in a different way because there is more to do as far as movement. You can’t just get up and move. Kristen: Yes, it’s true. Meagan: Right? Or being on hands and knees, you need that extra support. Whatever it may be, we are now restricted a little bit with movement so as doulas, we are going to be doing more with epidural. A lot of people think if I got an epidural, a doula is not worthless or it’s pointless. Go ahead. Kristen: Sorry to interrupt, but if I hadn’t have had my doula when I got my epidural, I probably wouldn’t have known if I could actually do certain positions. I was like, Oh, well I have this epidural so I’m not really supposed to move. No, actually you can do this. And laying down, due to my prior induction was like, I know it’s bad. Don’t lay on your back. She was like, “Well, actually if you sit yourself up just a little bit, you’re actually going to be just fine. This is actually okay. It’s like, “Okay. I’m so glad you are here. If you weren’t here, then maybe the nurse would have told me I’m okay or maybe she would have helped me. Nope, probably not. She’s got her own stuff that she’s doing.” Yeah, that was a really big deal for me too especially for a VBAC and an induction on top of each other. I’ve got so many things in my mind while you’re giving birth. I can get this baby out with no problems. I can do this. That’s where your focus is so having that doula say, “Hey, you know what? Change this a little bit,” and being there to support you in that way was awesome. Meagan: Absolutely. Absolutely. I love that you pointed that out. 38:55 Facts about doulasMeagan: Here are some facts. Doulas help you cut costs. There is a 39% decrease in the chance of having a Cesarean which is an increased cost a lot of the time. Some insurances are amazing, but there is that. There’s a 15% increase in the chance of having a spontaneous vaginal delivery which is non-induced. We know that induction is also an added expense. A 10% decrease in the need for any medication for pain relief, a 41-minute average reduction in the length of labor, a 38% decrease in a low 5-minute APGAR score, and a 31% increase in satisfaction for the overall birth experience. Holy cow. This is what a stat says on our blog. It says, “In the U.S., an epidural alone costs an average of $2,132.” Now, this was written back in 2021 and we know that since a lot of things in our lives have happened, things have increased. I would put money on that that is definitely more now for sure. There are a whole bunch of other facts on here. We’re not going to go over all of them, but I would encourage you to check out our blog. It’s going to be listed in the show notes. We’re also going to list in the show notes a couple of other groups especially if you are a special scar listener, we want you to know about an amazing group. Did you ever go to Special Scars, Special Hope? Kristen: I did not actually. Meagan: Okay, that is a Facebook group and honestly, it’s amazing for special scars. We’re going to link that. We’ll have a special scar blog so you can read more about special scars and their chances. Definitely check out the podcast even more for some more special scar episodes. If you are looking because you have a special scar, know that there are risks involved, but there are also very high chances that you can. You do need to find the support. Do you have any other tips, Kristen, that you would suggest for moms who may have special scars or gone through similar experiences like you where you were not even exactly sure what happened? 41:05 Kristen’s advice to other women with special scarsKristen: For me, it’s always come down to not just doing research by yourself, but take your time with everything. I think we get into this, I have to find this supportive provider right now and if it doesn’t work out the first time, then we get flustered and stressed about never being able to find the right person. If it didn’t work out the first time, then I’ll never be able to find it. I took my time and really tried to do my research honestly even before we got pregnant with our daughter who we had the successful VBAC with. As soon as I was mentally and emotionally ready to start thinking about having another baby, I was telling myself, I can do this. Granted, like I said before, no one is going to tell me no. That’s just my motivation. I know some people where that might be intimidating to think about. I just don’t know. That’s okay. Accept yourself where you are and go from there. If it’s something that you want to pursue, then do your research on providers and find women who have been there. I think that was a big deal for me knowing that, Oh, there are a pretty decent number of people who have had special scars like me. It’s not impossible to make it happen. Like we said about my particular provider, it’s almost like that cliche phrase, “When you know, you know.” Meagan: When you know, you know. Kristen: It’s like, Oh, I found my provider. That’s just how it was for me personally. I know it may not be like that for everybody, but yeah. You take your time. I’m sure you guys have had many, many episodes in the past where it’s like, I changed providers halfway through. It probably happens all of the time or more often than you think it does. Don’t be afraid to say, “You know what? I’m not feeling the support exactly how I want right now so it’s time to go a different route. Be confident in that. That’s it. 43:26 Listening to your intuition when choosing a providerMeagan: Absolutely. One of the things I want to talk about when you were saying that is even if you were with a provider that the world is saying they are supportive of VBAC– I want to take it personal and share my own experience. I was with probably the most supportive provider in Utah at the time and I felt very, very good but then there was something that was telling me I should switch. It seemed so weird. It seemed so weird, but I had to take the time to really ponder and listen to my intuition and I had to follow that. I couldn’t deny my intuition. I know Julie and I for years talked about it and I’m still talking about it today. Follow your intuition. Sometimes it might not make sense to someone else and that’s okay, but if it makes sense to you and it feels true to you, then follow it. Follow it and take your time like she said. Kristen: Totally, yep. That was a big deal and now that we found out that this is our fourth pregnancy now that I’m on right now. I’m pregnant right now expecting twin girls in August and who knows how this is going to go obviously, but I’m shooting for another VBAC. Here we go. Meagan: You’ve got this. Kristen: This is a very different scenario. Meagan: Very. Kristen: Every pregnancy is so different. They say that. You hear that all the time. “Every pregnancy is different. Every kid is different.” But I feel like seriously, okay. Everyone is so different. Meagan: You ring it real true. Kristen: So this is a totally new way to navigate this. From what I understand correctly, every birth after even if you have had a vaginal birth between like I did, I had a Cesarean and I had a VBAC, this is still considered a VBAC so this will still be considered a VBAC twin birth. Wish us luck and hopefully, I will have some updates later for you. I don’t know.Meagan: Yes, please keep us posted and congratulations on the pregnancy and congratulations ahead of time on your birth. Yes, please keep us posted on how things go and thank you so much again for being here with us. Kristen: You’re so welcome. Thank you, Meagan. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
46:2319/06/2024
Episode 309 How to Tell if the VBAC/HBAC Information You See is Real or Fake

Episode 309 How to Tell if the VBAC/HBAC Information You See is Real or Fake

Julie Francom joins Meagan on the podcast to talk about checking the validity of the information you see surrounding VBAC. There is so much information out there and so much misinformation that we want to help you figure out what is actually evidence-based! Julie and Meagan draw on their personal experiences with making corrections to information they understood and have shared. They talk about how the structure, size, and date of a study can influence the statistics. Julie shares why Cochrane reviews are her favorite.The VBAC Link is committed to helping you have the most evidence-based and truthful information as you make your birthing decisions. We promise to update you with all of the new information as we receive it!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 03:30 Checking the validity of social media posts08:01 Our corrected post about VBA2C12:56 The production behind a statistic or article18:37 Cochrane reviews19:06 Checking the dates of studies and emailing us for verification23:29 Nuchal cords25:21 Julie’s sleep training story29:45 Information at your fingertipsMeagan: Hey, hey everybody. Guess what? We have Julie today on the podcast. Julie: Hey. Meagan: Hey. We’re going to be doing a short but sweet, maybe also a little sassy because as Julie has said, she likes to get sassy these days. We’re going to do a short but sweet episode on how to tell if VBAC or HBAC or really just anything–Julie: Any. Meagan: Yeah, any information you see online is real or fake. Now, if you’re following along on our social media, you likely have seen a lot of our myth and fact posts. I think we share them probably once a week honestly because there really are so many things out there that are myths and things that are facts, but on a whole other side and a whole addition to myth and fact is really what should we be believing? What should we be resharing? Right, Julie? I think that this definitely is something that is close to our hearts at least I’m going to say is close to my heart. I think it’s close to Julie’s heart. Julie: Oh, for sure. Meagan: We want to protect this community and we want this community to find the real information, and not the false information. We know. You can Google anything. Julie: So much false information. Meagan: You can Google anything and find the real and false information but when it comes to VBAC, like she said, so much false information. We’re not even going to do a Review of the Week. We are going to jump right in in just a second after the intro. 03:30 Checking the validity of social media postsMeagan: All right, Julie. Are you ready to get spicy?Julie: Yeah, I think maybe the biggest reason we decided to do this episode and at least for me anyway why I brought it up is because there is so much information out there that looks good, right? You can be like, Oh my gosh, yes. This is amazing. We’re passionate. We as in me and Meagan, but we as in you too who is listening. Clearly, you’re passionate. But we really need to be careful what we’re sharing both from our business accounts and what we’re resharing from other people because sometimes if you share this information and it’s incorrect and wrong and it goes viral which there is a recent post that has and sparked this thing, and we’re not going to call anybody out, but when you share misinformation and it goes big and people start believing this incorrect information, it can really do damage to the efforts that we’re trying to make here which is increasing access to VBAC for everybody. If you have this entire group of people who think that their chances of having a VBAC at a hospital let’s say are 30% or something like that when really your chances of having a successful VBAC if you get to try– get to try I’m using very loosely– are really between 60-80%. Those are the numbers. But there was a post recently that went viral that said it was around 32% in the hospital and that is just simply not true. The post went viral and everybody is jumping on board like, Look how much better home birth is than hospital birth, but those statistics were very flawed from a flawed study that was super small from Germany 20 years ago. Meagan: Less than 2000 people. Julie: Yeah. Yeah. It could give you some pretty conclusive. Some, but it’s not big. It’s not a meta-analysis. It’s definitely not something to be definitive. It’s from Germany and there are a lot of flaws in the study as well. But everybody saw this thing, Oh, HBAC success is 87% and hospital VBAC success is 32%, or whatever the number was. People are like, Look how much better it is at home, and spreading this information which don’t get me wrong, having three HBACs myself, I love home birth. I love home birth after Cesarean for whoever feels it is appropriate for them, but I also know that those numbers are just wrong and if you share that information and these people believe it, they might be choosing HBAC out of fear. Meagan: Well, yeah. Absolutely. Julie: Instead of having the right information and making the right choice for them. I don’t know. That’s what we want to do here. We want to help you spot misinformation easier and learn to question the things that you see on the internet which sounds so silly. For me, I’m like, Okay. Let’s challenge everything. But I saw that post and my first thought was, Heck yeah. That’s crazy. I’m all for home birth but then I was like, Wait a minute. These numbers don’t feel right to me. Meagan: It doesn’t make sense. Julie: So then I dug a little bit deeper into it. We just want to equip you with knowledge so you are doing your best to get the most accurate information and spot the information that is not necessarily true. I think we are all guilty of it. I’m just going to keep talking, Meagan::. Meagan: I know. I was going to say really quickly. Just like what you said, you were like, Heck yeah, as someone who is passionate about birth or maybe someone who may have trauma. I’m talking about this specific post but really in any general post, someone who may have trauma surrounding the opposite of what that post is supporting, it’s so easy to just be like, Boom. Share. You know?Julie: Yeah, you’d be like, Oh my gosh, yes. I love HBAC. Let’s share this. Let’s increase VBAC. Everyone needs to hear this. This is important information. We get excited, right? Meagan: Right, but we need to do exactly what Julie said and take a step back and I mean, this goes for anything. It might be sharing the correct age of a child being out of a car seat. I mean, just random and you’re like, Yeah, that looks good. Boom. Share. Make sure that you are sharing the right stuff. 08:01 Our corrected post about VBA2CMeagan: So let’s talk about this. Keep going, Julie. I know you were on a tangent going into it. Let’s talk about how to understand if it’s real. Julie: Well, first of all, I think before we do that, I want to admit that we have been guilty of sharing, I don’t want to say misinformation because I guess it kind of was. A few years ago, we misquoted an ACOG bulletin about VBAC. Meagan: Yeah. Julie: It was me. I did it. It was me. I’m the problem, Taylor Swift fans. What had happened was that ACOG, in their bulletin about VBAC after two C-sections, cited two studies. One study that they cite– first of all, they say that VBAC after two Cesareans is a safe and reasonable option for parents to attempt and the decision should be patient-based. Anyways, so they cite two studies. One study that they cited about VBAC after two Cesareans shows no increase in rupture rates with VBAC after two Cesareans compared to one. The second study that they cited showed risk of almost double the rupture rate for VBAC after two Cesareans compared to one. It’s really interesting because they cite these two studies that are equally credible that had drastically different results. So when I made the post, I paraphrased the bulletin that said something to the effect of, “VBAC after two Cesareans shows no increase of rupture risk.” Now, that was only really kind of half true because I saw the study and I was like, Oh my gosh, like Meagan:: said, This is exciting! Everyone needs to know this. I made the post then we started getting some kickback on it and so we looked again because I was like, Oh, well I will show you where in the ACOG bulletin it says this, and then I went and I was just like, Oh yeah, it doesn’t say exactly that. I unknowingly spread this misinformation so what we did is we updated the post and we posted an additional post that was a correction because here at The VBAC Link, we want to make sure we are giving you 100% accurate information all of the time. The reality is that we are humans. We are going to make mistakes sometimes but as soon as we realize that we make these mistakes as long as they are actual mistakes and not just people wanting to talk crap, we’re going to correct ourselves. That’s the biggest thing. I want to say that it’s okay to not be perfect all of the time, but I think it’s also important that when you realize you’ve made a mistake that you correct it in the same space that you made it. Anyway, I just wanted to say that. Meagan: Yes, not wanting to shame anyone for being excited and making these posts. Julie: You should be excited. We’re excited. Meagan: Yeah. We were really excited to even see that post earlier and then we had to take a step back. It’s not to even shame that person. They are probably really excited to share that information but again, as a poster, one, take a step back before you share, and two, take a step back before you post. If you post and there is question which unfortunately there were a lot of questions on this post, change it. It’s okay. It’s okay to be like, Oh, I actually misunderstood this. Julie: Update it. I didn’t see this. Yes. Meagan: Or, I didn’t realize this wasn’t as credible as it felt. Julie: Or seemed. Right. Meagan: One of the best ways to find out of the research or the study or what you are looking at is really, really credible is if it’s peer-reviewed honestly. Right? Julie: Right. I think before you even go into that is if you see data or information like this post shared and it doesn’t seem quite right or even if it does seem right and you don’t see a source cited, ask for a source. Meagan: Ask for it. Julie: Mhmm, especially if they are throwing out numbers like, Home birth has an 87% success rate for VBAC and hospital birth only has 32%, everybody wants to get on board with those numbers, but there were no studies posted. There was no anything so I actually went on and made a comment. I asked about it and she posted four different studies. I was like, Three of these studies aren’t even relevant at all and this one where you are getting numbers from is incredibly flawed. I think it’s really cool to get on board with something that shows these fancy numbers, but it’s really important to at least see a source cited I would say. Bare minimum, see a source. Ask for a source and then go through and verify the source. Meagan, yeah. Let’s talk about what makes a source credible. 12:56 The production behind a statistic or articleMeagan: Yeah. Julie: These are just some things. Not all of these things are going to be true all of the time for a credible source, but these are things to look for and why they are important. Sorry, go ahead. Meagan: No, yeah. I think one is looking at who even produced it. Who produced this stat or this article or whatever? A lot of the time, someone who produced the article may not be the person who produces the stat or the evidence. That’s something to also keep in mind just because if Sally Jane at whatever company shared an article, it doesn’t mean that she’s not a credible person but I think sometimes when we are digging deep into what is credible and the real original source, it will take us to the original source which then we need to look at. ACOG, right? We pay attention to ACOG. Midwifery groups and things like this, we want to look. Who wrote it? I think one of the things is what is the full purpose? Julie: Yes. Meagan: One of those articles that I was reading actually wasn’t in relation to what the post was about. Julie: Exactly. Meagan: I don’t know if you saw that. Julie: Three of them. Meagan: The purpose of this article and the goal of why they are one writing it in general and what’s their ultimate goal in giving you the information. Julie: Right. Meagan: I mean, when I was reading one of them, I was like, Wait, what? Julie: And when she shared these four links and I called her out, I said, “These three are about this, that, and the other thing. They are not related to the other things that you posted,” she deleted all of the other information that she shared and just kept the one outdated German study up. I felt really salty then. I still feel a teeny bit salty about that. But yeah, I feel like asking the author and the poster. I know that at The VBAC Link, when I was there, I tried to really make sure that we did this and I feel like you still do but whenever we post anything with stats or numbers or anything like that, we try to post a source with that every time. Meagan: Yeah, for sure. Exactly. Julie: It’s in the course like that. Sorry. I feel like we are going in different directions there so circle back. Meagan: Yes. I think you really need to break it down and look at the ultimate study. If it is saying that you have a whatever success chance of having a VBAC in the hospital or having a VBAC in general and you’re looking at the stats, if you’re looking at a review that has 9,000 people and then there is another one that has 400,000 people involved in that study, to me, automatically I’m going to be looking at the difference there because to me, 9,000 is a lot but this one was less than 2,000 specifically. Julie: Right. Meagan: So when we’re looking at big studies, if you have a very small control group, it’s just not as credible as some other sources. Julie: Right. 18:37 Cochrane reviewsJulie: What I really love is when I can find a Cochrane review of something. Cochrane reviews in my opinion is the most credible place because what Cochrane reviews are is they are a meta-analyses of a bunch of different studies. What they do is they find a whole bunch of different studies or research papers or evidence or just huge collections of data. They go through and pick them all apart and find out which ones are credible or which ones are not credible and then they compile the results in those studies to have a bigger meta-analysis which is a collection of a whole bunch of credible studies pulled apart and data presented. I love if I can find a solid Cochrane review because I know that is just about as credible as you can get. Also realize that most studies have flaws and limitations like Meagan:: was talking about. Who is behind the study? Who funded the study? Who contributed to the study? What were the study controls? How many variables were there? Because if you have a study with more than one variable, then your numbers are going to be skewed anyway because these different variables may influence each other. If you have, for example, the ARRIVE trial. The ARRIVE trial we know had flaws. I’m not going to go over all of them but they were funded by a doctor at a hospital whose goal was to show that induction provides the same or better outcomes than waiting for spontaneous labor. That was the intention of the study. When you go in trying to prove something, you’re already introducing bias into the study and you could bring protocols or procedures into the study that might not be realistic in the real world that could influence the results of the study which is one of the things that actually happened in the ARRIVE trial. A lot of studies I feel like could be picked apart and torn apart which is why I really love Cochrane reviews and meta-analyses is because you can compile all of these and get more accurate results and information. Also, here’s the thing with that study, that one study that she showed that had less than 2,000 people and is 20 years old and is based in Germany, that’s not going to be relevant in the current day in the United States. Meagan: That’s another thing that I wanted to bring up. 19:06 Checking the dates of studies and emailing us for verificationMeagan: How long ago was the study? If the study was done in 1990 and we are now in 2024, there is a large chance that things have changed either way. Maybe in favor of that or the opposite. Julie: Right. Meagan: So we need to look also at the date. If you are looking at something and here at The VBAC Link, we know we have stuff that was even published in 2020 that there may be a new article out in 2022 or 2023 and we need to stay up to date on these things so it is so important to also look at that date because something 20 years ago or even 10 years ago, that might actually be the most recent study. Julie: Yeah, and if that is, that’s all you can use. Meagan: Right. Right. There’s that. But there may be a newer study. So again, before just clicking “share” or “create” or something like that, it just goes back to stepping back and looking at it. Let me tell you, Women of Strength, right now, if you find a study online and you are like, Wow. I am really, really curious about this post or about this study or whatever it may be, but you are unsure, email us at [email protected]. Email us. We will help you. We will help you make sure to break it down and tell you the efficacy. Julie: The corrected-ness. Meagan: How efficient and correct it is. Julie: I don’t think efficient is the correct word. Accurate. Meagan: Accuracy. Julie: Oh my gosh. You should listen to us. We know how to speak. Meagan: Email us, you guys. I don’t even know how to use my words but I can tell you how to break down a study. No, but really. Accuracy. That’s the right word. Thank goodness for Julie. Julie: I think that maybe a more appropriate thing for her to have said in that post would be like, “Your chances of having a VBAC are higher at home than in a hospital.” That is accurate, 100% because it is true. Out-of-hospital births, at least around here in Utah. I can’t speak to other parts of the country so maybe I should say that. Around here in Utah where we are, I can confidently say probably in other parts of the country too, when you have a skilled home birth midwife and you are a low-risk pregnancy and VBAC does not make you high-risk P.S., you have a much higher chance. Now, there are no studies done here in Utah, but we have seen a lot. I mean, there is this Canadian home birth study that was just done that took a look at VBAC as well that showed some similar things but we know that the American Pregnancy Association says that women who attempt a VBAC have between 60-80% chance of getting a VBAC. Now, around here, we in our birth centers and out-of-hospital births and home births see over 90% of that success rate in all of the midwives and stuff like that who we have seen and talked to who have shared their data with us. That is good data. Meagan: It is pretty high here. We are lucky here. I have only seen out of 10 years of doing births two VBAC transfers and actually, the one was because she really just wanted an epidural. That’s the only reason why she left and the second one was because we did have quite a stall. I think it all was a mental thing. I think she actually needed to be at the hospital and then they still had VBACs so that’s great. Julie: For sure. I’ve seen one transfer, but that cord was wrapped around that baby’s neck four times and they had to cut the cord before they took the baby out via Cesarean. Meagan: Whoa. 23:29 Nuchal cordsJulie: Nuchal cord, a cord wrapped around the neck most of the time is not a need for a Cesarean, but this mom pushed and pushed and pushed at home for hours. We transferred and got her an epidural. Baby’s heart rate started to not do good. They took her back for a C-section. The cord was wrapped around its neck four times and they couldn’t even take the baby out because it was wrapped so tightly. They had to cut the cord in four places before they could pull the baby out by C-section. Meagan: Wow, wow. Julie: Wild, right? That was an absolutely necessary Cesarean. That baby was not coming out. Absolutely necessary. And things like that are going to happen and it’s cases like that where we are so grateful for C-sections. This is one of those things where if it had been 300 years ago, mom and baby probably would have died because that baby was so wound up in there. This was one of those true cases. Most of the time when people say that, it’s not true in my opinion. Don’t cite me. Meagan: Okay, well the true takeaway from today’s episode is to check your facts and if you see something that doesn’t feel right, check it again but don’t just share it and ask for the source if there’s not a source. Check if it’s peer-reviewed. Check if it’s a Cochrane review and all of these things. Again, check the date. Check the amount of people who were in it. Really do your research and if you do have a question, please do not hesitate to email us at [email protected]. We’d be glad to help you decipher if that is a good and factual or not-so-factual article or stat or whatever it may be. Julie: Whatever it may be. 25:21 Julie’s sleep training storyJulie: Do you know what is funny? Let me throw out another example really fast and then we will wrap this thing up. Years and years and years ago, nine years ago– my first VBAC baby just turned 9. After he was born, oh my gosh. All the things. I had all of the mental health things. One of my biggest things was that I thought, this is probably going to be a little controversial. I thought that in order to be a good mom, I had a checklist because I wasn’t going to have a NICU baby. I wasn’t going to have the same situation. I thought it had to be completely different. I had to breastfeed. I had to go and get him every single time he cried right away instantly and drop everything. I thought I had to do all of these X, Y, and Z things. What is that method called? It starts with a W I think. Anyway, it’s kind of a modified version of crying it out. You let them cry for a minute and then two minutes or whatever. It worked really well and he is still my best sleeper to be honest. I thought, Oh my gosh. I am so bad. I can’t believe I damaged my child. Yada, yada, yada and there are probably people listening right now who are like, Well, you did damage your child by doing that. But anyway, he’s damaged for other reasons but not that one. So with my second, I wasn’t going to do it because there was a study that showed that babies who were left alone to cry it out had the stress part of their brain remain activated up to an hour after they stopped crying and all of these things. I was like, Oh my gosh, I can’t believe I did that. I’m the most horrible mom ever.Clearly, I think differently now, but I paid a postpartum doula to come in and help me learn how to gently encourage them to sleep. Well, it turned out my stinking baby would cry in his sleep. He would cry while he was sleeping. Meagan: Oh, no way. Julie: I would go in there and I would be like, Oh, super mom to the rescue. I would pick him up and wake my baby up who proceeded to cry for two hours because he couldn’t go back to sleep because I was waking him up. Anyway, it was this whole thing. I know, stupid right? Every baby is different. But my point is that this study which everybody was sharing about the damages of crying it out and how we are damaging our children and they are going to grow up to be people who feel unloved– that was the thing. Do you remember that? Do you remember that? It was 9 years ago or so, maybe a little bit more recently than that. The study had four babies in it. Four, Meagan::. Four babies. Meagan: Four? Julie: Four. And these babies were in a hospital environment in those little plastic bassinets so not only were there only four babies, but they were monitoring them in an environment that is unfamiliar and not letting their caretaker come in and soothe them at any time during this study. Meagan: What? Julie: Yes. Don’t let your baby cry until they throw up for sure. Go and soothe your baby, but four babies in an unfamiliar environment without their caretaker there at any part of it. Meagan: Wow. That was enough to say that that was– Julie: Yes. This is where all of these advocates for not letting your baby cry at all got their information from. Isn’t that ludicrous? That is insane, right? Meagan: That is insane. That just means that we need to take a steb back, look at what we are sharing, don’t just share it, and always look at the study. Always, always, always look at the study. Julie: Absolutely. And look at the damage that did to my mental health and not only me, everybody else’s. I know I’m not the only one. So seriously, dig in deep and trust your intuition and follow your instincts. You know what’s right. Going on the tangent for your baby, but also if you see something that feels a little strange or is showing numbers without information, ask for evidence. Ask for proof. Where did you get that information from? 29:45 Information at your fingertipsJulie: Because we have, I will say this and then we will close it up. I promise. I hate it when people say, “Oh, don’t confuse your Google search for my medical degree.” Well, that’s B.S. because do you know how many times I’ve seen doctors Google something while I’ve been in their office? Yeah, for real. First of all, not saying that a Google search is the equivalent of a medical degree at all. I know way more goes into that. But, we have access to the largest database of information that was ever existed in the entire history of humanity. We have access to Google. There’s Google. There’s Google Scholar and if you know how to distinguish between credible versus non-credible information, there is so much power in a Google search that you can use to help you in anything you need to know. Anything in the entire world. Should you have a doctor? Sure. You absolutely should. But also, you know yourself and you have access to all of this information and it’s a very powerful tool that we have and we should be really grateful for it because we don’t have to rely 100% on other people with a different knowledge than us anymore. So don’t discount that. Don’t discount your ability to find out if something is credible or not because you have access to that power at your fingertips. It’s pretty freaking amazing. Okay, done.Meagan: It is. Okay, done. All right, Women of Strength. We are going to let you go. We said it was going to be a quick one. It really was and hopefully, you got some information and will feel more confident in going out and looking at all of the many things that it said about VBAC. I honestly think that is another reason why we created our course, Julie, because we were so easily able to find so many things that were false out on the internet and we wanted to make sure that all of the real, credible sources were in one place. So find those places, you guys. Check out our blog. Check out the podcast. We have lots of links. Check out our course. So many amazing things. So many great stats. And hey, if you find a stat and find something within our blog and you are like, Oh my gosh, I’ve seen something new, let us know for sure. We want to make sure that the most up-to-date information is out there. So we do not hesitate to take any suggestions. If you see something, question us for sure. Please, please, please because like Julie said earlier, sometimes people misunderstand or misword or whatever and we want to give them credit but we really want to make sure that the right information is given to you. Julie: Absolutely. Meagan: Without further ado, I’m going to say goodbye and I love you. Bye. Julie: Without further ado, we will say adieu. Meagan: We will say goodbye. Julie: Bye. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan::’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
33:0417/06/2024
Episode 308 Shannon's VBA3C + Doubt From Her Delivery Team

Episode 308 Shannon's VBA3C + Doubt From Her Delivery Team

“I did it. They said I couldn’t, but I did it.”When planning for her VBA3C, Shannon got just about as much kickback as someone can get. She was ambushed. She was coerced. She was given the scariest information. Shannon joins us from England today and talks about how each of her four births brought her to where she is today. By the time she was pregnant with her fourth, she was ready to advocate. She was ready to fight for something she had never gotten to experience. Though none of her providers were supportive, Shannon stayed grounded. She made her desires known and stood by them. Shannon labored unmedicated for just over 14 hours. Then to everyone’s surprise, she pushed her fourth baby girl out vaginally in 14 minutes!The VBAC Link Blog: Is VBA3C Right for You?The VBAC Link Blog: VBAMCHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 04:04 First pregnancy and birth08:31 Second pregnancy and scheduled repeat Cesarean10:56 Third pregnancy14:04 A heartbreaking third Cesarean17:42 Postpartum during COVID19:55 Fourth pregnancy24:37 Getting ambushed28:40 Shannon’s VBA3C birth36:32 “We are all so proud.”38:30 VBAC after three CesareansMeagan: Hello, hello. You are listening to The VBAC Link. We have our friend, Shannon. Are you from England? Where are you?Shannon: England, yeah. New Cambridge. Meagan: Okay, see? I’m so glad my mind is remembering. You are in England and you guys, she is recording. It is quite late there. She is such a gem to stay up and record and share her VBAC after three C-sections. Shannon: Three. Meagan: Yes. Her fourth was a vaginal birth. Uno, dos, tres. I can’t even say. I can’t even pretend that I know Spanish. Let’s be honest. So three, you guys. After three Cesareans and we know in our community that this is definitely something that people want to hear. People want to hear these stories because it is harder to find the support. They want to hear what people are doing, how they are navigating through, where they are finding support, and what they are doing to have their vaginal birth after multiple Cesareans. We are excited, Shannon, for you to share your stories today. 01:07 Review of the WeekMeagan: We do have a Review of the Week so we’re going to get into that and then we’ll dive right in. Okay, so this is from morgane and it says, “I’m Not Alone.” I love that title because Women of Strength, you are not alone. This community is so incredible and we’re all here for you. It says, “This podcast has provided so much comfort for me in coping with my unplanned Cesarean and now planning for VBAC in March. The transition to motherhood has been somewhat lonely for me since most of my friends are not mothers and hello? Pandemic.” So this is a little bit ago, right? It says, “I am also an aspiring doula and spurred on by these ladies and their work. So thankful I stumbled across this group.” Oh my gosh. It says, “Us women really are strong.” I love that. Us women really are strong. I could not agree more. You guys, you are strong. You are capable and you have options. If that is not anything and everything that we talk about on this podcast, then I’m doing it wrong and you need to let me know on your next review. As just a constant reminder, if you wouldn’t mind leaving us a review, that would be so great. You can leave it on Apple Podcasts, Google, or you can even email us. 04:04 First pregnancy and birthMeagan: Okay, Shannon. Uno, dos, tres– three. I’m saying it correctly now. After three Cesareans, you have had quite the different journey with each birth. Shannon: Yeah. I think each one taught me a little bit more and I probably wasn’t ready for a vaginal birth with my first three. I think that while looking back on my journey it’s difficult, I think it led me to where I am today. Meagan: Me too. I’m right there. Amen. Same. I love birth and I’ve always loved birth, but I do not think that I would be here right now with you today if it weren’t for my experiences. Shannon: Yeah. I think the same. I’ll get into where I am now when we’re after my fourth, but had it not happened the way it did, I wouldn’t be where I am now. Meagan: Who you are today. We grow and we learn and we inspire and here you are sharing your story. So let’s talk about baby numer one.Shannon: Okay, so I was 19 when I had him. I just assumed that he was going to come out that way, that he was going to come out vaginally. It was going to go well. There were going to be no complications and it didn’t turn out like that. I was due in the end of May and I think I was about a week over due. I went into the day unit here. It would be just where you would go if you had concerns that were slightly more than you would go to your midwife for but not enough that you would need to go to the labor ward for. Meagan: Kind of in between? Shannon: Yeah. Here, you have a midwife who is assigned to your GP surgery, your doctors, and they are usually who you see throughout. It’s supposed to be a continous midwife, but it can chop and change. You don’t see that midwife usually in the hospital so you deliver with someone completely different. Meagan: Oh, okay. Shannon: Yeah, so you don’t get that continuity of care in labor. So I went to the day unit because I was having some hip pain. It was really difficult to walk and because I was overdue and I was already booked in for an induction purely because I was overdue, they brought my induction forward. I think I was 8 days overdue when I went in. I was induced. I had the pessary induction and it worked pretty quickly. It worked within about an hour, an hour and a half. Meagan: Oh wow. Shannon: They didn’t believe me. They told me that it couldn’t happen that quickly. Meagan: That’s not super normal but it can happen. Shannon: They sent my husband home and left me on my own for three hours before they summoned me. I was 5 centimeters which is when they take you over to labor ward. I was wheeled over. I called my mum and my husband. Then it’s kind of a bit fuzzy. I don’t remember a lot from his birth. I remember that they broke my waters and there was meconium. They put the monitoring clip on his head. Meagan: The FSC, the fetal scalp electrode? Shannon: Yes. They put that on him and I was managing fine on the gas and air. Meagan: Was it nitrious? Shannon: Yes, yeah. Meagan: Okay. Shannon: Yes, the gas and air. It was about 3:00 in the morning and they told me that the anesthetist was going home and if I wanted an epidural then that was my last chance. I felt pressured so I got the epidural. All stalled from there. I didn’t move off the bed. I think I got to 10 centimeters at 10:00 the next morning so I’m now 9 days overdue. I pushed. Nothing happened. They wheeled me to theatre. I think I started pushing at 11:00 and he was born at half 12:00 so lunchtime. He was a big baby. He was 9 pounds, 13. Meagan: Okay. 08:31 Second pregnancy and scheduled repeat CesareanShannon: That was that. I recovered and didn’t think anything of it. 18 months later, we decided to have our second. I fell pregnant I think within the first month. It happened quite quickly. I did my research. I wanted a VBAC. I actually got signed off for an HBAC.Meagan: Home birth? Shannon: Yep. It was all going fine. Then I got to 32 weeks and I panicked because my mom is our only childcare and she lives about an hour. I didn’t know how quickly I would labor because I had never labored spontaneously. I didn’t know what was going to happen. So I booked a routine section. That was booked for 39 weeks. At 38 weeks and 3 days, I went into again, the day unit because I had reduced movements. They put me on the monitors and his heart rate was quite erratic. It wasn’t settling. It was either quite high or quite low. There was no middle ground. I think they put me on there for about 4 hours and they just weren’t happy so they brought my section forward to the next day. Meagan: When I read your note, I’m like, I don’t know why, but that got me. If baby’s heart rate is that erratic and they are that concerned, it would be that day and then. Shannon: Yep, but they were happy for me to go home and come back the next day. Meagan: Yeah. Yeah. It’s just convenience. It seems, I am not going to say, but it seems like it was more of like, Well, it’s already going to happen so we will make it for tomorrow. We’ll give you this as a good reason why to validate it. Shannon: Yeah, no I agree now. At the time, I don’t think I thought about it like that. Meagan: Of course not, no. Shannon: Yeah, because with my fourth, with my VBAC, I went through a lot of what happened before. I definitely think it was a case of they didn’t want me to come back with more reduced movements and just sit there so because the section was going to happen anyway, they just thought– Meagan: Mhmm, let’s do it. Let’s move it up. Shannon: Yes. He was born at 38 and 4. He was 10 days early and he weighed 8 pounds, 11 ounces. Again, he was quite a good size. Meagan: At 38 weeks, yeah. 10:56 Third pregnancyShannon: So then we decided to have a third. It took us a long time to get pregnant with her. It took us 14 months which was our longest conception. Our first one was four months and then a month so it took a while. She was due the 11th of April, 2020. I got to, I think it was about 30 weeks when talk of the pandemic was rolling in. We were like, Oh, it’s fine. We don’t need to worry about it. And then it all blew up. I had to go to midwife appointments alone, the hospital scans alone because I had to have growth scans because my babies are big. Everything was fine. I did want a home birth again with her, but they kept me waiting. I wasn’t signed off until 37 weeks. They kept me waiting a long time to sign me off for that, but it was all signed off and we were good to go. I was feeling good despite the pandemic because we were in lockdown by the time she was due. I think the lockdown was called a month before she was born. Lockdown here for the first time was called on the 23rd of March and she was born on the 23rd of April. I remember I went into hospital and I had a growth scan at 40 weeks. She was absolutely fine, no issues. She was measuring fine. The water levels were fine. The placenta looked good. They gave me a sweep and sent me on my way and said, “I don’t think I’ll see you next week. You’ll have this baby by the weekend.” It didn’t happen. I got to 41 weeks and I went back for another routine growth scan. I remember going in the car on my own obviously and I felt good. I thought that they were going to say that everything was fine again and that they were quite happy for me to just carry on. It didn’t go like that. I should probably mention that my hospital’s policy is that if you haven’t had your baby by 41 and 4, so 41 weeks and 4 days, they either induce you or they give you a section. That’s their policy. I had this growth scan at 41+3. I went in, had this growth scan, and I was on my own. I didn’t have any support. It was about 3:00 in the afternoon. She scanned me. In a week, my placenta had aged. It calcified and it was failing. Those were the reasons she gave me that she needed to get my baby out the next day. She gave me the pre-op swabs. She took my blood and she basically told me to come back the next day at 11:00. I had no time to prepare. I had no time to research. I had no time to ask questions. It was, “This is what’s happening. You’re going to do it.” Meagan: See you tomorrow. Shannon: Yep, basically. Meagan: Was baby’s heart rate struggling? Shannon: No, she was fine. Meagan: She was fine. Shannon: She was fine. There was no reason at all. Meagan: That’s interesting. Okay. 14:04 A heartbreaking third CesareanShannon: Then it was a mad dash too because I am the only driver in my house. My husband doesn’t drive. Obviously, having a section means we can’t go anywhere. Meagan: Yeah, and during the pandemic on top of all of it. Shannon: Yeah. It was a mad dash that night to get enough food in. House deliveries were like unicorn dust so to get enough food in, I had to arrange childcare with my mom. Otherwise, I was delivering alone. Again, she still lives an hour away in a different county. We were sure what the rules were because here, you weren’t allowed to cross county lines. Meagan: Oh no way. Shannon: Yep. It was difficult. She did come up and she did look after the boys. I did see her before I went into delivery, but I didn’t see her again until baby was 6 weeks old. She had gone home by the time I came home so that was difficult. I went in. I think I got to the hospital at 11:00. I was pulled down to theatre at 2:00 and baby was born at 3 minutes past 3:00 in the afternoon. She weighed 9 pounds, 4 ounces, so again, she was a good size. I got back to the recovery ward. My husband stayed with us for an hour and then he left. He wasn’t allowed to come back. I still had my catheter in. I was still numb. My phone was dead and I was just left because I couldn’t get anything. Every time you had to call a midwife in, they had to put in new PPE on and it just took so much longer. I didn’t get wheeled around to the actual recovery ward until about 1:00 in the morning. They admitted to me that they had forgotten about me. I was just in this room on my own. Meagan: I’m so sorry. Shannon: Yeah. They wheeled me into recovery. I still had the catheter in. That didn’t come out until 7:00 the next morning so I was bed-bound with this new baby. They came around and took my observations. My temperature was raised which is normal after a section, but I was told that I might have COVID, that my baby might have COVID. I would need to be separated from my baby and we wouldn’t be able to leave the hospital for 3 days. Meagan: Stop it. Shannon: No, honestly. Meagan: I am feeling very frustrated for you right now and very saddened. Yeah. I feel a little enraged because this shouldn’t have happened. These things didn’t need to happen to people. Shannon: I know and the more that I talk to other people who have had babies during the pandemic, it’s not unusual either. Meagan: No, it’s not. It’s maddening. Shannon: It is. It’s strange now to talk about it without either filling up or actually crying because it has taken me a long time to get to this point. Meagan: To process. Shannon: Yeah. She said she would come back in an hour. I remember, obviously, I had my catheter in so I didn’t have to get up and go to the toilet. I was just downing water trying to get my temperature down. She came back at 4:00 and I did get my temperature down because I didn’t have COVID. It was a strange experience. There were six beds in this ward, but I was on the end bed and there was a woman diagonally to me and there was a woman two beds over and that was it. There was no one else there. It was eerie. It got to the point where I couldn’t do it anymore so 26 hours after my baby was born, I discharged myself and I went home. I was not staying in there any longer. 17:42 Postpartum during COVIDShannon: Even after that, I got home and I spent the first week in tears. Motherhood wasn’t new to me. She was my third baby, but giving birth during a pandemic was a completely different experience. I don’t know what it’s like over there, but here you have a midwife check in at day 3 and day 5 and then you get signed off at day 10 by the midwife then you get sent to a health visitor who then looks after you until your baby is about 5 then they go to school. Meagan: Wow, I like that. We do not have that. We are just told, “We’ll see you in 6-8 weeks. See ya.” Shannon: Oh. Meagan: Then you just go home. Yeah. It’s very different for a lot of home-birth people, but that’s how the hospital is. It’s like, “We’ll see you in 6-8 weeks and we’ll see you then.” That’s really it. Shannon: That’s interesting. I didn’t know that. Meagan: Yeah. It’s not great. Shannon: No. So on day 3 and day 5, I had to go to a clinic. They usually go to your house especially if you’ve had a section, but because of the pandemic, I had to go there, and being the only driver– my husband can drive. Meagan: You can’t even drive after a section, really. Shannon: My husband can drive but we had to stick the old plates on. We made it there but it wasn’t great. Yeah, we did that. We do have a 6-week check. It’s with a doctor. That was over the phone and then you get introduced to your health visitor. Normally, they come over to your house. That was on the phone. And then that was it. We were just left. No one met her until she was 6 weeks old. She was the first granddaughter because I’m the oldest and my husband is an only child. She was the first granddaughter after two boys. No one met her until she was 6 weeks old. I spent the first week in tears trying to process everything that happened. It was a difficult time. After that, we said we didn’t want another one so we locked it away somewhere and didn’t deal with it. 19:55 Fourth pregnancyShannon: And then we decided to have a fourth. I had to come to terms with it. This is the reason why I’m here now. I found out I was pregnant in October 2022. It was a difficult journey to get my VBAC. It was the biggest fight that I’ve ever had to do. When you find out you’re pregnant, you contact your GP surgery and then you are assigned a midwife. The midwife I had this time was the same one I had with my third pregnancy, but the first appointment, she was actually off so I saw someone completely different and she was horrible. I only live 9 minutes from the hospital. Meagan: That’s really close. Shannon: Well, I know from listening to your podcast that women travel for hours. Meagan: Way far, yeah. Like to other countries sometimes even. Shannon: Yep, but 9 minutes was too far for them. She said that 9 minutes was too far. The paramedics might not get to me in time. If I bleed out, I’m going to die. If baby gets stuck, I’m going to die. I’m putting my birth experience over a live baby.Obviously, they know I care about the safety of my baby but that’s obviously their job. I left that appointment in tears. It was a great start. It didn’t improve from there, really. I think spent the next, I think your booking-in appointment is about 8-10 weeks so I then spent the next 30 weeks listening to your podcast, and researching stats, risks, benefits, and percentages. I lived, breathed, and slept statistics for VBACs because she probably 99% is our last baby. We’ve now got two of each so we don’t need any more. I knew that this was my last chance to get the birth that I wanted. Off the back of my booking-in appointment, they referred me to the consulting midwife at the hospital. She is higher up than a community midwife or just a midwife on the ward but not quite the head of midwifery. She’s kind of somewhere in the middle. I had a few appointments with her and while it was beneficial, it still felt like I was banging my head against a brick wall because she wasn’t listening to what I wanted. Every time I would come back with a statistic or a risk that she had– like if I corrected her, then I’d just get a “Mhmm, yeah. Okay,” or a patronizing nod. Meagan: Like, Yeah, sure. You think you know what you’re talking about but you don’t. Shannon: Yeah, kind of. At this point, I was 28, a mother of three and I was about to have my fourth. They were treating me like a child or that’s what it felt like anyway. So I went to every appointment knowing that’s what I wanted. I read off my stats, my risks, my percentages and told them I wanted a home birth. They again weren’t for it. They tried everything they could to get me into the hospital. We have a midwife-led unit and we have the labor ward. The labor ward is more for ordinary births like if you are going for the epidural and you want the more hospitalized birth whereas the midwife-led unit is more of a hands-off. That’s usually where the birth pool is. Meagan: If you want more of a medicated versus unmedicated, those are the differences here. Shannon: As a VBAC after three sections, normally there would be no way on earth that they would have signed me off for the midwife-led unit. I was too high risk. However, to get me into the hospital, they signed me off for the midwife-led unit. Meagan: Nuh-uh. Shannon: Yeah. That’s the option they gave me because I was close enough if there was an emergency, but I wasn’t too far away. That was their trump card. Meagan: Okay, okay. 24:37 Getting ambushedShannon: I still said no. I still wanted a home birth because that hospital was the one I had my daughter at during the pandemic and I did not trust any of them after being lied to by the consultant and coerced into having that third section. I just didn’t trust them to do what I wanted. Meagan: Yeah. It makes sense. Shannon: Pardon? Meagan: I said it makes sense that you didn’t feel that they were completely trustworthy. Shannon: So then I got to 36 weeks and I had a routine midwife appointment at 36 weeks. I walked into the room and my midwife was there but so was the head of community midwifery. I wasn’t told she was going to be there. I was ambushed. She basically said to me that– I have it written down because I made a post at the time. She said that basically, my baby would die if I carried on with my plans to home birth, that there was a risk of shoulder dystocia, and hemorrhage that would both result in death. A delay in the paramedics getting to me so that would be death. I didn’t want a cannula inserted as a routine at the hospital so that would be a risk factor. I have a high BMI so again, that goes against me and they said I had low iron because I was refusing blood tests so that again was something that went against me. I was told that if I hemorrhaged and lost around two pints of blood that I would die, that my veins would have shrunk so they wouldn’t be able to get a cannula in me. I was told that they wanted to send three midwives to my birth. They normally send two but for some reason, they wanted three. I was told that my previous experience should be put to one side because it happened during COVID and it’s not representative of how it is now. I was told that I was making the entire midwifery twitchy. Meagan: Oh my. Shannon: Oh, the midwife I saw at the first appointment, the one who made me cry, she was one of the ones who was on call and they told me if she was on call, would I go to hospital and I said, “Maybe.” In my mind, I’m thinking that they were trying to put her on rotation to get me into hospital. Meagan: Sneaky. Shannon: Yep. I was told that the head of community midwifery’s responsibility is to make sure I’m comfortable with the risks but it’s also her responsibility to make sure her midwifery team isn’t traumatized by my birth. I was also told– oh, they wanted my husband to be at the home birth assessment as it’s their responsibility to make sure he is aware of the risks of death so he is not traumatized like I hadn’t spoken to him about any of this. Meagan: Oh my gosh. Oh my gosh. Shannon: On my way out of that appointment, my midwife, the one who had supported me as best as she could said to me that she can’t wait until I give birth so that it’s all over. Thank you. Meagan: Oh my gosh. Shannon: Yeah. So that was that. Meagan: Wow. What a way to feel loved. Shannon: I know. Again, I had to go to these appointments alone because my husband was home with the three kids, and my mom, again, lives an hour away. I don’t have the support here so I had to go to these appointments on my own and to be faced with two midwives who are just coming at you with these scary statistics, it felt like I was ambushed.I think I sent an email then and complained. I got this really lengthy email back but it was basically filler but it had happened already. 28:40 Shannon’s VBA3C birthShannon: Yes. So, my birth. She was due on the 1st of July but I always thought she would be due somewhere between the 25th of June and the 28th of June. I remember the 27th of June, I needed to go and get new brake pads and discs put on my car. It was the last thing I needed to do. I sat in the mechanic’s feeling a little bit uncomfortable and a lot of pressure. I think I was about 39+3 at that point. I was just really uncomfortable. I sat there for about two hours and I was just like, Ugh, why is this taking so long? Meagan: You were ready to move on. Shannon: Yeah. The next day, my husband went into the office and I remember messaging him, I think you should have stayed at home today. Something just doesn’t feel right. I feel a bit off.I woke up on the morning of the 29th of June and I had hip and leg pain which isn’t unusual for me. I’ve got hyper-mobility syndrome so my joints are extra bendy anyway so to wake up with pain is quite normal, especially in pregnancy. It was half-7:00 in the morning and my husband thought it would be a really good idea to cut his hair for him. It’s half-7:00 in the morning. I’m nearly 40 weeks pregnant and I was doing his hair. Then I felt a twinge. I was like, I don’t recognize that pain. I’ll keep an eye on it. They turned into contractions. I had my first contraction at half-7:00 in the morning and they got stronger. I said to my husband, “I think you need to sign off now. This is it. It’s happening. I’m going for a bath to see if they go away or if they stay.” We had a food delivery come in that day. We had an Amazon delivery come in and we had I think the carseat base was coming in as well that day. So in between my contractions, I was having to go to the door a deal with all of this stuff that was going on around me. The contractions stayed and they didn’t peter off. They just stayed. At this point, I was on all fours in the living room mooing like a cow which is bizarre because, with my first one who was my only experience of labor, my mum said that I was eerily quiet. It was different to make noise this time. My husband rang my mom and let her know what was happening and then he rang the hospital. They told me that the home birth service wasn’t available that day so I’d have to come into hospital. It was only after he told them my name that that happened. We’ll leave that just hanging there. Meagan: Yeah. Shannon: Then I burst into tears because I thought that as soon as I go into hospital, that’s it. I’m not going to get my vaginal birth. They’re going to find some reason to section me and that’s it. My mom came and drove us to the hospital. She was staying with the kids anyway. I think I got to the hospital at about 3:00 in the afternoon. They examined me and I was 4 centimeters so I was allowed to stay. They took me into the room and I stayed there until I had my baby. I just labored. I don’t remember a lot of it to be honest. When they say you go to another place, you go to another place. Meagan: You do. Shannon: The gas and air were amazing. I did try the birth pool but we had an issue here where they had to have air vents fitted in the rooms with the gas and air and they weren’t done in the birth pool. I was in the birth pool for about an hour, but I wasn’t allowed the gas and air. The pool was all right, but the gas and air were helping me more. I went back into the room with the bed and even though I said to my husband, “I don’t want to be on my back,” I was on my back for most of the time. That’s where I was comfortable. When I was in the pool, I said no to the continuous monitoring. I just wanted intermittent with the monitor. We didn’t know what she was. At this point, we had no idea what she was but they couldn’t find her with the Doppler. They asked me to get out of the pool and put me on the bed and they were going to scan to see where she was. I couldn’t roll onto my back at this point. I was on my side and I couldn’t roll on my back to get them to scan me to see where she was. Then I opened my eyes and the consultant that had lied and coerced me into my third section was in the room and I specifically said I don’t want to see her. She was standing at the end of the bed and she said to me, “How long are you going to push for?” I said, “As long as I need to. As long as me and my baby are safe,” and she left. That was the end of it. I didn’t see her again. Meagan: Oh my gosh. Shannon: Yeah. That was that. They managed to scan me and they found her. She was just really low. That’s the only reason they couldn’t find her. She was fine. She was happy. It went on again for about another couple of hours of moving from all fours on the bed to my back and I remember sitting up on my knees upright and I felt something go. I was like, “Okay, I think my waters have gone.” They had a look and they had gone on their own. I didn’t have to have them pop like last time. There was no meconium. It was all good.I remember spacing out for a while going to that other place. I came to and it was burning. That ring of fire is real. It was real. I said, “Okay, it really stings. Something has changed.” The midwife lifted up the sheet and she said, “Oh, there is the head. Quick!” They had to scramble to get everything they needed. My husband was texting my mum so I got all the time stamps. They saw her head at 3 minutes past 10:00 at night and she was born at 14 minutes past 10:00. She slid out and we found out she was a girl which my husband told me which was what I wanted. I remember saying, “I did it. They said I couldn’t, but I did it.” They wanted to get her a yellow hat because we didn’t know what she was but because she came out so quickly, they only had a blue one so she’s got a little blue hat and yeah, she was here. It was amazing. I did have two second-degree tears. They did only repair one and I wish they had repaired both because going for a wee afterward with the open one was hell. Meagan: Yes, not fun. Shannon: But I would take that over a section recovery any day. I was going to the park with the kids 3 days post-birth. I was walking around the house. I was able to go up the stairs. It was amazing. Yeah, I did it. They told me I couldn’t and that I would die or she would die. Meagan: They really put up a fight and tried so hard. Let me tell you too, I don’t know the right word but to stand up to that type of pressure, oh my goodness. That is hard. That is very, very hard. The fact that you did and it’s not like it didn’t affect you. Of course, it affected you but you were able to go and you were like, “Listen, I know the research. It’s in my favor. I’m okay. I believe that it’s the best choice because I really have researched it and truly believe that it’s the best choice for me and my baby.” They just tried so hard to not let that happen. 36:32 “We are all so proud.”Shannon: They did. I think it was the next morning and I was just sitting in my room with my baby quite happy. The head of midwifery came into the room and I had met her once before. She said to me, “Well done, you did it. All of our phones were going off last night because it was flagged that you had gone into labor and we were all waiting to see what had happened. But you did it vaginally and we are all so proud. Well done.” I was like, “Well, you didn’t tell me that at the time, did you?” Meagan: You’re like, “I wish you had cheered for me in my pregnancy and not made me feel like I was crazy or scheming my husband,” or all of that. Oh my goodness. Shannon: Yeah. Meagan: You have gone through a lot on top of your birth and trauma there and recovering from all of that. You have grown so much and achieved so much. You should be really proud of yourself. Shannon: Thank you. I am. I think that like I said at the beginning, if it hadn’t happened the way that it happened, I’m going to train to be a doula in May and June. Meagan: Yay!Shannon: Because I don’t want other women to go through what I went through. Like I said, if it hadn’t happened the way it happened then I wouldn’t be here today. I’m grateful for the experience, but I wish that I had more support at the time. Meagan: Right, totally. I mean, that’s definitely something that led me to the doula and obviously here where I’m at too. I think through these birth experiences, it’s hard to deny that fire inside of you when you feel it. Right? You’re like, I want to help people not have the experience that I had and have a better experience to the best of my ability. I’m sure that you will do it and you’re going to take this passion and you’re just going to flourish and touch so many lives. I’m so excited for you. Shannon: Thank you. 38:30 VBAC after three CesareansMeagan: Okay, so let’s talk about VBAC after three C-sections. I think this is sometimes a hard one because we do have providers throwing out things and blank statements like, “If you hemorrhage, if this, if this, and if this, you and your baby will die.” When we hear those things, it is very scary and very overwhelming. When it comes to VBAC more than two after multiple Cesareans and more than two, the stats are harder to find. Did you find that it was really harder to find? There are not a lot of huge Cochrane studies at least that I know about where they have studied VBAC after three Cesareans specifically. Shannon: Yep. Meagan: We are often told by providers that the chances of uterine rupture are astronomically higher than our typical VBAC or VBAC after two Cesareans. For people in your area in England, what did you find local study-wise for your stats? I’m curious to see the difference. Shannon: I didn’t. There wasn’t anything, no. I remember I had to relay as much information as I could on VBAC after multiple Cesareans because I remember them saying to me that after two Cesareans, the risk of uterine rupture doubles and when they say that to you, you’re like, Oh my god, that sounds really scary. What they don’t tell you is that it only doubles from 1% to 2%. There’s not much here that is different because there really isn’t a lot. There was not support especially not from my hospital or anywhere like that for me. I just had to do it on my own. The internet is your best friend. Meagan: Yeah, I know. This darn internet can be your best friend and your enemy at the same time. That’s why we are here and why we have our blog and all of the things because we want people to be able to find that best friend side of the internet and really dive in. We do have a blog on vaginal birth after three Cesareans. It is titled, Is VBAC After Three C-sections the Right Choice For Me? We will have it here in the show notes so definitely check it out. In it, we talk about how uterine rupture makes the idea of VBAC very scary. The word itself, “rupture” makes it very, very scary. When I think of something rupturing, it doesn’t look pretty. It’s something that we want to talk about in its real form. Uterine rupture happens. When it does, it is typically an emergent situation. However, it doesn’t happen very often and when we’re talking about VBAC, the world feels like, and I’m talking about world as in other countries too, it is bigger than it is like you were saying. It happens in really less than 1% of people so they are showing that with VBAC after multiple Cesareans, it might be slightly higher around 1.2%. It’s just so hard. What I think is unfortunate is that it’s not being offered enough to show the real stats, but what this podcast and what Facebook and all of the groups out there, the VBAC groups are showing, is that VBAC after three Cesareans is possible. It is possible. Do your research. Find the support and you did it. I mean, I’m going to say that you did it without support. I mean, you had support from your husband and stuff, but to the fact that they were showing up at the end of your bed like, “How long are you going to push for?” That type of stuff is not combined with the definition of support for me by the way and ambushing you and those things. You got through it without that much support backing you up in this decision. That is where we are shy here. I think that we don’t offer the support. One, if you’re listening and you’re a provider and you offer VBAC after three Cesareans, please let us know so that we can chat with you and get you added to our list. If you’ve had a VBAC after three Cesareans and you are listening and had support, please message us so we can add your provider to the list because VBAC after three, four, and all of the Cesareans may not be the best choice for everyone, but for those who want it, let’s try to get the information out there. Read up. Get the information. Like I said, it’s going to be in the show notes and the blog. We have our course. There’s not a ton out there on vaginal birth after multiple Cesareans so find what you can. Read what you can. Find the stats and do what’s best for you. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
44:1412/06/2024
Episode 307 Dr. Christina Pinnock + High-Risk Situations & What They Mean for TOLAC

Episode 307 Dr. Christina Pinnock + High-Risk Situations & What They Mean for TOLAC

Dr. Christina Pinnock is a Maternal Fetal Medicine Specialist/Perinatologist based in California and creator of the ZerotoFour Podcast. She is here to help us tackle topics like what constitutes a high-risk pregnancy, lupus, preeclampsia, HELLP syndrome, gestational diabetes, fibroids, and bicornuate uteruses and how they relate to VBAC. The overarching theme of this episode is that all pregnancies are individual experiences. If you are hoping to achieve a VBAC and you have pregnancy complications, find a provider whose goals align with yours. By ensuring that your comfort levels are a good match, you are on your way to a safe and empowering birth experience!Dr. Pinnock’s Website and PodcastNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 00:58 Review of the Week03:13 Dr. Christina Pinnock03:56 Importance of a VBAC-supportive provider06:36 High-risk pregnancies11:02 Lupus and TOLAC14:31 Preeclampsia 17:19 Varying ranges of preeclampsia20:46 HELLP Syndrome 26:36 Other High-risk situations 27:54 Gestational Diabetes35:00 Inductions with gestational diabetes42:25 Fibroids 46:33 Do fibroids tend to grow during pregnancy? 51:20 Bicornuate UterusMeagan: Have you ever been told that you were high risk, so you’ll be unable to TOLAC? Or maybe you can totally TOLAC assuming nothing high-risk comes into play? What does high risk mean? We often get questions in our inbox asking if having your previous cesarean makes them high risk. Or questions about topics like preeclampsiaclampsia, gestational diabetes, bicornuate uterus, fibroids, and more. I am so excited to have board-certified OB/GYN Dr. Christina Pinnock on the show today. She is a high-risk pregnancy doctor passionate about educating women along their pregnancy journeys so they can be more informed and comfortable during their pregnancy. She is located in California and has a podcast of her own called “ZerotoFour” where she talks about topics that will help first-time moms prepare for, thrive, and recover from pregnancy as well as shares evidence-based information and answers everyday questions like we are going to discuss today. 00:58 Review of the WeekMeagan: We do have a Review of the Week, so I'm going to jump into that and then we can dive in to get into these fantastic questions from Dr. Christina Pinnock. Today’s reviewer's name is Obsessed!!!! It says, “The best VBAC and birth podcast. I am grateful to have discovered Meagan and this podcast. I definitely believe listening to stories of these amazing women and their parent’s course helped me achieve my two VBACs. Thank you for all you do The VBAC Link.”Oh, thank you so much Obsessed!!!!!  And as always if you wouldn’t mind, drop us a review leave us a comment and you never know, it may be read on the next podcast. 03:13 Dr. Christina PinnockMeagan: Okay, Women of Strength. I am seriously so, so excited to have our guest here with us today! Dr. Christina, is it Pinnock? How do you say it? Dr. Pinnock: Yes that’s perfect.Meagan: Ok, just wanted to make sure I was saying it correctly. Welcome to the show! You guys, she is amazing and has been so gracious to accept our invitation here to today to talk about high-risk pregnancy and what it means. Hopefully, we’ll talk a little bit about gestational diabetes because that's a big one when it comes to VBAC. And if we have time, so much more. So welcome to the show and thank you again for being here.Dr. Pinnock: Thank you so much for having me, I'm excited to be here and chat with you and your audience about these great topics, so thank you.03:56 Importance of a VBAC-supportive providerMeagan: Yes! Okay well, this isn’t a question we had talked about, but I’m curious. Being in California, do you find it hard to find support for VBAC or do you find it easy? I mean, California is so big and you’re in Mountain View. So I don’t know exactly where that is. You said the Bay Area, right? So how is it in your area? How is VBAC viewed in the provider world in your area?Dr. Pinnock: Yeah, that’s a good question. I actually did most of my training on the East Coast, so it’s been a good experience seeing the differences in coastal practices. I think where I did my training we were pretty open to VBACs and supported them. In California, I’ve had a similar experience and I think it really depends on where you are.  I’m in the San Francisco Bay Area and I work at an institution where we support TOLACs and want our moms to VBAC as long as it’s safe and it’s what they desire. But I really think the opportunity to TOLAC depends on your individual OB provider that you have and their comfort in offering that. And importantly, the hospital resources that you have available in your area. California’s huge and depending on where you live it can be a very, very different infrastructure both geographically and specifically within the hospital. And so I really think that differences in that offering is based around those resources rather than maybe patient desire or even sometimes provider desire. So it really just depends on those things. Meagan: That’s so good to know. I mean, we tell our community all the time that provider is a really, really big key when it comes to being supported. But also I love that you were talking about the actual hospital because for me with my second– I had a VBAC after 2 C-sections and with my second, my provider was 100% gung-ho and super supportive. But in the end, I ended up switching because the hospital was going to end up restricting my provider in supporting me in the way he wanted to support me, right? So it’s also really important to vet your location and your hospital.Dr. Pinnock: Yes, absolutely. Sometimes, someone may live in a location where they don’t have that choice, unfortunately. If you do have that choice and you can choose hospitals and providers that can support it, by all means if you have that ability. 06:36 High-risk pregnanciesMeagan: Absolutely. Ok well, let's dive in more to high-risk. So a lot of the time, I'd love to see what you think about this. A lot of the time, providers will tell moms because they’ve had a previous Cesarean, not even a special scar or anything like that, that they are automatically grouped into the high-risk category. So I don’t know what your thoughts are on that in general, but let’s talk more about high-risk pregnancy. What does it mean? What does it look like for TOLAC? How is it usually treated? And are there often restrictions given for those moms? Dr. Pinnock: Yeah, no. That’s a really good question. One thing about pregnancy, there’s some level of risk in all pregnancies. No matter if you're completely healthy, no medical problems, or you're trying to TOLAC, or you have other medical conditions that exist before pregnancy, all pregnancies carry some level of risk but not all the risks are equal. There are some conditions that the mother can have before pregnancy that can put her pregnancy at a higher risk of developing some complications. There are some conditions that can actually develop during pregnancy that can cause the pregnancy to be at a higher risk of developing complications. Lastly, there are some conditions specific to the placenta, the baby, how the baby developed, or even the genetic makeup of the baby that can contribute to a high risk of having complications. All of these three categories can impact the status of your pregnancy being considered high-risk. So typically, if you have a condition that falls in one of those three boats, then your pregnancy could be considered a higher risk. Usually having a previous C-section or even two previous C-sections by itself is not really something that I would use to classify someone as having a high-risk pregnancy. I do think that definitely talking with your provider about your desire for delivery earlier on can help both people to be on the same page, but if you otherwise have nothing else going on in the pregnancy and you have one previous C-section or even two previous C-sections, I think the pregnancy itself, I wouldn’t consider it a high-risk pregnancy. Meagan: That’s good to know. Dr. Pinnock: Yeah no, absolutely. And when you think about the delivery, I think about it a little bit differently than the pregnancy. I think for the delivery if you are interested in having a TOLAC and you have a previous C-Section or two, then the management of your delivery and the risk of your delivery isn’t the same as someone who hasn’t had a C-section. I think about them as like two different boats. But overall, conditions that are related to maternal health can be high blood pressure, diabetes, and autoimmune conditions like lupus. Those things can cause your pregnancy to be considered high-risk. A good example of a few things that can develop in pregnancy that can make your pregnancy high-risk include things like preeclampsia which is high blood pressures of pregnancy. Having twins or having triplets can make your pregnancy a higher risk. In some instances, even gestational diabetes depending on what’s going on and where you are can be considered a pregnancy with some high-risk features. And then genetic conditions for baby whether that’s a difference in how one of your babies’ organs developed, or a genetic condition that’s discovered from testing; any of those things can really impact that high-risk status and how your pregnancy will be monitored and managed after that. Meagan: Ah these are all such great topics and actually things that we get in our inbox. Like, “Hey, I have lupus,” or we’ll have one of our VBAC doulas say, “Hey, I have a client who has lupus. She really wants to TOLAC and have a VBAC. What does that mean for her?” Obviously, all of these conditions are going to be treated differently throughout the pregnancy and probably even during the labor and delivery portion. 11:02 Lupus and TOLAC Meagan: I don't know if we can touch on a couple of those like lupus. What does that look like for someone? If I have lupus coming in, I’m doing okay right now. I have it. What does that look like for someone wanting to TOLAC and to have a VBAC?Dr Pinnock: Yeah. I think it’s similar to your first question about whether a C-section would make your pregnancy considered high-risk. So the lupus diagnosis would increase the risk of certain medical conditions happening in pregnancy relating to both mom and baby. Your doctor may get some extra blood work to monitor how your lupus is progressing in pregnancy. Your doctor may get some extra ultrasounds to make sure that baby isn’t too small and add some extra monitoring to make sure that baby is staying safe and that if there is a risk for baby to be in distress that that is picked up. And so the actual monitoring and management of the pregnancy is usually done with the help of a high-risk pregnancy doctor like myself with an OB provider. That is really specific to what is going on with that person. If everything goes smoothly and lupus stays under control and we get to the moment where we’re thinking about how we’re going to deliver baby, that’s sort of a separate boat. In an ideal world, everything goes well in terms of the lupus and pregnancy and if you’re interested in having a TOLAC, having a diagnosis of lupus should not restrict you from that option. You can still have that as an option but it really just depends on the specifics of how your pregnancy has unfolded. Have you developed any other conditions like high blood pressures in pregnancy or preeclampsiaclampsia where your doctor is maybe thinking you may need to deliver earlier? Are there things going on with your baby where we think baby is under more stress where we would really need to be very intentional about how we deliver baby? It’s a really nuanced thing and it’s based on the specifics on that person’s condition. I think an overarching theme is whatever is going on with the pregnancy that impacts the delivery if things are not going as smoothly. But if things are going smoothly and you want to try for a TOLAC, that’s not necessarily a reason to say, “No, you absolutely can’t do this,” unless there are specific conditions that came up in your pregnancy that make it less safe for either you or baby as the mom. Meagan: Yeah. Something that I’m just hearing you say so much that’s standing out is that really is individual, depending on that individual and depending on that individual’s case. I think that’s something important for listeners to hear because someone who may have lupus that’s going really, really fine, TOLACs going to be a really great option for them. But someone who may have active symptoms and it’s going and it’s really hard, that may be a different suggestion in the end. But I like that you’re like, We’re in this boat and then we travel over to this boat into this time, and then it’s a matter of how we float that boat and how we get to our destination.Dr. Pinnock: Exactly.14:31 Preeclampsia Meagan: Would you say that the same thing goes for preeclampsia? Preeclampsia can develop at any stage of pregnancy. I mean, we've had clients in weeks 18-20 develop it and then have to be really closely watched and all of these things. Is that someone also where you would say the same thing? Where it’s like, We’re in this boat doing these things and these tests and monitoring, and then again we get into this next boat and we have to decide what the best route is?Dr. Pinnock: Yeah, no. That’s a good question. I think it’s similar but a little different with preeclampsia. It depends on the type of preeclampsia that’s going on. Preeclampsia is a spectrum and with the part of the spectrum that’s more on the severe side, we still try for a vaginal birth. It really depends on, as you’ve mentioned, how far along you are in the pregnancy.Maybe you are 28 weeks and you have such a severe form of preeclampsia that your doctor is like, “I don’t think we can get any more time with the pregnancy,” that’s a very different situation than someone who has a very non-severe form of preeclampsia at 39 weeks who wants to TOLAC and have all of those options available. It really does depend but the overall theme with preeclampsia if you do want to try for a vaginal birth and your health and baby’s health are stable in the moment, then usually we do try as much as possible to have a vaginal birth. But things like very early gestational age and really severe complications of preeclampsia make the possibility of having a vaginal birth less likely. It makes the possibility of someone who wants to TOLAC in that setting less likely. It really depends on the severity of that spectrum of preeclampsia, but we always try for a vaginal birth if we can. Meagan: Yeah. This may be too hard of a question to answer, but can we talk about that range and the severity? What does a low to moderate to severe case of preeclampsia look like in a person? What would be considered that severe, “Hey, we might need to reconsider our birth desire here,” to “Hey, you have it. It’s really low right now,” or to “We’re in choppy waters right now.”17:19 Varying ranges of preeclampsiaDr. Pinnock: That’s a good question. Pre-e is defined as elevated blood pressure in pregnancy after 20 weeks. So once you hit 20 weeks, if your blood pressures are elevated, 140/90 times multiple times and we see any evidence of preeclampsia’s impact in some organs in your body.One of the most common things that we used to use to diagnose is the presence of protein in the urine. Once we see that, we’re like, “Oh, man. I think you may have preeclampsia,” then we do an evaluation of the rest of the body to understand how severe it is. Preeclampsia is a disease that’s thought to develop from the placenta when it implanted. It can cause dysfunction or impact on the organs. It can cause severe headaches. It can cause changes in your vision and problems with your blood cells, your liver, your lungs, and your kidneys. We go from head to toe and take a look at how those organs are being impacted by preeclampsia and then we ask you how you’re doing. If you’re having a headache, if you’re having changes in your vision, pain in the belly, and all of that, it helps us to understand the severity. So depending on your symptoms, your blood work, and your blood pressures, those things together help us say, “Is this a severe form of preeclampsia?” and if it is, then we usually have some specific things that we have to do. Generally, you likely are monitored in the hospital. We keep a close eye on your blood pressure and your organs. That pregnancy is considered to be very high risk. Very high risk for a harm for mom, so risk of seizures, impact on the organs that can sometimes be lifelong and risk to baby. The highest risk to baby is that risk of being born early, so pre-term delivery. And usually if you have severe preeclampsia, we usually recommend delivery no later than 34 weeks. So once we do develop that severe form, we keep a close eye on things. If you have the non-severe form, so if your organs look oay and your blood pressures are stable but you have some protein in your urine and we do think you have preeclampsia but it’s not severe, then we give you some more time. We still monitor you and baby very closely, but we can maybe try to get the pregnancy up until 37 weeks and after that, the risk of continuing the pregnancy and harm to maybe the mom and baby are a bit higher than some of the risks of being born at 37 weeks. So at that time is when we would say, “Let’s have a birthday.” It really depends on those things. Meagan: Okay, that’s so good to know. I think sometimes that also can vary like, I’ve got high blood pressure, but I don’t have protein. Or I’ve got a trace of protein but I’m doing okay, I don’t have any symptoms. But we also know with preeclampsia it is important to watch really closely no matter whether severe or not because it can turn quickly. Where you have zero signs and the next morning and you wake up with a headache and crazy swelling and you have that blurred vision with really high numbers. So it’s just really important to watch.Dr. Pinnock: Exactly.20:46 HELLP SyndromeMeagan: I really do like to ask that question because a lot of people ask, do I have to have a C-section? Do I have to be induced? What does that mean? Am I severe or not severe? And we also note, we weren’t even talking about this, but HELLP syndrome. So we can develop more, right? Preeclampsia affects more the mom, but then alsothe  baby timewise. HELLP syndrome is another really high-risk complication. What would you suggest for that when it comes to TOLAC because we have platelets being affected there? That one is a tricky, tricky one. Dr. Pinnock: I think HELLP syndrome is on that same spectrum of hypertensive disorders in pregnancy. But HELLP syndrome can be pretty life-threatening and dangerous for mom and by extension baby. So HELLP syndrome is when we find that your body’s sort of hemolyzing so there are some things in your blood that’s causing your blood vessels to sort of open red blood cells. We find also that you have elevated liver enzymes so your liver’s being impacted pretty severely and then the platelets or the blood cells that help with clotting get really, really low. And so the combination of that with or without elevated blood pressures make us very concerned about HELLP. So the worry is if we don’t deliver the baby pretty expeditiously and deliver the placenta which is thought to be really the source of the diagnosis, mom can get really ill and we really try to deliver as soon as possible. The exact way we deliver is really dependent on the specifics of what is going on. So maybe if your liver enzymes are very, very elevated and there's a high concern for mom’s health and safety, your doctor may say, “I don't think we have time to try for a TOLAC, especially if you're not in labor. I think it would be too unsafe. I think I would recommend a C-section at this time because of that,” then that would be that recommendation. Sometimes we do try for a vaginal birth with HELLP, but it would be a case where we would want to limit how long we try but overall we try to deliver as fast as possible either vaginally or with a C-section. And if you do want to try for a TOLAC in that setting, I think my recommendation is to really, really be open to whatever is best for your health and your babys health. That’s my advice for all women who are in labor. It’s such an unpredictable experience and you can come in with your desires and your doctor can come in with their desires for you, and your baby or your health just dictates something else. And so with HELLP, that’s an even more significant moment where if your body’s telling us one thing, we have to listen. You may not be eligible for a TOLAC at that point. I think in more cases than not, many providers may not have that bandwidth or think it’s safe to try for TOLAC in that setting. Meagan: Yeah. I’ve had very few clients as a doula who have had HELLP, but one of the clients– they actually both ended up having a Cesarean, but one of the clients’ providers was even uncomfortable with even having an epidural and actually suggested general anesthesia. Is that a common thing if HELLP is super severe that could possibly be what’s suggested or best?Dr. Pinnock: Yeah, no as I mentioned with that kind of diagnosis, you can have pretty low platelets. And so when we think about a procedure like an epidural or even a spinal, so any sort of neuraxial anesthesia where we’re not putting mom to sleep, we’re just numbing mom from the waist down, that requires insertion of a needle or a catheter in the back. That’s near a lot of important structures so once you have that puncture, you’re going to have some bleeding. And if those platelets aren’t enough to sort of prevent that bleeding from extending, then our anesthesia team may not be comfortable doing that procedure safely because it’s not safe. They may offer to give some platelets etc but often with HELLP, it may not be as fast acting and sometimes you may just hemolyze again. Those platelets may go back to being very low and if we are thinking about having a delivery urgently, delaying for that reason may not be safe for mom and baby. Oftentimes, if the platelets are too low, then our anesthesia colleagues, who are a very important part of the team, may recommend against trying for an epidural or even a spinal and recommend general anestheia.In my experience, I don’t do C-sections under general anesthesia often, but when I do, it’s usually recommended for a very, very significant reason and it’s always with the safety of mom and baby in mind. It’s never something that we want to do. It’s only something that we do if we have to do for mom’s safety or for baby’s safety. Meagan: Yeah. So good to know. And they actually ended up doing a platelet transfusion as well specifically for the Cesarean. Obviously, we know blood loss is a thing that’s a big surgery so they were trying to help her there. 26:36 Other High-risk situationsMeagan: Okay, well are there any other high-risk scenarios where you feel like truly impact the ability to have a TOLAC offered?Dr. Pinnock: Yeah. I think the highest risk conditions that could prevent mom from having a TOLAC are probably conditions related to the heart or lungs where the physiology or the changes that happen in labor can make it so that a vaginal birth is not safe or recommended for mom or baby. A TOLAC in those high-risk settings is often not recommended. There are a lot of cardiac and lung conditions that we take care of. There are not that many that we would say you can’t have a vaginal birth, but sometimes there are blood vessels in the heart that can be dilated or blood vessels near the heart that can be dilated that we may say, “No, you definitely need a C-section,” so if you wanted to TOLAC we wouldn’t recommend that. Those are probably the highest-risk conditions that I take care of and where a TOLAC is not recommended or even offered because it’s just not considered to be safe. 27:54 Gestational DiabetesMeagan: Okay that’s so good to know. Okay, let’s jump in a little bit to gestational diabetes. We can have both managed and not managed. Do you have any advice for listeners who may have gestational diabetes or maybe had gestational diabetes last time and they’re preparing to become pregnant or wanting to learn more about how to avoid it if possible or anything like that? Do you have any suggestions to the listeners?Dr. Pinnock: Yeah, that is one of my favorite things. I really believe that just paying close attention to your health and taking steps before pregnancy can make a world of a difference in your risk of developing certain conditions. Gestational diabetes is one of those conditions that can be definitely most susceptible to things that we can do before pregnancy. And so I know that this is going to maybe sound like a broken record to those who had gestational diabetes before, but just look at your lifestyle factors. I think that the most undervalued or underestimated intervention is really exercise. It doesn’t have to be your training for an Iron Man or a marathon. It could just be like a 20-minute walk every day or a ten-minute job every day and work your way up. We definitely found that aerobic exercise more days of the week than not, and resistance training, it could be with resistant bands, if you have any sort of light weights or even body weight. Any resistance training to help build up that muscle mass can help to reduce your risk of getting gestational diabetes. If you couple that with adjusting your diet, and diet is such a big topic but essentially no matter what your background is, focusing on the whole foods of your cultural background is best. So low processed foods, more homecooked meals with whole grains, fruits, vegetables, fish, and limitations of red meat and processed foods. All of those things can go a long way with preventing gestational diabetes and also reducing the recurrence of gestational diabetes. I’m really passionate about that. Meagan: Yeah, us too. I didn’t have gestational diabetes, I had kidney stones weirdly enough because my body metabolizes nutrients differently during pregnancy and anyway, it’s totally not gestational diabetes but I had to look at my pregnancies and before as something like that. Really dialing in on nutrition. Really dialing in on my exercise. And I couldn’t agree more with you that it doesn’t have to be this big overwhelming Iron Man training or running a marathon. It really can be a casual 20, 30-minute stroll around the neighborhood walking the dog or whatever and dialing in on those whole foods. We love the book Real Food for Gestational Diabetes by Lily Nichols. If you haven’t ever heard of that, it’s amazing. It’s a really great one. You might love it. And I definitely suggest that to all of my clients. She even has one for Real Food During Pregnancy. Just eating good food and then we love Needed because we know that getting our protein and getting the nutrients that wer eally need can really help like you said recurring and current and just avoiding hopefully. So we really love that topic, too. But gestational diabetes doesn’t just nix the opportunity to TOLAC, correct?Dr. Pinnock: No, it doesn’t. Gestational diabetes can be a really tough diagnosis for a lot of women to get in pregnancy. It can be really disappointing especially if you may be a relatively healthy, active person and you don’t have a lot of risk factors for developing gestational diabetes. It can kind of feel like a gut punch almost. Meagan: Yeah! And it’s very overwhelming because you’re like, What? No! Dr. Pinnock: It is! And it happens fast. You’re diagnosed and then you have a flurry of things that you have to now do and change and think about. It can be very stressful. But I always tell my patients that there are things that put some people at risk of developing gestational diabetes more than others, but all women because of those placenta hormones can have insulin resistance or your body’s just not responding as well to the insulin that you’re making. Depending on those risk factors, some women develop it. Some women don’t. And once you do develop gestational diabetes, it’s something that we really pay attention to because it can increase the risk of things for moms so particularly it can increase the risk of mom developing preeclampsia and it can increase the risk of things for baby. Babies can be on the bigger side or have macrosomia if the blood sugars are too high. They can actually have a higher risk of having a birth injury if we’re having a vaginal birth or mom may actually have a higher risk of needing a C-section if you’re trying to TOLAC and baby’s on the bigger side. Rarely, and this is sort of the thing we worry about the most, is that if those blood sugars are too high for too long, baby can be in distress on the inside and it can increase the risk of having a stillbirth or having baby pass away. So because of those things, once we diagnose it, we do pay attention to it and we try our best to sort of make those changes hopefully with diet and exercise to sort of manage the blood sugars. If we’re having perfect blood sugars with those changes, then wonderful. If we’re not, and it happens and you need some additional support then your doctor provider may recommend some other management options like medications to help to bring the blood sugars down. But I think, when we think about TOLAC, we want to think about separately managing the pregnancy, keeping mom and baby safe, and then thinking about the safety of delivery. So as long as the baby’s size isn’t too big, as long as mom and baby are healthy and safe, you can definitely try for TOLAC with gestational diabetes. But those two things are big “buts”. You really want to try your best to manage your blood sugars so baby’s size doesn’t work against your efforts of trying to have a TOLAC.35:00 Inductions with gestational diabetesMeagan: Yeah, we know that the size can definitely impact providers’ suggestions or comfortablity to offer TOLAC. And we know big babies come out all of the time, but we know sometimes there’s some more risk like you were saying. So can we talk to the point of inductions?So a lot of providers will, and you kind of touched on it. There can be an increased risk of stillbirth. But a lot of providers seem to be suggesting that induction happens at 39 weeks. Some of the evidence shows that in a controlled situation, meaning all of the sugars are controlled, but what do you see and what do you suggest when someone is wanting a TOLAC, has gestational diabetes, may have a baby measuring larger or may have a provider who is uncomfortable with induction which we see all the time? Any suggestion there and what do you guys do over in your place of work?Dr. Pinnock: Yeah, that’s a great question and it’s something that I individualize to every patient. So let’s think about it in two different buckets or three different buckets. Say you have gestational diabetes that’s pretty well controlled with just diet. So with diet and exercise, your numbers are pristine. Baby is a good size, we’re not over that 4500-gram mark where we start to say, “Is it really safe to try for a vaginal birth?” and that’s okay. If we are in that boat, then I think it’s reasonable to allow for mom to go into labor and try for TOLAC if that’s their desire. The exact gestational age at which someone goes into labor varies. We don’t have a crystal ball. We don’t know. Meagan: Nope.Dr. Pinnock: We do have to balance waiting for that labor process with the inherent risk of babies being less happy and distressed and the risk for a stillbirth as the pregnancy progresses. Now, if you have gestational diabetes that’s well controlled with diet, we think from the studies that we have that our risk of stillbirth is similar to someone who does not have gestational diabetes which is good. And so for those pregnancies, depending on your specific location and provider, we may do some monitoring with non-stress tests or something like that later in the pregnancy until you deliver. Usually, we start at around 36 weeks or so if you’re well-controlled with just the diet and allow you time for your body to go into labor and have a vaginal birth. Now, if we get to your due date and nothing, baby is still comfortable inside. They’re like, Oh no. I’m just hanging out, we start to think, How long are we going to allow this to go on? At that length of time, we start thinking about, Okay. We’re at 40 weeks. What are the risks to mom and baby? And so at 40 weeks, we’re about a week past 39, and we know that the risk of– if things are perfect for anyone, the risk of having babies be in distress, maybe the placenta’s just been working for a long time and isn’t just working as well and the risk of stillbirth goes up, we don’t want to go to 42 weeks. So I think at that moment, it’s a good time to think of an exit strategy. If your baby is just so comfy on the inside, think about, when I would say is an upper limit of reasonablility to wait for labor? That varies depending on the person and provider. But I think reasonably, up until 41 weeks. I wouldn’t go past that. If we’re allowing our body to go into labor up until 41 weeks, then we have to think about, How does that impact my risk of having a successful TOLAC? After 40 weeks, some of our studies suggest that you may be at a higher risk of having a failed TOLAC or needing a C-section and that’s regardless of whether you're induced or whether you go into labor. TOLAC-ing does carry that inherent risk so it’s really just dependent on your doctor, you,  your provider, and balancing all of those things. I think going until 41 weeks is probably the maximum limit for a well-controlled gestational diabetes with perfect sugars, no medications, and we’re still doing monitoring to make sure that baby is doing well.Now, if you’re in the camp where you’re either gestational diabetes, or even controlled with diet, or if your gestational diabetes is controlled with medication or if you’re diet-controlled, but those sugars aren’t great, any scenario where the sugars aren’t perfect and we need either medications or your sugars aren’t perfect, I don’t generally go past 39 weeks.The reason being at 39 weeks, baby is fully developed and after that, the risk of having a  pregnancy loss goes up because of that uncontrolled or not optimally controlled gestational diabetes. I think at that gestational age you would want to think about maybe an induction or maybe a repeat C-section depending on how you’re feeling if your body isn’t going into labor. And that’s a personal decision. Now, if you have gestational diabetes managed with medication and your baby is big and maybe let’s say over 4500 grams which is sort of that range where we worry about the safety of a vaginal birth. And you’re now going into labor, then that becomes a little bit more of a shared decision-making where you want to think of, My baby’s big. I would need to be induced. Is this going to be something I want to commit to or is it something I don’t want to commit to? That’s a personal choice but I think at that gestational age I would say I wouldn’t want anymore. ACOG though does recommend or does allow for moms who do have gestational diabetes well controlled with medication, like if your blood sugars are perfect with the medication to go until 39 weeks and 6 days. So technically you can use those extra few days, according to our governing board or the American College of OBGYN. But it’s going to really come down to you and the relationship you have with your doctor and what you both are comfortable with. Maybe you have a provider that is open to that recommendation or a provider whose more open or comfortable to a 39-week delivery regardless of how well your blood sugars are controlled once you’re on medication. But ACOG does give us that wiggle room to say we can go further. 42:25 FibroidsMeagan: So good to know. Okay, let’s see. Is there anything else we would like to talk about high-risk-wise? I know I had mentioned one time about fibroids and heart-shaped uterus. Do you have anything to share on those two topics, because those are also common questions? Can I TOLAC with fibroids? Can I TOLAC if I have a heart-shaped uterus? Where does that land as VBAC-hopeful moms?Dr. Pinnock: Yeah, no. I think those are some great things to consider. So I think we can open with the fibroids. I think if you’ve have had fibroids and you’ve had that fibroid removed, so you’ve had a myomectomy, there are a handful of things where we usually say, “No, we don’t want you to TOLAC.” One of them is if you've had a previous uterine rupture or that previous Cesarean scar opened in a previous delivery, that’s an absolute no. The risk is too high. We don’t think it’s safe. The other is if you’ve had a previous surgery where that surgery included the fundus or the top of the uterus where those contractile muscles are. Usually, with a myomectomy or fibroid removal, that involves that area. If you’ve had a fibroid removed in that area or you’ve had a myomectomy, a TOLAC is not recommended. So those are sort of one of the few things or few times where we say, “Absolutely, no.” If you have a fibroid and maybe you just discovered you had it during pregnancy, most of the time fibroids don’t cause any problems. They’re benign growths of the muscle of the uterus that can vary in size. So generally if they’re small to medium size and depending on their location they may not cause any problems. If they do cause a problem, the most common thing women experience is pain. But usually if they’re not too big and they’re not in a location where we’re concerned about, it should not really your ability to TOLAC. Now if the fibroid is like 10 centimeters and located near the lower uterine segment or the part of the uterus where the baby transports through to come out through the vagina, then we’re going to take a pause and say, “Is this going to be a successful TOLAC?” Is the fibroid going to compete too much with the baby’s head for baby to come down safely and should we just think about doing a C-section? And a C-section in that event is also not straightforward or a walk in the park because either way, the fibroid is present near where we would use to deliver the baby. So short answer is that yes, you can TOLAC with a fibroid. But the long answer is that it really depends on how big the fibroid is, where it’s located and whether we think it’s going to obstruct that area where baby’s going to come from. If it’s not, then it’s reasonable to try and many women have TOLAC’d with fibroids all the time. So it’s definitely not a reason to say, “No, you definitely can’t.” If you’ve had the fibroid removed though, then it’s a no. That’s just one thing to talk about if you’re considering that procedure and you have an opportunity to talk with the provider who is offering that procedure, just knowing that after that for most surgeries that remove the fibroids you won’t be able to try for a vaginal birth. 46:33 Do fibroids tend to grow during pregnancy? Meagan: Good to know. Good to know. And is it common for fibroids to grow during pregnancy? Does pregnancy stem them to grow? Or does that impede them because you’ve got a baby growing in there and the focus is on growing a human and not growing a fibroid?Dr. Pinnock: No, that’s a good question. Interestingly enough, we see about a split group so about a third of them stay the same. They don’t change in size. A third of them shrink and a third of them grow. Meagan: Oh wow.Dr. Pinnock: We don’t know which third it will be. Two-thirds of them either get smaller or stay the same size. But there are women who experience growth of the fibroid and it’s actually due to those hormones estrogen, progesterone, and all of those hormones being released by the placenta. It stimulates the fibroid to grow and that’s actually when some women experience pain. The fibroid grows. It outgrows its blood supply and then it degenerates or dies off a little bit and it causes this pretty significant pain for some women, but interestingly it’s not 100%. A lot of people don’t have many symptoms and don’t have any pain. When I monitor fibroids, a lot of them don’t change in size. Some of them get smaller and sometimes I’m not able to see them later on because they’re so small. But there is that percentage who experience the growth of their fibroid and that’s usually when pain is experienced from them. Meagan: Okay. And you mentioned that they could. I mean, 10 centimeters is a pretty large fibroid but it can happen, right?Dr. Pinnock: I’ve seen it. Meagan: Yeah, so it can happen. You said it can compete with baby coming down. Can fibroids also inhibit dilation at all? Can it impact dilation at all?Dr. Pinnock: Absolutely. Some of the things that we see or that we worry about if there’s a large fibroid present is other than impacting the area where baby can come through, it can cause dysfunctional labors. So those muscles that are contracting in a uniform way aren’t going to be able to contract as uniformly as they would have if the fibroid wasn’t there. So sometimes the labor can stall. The cervix isn’t dilated as much. Even sometimes we see that fibroid causing babies to actually present head down and so that’s also something that we can see with very large fibroids. It can actually increase the risk of baby being breech or transverse or malpresenting in general. Meagan: interesting. And you said that sometimes there aren’t even any symptoms at all, so how would one find out if they do? Is that just usually found at 20-week ultrasound? Or is it possible that at 20 weeks you had it but it’s so minute and it’s so small, that you can’t even see it? And then in labor we have some of these symptoms or whatever and it’s there but we don’t know?Dr. Pinnock: Not usually. Most women, if they didn’t know they had a fibroid before pregnancy, get diagnosed in pregnancy at an ultrasound. Either a first trimester or 20-week ultrasound, we look at the uterus in detail and we can pick up fibroids. We are hopefully not going to have a 10-centimeter fibroid present at 10 weeks that’s missed that’s just going to magically present at 39 weeks and be a surprise. Usually the fibroid, if it’s there, is picked up on an ultrasound. That’s the most common way it’s picked up. Depending on the size, it may be a reason why your doctor or provider recommends for you to have ultrasounds in the pregnancy. Sometimes we monitor the fibroids. We monitor their locations, the size of them, and we make sure that they’re not too big to be causing a problem. Rarely if they grow, they don’t usually grow from like 3 centimeters to 10 centimeters. They may grow a centimeter or two. It’s very unusual to have that big change. And so for the most part, it’s picked up on ultrasound. We know the size of it. If it grows, it grows a small amount. It’s not going to grow from 5 to 10, and we’re going to know the location of it from that first time we evaluate it. It’s not going to be a surprise moment at delivery where we’re like, Oh my goodness, this wasn’t picked up.51:20 Bicornuate UterusMeagan: Okay, good to know. Good to know. Okay and last but not least, I know we’re running short on time and I want to make sure we respect that. Any information you have on a heart-shaped uterus? Is TOLAC possible with heart shaped uterus? Have you seen it? Have you done it?Dr. Pinnock: I have not seen it or done it to be honest. I do think a heart-shaped uterus just so we’re using the same language that’s considered a bicornuate uterus, is that–?Meagan: Yes, a bicornuate uterus.Dr. Pinnock: So for a bicornuate uterus or any kind of situations where the uterus developed differently, interestingly the uterus develops from two different stuctures. It develops from something called the Mullerian Duct and early in development when you are a tiny, tiny baby, those two structures fuse and when they fuse, they come side by side first, and then they fuse. When they fuse there, is a little wall in the middle that gets removed and so when all of that is done you have uterus that is shaped as we know it and we have that cavity on the inside where the baby would come in and grow. Now with a heart-shaped uterus, or a bicornuate uterus, there is an error when those structures come together side-by-side. So sometimes they just stay side-by-side and they don’t fuse as well or sometimes they fuse but only fuse partially. So you have the uterus that as we know it, but sometimes you can have two separate structures. So two separate cavities where the prgenancy can grow, or you can have one cavity where there is still some tissue right in the middle there. It can vary depending on the suffix of how that fusion happened. Essentially, if there’s less space in the cavity either from that tissue or having two separate but smaller cavities, there’s presumably less space there for baby to grow. There’s less contractile strength on that one side and so it can theoretically increase the risk of certain things happening in labor. I think the things that we see most commonly with bicornuate uteruses, it can have a higher risk of having a pregnancy loss, so a miscarriage. High risk of baby being born early because that area is just smaller so it’s not as strong in holding the pregnancy. And similarly, baby can also be malpresented more commonly because the are is much smaller than a full uterine cavity.Meagan: That’s what we see a lot is breech. Dr. Pinnock: Exactly. I haven’t seen too many cases. It’s a rare thing to see. I haven’t seen too many cases where baby’s head-down and we’re at full-term and wanting a TOLAC. A lot of cases I’ve had, baby is breech or malpresenting so we end up doing a C-section. The shape of the uterus is not going to change for the next pregnancy so chances are the baby’s usually malpresenting. I don’t think we have any big databases or big data to say is it safe? Is it not safe to TOLAC? I think the main thing you’d be concerned about it that spontaneous uterine rupture if there is labor going on even if you haven’t had a C-section and also if you’ve had a C-section before. So I think a TOLAC would be a little bit of an unknown for this situation. I would think on it pretty heavily and talk with your doctor about the specifics of your situation. If your previous C-section because baby was breech, chances are baby’s not going to be presenting head down because of the shape of the uterus. It tends to have things that recur as to reasons for having a C-section. So we don’t have any large databases where we have women who have TOLAC’d with this condition, so hard to say. So maybe give it a try, but maybe thing long on this one. Meagan: Case by case, it all comes down to case by case.Dr. Pinnock: Yes. That’s pretty much what I do. Anything in pregnancy that’s a little bit more nuanced and any high-risk condition, it’s very individualized. And we have to really have that approach with high-risk pregnancies or anything that comes up that makes your pregnancy higher risk of having anything happen to mom and baby for sure. Meagan: Right. Oh my goodness. Well, I love this episode so much and cannot wait to hear what people think about it. I’m sure they’re going to love it just like I do. I know I mentioned at the beginning of your podcast and things like that, but can you tell us more? Tell us more about the ZerotoFour podcast and where people can find you. I know you have YouTube and all the things, so tell us where listeners can follow you.Dr. Pinnock: Yeah. You can find me on Instagram @drchristinapinnock, the ZerotoFour Podcast so the zerotofourpodcast.com where I share the episodes with new moms about pregnancy. I really started the podcast with the goal of helping moms to be more informed and comfortable about everything along their pregnancy journey. I share topics from the whole spectrum of that journey to help you feel more prepared and informed and empowered about your pregnancy experience. You can find episodes there, on Apple Podcasts, Spotify, or anywhere that you listen to podcasts.Meagan: Awesome. So important. This is a VBAC-specific topic, but I mean those first-time moms, we have to learn. We have to learn all the things because there is really so much. We just talked about a little nugget of a couple of high-risk situations and there’s just so much out there that can happen. It’s so good to know as much as you can. Get informed. Learn all the things. Follow your podcast. I definitely suggest it. We’ll have all the links in the show notes and thank you for joining us today. Dr. Pinnock: Thank you so much for having me. It’s been a pleasure. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
57:5910/06/2024
Episode 306 Kelsey's Birth Center VBAC + Talk About Forceps

Episode 306 Kelsey's Birth Center VBAC + Talk About Forceps

Our friend, Kelsey, shares with us today what giving birth is like in Canada. From moving and traveling between provinces, Kelsey had experienced different models of care and when it came time to prepare for her VBAC, she was very proactive about choosing a birth environment where she felt safest. From a scary Cesarean under general anesthesia to an empowering unmedicated VBAC in a birth center, Kelsey’s journey is entertaining, beautiful, and powerful. We love hearing the unique details of her story including giving birth at the same time as her doula just in the next room over! The personalized care she was given during her VBAC is so endearing and heartwarming. As her husband mentioned, it should be the gold standard of care and we agree! The VBAC Link Blog: Assisted DeliveryFetal Tachycardia in the Delivery RoomIs There Still a Place for Forceps in Modern Obstetrics?Forceps Delivery ComplicationsNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 07:36 Review of the Week09:27 Kelsey’s stories11:47 Logistics of giving birth in Canada14:38 A normal pregnancy17:50 Arriving at the hospital21:37 Stalling at 7 centimeters26:22 Asynclitic and OP positioning29:31 Kelsey’s Cesarean under general anesthesia34:50 Second pregnancy and VBAC prep41:07 Switching to midwives46:14 Beginning of labor51:07 Driving to the birth center54:49 Pushing baby out in two pushes1:00:24 Differences in care1:02:11 Enterovirus1:08:02 Risk factors for forceps and vacuum deliveriesMeagan: Hello, Women of Strength. We have our friend, Kelsey, from Canada. Is that correct? Kelsey: Yes. Yeah. Meagan: She’s sharing her story with you guys today. Something about her first story of her C-section that stood out to me was that she had a forceps attempt that didn’t work out. Sometimes that happens. I want to talk a little bit about forceps here in just a minute before we get into her story. Kelsey, I wanted to ask you that this is something that in our doula practice we will ask our clients. If it comes down to an assisted birth with forceps or a vacuum, what would you prefer? It’s a weird thing because you’re like, Well, I’m not planning on that, but a lot of people actually answer, “I would rather not do those and go straight to a C-section.” Some people are like, “I would rather do every last-ditch effort before I go to a C-section.” Did you ever think about that before? Had it ever been discussed before as their style? That’s another thing. Some providers are really vacuum-happy. Some are really forceps-happy. I know it’s a random question, but I was just wondering, had you ever thought of that before going into birth? Kelsey: So no. I didn’t think about whether I wanted a C-section or a forceps delivery. However, I was really staunchly against having a C-section. That was primarily nothing against it, it was just that I have a really huge fear of awake surgery so with my forceps attempt, the OB who was there because it wasn’t my provider. That’s not the way Canada works. The OB who was there who was called in said, “Are you sure you want to do forceps? You could tear.” I told her, “I would rather tear than have a C-section.” That was just a personal preference for me because I was so terrified of having a C-section. Meagan: Yeah. I think that is very common and very valid to be like, “No, I would rather try this.” Kelsey: Yeah. Meagan: So I did. I wanted to go over just a little bit. I mean, I have seen a couple of forceps and they are not happening as often these days, but there was an article that said, “Is there still a place for forceps delivery in modern obstetrics?” I’m trying to say obstetricians and obstetrics. We’re just going to stop. Kelsey: We know what you mean. Meagan: You know what I mean. There was an article and I was like, That’s a really good question, because I think a lot of people think they shouldn’t be done anymore or a vacuum shouldn’t be done anymore either. It talked a little bit about the background. it says, that nowadays we are seeing a decrease in instrumental deliveries and a continuous increase of Cesarean rates. That makes me wonder if we were to increase vaginal and help instrumentally if that would decrease, but one of the things that I thought was interesting is that it says, “The prevalence of forceps delivery was 2.2% and the most common indication for a forcep delivery was fetal distress.” It is very common where it’s really, really close, baby is struggling. Baby is so low and let’s get baby out. That’s 81.6% which is crazy. It says, “Among mothers, the most frequent complication is vaginal laceration,” which means we have tearing at 41% and third and fourth-degree perineal tears were noted. It says, “Regarding neonatal APGAR scores, around 8 around the first and the fifth minute,” which is around 91.2% and 98% of newborns which is pretty great. An 8 APGAR is pretty great. I think a lot of people worry about that. It says, “8.8% experience severe birth injuries like hematomas and clavicle fractures.” Those are probably shoulder dystocias. That’s probably why they were having. It says, “Although fetal distress is the most common indication for forceps delivery, the vast majority of newborns were actually in good condition and didn’t require NICU care.” That’s something that was kind of cool. Obviously, there are a ton of more studies and deeper studies on that. This was just one, but it was kind of interesting. It was like, all right. That is a good question to ask as we are preparing for VBAC is hey, if for some reason a forceps or a vacuum is necessary, that’s something to think about. What do we want to do at that point? I love how you were like, “Yeah, I didn’t want a C-section. I feared that more than I did that.” Anyway, getting off that topic now so we can get this review and get on to your story but I think it’s a topic we don’t talk about and it’s not something that we are thinking about so as you are preparing, Women of Strength, for your VBAC, it might be something that you want to discuss and learn more about both vacuum and forceps and discuss with your provider what their tool of choice is and just have that in the back of your mind. 07:36 Review of the WeekMeagan: Okay, so onto today’s review. It is from laurenswat and it was back in 2023. It says, “Thank You.” It says, “I listened to as many episodes as possible when preparing for my VBAC. The stories on here were so encouraging to me and Meagan is so knowledgeable and reassuring. I am happy to say that I had my unmedicated hospital VBAC last week and I caught my own baby before the doctor even got in the room.” Oh my gosh, that is awesome. Seriously, catching your own baby is so amazing. I loved it personally myself as well and highly encourage it to anyone that is sort of interested because it is a really cool feeling. Thank you for your review and as always, we are looking for reviews. It is what helps people find this podcast. It helps us grow as a community. You can leave it on Apple, Google, email us, or whatever but we are so grateful for your reviews. 09:27 Kelsey’s storiesMeagan: Okay, Kelsey. Kelsey: Yeah? Hi. Meagan: Hello. Welcome to the show. Kelsey: Thank you. I’m super, super excited. Meagan: Me too. Me too. I would love to turn the time over to you. Both of your babies were born in Canada. That’s correct, right? Kelsey: Yes. Yeah. Meagan: Tell us the story. Kelsey: Yeah, so basically my husband and I got married in November 2019. Just prior to that, we had actually been living in New Brunswick. Just prior to getting married, we decided to move back because we are from Ottowa. We moved to Ottowa. We were living with his parents, his dad, at the time. We went to Mexico for our honeymoon and on our honeymoon, we decided to start trying to have a baby. We decided to start trying but not preventing it because we weren’t sure how long it was going to take and there was no indication that it could take a while but my husband is actually an IVF baby. It had taken 7 years for his parents to conceive him. Meagan: 7 years, wow. They are amazing. That’s a long time. Kelsey: He was actually their last attempt. When his mom got up to say our wedding speech, she was like my 1 in 7 or something like that and I was just bawling. So because of that, we decided to start trying and not preventing but there was nothing indicating it would take us a while. We started trying in December of 2019 and it just wasn’t happening for us so around the year mark, we had a lot of friends who started trying around the same time as us and were getting pregnant really, really quickly. I was going to so many baby showers and crocheting baby blankets that just weren’t for my baby. Actually, the year mark rolled around and I got my period the day of. My best friend gave birth the day of. I was trying so hard to be happy and stay positive and whatnot, but it was devastating. 11:47 Logistics of giving birth in CanadaKelsey: We ended up being referred to a fertility clinic. They did a full work-up on both of us and there was nothing. They didn’t come up with anything. So they said, “You could keep trying or we could start IUI.” My husband and I said, “Let’s do 3 more months of trying on our own, and then we will try for IUI.” Our fertility clinic was in Ontario and we ended up moving to Gatineau, Quebec in July 2020.The way it works in Canada is you have your healthcare which covers. You can go inter-provincially and give your card unless you are from Quebec. If you are from Quebec, it’s kind of like living in another country. If you have a RAMQ card, you actually have to pay for your care in Ontario. The Quebec government will reimburse you but only for 30%. It’s super weird. If you are from Ontario and go to Quebec, the Ontario government will cover you in Quebec. Meagan: What? So weird. This world is so weird. Kelsey: I know. It’s super bizarre. So essentially we moved to Gatineau because the housing market was a little less expensive. I was working in Gatineau at the time as a teacher. I was extremely stressed out in my job especially once COVID hit. We were sent back to the classroom before any of the other provinces were. Anyway, I was extremely stressed out in my job and I decided to switch to the Ontario side because you can go between the two. Where I lived, you cross a bridge and you can get to Ottawa so you are in Ontario. Essentially, we went through the fertility clinic. They said that nothing was going on but because the Gatineau government will cover you for IVF and any fertility treatments up to a certain price so we had to be referred back to Quebec for IUI. The month that we were referred back to Quebec for IUI, it was the day before my appointment that I found out I was pregnant. Meagan: Oh my gosh, yay! Kelsey: Yeah, on our own. It super just happened and some weird funny things happened. The day before, my husband and I went for a walk around our neighborhood. I found a quarter and was like If pennies are lucky, then quarters must be super lucky. I picked up the quarter and put it in my pocket and the day after, I found out I was pregnant. These weird things kept happening. My pregnancy made me oddly psychic too which I’ll get into after. 14:38 A normal pregnancyKelsey: I got pregnant in March. I was due November 28th. I had a super easy pregnancy. I was nauseous for the first little bit. I was working for a virtual school in Ontario so I didn’t have to go into the school which was really nice. I just got to hang out in my basement and yeah. I mainly had nausea as a symptom but I was also extremely anxious because it had taken us so long to get pregnant. It felt like it was so long. It was about 15 months. I was super anxious. I had heard so many stories of miscarriage and whatnot, but luckily, we were followed by the fertility clinic because we were with them so we had a scan at 5 weeks and we had a scan at 8 weeks and then at 12 weeks once we graduated which was really nice. It was a really, really normal pregnancy. I ended up going back into the school in September and I was working as a French teacher. I went off work at 36 weeks. It was pretty normal. The reason I say that I was psychic during my pregnancy is that I kept saying all of these things about my baby. I had this gut instinct that he was a boy and sure enough, it was a boy. Mind you, it’s because my husband’s family only really has boys but then with certain things, people would say, “When do you think he will be born?” I’d be like, “Oh, I think December 4th.” I would make off-hand comments like, “Oh, he’s going to have really dark hair.” My husband and I were both born at 5:00. I was born at 5:00 at night. He was born at 5:00 in the morning. I said, “Wouldn’t it be funny if he was born at 5:00?” I said, “He’s going to be over 9 pounds. I can just feel it. He’s going to be 9 pounds.” Then the other weird thing is that I said he would be born December 4th, but someone told me, “No, you don’t want him to be born on December 4th. He will share a birthday with your cousin.” I was like, “Okay, December 3rd.” December 3rd rolls around and I am 5 days past my due date. I wake up in the morning to go to the washroom and my water breaks. I had not been well-informed about birth. I was just going into it like, Yeah. Everything is going to be fine. I had a bunch of friends who just had babies and everything was smooth sailing. The only time I had heard of a C-section was when my aunt had two C-sections because she had a breech baby and a special scar and then they didn’t give her an option for a C-section. I was like, Oh yeah. It’s going to be fine. My provider told me, “If your water breaks, go straight to labor and delivery.” Meagan: Many do, by the way. Kelsey: Yes, I do know that. Meagan: It’s a very normal thing for people to say, but we don’t have to do that. Kelsey: Exactly. Meagan: I did the same thing, the same exact thing. 17:50 Arriving at the hospitalKelsey: Yeah, so we went into labor and delivery. Actually, we went slowly. My husband was like, “I’m going to take a shower.” I was under the impression that baby was going to be born in a couple of hours. I was like, “We’ve got to go.” He was like, “No, no. I’ve got to take a shower. First impressions are important.” I was like, “All right.” Then we went and we got Tim Horton’s because I was super hungry. I figured This will be the last time I eat.We got to labor and delivery. They monitored me for two hours and I didn’t have a contraction until 6:00 right as I was leaving and I was only a centimeter dilated. She was like, “Come back in 12 hours or sooner if your contractions get intense.” So I went home. I decided to go to sleep but I was having irregular contractions. I woke up probably around noon and I was starting to get uncomfortable. My contractions were starting to get closer together and they were more intense. I could feel them in my back and in my bum. I learned a lesson. Anyway, I’ll get into that after. I could feel them mostly in my back and in my bum. My husband was like, “You look like you’re really uncomfortable. We need to go to the hospital now.” He was afraid of getting stuck in traffic because I ended up giving birth in Ontario even though we lived in Quebec. The reason is the hospital I gave birth at actually takes your RAMQ card, the Quebec healthcare card so we weren’t going to be charged for it or anything. The Gatineau hospitals are not known for being super well-equipped for much so we preferred to give birth in Ontario. We drove to Ontario which was a 30-minute drive so not super terrible, but traffic can be bad going across the bridge sometimes. The whole way there, I had really uncomfortable contractions. We got to the hospital and the doctor had me in the waiting room for 30 minutes, not terrible. The doctor meets with us and immediately, I just was not into him. He just put me off. He made an off-hand comment about nurses. He was like, “I see pain. Do you want pain medication? Do you want Advil or Tylenol?” I was like, “Whatever you can give me, I don’t know.” I told him, “One of the things going into it is that my husband would really like to catch the baby. Can we do that?” He was like, “Well, do you think you can handle it?” I’m like, “Well, he was a firefighter so he’s pretty okay with that kind of stuff.” Yeah. I can’t even remember the comment now, but he made an offhand comment like, “Well, that’s what nurses are for,” or something like that. I just was super put off by him. We went into our room and I didn’t know at the time that maybe I could have asked for someone different or whatever. We go into our room and we get set up and they were like, “We have to monitor you for a little bit.” I was like, “I’d really like to labor in the tub. Can I get in the tub?” They said, “We need the monitor on you for an hour.” I’m like, “Okay.” They monitor me for an hour. They give me a shot of Demerol or whatever. I was under the impression and my mindset going into it was that when you give birth, you use pain medication as pain management. I hadn’t researched anything else. I was just like, “I want the epidural as soon as I can get it and whatever you can give me for the pain is great.” 21:37 Stalling at 7 centimetersKelsey: I was monitored for about an hour and they let me get in the tub. For two hours, I laid in the tub and that’s my best memory of my birth with my first. I laid in the tub and listened to music. My husband and I were in the dark. It was very calm, soothing, and relaxing. When I got out, the doctor was like, “We need to check you.” He checked me and I was at a 1 but he could stretch me to a 3. He said, “If you want your epidural, you can have it now.”I didn’t know any better so I said, “Yeah, okay. Give me the epidural.” Overnight, I was progressing 2 centimeters every 2 hours. We got to 3:00 in the morning. I told a nurse, “I feel a lot of pressure in my bum.” I said, “I feel like I have to push.” She checked me and she was like, “No, no. You’re only at a 7.” 5:00 AM rolls around. My nurse comes in again and she checks me and she’s like, “Oh, you’re at a 9.” Another nurse comes in right after and she says, “She’s not at a 9. She’s at a 7.”The two of them were like, “We need to get a doctor in here to confirm.” It’s 5:00 AM. The doctor didn’t show up until close to 7:45. He’s like, “I’m not going to check you because the changeover will happen in 15 minutes and the new doctor is going to check you. I don’t want to introduce any more bacteria.” The new doctor came in at 8:30. She checked me and she goes, “No, you’re still at a 7. You’ve been stuck at a 7 for a few hours. We really need to start talking about a C-section.” It was the first time she had seen me. I had been lying in a bed now for almost 12 hours. They gave me the peanut ball for 2 hours and then they took it away I think because my son’s heart rate had started to go funny or they lost it or something like that but he was doing fine. They lost it because he moved or whatever. They took the peanut ball away and nothing showed that he was under any distress at all but she was like, “You’ve been stuck at 7 for a while so I want you to talk about it with your husband.” I was in tears because again, the whole time, all I said to my own provider was, “I don’t want a C-section. I don’t care what happens. I don’t want a C-section.” So I’m in tears. She’s like, “Talk about it with your husband.” She comes back an hour later and we were like, “We want to wait a little bit longer.” She goes, “Okay, what we’re going to do is put you on the highest dose of Pitocin.” She was like, “We’re going to start you on Pitocin and every 5 minutes, we’re going to increase it until you’re at the highest dose. Then we’ll wait 2 hours, check you again, and if you haven’t gone anywhere, you’ll have to have a C-section.” I didn’t know any better so I was like, “Okay.” They started me on the Pitocin but I’m having intense pain and pressure in my bum. I’m like, “I feel like I have to push. My body feels like it is pushing.” I knew that if you pushed too soon, your cervix would swell. That’s one of the few things I did know. They put me on Pitocin and I was crying because I was panicking. My husband was having to push my bolus every 15 minutes when it came on because I could feel everything through the epidural. The nurse was not super kind about it. She was like, “You need to stop pushing. If I check you now and you’re not an 8, then you’re going to have a C-section.” She just was not overly compassionate or anything. Well, finally, she suggests, “Why don’t we put you on your hands and knees?” She put me on my hands and knees and I felt immediate relief. Something changed in baby’s position. I sat there and I was able to talk. I was comfortable and I was fine. I think we got to an hour and a half and then they checked me because what happened was they put me on my hands and knees and my feet lost circulation and turned purple and went numb. Yeah, so then they put me on my back again. They checked me and they were like, “Oh, you’re at a 9.5.” I’m like, “Yes.” I progressed. 26:22 Asynclitic and OP positioningKelsey: Finally, we got to 10 centimeters and I was a typical you push on your back type of thing. The doctor said, “We cannot wait to let baby descend. Your water has been broken too long.” Then she checks me and she’s like, “Oh yeah, and baby’s OP.” I should have learned. Had I done my research, I would have known all that pressure was my OP baby. So she said, “Baby is OP. We’re going to start pushing.” I was so frustrated by her because she would leave the room and then she’d come back and she’d sit there just with her hand inside of me and checking her watch and stuff. She was just waiting for the hours to pass. I’m doing everything I can. Once they told me that I could push, I was like, “Yes. Let’s get this baby out.” I pushed for 3.5 hours and then they said, “We’ll give you 30 more minutes and if you cannot get baby out in 30 minutes, we’ll try forceps but we’ll need an OB to come in because if forceps fail, you will have a C-section.” I decided to push for 30 more minutes and the nurse came in and said, “Let’s flip you.” They flipped me again and I lost all of my progress. They had also told me that not only was baby OP but he was asynclitic so his head was tilted to the side. They said, “That’s probably what’s happening.” But when I flipped, I lost my progress. There was a new nurse who couldn’t figure out how to get the monitor on me so I couldn’t push in that time. They were like, “Well, we’re going to stop pushing because whatever.” 30 minutes passed and I had lost all of my progress. They’re like, “Okay, we’re going to get the OB in.” She comes in and she says, “You could tear.” I said, “I would rather tear than have a C-section. I don’t want to have a C-section.” Then I said, “What are the chances that this will work?” She said, “I wouldn’t do it if I didn’t think it would work.” As she tried to get the forceps on, I could feel my body pushing. I’m like, “Can I push? Can I push?” She’s like, “No, don’t push right now.” My body is doing it for me and she can’t get the forceps on so she’s like, “I can’t do it.” As she was trying to put the forceps on, baby started getting tachycardic so they said, “Things are going to get really scary for a minute because this is an emergency C-section. A lot of people are coming in here and we have to turn on alarms in the hallway because we have to get you to the OR really quickly.” Meagan: Wait, so baby’s heart rate is high not low, and just because baby’s heart rate went a little high, they treated it as a true emergency. Kelsey: Yes. Meagan: Okay. 29:31 Kelsey’s Cesarean under general anesthesiaKelsey: They start throwing clothes at my husband. There were people piling in. I’m in a hospital that is French-speaking. I can speak French but not medical terminology. Nobody is talking to me. They’re all just talking around me and they’re rushing me down the hallway. I’m bawling and I’m like, “I don’t want this.” I have no idea where my husband is. They’re trying to push my legs together but baby is so low that it hurts to do that. I’m telling them to stop and whatnot. We get into the OR and I was inconsolable because I was terrified. They gave me my spinal which didn’t take. They gave me the pinch test and I was like, “I can feel it. I can feel it.” I’m crying, “Please just put me out. I don’t want to be awake for this. I’m scared.” They’re not talking to me and that’s the last thing I remember is saying, “I can feel that,” and they put me out. I was under general anesthesia and I woke up 2 hours later in recovery by myself. It was COVID. It was in December 2021. My husband couldn’t be there. I asked where he was and they said, “Oh, he’s in your room with your baby. Everything is fine.” I was sobbing. The first thing she said to me was, “Everything went great. You are a great candidate for a VBAC.” That stuck with me. The whole way back to my room, I was staring at the ceiling. I couldn’t look at anyone. I was just devastated by how everything had gone. I didn’t think I could ever look at my husband or my baby ever again. I was just like, What happened?I hear my husband. He is like, “You need to see. Our baby is here. You should see him. He is so beautiful. He has the most beautiful eyes.” He came around to my bed and he passed me my son and nothing mattered. None of it mattered. He was 9 pounds, 8 ounces so I was right. He was born on December 4th which I had said at 5:11 PM. Meagan: Oh my gosh. Kelsey: Yeah. He had a full head of dark hair. He was born in a snowstorm. That was the other thing. I said, “He’s going to be born in a snowstorm,” because my husband and I were both born during a snowstorm and he was born during a snowstorm. Yeah, he was perfect. He was huge and he was chunky and he looked exactly like me. Normally, they look like their dads is what I’ve heard but he looked exactly like me and was so beautiful. Throughout my pregnancy, I don’t like being pregnant because I don’t like sharing my body I’ve learned. Throughout my pregnancy, I said, “I don’t want another. I don’t think I want another.” When he was born and I held him, I was like, “I will do this again in a heartbeat.” 34:50 Second pregnancy and VBAC prepKelsey: Postpartum was good. I ended up starting therapy 5 days after my C-section. He latched and he did not have breastmilk for his first feed which makes me really sad. I was devastated from the C-section because I didn’t get to see my baby be born. I didn’t get to hear his first cry. I didn’t get to touch him first and my husband wasn’t there. He wasn’t allowed to be in the room. Postpartum was fine. I was seriously anemic. I was incredibly swollen. I had no knees because I was on fluids for so long and getting around was awful, but I just focused on our baby. He was perfect. He was so easy and 6 weeks rolled around and I was like, “Let’s have another.” But we waited. We decided around 9 months to start trying again and loosely trying because again, we were wondering how long it would take. Meagan: Right. Kelsey: We ended up trying got 6 months and I got pregnant in April of 2023. My due date was December 29th. Again, super, super easy pregnancy throughout. Immediately after my C-section, I decided to look into VBAC because that stuck in my head. I had been listening to a different birth story podcast. I searched for VBACs and there weren’t many and then I searched VBAC in general on Spotify and came across you guys.I started listening to VBACs before getting pregnant and I started doing lots of research about it. I learned about the cascade of interventions and how my case was really typical. I started learning about OP babies and how the pain I was feeling correlated with that. I wanted to try for a birth in a birthing center. Now, when I got pregnant with my second baby, I was living in Gatineau but we had a bunch of stuff happen. My mother-in-law ended up splitting up with her husband. We said, Hey, let’s buy a house in Ontario together and we’ll move in. I found out I was pregnant about 2 weeks before we put in an offer on a house and we moved in in July when I was 15 weeks pregnant. At the time, my GP was my provider for my first and I started off with her with my second as well. The thing was when I found out I was pregnant, I went to her. Sorry, I should have said. After my C-section, I went to her and said, “I was told I was a good candidate for a VBAC.” She said, “Yes, but you cannot go over your due date. We’re going to monitor your baby to see how big it is because you had a big baby before. You cannot be induced. You need to have 18 months between pregnancies.” Typical. Meagan: All of the red flags. Kelsey: Yeah. This was before I started listening to your podcast. Then I started listening to your podcast and when I went in to see her when I found out I was pregnant before I had gone into a birthing center, I said to her– and I’m not an outspoken person. I struggle to advocate for myself. I said, “I want to try for a VBAC, but I do not want you to put limitations on me.” I said, “I know that I can safely have a VBAC even if there is less than 18 months between my pregnancies. From birth to birth, it was 2 years and a bit so it didn’t matter. I said, “I know that big babies are 10 pounds+. That is macrosomia. I know that.” I said, “I know that I can’t be induced.” In Canada, they generally don’t do Pitocin for VBACs at all. They don’t generally induce for VBACs at all. I said, “I do know that there are safe ways to induce though and I do know that I can safely go past my due date.” She said, “I believe in informed consent and if you understand all of this, I think that you are well prepared and we can move forward with a VBAC.” I said, “Great.” I had applied for birthing centers prior to this but it is really hard to get into them here. I ended up being able to get into one in Gatineau. I was concerned about moving over cross-provinces again. It ended up working out. I did stick with my GP until I was about 20 weeks pregnant just in case. It didn’t work out with the birthing center after my move. What happened was, she was super, super supportive, but she would say things like, “Do you want me to book you an appointment with an OB just in case?” or “Do you want me to book you a C-section at 40 weeks just in case?” I was like, “No, I don’t want you to.” She said, “Okay,” but around 20 weeks, my midwife was like, “We can keep you on even though you live in Ontario. It’s no problem.” I said to my GP, “My midwife will keep me on.” My GP said, “You sound like a really good candidate so go ahead. I really hope it works for you. I hope that it’s everything that you want.”Meagan: That’s good. Kelsey: She was very supportive of it so I felt really good about it. 41:07 Switching to midwivesKelsey: I switched to the midwives full-time. My pregnancy was super smooth again, but there were little hiccups. I didn’t pass my one-hour gestational diabetes test. They said, “If you have gestational diabetes and it can’t be managed, we will have to transfer care.” Around 37 weeks, I started measuring large and they said, “We think we want to send you for an ultrasound just to be sure of how big baby is.” I said, “I know that those ultrasounds aren’t super accurate so I’m not sure that’s what I want.”I ended up getting a doula through The VBAC Link. I found a doula. Meagan: Yay!Kelsey: Yeah, what was funny about the doula is she was pregnant too and her due date was a week after mine and we found out that we were giving birth at the same place. Meagan: Oh my gosh. Kelsey: So she was like, “I’ll keep you on and I’ll do your prenatal appointments, but I probably won’t be at your birth. I have a partner who is a nutritionist.” She ended up being amazing. My son was in daycare. I got sick a lot and I couldn’t take anything for it so she would help me find natural ways of dealing with a cough. I think I had pregnancy rhinitis for the last trimester. I was constantly congested. I had terrible acid reflux. She originally had prescribed chest openers, but my midwife ended up putting me on medication for it because of the trigger to cough. She was afraid that my cough could trigger my water breaking too early. I couldn’t give birth at the birth center if baby came before 37 weeks. I had to make it past 37 weeks. Yeah, so pregnancy was smooth. I was extremely nauseous in the beginning. It was really hard with a less-than-two-year-old. I kept him home because I’m a teacher. I’m home over the summer. I kept him home over the summer and it was rough because he just is needy and my 9.5-pound baby continued to stay in the 99th percentile for height and weight. He wanted to be carried everywhere but he is so heavy and he is still so heavy. I was a lot more active during this pregnancy than I had been prior. I tried really hard to walk and whatnot and do lots of stretches. Around 30 weeks, baby was still breech and I started to panic a little bit. I started doing Spinning Babies exercises and lots of inversions and whatnot.When I first met with my doula, I talked with her about everything. I was able to just spit out facts that I had learned from you guys. She was like, “I’ve never met someone who is this prepared or who knows this much.” She was like, “I have all of this stuff to go over with you, but you already know it.” She ended up as well becoming certified in HypnoBirthing so I took a HypnoBirthing class. I was really concerned about doing an unmedicated VBAC because I didn’t know if I could handle the pain of it. I had originally wanted to VBAC in the hospital, but I watched– what is that documentary with Ricki Lake? Meagan: Um, okay, hold on. Kelsey: The Business of Being Born. Meagan: Yes, that’s all I could think of was Born. The Business of Being Born. Kelsey: My entire perspective on birth completely changed. My husband watched it with me and he was blown away by it. He was just like, “I want that. I want that for us. I want to be a huge part of this. I want to help you through it and be an active participant. Let’s do this.” We did the prenatal classes with my doula. He learned all of the pain management techniques. He was so excited for counterpressure and he wanted to be active. He was fully supportive and he wanted to catch our baby. This time around, we didn’t find out the sex of our baby. We wanted it to be a surprise. I was 100% sure it would be a girl. I didn’t even pick out a boy name. Anyway, we get to December 21st. I get checked and she can’t even reach my cervix. It was so posterior. I was super discouraged, in tears discouraged because I was afraid of going past my due date and they were afraid that this baby was going to be so big because I was measuring large. 46:14 Beginning of laborKelsey: Overnight, I started to have contractions. They were kind of regular, but they were manageable. December 22nd rolls around and I’m still having contractions on and off and I start feeling sick. I had pulled my son out of daycare to prevent getting sick. I started to get a cough and I was really congested. I wasn’t feeling well at all. I was supposed to go to Costco with my mom that day. I texted her in the morning, “I’m having contractions. Not feeling great. Let’s cancel,” but because my son was home, things started to slow down with the contractions. I said, “You know what? Never mind. I need something to do today.” My mom picks me up and my husband and her are joking that I’m going to go into labor at Costco. We walked the entirety of Costco as I was having contractions. My 18-year-old brother is in the back of the car. I’m breathing through them and he’s like, “What is happening right now?”I get home. I started timing them and they were 6 minutes apart. My husband decides that he is going to take our son. He was kind of off work so he took over care of our 2-year-old. I ended up going and taking a bath and all of the contractions stopped. That night, they started again and then on the 24th of December, they were still pretty inconsistent but my doula was suggesting things like, “Oh, if you’re comfortable, have sex, then take a shower. Sit on the toilet and do nipple stimulation for 15 minutes on each side and see if that gets things going.” We had sex and then it all stopped. We kept trying things and then my doula was like, “I just think that maybe your body needs to rest and relax so let’s try resting and relaxing.” Well then, the 25th is Christmas Day and I decided to host Christmas. Meagan: Because that would be a really good distraction. Kelsey: Yeah, I was like, “It’s going to be fine.” My mother-in-law was like, “I’ll cook Christmas dinner.” Prior to that, I had all of these ideas. I’m going to make bread by myself. I’m going to make all of these desserts. I’m going to make puppy chow. I’m going to wrap all of my kid’s Christmas gifts. I’m going to put together his Pikler Triangel we got for him and wrap that. Just all of these things that I wanted to do for Christmas. By the 24th, I was so exhausted from the contractions that I didn’t bake anything. There was no way. But I did host Christmas dinner and everyone told me, “Why? Why are you doing that?” I was like, “Well, it will be easy,” because my husband and I are both from divorced families. We’ll just have everyone over for Christmas, and then we won’t have to worry about going to anyone else. We had my mom and my brothers came over and his step-mom came over and my step-dad came over. It just was not great. Meagan: Like Christmas Vacation where the door keeps opening and all of the family members keep showing up. Kelsey: I know. I was still having contractions. I couldn’t stand up or sit down without having a contraction. I was just exhausted and uncomfortable and felt huge. People are like, “How are you doing?” I’m like, “I’m surviving. Right now, I’m just surviving.” So anyway, finally Christmas Day is over and Boxing Day, I wake up at 7:30. I had a weird contraction. I went to the washroom and I had my bloody show. I was like, “I’m just going to try to go back to bed,” because my son and my husband weren’t up but my back started to hurt. I was like, “Okay, I’m actually just going to get my son up and go downstairs.” My husband got up with me. We go downstairs. We started getting my son ready. I’m like, “I’m going to get in the bath and see if my contractions stop because I’m really uncomfortable.” I called my midwife from the bathtub and I said, “They are 5 minutes apart and they haven’t stopped, but I’m scared to come in because what if this isn’t real?” She said, “If you’re in the bathtub and they are still going, this is real labor. You need to get here now.” 51:07 Driving to the birth centerKelsey: We get all of our stuff in the car. It was a 50-minute drive to the birthing center. Meagan: 50? 5-0?Kelsey: 5-0. Meagan: Okay. Kelsey: The good part was that they were regularly 4 minutes so I could look at the clock and know that I was going to have a contraction and I could breathe through it. I was managing pretty well at that point, but before we had left, my mother-in-law decided to stop me at the door. She was like, “So where are you feeling them?” I’m like, “I just need to go. Please just let me go. I can’t talk to you right now.” My husband is trying to get me out the door too because he knows. We get to the birthing center. It was nice because I could choose the color of my room. They had options for the color of your room so I chose purple. I get into my room. It’s now 10:00. I could hear in the next room a woman screaming, literally screaming. I start panicking. I can hear her yelling, “Get out of me already!” Meagan: Aww. Kelsey: My vagina is on fire! I’m panicking. My midwife says, “I need to monitor you for a little bit, so can you get on the bed? I’m going to monitor your baby’s heart rate and then I’m going to monitor your contractions.” She could get baby’s heartbeat and she couldn’t get my contractions on the monitor. At this point, I’m starting to panic because I can still hear the woman screaming. My husband’s like, “I’m going to get you your headphones.” He gets me my headphones. Meagan: Very good call. Kelsey: He gets me my headphones and puts on my birth playlist. I’m laying there and things start getting really intense really fast. I was panicking that the same thing that had happened with my son was happening again. But I started getting irate and my midwife still couldn’t get the contractions on the monitor. I remember flinging my headphones off and just being like, “I need to go to the bathroom. Let me up. I can’t lay here anymore.”She’s like, “Okay. If you need to go to the bathroom, go to the bathroom.” I’m sitting there on the toilet. I’m crying and I’m telling my husband that I can’t do this. In the back of my head, I know what that means, but I couldn’t ration with myself at that point. My midwife hadn’t checked me yet at all so she goes, “I really want to check you because we haven’t done that.” I had to get off the toilet. I didn’t want to and as I was getting off the toilet, I was so hot. I’m flinging my clothes off. I get to the edge of my bed and I’m like, “It’s not me. It’s my body. I’m pushing.” I saw my stomach contort. It was just like my whole body was not me at all. It was so wild to me. My midwife gets me on the bed finally and she checks me and she goes, “You’re at the 7th centimeter.” She said, “You’re a second-time mom so if your body feels like it, it remembers. You can start pushing whenever you want.” It was such a different experience from being told in the hospital, “Do not push,” when I’m at 10 centimeters to my midwife being like, “If your body is pushing, it’s fine.” 54:49 Pushing baby out in two pushesKelsey: So she put me over a ball and then she called in the assistant midwife because she was like, “This is happening very soon.” The assistant midwife comes in and that was funny because she goes, “My name is Gabrielle.” I had a friend who had gone to the birth center who had Gabrielle. I turned to her and said, “You know my friend, Kelly.” She was just like, “Yeah.” I’m like, “I heard you’re really good.” She’s like, “Okay, let’s–.”So over the ball, my husband tried to do counterpressure on me and I was like, “Don’t. Don’t do it.” But he pressed my tailbone down and that made a huge difference and I just kind of let my body do its thing. They had to flip me a couple of times and I ended up being put on my back to push for the final little bit because they needed to keep monitoring baby’s heart rate. It kept going down every time I had a contraction so they were a little concerned. At one point, they said, “Don’t panic, but we are going to call an ambulance just in case just because we keep seeing this. We’re going to call an ambulance just so that they are here.” Yeah, so I pushed on my back for a while and I remember at one point, she said, “The head’s right there. If you reach down, you can touch it.” I was like, “I’m going to have my baby vaginally.” My husband was like, “Yeah, you are.” I was just so excited. In one push, his head came out and she goes, “Ope, he’s OP.” He was sunny-side up. My husband was like, “He’s looking at me.” Well, sorry. That’s a spoiler. “They’re looking at me. I can see the baby. Their eyes are open. Their mouth is going.” And then she said, “Okay, next time, one really big push,” and he came out on the second push. My husband caught him and put him right on my chest. I was like, “What is it? What is it?” It was another boy, so spoiler alert. We didn’t have a name. I got to hold him on my chest for 2 hours. We did delayed cord clamping. My doula made it in the last 15 minutes and she said to me, “I think Victoria is in the next room having her baby.” Meagan: Nuh-uh. I wondered when you were saying that. I was like, I wondered if that was her doula. Oh my gosh. Kelsey: Literally, our babies were born 2 hours apart. Meagan: Oh, that’s so cool. Kelsey: We were in the birthing center at the same time which was wild. I got to see her on my way out which was really nice. Meagan: That’s so special. Kelsey: Neither of us knew what we were having and we both had little boys. They weighed him and my super big baby was 8 pounds, 3 ounces. Meagan: Perfect. Kelsey: Perfect. Yeah. People were like, “That’s a good-sized baby.” I’m like, “My first was 9.5 pounds. He’s tiny.” My husband got to tell me the sex of the baby which was another thing I really, really wanted. We did delayed cord clamping. We had the golden hour. We just got to sit there and compared to my prior experience, I just felt so cared for. I remember a midwife putting a cold cloth on my head and I thanked her. Her response was, “I know you are grateful. Save your strength.” She was just like, “You don’t need to tell me thank you at this moment. Just don’t talk at all. I know you are thankful.”Meagan: Enjoy. Kelsey: Yeah, I was given water in between pushing. My doula sat there and rubbed my eyebrows so I wasn’t tense because I learned about the fear/tension/pain cycle. My husband got to be a huge part of it and he got to cut the cord. He didn’t get to do that with our first. He got to hold our baby. He touched him before anyone. It was just– my husband and I talked about it for a while afterward and he was just like, “You know, why is this not the gold standard for birth? Why is this not what we do every time? This is the most incredible thing.” We recorded the entire thing. Meagan: Yay. If you decide you want to share, post it in the community. Kelsey: There is a 30-minute video out there because my son was actually, so my first birth was 38 hours total. My second birth, I had my first real contraction at 7:30 AM. My son was born at 12:38 PM. There were 5 hours. Meagan: Another five, by the way. Kelsey: I know, so weird. I was not psychic for this birth because I had a boy. I was so convinced I was going to have a girl but he was a little boy and he was baby no-name for four days. We ended up naming him Oliver. 1:00:24 Differences in careKelsey: Yeah, I just felt so cared about and looked after. There were differences like my husband had to go out and search for food after I gave birth after my first. He was so exhausted, he couldn’t get out of the parking lot so my mother-in-law had to drive in to bring us food. I ended up scarfing down Popeye’s but I had been intubated and my throat hurt so badly. I ate the world’s driest biscuit and thought I was going to choke and die. But with my second birth, they had a postpartum doula who was there. She offered me lentil soup and a grilled cheese so that was my first meal. Meagan: So much better. Kelsey: Yeah, lovely lentil soup and grilled cheese. My son had been placed on my chest but I still had my bra so they washed it for me before I left. Just small things like that, I felt like I was cared for. Meagan: Yeah, absolutely. Kelsey: We ended up leaving at 5:00 PM. We were home in time to eat dinner at home. Meagan: Yeah. Yeah. Kelsey: That postpartum experience was incredible. We literally, I was able to get up and walk and I wasn’t dizzy or anything. I barely felt like I had a baby. I did have a second-degree tear but for some reason was just completely unbothered by it. My midwife came to me postpartum which was really lovely. 1:02:11 EnterovirusKelsey: However, one thing I did want to touch on was I had a cold during labor and this is something I wanted to mention because it is not something I knew about. I had a cough and five days postpartum, on New Year’s Eve, my doula came. Not my doula, my midwife. As they do, she temped my baby and he was measuring a little hot. She temped him a second time and he was normal. Around 4:00 AM on New Year’s Day, I realized he was very warm. I temped him and he had a fever. I only know Celsius but it was 39.9 which is really high. I temped him a second time and he was 39.2. Anything over 38 is a fever. I ended up having to take him to the hospital and I didn’t know what the protocol was if your baby gets a fever below two months. We were pretty much admitted on the spot. He had the full workup. He had bloodwork done. He had a lumbar puncture done. He didn’t have a birth certificate and had to have a lumbar puncture done because the problem was that they were looking for infections. When they did his lumbar puncture, they did find something. He had a virus called an enterovirus. In adults, it’s just a common cold, but if you get it while you are pregnant, you can pass it through your placenta to your baby just before you deliver and your baby can be born with the virus. It can just present as a fever, but it can also progress to viral meningitis. Meagan: Oh, scary. Kelsey: My son was kept in the hospital for two nights. Because of the fever, he stopped nursing. He was super sleepy and they make you stay for two nights even if they perk up and are nursing and everything seems fine. They will keep you for two nights because they are looking for things to grow on the lumbar puncture. If a fever indicates an infection and because the blood/brain barrier is so thin, infections can spread super quickly to the brain. Meagan: Scary. Kelsey: He ended up being okay. He didn’t have viral meningitis and I had the most incredible angel nurse while I was there. I was so grateful for her. I forgot my Peri bottle at home and she made me one. She did everything she could to prevent my son from being put on an NG tube while still getting the fluids he needed. She managed to get him nursing enough that we didn’t have to switch to an NG tube. We didn’t have to switch to bottle feeding. He continued to nurse. She stuck up for me when a resident came in and was like, “Well, what’s his urine output like?” I was like, “I don’t know. I have no idea.” She was like, “All of that is in his chart if you just check it. She’s obviously very tired. Leave her alone.” I had a lovely angel nurse but it is something I wanted to touch on because I had never heard of enterovirus. I did know what to do if your baby got a fever, but it definitely is that you take them right to the emergency room. Generally, they will admit you for two days. But yeah, otherwise, my postpartum experience was night and day compared with my C-section. I was up and moving and I did experience baby blues with my first. I cried for weeks. With my second, I was just so over the moon. But yeah, that’s my VBAC. Meagan: I love it. Thank you so much for sharing that. I had actually never heard of enterovirus.Kelsey: Enterovirus.Meagan: Enterovirus. I was like, What the heck? That’s actually with an E. I didn’t know that. I just Googled that so it’s really, really good to know that’s a thing. It does look like it’s pretty rare but it’s something to take seriously. Sorry, my dog was barking in the background. He’s got something to say too.I’m so happy for you and I’m so happy that you could see that it was a very similar situation with an OP baby and things like that and you were still able to deliver vaginally. Maybe it was a little bit of that asynclitic position that maybe made it a little harder to get under that pubic bone. It sounds like in ways they were willing to help you, but they also didn’t help you too much either. Kelsey: No. Meagan: Yeah. I just love that you were able to prove to yourself too. Not that we have to prove anything to ourselves or anybody, but it is definitely nice when you are like, This is the same situation and look, I did it. Yes, my baby was a little smaller, but it probably wasn’t the size more than it was just a slight bit of position and probably the cascade. I love that.1:08:02 Risk factors for forceps and vacuum deliveriesMeagan: Okay, so before I let you go, I wanted to touch a little bit more on those risk factors for forceps and vacuum because we talked about that in the beginning and tearing. Tearing is definitely a risk. You even said with your VBAC baby that you tore a little bit which is really common with a posterior baby coming out vaginally too just to let listeners know. Tearing can happen. It can happen with any baby. We can get rectal pain. Posterior babies, oh my gosh. Amazing to not only labor with one but push one out. It is hard work. You did an amazing job. Yeah. It may have a lower chance or a higher chance of coming out vaginally just in general. For baby, that bruising to the head or even nerve damage. It’s really rare but it is a thing. Temporary swelling, skull fractures– again, it’s rare but it is a thing so these are all things to take into consideration. For vacuum, we’ve got weakened pelvic floor, tears as well, possible even larger tears weirdly enough so that’s a thing and then yeah, for baby, the suction can pop off and need to be replaced or cause hematomas there. Just all things to take into consideration. In the show notes, I know this wasn’t a complete forceps delivery, but because it was something within your story, I wanted to touch on that today and make sure we included links. If you guys want to learn more, check out the show notes. Also, I just think it’s so fun that you and your doula were at the birth center at the same time giving birth at the same time. There are so many fun things about this story. Amazing support it sounds like from your husband, from your family, and from all of the things. I just loved your story and appreciate you so much. Kelsey: Thank you. Thank you so much for having me. Meagan: Absolutely. It’s been such an honor. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan’s bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
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