Podcasts about Apgar

Liz, a mama of two from Long Island, New York, joins us today sharing her experience with preeclampsia, an unexpected C-section, and her successful VBAC with her second. Liz had a perfect health history and never had any surgeries before her C-section. It was so frustrating to feel so out of control. In between her birth and her second pregnancy, Liz's mom unexpectedly passed away. She shares how she has been processing the intense grief from her mother's passing and from the positive birth experience she wasn't able to have. Liz made lots of changes going into her VBAC birth including diet, switching providers, and choosing to birth at home!Liz's DoulaCoterie Diapers - Use code VBAC20 for 20% offHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan Hello, everybody. We have our friend, Liz, from New York with us today. She is a mom of two and almost two years old. Right? Your VBAC baby?Liz: Yes.Meagan Almost two years since your VBAC baby.And then an almost six-year-old. And yeah, like I said, she lives in New York, and she's going to be sharing her stories with you guys today. With her first birth, she actually had preeclampsia, so she's gonna talk more about that. And then with her second birth, she didn't have preeclampsia. I think this is an important thing to talk about because we know that having preeclampsia again is a possibility, and it might be slightly increased if you've had it, but it doesn't mean you will. So I'm hoping that we can talk a little bit more if you did do anything to try to avoid it. The second one, we'll talk more about that in a little bit. But knowing that it's still okay. If you have preeclampsia, you can still VBAC. Now, in her second one, she didn't have preeclampsia, but you can still VBAC if you have preeclampsia. So we're going to talk about that a little bit after your first birth too, because I want to know more. All right. We do have a Review of the Week today, and this is by jess2123. It says "Best Podcast for VBAC". It says, "I listened to the podcast after my son's birth. I learned so much that I knew I wanted a VBAC for my second birth. When I became pregnant again, I would listen to this podcast during my walks. Thanks to the wealth of knowledge that I gained, I had my unmedicated VBAC in 2023." Congratulations, Jess, on your VBAC, and thank you so much for your review. I know this year we're tossing it up between reviews and educational pieces, but I just do want to remind you really quickly that if you haven't left us a review yet, we would love it. You can push "pause" right now and listen or leave a review on Apple Podcasts or Spotify. You can go over to Google. Google "The VBAC Link", and leave us a review there. These reviews really do help us and bring us so much joy. So without further ado, I want to turn the time over to you.Liz: Thank you so much. I guess every VBAC story starts with the Cesarean story, or at least there's one in there. My pregnancy journey did start with a Cesarean as far as the first birth. As Meagan mentioned, I am a mom of two. With my first son, I fortunately have been reproductively very healthy and otherwise healthy my entire life. I was able to track everything. I had regular cycles and really no issues there, so I feel really, really blessed in that regard. I was able to get pregnant pretty easily. I believe I got pregnant in about February 2018 for the first time. I found out mid-March after I tested in my bathroom and just ran out with the test to my husband, nothing super special. I think I was just shocked. I remember I had gone to a St. Patrick's Day parade and felt so tired that I said to my friend, "I'm going to go home and nap in between that and another event." They were all like, "Why are you napping?" I was like, "I don't know, I'm just really tired." I took the pregnancy test to rule out pregnancy. It was immediately positive which was amazing. My EDD, my estimated due date, was supposed to be Thanksgiving that year, so it was November 22nd which was Thanksgiving 2018. That just made me laugh because I was like, wow, what a far cry from Thanksgiving Eve spent even a decade previous. But yeah, so my pregnancy started out pretty status quo, I would say. I definitely experienced that nausea. My morning sickness was definitely an all-day thing, so it was a little tough. I think it threw me for a loop because I didn't know what to expect. I had always wanted to eat healthier, especially being pregnant, but it was like my body would not allow me to eat what I wanted or what my brain wanted me to eat. It was a lot of carbs to start out. I know that's pretty common. I remember when I went for my first appointment, I had called an OB's office. I'm trying to think. I think I had gone for one well-woman visit before, but I had two friends, actually three friends who had delivered with this OB and had good experiences, so I figured I would give it a try. The funny thing is, pretty much from the jump, I could tell that we weren't very aligned. I didn't really see eye-to-eye with him, but he had this nurse practitioner who was wonderful, and I feel like she drew people in because she was just very nurturing and calming, and she just had that great energy. I knew, obviously, she wasn't going to be at my birth, but I still stayed there.Meagan Oh yeah. So can we talk about that a little bit? So you had one provider that you're like, "I don't know, our energy doesn't match." And then one that you're like, "Our energy totally matches." But then they wouldn't be birthing with you. So tell me a little bit more of what that provider was that wasn't matching your energy.Liz: Yeah. So I guess because I had always been so healthy, my experiences with medical professionals were very limited. I had just gone to doctors for routine checkups my entire life, and everything was always fine. I think because I wasn't very experienced in the medical world, I almost had this aversion to it. I just was like, they're there if there's an emergency, but it'll be fine. Everything will be fine. I'm trying to do this as naturally as possible. He seemed very old school. I don't know how to describe it, just very set in his ways. I remember, I'll circle back around, but towards the end of the pregnancy when I had finally gotten the gall to tell him that I really wanted to try and do this unmedicated because I was so nervous to say that, he was like, "Well, don't expect this baby to just fall out of you. You're a first-time mom."Meagan Wait, what?Liz: He literally said that to me. And I was like, "Okay, I didn't think that." Meagan: I wasn't saying that. Liz: Yeah, I wasn't saying that I didn't think I wouldn't have to work hard. That's not what I'm saying. So just comments like that. The bedside manner just didn't seem very nurturing. He was very by the book, quick appointments, and asking me his little checklists of items, and that was it, whereas I felt like his nurse practitioner was very warm, had great bedside manner, and really just cared about mothering the mother in that situation. It wasn't just about the baby and how I was going to give birth or how I preferred to give birth. It was the entire experience. I remember at one point, she even said, "Obviously, there is a need for testing certain things and for keeping an eye on everything, but I really just feel like if we left women more alone to go through their pregnancies, they might be better off because we're so hands-on in the United States, and it just causes sometimes more anxiety throughout a time that's supposed to be really beautiful."So she did mention that she reminded me of, I don't know, a woman who crouched down in the field and gave birth to her babies in the woods. That's who she reminded me of. I don't know if that's the truth for her. I never did ask anything about her birthing experiences, but that's who she reminded me of. Just super warm and nurturing. I think also I maybe just aligned more with a female provider. It could have been just that too.Meagan: Yeah, it could have been. But I mean, what you were saying, comments like that, if I'm being super straight, we've interviewed providers on here that have come across really great, and then the more I've interviewed them, I'm like, "Oh, I don't know if I like that. I don't know."That can just happen. I think that's where it comes with vetting your provider and going with who makes you feel warm and fuzzy. But at the same time you're in this place where you're like, well, we've got this medical. We'll see how it goes. I've got this to also like, I've got this warm, fuzzy, filling-my-cup over here. So it seems like it's an okay match, right?Liz: Yeah. And I also manipulated it to the point where I would only make appointments when she was available throughout my pregnancy where the office was like, "You have to see the OB. You have to. He is going be the one who's attending your birth." I'm just like, "But I don't want to. I don't want to do that."Meagan: Yeah.Liz: I just stuck with the practice, I think, because I was nervous. I was new to it and like you said, I was getting my warm and fuzzy cup filled by that nurse practitioner's presence. Things progressed. I finally outgrew that morning sickness. By the second trimester, it was week 12 or 13 and it let up, and I was feeling good. I was pretty energetic. I was doing yoga on a somewhat regular basis. Nutritionally, I do want to mention because I think this does play a role in how things may have gone with the preeclampsia. But nutritionally, I was actually coming off of a vegetarian diet. I had been a vegetarian for a few years. I had gotten really deep into yoga in the early 2010s, and I became a vegetarian when I was doing teacher training for that. So I was purely vegetarian for a few years, and then I started integrating poultry back into my diet. I ate very little because my husband also doesn't consume a lot of meat, so we just didn't eat a lot of meat. I feel like I'm already a picky eater even as an adult. I definitely was as a child, but even as an adult, I still have things that I just don't like, so I feel like my diet was pretty limited, and I perhaps was not getting the nutrients that I needed, especially when my body underwent this or got pregnant and was going through this stressful event.Meagan: Yeah. Growing a placenta and a baby. Yeah, it needed its nutrients.Liz: Yeah. So I feel like during my pregnancy, especially once I started to feel good again, I ate whatever I wanted. So that whole like, I'm just going to eat so healthy, I was just like, yeah, no. I'm eating for two. I totally knew that's not what you're supposed to do. Meagan: I did the same thing. Liz: Yeah. I was like, whatever. I'm feeling great. I'm going to eat it. It's there. I'm going to eat it. So I get to my 20-week anatomy scan. I'm not even sure if it was exactly at 20 weeks, and everything goes well. Fortunately, no complications with the baby. Oh, I had also gotten a NIPT to find out the sex of the baby, so I knew I was having a boy. The anatomy scan did validate that. But that week, I don't know if it was right before or right after my anatomy scan, I noticed that I was starting to swell just on my right side of my body. My right foot was swollen. My right ankle leg was a little swollen. I remember reaching out to my social media friends. I just put out a status like, "Hey, pregnant lady here. I don't really know what's going on. Is this normal? Is this something I should bring up to my provider? What do you guys think?" There were plenty of people who were like, "No, it's totally normal to be swollen at that point." I even said, "It's only on one side though. It's weird."Meagan: Yeah, yeah.Liz: So they were like, "Just elevate your feet. See what happens." It would always go down, but it was just odd that I happened to notice just the swelling on one side of the body. So definitely interesting. Yeah. So I keep going. I'm getting bouts of pretty much every pregnancy symptom, but it would always be very short-lived. I definitely had some reflux, short-lived. I got sciatic pain so bad one day that I couldn't get out of the car. I remember I was sitting in the passenger seat and I said to my husband, "I can't walk on my right leg right now because of my sciatic nerve." So I was doing all these exercises to try and get the baby off my nerve and all of that, and everything just waxed and waned. Nothing was long-lived by any means. So I get to 30 weeks. I think it was at my 30-week appointment, and I believe it was the medical assistant who come in and took my blood pressure and wait like they always do. I don't know if it was her or the nurse practitioner who said that I had my first high blood pressure reading. Like, "Oh, it's elevated a little bit." And I was like, "Oh, that's so strange. I've been a 120/80 girl this entire time, and my whole life, I've never had blood pressure issues." And they're like, "Okay, well it's something to keep an eye on. Let's see. We're going to let you lay on your side, and see if we can have it come down. We'll take it at the end of the appointment again." And it did. It would come down, but they definitely were like, "We're going to keep this in our back pocket, and we might have to have additional monitoring if this progresses." I didn't really know what high blood pressure and pregnancy could mean, so of course, I go to Dr. Google like a good pregnant lady does, right?Meagan: Yep. A lot of us, I'm guilty.Liz: Guilty. Yeah. I was like, okay, so it could be hypertension in pregnancy or it could turn into preeclampsia. I was reading all the things, how this could turn and what that all meant. So in the back of my head, I always thought like, okay. I'm aware of what could indicate preeclampsia, but that's not going to be me. I am a healthy person, right? I've always been healthy my entire life. There shouldn't be any issues while I'm pregnant. And that wasn't the case, unfortunately. But I did go in a few more times, and I did get elevated blood pressure readings. So I don't know what week I was, but I know it was the beginning of October. I saw this other nurse practitioner who was not warm and fuzzy. She was new to the practice and she saw me. She took my pressure, and you could see the alarm in her face, but she wasn't saying much. This stuck with me to this day. It's just so crazy. She handed me this paper. The hospital that I was delivering at is a small community hospital, but it's affiliated with this Catholic healthcare system where I live, so they have a few different hospitals that are also within that same system. She just gave me this paper that had a listing of all these numbers for these different departments at these hospitals, and she just said, "You need to call them and make an appointment." And I'm like, "I have literally no idea what this is about." She's like, "Your pressure is high. You need to go make an appointment with them," but that's all she said to me. Meagan: For what? Yeah. Liz: Yeah, what is happening right now? I remember even that day, she asked me about my face. She was just like, "Is your face swollen? Does your face normally look like that?" I was like, "I have a very round face. I have big cheeks. To me, my face doesn't look different." Yeah. So she handed me that paper, told me to call, and like the good patient I am, I was like, "Sure, I'll call." So I called. I found out it was maternal-fetal medicine, which for those of you out there that don't know what that is, that's a high-risk doctor, and I had no idea. So this is my first experience with that. I did call. I made an appointment, and my OB office had me do a 24-hour urine drop or urine drip, however you want to call that. Meagan: Urine catch? Urine catch, probably?Liz: Yeah, so for those of you who don't know what that is, they give you a jug from a lab, and you have to put your urine into that jug for an entire 24 hours. They test it, and they're checking to see if there's any protein that is spilling into your urine because that could indicate decreased kidney function. Meagan: Preeclampsia. Yeah.Liz: Yeah. That is a symptom of preeclampsia. So I did do that. I went and saw MFM, and in the office there, my pressures were labile. They even called them that-- labile. It had elevated a little bit, probably in the 130s over 90s, but then by the end of the appointment, it had come down. My labs for that urine catch did indicate that there was protein present, but it wasn't within a diagnosable threshold. It was below that lab threshold, so I basically wasn't diagnosable. But they were like, "Now we're going to watch you." Most people like to see their babies on ultrasounds. That's an exciting thing. I became so fed-up with having to go in. I was, at that point, a frequent flyer. I was going in weekly earlier than a pregnancy that wasn't having any sort of complications. I was getting not only an ultrasound, but an NST every time I went in, so I'd have to lay there for 45 minutes while they looked at the baby's heart tones and everything. Yeah, at that point, I was just really stressed out because I was like, is that what this is turning into? But I don't have preeclampsia. I think I also saw my OB within that timeframe and he mentioned, "If this progresses, we will be doing a 37-week induction." And I was like okay, so I'm going to keep that in mind. But again, this isn't going to progress to that because I'm healthy and we're going to make it past 37 weeks. I probably wouldn't get the type of delivery that I wanted. And that's probably something I should mention. If I was induced at 37 weeks, I was preparing to have an unmedicated birth, a vaginal birth, and I was even taking a HypnoBirthing class to try and labor as long as I could at home. My whole thing was that I didn't want to go to the hospital until I needed the hospital or until I felt I needed the hospital. So here I am thinking, okay. I want this unmedicated, low-intervention birth, but I'm having all these interventions right now because they need to monitor me. There's some sort of issue that might be brewing. Yeah. I already said I went to MFM and all of that. My symptoms, at that point, were mostly swelling. I was getting very swollen at this point. I had that pitting edema in my legs, so I could press my finger into my leg. Meagan: It stayed. Liz: It stayed, and then my feet were like little loaves of bread. My feet will never forget what they went through. My husband would just massage them every single night, trying to get the fluid to move out of my tissues. It was crazy. I had another experience with a different OB who was not my OB, but I was out at a family event at this restaurant, and this woman approached me, told me she was an OB, and asked me if I was okay because my legs and my feet did not look so great.Meagan: What?Liz: Yeah. I was just standing in the lobby minding my business, and she's like, "Are you okay?" as if I'm not being monitored, but do you think I'm just going through this free and unaware of what's happening? Yeah. So that was interesting. She said that she was an OB. Yeah. So I went for weekly NSTs, the ultrasounds, and everything looked great with the baby. He was never under any sort of distress. No concerns of intrauterine growth restriction, nothing like that, but my pressures just kept being labile. I actually borrowed a blood pressure cuff so I could monitor at home. There were some mornings where I'd lay down on the couch after I woke up, and my blood pressures were reaching into those like 140s over 90, 91 maybe. I just would cry. I was just hysterical. Like, why is this happening? I don't want to go to labor and delivery right now. I don't want to be monitored. I'm already being monitored so much. There were probably some weeks towards the end where it was more than once that I went into my OB's office for monitoring. So fortunately, we made it through that 37-week mark. We made it all the way to, essentially, the end. And we get to Thanksgiving Eve, right? So my due date is the next day. I'm at 39 and 6. This was one of those appointments where they said, "You have to see the OB." I know I just kicked and screamed, not really, but in my head like, "F"ine, I'll see him. So the medical assistant comes in, takes my pressure and my weight, doesn't say anything, and leaves the room. He comes in, takes my pressure in my weight, and he asks me to meet him in his office.Meagan: Really?Liz: Yes. So I get myself dressed out of the gown that they had given me, and I go meet him in this fancy office. And he's like, "Your pressure is very high today, very high. So you're going to be going to labor and delivery straight from here." He's like, "I have a few meetings that I have to attend to here, but I will meet you over there in a few hours." And I was like, obviously, on the verge of tears. I'm just like, "Can I please stop home and get my stuff? Like, I have bags, I have a dog."Meagan: If you can go to your meetings, I can go to my house.Liz: Right. And yeah, my OB's was maybe 12-13 minutes away from my house, and the hospital was about five minutes down the road. So I was just like, "Can I just go home and grab my stuff?" And he's like, "No, no, no. Go straight to the hospital." And he goes, "And you're probably going to have a Cesarean."Meagan: What?Liz: This is after I tell him my natural birth, or my unmedicated, definitely wanting a vaginal birth. I was like, what? Literally, that was when the tears of waterworks really started. I was just like, "there's no shot at me having a vaginal birth?" And he's just like, "Well, I'm going to be putting you on medication to prevent seizures, so you can either labor with that and have it cancel out my induction medication, or you can just be calm and go to a Cesarean." Like, go to the OR, essentially.Meagan: What were your pressures?Liz: 170/110 that day.Meagan: Okay. Okay.Liz: So, high. Meagan: Yeah. But he's like, "You can do this, but it's not going to work, or you could just calm down and do this."Liz: Yeah, yeah. It was like, those aren't options, so that's not really an option. Right? That's what you're telling me. Meagan: Yeah. Liz: Yeah. So I called my mom. I called my husband, frantic. I was just flipping out. I get out of the office, I'm crying in the parking lot telling everybody. They're telling me to go right to the hospital. So, of course, my husband rushes home from work. He was at work. It was a Wednesday, and he got my dog. He had to bring my dog to my mom's, grab our bags to the extent that they were packed, and he met me there. I was crying. I walked myself into the hospital. It was the most surreal thing. I checked myself in knowing that I was going to come out with a human being, which was bizarre. And when I finally got to labor and delivery, my nurse was so sweet, but I was crying so much that she was just like, "Are you going to be okay?" And I was like, "I really want a vaginal delivery." And she's just like, "Honey." She goes, "I understand. I do think he's making the right choice. I do think you're making the right choice," which again, I don't really feel like I had a choice in that.Meagan: Yeah, you're like, "I wasn't really given a choice."Liz: She was also trying to relate. She's like, "I've had three Cesareans. I promise you're going to be okay. You're going to be okay." I was just like, "I've never even had a tooth pulled. I don't know if I could do this."So my husband arrived again. I'm just crying. He's trying to cheer me up, trying to keep our eyes on the prize and the fact that we were going to hopefully have a healthy baby at the end of all this. I want to say between check-in and when my OB arrived and scrubbed himself in, it was probably about three hours. Yeah. And I walked into the OR, another bizarre experience. I just walked in.Meagan: Yeah. Yep.Liz: Okay, so everybody scrubs in. There's a whole host of people in there, including my nurse. I had never had surgery, so they're giving me all the instructions as to how I need to lean forward so that they can put a spinal block, I think, at that point, the anesthesiologist, and it was so bizarre. It felt like the most claustrophobic thing. If any of you have ever had Cesareans, hopefully you can relate to me, but feeling the numbness just go up your legs.Meagan: It is very strange. I walked in for my second one. With my first one I just had an epidural, but the second one I had a spinal.Liz: Yeah, yeah. So I mean, so bizarre. Then, like I had already mentioned I was so swollen, so they had to just take my very swollen-- I felt like a beached whale-- body parts and put them onto this operating table because I couldn't move once. Obviously, the spinal had activated. So that was bizarre. But my husband, I mean, this man is the calmest person and the nicest person I know. Thank God for him and his presence on that day. He kept me nice and calm. Everybody was really, really nice in the OR. The only thing I happened to notice at one point was they had my blood pressure cuff on. That's why I'm here, right? Because my blood pressures are so hig,h and it had slipped down to my wrist, so I had my arms out. I don't think my arms were strapped down. I don't remember that. I had them out, and I look over to the extent that I could to the anesthesiologist, like, "Hey, does somebody want to maybe put this cuff on? Because that's why I'm, here. That's why we're in this position right now." But yeah, my husband and I just chatted and laughed the entire surgery. Everything worked out really well with the spinal. I did not feel any pain. They did talk me through to an extent about what I would feel as far as tugging or pulling or pressure. My son was fortunately born really healthy, screaming, great Apgar score, the whole nine. He came, and oh my god, what a feeling. Obviously, I was so emotional because of how the birth had gone and what had led me there. But becoming a parent and seeing your child for the first time, you can't really describe that. It's amazing. I have really nice photos and video that the nurse took. They brought the baby over to me. They did not do skin-to-skin with me. Again, I had all of these birth plans, preferences, and, none of that came to fruition. None of that pertained to my or situation. I was so, so happy and also so sad. I don't know how to describe it. It was like the happiest and saddest day of my whole life up until that point. So recovery was interesting. I feel like I got maybe 5 hours of sleep in the hospital total. I was on a magnesium drip. People had told me that the side effects could be a little bit gnarly with that, but I fortunately didn't find anything abnormal. I think I had so much adrenaline. But I did try to get my son to latch, and he was having a really hard time latching. They had a lactation consultant from the hospital come in and see me, and I could not get him to latch. I happened to notice that his tongue was really tethered, super tethered. I could see the tie was really far forward, and he couldn't lift his tongue. So I kept telling them, I was like, "He can't lift his tongue up the way that I feel like he needs to." They just kept telling me how to hold my own body to try and breastfeed properly. I'm like, "I don't think that that's the problem though." So that was really challenging. They did want me to stay extra time for some monitoring. So the next day was Thanksgiving. I don't think my OB wanted to be there. It was a holiday, right? He took his sweet time coming in because they wouldn't even let me eat. That was the thing. I was on magnesium. They brought breakfast in at like 7:00, and he strolls in at like 10:30. I just watched my breakfast get cold in the corner. So that was interesting. But yeah, I think at that point, if you had had a Cesarean without complications, they were looking at about a 48-hour stay. But they asked me to stay an additional day because my pressures were still labile. They were still elevated. I did get put on-- I can't remember the name of medication, but it was blood pressure medication. I was taking Motrin for pain management, the hospital-grade Motrin for my Cesarean. I cannot even describe what it was like trying to get up and walk around that first time after surgery. It's insane. That was something I didn't expect. But yeah, I didn't get much sleep. The last day that I was there, my dog had gotten into a place in my mom's house that she couldn't get him. He had gotten into something, and she couldn't reach him, so she was flipping out. She called my husband. She didn't call me and just told him, "Listen, you have to come get the dog. I can't get him." So he did. I told him, "It's fine, it's fine, you can leave." While he was gone, I had friends come and visit me. They were still visitors pre-COVID. The covering physician came in. I had my son on Wednesday. Thursday was Thanksgiving and I saw my OB, and then there were covering physicians for Friday and Saturday. So we're at Friday now, Friday evening. He came in and saw me and he's like, "You know what? I might be able to discharge you tonight." I got so excited because I was like, this is my first experience having a newborn baby. My husband is trying to go deal with my dog. How awesome would it be if we could just go home tonight?So I got super excited. He said this right in front of my friends, too. He comes back in a short while later and was like, "I just looked at your chart. I looked at your pressures." He didn't clear out the room, nothing. And he's like, "You know what? I can't discharge you. Not with pressures like this. I can't do that." And he's like, "And the covering physician tomorrow won't be able to discharge you any sooner than late afternoon, early evening because that is when he will be here." I was like, okay. So here I am in my head thinking I could go home tonight, and now you're telling me I might be able to go home tomorrow afternoon or evening. I'm already very hormonal. I'm very emotional. My husband's not here.My friends wound up leaving, and I just sobbed. I just sobbed in my room like, oh my god. this is a nightmare. Why can't my body get it together? Why can't I just have normal blood pressures again?Meagan: Yeah.Liz: Yeah. We did wind up getting discharged the next day, but I remember that physician just being so the last straw for me in that experience. You didn't have to say anything at all, and then you also set it in front of all of my friends.Meagan: Uh-huh. Yeah. So you didn't stay with this provider, did you?Liz: I did not stay with this provider.Meagan: For your VBAC? Okay.Liz: No, absolutely not. Absolutely not. Yeah. I guess I should probably get into that story, right?Meagan: No, this has been great. This has been great. Yeah. Yeah. So you were done. You went home. You're like, last straw, no more, never again.Liz: Yeah. Yeah. And I did have my. My son assessed by a lactation consultant, and she said that was one of the most severe tongue ties that she had ever seen. She did recommend a release. I was four days postpartum at this point. I wound up supplementing with formula which was something I so didn't want to do, but I was just like, this kid is starving. He can't latch properly. I did. I went and saw a specialist, and I had his tongue and lip ties both revised, and it was severe. That was a severe tongue tie. I know people have mixed feelings about that, but he needed it. Even in my opinion, as a lay person.Meagan: Yeah. Yeah.Liz: But yeah, pretty much immediately I knew I wanted things to be different the following pregnancy and birth. I think I started thinking about my VBAC probably that day. It was probably the day I gave birth to my son. This cannot be how this goes every time.So it took me a really long time to even want to conceive again. Not only did I have all these complicated feelings about my birth because yes, I did have a healthy baby. Yes, I ultimately weaned off of blood pressure medication and my body came back to however you want to phrase normal, but I had had this experience that I was holding onto a lot of trauma from, and unfortunately, my son was four months old and my mom suddenly passed away. So yeah, it was unexpected. It was sudden. I still to the day am shocked that I didn't lose my milk supply, but I was able to pump in the hospital and get my son milk. That is a crazy, surreal experience losing a parent, but I don't think that there's much more cruel than losing someone that you care about so much. My mom and I were so close in a postpartum period that's already complicated by birth trauma. So now I had this grief for my mom. I had this grief for the birth experience I didn't have. I think that largely contributed to me waiting to conceive again. I also wanted to try and find out as much as I could about what causes preeclampsia. What exactly goes on in the body that would cause that to happen? Funny thing is the verdict is still out there. They're not exactly sure what causes it.Meagan: Yeah. And there are things that we can do to try to help avoid it, but there's nothing specifically that's like if you do this, you for sure won't have it.Liz: Yeah.Meagan: The same thing with gestational diabetes. It's within the placenta, but we don't know. It needs to be further studied.Liz: Yeah. I have heard that it has to do with the father. Have you heard that too?Meagan: I have heard that as well, that there's a connection. Yes.Liz: Yeah. So I wound up, I remember I saw a home birth my wife just for blood work between having my son and conceiving my daughter. She did mention, "Preeclampsia is largely a first-time pregnancy illness. Largely. It doesn't mean you can't have it a second time," but she was the one who mentioned to me you have a higher instance of getting it again if you have the same father for your child. And I'm like, "Well, I'm married."Meagan: Well, I am going to have the same father.Liz: Yeah. So that was always in the back of my head. It's like, okay well, subsequent pregnancy, less of a chance. But same father, more of a chance. So I was just wondering what my odds were. It definitely was there on my mind for a long time. I studied as much as I could about what could cause it. I've read Lily Nichols, Real Food for Pregnancy, cover to cover. Obsessed with her. Obsessed with everything she has to say. There it is right here.Meagan: And right here and right here. Real Food for Gestational Diabetes. Real Food for Pregnancy. Food is powerful, you guys. It's very powerful. But it's changed over the years.Liz: I know. I love how she presents the research because she's the one who really delves into it and presents it in such a digestible way. It was such an easy read. I was like, okay. Okay, here are some things that I can control. Can I control everything? No. But here are the things that I intend to do the next time.Meagan: Yeah.Liz: So my mom passed away in April 2019. It took, again, a few years, but by spring 2022, I was feeling ready. And my husband and I kind of discussed it. It was in little passing. "Hey, should we try and get pregnant again?" And it was one time. It's not lost on me how lucky I am in that sense that it took me one shot to get pregnant.Meagan: Which is awesome. Liz: Yeah. I found out my EDD for that pregnancy was going to be on Christmas Day.Meagan: Oh my gosh.Liz: Yeah. And I just said, "Wow, I can't avoid major winter holidays, apparently, with my pregnancies."Meagan: Yeah. Oh, my gosh.Liz: So we did not find out that we were having a girl, but she did wind up being a girl. Spoiler alert. But, yeah, I was really not feeling well that pregnancy. It was like aversions times 1000. I had this really bizarre one that I had never even heard anybody discussed before, but I had so much extra saliva in my mouth. I'm sorry. That might sound disgusting. It felt like when right before you're going to get sick, how your mouth fills up with saliva but all day.Meagan: Like your saliva glands were just excess all the time, giving you all the spit possible.Liz: Yeah, it was disgusting.Meagan: That is interesting. I don't think I've ever heard of that.Liz: Yeah, it was terrible. Fortunately, I was working from home. I was working full-time, but I was at home. I would just walk around with a spit cup. Like, how disgusting. It disgusts me to even talk about it. It's just like, what is happening? I was waiting for those aversions to let up because I couldn't stand the smell of coffee, which, I love coffee. Basically the sight of anything that wasn't pure oxygen was disgusting to me. The sight of opening up my refrigerator was like, ugh. Exactly. The gag reflex. That lasted my second pregnancy until 22 weeks. So it was rough. I joked that I was horizontal for 2022, and that's not even a joke. I really was lying down. I had so much guilt because my son was so energetic at this point. He was nearly four years old, and he had so much energy. He wanted to do things, and I could not muster up the energy most of the time. My husband was the default parent, and I never thought that that would be the case. That was really, really hard. That was probably the hardest part of the pregnancy. But yeah, so I started to really actively plan for that VBAC. I started to see a hospital-based group of midwives. I loved them. I had gone for well-woman visits between as well. But every provider that I saw was just amazing. I didn't have any bad things to say. I knew that I would be with them if I was in the hospital. But deep down in my heart, I really, really wanted to be at home. I had seen so many beautiful home birth videos when I did HypnoBirthing. And I also associated hospitals with sickness. I had been there because I developed preeclampsia.Meagan: Uh-huh.Liz: I had been there when my mom was sick and passing away. It was a sick place. I wanted to be at a place where I felt most safe. For me, that was home. I know people have a lot of feelings and opinions about that all over, but for me, that was what I wanted to do. I wanted to do all of the things to keep myself low-risk and able to birth at home if possible while still making plans for transfer and even surgery if it was needed again. So I wasn't ignorant to the fact that it could turn into that, but I was going to try all of the things.Where I live, there actually aren't a lot of home birth midwives who support HBACs, VBACs at home. But I found one and we clicked immediately. When I spoke to her on the phone, I was like, she is my girl. I need her. I need her energy at my birth. We met in person a few weeks later, and she was so, so gung-ho about it. She had mentioned that her mom actually had an HBAC, and she witnessed her mom having that HBAC. It was just ingrained into her. She really supported me with advice on diet. She helped me with supplementation. I was on a lot of supplements for this pregnancy. I'm not even going to front. I had so many alarms set for all my supplements daily. So yes, I was trying to support myself with diet, of course, but I was trying to also fill in any gaps that might be there with supplementation. I just know my diet's not perfect, and it certainly wasn't when I was feeling terrible.Meagan: Yeah, no one's is. No one's is. That's just the reality of it. We can be eating the best we can, and we still are often falling short. That's why supplements are really great.Liz: Yeah. Yeah. I was seeing a Webster-certified chiropractor the entire time to get myself into the best alignment to have that vaginal birth. The supplementation, I was doing reformer pilates. I had started it the year before, and I did it all the way until the very end of November 2022, so I was staying active. I was really trying. I basically said that I will do almost anything to keep myself at home. That was really my motto. Yeah, I really can't say I was totally worry-free. I was waiting for something to go wrong. I was. I was trying to keep this brave face as like, okay. I can do this. I can birth the way that I want to. I can have this complication-free birth and pregnancy experience. And in the back of my head I'm thinking, when is the next shoe go going to drop?Meagan: I mean, it's what you've experienced in the back story, the last story. And it's hard. Even if we've processed through things, there's still sometimes those little creeping thoughts that come in.Liz: Yeah. That is for sure. My midwife did recommend that I get a third-trimester ultrasound. That was more for her, but it was also for me. She never ever said, "You have to do this." Everything was really a conversation. The appointments, especially with a home birth midwife were an hour long or more sometimes. Just amazing. I loved going to see her. So I did get that third trimester ultrasound. It was more to check to make sure that the placenta wasn't compromised in any way and whether it was in a good position. There was no accreta. That was something that we really wanted to rule out to keep me low-risk and at home. I agreed with that. I am not anti-medicine by any means. I just want to put that out there just because I chose to have a home birth. I do respect medical professionals and their jobs and the need for surgery but I also wanted to keep myself in a place, again, that I felt safe, and that's really what it came down to. So in my head, I had mentally prepared to go to 41 weeks. I think that's where I prepared to go because I had learned that many, many women, especially first-time laboring women, because I did not labor with my son, I neglected to mention that I didn't labor at all. So first-time laboring women will go into labor typically, but somewhere between 40 and 41 weeks. Post-dates is very, very common. So in my head I prepared to go to 41 weeks and we got there. We got to Christmas. We through there. I was like, I'm going to go somewhere before New Year's Eve. No, nothing. So we got to New Year's Eve and here I am in my 41st week, and I'm just trying to keep myself calm. What am I going to do? I cannot go to 42 weeks. I can't do it. Mentally, I can't do it. Physically, I can't do it. I'm going to wind up at the hospital. Of course, all of these negative thoughts are swirling. I went for another adjustment with chiropractor. I went for an acupuncture session. I went for a few of them, but I did induction points with my acupuncturist. I was just trying to do all the things-- curb walking, I did the Miles circuit and all the things to try and help this baby engage. So we get to 41 and 1 for me, which is a Monday, and I was woken up with contractions that felt like period cramps. That's how I would describe them. Around 2:00 AM, I started timing them. They were 12 to 15 minutes apart at that point, but they weren't letting up. They were consistent. I woke up my husband getting all excited like, "Oh my gosh, this might be it. Here we are." And they weren't getting closer, but they weren't easing up. So they just continued like that for the rest of the day. I had gotten up from the couch at one point, and I felt like this small trickle. I went into the bathroom, and it didn't look like anything to me. It didn't look like much. There wasn't a huge gush of fluid, nothing. So I was like, oh, I think it's probably just discharge or maybe part of my mucus plug. I have no idea. I have literally no idea. But I was like, nothing seems off to me, and it wasn't enough fluid to be concerning. I did text my midwife to update her and she mentioned to me, "A lot of women will drop into more active labor when the sun goes down. Things get quiet. It starts to get calmer. I can almost guarantee that we're going to have a baby at some point in the next 24 hours." So I go to bed that night and thinking, I'm going to wake up Tuesday probably either be having a baby or have a baby already. I woke up Tuesday, and I was still pregnant. Here I was.Meagan: You're like, this is not what I was thinking.Liz: I remember I would wake up with a contraction, but again, they were 12 to 15 minutes apart. I would go to sleep between no issues and just wake up, breathe through the contraction, and go back to sleep. And that's how the whole night went. I just couldn't believe I was still pregnant. I really was starting to get a little down on myself. I was like, these aren't coming closer together. They're not intensifying. They're not letting up, but there's nothing really happening at this point. I texted my midwife again that morning, Tuesday morning, and she said she needed to come see me for the 41-week appointment anyway, so she said that she would come by that day. She was going to come to my house. And then we get to the mid-morning. It was probably around 10-10:30 and my contractions stopped, like literally up and left. Like, what is happening right now? I can't. I was in shock, literally in shock. Especially because labor had been going on for over 24 hours. It was absurd to me. But she's like, "Don't worry. I'm going to come see you for your appointment anyway." When she arrived later that day, I did ask her to do a cervical check because at this point I'm like, "Something has had to happen whether the baby moved down into a better station or I'm a little bit more dilated or just more engagement. Whatever it is, I just want to know at this point."Meagan:: Yeah.Liz: So she did. She said, "I'll go in there. I can do a cervical check and if I can get in there, would you like me to do a membrane sweep?" And I was like, "I would love that. Anything to get this going. Let's get the party started." I'm at my house. She does the cervical check. She's like, "I can do a membrane sweep." And as she basically finishes up, I feel this gush of fluid.Meagan:: Your water.Liz: Yeah. She stopped, and I said, "Was that fluid?" She's like, "I'm going to make sure it's amniotic fluid. I have the test strip," and of course, it lit up like a highlighter. She's like, "Yes." She goes, "So guess what? We're going to go after baby today. We're going to get this. We are going to get this party started." I had kept telling her, "I can't go to 42 weeks," and she kept saying, "Let's not go to 42 weeks. You'll be fine. We're going to get it moving." And here we are. She did mention, I was at that point, about 3-4 centimeters dilated, so pretty good. But she was like, "I can offer you, I have a Foley. I can offer you a Foley balloon just to put a little bit more pressure on the cervix and maybe we can get those contractions to start to start up again, and then hopefully come closer together." Yeah. So she did. She put that Foley in and she waited with me at my house, and we just chatted. It came out a short time after. It took very little. I didn't have discomfort with that, thankfully.Meagan: That's, good. I mean, your cervix was starting to come forward. Things were going.Liz: It was going. Yeah, yeah. So again, she stayed with me and once the Foley came out, she just advised me to put on some sort of protective underwear whether it was the adult diapers or a pad because now we knew that my fluid was at least leaking, but it wasn't coming out consistently anymore. I don't think it fully came out. It wasn't a big enough gush for it to be all of the fluid, if that makes sense.Meagan: Yeah, yeah, yeah.Liz: So she told me to do a few things. She's like, "I'm going to head out. You're going to call me when you need me," which, at that point, I was like, I have no idea what that means, but okay. And she's like, "Here are the things that you can do. Obviously nothing in there anymore, because we know that your amniotic sac is open.Meagan: It's broken. Liz: Yeah. Yeah, exactly. But she said, "You could do some pumping. You could use some clary sage essential oil." She gave me her TENS machine, and she's like, "You could try the TENS machine." I had never known that you could actually use that not for pain management. I only thought it was for pain management. So I was like, "That's so interesting." So she's like, "Do the pumping. Do that." So I did. I did one session, I think, before I put my son to bed for the last time as an only child. I did. I went and laid down with him and just knew that was probably going to be the last time that he would wake up or the last time he had woken up as an only child. And then I did it one more time, and not only did my contractions come back, I started timing them on the app, and I'm watching them get closer. They're going from 10 minutes to 8 minutes to 7 minutes to 5 minutes. I'm just watching them like, oh, my gosh. So we get to 11-11:30 at night, and it's just me and my husband there, and they are three minutes apart, and they're not easing up, and they are getting intense. So there it was. They came back.Meagan: And labor begins.Liz: Oh, it began. It began. I have so many interesting photos that my doula wound up taking. Thank God for her. Not only for the photos, but for everything that she did during the labor and delivery. It was intense. It gets intense, or in my experience, active labor when you get the breaks between the contractions and you are able to rest. I took every opportunity to rest. My doula was trying to guide me into different positions. She would help by putting a warm compress on my back at times. She would encourage even location changes in my house just to see if I could use the toilet. She told me to get into the shower at one point. I was like, "I'm too claustrophobic in here." I didn't like that, but she was trying to get me to try different things. But it was so intense. The craziest part for me was transition. That was truly an out-of-body experience. Everybody was doing these hands-on manipulations, my husband and my doula. But I could not do anything but just sway. I was standing, swaying back and forth in my living room, arms up. Why were my arms up? I have no idea, but they were up. I was doing that horse lips, breathing. Yep. It was just what my body did intuitively. I just, at that point, wasn't really getting a break. It was just insane. So that was intense. Out-of-body. I cannot replicate that level of pain in my head. There's just no doing that, but I knew that even if I needed to transfer, which I wasn't planning, but even if I needed to do that for pain management, I couldn't sit down in a car. I was at that point, so I thought to myself, the only way to this is through this. Like that is it. You've got to do it. We're just going to do it. So I knew that in my head. At no point did the pain concern me though. I mean, was it so intense and crazy? Yeah, but it was never like, there's something wrong.Meagan: Uh-huh. Yeah.Liz: So that was really good. I didn't think anything negative during that time except that I was in an intense amount of pain. But it was like pain with a purpose, if that makes sense.Meagan: Productive.Liz: Yes, yes. In the meantime, my doula had set up a birth pool because I definitely wanted to try to be in the pool when I gave birth, but I wasn't sure how I'd feel about the water since I didn't really like the shower experience. It took a while because the hose kept slipping off of our faucet or whatever, so they had to boil pots of water. I just remember my doula walking back and forth. In the meantime, they did call my midwife. Somebody did, and she showed up with her assistant. So there were like three or four adults trying to hold me in transition or do some sort of physical manipulations and then pour hot water into this birth pool.Meagan: Oh my.Liz: Yeah, it was very interesting. But yeah, my contractions, at that point, were 30 seconds apart and they were lasting a minute and a half. It was intense, yes. But the pool was finally filled at 6:45 in the morning on Wednesday, and the only reason why I know that is because we have pictures of me right before I got into the pool. When I got in, my body just relaxed. I didn't think I was going to be wanting to be in a supine position at all, beyond my bottom at all because I couldn't have even tried to sit on land. But once I got into the pool, everything relaxed and it was like, oh, this is what I needed. This is what I needed. I needed some relief. I also kept telling everybody how tired I was. Anybody who walked past me, I was like, "I'm so tired." They were like, "Yeah, no. We know. We know, but we're going to keep working."Meagan: Yeah.Liz: But yeah, I was in there for a really short time and I had heard of this before, but to actually experience it is next level. I had the fetal ejection reflex.Meagan: Oh yeah.Liz: So I did not even have another cervical check. Nothing. My body just started pushing that baby down and out. I couldn't have stopped it if I wanted to. I was making the most primal sounds. I have video of it, like low guttural sounds. It was probably going on for about 15 minutes. My son walked down, I heard his little pitter-patter of his feet, and he walked down. My stairs go right into my living room where I was. And the whole time the most nerve-wracking part of having a home birth for me was that I knew he was going to be home with us, and there really wasn't an adult aside from my husband and my birth support team who I wanted in my birthing space. So there was no other option of anybody to take care of him besides my husband if it came to that. I think in the back of my head, that was the most anxiety-inducing part of this.Meagan: Yeah.Liz: So down he walks. And of course, he's hiding. He sees these three other adults in our living room. I'm in the tub groaning.Meagan: Yeah.Liz: He's a little nervous. He's a little guy. Fortunately, I think it was either the birth assistant or my doula handed him his little digital camera that I had actually bought as a gift from the baby for him. Yeah. She encouraged him. She's like, "Why don't you take some pictures? Take some pictures of mommy and daddy." The minute that she said that and he started to do that, he calmed down and just wanted to be in it and part of it.Meagan: Yeah.Liz: Yeah. And I told him, "Mommy's making some interesting noises, but I'm okay. I'm safe. I'm okay." And he was just really good about it. I feel like all that anxiety went away, thankfully.Meagan: Yeah. Yeah. That's awesome.Liz: Yeah. I noticed my midwife was starting to gather her supplies and in my head, I actually probably said it out loud like, "Wait, we're doing this here?" And she was like, "Yeah." I was like, "I'm having a baby here in this room." She's like, "Yeah." I was like, "I don't need to go to the hospital?" She's like, "No, no, no. You're okay."And, yeah. My body just kept pushing the baby out. And it was an hour, not even an hour. It was less than an hour from when I first got into the pool until my daughter was out. My husband got to reach down and put his hands there. As she came out, he felt her really chubby cheeks. She has big cheeks like me and her ear, and brought her up to my chest. I was just in shock. I couldn't believe that I had done that. But then, of course, I look and I see that she's a girl. I just knew my mom had sent me her. That's how I felt.Meagan: Oh, that just gave me the chills.Liz: Thank you.Meagan: Oh my gosh. That is so beautiful. I love that your son was able to be involved, and you could feel your mom. Oh huge. Congrats. Liz: Thank you so much.Meagan: Yes. Liz: My mom's name was Faith, and so my daughter's middle name is Faye because everybody who loved my mom called her Faye. She was Aunt Faye to everybody, every cousin. So my daughter's name is Luna Faye. So she is her namesake, and she's amazing. And like you said, I can't believe she's almost two. I can't believe this was almost two years ago.Meagan: Two years ago. I know. We get so many submissions and sometimes we can't get to everybody, but it does take a while sometimes. I'm so glad that you were able to come and still record your beautiful stories and give us so much detail of each one and guidance, and the experience. Yeah. I'm just so happy for you.Thank you so much. I don't think I'll ever come down from that high, that birth high. Like, I think I'll be riding it out for the rest of my life. I'm not sure I'm going to have any more children. I think we're pretty much done, but I would love to give birth like that a thousand more times. It was the redemptive story that I needed. It helped so much with my previous birth trauma, and it made me feel so strong. I have never felt more strong and more powerful than that experience. I don't think I ever will.Meagan: Yeah, well, and there's so much that went into it-- time preparing, research, finding this team, and then even dealing with the prodromal. I mean, that could be defeating within itself. You're so tired, but then you just kept going.Liz: Yeah, I kept doing the things. I mean, that was one thing that my doula and my midwife both commented on. They were like, "You did everything that you could, and you tried to control everything that you can control, and look what happened. That's amazing."Meagan: Yeah. Thank you again so much.Liz: Thank you. I'm so happy to have been able to talk to you and share my story.Meagan: Me too. Do you have any final advice to any of our listeners?Liz: I think my ultimate advice for any birthing person is to find a provider that you align with. I think they can really make or break that experience. No matter where you choose to birth or where you wind up birthing, have that provider that you trust, that you feel like you could have open conversations with. If you say you want a natural birth, they're not going to scoff at that, and somebody who's going to have conversations with you instead of talking at you.Meagan: Yeah, I agree so much. I want to add to just vet them. If they're feeling good at first, okay, stay. And if something's happening, keep going. Keep asking the questions, and if something's not feeling right, don't hesitate to change.Liz: I know. And I not only hesitated, but I knew I had to change with my first provider, and I just didn't. I think at that point, I was so tired.Meagan: Yeah well, it's daunting. It's a daunting thing. I mean, I was there too, so no shame in it. It's just hard when you realize looking back, oh, I could have. I should have done something different. I didn't, but that's okay. We've learned, we've grown, and we've had healing experiences moving forward.Liz: 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

  Our team is dispatched to a scene where they understand a pregnant woman is experiencing footling breech during the birthing process. When they arrive, they find the baby already delivered and being tended to with Basic Life Support practices, although she is in rough shape. How does the team pivot? What steps do they take as the baby is in cardiac arrest? The answer, as it frequently is, is to go back to basics. Listen in on this incredible story with an unexpected ending.   Interested in obtaining CE credit for this episode? Visit OnlineAscend.com to learn more. Listeners can purchase individual episode credits or subscribe to the Critical Care Review Bundle and gain access to all episode CE Credits.    We are joined by:     Breanna Bingel RN, BSN, PHRN, TNS, CFRN, CEN, TCRN, CTRN Click here to download this episode today! As always thanks for listening and fly safe! Hawnwan Moy MD FACEP FAEMS John Wilmas MD FACEP FAEMS Nyssa Hattaway, BA, BSN, RN, CEN, CPEN, CFRN

A atriz e apresentadora fala sobre família, religião, casamento e conta pra qual de seus tantos amigos ligaria de uma ilha deserta Regina Casé bem que tentou não comemorar seu aniversário de 71 anos, celebrado no dia 25 de fevereiro. Mas o que seria um açaí com pôr do sol na varanda do Hotel Arpoador se transformou em um samba que só terminou às 11 horas da noite em respeito à lei do silêncio. "Eu não ia fazer nada, nada, nada mesmo. Mas é meio impossível, porque todo mundo fala: vou passar aí, vou te dar um beijo", contou em um papo com Paulo Lima. A atriz e apresentadora tem esse talento extraordinário pra reunir as pessoas mais interessantes à sua volta. E isso vale para seu círculo de amigos, que inclui personalidades ilustres como Caetano Veloso e Fernanda Torres, e também para os projetos que inventa na televisão, no teatro e no cinema.  Inventar tanta coisa nova é uma vocação que ela herdou do pai e do avô, pioneiros no rádio e na televisão, mas também uma necessidade. “Nunca consegui pensar individualmente, e isso até hoje me atrapalha. Mas, ao mesmo tempo, eu tive que ser tão autoral. Eu não ia ser a mocinha na novela, então inventei um mundo para mim. Quase tudo que fiz fui eu que tive a ideia, juntei um grupo, a gente escreveu junto”, afirma. No teatro, ao lado de artistas como o diretor Hamilton Vaz Pereira e os atores Luiz Fernando Guimarães e Patrícia Travassos, ela inventou o grupo Asdrúbal Trouxe o Trombone, que revolucionou a cena carioca nos anos 1970. Na televisão, fez programas como TV Pirata, Programa Legal e Brasil Legal. "Aquilo tudo não existia, mas eu tive que primeiro inventar para poder me jogar ali”, conta. LEIA TAMBÉM: Em 1999, Regina Casé estampou as Páginas Negras da Trip De volta aos cinemas brasileiros no fim de março com Dona Lurdes: O Filme, produção inspirada em sua personagem na novela Amor de Mãe (2019), Regina bateu um papo com Paulo Lima no Trip FM. Na conversa, ela fala do orgulho de ter vindo de uma família que, com poucos recursos e sem faculdade, foi pioneira em profissões que ainda nem tinham nome, do título de “brega” que recebeu quando sua originalidade ainda não era compreendida pelas colunas sociais, de sua relação com a religião, da dificuldade de ficar sozinha – afinal, “a sua maior qualidade é sempre o seu maior defeito” –, do casamento de 28 anos com o cineasta Estêvão Ciavatta, das intempéries e milagres que experimentou e de tudo o que leva consigo. “Eu acho que você tem que ir pegando da vida, que nem a Dona Darlene do Eu Tu Eles, que ficou com os três maridos”, afirma. “A vida vai passando e você vai guardando as coisas que foram boas e tentando se livrar das ruins”. Uma das figuras mais admiradas e admiráveis do país, ela ainda revela para quem ligaria de uma ilha deserta e mostra o presente de aniversário que ganhou da amiga Fernanda Montenegro. Você pode conferir esse papo a seguir ou ouvir no Spotify do Trip FM.  [IMAGE=https://revistatrip.uol.com.br/upload/2025/03/67d446165a3ce/header-regina-interna.jpg; CREDITS=João Pedro Januário; LEGEND=; ALT_TEXT=] Trip. Além de atriz, você é apresentadora, humorista, escritora, pensadora, criadora, diretora… Acho que tem a ver com uma certa modernidade que você carrega, essa coisa de transitar por 57 planetas diferentes. Como é que você se apresentaria se tivesse que preencher aquelas fichas antigas de hotel? Regina Casé. Até hoje ponho atriz em qualquer coisa que tenho que preencher, porque acho a palavra bonita. E é como eu, vamos dizer, vim ao mundo. As outras coisas todas vieram depois. Mesmo quando eu estava há muito tempo sem atuar, eu era primeiramente uma atriz. E até hoje me sinto uma atriz que apresenta programas, uma atriz que dirige, uma atriz que escreve, mas uma atriz. Você falou numa entrevista que, se for ver, você continua fazendo o mesmo trabalho. De alguma maneira, o programa Brasil Legal, a Val de "Que Horas Ela Volta", o grupo de teatro "Asdrúbal Trouxe o Trombone" ou agora esse programa humorístico tem a mesma essência, um eixo que une tudo isso. Encontrei entrevistas e vídeos maravilhosos seus, um lá no Asdrúbal, todo mundo com cara de quem acabou de sair da praia, falando umas coisas muito descontraídas e até mais, digamos assim, sóbrias. E tem um Roda Viva seu incrível, de 1998. Eu morro de pena, porque também o teatro que a gente fazia, a linguagem que a gente usava no Asdrúbal, era tão nova que não conseguiu ser decodificada naquela época. Porque deveria estar sendo propagada pela internet, só que não havia internet. A gente não tem registros, não filmava, só fotografava. Comprava filme, máquina, pagava pro irmão do amigo fazer aquilo no quarto de serviço da casa dele, pequenininho, com uma luz vermelha. Só que ele não tinha grana, então comprava pouco fixador, pouco revelador, e dali a meses aquilo estava apagado. Então, os documentos que a gente tem no Asdrúbal são péssimos. Fico vendo as pouquíssimas coisas guardadas e que foram para o YouTube, como essa entrevista do Roda Viva. Acho que não passa quatro dias sem que alguém me mande um corte. "Ah, você viu isso? Adorei!". Ontem o DJ Zé Pedro me mandou um TED que eu fiz, talvez o primeiro. E eu pensei: "Puxa, eu falei isso, que ótimo, concordo com tudo". Quanta coisa já mudou no Brasil, isso é anterior a tudo, dois mil e pouquinho. E eu fiquei encantada com o Roda Viva, eu era tão novinha. Acho que não mudei nada. Quando penso em mim com cinco anos de idade, andando com a minha avó na rua, a maneira como eu olhava as pessoas, como eu olhava o mundo, é muito semelhante, se não igual, a hoje em dia.  [VIDEO=https://www.youtube.com/embed/rLoqGPGmVdo; CREDITS=; LEGEND=Em 1998, aos 34 anos, Regina Casé foi entrevistada pelo programa Roda Viva, da TV Cultura; IMAGE=https://revistatrip.uol.com.br/upload/2025/03/67d49b0ede6d3/1057x749x960x540x52x40/screen-shot-2025-03-14-at-180926.png] O Boni, que foi entrevistado recentemente no Trip FM, fala sobre seu pai em seu último livro, “Lado B do Boni”, como uma das pessoas que compuseram o que ele é, uma figura que teve uma relevância muito grande, inclusive na TV Globo. Conta um pouco quem foi o seu pai, Regina. Acho que não há Wikipedia que possa resgatar o tamanho do meu pai e do meu avô. Meu avô é pioneiríssimo do rádio, teve um dos primeiros programas de rádio, se não o primeiro. Ele nasceu em Belo Jardim, uma cidadezinha do agreste pernambucano, do sertão mesmo. E era brabo, criativo demais, inteligente demais, e, talvez por isso tudo, impaciente demais, não aguentava esperar ninguém terminar uma frase. Ele veio daquele clássico, com uma mão na frente e outra atrás, sem nada, e trabalhou na estiva, dormiu na rua até começar a carregar rádios. Só que, nos anos 20, 30, rádios eram um armário de madeira bem grandão. Daí o cara viu que ele era esperto e botou ele para instalar os rádios na casa das pessoas. Quando meu avô descobriu que ninguém sabia sintonizar, que era difícil, ele aprendeu. E aí ele deixava os rádios em consignação, botava um paninho com um vasinho em cima, sintonizado, funcionando. Quando ele ia buscar uma semana depois, qualquer um comprava. Aí ele disparou como vendedor dos rádios desse cara que comprava na gringa e começou a ficar meio sócio do negócio. [QUOTE=1218] Mas a programação toda era gringa, em outras línguas. Ele ficava fascinado, mas não entendia nada do que estava rolando ali. Nessa ele descobriu que tinha que botar um conteúdo ali dentro, porque aquele da gringa não estava suprindo a necessidade. Olha como é parecido com a internet hoje em dia. E aí ele foi sozinho, aquele nordestino, bateu na Philips e falou que queria comprar ondas curtas, não sei que ondas, e comprou. Aí ele ia na farmácia Granado e falava: "Se eu fizer um reclame do seu sabão, você me dá um dinheiro para pagar o pianista?". Sabe quem foram os dois primeiros contratados dele? O contrarregra era o Noel Rosa, e a única cantora que ele botou de exclusividade era a Carmen Miranda. Foram os primeiros empregos de carteira assinada. E aí o programa cresceu. Começava de manhã, tipo programa do Silvio, e ia até de noite. Chamava Programa Casé.  E o seu pai? Meu avô viveu aquela era de ouro do rádio. Quando sentiu que o negócio estava ficando estranho, ele, um cara com pouquíssimos recursos de educação formal, pegou meu pai e falou: "vai para os Estados Unidos porque o negócio agora vai ser televisão". Ele fez um curso, incipiente, para entender do que se tratava. Voltou e montou o primeiro programa de televisão feito aqui no Rio de Janeiro, Noite de Gala. Então, tem uma coisa de pioneirismo tanto no rádio quanto na televisão. E meu pai sempre teve um interesse gigante na educação, como eu. Esse interesse veio de onde? Uma das coisas que constituem o DNA de tudo o que fiz, dos meus programas, é a educação. Um Pé de Quê, no Futura, o Brasil Legal e o Programa Legal, na TV Globo… Eu sou uma professora, fico tentando viver as duas coisas juntas. O meu pai tinha isso porque esse meu avô Casé era casado com a Graziela Casé, uma professora muito, mas muito idealista, vocacionada e apaixonada. Ela trabalhou com Anísio Teixeira, Cecília Meireles, fizeram a primeira biblioteca infantil. Meu pai fez o Sítio do Picapau Amarelo acho que querendo honrar essa professora, a mãe dele. Quando eu era menina, as pessoas vinham de uma situação rural trabalhar como domésticas, e quase todas, se não todas, eram analfabetas. A minha avó as ensinava a ler e escrever. Ela dizia: "Se você conhece uma pessoa que não sabe ler e escrever e não ensina para ela, é um crime". Eu ficava até apavorada, porque ela falava muito duramente. Eu acho que sou feita desse pessoal. Tenho muito orgulho de ter vindo de uma família que, sem recursos, sem universidade, foi pioneira na cidade, no país e em suas respectivas... Não digo “profissões” porque ainda nem existiam suas profissões. Eu tento honrar.  [IMAGE=https://revistatrip.uol.com.br/upload/2025/03/67d49d1e03df5/header-regina-interna6.jpg; CREDITS=Christian Gaul; LEGEND=Em 1999, a atriz e apresentadora estampou as Páginas Negras da Trip; ALT_TEXT=] Você tem uma postura de liderança muito forte. Além de ter preparo e talento, você tem uma vocação para aglutinar, juntar a galera, fazer time. Por outro lado, tem essa coisa da atriz, que é diferente, talvez um pouco mais para dentro. Você funciona melhor sozinha ou como uma espécie de capitã, técnica e jogadora do time? Eu nasci atriz dentro de um grupo. E o Asdrúbal trouxe o Trombone não era só um grupo. Apesar do Hamilton Vaz Pereira ter sido sempre um autor e um diretor, a gente criava coletivamente, escrevia coletivamente, improvisava. Nunca consegui pensar individualmente, e isso até hoje é uma coisa que me atrapalha. Todo mundo fala: "escreve um livro". Eu tenho vontade, mas falo que para escrever um livro preciso de umas 10 pessoas de público, todo mundo junto. Sou tão grupal que é difícil. Ao mesmo tempo, eu tive que ser muito autoral. Eu, Tu, Eles foi a primeira vez que alguém me tirou para dançar. Antes eu fiz participações em muitos filmes, mas foi a primeira protagonista. Quase tudo que fiz fui eu que tive a ideia, juntei um grupo, a gente escreveu junto. Então, eu sempre inventei um mundo para mim. No teatro eu não achava lugar para mim, então tive que inventar um, que era o Asdrúbal. Quando eu era novinha e fui para a televisão, eu não ia ser a mocinha na novela. Então fiz a TV Pirata, o Programa Legal, o Brasil Legal. Aquilo tudo não existia na televisão, mas eu tive que primeiro inventar para poder me jogar ali. Eu sempre me acostumei não a mandar, mas a ter total confiança de me jogar.  E nos trabalhos de atriz, como é? No Asdrúbal eu me lembro que uma vez eu virei umas três noites fazendo roupa de foca, que era de pelúcia, e entupia o gabinete na máquina. Eu distribuía filipeta, colava cartaz, pregava cenário na parede. Tudo, todo mundo fazia tudo. É difícil quando eu vou para uma novela e não posso falar que aquele figurino não tem a ver com a minha personagem, que essa casa está muito chique para ela ou acho que aqui no texto, se eu falasse mais normalzão, ia ficar mais legal. Mas eu aprendi. Porque também tem autores e autores. Eu fiz três novelas com papéis de maior relevância. Cambalacho, em que fiz a Tina Pepper, um personagem coadjuvante que ganhou a novela. Foi ao ar em 1986 e até hoje tem gente botando a dancinha e a música no YouTube, cantando. Isso também, tá vendo? É pré-internet e recebo cortes toda hora, porque aquilo já tinha cara de internet. Depois a Dona Lurdes, de Amor de Mãe, e a Zoé, de Todas as Flores. Uma é uma menina preta da periferia de São Paulo. A outra uma mulher nordestina do sertão, com cinco filhos. A terceira é uma truqueira carioca rica que morava na Barra. São três universos, mas as três foram muito fortes. Tenho muito orgulho dessas novelas. Mas quando comecei, pensei: "Gente, como é que vai ser?". Não é o meu programa. Não posso falar que a edição está lenta, que devia apertar. O começo foi difícil, mas depois que peguei a manha de ser funcionária, fazer o meu e saber que não vou ligar para o cenário, para o figurino, para a comida e não sei o quê, falei: "Isso aqui, perto de fazer um programa como o Esquenta ou o Programa Legal, é como férias no Havaí".  Você é do tipo que não aguenta ficar sozinha ou você gosta da sua companhia? Essa é uma coisa que venho perseguindo há alguns anos. Ainda estou assim: sozinha, sabendo que, se quiser, tem alguém ali. Mas ainda apanho muito para ficar sozinha porque, justamente, a sua maior qualidade é sempre o seu maior defeito. Fui criada assim, em uma família que eram três filhas, uma mãe e uma tia. Cinco mulheres num apartamento relativamente pequeno, um banheiro, então uma está escovando os dentes, outra está fazendo xixi, outra está tomando banho, todas no mesmo horário para ir para a escola. Então é muito difícil para mim ficar sozinha, mas tenho buscado muito. Quando falam "você pode fazer um pedido", eu peço para ter mais paciência e para aprender a ficar sozinha.  Você contou agora há pouco que fazia figurinos lá no Asdrúbal e também já vi você falando que sempre aparecia na lista das mais mal vestidas do Brasil. Como é ser julgada permanentemente? Agora já melhorou, mas esse é um aspecto que aparece mais porque existe uma lista de “mais mal vestidas". Se existisse lista para outras transgressões, eu estaria em todas elas. Não só porque sou transgressora, mas porque há uma demanda que eu seja. Quando não sou, o pessoal até estranha. Eu sempre gostei muito de moda, mais que isso, de me expressar através das roupas. E isso saía muito do padrão, principalmente na televisão, do blazer salmão, do nude, da unha com misturinha, do cabelo com escova. Volta e meia vinha, nos primórdios das redes sociais: "Ela não tem dinheiro para fazer uma escova naquele cabelo?". "Não tem ninguém para botar uma roupa normal nela?".  [IMAGE=https://revistatrip.uol.com.br/upload/2025/03/67d49c62141c1/header-regina-interna4.jpg; CREDITS=Christian Gaul; LEGEND=Regina Casé falou à Trip em 1999, quando estampou as Páginas Negras; ALT_TEXT=] Antes da internet, existiam muitas colunas sociais em jornal. Tinha um jornalista no O Globo que me detonava uma semana sim e outra não. Eu nunca vou me esquecer. Ele falava de uma bolsa que eu tinha da Vivienne Westwood, que inclusive juntei muito para poder comprar. Eu era apaixonada por ela, que além de tudo era uma ativista, uma mulher importantíssima na gênese do Sex Pistols e do movimento punk. Ele falava o tempo todo: "Estava não sei onde e veio a Regina com aquela bolsa horrorosa que comprou no Saara". O Saara no Rio corresponde à 25 de março em São Paulo, e são lugares que sempre frequentei, que amo e que compro bolsas também. Eu usava muito torço no cabelo, e ele escrevia: "Lá vem a lavadeira do Abaeté". Mais uma vez, não só sendo preconceituoso, mas achando que estava me xingando de alguma coisa que eu acharia ruim. Eu pensava: nossa, que maravilha, estou parecendo uma lavadeira do Abaeté e não alguém com um blazer salmão, com uma blusa bege, uma bolsa arrumadinha de marca. Pra mim era elogio, mas era chato, porque cria um estigma. E aí um monte de gente, muito burra, vai no rodo e fala: "Ela é cafona, ela é horrorosa". Por isso que acho que fiquei muito tempo nessas listas.  O filme “Ainda Estou Aqui” está sendo um alento para o Brasil, uma coisa bem gostosa de ver, uma obra iluminada. A Fernanda Torres virou uma espécie de embaixadora do Brasil, falando de uma forma muito legal sobre o país, sobre a cultura. Imagino que pra você, que vivenciou essa época no Rio de Janeiro, seja ainda mais especial. Eu vivi aquela época toda e o filme, mesmo sem mostrar a tortura e as barbaridades que aconteceram, reproduz a angústia. Na parte em que as coisas não estão explicitadas, você só percebe que algo está acontecendo, e a angústia que vem dali. Mesmo depois, quando alguma coisa concreta aconteceu, você não sabe exatamente do que está com medo, o que pode acontecer a qualquer momento, porque tudo era tão aleatório, sem justificativa, ninguém era processado, julgado e preso. O filme reproduz essa sensação, mesmo para quem não viveu. É maravilhoso, maravilhoso.  [QUOTE=1219] Não vou dizer que por sorte porque ele tem todos os méritos, mas o filme caiu num momento em que a gente estava muito sofrido culturalmente. Nós, artistas, tínhamos virado bandidos, pessoas que se aproveitam. Eu nunca usei a lei Rouanet, ainda que ache ela muito boa, mas passou-se a usar isso quase como um xingamento, de uma maneira horrível. E todos os artistas muito desrespeitados, inclusive a própria Fernanda, Fernandona, a pessoa que a gente mais tem que respeitar na cultura do país. O filme veio não como uma revanche. Ele veio doce, suave e brilhantemente cuidar dessa ferida. Na equipe tenho muitos amigos, praticamente família, o Walter, a Nanda, a Fernanda. Sou tão amiga da Fernanda quanto da Nanda, sou meio mãe da Nanda, mas sou meio filha da Fernanda, sou meio irmã da Nanda e também da Fernanda. É bem misturado, e convivo muito com as duas. Por acaso, recebi ontem um presente e um cartão de aniversário da Fernandona que é muito impressionante. Tão bonitinho, acho que ela não vai ficar brava se eu mostrar para vocês. O que o cartão diz? Ela diz assim: "Regina, querida, primeiro: meu útero sabe que a Nanda já está com esse Oscar”. Adorei essa frase. "Segundo, estou trabalhando demais, está me esgotando. Teria uma leitura de 14 trechos magníficos, de acadêmicos, que estou preparando essa apresentação para a abertura da Academia [Brasileira de Letras], que está em recesso. O esgotamento acho que é por conta dos quase 100 anos que tenho". Imagina... Com esse trabalho todo. Aí ela faz um desenho lindo de flores com o coração: "Regina da nossa vida, feliz aniversário, feliz sempre da Fernanda". E me manda uma toalhinha bordada lindíssima com um PS: "Fernando [Torres] e eu compramos essa toalhinha de mão no Nordeste numa das temporadas de nossa vida pelo Brasil afora. Aliás, nós comprávamos muito lembranças como essa. Essa que eu lhe envio está até manchadinha, mas ela está feliz porque está indo para a pessoa certa. Está manchadinha porque está guardadinha faz muitos anos". Olha que coisa. Como é que essa mulher com quase 100 anos, com a filha indicada ao Oscar, trabalhando desse jeito, decorando 14 textos, tem tempo de ser tão amorosa, gentil, generosa e me fazer chorar? Não existe. Ela é maravilhosa demais. [IMAGE=https://revistatrip.uol.com.br/upload/2025/03/67d49b9f0f548/header-regina-interna3.jpg; CREDITS=João Pedro Januário; LEGEND=; ALT_TEXT=] Eu queria te ouvir sobre outro assunto. Há alguns anos a menopausa era um tema absolutamente proibido. As mulheres se sentiam mal, os homens, então, saíam correndo. Os médicos não falavam, as famílias não falavam. E é engraçado essa coisa do pêndulo. De repente vira uma onda, artistas falando, saem dezenas de livros sobre o assunto. Como foi para você? Você acha que estamos melhorando na maneira de lidar com as nossas questões enquanto humanidade? É bem complexo. Tem aspectos que acho que estão melhorando muito. Qualquer família que tinha uma pessoa com deficiência antigamente escondia essa pessoa, ela era quase trancada num quarto, onde nem as visitas da casa iam. E hoje em dia todas essas pessoas estão expostas, inclusive ao preconceito e ao sofrimento, mas estão na vida, na rua. Há um tempo não só não podia ter um casal gay casado como não existia nem a expressão "casal gay", porque as pessoas no máximo tinham um caso escondido com outra pessoa. Então em muitos aspectos a gente avançou bastante. Não sei se é porque agora estou ficando bem mais velha, mas acho que esse assunto do etarismo está chegando ainda de uma maneira muito nichada. Se você for assistir a esse meu primeiro TED, eu falo que a gente não pode pegar e repetir, macaquear as coisas dos Estados Unidos. Essa ideia de grupo de apoio. Sinto que essa coisa da menopausa, do etarismo, fica muito de mulher para mulher, um grupo de mulheres daquela idade. Mas não acho que isso faz um garoto de 16 anos entender que eu, uma mulher de 70 anos, posso gostar de basquete, de funk, de sambar, de namorar, de dançar. Isso tudo fica numa bolha bem impermeável. E não acho que a comunicação está indo para outros lados. É mais você, minha amiga, que também está sentindo calores. [QUOTE=1220] Tem uma coisa americana que inventaram que é muito chata. Por exemplo, a terceira idade. Aí vai ter um baile, um monte de velhinhos e velhinhas dançando todos juntos. Claro que é melhor do que ficar em casa deprimido, mas é chato. Acho que essa festa tem que ter todo mundo. Tem que ter os gays, as crianças, todo mundo nessa mesma pista com um DJ bom, com uma batucada boa. Senão você vai numa festa e todas as pessoas são idênticas. Você vai em um restaurante e tem um aquário onde põem as crianças dentro de um vidro enquanto você come. Mas a criança tem que estar na mesa ouvindo o que você está falando, comendo um troço que ela não come normalmente. O menu kids é uma aberração. Os meus filhos comem tudo, qualquer coisa que estiver na mesa, do jeito que for. Mas é tudo separado. Essa coisa de imitar americano, entendeu? Então, acho que essa coisa da menopausa está um pouco ali. Tem que abrir para a gente conversar, tem que falar sobre menopausa com o MC Cabelinho. Eu passei meio batida, porque, por sorte, não tive sintomas físicos mais fortes. Senti um pouco mais de calor, mas como aqui é tão calor e eu sou tão agitada, eu nunca soube que aquilo era específico da menopausa.  Vou mudar um pouco de assunto porque não dá para deixar de falar sobre isso. Uma das melhores entrevistas do Trip FM no ano passado foi com seu marido, o cineasta Estêvão Ciavatta. Ele contou do acidente num passeio a cavalo que o deixou paralisado do pescoço para baixo e com chances de não voltar a andar. E fez uma declaração muito forte sobre o que você representou nessa recuperação surpreendente dele. A expressão "estamos juntos" virou meio banal, mas, de fato, você estava junto ali. Voltando a falar do etarismo, o Estêvão foi muito corajoso de casar com uma mulher que era quase 15 anos mais velha, totalmente estabelecida profissionalmente, conhecida em qualquer lugar, que tinha sido casada com um cara maravilhoso, o Luiz Zerbini, que tinha uma filha, uma roda de amigos muito grande, um símbolo muito sólido, tudo isso. Ele propôs casar comigo, na igreja, com 45 anos. Eu, hippie, do Asdrúbal e tudo, levei um susto, nunca pensei que eu casar. O que aconteceu? Eu levei esse compromisso muito a sério, e não é o compromisso de ficar com a pessoa na saúde, na doença, na alegria, na tristeza. É também, mas é o compromisso de, bom, vamos entrar nessa? Então eu vou aprender como faz isso, como é esse amor, como é essa pessoa, eu vou aprender a te amar do jeito que você é. Acho que o pessoal casa meio de brincadeira, mas eu casei a sério mesmo, e estamos casados há 28 anos. Então, quando aconteceu aquilo, eu falei: ué, a gente resolveu ficar junto e viver o que a vida trouxesse pra gente, então vamos embora. O que der disso, vamos arrumar um jeito, mas estamos juntos. E acho que teve uma coisa que me ajudou muito. O quê? Aqui em casa é tipo pátio dos milagres. Teve isso que aconteceu com o Estêvão, e também a gente ter encontrado o Roque no momento que encontrou [seu filho caçula, hoje com 11 anos, foi adotado pelo casal quando bebê]. A vida que a gente tem hoje é inacreditável. Parece realmente que levou oito anos, o tempo que demorou para encontrar o filho da gente, porque estava perdido em algum lugar, igual a Dona Lurdes, de Amor de Mãe. Essa é a sensação. E a Benedita, quando nasceu, quase morreu, e eu também. Ela teve Apgar [escala que avalia os recém-nascidos] zero, praticamente morreu e viveu. Nasceu superforte, ouvinte, gorda, forte, cabeluda, mas eu tive um descolamento de placenta, e com isso ela aspirou líquido. Ela ficou surda porque a entupiram de garamicina, um antibiótico autotóxico. Foi na melhor das intenções, pra evitar uma pneumonia pelo líquido que tinha aspirado, mas ninguém conhecia muito, eram os primórdios da UTI Neonatal. O que foi para a gente uma tragédia, porque ela nasceu bem. Só que ali aprendi um negócio que ajudou muito nessa história do Estêvão: a lidar com médico. E aprendi a não aceitar os "não". Então quando o cara dizia "você tem que reformar a sua casa, tira a banheira e bota só o chuveiro largo para poder entrar a cadeira de rodas", eu falava: "Como eu vou saber se ele vai ficar pra sempre na cadeira de rodas?".  [QUOTE=1221] Quando a Benedita fala "oi, tudo bem?", ela tem um leve sotaque, anasalado e grave, porque ela só tem os graves, não tem nem médio, nem agudo. Mas ela fala, canta, já ganhou concurso de karaokê. Quando alguém vê a audiometria da Benedita, a perda dela é tão severa, tão profunda, que falam: "Esse exame não é dessa pessoa". É o caso do Estêvão. Quando olham a lesão medular dele e veem ele andando de bicicleta com o Roque, falam: "Não é possível". Por isso eu digo que aqui em casa é o pátio dos milagres. A gente desconfia de tudo que é “não”. É claro que existem coisas que são limitações estruturais, e não adianta a gente querer que seja de outro jeito, mas ajuda muito duvidar e ir avançando a cada "não" até que ele realmente seja intransponível. No caso do Estêvão, acho que ele ficou feliz porque teve perto por perto não só uma onça cuidando e amando, mas uma onça que já tinha entendido isso. Porque se a gente tivesse se acomodado a cada “não”, talvez ele não estivesse do jeito que está hoje. [IMAGE=https://revistatrip.uol.com.br/upload/2025/03/67d49af631476/header-regina-interna2.jpg; CREDITS=João Pedro Januário; LEGEND=; ALT_TEXT=] Eu já vi você falar que essa coisa da onça é um pouco fruto do machismo, que você teve que virar braba para se colocar no meio de grupos que eram majoritariamente de homens, numa época que esse papo do machismo era bem menos entendido. Isso acabou forjando o seu jeito de ser? Com certeza. Eu queria ser homem. Achava que tudo seria mais fácil, melhor. Achava maravilhoso até a minha filha ser mulher. Fiquei assustadíssima. Falei: "Não vou ser capaz, não vou acertar". Aí botei a Benedita no futebol, foi artilheira e tudo, e fui cercando com uma ideia nem feminista, nem machista, mas de que o masculino ia ser melhor pra ela, mais fácil. Mas aí aprendi com a Benedita não só a amar as mulheres, mas a me amar como mulher, grávida, dando de mamar, criando outra mulher, me relacionando com amigas, com outras mulheres. Isso tudo veio depois da Benedita. Mas se você falar "antigamente o machismo"... Vou te dizer uma coisa. Se eu estou no carro e falo para o motorista “é ali, eu já vim aqui, você pode dobrar à direita”, ele pergunta assim: “Seu Estêvão, você sabe onde é para dobrar?”. Aí eu falo: “Vem cá, você quer que compre um pau para dizer pra você para dobrar à direita? Vou ter que botar toda vez que eu sentar aqui? Porque não é possível, estou te dizendo que eu já vim ali”. É muito impressionante, porque não é em grandes discussões, é o tempo todo. É porque a gente não repara, sabe? Quer dizer, eu reparo, você que é homem talvez não repare. Nesses momentos mais difíceis, na hora de lidar com os problemas de saúde da Benedita ou com o acidente punk do Estêvão, o que você acha que te ajudou mais: os anos de terapia ou o Terreiro de Gantois, casa de Candomblé que você frequenta em Salvador? As duas coisas, porque a minha terapia também foi muito aberta. E não só o Gantois como o Sacré-Coeur de Marie. Eu tenho uma formação católica. Outro dia eu ri muito porque a Mãe Menininha se declarava católica em sua biografia, e perguntaram: "E o Candomblé"? Ela falava: “Candomblé é outra coisa”. E eu vejo mais ou menos assim. Não é que são duas religiões, eu não posso pegar e jogar a criança junto com a água da bacia. É claro que eu tenho todas as críticas que você quiser à Igreja Católica, mas eu fui criada por essa avó Graziela, que era professora, uma mulher genial, e tão católica que, te juro, ela conversava com Nossa Senhora como eu estou conversando com você. Quando ela recebia uma graça muito grande, ligava para mim e para minhas irmãs e falava: "Venham aqui, porque eu recebi uma graça tão grande que preciso de vocês para agradecer comigo, sozinha não vou dar conta." Estudei em colégio de freiras a minha vida inteira, zero trauma de me sentir reprimida, me dava bem, gosto do universo, da igreja. [IMAGE=https://revistatrip.uol.com.br/upload/2025/03/67d49cbe34551/header-regina-interna5.jpg; CREDITS=Christian Gaul; LEGEND=Em 1999, Regina Casé foi a entrevistada das Páginas Negras da Trip; ALT_TEXT=] Aí eu tenho um encontro com o Candomblé, lindíssimo, através da Mãe Menininha. Essa história é maravilhosa. O Caetano [Veloso] disse: "Mãe Menininha quer que você vá lá". Eu fiquei apavorada, porque achei que ela ia fazer uma revelação, tinha medo que fosse um vaticínio... Até que tomei coragem e fui. Cheguei lá com o olho arregalado, entrei no quarto, aquela coisa maravilhosa, aquela presença.. Aí eu pedi a benção e perguntei o que ela queria. Ela falou: "Nada não, queria conhecer a Tina Pepper". Então, não só o Gantuar, o Candomblé como um todo, só me trouxe coisas boas e acolhida. A minha relação com a Bahia vem desde os 12 anos de idade, depois eu acabei recebendo até a cidadania de tamanha paixão e dedicação. É incrível porque eu nunca procurei. No episódio da Benedita, no dia seguinte já recebi de várias pessoas orientações do que eu devia fazer. No episódio do Estêvão também, não só do Gantuar, mas da [Maria] Bethânia, e falavam: "Olha, você tem que fazer isso, você tem que cuidar daquilo". Então, como é que eu vou negar isso? Porque isso tudo está aqui dentro. Então, acho que você tem que ir pegando da vida, que nem a Dona Darlene do “Eu Tu Eles”, que ficou com os três maridos. A vida vai passando por você e você vai guardando as coisas que foram boas e tentando se livrar das ruins. A gente sabe que você tem uma rede de amizades absurda, é muito íntima de meio mundo. Eu queria brincar daquela história de te deixar sozinha numa ilha, sem internet, com todos os confortos, livros, música. Você pode ligar à vontade para os seus filhos, pro seu marido, mas só tem uma pessoa de fora do seu círculo familiar para quem você pode ligar duas vezes por semana. Quem seria o escolhido para você manter contato com a civilização? É curioso que meus grandes amigos não têm celular. Hermano [Vianna] não fala no celular, Caetano só fala por e-mail, é uma loucura, não é nem WhatsApp. Acho que escolheria o Caetano, porque numa ilha você precisa de um farol. Tenho outros faróis, mas o Caetano foi, durante toda a minha vida, o meu farol mais alto, meu norte. E acho que não suportaria ficar sem falar com ele. 

Fred Apgar worked in Air Force intelligence during the Vietnam War. However, he was part of the clandestine war in Laos that was not acknowledged at the time. We talk fire support, electronic warfare, and Fred's return to the country to close that chapter of his life. Support the showhttps://www.patreon.com/formeractionguyshttps://www.jcramergraphics.comhttps://www.ANGLICOshop.comFred's Bookhttps://www.amazon.com/Return-Plaine-Jarres-Fred-Apgar/dp/196430003700:00:00 J Cramer Graphics Ad00:00:40 Intro | Joining the Air Force00:04:07 Treatment of Veterans | Deployment Cycles00:14:08 Individual Augments to Vietnam | Joining the Air Force00:17:49 Vietnam Vet Reacts to Afghanistan Withdrawl00:29:31 Airborne Intelligence in Laos and Vietnam00:32:20 What are the JTAC and FAC Jobs?00:41:28 Operations in Laos and the Naming of the Podcast00:44:43 Laos ELINT Missions | TF Alpha00:53:27 First Paveway Bombs | Dragon's Jaw Bridge01:00:46 "We Weren't In Laos"01:07:22 Redemption01:18:11 Keep Your Honor Clean | POWs

Rare condition research is evolving, and patient communities are driving the breakthrough. In this special Rare Disease Day episode, we explore the challenges and opportunities shaping the future of rare condition therapies. From groundbreaking gene therapy trials to the power of patient-driven research, our guests discuss how collaboration between families, clinicians, researchers, and regulators is paving the way for faster diagnoses, equitable access to treatments, and innovative approaches like nucleic acid therapies and CRISPR gene editing. With insights from Myotubular Trust, we follow the journey of family-led patient communities and their impact on advancing gene therapy for myotubular myopathy - showcasing how lived experience is shaping the future of medicine. However, while patient-driven initiatives have led to incredible progress, not every family has the time, resources, or networks to lead these research efforts. Our guests discuss initiatives like the UK Platform for Nucleic Acid Therapies (UPNAT), which aims to streamline the development of innovative treatments and ensure equitable access for everyone impacted by rare conditions. Our host Dr Ana Lisa Tavares, Clinical lead for rare disease at Genomics England, is joined by Meriel McEntagart, Clinical lead for rare disease technologies at Genomics England, Anne Lennox, Founder and CEO of Myotubular Trust and Dr Carlo Rinaldi, Professor of Molecular and Translational Neuroscience at University of Oxford. "My dream is in 5 to 10 years time, an individual with a rare disease is identified in the clinic, perhaps even before symptoms have manifested. And at that exact time, the day of the diagnosis becomes also a day of hope, in a way, where immediately the researcher that sent the genetics lab flags that specific variant or specific mutations. We know exactly which is the best genetic therapy to go after." You can download the transcript, or read it below. Ana Lisa: Welcome to Behind the Genes.    [Music plays]  Anne: What we've understood is that the knowledge and experience of families and patients is even more vital than we've all been going on about for a long time. Because the issue of there being a liver complication in myotubular myopathy has been hiding in plain sight all this time, because if you asked any family, they would tell you, “Yes, my son has had the odd liver result.”  There were some very serious liver complications but everybody thought that was a minor issue, but if we are able to engage the people who live with the disease and the people who observe the disease at a much more fundamental level we may be able to see more about what these rare genes are doing.  [Music plays]  Ana Lisa: My name is Ana Lisa Tavares, I'm Clinical Lead for Rare Disease research at Genomics England and your host for this episode of Behind the Genes. Today I'm joined by Anne Lennox, Founder and CEO of the Myotubular Trust, Dr Meriel McEntagart, an NHS consultant and Clinical Lead for Rare Disease Technologies at Genomics England, and Dr Carlo Rinaldi, Professor of Molecular and Translational Neuroscience at the University of Oxford.    Today we'll be hearing about the importance of involving the patient community, particularly as new rare therapies are developed, and discussing the forward-facing work that's happening that could have potential to unlock novel treatments for many rare conditions.  If you enjoy today's episode we'd love your support. Please like, share and rate us on wherever you listen to your podcasts. Thank you so much for joining me today.  Please could you introduce yourselves.   Anne: I'm Anne Lennox, I'm one of the founders of the Myotubular Trust, a charity that raises research funds for and supports families affected by the rare genetic neuromuscular disorder myotubular myopathy.  Meriel: I'm Meriel McEntagart, I'm a consultant in clinical genetics in the NHS and I have a special interest in neurogenic and neuromuscular conditions.  Carlo: Hi, I'm Carlo Rinaldi, I'm Professor of Molecular and Translational Neuroscience at the University of Oxford. I'm a clinician scientist juggling my time between the clinic and the lab where we try to understand mechanisms of diseases to develop treatments for these conditions.  And I'm also here as a representative of the UK Platform for Nucleic Acid Therapies, UPNAT. Thanks for your invitation, I'm very pleased to be here.  Ana Lisa: Thank you. Meriel, I'd love you to tell us a bit about your work and how you met Anne, how did this story start?  Meriel: Thank you. Well prior to being a consultant in clinical genetics, I spent 2 years as a clinical research fellow in neuromuscular conditions, and as part of that training I worked on a project where the gene for myotubular myopathy had just been identified, and so there was a big international effort to try and come up with sort of a registry of all the genetic variants that had been found as well as all the clinical symptoms that the affected patients had, and then do kind of a correlation of the particular variant mutation with symptoms.   I worked when I was training to be a clinical geneticist because of my interest in neuromuscular conditions so when I eventually became a consultant at St George's Hospital I was actually interviewed by the Professor of Paediatrics and he knew Anne and her son, when Anne was looking for more information about the condition he suggested that perhaps I might be a good person for Anne to talk to.  Ana Lisa: Thank you. Interesting connections. Anne, can you tell us your story and how this led you to found the Myotubular Trust?  Anne: Yes, thanks Ana-Lisa.  Well, as many families will tell you when they're newly diagnosed with a rare disease, you go from knowing nothing about a condition to being one of the few deep experts in that condition because there are so few deep experts. So this happened to us in 2003 when our son, Tom, was born, and when he was born he was floppy and his Apgar scores, the scores they do on new-born babies, were pretty poor, and before long we knew that it was more than just momentary issues at birth.  And, cutting a very long story short, 5 weeks later he was diagnosed with this very rare neuromuscular genetic disorder that we didn't know we had in the family.  We were told that this was a very serious diagnosis.    At that time – more than 20 years ago – over 80% of those boys didn't make it to their first birthday and the stark statistic we had in our head a lot was that only 1% made it past the age of 10. And that has changed due to better ventilator and breathing equipment, etc, but at the time we expected that he might not make it to his first birthday.    We were very lucky, we had Tom longer than one year, we had him for nearly 4 years, 4 very lovely years where it was tough, but he was a really lovely member of our family.  Despite being really weak he managed to be incredibly cheeky and bossy, and he was a great little brother for his big sister. We were also very lucky that he was being looked after by Professor Francesco Muntoni, who is Head of the Paediatric Neuromuscular Service at Great Ormond Street. And, like Carlo, he is a clinical researcher and actually that I found to be amazing as a family member because you knew what was happening out there and Professor Muntoni, other than living with the reality day to day you want to know where things are going.    We began to realise that back then 20 years ago the more common rare neuromuscular diseases were finally beginning to get some fundamental research funds, like Duchenne, spinal muscular atrophy, and Professor Muntoni was very good at explaining to lay non-scientific parents like us that one day the technologies that would lead to a cure, that would re-engage proteins for other conditions and would translate down eventually into the possibility of replacing myotubularin, which is the protein not being produced or not being produced enough in myotubular myopathy. And then we began to understand actually what the barriers to that would be, that translating developments in more common, or let's say more prevalent conditions, would be hard to do without some translation research being done; you could not just not lag years behind, you could lag decades behind if you haven't done some other work.    So, I met Wendy Hughes, another mother, of a boy called Zak who was a few years older than Tom, and these were the days before social media, and it was amazing to be in contact with another family going through something similar and we had great conversations. But then they were also looked after by Professor Muntoni and we particularly began to develop the idea as 2 families that we might be able to raise some research funds towards this concept of keeping pace with the scientific developments.  And then we discovered there was no charity we could channel those funds through. Even the umbrella body for neuromuscular diseases who were covering 30 to 40 conditions, frankly, they just couldn't trickle their funding down into investing in every neuromuscular disease, and slowly but surely it dawned on us that if we did want to make that difference we were going to have to set up our own charity.   So that's what we eventually did and back in 2006, we founded what was actually the first charity in Europe dedicated to myotubular myopathy – luckily, more have come along since – and we were dedicated to raising research funding. In fact, it wasn't our goal to set up another charity but around that time, about a year in, we happened to go to a meeting where the Head of the MRC, the Medical Research Council, was giving a talk and he said that in the last few years the MRC had begun to really realise that they couldn't cure everything, that they couldn't cure the diseases that would be cured in the next millennium from a top down perspective. There had to be a trick, there had to be a bottom up as well, because that was the only way this was going to happen. And I have to say that that was a really reassuring moment in time for us to realise that we weren't just chasing pipe dreams and trying to do something impossible, that there was a role for us.    Ana Lisa: I think it would be really interesting for people to hear your story and the amazing set-up and fundraising that you've done, and at the same time it would be really good for us to reflect on how this isn't feasible for every patient and every family and how we're going to need to work cooperatively to move forwards with rare therapies.  Anne: When we explored the idea with Professor Muntoni and Meriel and others about setting up a charity one of the really reassuring things that Professor Muntoni got across to us was that this wasn't about raising the millions and millions it would take to fund clinical trials but the issue in the rare disease space was funding the proof of principle work, the work where you take a scientist's hypothesis and take it over the line, and the rarer the disease, the less places there are for a scientist to take those ideas. And the example he gave us was a piece of research like that might cost a hundred to a couple of hundred thousand, if you fund a piece of work like that and if it is successful, if the scientist's principle gets proven, then behind you it's much easier for the bigger muscle disease charities to also invest in it. It's harder for them to spread their money across all the very rare diseases hypothesis out there, but if you've helped a scientist get over the line they'll come in behind you and then they won't be the ones who fund the tens of millions that it takes to run a clinical trial.    If it's got potential, then that's where the commercial world comes in, and that's where the biotechs come in. So he'd given the example of if you spent £ten0,000 on a piece of research and it actually is proven, in behind you will come the bigger charities that would put in the million that takes it to the next phase, and in behind them will come the bio-checks that'll provide biotechs that'll provide the tens of millions.    And then, you know, a lot of what happens relies on serendipity as well, we know that, and you could easily run away with the idea that you made everything happen but you don't, you stand on the shoulders of others. And our very first grant application in our first grant round, which received extraordinary peer review for how excellent the application was, was a £100,000 project for a 3-year project that had gene therapy at the core of it by a researcher called Dr Ana Buj Bello at Généthon in Paris. This piece of research was so promising that 18 months in she and another researcher were able to raise $780,000 and, as Professor Muntoni predicted, from the French muscle disease charity AFM and the American muscle diseases charity MDA.  And 18 months into that 3 years it was so promising that a biotech company was started up with $30 million funding, literally just on her work.    So that doesn't always happen but, as Professor Muntoni explained, our job was not that $30 million, our job was that first £100,000, and our job was also to make ourselves known to the people in the neuromuscular field.  If you have lab time, if you have research time and you have a choice where you're putting it there is a place you can go to for a myotubular myopathy related grant application, so it's not just that this will come to us out of the blue, people will have done prior work, and our existence makes it worth their while, hopefully, to have done that prior work.  Ana Lisa: That's an amazing story how you've set up this charity and how successful that first application for gene therapy was. I'd love to hear more about that gene therapy and did it get to the clinic and to hear that story from you.  Because I think there are a lot of learnings and it's really important that the first patients who are treated, the first families that are involved, the researchers who start researching in this area, the first treatments lead the way and we learn for all the other treatments for all the other rare conditions that we hope and that together as a community we can share these learnings.  Anne: Yeah. I sometimes describe it a bit like going out into space. When you see a rocket going off look at how many people are behind and the amount of work that's been done, the degree of detail that's managed, and then you go out into space and there are a whole load of unknowns, and you can't account for all of them.  Who knows what's out there in this sphere.  But the amount of preparation, it feels similar to me now, looking back.  We were so idealistic at the beginning.  Our grant to Dr Buj Bello was 2008 and actually it is a really fast time in, the first child was dosed in the gene therapy trial in September 2017.  Ana Lisa: So, we're talking less than 1 years.  Anne: Yeah. And in the meantime obviously as a charity we're also funding other proof of principle research. One of the founding principles of the charity was to have a really excellent peer review process and scientific advisory board so that we wouldn't get carried away with excitement about one lab, one research team, that everything would always come back to peer review and would be looked at coldly, objectively. I don't know how many times I've sat in a scientific advisory board meeting with my fingers crossed hoping that a certain application would get through because it looked wonderful to me, and then the peer review comes back and there are things you just don't know as a patient organisation. So, yes, in those 9 years we were also funding other work.  Ana Lisa: You've just given an interesting perspective on sharing the learnings between the scientists, clinicians, the experts in a particular condition, if you like, and the families, and I'd be really interested to hear your views on what's been learnt about how families and the patient community can also teach the clinical and scientific community.  Anne: So, the first child was dosed in September 2017 and by the World Muscle Society Conference 2 years later in October 2019 the biotech had some fantastic results to show. Children who had been 24-hour ventilated were now ventilator-free, which, unless you know what it's like to have somebody in front of you who's ventilator-dependent, the idea that they could become ventilator-free is just extraordinary.    However, one of the things we've learnt about gene therapy is that we are going out into space so there are extraordinary things to be found, and extraordinary results are possible, as is evidenced here, but there is so much that we don't know once we are dealing with gene therapy. So unfortunately, in May, June and August of 2020, 3 little boys died on the clinical trial. So we have a clinical trial where the most extraordinary results are possible, and the worst results are possible, and both of those things are down to the gene…  What we discovered and what is still being uncovered and discovered is that myotubular myopathy is not just a neuromuscular disorder, it is a disorder of the liver too, and these children didn't die of an immune response, which is what everybody assumes is going to happen in these trials, they died of liver complications.    And one of the things that has come out of that, well, 2 sides to that. Number one is that it is extraordinary that we have found a treatment that makes every single muscle cell in the body pick up the protein that was missing and produce that protein, but also what we've understood is that the knowledge and experience of families and patients is even more vital than we've all been going on about for a long time. Because the issue of there being a liver complication in myotubular myopathy has been hiding in plain sight all this time, because if you asked any family they would tell you, “Yes, my son has had the odd liver result, yes.”    We could see something that looked like it was not that relevant because it was outside the big picture of the disease, which was about breathing and walking and muscles, but actually there was this thing going on at the same time where the children had liver complications. There were some very serious liver complications but everybody thought that was a minor issue but if we are able to engage the people who live with the disease and the people who observe the disease at a much more fundamental level we may be able to see more about what these rare genes are doing.  Ana Lisa: Yeah, thank you very much for sharing such a moving story and with such powerful lessons for the whole community about how we listen to the expertise that families have about their condition, and also I think the really important point about how we tackle the research funding so that we're including and sharing learnings from the conditions that are initially studied in greater depth, and we hope that many more conditions will be better understood and more treatments found and that actually the learnings from these first gene therapy trials will really help inform future trials, not just for gene therapies but also for many other novel therapies that are being developed.  [Music plays] If you're enjoying what you've heard today, and you'd like to hear some more great tales from the genomics coalface, why don't you join us on The Road to Genome podcast. Where our host Helen Bethel, chats to the professionals, experts and patients involved in genomics today. In our new series, Helen talks to a fantastic array of guests, including the rapping consultant, clinical geneticist, Professor Julian Barwell, about Fragile X syndrome, cancer genomics and a holistic approach to his practice - a genuine mic-drop of an interview. The Road to Genome is available wherever you get your podcasts. [Music plays] Ana Lisa: Carlo, I would really like to come to you about some of the initiatives that are happening in the UK, and particularly it would be really interesting to hear about the UK Platform for Nucleic Acid Therapies as a sort of shining example of trying to do something at a national scale across potentially many different rare conditions.    Carlo: Thanks, Ana-Lisa. Thanks very much, Anne, for sharing your fantastic story. I mean, I just want to iterate that as clinician scientists we do constantly learn from experiences and constantly learn from you, from the patient community, and this is absolutely valuable to push the boundary. And I really liked your vision of a rocket being launched in space and I would imagine that this is a similar situation here. So, we are facing a major challenge. So, there is over 7,000 rare diseases in the world and with improvements of genetic diagnosis this is only increasing. So, in a way rare diseases is the ultimate frontier of personalised medicine and this poses incredible challenges.   So, you mentioned the bottom-up approach and the top-down approach and in a way, both are absolutely necessary. So your story is a fantastic story but also makes me think of all the other families where they don't share perhaps the same spirit, you know, they are in areas of the world that are not as well connected or informed, where patient community simply cannot be ‘nucleated', let's say, around the family. So, there is definitely an issue of inclusivity and fair access.    So, what we're trying to do at UPNAT, which is the UK Platform for Nucleic Acid Therapy, is to try to streamline the development both at preclinical and clinical level of nucleic acid therapies. So, we'll start with antisense oligonucleotides just because those are the molecules of the class of drugs that are most ‘mature', let's say, in clinic. So, there are several antisense oligonucleotides already approved in the clinic, we know that they are reasonably safe, we understand them quite well, but of course the aspiration is to then progress into other forms of gene therapy, including gene editing approaches, for example.   And one of the activities that I'm involved, together with Professor Muntoni, is to try to streamline the regulatory process of such therapies and in particular curate a registry of, for example, side effects associated with nucleic acid therapy in the real world, and you would be surprised that this is something that is not yet available.  And the point is exactly that, it's trying to understand and learn from previous mistakes perhaps or previous experiences more in general.    And this is very much in synergy with other activities in the UK in the rare disease domain.  I'm thinking of the Rare Disease Therapy Launchpad, I'm thinking of the Oxford Harrington Centre, I am thinking of the recently funded MRC CoRE in Therapeutic Genomics. These are all very synergistic. Our point is we want to try to amplify the voice of the patient, the voice of the clinicians working on rare disease, and we want to systematise. Because of course one of the risks of rare disease therapies is the fragmentation that we do all these things in isolation. And I would argue that the UK at the moment leveraging on the relatively flexible and independent regulatory agencies, such as the MHRA, on the enormous amount of genetics data available through Genomics England, and of course the centralised healthcare system, such as the NHS, is really probably the best place in the world to do research in the rare disease area, and probably I'm allowed to say it because I'm a non-UK native.       Ana Lisa: Thank you, that's a brilliant perspective, Carlo, and across all the different therapeutic initiatives that you're involved with. And, Carlo, presumably - we're all hoping - these different initiatives will actually lead to ultimately a bigger scaling as more and more novel therapies that target both our RNA and DNA and actually are working, I guess further upstream in the pathway.    So classically in the past it's been necessary to work out all the underlying biology, find a druggable target somewhere in that pathway and then get a larger enough clinical trial, which can be nearly impossible with many of the rare and ultra-rare conditions or even, as you've said, the sub-setting down of more common condition into rarer subtypes that perhaps can be treated in different ways.  And with the many new different treatments on the horizon, ASO therapies, as you've said, is a place that's rapidly expanding, and also crisper gene editing. I'd be really interested to hear your reflections on how this might scale and also how it might extend to other new treatments.  Carlo: Yeah, that's exactly the right word, ‘scaling up'. I mean, there will be of course very unique challenges to every single rare disease but I would argue that with genetic therapies, such as ASOs or crisper gene editing, the amount of functional work that you need to do in a lab to prove yourself and the scientific community that this is the right approach to go for can be certainly very important but can be less just because you're addressing very directly because of the disease.    And then there are commonalities to all these approaches and possibly, you know, a platform approach type of regulatory approval might serve in that regard. You know, if you are using the same chemistry of these antisense oligonucleotides and, you know, similar doses, in a way the amount of work that you need to produce to again make sure that the approach is indeed a safe approach and an effective approach might be also reduced.    I would say that there are also challenges on other aspects of course, as you were saying, Ana-Lisa. Certainly the typical or standard randomised placebo control trial that is the standard and ultimate trial that we use in a clinical setting to prove that a molecule is better than a placebo is many times in the context of rare diseases simply not possible, so we need to think of other ways to prove that a drug is safe and is effective.   This is something that we all collectively as a scientific community are trying to address, and the alliance with the regulatory agencies, such as the MHRA, and you said that you have found your interaction with the MHRA very positive, and I can tell you exactly the same. So we are all trying to go for the same goal, effectively, so trying to find a way to systematise, platformise these sort of approaches. And I guess starting with antisense oligonucleotides is really the right place to go because it's a class of drugs that we have known for a long time, and we know it can work.  Ana Lisa: Meriel, can you tell us a little about the National Genomic Research Library at Genomics England and how this could link with initiatives to find many more patients as new treatments become available for rare and ultra-rare conditions?  Meriel: Yes, I think what's wonderful now is actually that what we're really trying to do is give everybody the opportunity to have their rare condition specifically diagnosed at the molecular level, and the way in which that is being done is by offering whole genome sequencing in the NHS currently in England but to all patients with rare diseases.    And so, it's about trying to establish their diagnosis. And as well as that, even if the diagnosis isn't definitely made at the first pass when the clinical scientists look at the data, because the whole genome has been sequenced, actually all that information about their genome, if they consent, can then be put into the National Genomics Research Library.  And that is a fantastic resource for national and international researchers who get approved to work in this trusted research environment to make new disease gene discoveries and identify these diagnoses for patients.  What's also offered by Genomics England as well is when the National Genomics Library data results in a new publication, the discovery of a new gene or perhaps a new molecular mechanism that causes a disease we already know about, that feeds back into the diagnostic discovery pathway within Genomics England back onto the diagnostic side of all the data.    So, patients who may have had genetic testing previously using whole genome sequencing where they've, if you like, had their sequencing done before the diagnosis was sort of known about, will also be picked up. And so, what this is really doing is trying to kind of give this really equal platform for everybody having testing to all have the same opportunity to have their diagnosis made, either on the diagnostic side or with research.  Ana Lisa: So, sort of on a cohort-wide scale as new discoveries are made and published you can go back and find those patients that may actually have that diagnosis and get it back to them, which is brilliant.  Meriel: Exactly. And this speeds up the whole process of getting these diagnoses back to people. So on a regular basis in the NHS, we will get feedback from the Diagnostic Discovery Pathway about “Here's some patients who you requested whole genome sequencing from a number of years ago and actually now we think we know what the particular molecular condition is.”  And so, it's key of course for our patients with rare conditions to make that molecular diagnosis because then we're able to have them identified for our colleagues who are doing this ground-breaking research trying to bring therapies for these rare conditions.  Ana Lisa: Thank you. And I hope that, as currently, if a novel genetic mechanism, as you've just described, is identified that could explain a rare condition that those patients can be found and they can receive that diagnosis, even many years later, and hopefully as novel treatments become available and say there's a chance to individualise ASO therapies, for example, to start with, that one could also go and look for patients with particular variants that could be amenable potentially to that treatment. And that's really sort of exciting that one could look for those patients across England, irrespective of which clinic they're under, which specialist they're under, and I think that could be really powerful as new treatments develop. I suppose, Meriel, if somebody comes to see you now in clinic are things different?  Meriel: Well, I think one of the things for me when patients come to clinic now is we might have an idea about what we think their condition is, maybe even we think it's a specific gene. And we can offer whole genome sequencing and so it's not just the way we used to do things before by looking just at the coding regions of the gene, we can find more unusual ways in which the gene can be perturbed using whole genome sequencing.  But let's say we don't make the diagnosis. I encourage my patients, if they're comfortable with it, to join the National Genomics Research Library, because really it's been incredibly productive seeing the new genetic discoveries that are coming out of that, but as well I say to them, even if we don't get the diagnosis the first time round when we look at the data, actually this is a constant cycle of relooking at their data, either if they're in the NGRL or as well on the Diagnostic Discovery Pathway side of the service that's run by Genomics England. So yeah, I feel like it's a very big difference; they don't have to keep coming every year and saying, “Is there a new test?” because actually they've had an excellent test, it's just developing our skills to really analyse it well.  Ana Lisa: Yes, and our knowledge, the technology and the skills keep evolving, certainly.  And I think one of the things that I'm sort of hearing from this conversation is that balance of hope and realism, Carlo we were talking about earlier how you need all the pieces of the puzzle to be lined up - so the regulatory agency, the clinicians, all the preclinical work has to have been done, monitoring afterwards for side effects - every piece of the puzzle has to be lined up for a new treatment to make it to a patient.    And, Anne, I'd like to come back to you because we've talked about this before, how one balances these messages of optimism and hope which are needed for bringing everybody together as a community to crack some of these very difficult challenges highlighted by treatments for rare and ultra-rare conditions and at the same time the need for realism, a balance conversation.  Anne: Yeah, that was one of our big learnings through the gene therapy trial and other trials we've had in the condition. As a rare disease charity, you do everything. You know, my title is CEO, but I tell people that's Chief Everything Officer because there's only a few of you and you do everything. So, you go and you lead the London Hope Walk and you also are a layperson on the Scientific Advisory Board and you also send out the emails about grants... And so, you could easily as a small rare disease charity conflate different communication messages because you're in a certain mode.  And so we have been from the early days in the mode of raising hope for people to say, “Look, we can make a difference as a patient community, we could raise funds, we might be able to move things forward, you've got the power to make a difference if you want to.” That's one set of hope.  And it's not dreamlike hope, we're linked to the reality of there are great breakthroughs.  So, you know, in the world of spinal muscular atrophy these clinical trials have led somewhere very quickly, so we're not selling false hope, we're talking about the difference we can make.    But then as soon as you flip into “There's a clinical trial being run” that's a completely different type of communication and you cannot conflate that message with the previous message.  And we always say to everybody, “We're your team, we're a family, we're a team, we all help each other.  When you are considering joining a clinical trial your team is the clinical trial team.    The other team does other things for you but the people you need to work with and ask hard questions of and listen hard to, that's your clinical trial team led by the principal investigator because then you're in that with them. And, you know, the reality of the fact that many, many clinical trials don't work as we wish they would be and the decision you make for your child, your baby, your little one, to join a clinical trial… because that's what it comes down to in our disease, has to be made with that team, not the team that's selling you a fundraising event. It's worth reminding rare disease patient organisations we're wearing different hats and the hope and the realism are different tracks you have to go down.    But at the same time as being realistic you also have to keep remembering that there is still grounds for hope, we are moving forward. And 21 years ago, when Tom was born the idea that you would be able to get all of the muscles in the body to switch back on – putting it in lay terms – seemed like a bit dream. Well, that is what has happened in the gene therapy clinical trial, we just have to now make it safer and understand more about what we're dealing with. So, the 2 things, the hope and the realism, do exist side by side.  Ana Lisa: I think that perfectly encapsulates a lot of the messages around rare disease therapies where there's such hope that novel treatments will really target directly the DNA or RNA to potentially correct the problem across many different rare conditions and therefore actually making treatments one day suddenly available to a much, much bigger population of people with rare conditions than we could've dreamt of 20 years ago or perhaps now, and at the same time this massive need to work cooperatively to all make this as fair, as equitable. Not everybody is going to have the opportunity to fundraise massively to be an expert about their condition, and the importance of sharing these learnings and also really, really listening to the patient community and really, as Carlo was saying, keeping track of side effects, having registries/databases to share these is going to be incredibly important.  [Music plays]  Ana Lisa:  Anne, can you tell us a little about your reflections on equity from the patient community perspective?  Anne: Well I mentioned serendipity early and one of the aspects of serendipity that played into our favour for setting up the Myotubular Trust was that by hook or by crook Wendy Hughes, who set up the charity with me, and I were both able to devote time at that period of our lives to setting up a charity. When my husband, Andrew, and I were told that Tom would more than likely die before his first birthday, one of the decisions we made as a family was that he would never not be with a parent, we would always have someone around, and that kind of meant someone had to give up a full-time job and that was me.  We thought, “If Tom has a few scarce months on the planet, we'll be with him.” And then when Tom lived to be nearly 4, as a family we got used to living on one salary and we were very lucky that we could pay the mortgage that way and run our family that way and eventually that meant I had the time to run the charity.    That doesn't happen that easily, that's a tall order, particularly when you have somebody in the family who has such high needs. And one of the things that I have often thought about is that in the rare disease space we could do with a different funding model for rare disease charities, we could, in an ideal world I have this nirvana that I imagine where there's a fund that you can apply to that is contributed to by the people who make profits out of finding rare disease cures - so the pharmaceutical companies and the biotechs - and there's a fund that they contribute to and that if you have a rare disease and you are willing to set up an organisation that supports families, that raises research funds, that provides a way of hearing the patient voice, then you could apply to that for running cost funds and then you'd be able to run this charity. And then you wouldn't have to rely on whether you live in an area where people will raise money for you or…  We were very lucky that we came across a few great benefactors who would give us money for running the charity, which is actually how we fund it.    All the research money we raise goes 100% into research, not a penny of it goes towards running costs because we have serendipitously found people who will be benefactors for the charity, but we're relying on a lot of good luck for that kind of model to work. And when you look at how much profit is made from developing rare disease treatments and cures – which is fine because that's what puts the passion and that gets people working on it – then why not have an advance fund to run rare disease charities? One of my nirvana dreams.  Ana Lisa: It's good to dream. Indeed, my hope is that there will be some amazing shining examples that lead the way that open doors, make things possible, prove that something can work and how and that then that will enable many other treatments for many additional rare conditions to be added in so that if you've learnt how this particular treatment modality works for this rare condition and there was funding behind it and everything else that's needed that then you can, the learning from that, I'm going to use the word ‘tweak', which sounds minor and could be very major but actually the concept that you can then tweak all those learnings and findings so that that same type of treatment modality could be adapted to treat somebody else with a different rare condition in a different location would be absolutely incredible and really powerful, given that if something like 85% of rare conditions affect less than one in a million people it's not going to be feasible to use the same strategies that have been used in the past for very common conditions.    One of the other big barriers is the cost of developing treatment for ultra-rare conditions.  Where it's a small number of patients that you have and therefore all the challenges that come with monitoring, checking for efficacy, monitoring safety and ultimately funding the challenges are much greater, however if some of these treatment modalities are also going to be used to treat common conditions it might be that actually there's a lot more cross-talk between the nano-rare, ultra-rare, rare and common conditions and that we can share a lot of that learning. I'd love to hear from each of you where you hope we will be for rare disease and rare therapies.  Carlo: Well my dream is that in 5 to 10 years' time an individual with a rare disease is identified in the clinic, perhaps even before symptoms have manifested, and at that exact time the day of the diagnosis becomes also a day of hope in a way where immediately the researcher, the centre, genetics lab, flags that there are the specific mutations, we know exactly which is the best genetic therapy to go after, antisense oligonucleotides as opposed to CRISPR editing, and a path forward, both at the preclinical and clinical level, to demonstrate and to cure these patients eventually is already laid out in front of the patient.  So, transforming the day of their diagnosis as a day of hope, this is my dream with the next ten years.  Ana Lisa: Thank you, that's a wonderful dream. Meriel, can I come to you?  Meriel: Yes, I think I just want to echo Carlo.  We've had great developments and progress with getting whole genome sequencing into the NHS for testing but what we really need is for it to be fast and efficient and getting those diagnoses established quickly. And we have had that set up now and we're really getting there in terms of speed, but then what we need is exactly what's the next step and actually structure like UPNAT that are developing these processes that we can then say to the patient, “And from there, now that we've established your diagnosis, this is what we have options to offer.”  Ana Lisa: Brilliant. And presumably that if the diagnosis isn't achieved now there is a hope that it will be achieved in the future as well. Anne...  Anne: Well, stepping one hundred per cent into the patient's shoes rather than the scientific side that we don't so much influence....  stepping in the patient's shoes, in 5 years' time I would absolutely love it if we were in a situation where all the parties that have come to the table looking at a therapy or in the earlier research genuinely want to bring the patient voice into the room. As Carlo talked about, there's even going to be more and more and more of these rare diseases, then those voices, those few people who have experience of it, they may be able to shed light on something. Maybe even sometimes don't even know it's a fact that they know but that were brought to the table as passionately as everything else is brought to the table.  [Music plays]  Ana Lisa: We'll wrap up there. Thank you so much to our guests, Anne Lennox, Carlo Rinaldi and Meriel McEntagart, for joining me today as we discuss the collaborative power of working together and look to the future of rare therapies that could have the potential to unlock treatments for many rare conditions. If you'd like to hear more like this, please subscribe to Behind the Genes on your favourite podcast app.  Thank you for listening.  I've been your host, Ana-Lisa Tavares. This podcast was edited by Bill Griffin at Ventoux Digital and produced by Naimah Callachand.  

Antek urodził się w 25 tygodniu ciąży ważąc 930 g, z 1 punktem w skali Apgar i całą listą chorób, które miały uniemożliwić mu normalne życie. Po 20 latach Antek nie może sam funkcjonować, ale jest triathlonistą, laureatem sportowej nagrody Miasta Poznania i stara się (wraz z rodzicami) o stworzenie kategorii sportowej, w której miałby szansę zdobyć medal podczas letnich Igrzysk Paraolimpijskich w Los Angeles w 2028 roku. Antek sam nie mówi, dlatego o tym, co wydarzyło się przez ostatnich 20 lat (a szczególnie o ostatnich kilku) opowiada jego ojciec, towarzysz biegowy, który za synem już nie nadąża. // Arkadiusz Dworczak // tata Antka, sportowca przygotowującego się do Igrzysk Paraolimpijskich w 2028 roku -------- Wesprzyj nas, będzie nam miło i pomożesz tworzyć podcast: - abonament, czyli duża wdzięczność: www.patronite.pl/drugawersja - kawka w podziękowaniu za odcinek: www.buycoffee.to/drugawersja -------- My na www: www.drugawersja.pl  My na Spotify: https://spoti.fi/3MWjX9v My na fejsie: www.facebook.com/drugawersja My na YT: https://www.youtube.com/@podcast_poznanski My na insta: www.instagram.com/druga.wersja My na tiktoku: https://www.tiktok.com/@drugawersja

In this episode of the Prime Podcast, Dr. Skip and Dr. Julie Weiss delve into the critical developmental milestones in the first two years of a child's life. They emphasize the importance of these milestones occurring in the correct sequence and how missteps can lead to long-term developmental issues. The hosts discuss common misunderstandings, advocate for proactive pediatric chiropractic care, and explain the significance of Apgar scores and primitive reflexes in assessing a newborn's health. This episode is essential for parents seeking to understand and support their child's early development. 00:00 The Importance of Developmental Order  01:17 Introduction to the Prime Podcast  01:44 Understanding Baby Milestones 06:38 The Critical Role of APGAR Scores 15:47 Primitive Reflexes and Their Significance 20:04 The Mission to Educate Parents 21:22 Call to Action and Conclusion  https://theprimepediatricpodcast.libsyn.com =============================================== Order Standard Process Here: https://primefamilycenters.standardprocess.com   ================================= Download our App Here: Apple Play Store: https://apps.apple.com/us/app/prime-family-chiropractic-app/id6474149243 Android: https://play.google.com/store/apps/details?id=com.ub378e75245a.app&pcampaignid=web_share =================================    Please like, subscribe, comment, and share this video!    //Dr. Julie Wyss  - Prime Family Chiropractic Centers//  Dr. Julie Wyss DC is a highly respected chiropractor with a special focus on pediatric and pregnancy care. Her extensive training and experience in these areas has made her a trusted advisor to families seeking a tailored and personalized type of care focused on the body's ability to heal itself.   As a mother herself, Dr. Wyss understands the unique challenges that come with pregnancy and postpartum recovery. She believes that chiropractic care can play a vital role in supporting the health and wellbeing of both mother and child during these transformative stages of life.   In addition to prenatal care, Dr. Wyss specializes in postpartum care to help new mothers recover and regain their strength and vitality. She provides gentle adjustments and breathing exercises to address issues such as diastasis recti, pelvic floor dysfunction, and breastfeeding difficulties.   //Dr. Skip Wyss - Prime Family Chiropractic Centers// “When you get the chance to change lives from their first days of existence, you do not take it lightly. But you can take it with a dash of light-hearted joy!”   That's how Dr. Skip Wyss chooses to manage Prime Family Chiropractic Centers, a 15-year staple in his Green Bay Community. He decided to take that experience and developed the internationally recognized educational program, The Prime Coaching Company, focused on pediatric, prenatal, and family health.   Dr. Skip is an internationally recognized speaker, ICPA certified pediatric chiropractor and host of The Prime Podcast. The show is a platform for his wife, Dr. Julie Wyss, and himself to provide incredible education and resources on having an incredible marriage, business, family, faith, and health for service providers and their community!   // Prime Family Chiropractic Centers //  Certified Prenatal and Pediatric Family Chiropractic Healthcare. Get Primed for life and success with healthcare re-imagined.   Website: https://primefamilycenters.com/   Follow us on Social Media! Instagram: https://www.instagram.com/primefamilycenters/ Instagram: https://www.instagram.com/drjuliewyss/ Instagram: https://www.instagram.com/skip_wyss_dc/ Instagram: https://www.instagram.com/primepediatrics/ Facebook: https://www.facebook.com/PrimeFamilyCenters Facebook: https://www.facebook.com/profile.php?id=100094650643408 Facebook: https://www.facebook.com/DrJulieWyss YouTube: https://www.youtube.com/@PrimeFamilyChiropracticCenters   #primefamilycenter #primefamilychiropracticcenters #primepodcast #adversity #winning #losing #chiropractic #chiropractor #neckpain #shoulderpain #nervoussystem #spinehealth #headacherelief #pediatricchiropractor #familychiropractor #childwellness #healthyhabits #nutritionandwellness #sportschiropractor #chiropractornearme #pregnancychiropractor #prenatalchiropractor #prenatalcare #babychiropractor #greenbaywi #greenbaywisconsin #greenbaychiro #drskipwyss #drjuliewyss   

Katie has had a Cesarean (failure to progress), a VBAC, and most recently, an unmedicated breech VBAC!She talks about the power of mom and baby working together during labor. She is 4'10” and attributes so much of her first successful VBAC to movement. Katie's most recent baby was frank breech throughout her entire pregnancy. After multiple ECV attempts, she exhausted all options to seek out a vaginal breech provider. She was able to work with providers while still advocating for what felt right to her. Though there were some wild twists and turns, this breech vaginal birth showed Katie, yet again, just what her body is capable of! The VBAC Link Blog: Why Babies Go Breech & 5 Things You Can Do About ItThe VBAC Link Blog: ECV and BreechHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Julie: Welcome, welcome. You are listening to The VBAC Link Podcast. This is Julie Francom here with you today. I'm super excited to be sharing some episodes with you guys this year and helping out Meagan a little bit and keeping things rocking and rolling here at The VBAC Link. I am excited to be back, and I am especially excited to be joined by Katie today who has a really, really incredible story about her three births. Her first was a C-section. Her second was a VBAC, and her third was an unmedicated breech VBAC. I absolutely love hearing stories about vaginal breech birth because I feel like it's something that we need to bring back. It's only fair to offer people options when we have a breech baby. I don't think it should just be an automatic C-section. I'm excited to hear her story. I'm excited to hear her journey to find support in that regard. But first, I'm going to read a review. This review is actually from our VBAC Prep course. If you didn't know, we do have a course preparing you all about all of the things you need to know to get ready for birth after Cesarean. You can find that on our website at thevbaclink.com. But this review on the course is from Heather. She says, “This course was so helpful especially with helping to educate my husband on the safety of VBAC as he had previously been nervous about my choice. We watched all of the videos already, but will also be reviewing the workbook again right before birth. I highly recommend.”I absolutely love that review from Heather because I feel like we get a lot of these comments about people and their partners really being on board and invested after taking the VBAC prep course with their partners. This course is chock-full of information about the safety of VBAC, and different types of birth situations. It talks about different interventions and hospital policies that you might encounter. It talks about the history of VBAC. It talks about all of the statistics and information. It talks about mental prep, physical prep, and all of those things. There are videos. There is an over 100-page workbook. There are actual links to sources, PDFs of studies, and everything you can even imagine. It is in this course. I also highly recommend it. Anyway, thank you, Heather, for that review. All right, let's get rocking and rolling. I am so ready to hear all about Katie's birth stories. Katie is right here snuggling her sweet little baby with her. I cannot wait. I hope we get to hear some little sweet baby noises. They are kind of my favorite. But Katie, go ahead and take it away, my friend. Katie: Yeah, thanks so much for having me. I'm excited to be here and hopefully share some things that I would have loved to have shared with me. So let me just start from the beginning with my first baby 5 years ago. I was planning to have a birth. I wasn't quite sure what it would look like, but I thought I wanted unmedicated. It was my first baby, and I wanted to labor spontaneously. The labor was long, so 3+ days of labor. It ended in me getting to 10 centimeters and pushing. However, due to fatigue and the multiple interventions that I had and the cascade of interventions, I believe, resulted in a diagnosis of failure to progress so I had a C-section. It was, I would say, disappointing to me not because of anything except that I would have loved to continue on my path of vaginal delivery. That wasn't in the cards with this one for me. Then with my second 2.5 years later– oh, I should also say that I was at a teaching hospital. There were lots of people. They were very pro-intervention. You name it, I had it across those 3 days. So 2.5 years later when I got pregnant, I thought, “Okay. I know I want to attempt a VBAC.” My husband, my partner, was so on board. He got a shirt that said, “You've got this.” He was wearing it all of the time. We watched a ton of positive VBAC birth stories on YouTube. We listened to podcasts like this one. We followed all of the things on social media and prepared with an amazing doula. I went into spontaneous labor again and this time, I was sure I wanted– actually, I should say I had a membrane sweep, and then I went into spontaneous labor. I was sure I didn't want interventions for this one. My doula was on board. My partner was on board. I labored at home for quite a while. I came into the hospital. It was the same hospital. That doctor was not so supportive of me attempting a VBAC, however, another OB had said that because of our family planning, I said, “I think I want more kids,” another OB told that OB, “Hey, let's make it as safe as possible to do what she wants, so let her give it a try.” My doctor was semi-supportive, but I came in. I was 9 centimeters. It was unmedicated. I was in there for less than 3 hours. I pushed the baby out with a bar. I was squatting. They didn't even know the baby was out. In fact, the baby started crying, and it felt like minutes or hours in my mind, but it was just a couple of pushes. My doula said, “Baby out. Baby out.” Everyone rushed because they were so surprised because normally, I think, folks labor on their backs, and I had requested a bar. That was pretty amazing. It was just me and my son doing the thing. It was incredible. I remember that OB who was skeptical said, “You did it. You've changed my mind.” So that was exciting. 3 years later to now, I became pregnant with my third baby. I went in for my anatomy scan at 20 weeks, and the ultrasound tech said, “Baby is breech. No big deal. Tons of babies are breech.” Because I have some other health complications, I guess they deemed me as high risk. I went to multiple ultrasounds, so that means I get to see my baby once a month which also meant I continued to see that baby was breech each time. Each time, they kept saying, “Oh, don't worry. Plenty of time. Plenty of time to turn.” As we approached my due date, I was like, “I feel his head. I don't think he's going to turn.” So they started to let me know what type of breech he was. My baby was frank breech. There are a few different types of breech positions which I didn't know prior to this baby, but now I'm very well-versed in the different breech positions. Frank breech is basically a pike position. The feet are by the head, and his little rump was just hanging out in my pelvis. I was also hoping to birth at a birthing center with my doulas. This was different than that learning hospital that I shared because I just wanted a different experience where they were less pushy with interventions. I knew that with my last birth that they used the term “something pelvis”, but anyway, I was ready to do something different with less people in the room. However, when they found out that I was breech, I was told what I think is the stock option which was, “Hey, if baby stays breech, but don't worry, there's plenty of time and he'll probably turn, but this is what we'll do. We'll try an ECV, and if that doesn't work, we'll schedule your C-section. We'll give you an epidural, try the ECV one more time, and that way, you can go right into your planned C-section. But don't worry, we have time. The baby is going to turn.” I left and was like, “I don't want that. My baby is healthy. I'm healthy. I am on the fence about this plan.” Now, I'm 36 weeks so at 37 weeks, I go in. We have the ECV. They give me the shot to relax my uterus. The ECV is the external cephalic version where they put their hands and try to rotate the baby. It was unsuccessful. So I said, “Can we try again?” She looked at me like, “What?” She said, “We'll try again with that epidural when you schedule your C-section.” I said, “No, no, no, no, no. Can we try again?” This is where, I think, that advocacy and that information and research are so important. She said, “Sure. We can try it again.” We scheduled another ECV. I went back in, and it was also unsuccessful with her. She could tell at this point, I was grieving what I thought was the end of this journey for me, and also not necessarily on board with the protocol they had put in place. We planned. I said, “Hey, can I try a different provider?” I know that you can do up to four ECVS. I'm not suggesting that people do that. I just wanted to make sure that I did everything possible for me and baby to have a vaginal birth. They seemed pretty gung-ho about not delivering unless baby was head down. She said, “Sure. We can do that.” That was also unsuccessful. At this point, the OB said, and I appreciated this. They said, “I feel really uncomfortable delivering a breech baby. I think you should go to our sister hospital in a city away if you are considering breech because we don't have a NICU here.” That felt reasonable to me because I had said to her previously, “I hear you, and I hear that protocol with what you're suggesting. I also feel really healthy, and I will absolutely change course if me or baby's health is in jeopardy, but unless that is imminent, I consider breech a variation of normal,” so I didn't necessarily think that was the rationale for the C-section knowing what that recovery is like and knowing that I had a 5 and a 3-year-old back at home. Julie: Oh, I love that so much. I love that they gave you options, and they admitted that they weren't comfortable with it. So many times, doctors will be like, “We don't do breech here.” They don't tell you that it's because they haven't been trained or they're not comfortable with it or it's not safe, they just tell you that's not the protocol, and they don't offer you other options. I really love that, and I love the conversation you had where you were like, “I understand the risks, but however, this is how I feel.” I think that's a really healthy way to go about it on both sides. So, cool. Kudos to your provider. Katie: Yeah. Then that doctor suggested this. It was in the underground world. It wasn't like, “Go to the next place.” She also suggested, “Why don't you consult with UCSF?” That's the University of California San Francisco. That's maybe an hour and 20 minutes with traffic, and it can be up to 3 hours, but they do breech birth there. She referred me to have a consultation with UCSF to talk about breech birth which they are very comfortable with. The consultation was great. The people were really helpful. They also had a lot of requirements for me to deliver there. Those requirements were things like an anatomy scan to ensure that the head and rump sizes were comparable for safety of baby. They wanted me to do a pelvic pelvimetry MRI. Julie: Pelvimetry? Katie: Yes. They said, “You have a proven pelvis,” which is the word I couldn't remember earlier, but because I'm very short– I'm 4'10”--, they just wanted that in this case. I said, “Sure. I'll do all of the things if this is the place where I know I can make that birth plan with you and we can do it.” Then they said, “We also give you an epidural. You'll birth in a birthing room, then we'll transfer you to an OR. You'll have an epidural, and that's in case anything goes wrong.” I fully understand the risk and the why behind that, but given with my first baby, one of the interventions was the epidural and I labored on my back, I wasn't quite confident that was the way baby and I were going to do this because what I found in my second birth is me and baby working together and moving together was what, I think, was all of the difference in the world for us to be able to meet each other. That gave me a little bit of pause, but nonetheless, I was like, “Okay. They are being upfront with me about all of the things I need to do.” I had the anatomy scan. Rump to head ratio was 1:1. It looked great. They were scheduling this MRI for me to take. Now, keep in mind, I'm 38 weeks pregnant now. The other things I was concerned about, or more my husband I should say, was that San Francisco, like I said, is about an hour and 20 minutes away from me. With traffic, it can be 3+ hours. Julie: Oof. I've driven in San Francisco during traffic and let me tell you, it is a nightmare. Katie: Yeah. My husband was like, “What if you don't get there in time? How are we going to make this work?” These were all pauses that we had around it. Nonetheless, we were on this track and UCSF was so helpful and wonderful. I'm so grateful for my provider for recommending this consult. Then my doula, as well as other providers, started sharing information with me. I want to say it's an underground network of knowledge where people aren't advocating for vaginal birth on the record because either the hospitals don't want to or don't condone it for whatever reason. I guess you can guess the reasons whether it's money or policy or education and patriarchy, but there is definitely a need. Breech babies are born all of the time. They said, “There are three providers at that sister hospital (that my doctor had initially recommended that was 15 minutes away) who are experienced with breech.” I thought, “Okay. In the event of an emergency and I went into labor, that's where I want to go.” They had a NICU. They had all of the things that made me want to feel more at ease knowing that we were doing something new to me and to keep myself and my baby safe. I still told the UCSF doctors, “Don't worry. I know I'm 38 weeks, but my other babies came at 40 weeks and 1 day, so I've got 2 weeks. He's cooking for 2 more weeks.” Then, at 38 weeks– Julie: Third babies, man. Third babies. Katie: Right? At 38 weeks, 4 days, I wake up. I should say, sorry. The UCSF doctor also said one other thing to me. She said, “Please do one more ECV, and this time, do a spinal.” I was like, “Ugh, this sounds awful.” But I understood the rationale. The safest way to come out was head down. I wanted to compromise and do everything in my power to do that. She said, “Because they hadn't done a spinal previously, there's data that shows it's more successful.” She shared all of that research with me, so I requested that from my local doctor. My doctor was like, “We don't usually do this,” but to their credit said, “We will. We will absolutely do it.” Keep in mind, I went in. I was like, “I know that this baby is loving where they are at. They are not moving, but if I don't try it, I'll never know.” Knowing the risks of ECVs, and knowing all of these things, I did do that because it was a request of the hospital that was going to be potentially the hospital where I give birth, so I wanted to make sure to follow all of the things. I do that. It was also unsuccessful. Then, now fast forward to 38 weeks and 4 days, I wake up and it's been a couple of days since that ECV. The spinal they give you is on your back. I wake up and I have some stomach cramps. I thought, “Man, this is strange, but it's probably from the ECV,” because in the past, it did cause some cramping for me. Because I had the spinal, I wondered if perhaps it just was residual. In my past labors, all of my laboring started with my back. I had a little bit of back aching, but it was again, I chalked it up to the spinal and just recovering from that. I went about my day. It was right before Halloween. I'm telling my partner, “Let's carve pumpkins.” My 5-year-old had a soccer game. I'm trying to get him ready, and I keep getting these cramps. They start to be regular. I thought, “Oh.” I'm 90% sure I'm in labor. This labor just felt different. Maybe it was because it was a breech baby. Maybe it was because it was a third labor, who knows? But nonetheless, it took me a while to get there. Maybe I was thinking it wasn't happening and willing that 40-week mark. Nonetheless, I was laboring. I texted my doula, and I'm timing my contractions. We had agreed that she would come over earlier this time because the baby was breech. All of the doctors said, “Labor at home. Come in during active labor.” We agreed that I would come in earlier than I did last time because of the circumstances. She comes over. She says, “Where I'm laboring, if the contractions are feeling intense, however, I can talk and laugh in between them,” so we agreed that I might be 5 centimeters. I just started to think, “I've got to lie down. I feel super tired. I had this ECV. I want to keep my energy up,” thinking this could be a long labor. Let me eat something. Then she says, “Just go. Sit on the toilet because your body does something different.” I do that. It's 1:00 in the afternoon now, and my water breaks. My husband was packing the bags to get to the hospital thinking, “Where do we go? Do we go to UCSF? Do we go to that sister hospital?” I say, “My water is broken.” I have another contraction. She's watching it. She was like, “We've got to–”, and I started to feel nauseous which are all signs of labor. Julie: Good signs. Katie: Yes, so she was like, “Let's go. Let's go now.” We get in the car. I think this is funny. It's a little on the side, but my husband had set up the car seat right behind me. I'm laboring. I'm definitely contracting and trying to retract my seat. There is this car seat, so I just remember picking it up and tossing it across the side saying, “Why would you set this up here?” He's looking at me, “Oh, you are really in labor. This is clear.” I'm trying to lay down. He has the GPS set. I am in the car. We get going. It's now between 1:00 and 2:00 on a Saturday. There is a ton of traffic and construction. I'm looking at the GPS and I see 25 minutes to the sister hospital, and to San Francisco was 3 hours. We don't have 3 hours. My doula says, “Where are we going?” I say, “That sister hospital. Let's go.” I also happen to know that there are three doctors there through that grapevine and underground network who are experience at delivering breech babies there, so I thought the odds of me having one of them would be beneficial. I would much rather have had conversations with all of them, but I didn't plan to go there thinking I was going to go to UCSF. We get in the car and are driving in this traffic. I'm just looking at the GPS and at the time ticking down. I'm really quiet which was also strange because with my other births, I was super vocal. My husband and I were thinking, “I'm in labor, but maybe I'm just not as far along, even though my water broke.” I've never been quiet. I was dead silent through this whole thing just staring at this GPS. Then all of a sudden, we're going on a bridge called the Causeway and I looked at him, and I said, “I have to push right now.” Julie: No. Katie: He looks at me and says, “No,” which is not very much– he's a very supportive person. What he meant by this was that we didn't come this far to get this far. We're going to get to this hospital. We are driving, and I just remember internally that I was so quiet going inward. I was talking with my baby, talking with myself and saying, “Okay. We've got to get to the hospital. We didn't come this far to get this far. I'm not having a baby breech unassisted delivery.” That was not something that I was comfortable with. We get off the off-ramp, and we're finding the patient drop-off. I'm contracting and I see the sign, and my husband drives right by it. I look at him right after I contract and I say, “You drove right by the patient drop-off. You have to put on hazards. I have to get out now. I have to push.” He's like, “I can't. We're parking.” So he parked the car, and I was like, “What do you want me to do?” He says, “We've got to walk.” Keep in mind, the parking lot where he went is not right next door. It's a block and a half or two blocks away.Julie: No way.Katie: I just was like, “I can't do this. I can't do this.” He says, “Yes, you can. Yes, you can. You have got this.” So I was like, “Okay. I've got this.” I get up, and I walk. When I start contracting, I'm walking down this busy street. I said, “I have to poop.” I had this big contraction, and I think I possibly poop. I'm just looking at these cars thinking, “Why won't somebody stop and help me?” That's when I channeled back to this idea, at the end of the day, It's just you and your baby. You are the team. I contract. We are going. We finally get to the hospital. I have another contraction. I say, “Run in and tell them to help.” He does. I'm holding on to the railing. This lovely woman with her family sees me. She tells her 13-year-old son, “Get her!” I was standing by myself, definitely in labor.” She says, “Get her a wheelchair!” This amazing 13-year-old does just that as my husband runs back. He gets me this wheelchair. I'm sitting in it, but I can't sit down. Again, I think it's because I've had this bowel movement and maybe I'm in transition. I don't know. We get up and pass security, so security is yelling at us. My husband was like, “I've got to go. We've got to go.” We got to L&D and came in. This amazing nurse midwife welcomes us. I don't know if she saw me not sitting down all of the way in my wheelchair or what, but she yells, “Get her a room right now.” She says, “We're going to deliver this baby.” I say, “My baby is breech. Can you help?”She says, “Call this doctor.” My heart is so relieved because this is one of those three experienced doctors who I know is comfortable with breech delivering. He scrubs out of a C-section, I guess. She helps me take off my pants, and then realizes what I thought was poop was really– it's called rumping as a breech instead of crowning. She was like, “Change of plans. Get on all fours.” I just started laboring. The doctor comes in scrubbed out of that C-section. I know that the nurses are saying, “You're doing great. You're going to meet your baby,” and all of the things that are so wonderful. I couldn't speak more highly of the people in that room at that point. My doula joined us because it took her a minute to find us in all of the mayhem. He tells my partner, “Please make sure she goes on her back.” I had this vision of doing breech without borders on your hands and knees, but given that this doctor was very experienced with breech delivery through this underground network of knowledge, I was like, “Okay. We didn't come this far to get this far. I'll do whatever you want. Let's just see this baby.” I turn around after, my husband said, my baby was halfway out. He sees the legs drop which again, in a frank breech position, that happens. You see the rump, and then you see the back and the legs drop. He sees the rest of the body come out as I'm laboring on my back which I didn't do with my first. I wasn't actually, I didn't know if that was something my body was down for. But here I was delivering this breech baby. Of course, I should have known. Women are amazing. We do amazing things, and our bodies are built for this work. I labored, and then I felt him come out completely. I held my breath for a second because what I do know, and excuse me if this statistic isn't 100% accurate, but my understanding is that 1 out of 7 babies born head down might need resuscitation, but 1 out of 3 babies born breech might need resuscitation. So one of the things I was pausing for at this moment was to hear this sweet baby's voice, and so I just start hearing crying immediately. They tell me that his APGAR score was 9/8 which was exactly the same as my first VBAC. Julie: That's great!Katie: Yeah. They were like, “Baby is great. Baby is healthy.” They put him on me. I was trying to feed, but my cord was short, so low and behold, I have a feeling that the reason he was not interested in turning is because my cord was kind of short. He just was sitting fine where he was at with my posterior placenta up high. He and I sat and met each other. We celebrated. The doctor was so funny. He said, “You keep it interesting. You've had every kind of birth you could possibly have.” Julie: You keep it interesting. Katie: Yeah. Every type of birth you could possibly have. The nurses came in after. They said they wanted to come in and watch because they don't see this. They said, “This is amazing. We wanted to respect your privacy.” But they were so supportive of the whole thing. I just felt elated to have the people in the room and around me who believed in me and my baby as much as we believed in us to make it happen. I should say that I came in at 2:10 to this hospital. I delivered at 2:24. When I say it was fast and this was going quickly when all of those things happened, I wouldn't recommend any of those things. However, I think that advocacy and all of those things like knowing all of the data made me feel prepared to do that. That's my breech delivery story. Julie: I absolutely love that. I love that. I was like, “Aw, dang. Too bad she didn't have her baby in the car.” No, I mean that would not have been ideal for you, but it is a dream birth of mine. I mean, I would have loved to have my own baby in the car. It would have been amazing. I love the stories. One day, I dream of documenting a car delivery, but alas, here I am still waiting. But it's fine. Here's the cool thing. I really love how you navigated your birth. You sought out all of your options. You made a choice that you were comfortable with. You heard the risks that the doctors were telling you about. You acknowledged them, but you also stood up for yourself and your plan. I feel like when you can have that mutual respect where you can trust your provider and your provider can trust you, I feel like that's a great place to be. I love how you adapted and changed plans when needed, but you still stood firm for the things that you wanted. It doesn't always work out like that when you have to change plans, but I love that you had the plan and you navigated it with the twists and turns and all of the things that come with the unpredictabilities of birth. I love how you did all of that. I think it's really important and necessary to have strong opinions about how you want to birth. Like I said before, it doesn't always mean that the strong opinions that you have are going to hold true about what you actually end up getting. I think that the value in having those strong opinions about birth is the things that you learn along the way and the things that enable you to navigate through those changes of plans and things like that. I think that's really, really important for us to be able to have and do and be flexible. I do have a few different blog articles on our website related to breech babies. Now, there's one that is just recently published. It was a few months ago. Well, maybe it will almost be a year ago by the time this episode airs. It talks a lot about ECVs, the external cephalic version, in order to try and manually flip a breech baby. It talks about what ACOG recommends and ACOG's stance on it, things you can do, who is right for it, what may exclude you from having an ECV or attempting one and all of those things. It talks about the safety for VBAC and how it's performed, what it feels like, and all of those things. If you ever want to know about ECV, we have a blog for you. It's called ECV and VBAC: What you Need to Know. It goes into all of that stuff. I definitely recommend looking into it because like we said before, you don't really know your options until you have them, and the more information you have in your arsenal, the easier it's going to be for you to navigate those things. Basically, ECVs are pretty safe for most people. They have a success rate of 60% which is a really cool success rate. It's higher than 50%. You're more likely for it to work than not. Sometimes babies are breech for a reason, and they need to stay that way for some reason. There are really only a few things that exclude you which is excessive vaginal bleeding, placenta previa or accreta, if you have really low levels of amniotic fluid, fetal heart rate issues, if your water's already been born, sometimes providers won't do it that way, or if you have twins or multiples, I think that excludes you. It's listed here, and it makes sense. We've got lots of babies tangled up in there. It's absolutely safe for VBAC as well. We also have a couple more blogs about why babies go breech and some things that you can do about it. I'm sure, Katie, you probably tried all of these things, all of the Spinning Babies protocols, all of the forward-leaning inversions and things like that too that can help. There's another article in here about how to turn your breech baby– 8 ways to flip your baby. Like we said, sometimes babies are breech for a reason and they do not want to turn. I'm just really looking forward to the day where breech can be just a variation of normal again. The biggest problem is that our providers are not learning how to deliver breech babies. It does take a different skill in order to do that. You have to be really hands-off. You have to watch for certain things and depending on the type of breech, there are different techniques that you would use. Those techniques are not being taught. Kudos to your original provider who admitted that they were not comfortable or did not have the knowledge to feel comfortable in delivering a breech baby. I'm excited there are organizations called Reteach Breech, Breech Without Borders, and Dr. Stu. If you know Dr. Stu, he is leading a great mission to bring breech back so that women can have options for delivering their breech babies. So what happens if you don't know your baby is breech and your baby is delivered foot first? You can't just stop and go for a C-section right then. It's impossible. So to deliver breech babies safely no matter the circumstances, the knowledge there is important. I'm hoping that one day, that can be an option for anybody if they want that. All right, Katie, I'm so glad that you joined me today. It was so great hearing your story. I love how it all went. I do not pity you having to drive in San Francisco at traffic time. Yeah. I'm glad everything worked out. Katie: We ended up going to this other hospital closer. Julie: Yeah, yeah. But I mean just ever, not even in labor. Just ever. Katie: Yes. Yes. Julie: All right, Katie. Before we sign off, will you tell me, what is your best piece of advice for somebody preparing for a VBAC?Katie: Oh, I think it is so important to do two things. One, educate yourself and surround yourself around folks who are down with that education and believing in you and baby. What I mean by that is knowing what's happening so you can make those important decisions. You understand what consent looks like. You understand those risks. You understand all of the tips and techniques like in this case of breech and turning that baby, and then making sure that you also are advocating and you have people around you who are advocating, but not so stuck on that that you get stuck. You want to do what's best for you and the baby, but as you said, breech is a variation of normal. I think that being around people who are supportive of you, they don't necessarily have to agree with you, but they are working with you, is just so important to empower you because at the end of the day, it's you and baby doing the thing. People who believe in you as much as you believe in yourself and you believe in your baby are so important to get to that finish line in labor. Julie: Yes. I absolutely love that. You have to have people who believe in you and who are on your side and who will support you even if they don't necessarily understand your decisions. They trust you to make those decisions because that is a huge deal. Katie: And give you the information so that if the information you have is not full or complete, you can reevaluate. You don't know what you don't know until you know. I just think that you need to make sure you take it all in if you can unless you don't know your baby is breech and you find out when you are delivering and you make that snap decision, and it'll be great. Julie: Yes. No, I love that. There's something about people bringing you information especially in a respectful way because I feel like in today's world, when people disagree with others, it's very aggressive and condescending and judgmental. I think it's important that we can disagree respectfully but also bring information if you are concerned or if you have another point of view in a respectful way as well. I think it's received a lot better and I think that's where we can really bring that true change and sway people's opinions. It's if we do that in a respectful and understanding way. Yeah, I appreciate that. Good point, Katie. That was awesome. Okay, well thank you so much for sharing your story with me today. I cannot wait for the whole world to hear it. Katie: Thanks so much for allowing me the space to do it. I hope that women are able to explore their options and do what's right for them and their baby and their families. Julie: 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

S pediatričkou, neonatologičkou a mamou MUDr. Denisou Jaššovou sme sa rozprávali o zdraví novorodencov. Prešli sme si všetky dôležité témy od dotepania pupočníku cez Apgar skóre aj úbytok a priberanie na váhe novorodencov. Prebrali sme, aké základné vyšetrenia vás v pôrodnici čakajú, aj čo je ich význam. Zamerali sme sa aj na to, aké prípadné komplikácie vás a vaše dieťatko môžu v pôrodnici postretnúť a aj ako sa starať o dieťa po návrate domov. Denisa je aj autorkou dvoch skvelých kníh Zdravé dieťa a jej pokračovania (Ne)Zdravé dieťa, ktoré si môžete zakúpiť vo výhodnej cene na jej webe www.mojedieta.eu, prípadne vo všetkých dobrých kníhkupectvách.

Wenn jemand fragt "Wie geht's dir?", ist das ja manchmal gar nicht auf die Schnelle zu beantworten. Es gibt eine Situation, in der aber besonders wichtig wäre, innerhalb von Sekunden zu wissen, wie es jemandem geht. Und zwar in dem Moment, in dem ein Mensch geboren wird. Wie kann man erkennen, ob es einem Säugling gut geht? Dafür hat Virginia Apgar eine Checkliste entwickelt, die bis heute in der Geburtshilfe benutzt wird. Sie hat Standards für die Zukunft gesetzt, obwohl viele Kollegen versucht haben, sie aus ihrem Fachbereich rauszudrängen. Hier ein Interview von Chirurginnen der Uniklinik Darmstadt, die berichten, wie es heute für Frauen ist, in der Chirurgie zu arbeiten. Willkommen beim einzig wahren True Science-Podcast! Hier geht's um die Lebensgeschichten von Menschen, die mit Wissenschaft unsere Welt verändert haben. Wir fragen uns: Was hat sie bewegt, was haben sie erlebt, und wie kam es zu diesem einen Geistesblitz?! Dabei ist eins sicher: In der Wissenschaft gibt's jede Menge Gossip und den hört ihr hier. “Behind Science” gibt's jeden Samstag - am Science-Samstag. Zwischendurch erreicht ihr uns per Mail und Instagram, und hier gibt's unsere Links, die gerade wichtig sind. Hosted on Acast. See acast.com/privacy for more information.

Send us a textAt twenty-one years old, Lacey was pregnant with her first child. She was young and healthy and expected everything to go perfectly in her labor and birth. As a result of high blood pressure, she was induced for labor. When her son was born blue and unresponsive with an APGAR score of one, she knew something was off. She held her son for only a minute before he was whisked off to the NICU. Noticing that his ears seemed disproportionally small, her maternal instincts were alert. Five days later, she learned her son had Down Syndrome when a nurse inadvertently said, “This is the second baby with Down Syndrome this week,” upon entering the room. According to Lacey, how and when the news was reported to her and her husband was more difficult and painful than receiving the diagnosis itself.Today, Lacey shares her mission to help parents understand the gift and beauty of raising a child with Down Syndrome. **********Our sponsors:Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort.Needed -- Our favorite nutritional products for before, during, and after pregnancy.Use promo code: DOWNTOBIRTH for all sponsors.DrinkLMNT -- Purchase LMNT with this unique link and receive a free 8-day supply. Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

Today on Beating Cancer Daily, stage IV cancer survivor and Host Saranne is joined by Joe Apgar, CEO of Pelotonia, and a multi-decade cancer survivor. Listen if you are thinking of using your experience with cancer to help others or you want to help make an impact in cancer research. You will also discover their male-female perspectives on fertility, adoption and finding cancer in their 20's.Joe Apgar is the first male guest on Beating Cancer Daily after 330+ episodes. Residing in Columbus, Ohio, Joe brings a unique blend of personal experience and professional insights to their conversation navigating his journey through cancer diagnosis and treatment, combined with his passion for social entrepreneurship and parenthood. Pelotonia is an innovative Ohio-based non-profit organization and entrenched in biking community; dedicated to profoundly funding cancer research. Saranne and Joe share his commitment to fostering a positive, fun, and high-performing corporate culture at Pelotonia while raising hundreds of millions of dollars for research. He was wearing a Livestrong bracelet when his life took an unexpected turn as a college student, being diagnosed with cancer while at Penn State. Joe shares how he handled infertility caused by cancer treatments to proudly embracing adoption. His personal story, including his battle with testicular cancer and experiences with adoption, underscores his dedication to openness, vulnerability, and the ongoing fight against cancer. Today on Beating Cancer Daily: ·     Joe Apgar shares his secrets to staying cancer-free and the importance of humor.·     Pelotonia has raised substantial funds for cancer research, making significant strides in treatment advancements.·     Cora, Joe's daughter, is a bright spot in his life, showing independence early on with milestones like riding a bike without training wheels.·     Saranne and Joe discuss the significance of maintaining overall health while awaiting new cancer treatments.·     Pelotonia fosters a supportive community that attracts participants from diverse backgrounds, focusing on inclusivity and empowerment.·     Both Saranne and Joe recognize the ongoing challenge of effectively disseminating cancer treatment information on a global scale. Guest Contact Information:Joe Apgar: Pelotonia.orghttps://www.pelotonia.orgLinkedIn: Joe Apgarhttps://www.linkedin.com/in/josephapgar/  The #1 Rated Cancer Survivor Podcast by FeedSpot and Ranked the Top 5 Best Cancer Podcast by CancerCare News, Beating Cancer Daily is listened to in more than 91 countries on six continents and has over 330+ original daily episodes hosted by stage IV survivor Saranne Rothberg!   To learn more about Host Saranne Rothberg and The ComedyCures Foundation:https://www.comedycures.org/ To write to Saranne or a guest:https://www.comedycures.org/contact-8 To record a message to Saranne or a guest:https://www.speakpipe.com/BCD_Comments_SuggestionsTo sign up for the free Health Builder Series live on Zoom with Saranne and Jacqui, go to The ComedyCures Foundation's homepage:https://www.comedycures.org/Please support the creation of more original episodes of Beating Cancer Daily and other free ComedyCures Foundation programs with a tax-deductible contribution:http://bit.ly/ComedyCuresDonate THANK YOU! Please tell a friend who we may help, and please support us with a beautiful review. Have a blessed day! Saranne

On today's episode of The Wholesome Fertility Podcast, I speak to longevity expert Leslie Kenny. @lesliesnewprime   Leslie shares her personal journey of overcoming autoimmune diseases and infertility through patient empowerment and alternative therapies. She emphasizes the importance of partnering with doctors and exploring alternative treatments that resonate with individuals. Leslie's story highlights the power of lifestyle changes, such as an anti-inflammatory diet and the use of anti-aging molecules like spermidine in improving health and reversing the aging process.    Our conversation covers the topic of spermidine and its role in healthy aging. Spermidine is a compound found in our diet and produced by our gut biome. It is correlated with healthy lifespan and can be obtained from plants and fermented foods. Our conversation also touches on gluten-free options for spermidine, the importance of fiber in the diet, and the potential benefits of systemic enzymes.    Leslie also shared her personal experience with hypothyroidism and the importance of finding a doctor who will help you uncover solutions for your reproductive health.    Podcast Takeaways: Partnering with doctors and exploring alternative treatments can empower patients to take control of their health. Lifestyle changes, such as an anti-inflammatory diet, can have a significant impact on autoimmune diseases and overall health. Anti-aging molecules like spermidine and rapamycin have the potential to slow down the aging process and improve fertility. Maintaining a balanced hormonal system is crucial for reproductive health and overall well-being. Spermidine can promote cell renewal and recycling. Spermidine is correlated with healthy lifespan and can be obtained from plants and fermented foods. Fiber is important for the gut biome to produce spermidine. Finding a doctor who believes in you and is willing to explore your symptoms is crucial.   Guest Bio:   Leslie is a longevity expert, and co-founder of the prestigious Oxford Longevity Project, a non-profit that brings scientists together to discuss breakthroughs around the science of ageing and autophagy, which is our body's natural cell recycling system.   www.oxfordhealthspan.com - Use coupon code WHOLESOMELOTUS for 15% off all items!   https://www.instagram.com/lesliesnewprime/ https://oxfordlongevityproject.org       Learn more about my new book “The Way of Fertility” here: https://www.michelleoravitz.com/thewayoffertility   For more information about Michelle, visit: www.michelleoravitz.com   The Wholesome FertilityFacebook group is where you can find free resources and support:   https://www.facebook.com/groups/2149554308396504/   Instagram: @thewholesomelotusfertility   Facebook: https://www.facebook.com/thewholesomelotus/     Transcript:   Michelle (00:00) Welcome to the podcast Leslie.   Leslie Kenny Oxford Healthspan (00:02) Thanks so much for having me, Michelle. It's a pleasure.   Michelle (00:05) So I would love for you to share your story of how you got into the work that you do today. And I know that you're very passionate. We just had a little pre -talk and I'm very excited to get started.   Leslie Kenny Oxford Healthspan (00:14) You   Well, my story is one of patient empowerment, just like you. And it started, as it can with many women, with a fertility quest. So in my mid to late 30s, I really wanted to have a baby and found that I was having problems. So started with IUI, did three of those, didn't work, and then moved on to IVF.   And it was as I was doing my fifth IVF round with donor eggs, I might add, and being mixed race, I'll tell you, it's not easy to find a donor, you know? And it was a high stakes game, as it were. And right before embryo transfer, I began to notice pain in my hands. I was having trouble.   Michelle (00:54) Mm   Leslie Kenny Oxford Healthspan (01:08) using scissors, turning doorknobs, turning faucets. And I just thought, strange, I think this is probably what arthritis feels like. I better just have it checked out since obviously I want this IVF with donor eggs to go perfectly. And I went to the doctor, she ran some tests. I thought, you know, they'd say, you know, it's something, have steroids do something that I'd heard of before. And instead she called me and asked me to have a meeting with her in her office.   Michelle (01:17) Mm   Leslie Kenny Oxford Healthspan (01:38) and always a bad sign, right? If they can't explain it to you over the phone, and if it's not the nurse telling you, there's nothing to worry about. So I went and talked to her and she said, you do have arthritis, it's rheumatoid arthritis. This is where your body is attacking your joints. And here are some pre -filled syringes that you can inject into your belly, they're immune suppressants to basically   Michelle (01:40) Yeah.   Leslie Kenny Oxford Healthspan (02:08) halt your immune system from attacking your body. And, and I immediately said, Hmm, don't I want my immune system to be strong? Like, don't I need that? And she said, well, normally you would, but in this case, it looks like your body is fighting cancer, except you're trying to destroy your own tissues. So I thought, okay, well, fine. Got the drugs. these are tiny diabetic needles. It'll be okay.   And then she said, but you also have something else. You have lupus. And that I'd never heard of. It was almost as if she'd said, you you have funny tree disease or something. It just made no sense to me. I didn't know what it was, had never heard of it. And I said, what's that? And she said, another autoimmune disease. And I said, okay, so what's the prescription for that?   And she said, unfortunately, there isn't a prescription for that. There's really nothing that we have right now to treat it. And you will slowly and progressively get worse. And I said, this is really not a good time for me to have this happen because I'm doing my fifth IVF with donor eggs. I'm waiting for embryo transfer. This is a terrible time. Can't we do something?   something else, anything else? Is there anything I can do? No, there's nothing you can do. Like, could I do my diet, my sleep? No, there's nothing you can do. Well, but what about this round? You know, I've done a lot to tee this up and a lot of money has gone into this. As you probably know, I've put in over a hundred thousand US dollars at this point in time into all of these treatments. And she said, I wouldn't do it. Don't do it.   you have a good five years left. And I thought, okay, well, that's a big statement to make. And I was so gobsmacked by it.   Michelle (04:08) That's crazy.   Wait, wait, She was saying you have five years left to live? Is that what she was saying?   Leslie Kenny Oxford Healthspan (04:16) That's how I interpreted it. That's how I interpreted that if I, if this was successful, if this round was successful, I would only be able to parent this child for five years or four years, I guess, as it were. And I, it was a lot to process. you know, if you're a patient and you're told you have one thing that's a lot to take on, you know, and then you're thinking about.   the treatment protocol and the things you have to do. And I think already, if it's not a tablet to swallow, but you're injecting yourself, that's another big thing to take on board. Then an illness that you've never heard of before where they say there's no treatment, there's no cure, and then she says five years left. I'm thinking in the back of my mind, thinking, have this, I want to become a mother. I have this.   cycle I have to go through, we're going to embryo transfer. My uterus has to be in good shape. What are you doing? What are you saying? How does this impact that? Because I've got acupunctures lined up for embryo transfer, right, before and after. And so I did have at least the presence of mind to say to her, can I, well, could this be a false positive? She said, no, we've done multiple types of tests.   Michelle (05:11) Yeah.   Leslie Kenny Oxford Healthspan (05:35) and they all come back consistently indicating that you have these diseases. So then I said, can I test again? And she said, she shrugged her shoulders and said, sure, it's your insurance. So I vowed then and there that I would test again. And in the meantime, I would do everything possible. didn't matter what it was, whether it was my in uterine massage, which I did, or visualization, which I did.   Michelle (06:00) Mm -hmm.   Leslie Kenny Oxford Healthspan (06:05) or trauma work, which I did, or, you know, new therapy, intravenous immunoglobulin transfusions, which I did, an anti-inflammatory diet. I was gonna do it all. I was gonna throw the kitchen sink at it. And any woman who is trying to get pregnant knows exactly where I was and that feeling of, I've gotta make this happen. And I will just pull out all the stops. We're doing a full court press, right? And...   And so I did all those things and I came back within six months for a regular sort of review with your doctor. She opened the folder and she clearly not looked at the results ahead of time. And she said, well, look at that. You, don't have lupus and you don't have RA. And I said, would you like to know what I did? And she said, no, that's okay.   Michelle (06:54) What?   Leslie Kenny Oxford Healthspan (07:04) And I said, well, that is, you know, that's pretty, that's pretty groundbreaking, right?   Michelle (07:11) Yeah,   Leslie Kenny Oxford Healthspan (07:12) so in any event, I was so, I was so shocked by all of this and, really for me, the penny dropped that doctors don't know everything that we treat them as if they must, that they are the Oracle and that they are the, the guide to whom we can outsource our health problems.   Michelle (07:23) Mm   Leslie Kenny Oxford Healthspan (07:35) But in fact, we have to work in partnership with them. And sometimes they're not willing for insurance or liability reasons to talk about or consider alternative therapies that might work. But we patients have the opportunity to explore those things that resonate with us that might have a meaningful impact. so my journey has really begun   Michelle (07:38) Yes.   Mm   Leslie Kenny Oxford Healthspan (08:04) as a patient advocate, really telling other women, you have more power than you think to move the needle on your health. And as a matter of fact, the things that you do might even be more important than what happens when you go to your acute care doctor, right? When you go into the doctor's office or into a hospital. And it has then...   taken me on a journey all the way to Oxford, England, where I ended up meeting a wonderful group of scientists here, a number of whom I helped fundraise for their companies for, all in the regenerative medicine space, and some of whom I've worked on longevity, healthy longevity advocacy.   other scientists whom I've worked on to bring an interesting anti -aging molecule called spermidine to market. So those are the...   Michelle (09:04) Yes. Is that, that's, that comes from   Leslie Kenny Oxford Healthspan (09:10) We can get it from wheat germ. We can get it from mushrooms. can get it from a huge variety of foods that are all plants. Essentially, if you want spermidine, it's almost exclusively in plants. only animal source is chicken liver, which is ironic because, of course, I remember my mother saying, you have to eat chicken liver. So moms do know, right? They've got a wisdom.   Michelle (09:19) Mm   Mm -hmm.   Yes.   Leslie Kenny Oxford Healthspan (09:36) But it comes from plant sources. We also make it in our tissues. We moms make it in our breast milk. When we give it to our babies, it's there to help them grow. Men, of course, make it in their seminal fluid. is in there because DNA wraps itself around spermidine. And it's very tightly wound.   Michelle (10:00) Mm   Leslie Kenny Oxford Healthspan (10:04) Normally DNA is wrapped around something called histone bond. It's too big to really fit into semen. And it's also there in semen as an anti -inflammatory because it turns out that when men make sperm, it's a high reactive oxygen species event. Women and men can both make it in our gut biome as well. so those would be the main, the three sources would be from our tissue production.   Michelle (10:27) Mm   Leslie Kenny Oxford Healthspan (10:33) And that falls, that declines dramatically similar to the decline in production of estradiol, progesterone, testosterone, melatonin as we get older. And then the second area is the microbiome and then third is from our food.   Michelle (10:51) So interesting. So let's go back and talk about what, what do you think it was specifically that changed? Like, what do you think happened with your body? Because you came into the doctor and you had all the signs that showed that you had two different autoimmune diseases that she could pick up. And then you changed your diet, you changed your lifestyle. You really went through so much. and of course it's hard sometimes to figure out exactly what specifically, but now that you know what you know, and this is   Leslie Kenny Oxford Healthspan (11:03) Yeah.   Yum, yum.   Michelle (11:21) the work that you're doing. What are some of the things that come to mind?   Leslie Kenny Oxford Healthspan (11:22) Hmm.   I went on an anti -inflammatory diet. So one of the first things I did was I researched a lot about both of these illnesses and I could see that inflammation was part of the root cause. And I'd heard about a diet called the Zone Anti -inflammatory Diet. This was popular in the early 2000s. And so I did that and that had a high emphasis on omega -3fatty acids.   on extra virgin olive oil. These are anti -inflammatories. It had a high emphasis on plants. And so my diet changed dramatically from more meat and charcuterie, sort of salami, these types of things over to plants. I also eliminated things which were known to be inflammatory triggers for me. So I had an allergy test done.   I could see that dairy was a problem, gluten was a problem, eggs happened to be a problem, which was a shame because I loved eggs. But we can't eat them every day and think the body won't notice. We have to kind of mix it up and have a diverse diet. So I essentially removed the inflammatory triggers to the immune system. I added in things that were naturally anti -inflammatory, like the omega -3s. And at the same time, when I did the intravenous immunoglobulin,   Michelle (12:44) you   Leslie Kenny Oxford Healthspan (12:50) I reset my immune system and there were studies in, there were small groups of patients with both rheumatoid arthritis and lupus who had done IVIG already in 2004 when I was diagnosed and I could see it work for them and I sort of felt like I have nothing to lose. It's kind of this or I wait for the inevitable.   And I did have people tell me, don't do the IVIG, because this was the time of mad cow disease. And people were quite concerned about prions, these proteins in blood plasma. And they were worried that you might be able to get that or hepatitis C. These were things that had been transmitted through transfusion products previously. But I still felt that, what, five years?   Michelle (13:25) Mm   Leslie Kenny Oxford Healthspan (13:49) I have nothing to lose. So I'm so glad that I did do that. know that everyone has to weigh up the risk -benefit analysis of any new treatment and their own situation. But for me, that was a decision that I made, and I'm so glad I did, because I spent 20, my insurance company spent $24 ,000 US on two transfusions, eight hours in total. And I have   Michelle (13:52) Mm   Leslie Kenny Oxford Healthspan (14:19) Going into remission meant that I have foregone over a million US dollars worth of immune suppressing drugs or chemo drugs because often we autoimmune patients get moved on to methotrexate, which is a chemo drug. I've not had to do any of those over these 20 years. And of course, I also don't live in pain and I don't.   Michelle (14:29) Mm Right.   Leslie Kenny Oxford Healthspan (14:45) live in fear of because I'm suppressing my immune system, I have to avoid social situations where people might have a cold and give it to me and compromise my immune system. So it was a fantastic outcome for me. It's not one I think a lot of people hear about, but I think they should.   Michelle (15:06) for sure. I mean, it's good to hear everything. And I agree with you that everybody has to really assess their own personal situation. I think, I believe in the innate intuition that's kind of like our body's intelligence speaking to us, just like it does when we have an allergy or we feel some things off when we eat something. So I think that that is a really important component to that. And it's the thing that spoke to you when you were at your doctor's office, because it,   Leslie Kenny Oxford Healthspan (15:20) Yeah, agreed.   Yeah.   Michelle (15:36) You could have just said, okay, I'm going to completely bypass any questions that I have and fully just accept everything that I'm given. But something inside of you said, wait, hold up. Let me just do this again. Let me look at this. me think about this. So I really believe in that. think that is so important and important for people to hear because so often we do that. We bypass our own internal judgment and knowing.   You said something important is partnering up with your provider so that it's not an all or nothing. Of course you're going to utilize and you did, you got benefit from getting those tests because that woke you up to doing so many new and amazing things in your own life and implementing a better diet and so on. As far as Omega -3 goes, this is just something that I've been hearing of late.   that some of the supplements go rancid and that it makes it worse. it, have you heard about that?   Leslie Kenny Oxford Healthspan (16:36) Yeah, I've heard that. Yeah, and apparently what you need to do is take this supplement and put it into the freezer. And if it gets cloudy, that is what I've heard is that then that's not good. It's supposed to remain clear throughout. I'm not an omega -3 fatty acid expert. I have lived for a number of years, very nearby one here in Oxford, Professor John Stein.   Michelle (16:45) Mm   Leslie Kenny Oxford Healthspan (17:05) who's done a lot of the research on mental health issues and omega -3s and how important they are for brain health. But yeah, I think, you know, get it from your diet first and foremost. Fatty fish is a great source, right? Yeah. Salmon, if we, you haven't already eaten all of it. Yeah.   Michelle (17:18) Right. Good fish. Yeah.   Wild caught, yeah. Yeah, I know. It's so crazy. Well, also just the mercury in some of the salmon, you know, the chemicals, but wild caught, I always say just.   Leslie Kenny Oxford Healthspan (17:33) Yeah, wild caught. Yeah. And also anchovies, mackerel, sardines, right? The small fish are a really good source of omega -3 fatty acids. And those tend not to have the mercury. Obviously, if we're trying to get pregnant, mercury, definitely not your friend. So yeah.   Michelle (17:38) Sardines, yeah.   Yeah.   Yeah, for sure. I always say, you know, if you're not going to have it when you're pregnant and if you don't have it when you're trying to get pregnant because tuna, for example, they always caution not to have that because of the high mercury, but you don't want that in your system if you're trying to conceive. So for I was very intrigued by your story and I was also intrigued by what you do because when you think about egg quality, sperm quality and really reproduction,   Leslie Kenny Oxford Healthspan (18:02) Yum. Yum.   Hmm.   Michelle (18:18) you think anti -aging, that's like ultimately anti -aging in a nutshell. Like that's really what I do for people that I work with. And it benefits me because I'm like, okay, you know, I'm just going to apply a lot of these things as I learn. it definitely, but that's what it is. It's anti -aging. Like I'm big on meditation, which has also been shown take our clocks back, but food and diet and certain supplements,   Leslie Kenny Oxford Healthspan (18:20) Mm -hmm. 100%. Yeah.   Yeah. Yeah.   Michelle (18:46) can actually shift and slow down your aging or sometimes even like reverse your biological clock. And I know you're the expert in this specific topic. So I'd love for you to talk about that and what has been discovered and seen in this subject.   Leslie Kenny Oxford Healthspan (18:57) Sure.   So when we are at our peak health is when we are reproductively capable. And we visually know this when we go out and we see a woman with glossy long hair, with long eyelashes, with healthy radiant skin, of healthy body weight, we know that that is someone who is   who is really attractive and why are they attractive? Because they are at their reproductive height. And interestingly, all of the things I have described are also linked with your spermidine levels. And so that's quite interesting. But also, your hormones are in perfect balance when you can reproduce and that includes not just the usual female sex hormones,   Michelle (19:36) Mm   Mmm.   Leslie Kenny Oxford Healthspan (20:01) but also your thyroid hormones. So I'm also a Hashimoto's survivor as well. And so I'm a hypothyroid patient and that is also really important. So it's got to be in perfect balance then. And one of the things that happens with some of these anti -aging molecules is that they extend fertility.   Michelle (20:07) Mm   Mm   Leslie Kenny Oxford Healthspan (20:28) partly by reversing your age, but they will start the reproductive cycle back up for some people. And it kind of depends how far away from menopause you are. But we've certainly had clients who've said, what happened? I've been in menopause for two years and I've gotten my cycle back. And...   On the one hand, want to say, congratulations, that's great. But they're thinking, this means I can't wear white trousers now, right? And I thought I was done with the pads and the tampons. So I know it's a little bit of a double -edged sword. We women are often thinking about, how do we get rid of our cycles? But in fact, they are nature's way of saying that we are in peak health and are capable of bringing another life into this world.   Michelle (20:55) Hahaha   Yeah.   Leslie Kenny Oxford Healthspan (21:22) You know, we do have to bear that in mind. Of course, the same is true for men. And we know there's a problem with testosterone declining in young men, whether it's due to endocrine disruptors in our food and our water supply, toxins in the air. There is a challenge to men as well. And we do want to see them at their reproductive best in order to be at optimum health, too.   And that is also something that these geroprotectors, these senolytic drugs, these anti -aging molecules can do. They seem to restore fertility in men as well as women.   Michelle (22:03) Amazing. And so let's break it down for people who have never heard of these molecules and these supplements and spermidine. So take a step by step, like, so that people listening can understand what it is.   Leslie Kenny Oxford Healthspan (22:07) Yeah.   Sure. OK. Well, first, me just say that there are scientists believe that there are 12 reasons why we get older. And these are known as the hallmarks of aging. And they include things that you and your listeners will have heard of before, things like inflammation, leaky gut, stem cell exhaustion or dysfunction, mitochondrial dysfunction.   So, you know, where you have no energy. Telomere shortening. So telomeres are at our in caps and they limit the number of times that we can replicate ourselves. So all of these reasons why we get older, scientists have looked at different molecules that can inhibit those, you know, us going down those pathways. And they have a list of these molecules that   inhibit certain numbers of molecules. And the two that do the most are one called rapamycin, which is a bacteria, and the other one is spermidine, which we manufacture ourselves, like I said, in our gut, in our tissues, and also we get from food. But importantly, it is found in both breast milk and in sperm, and it's so necessary for the survival   the start and survival of the next generation, that it's also in the endosperm of all plants. So these two molecules, rapamycin and spermidine are kind of the darlings of the anti -aging set. And one of spermidine's superhero powers is that it activates cell renewal and recycling.   So if we think about staying in perfect health, one of the first things we want to do is make sure that we can do is every day oven cleaning, right? And the cells do have that function. Maintenance, exactly, exactly. Now, when we're young, it happens naturally and we don't think anything of it, but as we begin to age, that process falters and the cells, the dysfunctional cells,   Michelle (24:16) Mm -hmm. It's a maintenance.   Leslie Kenny Oxford Healthspan (24:32) which we call senescent cells, they begin to stack up. And the more of these senescent or zombie cells that we have, the less well the other cells function. And I sometimes say that these zombie cells are a bit like your uncle Ted who has too much to drink at a wedding, and he begins to say inappropriate things.   Michelle (24:45) Mm   you   Leslie Kenny Oxford Healthspan (24:56) and do really silly stunts and you just think, okay, we got to get Ted over with pot of coffee in the corner away from everybody else or he's going to ruin the party for everyone else. This is what senescent cells do to you. You have one senescent cell and it begins to leak inflammatory contents to the other cells nearby and zombie -izes them and does the same to the other cells. It's a cascade effect.   Michelle (25:09) Mm.   Leslie Kenny Oxford Healthspan (25:25) That is what spermidine can actually, one of the things it can help with in particular with immune cells, it can prevent those immune cells, well rather it can rejuvenate senescent immune cells and that is the work that was done at the University of Oxford.   Michelle (25:43) That's amazing. you moved there to work with them in the research?   Leslie Kenny Oxford Healthspan (25:48) Well, I came here anyway. I came here because my ex, now sadly my ex, but we have two wonderful children together. He was from Oxford and moved here to be closer to his family and still close to them and absolutely fell in love with the town and just the vibe. University towns are definitely my kind of place.   Michelle (26:09) Hmm. That's nice.   Mm   Leslie Kenny Oxford Healthspan (26:18) Just the scientific rigor here in the life sciences, it's phenomenal. It's really impressive.   Michelle (26:29) That's amazing. so the two things you're saying are spermidine and rapamycin. and so spermidine is something that you could take from supplements, but not so much rapamycin.   Leslie Kenny Oxford Healthspan (26:39) You can't, no, not rapamycin, no. It's not something you're going to find in food. So it was basically isolated on Rapa Nui, which is one of the Eastern islands. And one of the pharmaceutical company, a researcher basically took it back home to the United States and it was later researched and found to do.   some really amazing things, one of which is that it can suppress the immune system. And this is important for people who have organ transplants because the tissue match is not perfect and their bodies necessarily want to reject any foreign material in their bodies. So if you give these patients immune suppressants to stop the rejection of the organ, they can live quite nicely with   Michelle (27:16) Mm   Leslie Kenny Oxford Healthspan (27:33) with that organ and continue in reasonable health, understanding that their immune system has been suppressed. Spermidine, though, of course, it's in our diet. It's something that our gut biome, if it's not been compromised by too much exposure to broad spectrum antibiotics, it can make. And in all of the longevity hotspots of the world, these populations of healthy centenarians, their spermidine levels are   high, they're similar to those of people who are in their 50s. And it's correlated with healthy lifespan. So I always recommend that people try to get more plants in their diet because you will get spermidine in your plants. If you can have fermented foods,   Michelle (28:12) Mm   Mm   Leslie Kenny Oxford Healthspan (28:29) If you don't have a problem with histamine load, and some people do for allergy, you know, if they've got allergies, but if you don't have a problem with histamine, then, you know, kimchi, sauerkraut, even things that are long matured like cheese. And a lot of people can say, I'm not allowed cheese because it'll make me gain weight. Well, yes, but there is also some spermatine there. The longer the maturity of the, of the cheese, the more it's been aged, the higher the spermatine content.   Michelle (28:45) Mm   Leslie Kenny Oxford Healthspan (28:58) Usually these are harder cheeses like a Parmesan or a cheddar. These would be good sources. And then for individuals who need extra, then a supplement makes sense. But I always say, get it first from your food. Please do not rely on a supplement, right? That's not doing, it's a disservice to think that you can just have a bunch of little pills on your plate.   Well, at first you're not going to get any satisfaction from it. But the other thing is that we need the fiber in those plants because that fiber, although our bodies don't, don't digest it, the gut biome needs that. And so you, you want to also feed the colonies in your gut biome that can make more spermidine for you. You know, we have these little pharmaceutical factories that make   Michelle (29:46) Mm   Yeah.   Leslie Kenny Oxford Healthspan (29:54) everything from B vitamins and serotonin, one of the happiness hormones, and spermidine. So why waste it? actually in our supplement, the wheat germ derived one, we have a fructo -oleigosaccharide in there, an FOS, can selectively feed the bacteria that make spermidine. And the reason I want it there is because that's also what's in breast milk. In breast milk, you have   these fructo -aligosaccharides, you have spermidine, sperminine, another polyamine that actually helps turn good genes on, bad genes off, and then a precursor polyamine called putrescine. So you want some fiber, basically, that's the takeaway. Please, you want the fiber, yeah, exactly, because it's always better to, what do they say? Teach a man to fish, feed him for life, right?   Michelle (30:38) With the spermidine. Yeah.   Leslie Kenny Oxford Healthspan (30:49) rather than just give him the fish. And that's kind of what we want to do. We want to train your body to make more of it, especially as you get older, because you'll have to eat increasing amounts of plant material to make up the shortfall of your tissue production of spermidine going offline.   Michelle (30:57) Right.   It's fascinating. So wheat germ is not necessarily gluten -free. For people who are gluten -free, what do they do?   Leslie Kenny Oxford Healthspan (31:16) Well, OK, so yes, obviously, this is a problem in particular for autoimmune patients. And I went on the autoimmune paleo diet myself. I got rid of all gluten. I was off all lectins. Gluten is most famous lectin. So I had so many autoimmune patients getting in touch with me who'd heard my story that I actually looked for a plant source high in spermidine that was not a lectin. And I found it in an unusual strain of chlorella.   Michelle (31:28) Mm   Leslie Kenny Oxford Healthspan (31:45) So I went to Okinawa and had to test 120 different strains, substrains of chlorella to find the single one that had very high expression of spermidine. And we commissioned that to be grown in open -air freshwater ponds that are on land in Okinawa, but next to the ocean, but not in the ocean.   Michelle (31:46) Mm   wow.   It's wild.   huh.   Leslie Kenny Oxford Healthspan (32:11) And that's what we use in our gluten -free product, which also has Okinawan autumn turmeric and has Okinawan lime peel. So lime peel has another autophagy activator. That's that cell renewal process. This autophagy or cell renewal activator is called nobilitan. And it's also in bergamot, in bergamot, the citrus fruit.   Michelle (32:16) Mm -hmm.   Mm   Mm -hmm. Right.   Leslie Kenny Oxford Healthspan (32:38) And that actually, interestingly enough, is an Earl Grey tea. So if you're going to drink a tea, maybe some Earl Grey, you'll get some nobilitan in that. But that formulation was especially made for celiacs and for other autoimmune patients who really wanted the benefits of autophagy but couldn't use the defatted wheat germ version that we had brought to market first.   Michelle (32:42) wow. Interesting.   Mm   Mm   Amazing. Let me ask you a question. Have you looked into enzymes, pro proteleic? No, enzymes that are actually systemic enzymes that you have on an empty stomach. like things like wobe enzyme and yeah. And I think that there's another one, it's Nuzheim or there's another pretty well -known company. And I think it's from Europe.   Leslie Kenny Oxford Healthspan (33:11) You mean like digestive enzymes or?   I've taken wovenzyme.   So yeah, wabenzim is German. I took that, gosh, maybe it's been around for decades and it does work. I took that from my, interesting. I took it, I didn't know that. I took it for joint pain. And so this was something that I was taking as a way to try and treat myself for the rheumatoid arthritis. So it didn't, it wasn't enough for that. I think it can help.   Michelle (33:40) It was beneficial for thyroid. Yeah, yeah.   Yeah.   Yeah.   Leslie Kenny Oxford Healthspan (33:59) more mild things, but definitely these are of benefit. And having a coach like you, who, you know, a trained practitioner who knows about all of the menu items that could be selected, you have the different tools, right? It's overwhelming as a patient. I mean, even just having my doctor say, just inject this one drug, that was like, whoa, can I get my head around the idea of injecting myself, right?   Michelle (34:13) Yeah, like different tools.   yeah.   Yeah.   Leslie Kenny Oxford Healthspan (34:29) So you do need a guide and I think it's great that you've got that knowledge that you can share with your clients.   Michelle (34:37) Thank you. also, so for people who are interested, is it mostly the spermidine that you're focused on?   Leslie Kenny Oxford Healthspan (34:45) Yes, so basically we are a small all -women company and you know, women -led companies, we get around 2 % of all venture capital funding. We don't have venture capital funding like our competitors. We very much are growing organically and are looking at really focusing on something that we know very well and making the most excellent   Michelle (34:49) Mm -hmm.   Leslie Kenny Oxford Healthspan (35:13) product on the planet. And for me, with my group of advisors, this has been the right thing to do because we've had so many raw material manufacturers and suppliers come to us telling us, try this spermidine. And when we tested in the lab, we see that it's basically a tiny amount of wheat germ, and it's been cut like a street drug with synthetic spermidine.   Michelle (35:15) Awesome.   Leslie Kenny Oxford Healthspan (35:42) And the problem with synthetic spermidine is, firstly, OK, I am biased against the synthetic because I watch my mother take the synthetic HRT. I'm so glad I'm on bioidentical HRT. But the synthetic has never been tested for safety or efficacy in humans. So I'm reluctant to bring a product to market that has not been tested. And when it comes to fertility,   Michelle (35:43) wow.   Mm   Mm   Leslie Kenny Oxford Healthspan (36:11) We know that in mouse studies where they have used synthetic spermidine, small amounts seem to help. But then when you give just a little bit more, it actually impairs fertility. so with these...   Michelle (36:22) wow. That's important. That's really important, you guys, to listen to that because that's huge.   Leslie Kenny Oxford Healthspan (36:28) Yeah, that's huge. So the problem is finding the Goldilocks zone. Each of us is bio individual. We have different ethnic difference, genetic differences, age, body shape, height, and metabolism. All of these things mean you want the right amount for you, but we don't know what that right amount is when it comes to synthetic spermidine. With plants, however, it's not a problem.   because the body recognizes this, we have co -evolved with plant -derived spermidine for millennia. So when there's too much, the body says, right, we're going to turn this into spermine, which is going to help with turning good genes on, bad genes off with the DNA methylation. But this doesn't happen with the synthetic. I think that on the fertility front, as a woman, I would never make that.   Michelle (36:55) Yeah.   Leslie Kenny Oxford Healthspan (37:21) I would never go for something that might possibly hurt my fertility.   Michelle (37:25) absolutely. Absolutely. I mean, it's a complete waste of time because you're trying to do all these other things and then you're going to take something that's not, that's a risk. and then I was curious, it says you were talking about it you were saying that sometimes they'll find it in certain mushrooms, cordyceps by any chance.   Leslie Kenny Oxford Healthspan (37:30) Yeah. Yeah. Yeah.   Mmm.   it will be in cordyceps. It will be in all mushrooms and the ones that have the highest amount of swirmed in our shiitake, oyster and trumpet, but all mushrooms will have it. And, know, if you, if you don't have a problem with, mushrooms, know, this is fall, it's autumn. This is the right time to, you know, get some mushrooms into your stews and your soups and,   Michelle (37:43) Mm -hmm. Mm -hmm.   Awesome.   Mm -hmm.   Leslie Kenny Oxford Healthspan (38:06) It's really, it's so, so good also because it's got vitamin D and we're just coming off of this period where we've soaked up the vitamin D from the sun over the summer, but now we're going into winter and we're gonna get less. So there are so many reasons to get it also a wonderful source of fiber.   Michelle (38:16) Yeah.   Yeah, amazing. So if people are interested and want to learn more and then also want to look at your products, how can they find you?   Leslie Kenny Oxford Healthspan (38:32) They can go to Oxford HealthSpan, like the span of a bridge, it's all one word, .com. And if they're interested in learning more about healthy aging, we do bring breakthrough scientists who talk about things, not just about cell renewal or autophagy, but talk about other things as well. We also have them talk about, say, NAD, things like this. That's at the OxfordLongevityProject .org.   Michelle (38:56) Yeah.   Mm   Leslie Kenny Oxford Healthspan (39:01) And then I have kind of a side hustle helping my girlfriends with gray hair reversal. And that's on Leslie's new prime. Spermadine helps with that as well. It helps with hair health and eyelash and eyebrow health. That is on Leslie's new prime on YouTube. So L -E -S -L -I -E is how I spell my name.   Michelle (39:08) nice.   Fabulous. Leslie, this was fascinating. I really enjoyed talking to you. And also a key point, you got pregnant naturally at 40. Okay. important thing to mention. And I kept thinking about it as we're talking about, wait, wait, let's go. Let's go talk about that, even though it's kind of the end of the episode.   Leslie Kenny Oxford Healthspan (39:34) I did at Yeah. Yeah. Yeah. Well, it's a, it's a happy ending. So, so the fifth IVF with the donor eggs didn't work. As a matter of fact, the embryologist said on embryo transfer, said, I don't know why you didn't use your eggs. Your eggs are better than this younger donor. I was like,   You're kidding me because I can't tell you how much I just sacrificed to pay for that. And, but, know, basically fast forward, I adopted a little girl from China. So I became a mom. become parents, you know, mother is a verb. It's not a noun. So that was, that was great. And as I was taking care of her, I still felt very, very tired and I couldn't understand what was going on, why I saw these other moms.   Michelle (40:02) wow.   Leslie Kenny Oxford Healthspan (40:27) running around with scout troops, planting gardens, walking dogs, five children. You know, why? How do they do it? They're the same age and they have so much more energy. And I just, I did go to Dr. Google. I put in every symptom I had and it came up hypothyroid. So then,   The GP here in the UK said, no, you're in the normal range. No problem. I went to a private GP. No, you're normal. I went to a private endocrinologist. No, you're normal. And I just thought, I know I'm not. These doctors keep telling me I'm normal. I know. We patients always, if you do feel like that, follow your intuition, find a doctor who believes you, and we'll run the test. We'll work with you to uncover the mystery. It's like a murder mystery, right? So.   Michelle (41:09) Yes.   Yes.   Leslie Kenny Oxford Healthspan (41:14) So I went on patient forums. Patient forums have been great help. Went there and people said, there is one doctor who will help you and he won't just look at your blood test. A lot of doctors look at thyroid problems and they only look at your blood test, your TSH, your T3, your T4. I went to him and he looked at clinical symptoms and he also ran a cortisol test. And he said that my...   Michelle (41:33) Mm   Leslie Kenny Oxford Healthspan (41:43) Cortisol was the lowest he had ever seen. It was so bad, he didn't know how I was standing in front of him. And I had classic cold hands, cold feet. Yes, my hair was thinning. I was exhausted. I was breathless as I went upstairs. I was losing the outer third of my eyebrows. These are all clinical symptoms of hypothyroidism. He then said,   Michelle (41:50) Wow.   Mm   Leslie Kenny Oxford Healthspan (42:09) What you need to do is address your adrenals first because of the cortisol problem, and then two weeks after that, take some thyroid. And because I actually do not convert levothyroxine, which is a standard thyroid hormone that most people get, like 60 % of all Americans will get that, but I can't convert it into the bioavailable.   Michelle (42:22) Mm   Right. Yeah.   Leslie Kenny Oxford Healthspan (42:33) thyroid hormone known as T3. And your cell receptors only have receptors for T3, not for levothyroxine. So if you've been taking loads and loads of levothyroxine, you still feel wiped out. You probably are just like me and have a genetic, you're genetically challenged and you can take a test with Genova diagnostics. I think it's called the DIO2 genetic test, D -I -O -2. And   Michelle (42:35) Mm   Mm   Mm -hmm. Mm -hmm.   Leslie Kenny Oxford Healthspan (43:01) here in the UK cost about 75 pounds and you then can get T3 prescribed either synthetically or you can do what I do and Hillary Clinton also does. take something, we take a desiccated pig's thyroid. In America there's Armour, There's Armour, there's Urfa, there are a few brands and that within, you know, two to three weeks basically on that   Michelle (43:16) Is that armor? Yes, yeah.   Leslie Kenny Oxford Healthspan (43:29) Pregnant right away. No idea. Had not even, didn't check if I was ovulating. You remember the days when you're like, you've got a thermometer under your tongue and you're checking, am I ovulating? Could it be now? And all the calendar work that you've got to do when you're trying to get pregnant, none of that. It just happened. And I was so shocked. yeah. So my daughter, Marguerite, was born, you know,   Michelle (43:38) Yeah.   That is so crazy.   Leslie Kenny Oxford Healthspan (43:57) Eight months later, was just one day shy of being premature, so I got her over the premature line. And 10 out of 10 on the Apgar score delivered at age 43.   Michelle (44:08) Amazing. mean, that is just incredible. I'm sure, I mean, I'm so excited about this episode because I just feel like it's mind blowing, first of all, just all the different stories. And it also covers things that I feel are really important. advocating for yourself as a patient. I mean, that is huge. And I think a lot of us have been in those kinds of situations. You said something that I was like, wow.   That's a quote, find a doctor who believes you. You know, because also getting different opinions is super important and it's a game changer. It'll totally change your whole journey.   Leslie Kenny Oxford Healthspan (44:37) Yeah, yeah, yeah.   Yeah.   Yeah. Well, look what this doctor did for me. So what none of the doctors had realized with those other two autoimmune conditions was that I had my autoimmune, the system, the immune system had not only attacked my joints and my organs, but it had attacked my thyroid. And the way that he could see it was, you know, he could see with.   Michelle (45:07) Mm -hmm.   Leslie Kenny Oxford Healthspan (45:11) that I had all the clinical symptoms, but with an ultrasound, he could see that I had only one eighth of a thyroid left. I had so little viable thyroid left. There was just nothing of the organ left. yet, because he didn't want to fall in line here in Britain, he was actually hounded by the British Medical Council.   Michelle (45:23) Wow, that is so crazy.   Leslie Kenny Oxford Healthspan (45:35) Mary Schumann, the thyroid advocate in the United States, who's written a number of thyroid patient handbooks, actually got a campaign together to try to gather signatures. And he had tens of thousands of signatures from grateful patients. But the medical council actually wasn't listening. They wanted their protocol to be followed. And it had to be a blood protocol.   Michelle (45:55) It's so crazy to me.   Leslie Kenny Oxford Healthspan (46:02) And this is the problem is the blood does not show everything. But of course, we patients get these data points 24 -7.We know if our hair is falling out, if we can't shift the weight, if we can't walk upstairs without getting winded, if we've got cold hands and cold feet, our partners know because they tell us, God, you're freezing. What's going on? So we need.   Michelle (46:06) you   Yeah.   Mm   Yeah, yeah, totally, totally.   Leslie Kenny Oxford Healthspan (46:30) Our partners know it. If, if you happen to be sleeping with a doctor, maybe he can be a prescribed for you and he'll believe it because of the cold feet. but otherwise, you know, you have to rely on your powers of persuasion to find a doctor who's willing to go the extra mile with you and get curious. I only ask that I just find a doctor who's willing to get curious with you.   Michelle (46:35) Right? Yeah.   Yeah, I love that. I love that. Well, I mean, I could talk to you for longer than we have. But let's say this is amazing information, like really, really, truly amazing. And I love your story. And I love the way you truly believed in yourself. And that's something that I want to tell everybody who's listening, just believe in yourself because you know, and you know what? The body is so forgiving, way more forgiving than we give it credit for. It's just a matter of   Leslie Kenny Oxford Healthspan (47:21) 100%.   Michelle (47:22) figuring out like what is it exactly that it needs, like just figuring it out, its own way of communication. So thank you so much, Leslie, for coming on today.   Leslie Kenny Oxford Healthspan (47:28) Yeah.   absolutely. Thank you for having me on. really appreciate it. It was lovely chatting with you, really fun. And keep going with your amazing work. Women need guides they can trust like you, who are willing to take the extra time to get curious and share the knowledge that you've gained over the years and the hard work you put in to get pregnant yourself, right?   Michelle (47:57) Thank you so much.    

In this episode of the Prime Podcast, hosts Dr. Skip and Dr. Julie Wyss discuss the importance of chiropractic care and milestones for babies, emphasizing how common issues like colic and ear infections are normalized despite not being healthy. They focus on the impact of stress on a newborn's development, the importance of skin-to-skin contact for regulating heart rate and breathing, and advocating for optimal APGAR scores to assess a baby's well-being post-birth. The Weisses highlight the significance of breastfeeding for neurological development and the necessity of ensuring a baby's nervous system functions without interference, promoting a thriving child instead of merely surviving. 00:00 Introduction: The Reality of Grumpy Babies 01:18 Welcome to the Podcast 01:43 The Importance of Chiropractic Care for Babies 03:59 Understanding Baby's Stress and Reflexes 06:35 The Critical Role of Skin-to-Skin Contact 08:17 APGAR Scores and Birth Trauma 11:46 Breastfeeding Challenges and Solutions 19:04 The Impact of Stress on Developmental Milestones 22:03 Breaking the Cycle for a Healthier Future 23:02 Conclusion and Call to Action   https://theprimepediatricpodcast.libsyn.com =============================================== Order Standard Process Here: https://primefamilycenters.standardprocess.com   ================================= Download our App Here: Apple Play Store: https://apps.apple.com/us/app/prime-family-chiropractic-app/id6474149243 Android: https://play.google.com/store/apps/details?id=com.ub378e75245a.app&pcampaignid=web_share =================================    Please like, subscribe, comment, and share this video!    //Dr. Julie Wyss  - Prime Family Chiropractic Centers//  Dr. Julie Wyss DC is a highly respected chiropractor with a special focus on pediatric and pregnancy care. Her extensive training and experience in these areas has made her a trusted advisor to families seeking a tailored and personalized type of care focused on the body's ability to heal itself.   As a mother herself, Dr. Wyss understands the unique challenges that come with pregnancy and postpartum recovery. She believes that chiropractic care can play a vital role in supporting the health and wellbeing of both mother and child during these transformative stages of life.   In addition to prenatal care, Dr. Wyss specializes in postpartum care to help new mothers recover and regain their strength and vitality. She provides gentle adjustments and breathing exercises to address issues such as diastasis recti, pelvic floor dysfunction, and breastfeeding difficulties.   //Dr. Skip Wyss - Prime Family Chiropractic Centers// “When you get the chance to change lives from their first days of existence, you do not take it lightly. But you can take it with a dash of light-hearted joy!”   That's how Dr. Skip Wyss chooses to manage Prime Family Chiropractic Centers, a 15-year staple in his Green Bay Community. He decided to take that experience and developed the internationally recognized educational program, The Prime Coaching Company, focused on pediatric, prenatal, and family health.   Dr. Skip is an internationally recognized speaker, ICPA certified pediatric chiropractor and host of The Prime Podcast. The show is a platform for his wife, Dr. Julie Wyss, and himself to provide incredible education and resources on having an incredible marriage, business, family, faith, and health for service providers and their community!   // Prime Family Chiropractic Centers //  Certified Prenatal and Pediatric Family Chiropractic Healthcare. Get Primed for life and success with healthcare re-imagined.   Website: https://primefamilycenters.com/   Follow us on Social Media! Instagram: https://www.instagram.com/primefamilycenters/ Instagram: https://www.instagram.com/drjuliewyss/ Instagram: https://www.instagram.com/skip_wyss_dc/ Instagram: https://www.instagram.com/primepediatrics/ Facebook: https://www.facebook.com/PrimeFamilyCenters Facebook: https://www.facebook.com/profile.php?id=100094650643408 Facebook: https://www.facebook.com/DrJulieWyss YouTube: https://www.youtube.com/@PrimeFamilyChiropracticCenters   #primefamilycenter #primefamilychiropracticcenters #primepodcast #adversity #winning #losing #chiropractic #chiropractor #neckpain #shoulderpain #nervoussystem #spinehealth #headacherelief #pediatricchiropractor #familychiropractor #childwellness #healthyhabits #nutritionandwellness #sportschiropractor #chiropractornearme #pregnancychiropractor #prenatalchiropractor #prenatalcare #babychiropractor #greenbaywi #greenbaywisconsin #greenbaychiro #drskipwyss #drjuliewyss    Green Bay, WI Chiropractors Best Chiropractor in Green Bay, WI Prime Family Centers Green Bay, WI Prime Family Chiropractic Centers Green Bay, WI Pediatric Chiropractors Webster Technique Pediatric Certified Chiropractor Dr. Skip Wyss Dr. Julie Wyss  

Send us a textJoin us for a discussion about practical assessments and interventions for newborn small ruminants with Dr. Michelle Kutzler of Oregon State University.  In this episode we review Apgar scoring as an assessment tool for newborn lambs and their need for intervention after birth as well as a technique for assisting lambs that struggle with the transition of birth called the Madigan Squeeze. This technique was popularized in horses but has also been used in cattle. Developing a modified Apgar scoring system for newborn lambs:https://pubmed.ncbi.nlm.nih.gov/32827990/Resuscitation compression for newborn sheep:https://pubmed.ncbi.nlm.nih.gov/33358064/Dr. Kutzler's work is funded, in part, by the Oregon Sheep Commission:https://oregonsheepcommission.com/Learn more about Dr. Michelle Kutzler and her work:https://anrs.oregonstate.edu/users/michelle-kutzlerIf your company or organization would like to sponsor an episode or if you have questions about today's show, email Office@AASRP.org

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

In this compelling episode of "Life on Pause," host Jill Robertson sits down with Joe Apgar, a cancer survivor and CEO of Pelotonia, to explore the deeply personal journey of family planning after a cancer diagnosis. Joe shares his and his wife's decision to pursue adoption following his battle with testicular cancer and the challenges they faced along the way. From discussing the emotional complexities of adoption to the importance of open communication with birth parents, Joe offers invaluable insights for anyone navigating the delicate balance of building a family after a life-altering health experience. Whether you're considering adoption or simply seeking inspiration, this episode is a powerful testament to resilience, love, and the many ways families are created.Don't forget to like, subscribe, and follow us on YouTube, Spotify, or wherever you get your podcasts!0:00 - Introduction to Joe Apgar2:03 - Joe's Journey to Fatherhood 5:13 - Choosing Adoption 9:59 - Adoption Process: Challenges and Insights 14:34 - Navigating the Adoption Paperwork 17:24 - Financial Considerations and Support 22:43 - Building Relationships Through Open Adoption 26:06 - Parenting After Cancer_________________________________________________________________#cancerandfertility #adoptionaftercancer #adoptionresourcesforcancersurvivors

Today's Episode Charlee reviews chapter 14 from the Pediatric Morning Report book. A premature female neonate is born to a G1P0-1 mother at 24 weeks and 5 days gestation with a birth weight of 769g via spontaneous vaginal delivery after preterm onset of labor. The infant requires immediate endotracheal intubation as she is noted to be markedly pale and edematous. Oxygen saturation is in the 60%–70% range. Apgar scores are 1 and 6 at 1 and 5 minutes, respectively. Today's Host Charlee Quarless is a 3rd year medical student at Ross University. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

Today's Episode Alexis reviews Case 48 from the Pediatric Morning Report book. A 7-week-old term male infant is brought in by his mother to the emergency department (ED) for the second time, with the chief complaint of episodes of pauses in breathing dur- ing sleep. These episodes are associated with perioral cyanosis lasting about 15 to 20 seconds, which resolves with gentle stimulation, such as tickling of his feet. Sometimes, these episodes are associated with pallor. His past medical history is significant for low Apgar scores requir- ing observation in the neonatal infant care unit (NICU), where he was noted to have periodic breathing. He was first seen at the ED at 1 month of age for short apnea and pallor, where he was observed overnight and diagnosed with a brief, resolved, unexplained event (BRUE). On physical examination, temperature is 36.9°C, heart rate is 130 beats/min, blood pressure is 87/50 mm Hg, respiratory rate is 32 breaths/min, and oxygen saturation is 97% on room air. He is well nourished, well developed, and not in respiratory distress. The breath sounds are clear. The rest of the physical examination is normal. Today's Host Alexis Burnette is a medical resident at Los Angeles General Medical Center. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj www.BeyondThePearls.net The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices

“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

Neste episódio do Journal Club, revisamos vários estudos recentes em neonatologia. Começamos discutindo um artigo sobre as tendências de mudança na pontuação de Apgar, observando uma mudança das pontuações de 10 para 9, provavelmente devido ao maior reconhecimento da acrocianose transicional normal.A seguir, apresentamos as diretrizes para auxiliar neonatologistas na indicação do melhor momento de realizar a transfusão de hemácias. Destacando a importância de incluir os pais e cuidadores nas decisões sobre os desfechos neonatais mais relevantes. O próximo artigo tem como um dos autores o nosso colega da versão francesa do Podcast, o Dr Gabriel Altit. Os autores discutem sobre a associação de persistência do canal arterial, displasia broncopulmonar e hipertensão pulmonar, no contexto de duas unidades: uma com conduta conservadora e outra com conduta intervencionista.Para finalizr, examinamos um estudo sobre o uso do ChatGPT e do Google Translate para traduzir instruções de alta pediátrica, encontrando resultados mistos em diferentes idiomas.  Esperamos que este Journal Club ajude a manter nossos ouvintes atualizados sobre as pesquisas mais recentes e encoraje o pensamento crítico sobre como aplicar essas descobertas na prática clínica.1. Nine is the New Ten of Apgar Scores: An Observational Retrospective Cohort Study - Nove é o Novo Dez dos Escores de Apgar: Um Estudo de Coorte Observacional Retrospectivo Disponível em: https://www.jpeds.com/article/S0022-3476(24)00253-1/abstract2. Clinical Practice Guideline for Red Blood Cell Transfusion Thresholds in Very Preterm Neonates - Diretriz de Prática Clínica para Limiares de Transfusão de Hemácias em Neonatos Muito Prematuros Disponível em: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820028?utm_campaign=articlePDF&utm_medium=articlePDFlink&utm_source=articlePDF&utm_content=jamanetworkopen.2024.174313. PDA management strategies and pulmonary hypertension in extreme preterm infants with bronchopulmonary dysplasia - Estratégias de manejo da PCA e hipertensão pulmonar em prematuros extremos com displasia broncopulmonar Disponível em: https://www.nature.com/articles/s41390-024-03321-1O site para a página NeoCardio Lab, do Dr Altit você acessa aqui: https://www.neocardiolab.com/4. Performance of ChatGPT and Google Translate for Pediatric Discharge Instruction Translation - Performance do ChatGPT e Google Tradutor para Tradução de Instruções para alta de pacientes pediátricosDisponível em: https://publications.aap.org/pediatrics/article-abstract/154/1/e2023065573/197484/Performance-of-ChatGPT-and-Google-Translate-for?redirectedFrom=fulltext?autologincheck=redirected Não esqueça: você pode ter acesso aos artigos do nosso Journal Club no nosso site: https://www.the-incubator.org/podcast-1 Se estiver gostando do nosso Podcast, por favor deixe sua avaliação no seu aplicativo favorito e compartilhe com seus colegas. O nosso objetivo é democratizar a informação. Se quiser entrar em contato, nos mandar sugestões, comentários, críticas e elogios, manda um e-mail pra gente: incubadora@the-incubator.org

Send us a Text Message.In our latest Journal Club episode, we review several important recent studies in neonatology. We begin by discussing a paper on the changing trends in Apgar scoring, noting a shift from scores of 10 to 9, likely due to increased recognition of normal transitional acrocyanosis.Next, we examine a study on using ChatGPT and Google Translate for pediatric discharge instructions, finding mixed results across different languages. We then review new transfusion guidelines for very preterm neonates, featuring an interview with co-author Dr. Ravi Patel who provides insights on the guideline development process and implementation considerations.We also discuss an observational study from Sweden on early skin-to-skin contact and its potential benefits for reducing intraventricular hemorrhage and sepsis in preterm infants, though we note limitations in the study design.Additionally, we review a pilot randomized trial comparing whole-body hypothermia to targeted normothermia for neonates with mild hypoxic-ischemic encephalopathy. The study found no clear benefits to cooling in mild cases and highlighted the need for further research.Finally, we highlight an op-ed emphasizing the importance of addressing mental health needs of new fathers, especially those with infants in the NICU. We note that while screening all NICU parents for postpartum depression is recommended, it is often overlooked, particularly for fathers.Throughout the episode, we provide thoughtful analysis of the studies' methodologies, findings, and clinical implications, offering valuable insights for our community. We hope this Journal Club helps keep our listeners up-to-date on the latest research and encourages critical thinking about how to apply these findings in clinical practice. As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a Text Message.Nine is the New Ten of Apgar Scores: An Observational Retrospective Cohort Study. Everett SS, Bomback M, Roth P, Goldshtrom N, Polin RA, Lyford A, Hays T.J Pediatr. 2024 Jun 14:114150. doi: 10.1016/j.jpeds.2024.114150. Online ahead of print.PMID: 38880381As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

In this episode Mel proposes that the use of Apgar scoring is invalid for women under the care of midwives, for babies who have their umbilical cord intact for longer than 60 seconds and for women having a physiological birth. Find out why in the episode To get on the mailing list for the podcast and to access the resource folders for each episode, visit www.melaniethemidwife.com Premium podcast members Hub Being a premium podcast member gives you access to the transcript and additional resources for each episode AND the 'ask Mel a question' button so you can submit questions for the monthly 'Ask me anything' episode. Only available in the premium podcast members hub Find out all the details here You can find out more about Mel @melaniethemidwife Disclaimer: The information and resources provided on this podcast does not, and is not intended to, constitute or replace medical or midwifery advice. Instead, all information provided is intended for education, with it's application intended for discussion between yourself and your care provider and/or workplace if you are a health professional. The Great Birth Rebellion podcast reserves the right to supplement, edit, change, delete any information at any time. Whilst we have tried to maintain accuracy and completeness of information, we do not warrant or guarantee the accuracy or currency of the information. The podcast accepts no liability for any loss, damage or unfavourable outcomes howsoever arising out of the use or reliance on the content. This podcast is not a replacement for midwifery or medical clinical care.

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.Our Sponsors:* Check out Dr. Mom Butt Balm: drmombuttbalm.comSupport this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

En este episodio, exploramos los servicios de maternidad integrales en el Centro Médico Salinas Valley Health. Conozca el proceso de parto, la preparación para emergencias y el cuidado del recién nacido, incluyendo la puntuación APGAR y las inyecciones de vitamina K. También destacamos el apoyo a la lactancia materna, la colaboración de la NICU con Stanford Medicine Children's Health y lo que significa ser un hospital Amigo del Niño.

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.Our Sponsors:* Check out Dr. Mom Butt Balm: drmombuttbalm.comSupport this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

What to expect POST Birth in the FIRST 48 hours postpartumIf you're a first time mom, then this episode is for YOU! Today's episode we're getting realistic and spilling the TEA on what immediate postpartum is like.Today's episode on the first 48 hours postpartum/ post birth: What can women expect physically and emotionally in postpartum?How does the hospital stay look different for moms who had vaginal births vs c-sections?What happens if baby fail a newborn test (APGAR or hearing test)?How do you see postpartum stays differ across hospitals?What things should we bring to the hospital to make my postpartum stay a better experience?What are  labor and postpartum hospital rooms like?What do you eat in the hospital?What are the pros and cons of letting visitors into the postpartum room?Any lasting tips or advice for women when it comes to your post delivery stay?AND MORE!-------------------------------------------------------------------------------------------------------------IMPORTANT LINKS:- Sign up for the Learning To Mom Newsletter HERE:- Fit Mama In 30: Prenatal Workout Program that I'm Doing: Click HERE                   Use code LEARNINGTOMOM for the BIGGEST discount they have!! ($20 off their annual plan)To order a Freeze Dried Breast Milk Shipping Kit or schedule a drop off visit BoobieJuice.  (Use code LTM for 15%)  Connect with BoobieJuice on their InstagramConnect with BoobieJuice on their Facebook- Get Jessica's Book: Once Baby's Here HERE- Connect with ME on Instagram HERE or at @learningtomom.podcastHow to connect with Jessica:- Her instagram is linked HERE-------------------------------------------------------------------------------------------------------------Are postpartum night sweats normal, are postpartum periods worse, can postpartum, depression last for years, can postpartum depression start at 4 months, can postpartum depression start at 3 months, what does labor feel like,  birth podcasts, how to prepare for birth, how to prepare for labor, how to prepare for an unmedicated birth, how to prepare for a natural birth,  what will birth feel like, natural birth experiences,   how to achieve a natural birth, natural birth tips, unmedicated birth tips, preparing for labor as a first time mom in postpartum, postpartum rage, postpartum psychosis,  when does postpartum bleeding stop,  The Postpartum 6 week appointment, Postpartum night sweats, Postpartum intrusive thoughts, Postpartum hormones, Postpartum bleeding (lochia), Postpartum sex, Postpartum hair loss, postpartum red flag,  Pregnancy relaxation techniques,  natural birth tips, newborn care, first time mom advice, birth podcasts, pregnancy podcast, postpartum podcast, best podcast on postpartum care, top podcast for first time moms, pregnant and scared, good podcasts for first time moms, baby sleep schedule, How to prepare for pregnancy, What is the best pregnancy podcast, That pregnancy

Jenny's story is one of pure gratitude and joy. She is so grateful to be a mother, for the miracle of her pregnancies, for a breech baby who flipped late in her second pregnancy, for the chance to experience labor, and for a beautiful, successful VBAC. Jenny talks about all of the ways she prepped and how she even had to travel over a mountain pass during a snowstorm while in labor to get to her VBAC-supportive provider. Meagan shares some statistics about breech birth and why we so badly need more providers trained in vaginal breech delivery.A long-time listener of The VBAC Link Podcast, Jenny shares her story with so much joy hoping to inspire other Women of Strength just as she was inspired by so many others. PubMed Article: Risk of Vaginal Breech Birth vs. Planned CesareanHeads Up DocumentaryInformed Pregnancy - code: vbaclink424Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:58 Jenny's first pregnancy with gestational diabetes06:10 Low amniotic fluid, breech presentation, and a C-section10:22 Healing in different ways14:16 Getting pregnant again and doing all of the VBAC prep22:52 Gestational diabetes test27:59 Breech at 34 weeks32:33 A head-down baby35:11 Traveling the mountain pass in a snowstorm39:43 Checking into the hospital45:42 Fetal ejection reflex49:20 Pushing out baby and postpartum blood loss57:10 Jenny's advice for breech mamas1:00:22 Statistics on vaginal birth versus planned Cesarean for breechMeagan: Hey, hey. You are listening to The VBAC Link Podcast and we have another amazing episode for you today. We have our friend, Jenny. Hello, Jenny. Jenny: Hi. Meagan: How are you today?Jenny: I'm good. I'm so excited. This is just– I am reeling actually that this is actually happening today. Meagan: I am so excited that it is. You know, it's so fun to get submissions in and then when we send them out, people are like, “Wait, what? Really?” Jenny: That is exactly how I felt. I was like, “This is never going to happen, but I'm just going to go for it. I'm just going to submit it.” I mean, The VBAC Link was such a huge part of my whole story and just to be on here and hopefully share something inspirational with somebody else, hopefully it helps somebody. That's my goal today. Meagan: It will. It's absolutely going to. The whole podcast, sorry if you guys hear any noise in the background by the way. I'm getting a new furnace today and he's installing it downstairs literally below me. So sorry if there's any extra background noise. But this podcast is literally something that I wish so badly that I had when I was going through my VBAC. Obviously, that's one of the reasons why we were inspired to create it, but every single story, even though they all might have similarities or even be in similar places, they are so different and unique and I love that. I love that almost 300 episodes in, we can prove that every birth is different. It's true. Every birth is different and you went through a lot with your births. I mean, I've got her list right here of things. You guys, this is going to be a jam-packed episode. She's got gestational diabetes, breech, advanced maternal age, and trusting the process. We're going to talk about traveling literally over a mountain pass. She drove over a mountain pass to find what she needed so I'm so excited to dive into your episode in just one minute after the intro. 02:58 Jenny's first pregnancy with gestational diabetesMeagan: Okay, Jenny. Here we go. You are– are you ready? Are you ready? She is dancing in the background. You can't see her but she is literally dancing. You can see she is so excited to share this amazing story with you. Jenny: I am so ready. Okay, so let me go back four years to my C-section baby. I can't believe it's been that long. Being a mom was never in the cards for me. I'm just going to start out by saying that. My husband and I, we had been married for 15 years. We went on this fabulous cruise and we were just having the time of our lives. We had a conversation that if I was past 30, it just wasn't going to happen for us and that was okay. So we never planned to have babies and then we had the most wonderful surprise of our whole lives. One day– I don't even know it had been since I had my period so I was like, “Oh, I'll just take a test.” He saw it and was like, “What is this?” I said, “I'm 98% positive that it's going to be negative. I just do this sometimes. It's fine.” I get out of the bathroom with this blazingly positive test and he's like, “No way. I don't believe that.” So I had to go the doctor and prove to him that I was. Anyway, I loved being pregnant. It was so incredible. The miracle of just growing a baby is beyond words. Just that first flutter to knowing that you are creating a human inside of you to the first ultrasound– anyway. I started listening to “The Birth Hour” and I went down the rabbit hole. I love it so much because like you were saying before, it shows you so much about the differences. I didn't know what I didn't know, so it was just an education in itself. I went down the rabbit hole and I am such a birth nerd now. I had no idea. When I found out I was pregnant, the first thing that came to my mind was, “I have to give birth. I'm so scared,” because of all the fear. We get so much media fear. You see all the people screaming and pushing. It just looked traumatizing then I remembered I had seen The Business of Being Born and I was like, “No.” I have always been this closet hippie. I was like, “No. I'm going to do this and I'm going to do it right.” I found myself at 28 weeks. We did a gestational diabetes test and I walked into the doctor's office and she was like, “You have gestational diabetes.” I was like, “No I don't. No, I don't.” She was like, “Yeah, you do.” She was like, “You are going to give birth at 39 weeks here. You are going to be induced. You will give birth on your back. You will do this. You will do this.” The language she used with me was so– I felt so defeated and I was only 28 weeks. I was so disappointed and it was a midwife. It was a midwife practicing under a hospital OB practice. But I live in a really small town, so it was the only midwife I could find really. Home birth wasn't an option for me. We do have a home birth midwife, but it wasn't affordable at the time. 06:10 Low amniotic fluid, breech presentation, and a C-sectionJenny: It turns out that I had low amniotic fluid and you know, they send you in for all of these screenings and tests once you know you have gestational diabetes. They were really concerned about it one time when I went in and they were like, “I don't see any amniotic fluid, like any.” They actually kept me overnight and pumped me full of saline.Meagan: A bolus?Jenny: I was drinking water. Yeah, it was crazy. They checked the next morning and they said, “Yeah, you still don't have any amniotic fluid so we're going to send you to an MFM over the mountains,” which is about an hour and a half away in the city. When I got over, the MFM walked into the room. She didn't even say hi to me. I was 34 weeks at the time and she was like, “We're keeping you here. You're going to have this baby. You're not going to leave this hospital until you do.” She hadn't even talked to me. She never said, “Hello.” I mean, she just looked at my chart. She didn't do any tests on me. I was just blown away by how she talked to me. I was just like, “Are you kidding? Hi. I'm a person.” The did the test right there and then. It turns out the city doctor and their tests are so much better. Based on the total amount of amniotic fluid, they released me that day. As I was walking out the door, she was like, “By the way, I'll see you back here for your delivery because your baby is breech and you're not going to have her naturally.” I was just like, “Okay. I'll show you. I'm going to flip this baby.”Anyway, I went down the rabbit hole. I did everything. I even signed up for the ECV. I don't want to traumatize anybody, but there were three people pushing on my belly trying to get that baby to turn and she didn't budge. She was there. I did have some lower amniotic fluid.Meagan: That can be a sign too if baby really, really, really isn't budging that's usually a sign that an ECV– and if it's extremely painful, sometimes the ECV just isn't going to be successful and sometimes we have to trust those little babes, right? There is a reason why. Jenny: Mhmm. Mhmm. I totally agree with you too. I even was mourning the loss this whole time because I so badly wanted to give birth just to experience it. I don't know. It's an innate woman thing. Men can't do it. It's something that I never experienced in my life. What else can we go through in our lives that you have to wait until you're an adult to feel? It was just this phenomenon. I was so curious about it and I wasn't even getting the opportunity. I was telling a nurse about it one day when I was getting a test done, “I just want the chance.” She was like, “Oh, honey. You don't want to ruin your cervix by pushing out a breech baby.” I was like, “Oh, so I would break myself?” I didn't say anything because at the time, I was this pushover. I was just like, “I'll do whatever,” but inside, I was dying. I just wanted the chance at everything. So I got to the point where I just walked into the OR with the MFM because she does five of them a day and I trusted her more than I trusted our small-town hospital. Jenny: The C-section was uneventful. It was really easy. We did the labor baby dance before we went in there and then I saw her come out of my belly and I was thinking, “I don't know this baby.” I felt disconnected but at the same time, I was overjoyed. I cried because they took her right over to the warmer. The anesthesiologist was right by my head and she was like, “Why are you crying? Are you okay? Are you in pain?” I was like, “No, that's my baby and I can't hold her and I'm right here.” The didn't tie me down. Nothing was traumatic. I was very prepared. Meagan: They just didn't bring her over. Jenny: No, I was separated. They were weighing her and laughing about how she was and I was trying to see her. Anyway, it's just not natural. I mean, it's just not how you want to have your baby. They did put her on my chest and everything was great. 10:22 Healing in different waysJenny: Fast forward six months, I was done with it. I was like, “Maybe we'll only have one. Maybe this will be it.” We weren't planning on having a baby anyway and we were just loving being in that baby nest. COVID started and talk about a crazy time. I definitely suffered a lot from postpartum anxiety. I had a lot of expectations maybe about motherhood and stuff. I really learned a lot. The transformation to motherhood is like a phoenix rising from the ashes as a total personality makeover. You're just coming out of this, “This is who I was and this is who I'm becoming and this is what I'm learning.” Kids really teach you that, don't they? They teach you how to fight for yourself and fight for them if you can't fight for yourself, and I just found that postpartum is harder than it should be. We don't have the support we have and it really, yeah. It made me go into a deep dive of what was going on with me. I started listening to The VBAC Link actually. I found it one day when I was listening to a “Birth Hour” podcast. It was six months and I was like, “You know, I'm just going to listen.” I was like, “I love this. I enjoy it,” but I couldn't relate to it anymore. I searched VBAC on Spotify and you were the first person that came up– you and Meagan at the time or, you and Julie. I was like, “This is me.” I could connect to all of the stories because women were sharing the same feelings that I felt and the same things so thank you so much. It was inspirational to feel like, “I can do this. I can do this again.” I remember even talking to the OB when she was stitching me up in the OR. I was like, “I can have a VBAC, right?”At the time, I wasn't really planning it or whatever and she was like, “I'm doing the double stitch, don't worry. You are a good candidate.” I was like, “Okay, that's cool.” It was so far out but just listening to the stories and knowing that I could do it, it was like, “I could do this again.” But I needed to listen for a long time to feel like I was ready and stuff. A lot of your episodes talked about working through past trauma so I started doing that. I started EMDR. I did pelvic floor physical therapy and I just want to talk about that for a minute because I cannot believe how ashamed I was to do it I guess maybe. I just want to say that really quick because I have a vaginismus and that's when your muscles involuntary close into your vagina and it's because of past trauma. So doing EMDR coupled with the pelvic floor physical therapy was really something that was so useful and I was so ashamed to do it because I've had it for years and I remember my GP suggesting it one time and I was like, “Absolutely not. I'm not having anybody touch me.” I just wasn't ready. Meagan: You're vulnerable. Jenny: It is. I was so ashamed and I don't know why. I was talking to my pelvic floor PT about it. It was the first session I had with her. I was like, “I was so ashamed and I'm ready now.” She was like, “I can tell you are ready.” It was so healing to go there and to work through some of that. While it never got better for me, I know how to work with my body now and that kind of comes into play with my vaginal birth because in a way, I was a little bit relieved. Sometimes when I thought about it, I was looking at the silver linings of the C-section. You just walk right in. I was also thinking that I wouldn't have to deal with this problem that I was really afraid of having. 14:16 Getting pregnant again and doing all of the VBAC prepJenny: So anyway, big plug for pelvic floor physical therapy. Since I had gestational diabetes, I read Lily Nichols' book. I just listened to the episode on her. She is amazing. I can't believe I didn't know about her before. I had heard her on another podcast and I just thought, “I need to read this book.” She is amazing. Meagan: Yeah. Jenny: There are so many amazing birth workers out there– her and Rebecca Dekker from the “Evidence-Based Birth Podcast” and the “Down to Birth Podcast”. All of those people taught me something very unique and special about birth. It's just this education, right? All of this knowledge and trust that we really have to get. We have to work through some of our things– traumas or whatever it is. Things that culturally have been accepted in our mind about birth and we get to this point where all of a sudden, I was excited. I was like, “Maybe I could do this again.” I did all of the things. I started eating eggs, Vitamin D, and magnesium and taking the protein supplement, the collagen powder. I even went non-toxic for my cosmetics and my house care. I started this. I heard this girl's birth story. Her name is Bae. She is from Australia. She does this whole program– Core and Floor Restore. I loved her birth episode. I listened to her. I went to her website. She has this whole program on how to help your pelvic floor and how to exercise post-birth. The way she talks to women in there, she is like, “Do you. You do you. Don't push it. Don't force something that you can't do. If you can't do this exercise right now, modify it so that you can.” It was just this education of how to trust your body, how to trust birth, how to–Meagan: Trust our minds, our hearts, and our gut. Jenny: Yes, that's part of it. Yeah, yeah. Anyway, all of this transformation got me to the point where I was like, “I have to be a doula.” It wasn't in the cards for me to be a birth doula even though I am a huge nerd. I have to have a scheduled life. Meagan: Maybe postpartum? Jenny: Yes. Yes. I was like, “I want to be a doula, but I will be a postpartum doula.” I actually really love helping women work through some of these things that were so transformational to me. Just overcoming some things that you didn't know about yourself but you are forced to face in motherhood, so I became a postpartum doula and it is incredible. I love it so much. Then I decided I was ready. I was ready to have this second baby. I was ready to have my VBAC and I did a deep dive into providers because that was what you told me to do. I needed to know if I could do this and so I went to my hometown hospital and I was like, “Hey. Can I have a VBAC here?” They were like, “Absolutely not. We will schedule you for a C-section at 39 weeks so that you don't go into spontaneous labor.” I was like, “Okay.” So I went to the midwife and I was like, “Hey, can I have a VBAC here?” She said, “Well, I could support you but I shouldn't. I don't have the resources. I would want to support you, but ultimately, I shouldn't.” So I was like, “Okay. Okay.” I was like, “I've already established myself at this big hospital over the mountains. I'm going to ask them.” I went to them and they were like, “Yeah, we'll support you.” They had this outlying hospital in the mountains. It is absolutely beautiful, these giant windows looking out over the Pacific Northwest and I'm telling you, I live in the best part of the country but it's really bad so don't move here. That's for anybody that's thinking about moving here because we like it being a small town. I had my heart set on this beautiful outlier hospital. I called them. I'm getting ahead of myself. I had a conversation with my husband after I found them. I was like, “Hey, we should have a second.” He was like, “I don't know. It's really hard. We're older now.” I was 35 at the time. He was actually 44. We have a pretty big age gap. We weren't going to do it in the first place so we had some big conversations. I was like, “Okay. Let's just try for 6 months and if it doesn't work out, it doesn't work out. It wasn't meant to be.” We have a really strong faith so we were just like, “Maybe we weren't meant to have it.” It was really fun actually trying instead of trying to prevent pregnancy. I had never been in that boat oddly enough having a baby and stuff. But it was really hard and I was trying to visualize conception. I was like, “It seems impossible how it all happens.” Meagan: Timing and everything. It's amazing. It's amazing. Jenny: It's incredible just visualizing it all. It's incredible how it can actually happen. At the time, I was thinking, “Man, it's not going to happen.” Five months went by and I was doing all of the testing. I was making sure and it was really fun to nerd out on this side of it beyond the total planning side of it. I love that part. Yeah. Finally, one day seven, six days after I ovulated, I felt all of this cramping and I was like, “Maybe this is the implantation.” I think five days after that, I tested and I had the tiniest, faintest line. I was like, “Holy crap.” I did not think it was going to happen. It was just so amazing. I kept it to myself all day. It was my little secret except I went in and told my little one. She was three at the time. I went over and I was like, “Hey, you're going to be a big sister.” She looked at me and I was like, “But keep it quiet for a day.” Meagan: Don't tell anybody. Jenny: I wanted to take the test the next day that said you are pregnant because I didn't want the same reaction from my husband the second time. I was like, “I'm going to give him the test that says, ‘You are pregnant'.” So I did. I did. I gave him the test and he was like, “Oh my goodness!” Actually, I had her give it to him the next day. It was so cool. It was just this sweet little moment. My age really concerned me. I thought I would be so chill because the first pregnancy was like, “Whatever, I didn't plan this. Whatever happens.” With the second one, I had the fear in me that my age was against me. His age is against me now.I spent more time than I wanted and I regret feeling not anxious but just disconnected. I was really afraid to connect to this pregnancy because I know a lot can happen in early pregnancy and I really want to say that to other people who might have the same feelings that you are not alone in feeling that way because it is really scary. I got to my 20-week ultrasound and I was holding my breath the whole time she was doing the test.  She was looking and looking. She was being really fast and really efficient. They actually asked us to leave the room and go wait out in the lobby for the doctor to come get you. I was like, “This doesn't sound good. I don't think this is right.” I was so anxious and the doctor just walked up to us casually in the lobby and was like, “Everything looks good. See you guys later.” Nothing was wrong. I started bawling and I could not stop sobbing for so long. I'm not really a crier either. It was the confirmation that everything is going to be okay and we did it. I can't believe it. It's so hard to get pregnant and then everything is going good and stuff. I was really excited about that. I was also really hyper-aware of her positioning because obviously, I had this past breech. So from 20 weeks on, I was legit obsessed with sitting upright, leaning forward. All the time, I was turning my chairs around. I was never reclining on my couch. Even in my car, I was sitting straight up. I was like, “I'm uncomfortable 100% of the time.” I was trying really hard not to have a breech baby because even at my 20-week ultrasound, they looked and were like, “Yeah, she's breech but anything can happen.” I was like, “I know, whatever.” 22:52 Gestational diabetes testJenny: I was doing all of the things, right? Spinning Babies, I was going to acupuncture. I was going to pelvic floor physical therapy, the chiropractor, all of it. I was chugging along. At 26 weeks, I get my gestational diabetes test. I talk to my midwife about it and she was like, “Yeah, we can just do the two-hour test because we know you had it last time. You might have it again this time.” I was like, “Okay. I think that's a good idea.” I didn't mention this before, but with my first test, my midwife wouldn't even let me retest. She just said, “You have diabetes.” It was just the one-hour screening. It's not a diagnostic, but I got the diagnosis from it anyway. I was like, “Why wouldn't you let me retest?” She said, “Your number, I just felt like you have diabetes.” I don't know. I was pretty upset about that. They wouldn't even let me try. I know other people who retest all the time and they are negative with the three-hour test. It didn't make sense to me. So anyway, I went into this one pretty informed. I was like, “Hey, I want the three-hour test. I want to know if I have it,” because if you have it, it's not a good thing and you really want to control it. My first one was diet-controlled. She ended up being 6 pounds, 9 ounces. Meagan: Little. Jenny: She was tiny and she was 39 and 6 when she was born. I wouldn't let them take her earlier than that even though they wanted to. I was like, “No.” They were like, “We won't let you go to 40.” I was like, “Okay. You can have her at 39 and 6 then.” I was so mad at them. Anyway, I digress. Jenny: Okay, so I did the two-hour test. I felt so sick. I was like, “For sure, I have it again.” I had been eating a gestational diabetes diet the whole time. I was like, “I'm just going to take care of my body.” I felt amazing taking care of my body like that so it's really kind of a blessing in disguise having it. I would not say that having been diagnosed with it the first time. I thought that I was a failure and whatever, but you're not. Meagan: No. It just happens. Jenny: Yeah, it happens. My mom has diabetes. I shouldn't be surprised, but I was healthy and I was thinking that it would never happen to me and it did. So anyway, I took the test and it turned out negative. I couldn't believe it so whatever Lily Nichols did in her book, I did all of the things that she told me to and it worked so I'm just going to give a shoutout to her. Thank you because you helped me have my VBAC and I couldn't be more grateful for just not having it because then I kind of ate whatever I wanted. It was great. I gained a little weight and it was really fun. It was the opposite of my first pregnancy. I was carefree and I had a lot more flexibility to do things I really wanted. Anyway, that was really cool. But also at my 26-week appointment, my midwife felt my belly and she was like, “You know, your baby is frank breech.” She was like, “I'm just saying that. There is obviously plenty of time for it to turn, but we want to see a head-down baby by 30-32 weeks.” I need to back up just for a second. I wasn't able to use the midwives that I wanted at that outlier hospital from the city because I chose to do a bloodless program and they don't support that even in the outlier hospital. It is only the ones in the city. It was an hour and a half drive through city traffic and a mountain pass. I was due in February and our mountain pass is no joke. It closes for multiple days during the winter a lot of times, so going that far was part of our conversation in having a second. I was like, “I'm not having a VBAC here in town. Can you drive me?” He was like, “I'm not scared. Let's do it.” That comes into play later, but it was a lot. I had to use the bloodless program in the city which meant traffic, snow, ice, all of it. They chose to support me which was great. I found them and I'm grateful that they were but they weren't the dream team as far as being really supportive. I would say they were tolerant of me being there. Meagan: Tolerant of you going for it but not super on board. Jenny: Yeah, exactly. They were like, “Yeah, this is great.” They weren't saying, “This is what we need to see.” They weren't saying, “You need to be in spontaneous labor by 39 weeks.” I was drilling them. I was doing all of the things. I was like, “What do you require of me? Can I go to 42 weeks? I want to know.” I had never felt a contraction before so it was honestly like, I knew I went to 40 with my first so I'm definitely going to go to that with my second at least I thought. I did all of the things to try and flip her obviously when they said that, but at 35 and 6, she was still breech. Actually, it was 34 weeks. I had even gone to acupuncture and felt her physically flip. She did the flip in my belly. I'm not joking. I felt her move the entire way down head down. I woke up in the morning and she was breech again. I was like, “Okay. She can do it. I know this baby can do it.” 27:59 Breech at 34 weeksJenny: I kept doing all of the things until 34 weeks which is when most babies are head down. I was like, “You know what? I've listened to enough podcasts and stuff to know that I needed to let some things go.” I regretted a lot about my first birth. I hoped until the last minute that I was walking into the OR that she was going to flip and she didn't. I was like, “You know what? I want to enjoy this pregnancy. I don't want to feel like I'm doing all of the inversions of my life.” I was doing headstands in my hot tub. I was doing everything and I was like, “I'm going to let this go.” I chose to let this go at 34 weeks and I was like, “I'm going to enjoy this whether I have a C-section or not even though I really want a VBAC.” My faith is a really big part of that because I was just praying, “I believe so much that our bodies are incredible and they were made for this.” And to not have the chance to even try is heartbreaking. It's sad that we don't have breech providers because these OBs are professionals. They are professional. They get trained for years in how to do this and that we don't even have a chance with them boggles my mind a little bit. Meagan: I know. Jenny: Anyway, I've heard a lot about just having the chance to experience what women are made to do and just feel. Even if it's hard and even if it's painful and whatever, I just wanted the chance. I found this renegade OB in a different city. He was willing to do this ECV on me because I heard he had a good success rate. I was like, “I'm going to do it again. I don't care. I'm just going to try.” At 35 and 6, I binged on the Evidence-Based Birth Podcast because she has a couple about VBAC and she has a couple of episodes about birth. I wanted all of the stats in my head. I was like, “They are not going to deny me this ECV because I have this scar on my uterus.” I was dead-set. I knew ACOG by this point. I walked in and I was like, “I'm going to do this. Let's do this.” He was like, “Okay. This girl knows her stuff,” because he was like, “I probably shouldn't do it because of the C-section.” I was like, “No, ACOG recommends that I am not a risk.” I knew and he was like, “Girl, you know your stuff. All right. You know the risks. Let's try it.” Meagan: That is so interesting that he was trying to scare you out of it but because you knew the stats, he was willing to do it, but if you didn't know the stats, what would have happened?Jenny: Right? I wonder and I don't think it's fair that women have to become experts in the field that's not our job. Our job is to grow this beautiful baby in bliss and instead, we've got to fight for everything, something that we should be able to do. 32:33 A head-down babyJenny: I get in there and he puts the ultrasound machine on my belly. As I was driving myself there, I was thinking, “Man, these kicks are weird.” They were fluttering up here and I was like, “That's so weird.” It was under my rib instead of down below. I thought, “That's really weird.” He put the ultrasound machine and he was looking right down where my cervix was because that's where he should see feet and he laughed and he was like, “That's a head. Your baby is head-down.” I was like, “No, it's not. I felt her head last night right under my ribs.” He was like, “No, her head has moved.” I poked, poked, poked and I was like, “Are you kidding me?!” I hit him and was like, “You're kidding me, right?” He was like, “No, girl. You've got a head down baby.” I was like, “I've never felt this before! I've never had a head down baby!”I was in my second pregnancy, 36 weeks along pretty much and I had never had a head-down baby so I just want to say to all of the breech mamas out there, it can happen and maybe it can't. I don't know. I was convinced that I grew breech babies at that point because I was pretty far along there. Anyway, so that was the biggest surprise of my whole pregnancy. At that point, I was like, “I've got to find a doula. I've got to take a birth class. I've got to do all of these things.” I had been holding out for this opportunity to have a chance and now I had it. It was the most incredible, freeing feeling. When I was driving home, I was just like, “I can't believe it!” I was yelling in the car. I called my sister right away, “I have a head down baby!” She was like, “Okay.” It's just not a big deal to people. It was just so thrilling to feel like I could get the chance. So anyway, I took this birth class that B does from Core and Floor Restore and she talks a lot about physiological birth in it and how the movements that we make and the sensations that we feel all help in this balancing act of getting our babies out. I was just like, “I've got to try. I've got to try. I need the chance. I'm getting the chance now and now I've got to try.” So I did all of the dates and I did all of the classes. At 39 weeks, I stopped work and I just lived it up. I was just laying around and I was just having a good old time with my baby girl. That was one day that I had and the next day, I put her down for a nap. 35:11 Traveling the mountain pass in a snowstormJenny: I was at 39 and 4. I told my baby as I put my toddler down for a nap, I was like, “You know, I'm ready. I'm ready to see you. I've got all my meals in the freezer. I've done the work. I feel good.” Meagan: You were prepared. Jenny: I'm a postpartum doula. I had my ducks in a row and then my girl was just starting to sleep and I felt my first contraction. I was like, “No. This cannot be happening. Are you kidding me?” I just laid there super still and I was like, “That was another one. It's happening.”I went to the bathroom and I had a little bit of my mucus plug and bloody show. I texted my doula right away like, “Oh my goodness.” She was like, “Oh, you know. Things are happening. Yeah.” I was like, “I know. I know. I need to go to sleep. I'm just going to go to sleep.” I looked at the pass because that was the biggest factor in what was happening. I looked. It was 2:00 in the afternoon. I looked at the pass and it said it was going to have 7-10 inches that night of snow. I was like, “Okay. Nothing is happening now, but maybe we should.” Our plan was to get over on the other side of the mountains in case it closed on us, we would be on that side. I was going to have this chance for VBAC no matter what. I texted my husband right away and I'm like, “Hey, I had a contraction. I've had several. I've got some stuff going on. Can you head home from work? He never responded.” 6:00 rolls around. My daughter got up. My contractions slowed just like they do when your toddler is awake. I was like, “Did you get my text?” He was like, “No, what?” I was like, “It's going to happen today. I've been having contractions. I feel it.” He was like, “Okay. I was like, “But the pass is starting to snow already up there and I think we've got to go. He was like, “Well, let's just see.” I was like, “Okay. All right. Let's do this. When she goes down for sleep, I bet it's going to pick up.”Sure enough, it did. 7:30 rolls around. I put her down and it started again just small contractions, but I felt it. He went to sleep and by midnight, I was having timeable 5-minute contractions trying to lay there. I was like, “I can't do this anymore. I've got to get up.” So I got up and I got in the shower. He came in and he was like, “Are you okay?” I was like, “I am having some pretty intense contractions. I cannot lay here.” He was like, “Okay.” We were just reading each other's minds at that point. We've been married so long and we were both thinking about the pass. What are we going to do? Who was going to come over at this point and see our kid? I was spiraling and I was like, “I'm going to get in the hot tub. I'm just going to get in the hot tub and slow these down. I know this is probably just prodromal so I'm going to get in the hot tub.”I get in the hot tub and I'm sitting there and it was the most beautiful night. The stars are out. The moon is out. The sun was not out. It was the middle of the night. It was 2:00 in the morning and I was sitting there. It was this surreal, beautiful moment. Having these contractions and the warm water, it was incredible. At that moment, I was so grateful to have the opportunity at this point. I had never gotten this far. It was so cool just to sit there. That was definitely one of the most beautiful moments of my labor. Jenny: Unfortunately, my contractions sped up in the hot tub instead of slowing down. Meagan: So they were real. Jenny: Which is good, they were real. I was thinking, “Oh gosh, what do we do?” They were 2-3 minutes apart by this point lasting over a minute. We called our midwife on the other side of the mountains and we were like, “Hey, this is happening I think.” She was like, “Do you think you can make it?” I was like, “I don't know, but we've got to try.” She was like, “But you pull over right away.” We knew where the hospitals were along the way. She was like, “If you feel like you are going to start pushing, you pull over right away and you call an ambulance.” I was like, “Okay.” We called somebody and woke them up in the middle of the night to come over and stay with our toddler and we started the trek over the mountains and it was insane. It was so insane, the snow. We were all over the place. There were semis in one lane and my husband was passing them on the other side. Just like I thought it would, my labor slowed down. It was a good thing because I was obviously in fear at that moment. I sat in the back. I sat backward. I put my TENS machine on and I was going to be in the zone. 39:43 Checking into the hospitalJenny: When we got there, they checked me and unfortunately, I was only 1 centimeter but I was 70% effaced. She was like, “It's real.” Meagan: Hey, that's good. Jenny: But it's prodromal. I was like, “Awesome. We just spent the whole night getting over here.” It was so crazy, but it felt really good to be on that side of the mountains at that point. That hurdle was overcome for us. We went to our relative's house that was close by. That was part of our plan and we just went to sleep. We just went there and tanked for the morning. I got a couple of hours of sleep. My contractions started to pick up again. She fed me some eggs and I threw them up right away. It was real. It was really happening. It was 2:00 in the afternoon. It started getting really intense. I got in the shower and the whole time, I was trying to stay on all fours. I was trying to lean forward. Part of B's birth class is getting all of that pressure forward and moving your body. It was so incredible. I lost so much more of my mucus plug that I didn't know was possible. I started having more and loose bowels and all of that. By the time my contractions were 4 minutes apart, we looked at traffic and it was insane rush-hour traffic, back-to-back. We called the midwife and she was like, “You'd better start making your way in here.” I was like, “Okay.” We got in the car and it took over a half-hour to get to what should have taken 15 minutes in bumper to bumper. It was so insane just sitting in the car. One of my friends who traveled to do her birth too, I asked her what she did in the car because I knew I was going to be in the car. She was like, “I concentrated on something. I found something to concentrate on and it helped me to cope.”I was like, “I'm going to time these and I'm going to use my TENS machine at the same time. I'm going to keep my mind distracted.” I also kept my birth affirmation cards in front of me and they were so helpful. I'm not one of those people who needs affirmations, but for some reason, telling my mind in that moment, “You're okay. You're safe. It's okay to do these things.” I had one that was a vortex. I don't know if that was on this podcast. I think it was where a girl was looking at this vortex and pictured herself opening. Anyway. It was so helpful. I felt like I was dilating. I really felt true movement at those moments. Of course, I was doing really slow, diaphragmatic breaths and trying to breathe through each one and stuff. Jenny: By the time we got to the hospital, my contractions were 2 minutes apart. They checked me and I was 5 centimeters and 100% effaced. Meagan: Yay!Jenny: I know. It was so wild. But my midwife wasn't on shift yet. They only had OBs. Anyway, they stuck me in triage and just left me on the monitor. It was so cool though. They worked with me. I was like, “I'm not sitting. I can't lay down. I have to keep moving and I have to keep swaying.” She was like, “Good. Let's put this on you and let's keep you in that position then.” She was like, “I think I can get a reading.” While they did have to do continuous fetal monitoring, it was okay. It really worked out. I was really worried about that. A lot of people talk about that and think it was one of the biggest hurdles, but it was really doable if you've got somebody who's going to work with you through it. My doula came and it started to become a blur. My husband started to read me my birth affirmations which was really kind of sweet because he is definitely not that way at all. One of them that came from the VBAC podcast was, “My vag is a waterslide.” I loved that one. We had such a good laugh because he was reading it to me. It was a really funny moment. Things were moving, man but we were stuck in that room for over 2 hours. It felt like 10 minutes to me because I was just in the zone. My doula tried to do a hip squeeze on me and I hated it but I couldn't even tell her because I was so in the zone. I could not verbalize at that moment. My nurse was moving super slowly. I think they were just stalling to get the midwives on staff.At 8:00, they finally moved me to my labor and delivery room. As I was walking by, the nurses were like, “Go, Jenny! You can do it!” It was so cool to hear them cheering me on and stuff. It felt like the victory line running towards the goal. It was really cool. I got in my room and it took her over 10 minutes to find her heartbeat. She was just sitting there trying to find it. I was almost like, “Maybe I should be worried,” but I was too in the zone. I was on all fours the whole time trying to move and just work with my body through it all. When she finally did it, she got the wireless monitors on me. I had been saying for 2 hours straight, “I just want the tub. Please give me the tub.” As soon as we got into that room, my doula went in. She drew the bath. She put the candles in there and all of the things. I was sitting on the bed just moving and I was like, “I've got to poop. I've got to poop. It's going to happen. I've got to go to the bathroom.” They were like, “Okay.” I walked away and I ran into the bathroom real quick. I was sitting on the toilet and I was thinking, “Man, this is insane. I feel like my body is just going to break apart. This is insane, the pressure.” It wasn't super painful, but it was but it wasn't. It's like pain with a purpose. Anyway, I was sitting on the toilet and I was like, “Man, nothing is coming out. This is crazy.” All of a sudden, another huge contraction hit and I jumped onto the floor and sat on all fours looking at the tub. It's right there. All the water was finally filled. I could get in after this contraction was over and my body started bearing down. 45:42 Fetal ejection reflexJenny: It's like I was throwing up from the back of my body. It was like down and out. It was like a feeling that I'd never felt before. It was so incredible. It was happening, the fetal ejection reflex and there was this new nurse next to me that was like, “You're pushing, huh.” I was like, “I'm not trying to but I think it's happening. I'm getting in the tub now.” She was like, “You're going to come back and get on the bed actually.” I was like, “No!” For 2 hours I had been begging for the tub and now I have to push. I was like, “I'm scared. I can't do it. I can't do this. It's all too much at this moment. I'm not ready.” Meagan: Yes. Jenny: I got on the bed. This new midwife just walks in. I had never seen her before. She locked eyes with me and she was like, “Let's do this.” I was like, “Okay, I guess we have to.” She checked me one last time. She was like, “You're 9.5 with a cervical lip, but I think it's time for you to start pushing.” I was like, “Okay. I can't help it. I'm pushing anyway.”I had this big contraction. I was still on all fours. They were trying to get the saline hep lock on me because they hadn't even done any of the things. I was GBS positive and they couldn't even get that in me fast enough. I had a contraction. I looked down and she was in my other arm because that vein had blown in that period of time. I was just like, “What is happening? It is so fast and crazy.” Labor land is such a blur, but at the same time, each time I came out of the contraction, people were like, “What do you want for this? What do you want for that? What's your preference?” I was like, “I want a physiological birth. That's all I know. I just want to do this. Let me do this.” Anyway, they had commented later that they don't normally see that in labor where the mom can verbalize what she wants but I had never met this midwife before and she was like, “I honestly don't know what your preferences are so I'm asking you now.” It was really nice that she was trying, but she was like, “With this next contraction, push.” I was like, “Okay.” I got on my hands and knees and I faced her which felt wrong and weird. She was like, “Okay, push.” I didn't because I was like, “I don't like this. This doesn't feel right to me.” But I couldn't say that. So then she was like, “Okay, with this next contraction, I want you to flip over on your back and I want you to push.” In my head, I'm like, “There is no way I'm going to do that. No,” but I couldn't say that.In the moment, I'm such a compliant person. I was like, “Okay, whatever. I'm just going to give her what she wants.” I flipped over on my back. She was like, “I want your knees up to your ears and I want you to bear down super hard.” I was like, “No, I know that's not right. None of that feels right.” I did and I didn't push at all. I was letting my body do its thing. I was just lying there for a second. She put her hand inside of me and she was like, “I want you to push here.” I was like, “I don't like that either.” As soon as I came out of that contraction, each one I was visualizing the wave coming up and cresting and coming back down. It was a really good visualization for me because I love the ocean. I came out of that and I was like, “I didn't like that. I want to do something different. Can you help me with that?” That's all I said to her. Meagan: I love that you said that. Jenny: It felt so good because I'm not normally somebody who stands up for myself, but I was like, “I want to do something different.” She was like, “Okay. Flip over on your side and hold your leg up and pop your knee out.” Do this crazy maneuver. Immediately, it felt right. It felt like the key in the hole locked into place. With that contraction, I pushed and she started crowning. 49:20 Pushing out baby and postpartum blood lossJenny: All I said with that contraction was, “There's so much pressure!” I was yelling it and yelling it. The contraction was over and instead of letting go, I held her there and clenched down so she would stay there and not go back up or anything because I could tell she moved right down and was right there. They were like, “Feel your baby's head!” I was like, “Okay, yeah. Whatever.” I tried to feel it. Meagan: Yeah, okay. Whatever. Jenny: Yeah, yeah. This is happening right now. I touched it and I was like, “Cool, okay. Yeah. There is a lot of pressure. I can't do this right now. I'm so scared.” At that moment, I was like, “The only way out is through. I have to push. I've got to do this.” With the next contraction, I just barely pushed and she just twisted and flew right out. It was insane, that feeling of a baby coming out of you. I just can't even describe it and I'm so grateful that I can describe it because it's incredible how we are made. I'm in awe. There are so many things that have to go right to get to that point. I am so grateful it did and I got to experience it. She came out right away and immediately, I was in business mode. I was like, “Is she breathing? Is she okay?” I was rubbing her down. People were kind of just hands off letting me do my thing. She started to crawl right up to my nipple. She did the breast crawl. It was all of the things that I wanted and never got with my first and it was so incredible to see this miracle happening right in front of me. I felt like I didn't do any of it. It was like it just happened almost. It was so incredible and unfortunately, I had a tear. She was looking at it and she had to go up and scrape some. I was trying to enjoy my baby at that point, but I was like, “Hey, can you just give me a Tylenol or something?” I hadn't had anything. She started to numb me and I felt all of that. I felt her stitching. I was like, “Can you give me some more of that because this really hurts?” I had an inside tear. After that, my nurse was kind of concerned that I was bleeding a lot, but my midwife wasn't. It was kind of weird. It almost seemed like nobody new my nurse or liked her. I think she was new. She was really slow so they were just like, “Yeah, it's fine. No big deal.” They were tracking my blood loss, but I got up to use the bathroom and at one point, she went out to fill my peri bottle and the water just wasn't getting warm. I was sitting for a long time on the toilet. I felt like a waterfall was just coming out of me. I was thinking, “I'm pretty sure this is normal. I don't know.” Anyway, she came back a minute later and she helped me go to the bathroom. I got back to bed and I was like, “Oh man, I don't know if I feel good.” They were like, “Okay, we're going to move you to your postpartum room.” I got in my wheelchair and I held my baby and I was like, “Hey guys, I think I'm gonna–” and then I passed out. When I woke up, I was having this cool dream and when I woke up, the whole room was filled with people who were all freaking out. My husband was looking at me. He told me later he was like, “I thought you were dying.” It was super traumatizing for him. I was holding the baby and they were trying to help me so they were all diving. He was diving for me with the nurse. Anyway, he was pretty upset having seen that and stuff. It turns out I had lost about half of my blood and they just hadn't been able to track it properly because they couldn't tell why I had passed out at first. They were like, “We don't understand. You didn't lose that much blood.” But they took the test. It came back. Meagan: Okay, this is interesting. This happened to me. Jenny: I know. I remember your birth story about it. Meagan: We still couldn't find it. Jenny: Yeah, isn't that crazy? Meagan: I still to this day don't know where it went. Jenny: I'm convinced mine was the waterfall in the toilet. I know that sounds so graphic. I'm sorry. Meagan: No, but that is a lot. Jenny: Yeah, it just felt like so much was coming out of me and nobody was there to document it. I was by myself. Meagan: Yeah, they were going to find the bottle. Jenny: Yeah, yeah. Meagan: Mhmm, interesting.Jenny: I know. It was crazy. Luckily, I was at a place that would help me with my preferences on blood loss and stuff so they worked with me really well. I'm so happy that there is alternative medicine out there so all of the rest of the people who can't take blood for whatever reason, it's available to them too. I'm grateful for that position and stuff. They work hard to help us in ways that maybe we don't think about. Meagan: I know. In some ways, I had regret that I didn't take the blood, but then I couldn't deny that my gut was telling me not to. It was just the weirdest. It was a disconnect. I still today don't know why. I've let it go and it's fine other than I'd be interested to know why, but we are just so grateful for those abilities to have those options. Jenny: Yeah. I'm really grateful I was where I was too because they were there within seconds to help me. It all turned out okay. I was fine. I was pretty weak and kind of gray for a little while, but I got a couple of iron infusions and that really helped. I was feeling like myself not as soon as I wanted. I was really hoping I felt a little bit better because you have the toddler at home and you want to do all of the things. I felt maybe disappointed in that regard of being so weak. The recovery was harder than I thought just with my tear and stuff too. I was surprised how hard it really was, so I'm really impressed by all those people who say that vaginal birth isn't that big of a deal. I've done both. My husband was like, “I really preferred the C-section honestly. The pass was open​​. We got to walk right in.” I was like, “Yeah, but it's just not the same.” Those moments.Meagan: There is something about it. There is definitely something about it. It's not to say that C-section can't be beautiful or amazing or healing even. My second C-section was completely healing, but yeah. There's something about it. There are no words but then there are so many words to describe it. Jenny: Mhmm, mhmm totally. I could talk about it all day. It's so exciting. Meagan: Well, oh my gosh. I'm so happy for you. I'm so glad you made it over the pass. I'm so glad that you were able to be there and even just find comfort even though you weren't super far progressed at first and that you were able to have this beautiful experience. I am sorry that you had these little hangups. It just goes to show that not every VBAC is perfect in every way just like every C-section isn't perfect in every way, but C-sections can be beautiful and so can VBAC. You just have to ultimately decide what is best for you. For you, you had that feeling and you were called to know what else your body could do. You knew it went through a really tough, tough birth with your first. Then you went through another tough birth, but an amazing one. One where, yeah. You were able to have that experience that you wanted. I'm so happy for you. Jenny: Thank you. Thank you for having us. Meagan: Oh my gosh. Absolutely. I'm so happy that you are here. 57:10 Jenny's advice for breech mamasMeagan: I did want to talk a little bit about breech. You said, “My baby turned. Maybe that's normal. Maybe it's not.” Yes, it can be normal and what breaks my heart is that so many people are left without an option. They are left without feeling like they could even try because we don't have those breech providers. They are few and far between. We love Dr. Berlin and the Informed Pregnancy Podcast and Informed Pregnancy Plus and Heads Up documentary and all of the things that they are providing because I feel like they are advocating. And Dr. Stu, they are advocating for breech birth that it is truly just a variation of normal. Anyway, if you have a breech birth, what would you give as advice for someone who's trying to figure out what to do? Do you have any that you would give?Jenny: Yeah, if they've tried all of the options because even the providers, I've talked to a couple of providers who do support breech birth and even they encourage you to try and get your baby to turn so if you haven't done all of the things, it's a good thing to try and do those things first. I mean, acupuncture, I couldn't believe how amazing that was. She wasn't moving a ton and then she flipped completely. So yeah, there's kind of something to that. Even though she didn't flip again until way later, yeah. I could still feel her moving a lot more during acupuncture than I did with any of the other treatments that I was going to. I was trying to see a Webster chiropractor and all of that too. There's a lot of things you can do to try and get your baby to turn, but I think trusting too is a huge one. Yeah, because I mean, I learned that a lot with my second birth too just to trust your body and if she's not turning or they are not turning, maybe there is a reason and to just go with that. Accept it. I am glad I tried to accept it sooner because maybe I relaxed more and she turned. Meagan: Hey, yes. Jenny: I wonder if that was part of it. I let it go. I really did. I just was like, “You know what? I'm going to listen to her. She's saying she wants to be breech. I'm just going to go with it and I'm not going to care anymore.” Then she turned. I don't know. Meagan: That's how my son was. It's kind of fun that we actually have some similarities here in our birth stories. But yeah, my son too. He kept flipping breech for whatever reason and we would flip him. My midwife would manually flip him and do an ECV, then I would feel those hiccups again up in my ribs. I'm like, “Dang it, he is breech again.” Jenny: That rascal. Meagan: Yes. I found myself very angry and I'm like, “If I have to have a third C-section because this baby is breech,” which I've never had a breech baby before, “I'm going to be ticked.” Then finally, my midwife said, “We have to. We have to trust him.” He flipped head down and stayed head down and it was all good. 1:00:22 Statistics on vaginal birth versus planned Cesarean for breechMeagan: I found a PubMed research paper on maternal and fetal risk of planned vaginal breech delivery versus planned C-section for term breech births. It shows that it was published in 2022 so just a couple of years ago. It goes through. It says, “The meta-analysis included 94,285 births with breech presentation.” Now, that's actually pretty decent. 94,000 births. It's also crazy to me to think that there were 95,285 people who had breech babies and it also just says that isn't that just a variation of normal? These babies are head up. I mean, 94,000 babies. But anyway, it shows the relative risk of perinatal mortality was 5.48 which had a 95% confidence interval. Sorry, 5.48 times higher in the vaginal delivery group compared to 4.12% for birth trauma and then the APGAR results show that the relative risk of 0.30% percent higher than a planned Cesarean group, so in the end which is kind of confusing I'm sure. I'm going to provide this in the show notes. It says, “In the end, the increment of risk of perinatal mortality, birth trauma, and APGAR lower than 7 was identified in a planned vaginal delivery.” We know that breech birth can become complicated. That's one of the reasons why a lot of these providers out there are just not willing to try. However, it says, “The risk of severe maternal morbidity because of complications of a planned C-section was slightly higher.”It's something to consider here where we are like, “Okay, well there is some birth trauma.” We know that sometimes we can have tissue tearing. We can have pelvic floor issues and trauma. We know that babies can come out a little stunned because of what happens when their body is delivered and their head is inside. And APGARS lower than 7 which is less ideal. However, even with a Cesarean, those rates were even slightly higher. In the end, we need to figure it out but what we need is more providers. We need more providers being trained and offered. They need to go to Dr. Stu's course. They need to listen to Heads Up. They need to get informed and offer people these options because just like Jenny and I, and even more Jenny than I, there is a lot of stress that goes into having a breech baby, and think about all of the things that you just said. If you had run out of options, meaning that you had done everything in your own power to try and help this baby flip and are now just relying on faith, which let me tell you, faith is amazing and we need to rely on faith all the time, but even then, if we are still at that roadblock, that is so hard. It's so stressful. I truly believe that we could lower Cesarean rates by a lot. I mean, even looking at these 94,000 people, we can lower that Cesarean by a lot if we just took one little step forward and offered breech birth again and trained providers. Jenny: I totally agree with you. I know. Just listening to all of the things I had to go through to get my VBAC, it could have all been prevented if I just had her, my first, vaginally. All of that stress and all of that, I wouldn't have had to do any of that. It could have just been normal. Instead, it's just this huge, stressful event and I can't say that enough because our lives are already stressful. Why should we stress more? Meagan: Yeah. I mean, it's 2024 which means that 24 years ago, breech birth started fading. We are really behind and it's something that breaks my heart to see if it's going to disappear. We can't let it disappear. We can't. Jenny: I agree. Meagan: Also, side note, if you listen to this episode and you know a provider who is willing to do breech, please message us at info@thevbaclink.com so we can get them on our list so we can help Women of Strength all over the world find a provider that may be willing to help with them. 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.Our Sponsors:* Check out Dr. Mom Butt Balm: drmombuttbalm.comSupport this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Pelotonia has changed Joe Apgar's life. “I'll never forget how I felt in the moment someone told me I had cancer,” the CEO of Pelotonia said in this episode. “You feel completely lost and by yourself and you don't have answers to the questions running around through your head.” Apgar was diagnosed with testicular cancer while a student at Penn State. Pelotonia is the fundraising cycling event that has raised more than $285 million for cancer research at the James. Apgar first rode in 2011, soon after he moved to Columbus to work for Rockbridge Capital, a private equity firm that sponsors a Pelotonia team Apgar helped create. “I remember standing at my first opening ceremony [of Pelotonia] and how uplifted and excited and supported I felt … that's when I could flip the switch on it and feel empowered by my own story and experience,” Apgar said of the start of his first ride and crossing the finish line. Apgar talked about his cancer journey, how he connected with a James physician for his follow-up cancer care, his Pelotonia experiences as a rider and leader, and the future of the event. Apgar also talked about the importance of the Pelotonia “community” and how it has helped connect members of the James team with riders, volunteers and donors. “I think [the Pelotonia founders] hoped that some of this sense of community would happen, but I don't think anyone could have dreamed it would happen at the scale it has,” he said.

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“Control what you can control.” Brooke's birth experiences have not been without challenges. She first had an extremely difficult miscarriage during COVID followed by intense bleeding due to massive subchorionic hemorrhages during her other two pregnancies. Her first delivery was a very traumatic C-section from not being completely anesthetized. After that, Brooke committed to doing everything in her power not to have that experience ever again and to do everything she could to avoid a C-section. Along with another subchorionic hemorrhage, her third pregnancy presented another challenge when she found out her baby had a bowel obstruction and would need surgery along with a NICU stay immediately after birth. Brooke was disheartened learning that she needed a medically necessary induction, but she was still committed to doing everything she could to achieve her VBAC. Her efforts to surround herself with a powerful team paid off. Everyone around her championed her VBAC. Brooke was able to go from the most traumatic birth imaginable to the most beautiful, empowering, and healing birth she literally dreamed about. Brooke's WebsiteInformed Pregnancy - code: vbaclink424Needed Website - code: vbac20How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 04:36 Review of the Week07:19 Brooke's first pregnancy11:18 Miscarriage15:01 Brooke's dream17:20 Second pregnancy21:26 Going into labor and getting admitted28:06 An extremely traumatic C-section32:53 Third pregnancy38:17 Bleeding again43:09 Finding a bowel obstruction in baby46:57 Switching providers the day before her scheduled induction50:57 Progressing to complete dilation54:54 Getting an epidural and pushing for three hours59:40 15 tips for birth1:04:22 Control what you can controlMeagan: Good morning, good afternoon, good evening– whatever time it is that you are listening to this episode, I hope that you are doing great. We are excited to get into another VBAC story today from our friend. Okay, so I'm trying to think. Remind me. Are you in North Carolina now or are you in New York City now?Brooke: No, I'm in North Carolina now, but the story starts in New York City. Meagan: The story starts in New York City. She's in North Carolina now. Her name is Brooke. Tell me a little bit more. You are an educator. You are helping kids read, right? Is this what I'm getting from your website? Brooke: Yes. Meagan: Okay, so tell us more about what you do. Brooke: I worked in New York City public schools for 10 years. I was a teacher, a literacy coach, and an administrator so I have experience both in the classroom and in school leadership. After we welcomed my daughter and after the pandemic, we moved to be closer to family in the Raleigh, North Carolina area and here I'm an education consultant. Meagan: Education consultant. Awesome. We will make sure to have your website linked for anyone listening. What type of people would want to go to your website? Brooke: I offer a number of services. The first thing that I do is pretty classic consulting in elementary school. I provide literacy support. My expertise is in pre-K through 3rd grade so early reading foundational skills. I help schools with their reading programs. But additionally, there's a big home school community in the Raleigh area. Meagan: I saw that on your website. Brooke: Yeah, I've had a really wonderful experience so far working with families getting set up on their homeschooling journey and supporting parents and caregivers in taking on the teacher role at home. Meagan: Awesome. Awesome. I think home school, especially since COVID has really taken off. I know a lot of people, some of my best friends in fact here in Utah even homeschool. It's a great resource. In addition to all of the amazing, great things you do, you have a VBAC story to share with us after a Cesarean that was performed pretty early, right?Brooke: Yeah, it was a pretty preterm and traumatic C-section. All VBAC stories start with a C-section so that's part of my journey. I'm so, so, so, so grateful. Thank you so much for welcoming me onto the show today. Putting this story out there, being on this podcast, and sharing my VBAC was part of my birth plan. It was on my vision board. It was a goal that I had set so I am just so, so, so grateful to have this opportunity to share that. Meagan: I'm really excited that you're going to dive in today. We talk about this a lot of the time with this podcast. Without these stories, without women of strength just like you, we wouldn't even have a podcast. I mean, probably I could get some content for sure but I think these stories are what makes this podcast. I'm so excited to dive in in just a moment. 04:36 Review of the WeekMeagan: I do have a Review of the Week. This is a review that actually was just given this year in 2024, the current year that we are recording. It's from a Bailee Atkins. She actually emailed us in a review. If you guys didn't know, you can email in us a review. It makes our hearts smile so big when we open up our email in the morning and we get these amazing reviews letting us know that everything that we are doing right here is helping, is inspiring, and encouraging, and educating.This says, “I just want to start off by saying I am OBSESSED with this podcast. I'm a labor and delivery nurse of four years, currently 29 weeks pregnant with my second baby. I'm praying for a redemptive VBAC this April. I absolutely love this resource for evidence-based information. Being that I am at the bedside as a nurse, I have plenty of knowledge. However, I don't have the experience of home birth or a birth center birth, so it's great to get all of the insight. I can't escape negative birth situations and stories as a pregnant nurse so this podcast is often my escape and positive note for the day. I've been listening since 2022 and couldn't feel more empowered for this VBAC. It is my dream to be on the podcast one day, so be on the lookout.” Okay, I love that. This is being aired probably after her due date. I mean, I don't know when her due date was, sometime in April, but we are now in May, so Bailee Atkins, if you are still listening, if you haven't already, email us and let us know how it goes and we would love to have you on the podcast. 07:19 Brooke's first pregnancyMeagan: Okay, cute Brooke. I am so excited to hear your stories. You also have a miscarriage story, too. Is that where this all began? Brooke: This is where it all began. I'm glad you brought it up because I did want to just say at first that my story– I just want to put a note out there to any listeners who are kind of sensitive. My story does include loss and a lot of medical trauma so I just want to put that on the listeners' radar. Meagan: Yeah. I think that's important. I know some people don't feel like they need any trigger warnings, but when you've gone through loss or medical trauma or things like that and it hasn't completely been worked through or processed or anything like that, and even if it has, it can be really triggering so we just wanted to make sure to mention that. It also is your story and I think that's also really important to share. Brooke: Yeah, so thank you for that. It was actually four years ago this week at the time of this recording. This is a really lovely way to kind of just close that chapter. It just is all working out beautifully.I'll set the scene. It's December of 2019. The world is still turning. Things are great. I'm at a New Year's party in Brooklyn. I'm just thriving. I had just come back from a great backpacking trip with my husband for the summer across Asia. Life was– we were on a high. Meagan: Wow, super exciting things happening. Brooke: Yeah. It was great. It was a great time. We call it the great grand finale. We are at this New Year's party in Brooklyn and I go to pour myself some champagne and I think, “Maybe I shouldn't. I think I could be pregnant.” I'm like, “No, no, no. Whatever.” Anyway, I take it easy. We go home early. A couple of weeks later, I'm so ill. I am so sick. I have the worst cough and cold situation I've ever had in my life. My boss at the school was like, “You need to go to the doctor. This has been too long.” I go to the doctor and I'm at urgent care. It's a Saturday morning and they're like, “Oh, we need to do some x-rays. We think you might have pneumonia. Is there any chance you might be pregnant?” I was like, “Oh my gosh, yeah. I didn't drink at that New Year's party. That was two weeks ago. I can't take this x-ray.” I go to the store. I pick up a pregnancy test. I go home. I take it. It's positive. I'm over the moon. This is the happiest moment of my life up to this point. My husband gets home. We are jumping up and down. We are so excited. Everything is smooth sailing. Everything is great. I immediately start getting sick and I'm breaking out. I just feel awful. I was complaining. As this pregnancy is progressing, the world is really starting to get a little bit of that pre-COVID hysteria. It's just starting. Meagan: Yeah. Especially in New York. Brooke: Yeah, right? I'm in New York City at this time. I go to the doctor. My husband is still allowed to come with me and things like that. This is the time before. We see the baby. Everything is normal. We go back again. We see the baby. Everything is normal. My doctor offered the NIPT genetic testing and I was like, “Yeah, let's do it.” We took the blood sample. I think I was about 10 weeks at that point. We got the results 7-10 days later in that window and it was inconclusive. The doctor was like, “It says there's not enough fetal DNA. We might have just taken it too early. This happens sometimes. Nothing to worry about.” I was like, “Okay, nothing to worry about.” 11:18 MiscarriageBrooke: It was maybe week 11 and I had miraculously felt better. I was like, “Phew. I don't have any more symptoms.” I'm there at the end of the first trimester and everything is fine. I go in. It was March 9th. It was a Monday. I had my nuchal translucency 12-week scan then and I was going to be 13 weeks the following day on Tuesday. It's Monday. I wake up. I'm getting ready for work and I start bleeding. It's just spotting. I call my doctor. She's like, “Spotting can be normal. I wouldn't stress about it just yet. You have an appointment later today.” I was like, “Okay.” I tried not to worry about it, but as the day went on, the bleeding got really bad. Really bad. I got in a cab and I called my husband who was at his last day of work at the job he was at. I was like, “You need to leave right now and meet me at the doctor's appointment. I know it's not until 3:00 but I'm going now.” It was around 1:00. I showed up at the hospital early and went in for my scan. I was like, “I'm bleeding. I can't wait 3 hours. Can you just take me now?” I was so shaken. Meagan: Yeah, that's a lot. Brooke: I was so scared. This is March 9th. People are masked. Everybody is a little bit scared of the hospitals because in New York, things had been happening at this point but nothing was closed down yet. I went into the room. A doctor I had never seen before because this was my first MFM visit does the scan and she comes in. She's like, “The baby isn't growing.” My husband is there with me and he's immediately crying. I'm just not computing. I'm like, “Okay, so does that mean he's going to have delays? What does this mean?”She's like, “No, there's no heartbeat.” I was like, “Okay, so what can we do about that?” I was just not understanding what she was very delicately trying to explain to me. I was like, “What do you mean he's not going to grow anymore? What does that mean? Is he going to have defects?” She was like, “No. The baby stopped growing 3 weeks ago somewhere between 9 and 10 weeks. You are 13 weeks now. We need to do a D&C.”It was like I was in a whirlpool. I had no idea what was going on. I just became a complete zombie. I just moved through the next two days just absolutely devastated like catatonic. It was the worst grief I had ever known. It was just so surprising. She was like, “You had a missed miscarriage” which I had never heard of to that point. I was like, “What does that mean?” Meagan: What does missed miscarriage actually mean? Brooke: Another term for it is a silent miscarriage. It is when the baby's heart stops when you have a miscarriage, but your body continues to grow. Your body grows. You still have symptoms. Your body doesn't recognize that the baby is not growing anymore and isn't viable anymore and doesn't properly miscarry. It was several weeks later before I started to bleed. It was that day. I didn't know. In retrospect, it's like that's why the NIPT came back the way it did. That's why my symptoms stopped. Those things on their own, in my first pregnancy, I didn't understand. 15:01 Brooke's dreamBrooke: On the 11th, we had the D&C that Wednesday and on Friday, March 13th, New York City shut down. I came out of this procedure just so sad and then was basically locked in my house for a year. My husband and I were grieving in total isolation. It was just a really tough time. Typically, after a procedure like that, you would go in for a follow-up appointment several weeks later and the doctor would make sure everything was okay. But because it was only emergencies in the hospitals at that time, my doctor just emailed. She was like, “Let me know if you have these symptoms and then I'll see you, but otherwise it's safer for you not to come in and you can get pregnant now.” In retrospect, I think she meant you can, not necessarily that you should but I was like, “Okay. I can get pregnant again.” This is maybe a little too much for some people, but I was crying myself to sleep just so, so, so sad and I was like, “I want my baby. I just need to know that it's going to be okay.” I went to sleep and I had the strangest dream that I watched myself through a snowy window of a nurse handing me a baby girl in a pink blanket and then I didn't see her, myself in the hospital bed didn't see her, but through the window, I watched the nurse also take a baby boy and lay him next to me. He was asleep. Meagan: That just gave me the chills. Brooke: Yeah, I'm happy. I'm holding a baby girl. I woke up and I just felt okay. Two weeks later, I found out I was pregnant again. The whole time, I was like, “It's a girl. It's a girl. It's obviously a girl,” and it was. I just knew right from the outset that I was having a baby girl. 17:20 Second pregnancyBrooke: I tested positive at 4 weeks. At 5 weeks, I started bleeding and this time, I was angry. I was like, “What is wrong? Why am I miscarrying again?” I go to the doctor and my OB who is amazing, my New York City OB took such incredible care of me. She is just really an all-star doctor. She was like, “I don't know why you are bleeding so much, but the baby is fine. They are still in there.” I went back a week later. The bleeding never stopped. When I say bleeding, I mean I'm passing clots the size of golf balls. Meagan: Whoa. Brooke: At 7 weeks, I went in. At this point, my OB was like, “I don't know what's going on. I don't understand why you are bleeding so much, but the baby seems fine.” Meagan: There's no placental tear? Brooke: No. Meagan: Subchorionic? Nothing? Brooke: At this point, they didn't know what it was. They did find out. I got on the table and I was like, “I'm really bleeding a lot.” She was like, “Okay.” She put me on the table and she was like, “Oh my goodness. It literally looks like you've been shot. There's so much blood just everywhere.” I mean, I'm not a doctor obviously, but I was like, I don't know how I can go on with this much blood loss. It was really extreme. Then the psychological impact of all of that bleeding when I've just had loss. The world's not turning. I'm locked in my house other than going to the hospital. There are field hospitals everywhere. I can see them from the window. It is really just apocalyptic. We go through the next several weeks. I go to the MFM. They diagnose a very, very large subchorionic hemorrhage. It was three times the size of my daughter. They were like, “We don't know if she's going to be able to sustain this much blood loss and there's really nothing we can do to stop it.” They were like, “There's not a lot of research on this kind of thing. We don't know how it's going to go. We'll just keep seeing you once or twice a week, making sure you're not losing too much blood and make sure the baby is still okay.” The whole pregnancy, she was totally fine. I bled and I bled and I bled. I was on total bed rest because any walking I did at all just aggravated it and caused more bleeding. I was so scared of that. I was really, totally isolated. It was very tough emotionally and physically, but my doctor took excellent care of me, helped me find mental health resources, and helped me to get a prenatal nutritionist just to really give me well-rounded care throughout the pregnancy. Brooke: By 24 weeks, it went away. Prayers were answered and the hemorrhage went away. Meagan: Halfway through the pregnancy. Brooke: Yep, by 24 weeks, it was gone. I didn't have any new bleeding although I was still bleeding, but it wasn't the full hemorrhage bleeding that I had been experiencing up until that point.I took it easy until 36 weeks when I was like, “I need to start walking and moving. I've been in bed this whole pregnancy. I know that's not good.” I'm usually a very active person, so I was a little anxious about that. Around 36 weeks, we started taking the daily hot chocolate walk. We would walk to a different spot and we would get a hot chocolate. It's winter time now. It's December. It's Christmas. We were just relaxing and then on January 15th, it was snowing in New York City. I was 38 weeks and 6 days and I went into labor. 21:26 Going into labor and getting admittedBrooke: I woke up at 3:00 in the morning and I was like, “I'm in labor.” I was so excited. It was happening. I labored at home for 14 hours and then we went into the hospital. The traffic was so bad from the snow that I ended up walking down 5th Avenue for 10 blocks because we were in gridlock. I was like, “I'm in labor!” I was nowhere near ready to go to the hospital but I didn't know. I went to the hospital way too early. Classic C-section red flag right there, but I didn't know. I got there and my doctor happened to be on call. I was so excited because she was just incredible. We had such a good relationship after the care she had given me throughout both of these pregnancies and I was just so excited. But then she left. She had me in triage. I was only 2 centimeters. She was like, “I think you should go home.” Meagan: You're like, “I just walked blocks to get here.” Brooke: I was like, “I can't.”She was like, “It's probably going to be another 12 hours until you really need to be here.” I was like, “I can't come back at 3:00 in the morning tomorrow.” I was so anxious. My anxiety from what I had been through, I was like, “There's no way I'm going home.” She was like, “I'll push it. We'll admit you now.” She was catering to my emotional and mental needs to have this baby monitored. I was so scared. Brooke: I get admitted. By the time I get upstairs, my poor husband is not admitted at this point. He's outside in the snow just walking around Central Park. Not until I'm in my room is he allowed to join me because he had to be tested for COVID and all of that. This is January 2021. Now, mind you, two days before that, I think the 14th was one of the worst days of COVID that we'd had up to that point in New York City. That is what everybody is focused on in the medical world. They're not like, “This routine birth. This girl is in labor. She's 39 weeks tomorrow.” Nobody's stressed. I get the epidural. By that time, I'm 5 centimeters. Two hours later, my water broke. I was at 8 centimeters. It's 7:00 PM. I'm 8 centimeters. I'm like, “This is happening.” Everything is smooth. I go to sleep. I keep telling everybody that the epidural is not working. I can feel the epidural on the right side of my body. The nurses moved me around, trying to get the medicine to other places, they had me just lying this way, laying that way, but I got up. Never walked around. Didn't get in any other position other than my back or my side. I went to sleep. I woke up in the morning and was still 8 centimeters. I had stalled out and now, everybody is starting to worry. The doctor who was on call, my doctor, who left after I was in triage, was someone I had never met. I have lots of friends who she delivered their babies and they had great experiences with her, so I'm sure she is absolutely wonderful, but I didn't know her and I felt really unsafe. She seemed very busy every time she came in and I was very anxious at this point. I was like, “I thought I was going to have this baby yesterday. What is going on?” My angel of a nurse just was so reassuring that whole time, but I kept telling her, “I don't think this epidural is working.” She was like, “Well, this is the max that you can have. Let's give you more Pitocin to get those contractions to kick in so we can get you all the way.” More epidural, more Pitocin. More epidural, more Pitocin. The cascade of interventions. This is all for a labor that I went into spontaneously. It's 39 weeks now. I'm full-term. My nurse goes on lunch break. It's now Saturday the 16th. My nurse went on lunch break and another nurse came in, someone I didn't know which is a theme throughout my whole VBAC journey. I really liked to know my provider. Meagan: That's an important thing, by the way, to know. It doesn't happen as much anymore, but to know who is going to be with you is very common to want that. It was for me. Brooke: It was not something that I thought I would care about, but at the moment, it was something I really needed. So this nurse I didn't know came in and took my temperature and was like, “Oh no. You have a fever. This is bad. I'm going to get the doctor. She's going to operate.” I was like, “What are you talking about I have a fever. What?” The OB comes in. She's washing her hands. She's putting on the fresh gloves. She's doing it. She just came out of C-section. She was like, “You have a fever? You've been at 8 centimeters for how long? All right. We're going to the OR.” I just immediately start hysterically crying. I was terrified. My nurse is back and she was like, “It's okay. Look. Your baby is perfect. She's not in distress. Everything is okay. It's just taking too long. You have this fever. We don't want the baby to get sick. This is the best thing.” The OB was like, “Why are you crying? Everything is fine.” Meagan: Oh my gosh. Brooke: My husband was like, “You know, she's been through a lot with the loss and the hemorrhage. We are scared.” The doctor was like, “What hemorrhage? What are you talking about? This wasn't your first pregnancy?” I felt in that moment like she didn't know me like she didn't know my case and I felt really unsafe. She's a great doctor and she knew what she was doing, but I felt nothing. Meagan: She wasn't really talking to you. She was telling you what you were going to do, not talking. Brooke: Exactly. In retrospect, I can appreciate that they are in the middle of a pandemic and it was truly unprecedented. I understand now where she was, but it was not good for me. 28:06 An extremely traumatic C-sectionBrooke: I go back into the OR and I'm sure all of the listeners are familiar with this moment where you are being prepped for surgery and it's really overwhelming. I was like, “Oh my gosh. I hope my husband is not in here right now.” I couldn't see. You're just staring up at the lights. I was like, “I hope he's not in here right now seeing this.” They bring him in and I'm prepped for surgery and they are testing where they are about to perform this surgery. I was like, “That really hurts.” They were like, “No, no, no. It's just pressure.” I was like, “No, it's pressure on the left side of my body, but it's pain on the right. I am telling you as I have been telling you since I was 5 centimeters yesterday, that the epidural is not reaching the right half of my body.” They were like, “Okay. Here is some pain medication through your IV, but we've got to do what we've got to do.” Meagan: Oh my gosh. Brooke: I think it was extremely traumatic for my husband also because I was screaming through my whole C-section. I was in extreme agony. I'll liken it to when you watch a Civil War movie and you're watching an amputee. I was being operated on and was not fully anesthetized. It was the worst thing I have ever experienced or could really imagine physically. It was excruciating. My daughter was born and they said, “The baby is out.” That was maybe the longest moment of my life because she didn't cry. The first thing I ever said. The first words my daughter ever heard me say were, “Is she alive?” I was like, the baby is out but she's not crying. They were like, “Yeah.” She cried. They did the suction and she cried. 100% healthy, perfect APGAR scores, everything was fine, but all the while, I'm just screaming. After they checked her, they handed her to my husband and they made him leave. He was down the hall taking the baby to where I would ultimately meet them in postpartum, but he could hear me screaming all the way down. Meagan: Oh, so traumatic for both of you. Brooke: Yeah, it was horrible, to say the least. I hate saying that because it was my daughter's birth and so amazing for so many other reasons, but my experience was bad. Bad. I was thankfully able to nurse her really well and hold her and everything from then on was just totally smooth sailing. She was perfectly healthy, but I knew immediately that I never wanted to have another C-section. Brooke: The next morning, they were doing their rounds in recovery, and the anesthesiologist who was there, not my anesthesiologist, someone I hadn't seen before. My husband and I were like, “Will this happen again? If I were to have another baby, would this happen again? What's wrong with me?” He was like, “Well, I'm not sure, but you probably have a window in your spine and yeah, this would happen with any epidural so I wouldn't recommend it in the future. We'd have to go a different anesthesia route for a different C-section or you would have to give birth unmedicated.” That was the story in my head moving forward. After that, I was like, “I'm not having another C-section,” so in my head, it was like, “I'm going to have an unmedicated VBAC in the future.” That was day one. To process all of that trauma, I started listening to VBAC podcasts. I just was listening to VBAC stories because that was really the only place where I was hearing C-section stories. I had so many friends who had C-sections before me and I didn't understand how horrible that recovery can be for some people. Mind you, lots of my friends had great C-section experiences, but I did not and it really took a lot of work to process that. At my postpartum visit, I was back with my doctor and she was like, “You know if you do decide to get pregnant again, we will do an anesthesia consult and really explore that and make sure that that never happens to you again.” Life goes on. I'm raising my daughter. We're in New York. We decide to move to North Carolina to be with family and to try again for another baby. We're in our new house and I don't really know anybody here beyond some family. 32:53 Third pregnancyBrooke: I found out that I'm expecting again and we are so excited, but there is obviously a lot of anxiety after everything that I went through. I was like, “This time around, I need a doula.” I was like, “We're in a different time. It's not New York at the height of a pandemic. I need a team. I know now after 2 years of listening to VBAC stories what I need to do. I'm going to control every single thing I can control so that this will go how I want it to go.” I made a vision board about it. I looked at it on my desk all the time. I was like, “These are the things I need to be doing every day to hit this goal.” Sharing my successful VBAC on a podcast was on that, so I am really excited to be able to do this today. Brooke: The first thing that I did was hire a doula, but I didn't know any doulas and I knew that I wanted one who would really support a VBAC that had experience with the emotional elements of it. I interviewed several doulas with that in mind, but what I did that I would definitely urge listeners to do if they don't have a supportive provider is I asked every doula that I interviewed if they knew of or could recommend or had worked with in the past any VBAC-supportive OBs. I knew for me and my anxiety given the complications that I had with the hemorrhage and the loss that I wasn't going to go the midwife/birth center route. I knew that I would want an obstetrician. I was looking for a hospital provider that would be VBAC-supportive. Every doula I interviewed recommended the same practice and the same hospital. I was like, “That's where I need to go because if all of the doulas are recommending this practice, that's where I need to try and get in.” I was relieved to find out that they delivered at WakeMed Raleigh and I say that because it's important to note that it is one of the lowest C-section rates in the country, that hospital. That alone was really reassuring to me because I was like, “They are not going to do it just because it's taking too long.” It's really going to be based on that medical evidence. If I need to have one medically, then that's what we have to do, but I wanted to make sure that it wasn't the result of interventions or stalling. I don't know if I had done things differently if my C-section would have or wouldn't have happened, but I know that I didn't set myself up for success. This time around, I was really determined to do it. I got a doula. I got a supportive provider. Through my doula, I did childbirth education classes. They recommended Spinning Babies and yoga. I did that. They recommended a Webster-certified chiropractor and I did that. All things really stemmed from my doula and the doula group that she was with. I cannot recommend that enough. I know getting a doula can sometimes be cost-prohibitive, but there are so many doulas on Instagram that share a lot of this information on social media that just following those recommendations, I tried it all. I really did. I drank the tea. I ate the dates, but early in this pregnancy, I hadn't even hired a doula yet. 38:17 Bleeding againBrooke: 6 weeks, I started bleeding again. I was like, “You've got to be kidding me.” I wasn't as scared because I had just been through my daughter's pregnancy and I was like, “This just must be the way that I am.” So I go and I get an appointment with this practice because I knew right away that that was where I wanted to go. They took me even though I was a new patient. They took me right away even though I was 6 weeks because I was bleeding. I don't think all practices bend the rules that much. Their policy is, “Oh, don't come in until 9 weeks,” but they took me. I really appreciated that. I loved the staff. They were like, “Yeah, we don't know why you are bleeding.” I said, “Well, I do. I'm telling you right now that it's a subchorionic hemorrhage.” They were like, “We don't say anything.” I was like, “You will.” Pregnancy was pretty routine after that. The bleeding stopped. I didn't worry too much and then I took my daughter to a museum at 12 weeks, 5 days which if you recall is just about to the day and the time of my loss. It was 12 weeks and 6 weeks when I started bleeding. I had a huge bleed. I mean, bad. I was like, “How could it be that I am miscarrying on the same day?” I was like, “This is crazy.” We went to the ER because it was nighttime and I was like, “I just have to know if there is a heartbeat.” The ER checked and it was incredible too because I could feel that the doctors were nervous for me and then I felt their relief telling me that there was a heartbeat. They were like, “We don't often get to give good news in the ER and we are just so happy to tell you that your baby is fine and you have a subchorionic hemorrhage.” I was like, “Knew it.” I continued to bleed for a few days. They were like, “Do you want to do bloodwork and see if there's anything else?” I was like, “No. That's what's happening. I don't need to stay for bloodwork. This is what it is. I've just got to ride it out and take it easy,” which is tough with a toddler, but I did my best. The bleeding stopped and everything was fine. The rest of my pregnancy was great. I had that second-trimester glow and it's sunny North Carolina. I'm with my family. I've made some friends. Things are going smoothly. Then at my 24-week appointment, I said to one of the OBs there that I was feeling pretty anxious. I was like, “I'm a little bit nervous just because I did hemorrhage this pregnancy. I hemorrhaged all last pregnancy. I don't feel okay with this being my last ultrasound until delivery. Can we just put  a growth scan on the chart?”She was like, “Of course. You need to feel comfortable.” I appreciated that. She didn't have a medical reason to do it, but she was like, “You're right. You've been high risk. Let's go ahead.” At 30 weeks, it was the night before my appointment and I had the strangest dream. I had a dream that I had the most amazing birth. My doula was there. I was standing up. I pulled my son from my own body. It was this redemptive, joyous dream. I felt this happiness. Then all of a sudden, it went dark and everything was dark. I was walking around an auditorium, a dimly lit auditorium with a bunch of empty bassinets. I was looking for my baby. I wasn't scared, but I was a little bit nervous walking around there, then all of a sudden, the nurse handed him to me and they were like, “Here he is.” I was like, “Where has he been all this time?” She was like, “Oh, he's been with us, but he's fine. You can go home.” I was like, “Okay.” Then I woke up. I went on with my day and I was like, “That was a weird dream.”I went to my 30-week scan and mind you, I had been put on there because of my advocating for myself. I looked at the ultrasound. It was just me and the tech in the room and I said, “What the F is that?” I had seen through weekly ultrasounds my entire pregnancy with my daughter. I'm not a tech, but I have a lot of experience as a mom looking at ultrasounds and I was like, “This is not normal.” His belly looked like sausage links. It was like nothing I'd ever seen before and the tech was like, “I need to go get the doctor.” 43:09 Finding a bowel obstruction in babyBrooke: She brought in another doctor at the practice. This is a big practice with lots of different OBs, all of whom were wonderful. This doctor who this was my first time meeting was just so sweet as she told me that my baby had a bowel obstruction and that he would need to have surgery and stay in the NICU for a while when he was born and that it was really likely that I was going to have to deliver him prematurely.I immediately became hysterical. She was so sweet. She asked if she could hug me. I was like, “Please.” It was just the most incredible practice of doctors. I felt just really supported by them. She sent me to the MFM where I had to get an ultrasound at least once a week. They did the antenatal screening there to check his intestines every few days because they wanted to make sure that they were balancing the risk of letting me go as close to term as possible while not risking his intestines bursting basically. Meagan: Right. Brooke: This was very scary again so I was like, “Oh my gosh. What is going on with me?” I go through with the rest of the pregnancy. I did have polyhydramnios because he is not passing fluid as he's supposed to be. It's all getting stuck where this obstruction is. But because it's a picture of a belly inside a belly and your intestines are so long, you can't see through ultrasound where the block is. There were five causes that they were going through. They weren't sure where this block was or if it was part of a larger disease or if this would cause lifelong issues. There were so many questions, but I just was like, “Listen. I had a dream with my daughter that I would have a baby girl in the snow and I did. I just have to trust that this baby is going to be fine too and I'm going to take it home too.” I'm going to have that VBAC and at every single appointment, once or twice a week, I ask, “Does this impact my ability to have a VBAC?” He was like, “No. It has nothing to do with pregnancy and delivery. That's going to be what it is. You make those choices based on your history. It's just that when the baby is born, you will have to have a huge team out there. The NICU team has to be there. Pediatric surgery needs to be there. You're going to have to give birth with 15-20 people in the room.” I was like, “There goes my unmedicated, serene vision with no epidural, no medical intervention, beautiful hospital birth in a dimly lit room with the candles. No.” All that planning is out the window. It's gone. I can't have that experience. So I'm like, “I have to control what I can control. The MFM is saying I can still do it. I'm still going for it.” So then at just before 37 weeks, they were like, “Okay, it's time. We need to get him out and get this surgery underway.” They were like, “He's doing well. You're doing well. Let's have an induction.” For a VBAC, being induced, I was like, “Oh no. This feels just like a death sentence to my VBAC plans, but this is what we have to do.” 46:57 Switching providers the day before her scheduled inductionBrooke: I'm meeting with one of the OBs and it's the day before my scheduled induction. This is on Monday. I like this OB a lot. We've worked together in the past. She's been great and supportive, nothing bad to say about her. But we were talking about my induction which was going to take place and I asked her a question about Pitocin. I just asked a question because I didn't know. Her response was along the lines of, “With all due respect, you need to let the nurses do their job. You're not trained in Pitocin and you need to let them do that.” Right then, I was like, “Mm-mm.” Medically, she's right. Would she have delivered my baby safely? Almost certainly, but I knew right then that was not the energy that I needed in the room. I felt immediately like I shouldn't have asked the question and I was like, “I can't feel like that this time.” I didn't ask any questions at my daughter's birth. I just went along with it. I was blind and this time, I need to be with a provider that I feel like I can ask anything and that I will get an answer. So I emailed the MFM and said, “Do you think it's safe if I push the induction a few days? I'm not comfortable with the plans we have right now. I want to give my baby and my body a few more days. What's the last possible day I can push this to?” He was like, “I'll let you go 72 more hours, but I really think we've got to get this moving.” I messaged the doctor I felt the most comfortable with in the practice and I was like, “Listen. I really want to have my baby with you. I just feel the most comfortable with you. You had mentioned you were going to be on-call that day.” I didn't do it because I wanted to do it sooner so I had scheduled it with a different doctor, but he was like, “Let me see what I can do. I have a full load that day, but let me call the hospital and see what I can do.” He called me back and he was like, “I pulled some strings and I got you in. I'm going to deliver your baby. We're going to do this induction. You're going to have your VBAC. I don't want you to stress at all. We're going to have your VBAC. Your baby is going to go to the NICU. He's going to be fine. You're going to come home happy.”I was like, “This is what I need.” I just felt like, “Ahh.” I was like, “Do you think it's safe to be induced? Is it safe for a VBAC?” He was like, “It is totally safe and I will let you know the moment things become unsafe and we will change the plan. But right now, this plan is safe and I will let you know when I don't think it is safe anymore and we need to do something different.” I was like, “Okay.” I went in for my induction and it all moved really fast from there. I had a Foley induction on the night before. I went in on Tuesday night and they gave me a Foley, but all that prep work paid off. I was already 2 centimeters dilated when I showed up at the hospital at 37 weeks for my induction. I was like, “Yes.” That baby was in a great position. I was in shape. I had done that Spinning Babies yoga. It was paying off. I had drank the red raspberry leaf tea. I ate the six dates a day and I will never eat one again.I was like, “Yes.” They put the Foley in. It fell out around 8:00 AM the following morning so this is on Wednesday now. Wednesday, September 27th. At 8:00 AM, they started Pitocin. By 10:00 AM, I was in back labor. It was mild. It was manageable. I was not stressed at all. My nurse was amazing and she helped me get into a lot of different positions. We got baby to move and back labor subsided. That made all the difference. 50:57 Progressing to complete dilationBrooke: By noon, just a few hours later, I was 100% effaced and I was 5 centimeters. I really wasn't feeling anything. I was totally fine. I was able to sleep and I was already 5 centimeters on Pitocin so I was feeling good. I was like, “Oh, I can do this. I do not need an epidural. This is happening.” My doctor came in and he was like, “I want to break your water. You have a bulging bag. Let's break this.” I was like, “Okay,” because I fully trusted him. He was so respectful of my birth plan. I had put on there that I wanted limited cervical checks because in my previous labor, I got the chorio infection and I was like, “I want to limit cervical checks because I don't want to have that infection again that caused my first C-section.” He was like, “I'm not going to check you unless I feel like we really need to and we can talk about it.” He was just so respectful of my wishes and how I wanted my birth to go. He was barely there. My contractions weren't intense, so at 2:00 PM, my nurse upped my Pitocin to a 10. I'm not really sure what that means as the other OB pointed out. I'm not trained in Pitocin. Meagan: It's starting to get into the higher does. Usually at 20 is when OBs will cap it off or try to get MFM involved to get more clearance or do an IUPC and stuff like that. 10 is low but still getting there and getting higher. Brooke: Okay. Okay. She put it to 10 and said, “It's time to get things going. I was just still coping fine and I was starting to get a little bit worried that I wasn't going to get past 8 centimeters because so far, it had been similar to my previous labor. It was taking a while, but I was feeling fine. I texted my doula. This was 2:00 PM. I texted my doula and she was like, “Go get on the toilet. Sit backward. I call it the dilation station. Just go sit there for a little while and I'll check back in with you at 3:00.” But at 2:10, so 10 minutes of doing that, I texted her that I was at 8 centimeters and I was in so much pain. I was like, “You need to come in right now.” 10 minutes. I was so sick. I thought I was going to throw up. I was screaming. I was not prepared for how bad this was going to hurt. I was not expecting that. It came out of nowhere. She got there at 2:35. I was pacing up and down the room yelling and I was screaming that I really wanted the epidural. My nurse gave me IV pain meds and I kept telling her I would get relief during the contractions but the contractions themselves really hurt. My doula was there applying counterpressure, helping to move me into different positions and she and my nurse were working together to get me from just one contraction at a time. One contraction at a time. I mean, I was just in labor land. I could not see beyond the moment that I was in. I was begging for an epidural. My husband didn't say anything because he was really supportive of just supporting my wishes, but I was like, “I really want an epidural.” My goal going into the birth was to have a good experience and not necessarily to have an unmedicated birth because the unmedicated part was because I was afraid that the epidural wouldn't work again. That's why I didn't want the epidural. It wasn't because I wanted the unmedicated birth. It just felt like that was my best option. 54:54 Getting an epidural and pushing for three hoursBrooke: I'm hysterical and I'm like, “I want the epidural. This is not a good experience. This is not on my birth plan.” My doula was like, “I think you're right.” My nurse checked me. She was like, “You're complete. You're complete. You can just push.” I was like, “I am not pushing without an epidural! This is not what I want!”An angel of an anesthesiologist came in and gave me that epidural. I was complete and I got that epidural and let me tell you, there is nothing wrong with me. There is nothing wrong with my spine. That was the most incredible relief that I have ever felt. I know now it was the right decision. My husband was so against it because he was so scared that I was just giving up and throwing in the towel at the final mile. But he didn't say anything at the time. The anesthesiologist was amazing. He kept coming in to check on me, making sure I was doing okay. That was around 3:30 that I got the epidural. I stayed on my hands and knees. My doula was giving me peppermint essential oil to help me cope with the nausea. She kept checking on me and I felt that relief around 4:15, then it was calm and joyous. I knew instantly that I had made the best choice for me. The nurse kept trying to get me to do practice pushes and my doula was like, “You don't really have to do that.” I was like, “I don't have to practice doing anything. My body is just pushing.” It was involuntary. It was just happening. I pushed for 3 hours. Yeah, 3 hours of pushing. Meagan: All right. All right. That's some time.Brooke: It was a long time. I started pushing around 4:15-4:30 and my baby was born at 7:28 PM. I had no tearing and it was exactly like my dream. His head was out and my doctor was like, “Reach down, Brooke. You can do it.” I reached down and pulled him from his shoulders up onto my chest and I got that completion of that circular motion. Pushing the baby out, completing the circle with putting him on my chest. He was crying and looking up at me. I had that skin-to-skin moment. Mind you, this is happening with 15-20 people in the room. The team rushed over. They took him. They checked him. They laid him back on my chest and they left. They were like, “He's perfect. We're good. We'll see you in an hour.” Meagan: Oh my gosh. Yay. Brooke: Yeah. Yeah. So I got to hold him on my chest and have that golden hour. It was just me, my husband, and my doula. It was the most incredible, healing moment of my life. I was pushing him out and I was like, “I could do this again! This is amazing!” It was just– at one point in pushing, I even asked my OB. I was like, “Oh my gosh. This is taking so long. Do I need to have a C-section?” My doctor was like, “Brooke, I'm touching his head. No. You're having a VBAC. It's here. It's done. You did it. This is it.” I was like, “Oh my god.” The baby was never in distress. He did great the whole time. They didn't feel any need to rush it because medically, he was monitored the whole time. I was monitored. We were both doing great. It just took a while. It was absolutely perfect and then they took him back to the NICU after that hour and he ultimately did need to have bowel surgery and stayed there for almost 6 weeks, but I'm happy to report that he is a 100% normal almost 6-month-old baby now and just absolutely perfect. It was the healing VBAC that I had pursued and I am just over the moon about it. It will remain one of the best experiences of my whole life in spite of all of those challenges that I had with another hemorrhage, an induction, and my baby with this obscure birth defect. Having that VBAC and that VBAC success really just completely changed my outlook on the whole situation. I could drive to and from the hospital to see him. I got to hold him for that hour. It was an amazing, amazing, amazing experience. 59:40 15 tips for birthMeagan: I am so happy for you and I'm so happy that you felt you were able to advocate for yourself. It is definitely something hard to do. It would be hard to email and be like, “Actually, I'm not going to go with this provider” or even say, “Yeah, okay. Great. I'm 10 centimeters, but this is not the experience that I'm wanting anymore and I'm going to do this.” I think that is something also they tell people a lot. You can't get an epidural after a certain number of centimeters. That's not necessarily true. Sometimes it can be heavy and harder to push, but a lot of the time, it is what a mom needs to push. You had 3 more hours. You knew what you needed. That was the most perfect decision that you could have made for you. Brooke: Exactly. Exactly. Meagan: You had that amazing full-circle moment of bringing your son up, feeling him, and holy cow, intuitive. Your dreams are on point. I'm just so, so happy for you and I do want to talk a little bit. There is something that you said a couple of times that stood out to me and it's something that I feel like I just in life in general, not even just in pregnancy and everything that I stick to. You can only control what you can control. That, in birth, is hard so what you did is what you could control. I want to give some of those tips. I've got 15 tips and I'm looking down here and I'm like, yeah. You did a lot of them. Learn the facts. Learn what the evidence says. A lot of providers are on the opposite side of your provider where they are like, “No. Pitocin is not safe. It is not acceptable. We cannot do this. You have to go into labor by tomorrow or we have to have a C-section.” Right?Brooke: Right, totally. Meagan: That's not what the evidence states. So you learned the facts. You found the provider. That's the next one. Find a supportive provider. Hire a VBAC doula if you can. I want to talk a little bit about doulas. Obviously, I am a doula and I have a whole doula program here at The VBAC Link so I advocate for doulas every single second of the day, but I know sometimes it's not possible and you mentioned that financially. There are avenues. You can go to Be Her Village or instead of a baby shower and getting a whole bunch of extra clothes, you can ask for support for doulas. There are ways around that but then I wanted to also talk about hiring a doula. Just like hiring a provider who is supportive of VBAC, you also want to try to find a doula who is supportive of VBAC as well. We had a story just a while ago that talked about how she had an amazing doula and it sounds like she was honestly amazing, but VBAC was something that made her uncomfortable. She didn't know that until she was in that space. Brooke: Yeah. I experienced that in my interviews. I did talk to a few doulas who were like, “Well, I've never done a VBAC but physiologically, it's the same as any other birth.” While that is definitely true, I knew that I needed somebody in my corner who understood the emotional impact and what this was going to do for my psyche. Physiologically, man. I have been listening to your podcast. I was like, “These women can do it. I can do it.” A very good friend of mine had a VBAC and the whole time through her pregnancy, I was cheering her on. It was in my head. I was like, “It has already happened. This is done. It's a done deal. You're going to have a VBAC.” Then it was my turn and I was like, I had that faith in my friend. I need to have that faith in myself. I can do this. I really can. I got that from listening to your podcast and hearing other women have this success. That was absolutely critical, but knowing that a doula who understood that and who had been there for other VBAC moms was critical for me. Actually, the doula that I ended up having with me that I hired and that was with me in my birth, she was the doula for her sister who had a VBAC so I was like, “She knows. It's personal to her.” It was perfect. It was perfect. Yeah. It's another part of your team that supports you and understands. Even if they haven't had a VBAC themselves, they are supportive of VBAC and really understand again those facts and the evidence surrounding VBAC. 1:04:22 Control what you can controlMeagan: Finding the birth location. You mentioned you knew that this other location may not have been the best idea and this is where you would feel more safe and you chose that. That is so important to choose where you feel comfortable and what resonates with you. Avoiding induction, however, we know induction happens. Here we are. An induction happened and an induction can happen. Avoid an induction that is not necessary, but also know that if induction comes your way, that doesn't mean that your birth dreams and your birth preferences and everything just go completely out of the window. It's still possible to VBAC if we didn't just prove it with this episode and many other episodes before with an induction. Processing past birth experiences, creating a birth plan. I love how you had a vision board and you were like, “This is my vision. I'm going to do these things. These are within my control.” Surround yourself with the people who support you even outside of your birth team. Going to the massage therapist, and chiropractor, doing Spinning Babies. All of these things are really, really going to help you have a better chance of a VBAC, but then also I feel like if a VBAC doesn't end up happening, you can go back and say, “I did everything I could do in my power and I controlled what I could control.” That message stuck out to me during your story. You said it just a couple of times, but that to me is very powerful. Control what you can control. Brooke: Yeah. I would want anybody listening to really hang on to that and to have faith in yourself. In my second pregnancy, I felt like I just needed to go along with what the doctor said. I had a high-risk pregnancy. I was bleeding like crazy. I didn't know what was going on. Everything felt really uncertain at that point in the pandemic and where I was living and it was just that I didn't take any control. I just did not own my birth at all. I will always wonder if I had done things differently. If I wasn't on bedrest and I was moving and if I drank the tea and if I had a doula which wasn't an option at that moment in time, but if I had done things differently, would I have had such a traumatic Cesarean birth? Would that experience have happened? I will never know, but I wanted to know going into this one that I did everything that felt right to me. My doula would make suggestions and I did the things that I was like, “Yeah. That's something I'm going to do.” Then there were suggestions that she made that I was like, “Mmm, that doesn't sound good to me,” so I just didn't do it. I followed my gut. I had faith in myself. I was like, “I'm going to do X, Y, and Z. I'm not going to do A, B, and C.” Doing what feels right to you and your body, my provider, and I had the mantras too. My provider was amazing, but I knew going into it that obstetrics is not as old as the wisdom of my body and I need to trust it first. My OB is one man. If there is something wrong, they are there to course correct but I just need to let my body do its thing. My provider was so supportive of that and I think that controlling that was huge. I mean, I literally changed doctors the day before my induction. That is something you can do. In my first birth, it was so obvious that I was just routine. I was in and out of the hospital, just another mom giving birth. Nameless. This is the biggest moment of your life and you have to do what you can do to make it the experience you want it to be. I knew that going in, my son needed an induction and that was the whole pregnancy, I was like, “I won't be induced. That's where I draw the line. I'll go for a repeat C-section before I get induced,” and it was time. They were like, “We need to induce.” I knew that was what I had to do to save my son. I was like, “We're going to go for it.” My provider made me feel really safe and I'm just really glad that up until that last minute, I was advocating for the birth that I wanted and that was when I got the birth I wanted, but I knew that if it ultimately ended in a C-section because that was what he needed or if something would occur that that was what I needed, that that is what was needed and not just, “Oh, time's up. Oh, you have an infection.” Control what you can control. Meagan: Yep. That's the message of the day. Control what you can control. VBAC is possible. You did it. I'm so happy for you and thank you so much for sharing your story with us today.Brooke: 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

You won't find an obstetrician anywhere in the United States who will birth triplets vaginally in the hospital, but today you'll hear the story of traditional midwife Kristine Lauria who welcomed them at home with the respect and reverence for birth every woman deserves.  Kristine witnesses some of the most "high risk" births around the world in her midwifery work for Doctors Without Borders. She has attended over 500 breech, twin, and triplets births! In this episode, you will hear the story of a mother in her 7th pregnancy birthing three babies at home as told by Kristine.  We discuss what it means to be a traditional midwife, what happens in a triplet homebirth, the dying art of midwifery skills, and how to manually extract a baby at home. You'll hear how the mother's own mother received the first baby and how this mother avoided preterm birth by leaving the hospital AMA after an episode of bleeding and went on to naturally birth her babies at 38 weeks with perfect APGAR scores! This story is a beautiful example of the true midwifery model of care, a fiercely dedicated mother, and a birth team who deeply trust the innate process of physiologic birth regardless of the number of babies or their positions.  Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

Cesareans can be peaceful, beautiful, and so healing. Though Alexis didn't have the VBAC she planned for, she still had the euphoric birth she dreamed of. Alexis unexpectedly experienced PPROM and preeclampsia at 36 weeks with her first baby. Trying to labor and push under the effects of magnesium and all of the other interventions was incredibly exhausting. When baby started having decels, she knew it was time for the Cesarean. After a rough NICU stay and having to exclusively pump, Alexis knew she needed to be proactive about healing from her birth PTSD. She went to EMDR therapy and found the healing her heart needed. Alexis shares all of the ways her second birth was different from the first. She went into labor spontaneously. She progressed quickly and felt strong. But when baby flipped breech mid-labor, Alexis knew it was time for another Cesarean. Her team took their time honoring every wish Alexis had and truly gave her the birth of her dreams!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:05 Review of the Week05:29 Alexis' first pregnancy during COVID09:41 PPROM and preeclampsia 13:27 Pushing turned emergent Cesarean16:54 NICU stay and exclusive pumping20:45 EMDR therapy and postpartum healing 22:24 Second pregnancy26:21 Beginning of labor29:47 A picture-perfect labor31:26 Baby flipping breech and going for a C-section38:03 The game changer40:56 A euphoric birth43:45 Ways to have a gentle Cesarean46:36 Music, skin-to-skin, clear drapes, mirrors, conversation, and maternal-assisted Cesareans50:32 Vaginal seeding, advocacy, and backward dilation52:29 Swelling in pregnancy and nutritionMeagan: Hello, hello everybody. Today's episode is one that I am actually really excited to hear and share. I think a lot of the time when we are listening to The VBAC Link, we are looking for empowering VBAC stories, positive VBAC stories, and sometimes when we are sharing these stories, it is accompanied by traumatic Cesareans. We know that through all of these stories, I have personal experiences that a lot of these Cesareans are traumatic, and a lot of the time they are traumatic because they are undesired or they are pushed really hard or people feel like they are backed in a corner or so many interventions come into play that they happen in a traumatic manner. But today's story is going to talk a little bit about how Cesarean doesn't have to be traumatic and it can be peaceful. I relate personally to it because my second C-section, I didn't want actually. I didn't want it at all. It wasn't what I planned on, but I still found so much healing through that birth and I think that in a lot of ways, it shifted my mindset of how to view Cesarean. I also want to recognize that our community doesn't always want a VBAC, right? We are here learning about the options for birth after Cesarean but that doesn't mean we only want VBAC so I'm excited to share this story today for everybody, especially for those who are unsure of what to do or want to maybe go the Cesarean route but want to have maybe a better experience than their last Cesarean. We're going to talk about how to have a peaceful Cesarean. We have our friend, Alexis, with us today going to be sharing her peaceful journey with you. 02:05 Review of the Week But of course, we have a Review of the Week, so I want to dive into that and then turn the time over to her. This is from Apple Podcasts and it says lilylalalala. Lots of la la la. It says, “Inspiring and uplifting.” It says, “I first found this podcast in 2020 in the depths of the postpartum after a very traumatic, unplanned Cesarean with my first baby. I listened to every single episode as I struggled to process what had happened to me. I finally gathered up the courage to seek help for postpartum PTSD that I was experiencing. “This podcast is a treasure trove for inspiring stories which helped me regain confidence in my body to have a beautiful VBAC with my second baby last year. Thank you for being such a huge part of my healing journey.” I feel like so often, we hear little things like, “Oh, I loved hearing it” or “That was inspirational” or “That helped me learn the knowledge” but I love hearing that it was a part of the healing journey. It healed. That is so amazing. Thank you so much lilylalalala for sharing your review. If you haven't yet, you guys, we would love your review on the podcast. You can review our Instagram or our Facebook community. Give us a review of The VBAC Link. You can leave your review at Google. You can just Google “The VBAC Link” and leave a review there. You can leave a review on the Apple Podcasts. I'm pretty sure you can on Google Play. Or guess what? You can even email us at info@thevbaclink.com subject “Review” and leave us your review there. 05:29 Alexis' first pregnancy during COVIDMeagan: Okay. I am so excited for you to share with us today. Remind me. Okay, so we are going to be talking about preeclampsia, EMDR therapy which I think is something that is super powerful. We are going to be talking about repeat Cesarean and it can be better. Yeah. Anything else that you're like, “This is what my story is going to touch on?” Alexis: NICU time also. We had some NICU time. That was a big part of my postpartum experience. Yeah. Meagan: Okay. Yes. Okay, well without further ado, I would love to turn the time over to you to share your story. Alexis: Thank you. Yeah. There is a lot that goes into this story, a lot of different factors that made my first experience really hard, but I got to learn so much through it and I've been able to help a lot of other friends and family just through my experience so I'm super excited to share my story with everybody. Meagan: Can you remind us where you are at as well? Where you are located? Alexis: Yes, Joplin, Missouri. Meagan: Missouri. Alexis: Yep, so southwest Missouri. We are originally from Oklahoma City. My husband and I have lived here for six or seven years now and we call it home. Yeah. We got married in 2017 and we were about ready to have a baby around this time the pandemic hit so fun timing there. I'm sure a lot of mamas can relate to that. I think that's a lot of our story. We got pregnant at the end of 2020. Things were kind of normalizing but not really medically. I mean, I never saw my OB's face. We were all wearing masks. My husband couldn't come to our first appointment because the regulations were still iffy on that. I Facetimed him to hear the heartbeat which was so sad for our first pregnancy.But as things kind of went on, the rules lessened a little bit, but still, it was COVID. We got pregnant really easily. We were so blessed for that experience. For the most part, my pregnancy was really healthy. I did have a lot of nausea and morning sickness. That kind of lasted the whole pregnancy and it probably was the reason that my nutrition was so terrible. Nothing sounded good. All I really wanted was french fries so I could never– the smell of our gas oven made me gag so cooking really wasn't happening. Meagan: You're not alone and that's one of the reasons why we talk about Needed, our partnership, because there are so many of us who go through this morning sickness and the smell of anything is just barf so we're not getting those nutrients, right? So we've got to try to get them in other ways because we're not getting them through food because we can't. Alexis: We can't, yeah. That is totally me. So yeah. My diet was terrible and I didn't know at the time. Of course, everyone says to eat healthier and a lot of protein, but I'm already not a good eater of protein, and certainly not when I am nauseous, so yeah. My diet was a big factor. I had pretty rapid weight gain and I'm a petite person so that was not normal for me. My midwife really kept an eye on that, but I was still doing CrossFit my whole entire pregnancy somehow. I felt good enough to do that, but yeah. I was probably just wearing my body down. I was not eating well and working out really hard. What's funny is I was working out because it is proven to decrease your chances of getting preeclampsia and that didn't happen. Meagan: Which ended up happening? Alexis: Yeah. I was like, “I'm going to be so strong. This birth is going to be so easy. I'm just going to squat down on the floor and pop this baby out, no problem.” Meagan: I love your confidence, though. That is important in any birth. The confidence in your body's ability is wonderful. Alexis: For sure. I think that because I was working out so hard, maybe my pelvic floor is tighter. I'll get into all of that. Anyway, that was the pregnancy. Everything was good and healthy. I didn't have any other issues. 09:41 PPROM and preeclampsia But around 30 weeks, I started swelling really badly. It was a summer pregnancy, so no one really thought anything of it. I knew it was unusual for me. It was a lot of swelling. My midwife was keeping an eye on it. I never had high blood pressure and no protein in my urine. There were no markers and technically, I think according to what ACOG says, swelling isn't a red flag necessarily for preeclampsia. I think they won't diagnose you unless, of course, it's blood pressure and protein. No one was worried about it. Yeah. We were just trucking along. Everything is good, just extremely swollen. My husband travels for work all of the time during the summer so one night, he had gotten back that day and I was about 36 weeks on the dot. He got back that day from California and I woke up in the night to go to the bathroom and sit up in bed and I felt a little bit of a gush. I was like, “That's weird.” I get up and go to the bathroom. Toilet paper is a little bit pink, watery-tinged so I kind of knew immediately. It smelled different. I knew something was up. I'm calling for my husband to come in there. He is very confused. At 36 weeks, we did not expect that. The chances of your water breaking are less than 10% or something? Meagan: They say 10% or less, yeah, especially before labor begins. You had PPROM and then there is PROM so premature rupture of membranes, PROM, and then premature birth. Alexis: Yeah, so never did I ever think that my water would break and that would be the start of my labor. I knew those facts and I had done a lot of research. I was really well-educated before I had my son. I just– we are all really good birthers and really good parents before we do it. So yeah. My water breaks. I call the midwife. It was my midwife on call which gave me a lot of reassurance too and she just said, “Go ahead and come in since your water broke. It sounds like that's exactly what happened.” Looking back now, that was such a God thing because my plan was that I wanted to go unmedicated. I planned on laboring at home for as long as possible, but my water breaking just messed up my mind and shifted all of my plans. That wasn't a part of my plan, so I was like, “Oh, okay. I'll go in. Sure.” I didn't think twice about it. When we arrived at the hospital, I felt fine. I had no headaches. I had no vision changes. I felt fine. My blood pressure was I think 200/110. It was insanely high. It was so bad. The nurse was like, “Oh, maybe you're just excited. We'll retake it.” We retook it. It was still crazy high and really dangerous. They started the magnesium drip and for any of you girlies who have ever done that, it is a nightmare. Meagan: Yuck. Alexis: I felt terrible. It makes you feel like you have the flu. I threw up the whole labor. I just was seeing double so anytime a doctor or nurse would come in, I would have to cover up one eye to be able to look at them because I couldn't see straight. I basically could not get out of bed. We had to do an epidural immediately to drop that blood pressure so I was totally bed-bound. The nurses were super helpful with moving me around, so I basically was just side to side on a peanut ball for 20 hours. I had felt some contractions leading up as we were driving to the hospital, but nothing super strong. After a while, my midwife suggested some Pitocin which wasn't a part of my plan. Again, I wanted to go unmedicated. I wanted to have a super crunchy, awesome birth and I have now had every medication under the sun. 13:27 Pushing turned emergent CesareanAlexis: We start some Pitocin. That gets some contractions going. I didn't mention this. I arrived, I think at a 3 or a 4 when we got to the hospital so not a bad place to start at 36 weeks especially. But yeah, we go through laboring in bed, on my back, on my side. Of course, feeling the pains of labor and contractions in addition to magnesium just felt terrible. I didn't do the research about positions or what I should be doing. I didn't have a doula so that's a big part of it too. But I do progress to 10. Things kind of move along over these 20 hours and we start pushing. I could tell you on that first push, I had the thought, “I need to have a C-section.” I was so exhausted before I really even began pushing just from being awake for 20 hours. That was such an exhausting, long, hard labor. I could not. I had no energy left. The midwife that was there tried a lot of different pushing positions. We did tug of war. I actually got on my hands and knees. She was really great about helping me with pushing, but I had no gas in the tank. I was so exhausted. I don't know what my son's position was either. I don't know how high he was. No one ever told me what station he was at. I remember thinking, “Is station just a silly thing people say on Instagram and it's not real?” Because no nurses have mentioned his station. Should I ask? I didn't want to feel stupid. Ask all of the questions. It is your birth. Meagan: 100%. Alexis: Ask. If you are wondering, ask. It's your body. I don't know why I felt afraid to ask what station or what my dilation was all of the time when they would check me. They just didn't tell me which was really weird. I pushed for two hours in every position under the sun and eventually, he started to have some heart decels so the OB on call rushed in pretty quickly. He told me it was time to go to a C-section. I, like I said, was kind of ready for it at this point. It was not my plan, but I wasn't going to put my baby at risk so I was like, “Okay. Let's do it.” We go back to a pretty urgent C-section. This was all also, perhaps more traumatic for my husband. I was so out of it with all of the medication and so tired and you are already in labor land anyway, so you don't remember it all. He relayed this all to me later and he was way more affected by it and that's such a big part of our story too is him. He's left in a room alone. They take me back. He does get to come in. I didn't have to be put under or anything, but that's got to be so scary as a spouse. You hear that things are dangerous. They take you out and now you're just waiting. Meagan: Yep, having no idea what's going on. Alexis: Yeah, he had no idea if I was okay or if the baby was okay. The C-section itself was actually fine. Everything went well. I was just loopy and out of it from everything I had been on so I don't remember it that well, but when they got my son out, his APGAR was a 2. He was not doing great. They had to do some resuscitation so that was just scary. As he came out just not really responding, but he did start to cry. His APGAR came up on that second check and everything was fine at that point. We also didn't find out gender so what a way to find out your gender was that moment. We were so scared. It was like, “That's great. He's a boy. We don't care.” We just wanted him to be okay. 16:54 NICU stay and exclusive pumpingAlexis: Yeah. They get him in a good spot breathing and crying. All is well. I did fine. The C-section was not– that wasn't the traumatic part for me. I got closed up. I don't remember honestly anything after this point. I don't know if I fell asleep. Maybe it was just blocked out of my mind, but we eventually got back to our room. They take my son to the nursery and I don't remember anyone asking us about that. My husband doesn't either. I'm sure I was not in a good place. My blood pressure was still through the roof. It wasn't a great time for skin-to-skin. I understand that, but looking back, it's just really sad that I didn't really see him. I didn't meet him then for two days after. My blood pressure was so high, I couldn't get out of bed from the morning after he was born until about 11:00 at night. Around 6:00 AM, his pediatrician came in and his blood sugar was low so he had to be sent to the NICU. Now we are in separate jails across the hall from each other because he was in the NICU. They wouldn't let me get out of bed because my blood pressure was just not controlled. It was so bad. So I didn't meet my son for two days. That's kind of where– Meagan: I'm so sorry. Alexis: –the trauma. Labor was traumatic. The C-section was fine and then postpartum was really traumatic as well. That's kind of my story. Eventually, my blood pressure starts to respond to medication and I'm able to go meet him, but seeing your baby hooked up to cords and a feeding tube is awful. It's terrible. That was really his only issue though. He didn't have any breathing problems, thank goodness as a 36-weeker. His only issue was blood sugar and feeding. He was just a sleepy guy. He was not taking the bottle. He wasn't really vigorous at the breast. We had lactation consultants come in, but it wasn't super helpful when you're in the tizzy of NICU. The NICU is not set up for breastfeeding success. Meagan: It's not. Alexis: You're on a 3-hour schedule. You don't feed on demand. You need to measure how long and how much they are eating. That is not how breastfeeding works. We feed on demand. We do skin-to-skin. I just didn't know at the time. I was like, “Oh, every three hours. Okay.” I'm pumping. I didn't nurse him a ton in the NICU just because it wore him out so much. It's a lot of work to breastfeed so we were like, “If you can take a bottle and we can get out of here faster, do it.” So I was pumping. Eventually, after eight days, we were able to bust out of there. Feeding was the only thing he had to get over. When we went home, I was still pumping. I would offer the breast, but I was so unsure of it and so overwhelmed with it all. I ended up just exclusively pumping because now, looking back, I can see postpartum anxiety 100%. I was afraid if he wasn't eating enough, they would stick him back in the NICU which would not have happened. They would have done other things before that. It was not emergent, but that is what anxiety tells you. Meagan: I was going to say that anxiety tells you things that aren't necessarily true. Alexis: Exactly. Meagan: We are in a state where that's what we believe. Alexis: Exactly. My husband and I were both so overwhelmed and traumatized from the NICU that it was just easier for us to pump. I remember going back to my six-week appointment and my midwife was like, “How's breastfeeding going?” I told her, “I'm exclusively pumping.” She was like, “Oh my gosh. That is much harder.” Meagan: That's a lot of work. Alexis: I was like, “No, you don't get it. It's not harder.” When your baby won't latch and they are crying on the breast, it is so stressful. No, no. This is not harder. But it is exhausting. It's so much work. I did it for a year. I'm very proud of that, pumping is not for the faint of heart.Yeah, that was kind of his whole experience. It was just really overwhelming is what I would say. We didn't really know what we were doing and the preeclampsia of it all was so scary. It's such a serious thing that I wasn't super duper-educated on what that could look like. Meagan: Right. 20:45 EMDR therapy and postpartum healing Alexis: After his birth, I just really tried to dive into therapy, and my husband too. We just wanted to work through that because we knew we wanted more kids. I already knew I wanted a VBAC. Immediately, I was like, “This was never my plan to have a C-section so we are going for a VBAC.” I was a great candidate for it. We plugged forward. I did EMDR therapy which I cannot recommend enough. It literally retrains your brain to hop off a thought and get on a healthier track of thinking. My main objective with my therapist was my anxiety around blood pressure because, to me, it felt like blood pressure was something I couldn't necessarily control. You can do things to support your body like diet and supplements and all of these things, but some of us just have chronic high blood pressure or white coat syndrome which was totally me. So I just wanted to eliminate that piece of it if I could and just calm myself down before appointments, not get stressed about it, and not add more to my plate of trying to be healthy for this next pregnancy. I just wanted to do that work before I even got pregnant. I went through EMDR therapy surrounding blood pressure and also just working through my birth and kind of getting to a place where even if that same exact birth happened again, I would have more peace about it because you don't know how it's going to go. The chances of having preeclampsia again the second time are higher than a first birth for anybody else. It could have gone the same way. You don't know, but I just wanted to be prepared to have a better experience, a better bonding experience with my baby, and a better birth. 22:24 Second pregnancyThat really got me to a healthy place. Around the time I was wrapping that up, I got pregnant with my daughter about two years later. I had just done this whole time in between kids and listened to as many VBAC Link episodes as I could. I tried to diversify the information that I was taking in too so a lot of the Evidence-Based Birth, also Dr. Fox's podcast is a really great one for a little bit of a different perspective. Meagan: Yeah. Alexis: He's an MFM. He's been on this podcast and has a very different perspective. He has seen it all so he's going to be a little bit more conservative with allowing any patient to VBAC or any type of “complication”. It's a really good perspective to add to the mix if you are looking for it. I just filled my brain with as many birth stories and as much research as I could. I did everything I could to avoid preeclampsia this time. I ate as close as I could to the Brewer diet. It's so hard if you've ever tried to eat exactly the Brewer diet. It feels impossible at least for me so I just did my best. I tried to eat a lot of protein and started my day with a lot of protein just trying to diversify my diet because I did not do that the first time. Also supplements, so any research that I found, I would take the supplement. So low-dose aspirin, I was on that from the beginning. I took magnesium-glycinate every night. Melatonin– I saw a study that shows a direct link between low levels of melatonin in preeclampsia. Vitamin C is to the strength of your bag of water so I took that every night. My water did not break so I don't know. That worked for me. I also was a little bit anemic during my first pregnancy so I took a grass-fed beef liver supplement and I had no issues with my iron this time either. Just a lot of different things to support my body so I'm like, “I'm giving you the best opportunity, body, to have a healthy pregnancy and that's all I can do.” You've got to throw your hands up at some point and just say, “I did everything I could.” That's what I did. I switched hospitals because I felt like going back to the same hospital would be kind of traumatic. Meagan: It can be triggering. Alexis: Exactly. I switched OBs. I switched to– a friend of mine had an OB who had a really low C-section rate. I think the lowest in the hospital and then also with her, she pushed for three hours. He really, really fought for her vaginal birth because he knew she did not want to have a C-section. Meagan: I love that. Alexis: I thought, “That's the type of doctor that I want.” So I went with him. He was really supportive the whole time. I hired a doula as soon as I could and that was a really great tool as well. Webster-certified chiropractor and all of the things. I just tried to throw everything at it that I could. Alexis: Everything was great. Super healthy. I had no issues again this time. My blood pressure was looking really normal, then a little bit toward the end at the end of 27 weeks-ish, I found out she was breech, my daughter. My chiropractor was on top of it. She was like, “I swear. I have a 97% success rate of flipping babies. I won't say I flip babies, but I give them the space to flip.” Yeah, so I felt confident in that. My doctor had checked. She turned head down later on so everything was good there. A thing that I'll say now is my husband and I had prayed my whole entire pregnancy if we were going to have a repeat C-section, let it be because of breech presentation. I'll get back to that, but that was just something. I'm not against a C-section. I'm against a traumatic birth and everything that we went through. I just don't want to have that experience. Birth is birth. C-section or vaginal birth. You are having this amazing, incredible experience and C-section is not the enemy. Traumatic birth is the enemy. That is what we were hoping for, but she was head down so we were like, “Okay. This is our sign. We're going for it. This VBAC is going to work. It's going to be awesome.” 26:21 Beginning of laborAlexis: As we got to the end, I was cool with cervical checks. That was something I was just kind of curious about. I wanted to know where I was at because my doctor was pretty anti-induction which is great. I just wanted to know where I was at by the end to see if we could do some sort of natural induction method. At 36 weeks, I think I was at 1.5 and then at 37 weeks, I was at a 2. I opted for a membrane sweep. My plan was, “I'm accepting. There is a small risk of infection or them breaking your water but it is a small, small risk.” You just have to weigh the pros and cons. For all of us who are VBACing, there is a risk of rupture. There is a risk of all kinds of things. You have to decide what is right for you. The risk of a membrane sweep was so worth it to me because if he wasn't going to induce me, let's do something natural that can get things going. So for me, I was going to do it every week. I had my first membrane sweep at 37 and 6 then I went into labor the next morning. It worked. I didn't notice anything that day really. I didn't have any bleeding which they usually tell you you could. I really didn't feel any cramps or anything after so I was like, “Oh, well. It didn't work. Whatever.” I get up for work the next morning and basically, as soon as I was vertical for the day, I was feeling contractions. Everyone says just ignore early labor. Pretend it's not happening so that's just what I did. I went to work and had a normal day. Around lunchtime, I was like, “I'm just going to time these and see where we are at.” They were every three minutes really consistently but lasting 30 seconds. They never changed from that rhythm. It was three minutes all day long and intensified throughout the day. I finished my work day. I picked up my son. I went home. My mom was coming up just for a visit and that ended up working out very well. I got home and things really intensified. I was on the ball just tracking things.Again, I was like, “Once I go to bed, these are going to go away. I'm 38 weeks on the dot. I'm not having this baby. I'm not that lucky.” But they just kept coming, so they intensified and intensified. They got longer. They were still three minutes apart. That rhythm never changed from start to finish. Meagan: Wow. Alexis: Yeah, so around 10:00, I got in the bath because I was like, “I'm going to sleep tonight. I'm going to take a bath and make these things putter out and then I'll have a peaceful night of sleep and go on for another week.” Alexis: The bath felt amazing. That really helped me to relax. I listened to some Christian HypnoBirthing tracks and then my husband and I decided we would go to bed. If something pops off, I'll wake my mom up. She's got my toddler and we will head to the hospital. But I was sure that things were just going to stop as they often do in early labor. They didn't. As I was trying to lay there, I went from around– I think we went to bed around 11:00 up until we went to the hospital at 2:30 AM. By that point, I was breathing through them, really feeling them. This was real. I had been letting my doula know, “This is what's going on.” A few hours before that, she was like, “Okay, let's give in an hour. If it doesn't lessen, then we need to start thinking about going to the hospital.” She was two hours away, so she had quite a drive. We were really on top of it and around 2:30 that morning, my husband was like, “Okay, no. We're done. Let's go.” He did not like seeing me that way. I probably would have gone a little bit longer if it was just me but he was not on board with suffering all night. 29:47 A picture-perfect laborAlexis: We headed to the hospital and I was stressed. Am I going too soon? You hear so many stories where contractions are so intense and you get there and you are not dilated at all or something. We get to the hospital in triage. They checked me and I'm at a 3. I'm like, “Okay, cool. That's great.” They hold you for an hour and check you again. If you progress, then they will keep you.” They checked again in an hour and I'm at a 4. We get checked in and at that exact same time, my doula had arrived from her two-hour drive through the night. Things felt so picture-perfect. What lucky girl would go into labor at 38 weeks? Going past your due date is so very normal. I felt like an anomaly even though I had an early birth the first time. I just never thought I would go into labor or that it would work and that I would have a spontaneous labor and that things would progress so easily. I didn't need Pitocin or anything. I felt so thrilled that things were going so well. After having such a birth where everything that could go wrong goes wrong, a birth that is just normal feels like you have won the lottery. That's how I felt the whole labor. Dealing with contractions, I knew how to breathe through them. I never sat down in the bed. That did not feel good and I knew that wasn't helpful so I was on my feet. I did a lot of slow dancing and squatting. I would pedal my feet. That felt really good. Things just progressed on their own. It felt magical. This labor is just happening. My blood pressure is perfect even. It just all felt so perfect. I felt euphoric during labor. It was just the most amazing thing to experience going through labor like that. 31:26 Baby flipping breech and going for a C-sectionAlexis: I mentioned I was at a 4 when we got to stay. We got checked in at around 3:30 AM. They checked me two or three hours later. I was like, “I'm done. This is terrible. I want the epidural.” I planned on getting the epidural just because my issue the first time with pushing was maternal exhaustion so I was like, “I want to be able to give my body the rest it needs so I am all for the epidural at a certain point once we are sure we are in active labor.”I was ready for the epidural. I was like, “Forget this. Get the epidural in here. I'm done. I'm tired.” Of course, in labor land, you have no clue what time it is and it had only been two or three hours. If you had told me that, I would have probably changed my plan, but my body knew. It was time. I got the epidural. They checked me once that had kicked in and I was at an 8.5 after two hours. From a 4 to and 8.5 super fast. We were all shocked so we were like, “Cool. We're about to have this baby.” My nurse was just like, “Okay. Chill out. Let's labor down.” We were coming up on a shift change with OBs on call in the next few hours and I had a bulging bag as well. My nurse was like, “We will probably, if you are okay with it, break your water and you will be complete at that point. You are very, very close.” So we were like, “Great. Let's all take a nap and then we'll do that and then we'll have a baby.” So smooth. Everything up to this point had been so perfect. That was the plan. I was good with all of those interventions. Yeah. My husband, my doula, and I all just conked out for a couple of hours. I also didn't mention this. I was GBS positive which I think kind of ended up working in my favor because it gave me more time to labor down. I had to finish the antibiotics. They could have rushed in and just broken my water then and there and bada bing, bada boom, tried pushing and maybe I wouldn't have been quite as ready, but it bought me three or four more hours to finish the antibiotics. They just left me to rest and to labor down. Even that felt like a treat when I was hoping so hard to not have GBS. I had taken the probiotics and everything. It felt like, “Oh no, one thing went wrong,” but for me, it was great. Just another thing that not everything is bad in these situations. It can be positive. We were able to just labor down. Then around 7:00 or 8:00 AM, I think the next OB on call came in. We broke my water. It was oh my gosh, the biggest gush I have ever heard. It was so much water. We didn't measure it or anything so I don't know if it was unusually a lot. Meagan: Abnormal, mhmm. Alexis: But it felt like it was a lot. Everyone in the room felt like it was a lot. She went to check me and she was like, “Okay. You're at a 6 or a 7.” We were all like, “No, what? No. You're wrong. Try again. That's not true.” She was like, “This is what I'm feeling. Maybe the nurse had it wrong.” I was like, “No.” I was so sure. I was like, “Absolutely not. No. I'm not a 6 or a 7. What is happening?” Then she keeps feeling around and she's like, “I don't know that I feel the head. I don't think this is the head.” I knew immediately. There must have been– I don't know if there has been a story on this podcast of a baby flipping during labor but I have heard it happen before so I knew in my gut. I was like, “She flipped. That stinker.” They bring in the ultrasound machine and sure enough, she had flipped breech after 8.5 centimeters and was breech. This sweet OB was so great and really, really compassionate. She puts her hand on my leg and is like, “I'm so sorry.” She knew I wanted this VBAC. She was like, “I'm so sorry. We don't have another option. We have to have the C-section.”Also, for me personally, I was not comfortable with a breech vaginal delivery. The doctor was not well-versed in it. That did not feel safe to me. Again, my goal was a birth that wasn't traumatic. My goal was not necessarily a VBAC. While at the same time my goal was a VBAC, number one is, “I don't want to be traumatized. I don't want my body to be super messed up and hurting after this like I was the first time. I want my baby to be okay.” That wasn't a risk I was willing to take. The C-section felt fine. So back to what I said earlier about if we were going to have a repeat C-section, let it be because of breech presentation. I was like, “Lord,” when she said that. Meagan: Very validating I'm sure. Alexis: Totally. I had immediate peace about it. My husband rushes over and he was like, “I'm so sorry. Are you okay?” He knew that it was going to be really triggering for me, but I was like, “No, I'm good. This is awesome. We just went through this amazing labor. I was unmedicated until 8.5 centimeters. I felt amazing. I was controlling my pain with my breath. Everything was perfect. Now we're just going to go for a C-section. That's fine.” I just had such a peace about it. It was slow. We got to really prep for it slowly. I brought all of the nurses in and we had a little meeting about– here's my birth plan for a repeat C-section. I had prepared that. Meagan: Good.Alexis: I think people think that is going to jinx them. Make the plan. Make the plan because I hope you don't need it. Meagan: Put it in the bag. Alexis: Yeah, but if you do need it, it will make your C-section awesome and it did. We went over that repeat C-section plan. The main things were immediate skin-to-skin. I still wanted delayed cord clamping and just the usual stuff but it did not happen with my first C-section so I was like, “Please, please, please can we make skin-to-skin happen? That was my big thing.” So yeah. It was slow. It wasn't obviously an emergent situation. She was just breech and hanging out. We prepped and slowly went back. We were just chatting with the nurses. I felt very awake and aware. They bolused up the epidural and it worked so I didn't have to be put under this time either thankfully. I told the OB, “Can you talk through the whole surgery?” That would maybe freak some people out to hear, “Okay, I'm cutting into your uterus now,” but I wanted to know. I wanted to feel involved in the birth. I didn't want to feel like it was happening to me like it did the first time. I got to be a part of that. She took my daughter out. She held her up in front of us for what felt like a really, really long time. It was because she was doing other things and letting the umbilical cord pulse. They actually took out the placenta still attached to her– Meagan: Awesome. Alexis: –which is awesome. Meagan: Yeah, pretty rare. Alexis: They totally met my wishes of delayed cord clamping. Then my husband got to see the placenta. They brought it over to me to look at. That was something I really wanted too. It was just so peaceful. I felt so a part of it. 38:03 The game-changerAlexis: Once they checked her out under the warmer for just a second, I got skin-to-skin for what felt like a really long time. It was awesome. It was so awesome. I never ever would have thought. I was so against another C-section like, “I've got a toddler at home.” My recovery the first time– I was not okay at 12 weeks postpartum with him. I did not feel good. I was going back to work after 6 weeks this time. I was like, “We cannot have another C-section this time. Not an option.” That was my attitude. Through all the work I did, by the time it happened, I was like, “This rocks. This labor was awesome.” It was such a silly way to have a C-section, but what a cool birth. What a funny story I will tell her whole life, “You flipped at 8.5 centimeters, girl. What were you doing?”Meagan: Seriously and the fact that you were able to do the labor, go into spontaneous labor, and see these things, see that your body was doing this and having all of that, that also is validating. Alexis: Totally. Meagan: To have everyone come in, sit down, and be like, “How can we make this special for you? How can we make this a good experience?” That is so empowering and exactly what you said. You can change it to be what may or could have been more traumatic– because honestly looking back, I don't know if you have ever asked yourself this, but if they didn't ask you any of those questions, if they didn't give you any of those opportunities, do you think you'd look at it the same way if they were just like, “We have to go right now”? Alexis: Totally. Yeah. It was a game-changer. Meagan: Yeah. Everything okay. Alexis: We've got time. Meagan: Let's talk about this. How can we make this a good experience for this family? I think that is so important. I think sometimes in the medical system, it's like, once a decision has been made that a Cesarean is going to take place, it's boom, bang, boom, boom, boom, baby out and it moves too fast when it doesn't need to. Alexis: It's still birth. Meagan: Yes, it's still birth. Have that conversation and say, “Okay. Your plans just changed a lot. Let's talk about this.” Or if it's a transfer from a home birth or a birth center. Let's embrace what they were wanting, the type of birth they wanted, and still try to help them have a good experience so we have less PTSD in the future. We have less negative opinions of interventions and Cesareans and things like that. I think a lot of the negative thoughts that we have are from the negative Cesareans that happen.Alexis: Yeah. You've got to advocate for yourself to get that and also, like I said, my doula was really helpful in reminding me of what I wanted and getting things going.40:56 A euphoric birthAlexis: Another piece that I think is cool to think about is– maybe this is weird to some people, but when do you ever get the opportunity to be awake in a surgery? If you're not in the medical field, think about it that way. What a cool thing. I'm in a OR. I get to see this thing that who else would get to experience being in a surgery and being awake for a surgery? Maybe that is someone's worst nightmare, but I was one of those people where I couldn't touch my C-section scar. It freaked me out afterward. I was truly traumatized by it but through all the work I did, I now am in this mental place where I was like, “This is cool. I am a part of this whole experience that is not a vaginal birth and that is disappointing for sure. I still feel like, “Man, that stinks.”However, I got this other experience and it went really well because I told them what I wanted. I got what I wanted. Afterward, postpartum was truly euphoric. I was even the person that was like, “I don't want the shot of Pitocin after my vaginal birth because that might jack with the way my body responds with natural oxytocin.” I was that girl, but it's not all or nothing. I still have those emotions. My body still did the work with my hormones. I bonded immediately with my daughter. It took months with my son because of the trauma. I just didn't feel those emotions yet. It was really hard for me to bond with him. This time, because of this different experience, I was bonded. The skin-to-skin was such a game changer for me. We had a few hours of it. We nursed on and off. Breastfeeding was a breeze this time. I never had a hiccup with it which is so different than my first experience. It was night and day different and I truly don't feel any sort of regret over not getting my VBAC. I almost feel like I still got it. I got the birth I wanted. I still am so shocked by the story. It's such a funny thing that happened. Not my plan, but it was an awesome birth. It was so cool. Meagan: I love that that is how you describe it. I love it so much and I hope, Women of Strength, if you are listening, and your birth turns in a different way that you weren't expecting or that you weren't desiring that you have the support that you have and all of these things to have a better experience. I think too, even with mine, I didn't want it. I didn't want it and still in some ways, I'm like, “Why? Why did I have that?” But at the same time, I'm grateful for it. I'm grateful for that experience. 43:45 Ways to have a gentle CesareanMeagan: Okay, let's talk about a few things. Ways to have a gentle Cesarean. Skin-to-skin, we talked about that right after. Babies can come out and be placed on your chest. They have those big bands where they put all of the monitors on. Sometimes they are straps, but they also have bands. You can ask for that. You wear a tube top. Alexis: Oh, that's cool. Meagan: Yeah, so you have them up here. Because when you're in a C-section, a lot of the time your arms are out straight. Sometimes they are strapped down. Alexis: They did do that. I had asked the anesthesiologist. I was like, “I don't want these. Don't strap me down.” He explained, “Here's why. Sometimes your body responds. You don't want to do it, but your arms reach out and try to stop what's happening to you, so we're going to leave these on. They are not tight.” He talked me through why they were that way and after he said that, I was like, “Oh, okay. That's fine.” He said, “We'll get you out of them as soon as she's born. We'll just do this for now.” I was like, “Okay, that's fine. That makes sense.” Meagan: That's another cool thing that your anesthesiologist was literally talking to you and breaking it down. But yeah, so a lot of the time our arms are straightforward or even strapped out to the side so they are like, “No, you can't have skin-to-skin because you're not going to be able to hold your baby.” Alexis: Not true. Meagan: That is not true. Ask for the tube top. Buy your own tube top as a backup. You can wear it then they can literally tuck baby right down in and place baby right there on your chest. So if you're not feeling the strength or you are feeling nauseous but you really want your baby to be on you, they can be right there and your husband can also help or your birth partner can also help support baby right there. Skin-to-skin is possible 100%. If for some reason, you are not doing well or you are vomiting or something like that because as a baby comes out, things shift and we can vomit, encourage Dad. Encourage Dad to do skin-to-skin. Alexis: That was on our birth plan. Meagan: That can be really comforting and healing to see as well. Those are two of the things. Skin-to-skin. We talked about the cord. Keeping the cord attached. A lot of providers will say, “Nope. We have to cut it. There's a risk of infection because your body is open so we have to cut it quickly and start the next process.” Not necessarily true. We can wait for it to pulse. If for some reason baby is not doing well or maybe there is bleeding or something is going on, they can milk it. They pinch it and they do a mini blood transfusion. They send any blood that is in the cord at the present time to the baby. They pinch it and milk it. Alexis: Cool. That's awesome. Meagan: That's a really good option if you can't have delayed cord clamping. 46:36 Music, skin-to-skin, clear drapes, mirrors, conversation, and maternal-assisted CesareansMeagan: Okay, so music. You can ask your nurse or anesthesiologist to play music in the room so it's not just beep beep.Alexis: They did that when my daughter was born. Meagan: You know? So yeah, so have that music. Alexis: Write it down too. You're not going to remember these things in the moment. I had all of these things written down. Meagan: You won't. Alexis: If I can't do skin-to-skin, my husband will. If it's not written, it might not happen. They're not going to think you are stupid for having a birth plan. Write it down. Meagan: Yes, so true. When I went for my first VBAC with my second baby, something I said is, “I just want to see it. I just want to see my baby come out.” That was so important to me so a lot of hospitals these days do have the clear drape, but a lot of them don't crazy enough. Something I said is if they don't have the clear drape, I want to see it in a mirror. My husband was like, “What?” Alexis: That's a cool idea. Meagan: So to your point, and actually when we were back there, I did not remember that. All I was seeing was a table I was climbing up on. It just wasn't in my mind. My husband said, “Hey, is there any way we could get a mirror so she could watch this and participate in the birth?” They were like, “Yeah, no problem.” They brought it over. They made sure before they even started that I could see and that the angle was perfect. Alexis: That's so great. Meagan: Then they started. My doctor said, “Hey, if at any point you realize what you are watching is happening to you and it weirds you out, just let us know. We will flip the mirror or you can close your eyes.” For me, I didn't get grossed out. I know a lot of people listening would be like, “No, hard pass.” But for me, that was part of my healing watching it happen and watching my baby be brought up earthside. So I really love that and same with you, I had my provider talk to me. Talk to me about what is happening because, with my first, they were talking about the weather and their vacation and how depressing it was to be back in the snow. I was like, “No, hello. I'm here.” Alexis: My plans specifically said, “No shop talk. I don't want anything else talked about.” They acknowledged that. They were like, “Got it. We won't.” Meagan: Love. Love that so much. So yeah, talk to them and say, “Talk to me. Tell me what you are seeing. Tell me what is happening to my body,” as long as that's something you want. I really wanted my husband to watch. I really wanted my husband to take pictures and so many providers are against pictures in the OR. It honestly is just dumb to me because if anything were to go wrong, don't they want proof that everything was okay and they did it right? All right, but whatever if they don't allow it. But it's something you can ask. “Hey, I want pictures” or “Hey, as soon as my baby is out, I want pictures of my baby.” You can also ask them to bring them up so they can see you and even better like Dr. Natalie who we talked to on the podcast last year in 2023, ask for maternal-assisted. It begins with us. Women of Strength, if you are having a Cesarean, we have to start advocating for those people who do want a Cesarean or even don't want a Cesarean but it happens. Let's get some maternal-assisted happening. Let's see that shift in 2024 in the U.S. I would love it. It's happening in Australia here and there. I don't actually know anywhere else. If you guys know of anywhere, if you are listening and you know of somewhere that does maternal-assisted, let me know. That's where they literally drop everything. They have moms with their hands reaching down and grabbing her baby and pulling it up. Alexis: So awesome. Meagan: How amazing could that be? Oh my gosh, it would have been amazing. 50:32 Vaginal seeding, advocacy, and backward dilationMeagan: Yeah, so music. Let's see what else. Oh, there's more. Alexis: I should have pulled up my birth plan. Meagan: I know. These are just things that stand out to me. Yeah, keeping your baby, letting your baby breastfeed. Vaginal microseeding sometimes. People will say, “Hey, can I swab my vagina before I go into my C-section and then have this?” It's a gauze. You have to do a sterile gauze. You put it in a sterile bag then baby can literally nurse on this gauze a little bit and wipe it on their eyes. Alexis: Really cool.  Meagan: Yeah, there are some really cool things. Know that it is possible to advocate for yourself. Advocating for yourself is going to help you. If you have a doula or your husband or a birth partner or a mom, help them know what you want. Help them know what is important to you and like she said, have a backup birth plan and birth preferences. It's okay to have them because, at that time, you are not in that space. A couple of other things that I wanted to touch on is you talked about how you were 8.5 centimeters and then they checked you and you were less after your water broke. Sometimes, Women of Strength, this could be a result in this type of situation where the bag is so bulgy that it's literally stretching like a Foley or a Cook catheter, stretching your cervix, and then it relaxes a little bit. That doesn't mean it's not dilated. It means that sometimes it is overstretched, then relaxes, and then it goes forward. Alexis: And that pressure was gone from her head since she flipped. That was part of it too. Meagan: Yep, and the pressure was gone. Yep, exactly. There are situations like that, but that doesn't mean your body is necessarily regressing a ton and we've got big problems. It just sometimes means that the situation has changed. A head isn't applied as well and your bag broke that was bulging. Okay, and I have all of these little notes here that I was writing. Okay, let's see. 52:29 Swelling in pregnancy and nutritionMeagan: Oh, swelling a ton in pregnancy. That's another thing. I also was like you. I just ballooned. I had people tell me I was unrecognizable but I didn't have protein.Alexis: Don't you love to hear that? Meagan: Yeah. I was like, “Thanks. I'm so fat. Awesome.” Alexis: Yeah, you already feel awful about it and people comment. Thank you. Meagan: Yes. But that is still something to watch for. Sometimes we think we have too much fluid so we back off on water. Don't back off on water. Stay hydrated. Add some citrus to it. Alexis: And electrolytes. I took electrolytes every day. Meagan: Yep. Electrolytes and magnesium baths. Do these types of things to help and then of course, just like you said, it doesn't matter if you had preeclampsia. Dial in on nutrition. Dial in on those supplements because naturally like you were saying, you don't get enough protein in your day-to-day life and then you are pregnant and you need more. It's really hard. That's why I love the collagen prenatal protein from Needed. I love getting prenatals that have protein supplements is what I'm trying to say and things like this. Get the nutrients that you need and your body deserves. Then again, let your body take the lead but give it all that it can to do the best it can. Alexis: Yeah. Do everything you can. That was good for me mentally to just do everything I could to support my body and it's like, “From here on out, this is on your body.” With my birth, I feel the same way. I did everything I could. I labored textbook how you should and yet, you still flipped. That's your fault, not mine. Meagan: Yes. It was out of your control. Do what you can. Control what you can. Trust the process. Get the support. Advocate for yourself and love yourself. Love yourself for all of the work that you have done. Women of Strength, we love you. Alexis, thank you so much for being here with us today and sharing your positive birth story. 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

Welcome to the Happy Nurse Educator podcast by nursing.com. Since 2018, nursing.com has been at the forefront of nursing education, guiding over 400,000 nursing students to academic success while helping the average student raise their lowest grade by 11.6% with an impressive 99.25% NCLEX® pass rate. Download free Lesson Plans at HappyNurseEducator.com Newborn Assessment Lesson Plan Objective By the end of the lesson, the nursing student will be able to comprehensively understand the importance of immediate skin-to-skin contact after an infant is delivered. This includes the crucial role it plays in stabilizing vital parameters such as respirations, temperature, blood sugar, and blood pressure while fostering bonding and facilitating breastfeeding. The lesson will empower the student to perform a thorough assessment of the newborn, employing the APGAR scoring system and conducting a head-to-toe evaluation. The nursing student will gain proficiency in therapeutic management techniques, including proper suctioning with a bulb syringe, promoting the first cry for lung clearance, and maintaining temperature stability through appropriate measures. Download free Lesson Plans at HappyNurseEducator.com  

To kick off Pelotonia 2024 Launch Week, this is a special re-release of episode 155, “The Next Leaps Forward in Cancer Treatment, with Guest Co-Host Raph Pollock.” The new version of this episode now includes an introduction and conclusion from Joe Apgar, Pelotonia CEO. Each of the James scientists and physicians featured in this episode has been funded by Pelotonia. Hearing directly from these individuals about the continued progress, groundbreaking research, and treatment advancements is inspiring as the Pelotonia movement kicks off its 16th year. Registration opens for Pelotonia's cycling events, Ride Weekend on August 3-4 and Gravel Day on September 28, 2024. Riders, Volunteers, and Challengers can sign up and commit to continue funding the work of James scientists and physicians like those you will hear from in this episode. Registration for Pelotonia 2024 opens on February 29 at Pelotonia.org/register.

Happy podcast Wednesday, Women of Strength! You do NOT want to miss today's episode. Clair shares her beautiful journey to a VBA3C. After fully dilating and pushing for hours but ultimately ending in C-sections with her first three babies, Clair finally had the vaginal birth she so badly hoped for with her fourth! Clair shows just how powerful birth can be when a woman's intuition is combined with informed consent and an open-minded birth team. There were unfortunately some technical difficulties during this episode and part of Clair's third birth story was not recorded. Clair graciously submitted this written account below.24:08 “With my third baby (attempted VBA2C), I dilated quickly and smoothly, baby was descending beautifully, and I started feeling like it was time to push. I pushed for a long time - a couple of hours - and he was coming down, but slowly. We tried many different positions, moving around, etc… but it was taking a while. Looking back, I was having some back labor and it's likely that when my water broke on its own, he dropped into a posterior position. After several more hours, we could see his head! I thought a VBAC might really happen! But baby's heart rate started having decels and having a hard time coming back up, so we decided to transfer to the hospital for monitoring. I was pretty exhausted by that point, so I was hoping that IV fluids would help me regain strength and keep going. When we got to the hospital, however, they would only let me labor in the operating room because I was a VBAC patient, so I was very limited in mobility and my options. Baby seemed stable, but they were basically prepping for surgery from the moment I walked in the door and wouldn't tell me baby's stats. We eventually called it, opting for a C-section on our terms so we could have delayed cord clamping and a calm environment. Baby boy was almost 10 pounds and had very healthy APGAR scores! I was disappointed I didn't have a VBAC, but I felt respected by my midwife the whole way through. Postpartum physical recovery was difficult, but emotionally this birth was much less traumatic because I had a supportive birth team. I also took two intentional weeks to do nothing but be with the baby and rest, which I hadn't done with my previous two births, and that made a huge difference in my mental health and bonding with my baby!”Additional LinksNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Time Stamp Topics01:56 Review of the Week04:30 Clair's first pregnancy and birth 07:50 Recovering from a C-section while moving 09:24 Getting pregnant at 3 months postpartum & dual care during COVID14:39 Laboring at home to complete & hospital check-in17:49 Clair's second Cesarean19:08 An emotional recovery23:38 Third labor with a home birth midwife24:08 Pause in story – read caption!24:20 Fourth pregnancy 28:49 Moving to Utah 35:34 Midwifery care in the hospital38:47 Active labor begins45:04 Circumvallate placenta Meagan: Hello, hello Women of Strength. We are at the end of February here and we have a story that I swear– VBAC after multiple Cesareans is very highly requested when it comes to this community so we have a story for you guys today for VBAC after three C-sections. Not only was it a VBAC after three C-sections, but it was also a pre-term VBAC after three C-sections. I think in a lot of places around the world if someone came in pre-term and they have had three C-sections, finding that support is going to be hard. It doesn't need to be necessarily hard, but I know that it can be so I'm excited for this story from our guest, Clair, today because it's a story that just shows that it is possible even if you have certain things stacked against you that the medical world looks at in a negative way. 01:56 Review of the WeekSo we are going to be sharing that story here in just a few minutes, but of course, we have a Review of the Week and this was shared on Apple Podcasts. It's by brittleesmith. It says, “Highly recommend for both VBAC mamas and mamas in general.” It says, “In 2019, after 30 hours of labor, I ended up birthing my son via unplanned C-section. I was devastated and knew my future birth had to be different. I immediately started digging into VBAC resources and came upon your podcast. I listened to every single episode before I even became pregnant with my second baby. The knowledge I gained from both of you as well as your many guests is truly invaluable. This resource is great for any expectant parent, not just VBAC moms and I wish I had discovered you all before my first child. “I am thrilled to announce that I got my VBAC this past February and I owe a lot of thanks to y'all. Keep it up, ladies.” Oh, I love that. I love when people say, “We found you. We learned and then we got our VBAC,” or “We found you. We learned and I didn't get my VBAC but I had a better experience.” This is what this podcast is here for to help people have a better experience, to learn the information, to feel more empowered to make the best choice for you, and even sometimes when the experience doesn't go exactly as we planned, to still have a better experience because we know what our options are. As usual, if you guys have not left a review, we would love them. They actually help Women of Strength find this podcast. They help people find the information and the empowerment for their births, do drop us a review. You can leave it at Apple Podcasts. You can even Google “The VBAC Link” and leave us a review there or wherever you listen to your podcasts, drop a review. 04:30 Clair's first pregnancy and birth Meagan: Okay, cute Clair. It's been so fun. I just was scanning over your stuff and I was just excited because of all of the people you had at your birth, I know personally because you are also here in Utah. I'm so excited to hear your whole story and your journey. I just want to tell you congrats in advance because it is so amazing. So amazing. Clair: Thank you so much. Yeah. We didn't expect to be in Utah, but it turned out to be a really great place to birth so we are really grateful to be here. My story actually starts on the East Coast thousands of miles away and I was due with my first in May 2019. I didn't really know much about birth in general. I'm the oldest child and kind of a rule follower. I was like, “Well, if I just do everything the way I'm supposed to, then birth will just happen.” Yeah. I had a really supportive OB. He has several children of his own. His wife was a friend of mine. He was a really great doctor. But at around 32 weeks, I was flying at the last possible second I was allowed to fly and running through an airport. I kind of felt the baby kind of settled in a weird spot after that. I started having prodromal labor at 39 weeks or something. That went on for about two weeks. What I didn't realize was that these were all signs that maybe he was posterior and not in a great position. My OB, even though he was really wonderful, wasn't trained to determine where the baby is, just that the baby is head down. Meagan: Right. Clair: So at 41+1, early in the morning, I was over a week past my due date. I was losing my mucus plug. “Hey hon, we're going to have a baby today.” I was so excited. We ended up laboring all day at home. We went to the hospital. I had really, really bad back labor so I ended up with a lot of IV fluids. I had a couple more interventions. They broke my water eventually and basically, what ended up happening was that 41+2, so 9 days after my due date, I had dilated to complete, but the baby wasn't dropping at all. He wasn't engaged. He was still really, really high and after a while, his heart rate wasn't tolerating labor well anymore and they recommended a C-section. Meagan: Did they have you push? Clair: I didn't push. Yeah. They said he was still too high. They didn't recommend that. Meagan: Interesting. Isn't that how we get babies down? Clair: Yeah. I'm not really sure. Meagan: Yeah. Yeah. Clair: It definitely was a situation he was not used to or prepared for. He was kind of surprised and honestly very sad that I didn't have the birth experience that I wanted. He came to visit the next day and just spent a few minutes with us. His wife came to visit who I was friends with. It was really hard and pretty traumatic, but it also could have been much worse. His bedside manner, I was really well taken care of. 07:50 Recovering from a C-section while moving So that was really hard. It was a challenging physical recovery because I had 48 hours of labor and most of it was without an epidural. It was really intense. The hardest part of that birth was that the first time I saw my son, I saw a picture of him that the nurses showed me because they took him away to be measured right away. So that was really hard. He was 9 pounds, just that plus not being in a great position and being with a provider that didn't have a lot of options of what to do if baby is not descending properly. That was a difficult adjustment to motherhood especially because that baby was born in Louisiana. We were moving back to Virginia where we have a lot of family and friends. We were planning on moving two weeks after the baby was born, but because he came late, we actually left the hospital and started driving north. I would not recommend this. Don't do it. Meagan: That's a lot. That's a lot. Clair: It's a really bad idea. Meagan: Oh my gosh. Clair: His first night out of the hospital was in a hotel in Birmingham, Alabama. Yeah, don't do it. So yeah, that was just hard because we were moving and I'm trying to physically recover. So it was pretty wild. 09:24 Getting pregnant at 3 months postpartum & dual care during COVIDClair: That was my first. My second– we surprise got pregnant three months after that baby was born. Meagan: Okay. Clair: He was a cycle zero pregnancy. I had no idea. I just felt off and was like, “Maybe I should take a test,” and I was so shocked that I was pregnant. Meagan: Oh my gosh, yeah. Clair: Like I said, we were in a new state. I found a birth center that would do my prenatal care because I knew midwives knew more about positioning and how to track it and maybe had some recommendations about things they could do to encourage baby to be in a better position because my pregnancy had been great. But because it was right around 12 months between deliveries, they wanted me to have co-care and deliver at a hospital. I kind of just took their word for it like, “Oh, well if that's what they are recommending, then the risk really must be that much higher.” So then in the middle of all of this, COVID happened and hospitals– I was due in May 2020. Hospitals were kind of changing their– Meagan: Everything. Clair: Yeah, but by the week it felt like. Meagan: By the day. They were changing by the day. It was insane. Clair: Yeah. It was crazy. So it was March. I was due in two months and I had just reached out to the birth center basically begging them to let me deliver out-of-hospital because I was like, “I don't want to deal with the hospital system right now. I know that they are truly supportive,” but they said that they weren't comfortable with that. So my plan was to labor at home with the midwife from the birth center, laboring home with me then to transfer to the hospital while I was in labor. She was supposed to be– that midwife was supposed to come with me as kind of like a doula almost in the hospital just as support. Meagan: Yeah. Yeah, a monitrice or whatever they call them. Clair: Yeah, yeah, exactly. So then I had to find a doctor to do co-care with. I had a new friend in the area who had a C-section with her first and she had a not-great experience with this one doctor in the area, but that was the one that the midwives usually worked with so I kind of took her experience as, “Maybe not. I don't want to work with him.” I found someone else who was really VBAC-supportive historically, but then he had me do an ultrasound to determine scar thickness. This was all in the third trimester. Pregnancy was going really well, but in the third trimester, I had to start doing my appointments with him. Baby was actually breech pretty late on, so I started doing chiropractic care during that pregnancy and she flipped on her own. It was great. I was so grateful. So then at that ultrasound, we determined that yes, she is head down. He was concerned about my scar thickness, although then I did a lot of research and was like, “I'm just not sure that this is actually evidence-based.” Meagan: Yeah. Clair: And then also, they were telling me that she was going to be 12 pounds. I carried a big baby a year before, literally to the day almost and I was like, “This feels just like my first. She's got to be around 9. I don't think she is that much bigger than he was.” Meagan: Was the ultrasound saying 12? Clair: Yeah, yeah, yeah, yeah. Meagan: Okay, okay, okay. Clair: Yeah. The ultrasounds measured it and I mean, spoiler alert– it turned out to be way off. She was 9 pounds, 3 ounces. Meagan: Most of the time it can be. Clair: Yeah. Yeah, especially with bigger babies later in pregnancy. I was in a fine headspace with that. I was like, “I know that this can be off. I'm not worried about it,” but they were really nervous and anyway, basically backed me into scheduling a C-section, but I pushed it as far down the due date path as I could because I had gone over with my first and I still really wanted a chance to labor. So chiropractic care this whole time was really helping. I had bad hip pain with my first and I didn't have any with her after that. They wanted to do another scan at 41 weeks later or another ultrasound at 41 weeks just to check on baby, but I got them to do a non-stress test instead because I was like, “What are we going to look at?” She was healthy at 40 weeks. I was really glad that I had advocated for myself there because that was good. I did have one funky day of pre-labor at 40 weeks where I really thought I was going into labor. It was early labor then it stopped. I was checked after that and I was at 4 centimeters. I was walking around for a week and a half it turned out to be at 4 centimeters dilated so it was kind of interesting to know that that could happen. Meagan: Yes. Clair: The midwives I was with said they see that with VBACs a lot too that the body just takes things slower sometimes which was interesting to hear their experience of that. 14:39 Laboring at home to complete & hospital check-inBut yeah, I went into labor at 41+3– or 41+2 I guess– which was when my son was born a year before. I was in early labor all day. My water broke as I was nursing my one-year-old for bed. Meagan: Oh my gosh. Clair: It was kind of crazy and exciting. I was like, “You're going to meet your sister.” I put him down for sleep. The midwife came over. I labored from a 6 to a 10 in three hours. By 9:00 PM, I was fully dilated. She was dropping. At that point, looking back, I wish I had just stayed home because she was almost born at that point, but I didn't because I still had the midwife's voice in the back of my head, “Oh, it's only been a year. You're at a higher risk for rupture.” I just was worried and at that point in labor is not the time to be making decisions like that. Meagan: You're very vulnerable. Clair: Yeah. We ended up transferring. I get to the hospital. They stick a thing up my nose to check if I have COVID. Meagan: Oh jeez, yeah. Clair: So you're in labor already really uncomfortable and they're like, “We're going to swab your nose.” You're like, “Thanks.” They wouldn't let the midwife in which we kind of knew, but she came with us just to see if they would let her in, but they were only allowing one support person so my husband came with me.I ended up getting an on-call doctor who wasn't the doctor that I had been seeing. It actually turned out to be the first doctor that I was trying to avoid in the first place. Meagan: Oh, really? Clair: Yeah, so that I was not happy about. He literally takes one look at my chart and says, “A VBAC? This baby is going to be 12 pounds? Don't even bother trying.” I was like, “Um, okay.” Meagan: You're like, “But I'm 10 centimeters.” Clair: Right. Everything is fine. I'm healthy. She's healthy. Heart rates are all good. We're doing it. It's not a question of can I because it's happening. But he started– I mean, I won't tell you the things he was telling me about what happens if I should have had a C-section and I don't and the whole dead baby thing. The nurses were trying to keep him out of the room for me. It was so bad. It turns out later that he did talk to the midwives the next day and was like, “Why did you send her in at all? Why did you tell her she could VBAC?” Basically, he confided in them, “You don't know what it's like to be sued.” I guess he had something in his past where he had been sued for something that had happened, so he was just really scared but he was taking that out on me. Meagan: Which is not okay. Understandable, but not okay. Clair: Right, yeah. It took a long time for me to get over this and forgive him for some of the things that he said. Anyway, so my body starts having a stress response. Labor starts slowing. My cervix starts swelling a little bit. Basically, my body is like, “We don't feel safe here. We're not having this baby here.”17:49 Clair's second CesareanI did push for two hours, but contractions weren't really working the same way. He started talking about, “Well, if it's an emergency, we have to put you under general,” and all of this stuff so I did end up getting an epidural. I basically got backed into a corner and eventually, we said, “Let's just call it and have the C-section because we can do it on our terms and maybe get a couple of the things we still want.” We really wanted delayed cord clamping. I really wanted to be able to see her right away which I didn't get to do with my son. So we felt like if we just called it, we would be able to do some of those things because it wasn't an emergent situation. So really, for no medical reason, I had my second C-section. She was 9 pounds, 3 ounces and the doctor actually said to my husband after that, “Oh, by the way, your wife has a fine pelvis. There is no reason she can't birth vaginally. She can totally do this again in the future.” Meagan: Oh gosh. Clair: My husband was like, “I don't want to talk to you right now about that.” Meagan: Yeah, like get out of my face. Clair: Yeah, after you just did what you did and backed us into surgery, and he just wanted to be able to control the situation. Meagan: Yeah. 19:08 An emotional recoveryClair: So emotionally, it was really hard to recover from that. I had a really hard time just working through some of the things that he had said and the images he put in my mind, but it was physically a lot easier. Meagan: Yeah. Clair: We did move again after that baby, but we only moved within the state so that was easier. We move a lot and we've moved with every baby at some point which is kind of crazy. 21:22 Clair's third pregnancySo that's my second baby. And then about, I don't know, 15 months later, we got pregnant with our third. We were pretty excited. We had a really early, early miscarriage between those two and it was still really hard and painful but it was like the day after we found out we were pregnant so that was a surprise and that made us think, “Well, are we ready for another baby?” I kind of just started like, “Yeah, actually I think we are,” even though at the time, I felt totally overwhelmed. So that's kind of beautiful because if we wouldn't have had that baby, we wouldn't have our third right now. We were in the same state. The VBAC laws in the state are pretty lenient so I end up having the opportunity to find a home birth midwife because I just at this point really did not want to go back to the hospital after everything. There really weren't any hospital practices that I knew of and I kind of looked around a lot that were VBAC-after-two-C-sections supportive. So I look around. I found a home birth midwife. I had a beautiful pregnancy. Kind of in the back of our head the whole time, we were thinking, “If we just stayed home with our daughter, things would have happened naturally. It just would have been fine.” The whole pregnancy, I was a little bit nervous, but I had some really, really awesome supportive friends– the same friend who had a C-section and had a VBAC since then. She was so in my corner and another good friend of ours were just cheering me on the whole time. My midwife was really, really supportive. I did have some fears and worries, but I was just like, “We're just going to walk it out. I have no reason to believe I can't birth this baby vaginally.” I was continuing chiropractic care. The friend who had a VBAC had since become a doula. I planned on having her there. 23:38 Third labor with a home birth midwifeClair: I went into labor six days after my due date after this pretty beautiful, smooth pregnancy in the early morning and then again, I was dilated to 10 by 9:00 in the morning. It was five hours later after my–Meagan: You labor beautifully. Clair: Right. At this point, I was like, “I know my body can do this,” but I just had never made it all the way. I was starting to feel pushy. I pushed for hours and hours and hours which turned out to be really hard. The midwife, when I started pushing was like, “We're going to have a baby so soon,” and then– 24:08 Pause in story – read caption!24:20 Fourth pregnancy Clair: My son was nine months old when we got pregnant with our fourth. Like I said, we had moved to this mountain town in Colorado. We were far away from a lot of things, so it was really hard for me to find a provider in general let alone one who was going to be supportive of a VBAC after three C-sections. I was really open to if I needed to have a fourth C-section, I was open to that. I just wanted to do what was going to be best so I was looking at all of my options. All of our family was back east though and we were looking at support after the baby was born so we were thinking we might go back to Virginia and have the baby there. I ended up doing remote care with my midwife from my previous birth, my last birth, for all of my prenatals. Everything was looking great. The bloodwork looked great. I was taking my blood pressure and checking with her occasionally. I was doing that with her while also looking for a provider and trying to discern what we were going to do for the birth. I should also mention that during this time, I started going to pelvic floor physical therapy. It had been recommended to me a few times, but I never pursued it before. My chiropractors in Colorado had a really strong recommendation for someone that they really liked, so I started going to pelvic floor PT. She found all of this chronic tension that I didn't realize I had. Actually, my hip pain had come back this pregnancy and releasing my pelvic floor actually took care of my hip pain. It was all referred pelvic floor pain which was so wild, but I felt relief within a couple of visits. She knew really good exercises to be doing during my pregnancy. It also made me more in tune with the rest of my body. I realized where else I was carrying tension and was better in check with my moods, so that was a huge game changer I think. I want to make sure that I mention that because I think that really, really impacted this pregnancy and birth. So we did an anatomy scan at 20 weeks and everything was looking good. It was a baby boy, but we found out he was measuring big which is normal for my babies at this point. Kind of around the same time, I guess, my husband got this really amazing job opportunity in Utah which meant we would have to move again. I was due in October with this baby and we would be moving during the summer. This time, we would move before the baby was born then hopefully have a couple of months to settle in. Because of that, I switched gears and started looking for providers in Utah so that I could have a pretty seamless transition. I found a really awesome midwife. I told her my whole story and when we were in Utah just interviewing and checking it out during the winter, she heard all of my stories and said, “I don't see why you can't birth vaginally. I think you are an excellent candidate for VBAC. I would gladly take you on.” Meagan: She is one of the most amazing midwives in Utah, too. Clair: Yeah. She has a ton of experience, too. I love how she has that much experience, so I really felt like she has seen it all. She has seen a lot and if she says I have a really good chance, but also, I totally trusted her to step in if we needed to step in and try different things during delivery. That's the one thing I felt like could have gone differently with my third baby was maybe we could have intervened a little earlier and maybe that would have gone differently. She also promised my husband that she would be straight with him because he kind of had an experience of people trying to shield him from the truth or whatever in the past just to kind of protect him in the birth process. He just wants honesty, so she was like, “I'm going to be really honest with you the whole time. I'm going to tell you exactly what I think.” It was just a really good fit for our family.28:49 Moving to Utah Clair: I went back and started packing up the house and everything, but I knew that I had a really solid provider waiting for me in Utah. We moved at the beginning of August. I was maybe 30 weeks or so, 29 weeks, 31 weeks, or something like that when we moved. I thought I had two months or so to kind of get settled and unpack the house and everything, then at about 35 weeks, I started having some pre-labor stuff and a few contractions, but I thought they were just really strong Braxton Hicks at night. I lost a bit of my mucus plug and that was consistent for about a week, but because with my second, I had a whole day of labor and then nothing for two weeks, I thought, “Oh, I've still got two weeks. Baby will be here right at 37, but that's fine. I think I still have a couple weeks left.” I checked with my midwife and she was like, “Are you concerned about going into early labor?” I was like, “I don't think so.” She goes, “Great. Don't worry about it.” To my surprise on a Sunday night at 5:00 PM coming back from the grocery store to pack lunch for my husband for his first official day of work the next day, my water breaks. I come home and I'm like, “I think my water broke.” He goes, “Uh, okay. This is really unexpected,” because with all of our other babies, I went past my due date and we had been in our house less than a month. I called my friend who is a doula now. I was just kind of out of it. I didn't really know what to do. She walked me through. “Okay, call your midwife. See what's going on.” I called her and she was like, “We can check to make sure that your water broke, but if you are pretty sure, you've had several children so if you are pretty sure it's your water, you should just go to the hospital.” She told me exactly which hospital to go to which I was really grateful for because I had no idea where to go and I really trusted her recommendation. Meagan: You were closer to a different hospital, honestly. You could have gone to this other hospital. Clair: Yes. Yeah, exactly. I was so glad that I called her. I walked in and they were like, “Oh, your midwife called ahead for you. Great. Come here. Let's check you out.” I was at a 5, so I was 5 centimeters dilated already which was crazy. They did an ultrasound just to double-check his position. He was head down which they were happy with. This OB comes in who was on call. She sits down and just says, “Well, frankly, I don't think a VBAC after three C-sections is too risky, but it's just risk. I don't see any health problems right now. You're fine.” They hooked me up to a monitor. Baby was fine. “So we're not going to force you to do anything that you don't want to do. You're going to make the call.” We were really surprised because when we knew we were going back in a hospital setting, especially after our last two experiences, my husband and I were like, “Whatever happens happens.” He even said, which was so great, “Let me deal with them. You deal with the baby.” Meagan: Mmm, yeah. Clair: “You don't need to go in fighting. I'll go in fighting and you deal with the baby.” But then we didn't even have to fight. They were disarmed right away.Meagan: Which is amazing because especially with preterm– Clair: Exactly. I expected a frenzy and it wasn't. It was peaceful. We just basically said, “We're not going to do that. We're not going to just do an automatic C-section. We're going to labor.” They looked at my ultrasound, saw that he was measuring big, and said, “We actually would have changed your dates in our practice with this ultrasound so we think you are closer to 38 weeks.” I was pretty confident in my dates because I had been using a monitor to check ovulation and everything. I still felt pretty confident that he was 35 weeks, so I really didn't want to induce or make labor happen any sooner than it started because I knew that his lungs could benefit from another couple of days in utero. We talked that through a little bit and the next day, there was a new on-call OB. The nurses were great. They listened to our whole story and they were like, “We are willing and ready and prepared to support you.” So the next day, we get a new on-call OB and she just says the same thing, “I don't think this is a very good idea, but I'm not going to force you to do anything.” She listens to our reasoning both why we don't want to induce and also about a VBAC and she goes and she calls the midwife who had been supposed to deliver or catch the baby. She says to the midwife, “I actually don't think this is a very good idea. Why did you send you here? It is really, really risky.” The midwife says, “It's not as risky as you think it is. Actually, go do the research a little bit. There are not great numbers out there, but what we have isn't what you are saying it is.” So that doctor actually called a maternal-fetal medicine doctor at a different hospital that she knew and asked, “Hey, what do you think about a VBAC after three C-sections? Would you recommend it for a mom?” He basically gave her the statistics of the risk of complications with a fourth C-section versus the risk of uterine rupture with a VBAC and he said, “The numbers aren't great, but as far as we can't be 100% confident. We don't have–”Meagan: Enough evidence. Clair: “--a lot of evidence, but I would absolutely support her. It's actually less risky for her to do this vaginally if she can.” This doctor comes back and tells us that. We were shocked. She said, “I actually think a VBAC is the best thing for you and your baby. I'm going to transfer you over to our hospital midwives–” which was wild and so not what we expected. She was like, “Because I think that's more like the model of care you wanted.” We were just floored because we never– yeah. We never expected that from a doctor. We had never been respected in that way. That alone was just so healing. 35:34 Midwifery care in the hospitalClair: This midwife comes in and I chat with her a little bit. She made sure I got some food. I hadn't really eaten much since I got there. Meagan: I bet. Clair: It was great. They just really attended to me as a person. I still was not in labor. They weren't checking me because my membranes were ruptured and she just talked me through that. “There's really not that much of an increased risk of infection if you are waiting longer as long as you are not doing checks. If you don't have an infection already, you're probably not going to get one essentially.” We did lots and lots of things in that 24-hour period. We prayed. We asked for so many prayers from our friends. We called the midwife and chatted with her a bunch. My husband– I joke that he was my daddy doula during that time because we learned a bunch of things during our other pregnancies. We were doing a Miles circuit. We were doing Spinning Babies and abdominal lifts and everything we could think of. I was pumping. They got me a hospital pump to use. I was showering and trying to relax. We even discussed leaving the hospital and going home. We talked that through with them, but I felt pretty confident that once I went into labor, it was going to be pretty strong labor and I was confident he was pre-term. I wanted to stay. My kids were able to come visit which was huge. That was so helpful. I did a lot of fear release conversation with the hospital midwife was a big deal. I was just really worried. My oldest was only four and I was really worried about, can I do this? Can I be a mother to these four babies? It's so much more manageable when you are pregnant. The baby is inside, so I think that was actually really helpful. I think that was kind of keeping me from labor in a sense. We just kind of did that for the next day. I was sleeping, but I was continually being monitored so my sleeping was really fitful. At 2:00 PM the next day, my nurses from their first shift are back. They were like, “Oh no, you're still here and you're not in labor and there's no baby. What can we do?” I just said, “I'm so tired. I just have not been sleeping well. Every time I roll over, this monitor messes up the baby's heart rate with mine so people come flying in the room and I just can't really rest right now.” She talked with the hospital midwife who was on call that day and she really wanted to get things going. She was a little bit more nervous about the length of time my waters had been broken and was stronger with recommending inducing or something. She said, “Yeah. Let's just get her off the monitors. We have two days of great readings from this baby. Let's get her off the monitors. Let's turn down the lights. Let's get her in a new room, fresh environment, turn the lights down, and let her take a nap.” My husband even left. He went to go get a snack or something outside of the hospital just to totally give me my space.38:47 Active labor beginsAround 3:30, I finally get tucked in for a nap and fall asleep immediately. I was so tired. Meagan: I'm sure. Clair: It was just a lot of mental stress and I wake up an hour later at 4:30 to a rip roaring, super strong contraction. I couldn't even believe it. I was like, “Oh my gosh. Napping worked.” It was just what I needed. It was like my body just needed to be left alone. Meagan: And even probably you mentally needed to just get out of the moment and just be. Clair: Yes. Yeah. No, definitely. I start timing them and within five contractions, they were all lasting over a minute. They were all about a minute and a half to three minutes apart. I call my husband. I'm like, “You've got to come back to the hospital right now.” They were really strong too, like super, super strong. Meagan: And keeping in mind you were 5 centimeters so you could be tipping into that transition active labor from no labor. Clair: Right? Meagan: No labor to active labor. Clair: Yeah, just thrown right into it. Yeah, it was wild. I felt like I was kind of behind from the beginning like I couldn't get on top of it for that reason. It was really intense. I called the nurse in the room because I needed to go to the bathroom and I wanted to stand up, but I was like, “I don't know what's going ot happen when I stand up, so I'm going to call her in.” She came. She observed me in between some contractions and was like, “I think the midwife should come.” I was like, “No, it just started. Don't worry. Don't bother her.” She was like, “No, really. We should get the midwife in here.” The midwife comes in and checks me. I'm only at a 6 so I was a little bit discouraged because it had been a half hour-45 minutes of these strong contractions at that point, but 90% effaced. Baby was dropping. Everyone in the room was like, “This is really good news.” I was like, “Yeah, there is still a lot of work to do.” I just refused to accept that. So I'm kind of wandering around the room just laboring standing up in different positions and supported by a nurse sometimes, then I end up kneeling on the ground and laboring over a couch just leaning on it. The contractions really picked up. There really was not much of a break between them at all so I felt like I couldn't release the contraction. Everything you hear is like, “Release the contraction. Let all of the tension out of your body,” and I couldn't do any of that. So I'm telling my husband, “I need an epidural. I'm not going to be able to do this for a long period of time. I'm not getting any kind of a break. I can't relax.” Meagan: You were already so tired. Clair: Yeah. I need an epidural. I'm not going to be able to do this naturally even though that's what I planned. He was like, “No, you're fine.” I was so mad at him, but he would look at the midwife, I guess I found out later and she was like, “No, this is happening.” She was really encouraging him, so he was like, “Nope, you don't need it. We're going to be there really soon.” Meagan: Good daddy doula, I guess, there. He knows what you want and will help you get it.Clair: Exactly. Exactly. I'm not saying he was just ignoring me– Meagan: Right, but he was like, “Ah, she's got this.” Clair: Yeah, exactly. I guess the midwife had observed some kind of a change in me because at 7:00 PM– this is 2.5 hours after these contractions start– she checks me again and she asked to check me. I was at 10. I was feeling pushy, but not in the same way I had before with other labors, so I was surprised. All of the nurses in the room were like, “This is great news!” In my head, I'm like, “I've been there before. I've been there three times before. It is not over yet.” I was still very much in the mindset of, “No, we've got work to do.” I end up trying a couple of different positions to push. I end up pushing on the hospital bed kind of supported by pillows on all fours. They put the back of the bed up and I pushed there for about a half hour or so, maybe 20 minutes in. They were like, “Oh my gosh. We can see the head. This is so great.” Because of my third baby, I was just like, “That's news, but it's doesn't mean it's over.” Meagan: Not what I need quite yet. Clair: I've been here before. So I end up, yeah. I was just kind of like, “I've been here before.That's not news to me, I guess.” But then I really felt a ring of fire and I was like, “Oh my gosh. This is actually happening. This is a new thing. This is a new sensation. This is a new place that I haven't been before.” So I end up, yeah. He ends up being born. I pushed with all my might. The midwife had to tell me, “Chill out. Slow down a little bit. You don't want to tear.” But yeah. It was just so beautiful. I was able to birth him vaginally and then they were like, “You have to roll over so you can hold him.” They were telling me what to do because I was in such disbelief when I was born. I got to hold him skin-to-skin for the first time of any of my babies which was such a gift. My husband cut the cord after it stopped pulsing and it was so peaceful. A couple of the nurses were crying because they had been there and were really invested in our story. The midwife was like, “You reminded me why I'm in this field. This is such a beautiful, redemptive story. I'm so happy for you.” I did have a small, little first-degree tear but it really wasn't bad. He ended up being 7 pounds, 7 ounces so I'm pretty confident that he was late pre-term because that is still small for my babies. Meagan: Yeah, because they are normally 9. Clair: So he was definitely earlier. 45:04 Circumvallate placenta I had a circumvallate placenta which is where part of the placenta turns in on itself when it is developing so there is a smaller area where the placenta can adhere to the uterus. Sometimes that can be related to IUGR and a couple of other things, but it's really hard to find via ultrasound. I kind of researched it later and sometimes, it's cause for big concern but there's really not much to do about it. There's just not a whole lot to be done. I'm glad I didn't know that because I feel like would have been a source of worry but unnecessary worry because there's nothing I really would have done differently in my pregnancy. Meagan: I wonder if that was your body being like, “Okay, it's time. I'm done doing my job. Now get the baby out.” Clair: Yeah, it can also be associated with pre-term or early labor. Meagan: Okay. Clair: Yeah because I was trying to find a reason. This was so strange. My midwife wasn't worried about it at all. She was just like, “Oh, interesting. Look at your placenta. This is so cool.” Meagan: In all of the years of encapsulating them, I've never seen one like that. Clair: Yeah, it's kind of rare but also, yeah. They're not sure why it happens. I don't know why it happened. Some people say babies that gestate at elevation are sometimes smaller too like at high, high elevation and they come earlier so I'm wondering if maybe that can be connected. I don't know if there are more placenta abnormalities in that way at elevation. I don't know. But yeah, he had great APGARs. He latched super well. It was so cool. The first OB that I had called me the next morning in the hospital room just saying, “Congratulations. We're go excited for you.” My second OB, the one who basically said, “I think this is the right thing for you to try,” came to the room because she was on call again and she congratulated me and just said, “Thanks for letting us be a part of this. This was so impactful to everybody in our practice.” Meagan: Yeah. Clair: I don't think they would have taken me on as a client upfront. Meagan: Probably not. Clair: For them to see this, and then I talked to the head midwife of that hospital OB/midwife practice and she was just saying that this is their hope that more women who really can labor without intervention or are given the chance to labor without intervention is kind of their goal. She was so happy that so many of the people in her practice got to be a witness to that because they really got to see what happens especially down to napping and leaving me alone is what helped me go into labor. Meagan: Yes. There was a lot of learning happening on all of their behalf, from the OB side, on the nurse side, on the midwife's side, there was a lot of learning. What I love so much is when places see births like this after– I mean, I'm not saying the midwives or anything. I think the OBs were originally like, “I don't think this is a good idea,” but then seeing it happen, it's like, “Okay. Let's take a step back,” because so many hospitals around the world just shut people out. “No.” They might not, like you said, have supported you walking in. “I've had three C-sections. I really want to have a VBAC.” She probably would have said the same. Maybe she wouldn't have, though. Maybe she would have said, “I don't know if it's a really good idea, but we can support you and let you go.” But would it have been the same situtation? I don't know. They are one of my favorite hospitals in that direction up north, so I love hearing, I love hearing all of this. And then to the point where the OB is like, “Hey, I recognize you are in my care, but I know you came from this care. Why don't we put you back in that model of care because we offer that here?” Just these fine details that these providers paid attention to was a huge deal. Clair: Absolutely. Absolutely. It's funny because I had a feeling that whole pregnancy that I was going to have a hospital VBAC. Meagan: Really? Clair: It was in the back of my head. “I think I'm going to end up in the hospital, but I also feel like I'm going to have a VBAC. I don't know,” but it was this weird thought because I definitely was not going to pursue providers in the hospital, so yeah. The fact that that happened, I was like, “Wow. This is just so crazy for those reasons.” Meagan: So awesome. Clair: Yeah. I just really feel like not being afraid to voice what we wanted was such a big part of this because if we hadn't spoken up, even though they were very, very willing to listen and were receptive, we didn't know that so we went in saying, “This is what we want and this is why we want it.” I think that having a conversation where you think the doors might be closed is good to have. Now, it's also good to be aware of when a provider is not actually going to be supportive of you, but in our case, we really didn't have any choice. We were where we were and just to, I think, the more calm conversation that is had and the more providers can experience births like this, the more it will become normalized which is really the goal here. Meagan: Absolutely. Well, huge congrats on your beautiful birth and I'm so happy for you. I just love hearing how it all unfolded even though in the beginning and at the end, it wasn't exactly– well maybe I guess it was something that you envisioned, but what on paper you were putting out that you envisioned this birth center birth with this awesome midwife, but I just love how it unfolded so much. Clair: Yeah. It was so healing for my husband. It was so healing for me. Yeah.” Meagan: Good. Good. Well, thank you again for being here with us. Clair: 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

Women whose fetuses are in the occiput posterior head position at the time of delivery are known to have longer second stages of labor and more complicated deliveries, including more operative assisted births, more 3rd and 4th degree lacerations, PPH, and in some studies lower Apgar scores and lower umbilical cord arterial pH. At what point in labor should the healthcare provider attempt to rotate the fetal head: first stage or second stage of labor? Recent intrapartum studies using ultrasound to verify fetal head position has provided new insights regarding the cardinal phases of labor. In this episode, we will tackle the fetal occiput posterior position and manual rotation. Should this be a 1st or 2nd stage of labor practice?

Ariel is a 7 month old infant, born at 40 weeks gestation, with Apgar scores of 9 and 10. The baby is up-to-date for well child care and immunizations and has had 2 minor episodic illnesses at aged 4 and 6 months with full recovery.  Ariel rolled tummy to back, started to purposely bring hands together, and babble at around age 4 months, and has had a social smile since age 2 months. Ariel is the youngest of three children, and today, parents mention that they are concerned that, “She's not sitting up by herself yet. Our older kids were all sitting by now. She tries but then falls over.” Physical exam reveals a highly interactive healthy appearing infant with excellent muscle tone, who age appropriately resists exam. The NP considers which of the following? A.  Refer the infant to an early intervention program for additional evaluation. B.  Discuss a referral for genetic counseling with the child's parents. C.  Advise that the child's clinical presentation is consistent with normal parameters for an infant of this age. D.  Order testing for plumbism and iron-deficiency anemia. ---https://www.youtube.com/watch?v=650oKqmbEgk&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=56Visit fhea.com to learn more!

Puppy Evaluation System Developed by a Woman Ahead of Her Time [caption id="attachment_12746" align="alignleft" width="360"] Virginia Apgar, who named the newborn evaluation system.[/caption] Dr. Marty Greer, DVM joins host Laura Reeves for their ongoing puppy discussion. This month Greer shares the story of Virginia Apgar, who named a now-famous newborn evaluation system after herself. Apgar was a human anesthesiologist who graduated from medical school in the 1930s, Greer noted. “She was the first female anesthesiologist admitted to the College of Anesthesiology back in an era where there were no women doctors. There were no women a lot of things. So she was truly remarkable, Greer said. “In that era, a lot of babies were born to mothers that were sedated or anesthetized. And so (Apgar) developed a scoring system to analyze the babies and it has stuck for the last 70 years and it's very impressive that it's something that people talk about every day, still using the word APGAR. The acronym stands for: appearance, pulse, grimace, activity and respiration.” The system was adapted for small animal veterinary use by a vet on staff at the University of Minnesota. “The advantage of a numerical score,” Greer added “is that it gives you something that you can measure and compare litter to litter, puppy to puppy within the litter over the course of time. And we have some really good data from Neocare, which we talked about last time, about what the relationship with the APGAR score and the survival of these puppies will be. So it's actually super cool that you can take all this information and turn it into something that you can use at home, you can use at your veterinary clinic, and that your veterinary clinic can help you with. So I would encourage people to learn to do APGAR scores. It's not hard, it's not mysterious. It's really pretty straightforward on what to do with it. “The value of this is when you go home (from a csection, for example) and you have a puppy that had an APGAR score of a four and a puppy that had an APGAR score of a nine, that you know the puppy with the four needs a lot more attention to have the kind of survival rates that one would hope for. We always hope for a hundred percent (survival), but reality is 100% is probably not a realistic goal. “Each of the five parameters, appearance, pulse, grimace, activity and respirations gets a score of a zero, one, or a two. So collectively, if you get twos on all five of your items, you have a score of a ten. “It's really simple to do. It doesn't require high level assessment and like I said, a lot of us probably are intuitively already doing this. When you have puppy born, if it's fish breathing and gasping and gaping, that's not good. But, if it's got nice pink color and it's wailing and it's crying and it's wiggling and it's pink and it's all those things, you know that you've got a puppy that's in pretty good shape. But it's just nice to be able to give it a more numerical sign because that gives you data to work with. “The average puppy is gonna be seven and up. It does give you a numerical score. The value of this is knowing that from the Neocare information, that's from the University at the Toulouse -France Veterinary School, the puppies with an APGAR score of less than seven have a 22-fold increased risk of death in the first eight hours after they're born. “And they also know that puppies with APGAR scores between a four and a seven can achieve a 90 percent survival rate with the appropriate interventions. So, what does that mean? That means you suction them, you put them in oxygen, you make sure that they're staying warm. You're doing all those things that you already have been trained to do to help with puppy resuscitation so that they're not just you know laying in the whelping box kind of hoping that they do okay.” Greer's seminal book "Canine Reproduction and Neonatology" is available

You know what an APGAR score is, but can you explain what it measures in Spanish? Stay tuned to find out how. ¡Bienvenidos! Welcome to Medical Spanish for Pediatric providers. Lesson5: Historial de nacimiento. Birth history for the newborn visit Complications = Complicaciones Birth weight = Peso de nacimiento Birth length = Tamaño de nacimiento Head circumference = Circunferencia de la cabeza NSVD, Cesarean, vaginal induced = Parto vaginal espontáneo normal, cesárea, inducido vaginalmente Gestational age = Edad gestacional Apgar = Apgar (Aspecto, pulso, irritabilidad, actividad y respiración) Hearing test = Prueba de audición Newborn screen = Pantalla de recién nacido Bilirubin = Bilirrubina Postpartum depression = Depresión posparto Extended Lesson, The Newborn History in Action Outro: Please don't forget to like, comment, follow and subscribe! ¡Hasta Luego! Learn more about the full program: pediatricmedspanish.com Disclaimer: this program is not meant to teach medicine or give medical advice, if you or someone you know is in need of medical care, please visit your assigned medical provider.

“It's very fitting that this is going to come out just before Thanksgiving because I feel very, very fortunate.”Becky's two babies were both posterior and asynclitic. They weighed exactly the same at birth, but their deliveries were very different. Becky shares her sweet experience going from skepticism around home birth to fully embracing all that it has to offer. Her first birth included residual trauma which made for a very difficult postpartum period. Her second birth was full of safety, peace, and healing which left Becky feeling so joyful, so strong, and so thankful. Happy Thanksgiving week to all of our listeners. We are thankful for your stories. We are thankful for your love for us and for each other within our VBAC Link community. Your commitment to healing, education, and better birth experiences lifts us all and makes the birth world a better place. We are thankful for YOU, Women of Strength! With love, The VBAC Link TeamAdditional LinksThe Lactation NetworkHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello. Welcome to The VBAC Link. You guys, this is my first episode back from taking a really big break through the summer. You guys have still had episodes, but I recorded up through May right before my kids went to school and then took the summer off so I could have fun and spend time with them. I've got a middle schooler who went back to school today for the first time in middle school. It was bittersweet then I've got a fourth grader and a second grader. So they are back to school today and I figured, “All right, let's get back to school today.” We've got Rebecca with us. Welcome, Rebecca. Becky: Hi. Meagan: Hi. Thank you so much for being here with us today. Rebecca is from Seattle, correct? The suburbs of Seattle?Becky: East side, yeah. Meagan: She is going to be sharing her VBAC story with us today. Her VBAC– we were just talking about this before we pressed record. It has a lot of things. We've got– okay. Do you want me to name it or do you want to go through it? Becky: I can name it. There was a late-term transfer to home birth with a sort of faux dual care that ended up not being dual care just before I went into labor and pushed on my back and a posterior and asynclitic baby. Meagan: Yes. Right there, posterior and asynclitic– those two together are like, whoa. It's awesome because a lot of the time, that is a reason for a C-section. Asynclitic or posterior, but when we have an asynclitic and posterior baby, that definitely adds some things so I'm excited for you to be sharing your story with us today. Okay, so her name is Rebecca but do you like to go by Becky? Becky: Yeah, actually you can call me Becky. That's fine. Meagan: Okay, yeah. Becky. I was going to say as I was reading through your form, I remembered seeing Becky. Yeah. Becky is a music teacher from little babies all the way to my oldest, middle schooler age. Let's see. You do voice and Music Together and composing and all of the things. So music is definitely really, really close to your heart. I love that in your bio thing that you gave me, you talked about singing in your C-section, right? Becky: Yeah, yeah. Meagan: And how healing that was. Becky: Yeah, I think it is really important just as an idea for someone to have if it works for you because it definitely was very helpful for me. Meagan: Yeah. I love that. Well, I can't wait to hear your story and more of the things that help. I think sometimes too when we have unplanned C-sections, or even if we are preparing for VBAC but go in for a C-section, it's always nice to have some of those tips to say, “Okay, I can try this to see if it helps me stay calm or brings me peace.” Review of the WeekAwesome, well we have a Review of the Week as always and then we will get into Becky's story. This is from postpartummama on Apple Podcasts and it says, “A surprisingly and valuable postpartum resource.” I love that because we are not a postpartum podcast, right? But there is a lot. We were just talking about it two seconds ago about things we can do during our birth to help it be a better experience. When it's a better experience, it helps with our postpartum experience. She says, “Once again, I found myself listening to episode after episode of this podcast. It is truly an invaluable resource for anyone preparing for birth or healing from a traumatic birth. Julie and Meagan approach topics that are often hard to discuss and they do so without judgment creating a community of acceptance during a season of life that can often feel alienating and overwhelming.” That just gave me the chills. She is not wrong. This journey can sometimes feel so lonely. I know I felt lonely during my experience prepping for my VBAC. It says, “I listened to this podcast while preparing for my VBAC and although my VBAC was successful, it was also traumatic. Now six months postpartum, I'm listening to each and every episode again and in doing so, I'm processing my second traumatic birth experience at my speed. It's helping me mentally and emotionally heal from everything that happened and lessening my fear of childbirth. Thank you, Julie and Meagan, for–” Oh, I just lost it. Hold on. I moved it. “Thank you, Julie and Meagan, for dedicating your time to educating women in such an approachable way. I can't recommend your podcast enough.” Wow, postpartummama, this was back in 2021 so a couple of years ago and that just makes me feel so happy. I don't think we've ever had a review that has talked about how it's truly helped them in the postpartum stage so I love hearing that. I love that she also talked about that she had her VBAC but it wasn't necessarily all sunshine and butterflies. It had some trauma involved. I think it's important to talk about that and realize that all C-sections aren't traumatic and all VBACs aren't sunshine and butterflies. Julie and I, in the past, have talked about that. We recognize that and I hope, postpartummama, that you have found your recovery and that maybe you are still with us today and listening to your review. But I hope that you have found that peace and recovery through your postpartum journey. As always, if you want to leave us a review, we never reject a review. You can leave it on any podcast platform so thank you so much. Becky's StoriesMeagan: Okay, Becky. Again, thank you so much for being here with us today. Becky: Thank you. Meagan:  Yes. Becky: So I'll just jump in, I guess. Yeah? Meagan: Just jump in wherever you feel that you want to start. Becky: Okay, so I'll start with the C-section. I was in New York at the time and I felt very committed to having a vaginal, unmedicated birth. I was with a midwife practice. It was three midwives who had birthing privileges, I guess is the term, at a hospital in midtown. Everything was really normal and healthy with my pregnancy. I got to 41 weeks and they asked if I wanted a membrane sweep. I said, “Yeah. Let's go for it.” So two days after the membrane sweep, I think I lost my mucus plug or something and then two days after that, we went to a restaurant in the evening. We were walking back to our apartment and I started to feel low cramping which I now know is contractions. At the time I didn't know. I feel like nobody tells you that it feels like cramps. It does. Meagan: Yeah. And it can. It can start just like little period cramps or maybe you even feel like you have to go to the bathroom like bowel cramps. Becky: Yeah. Uh-huh. The bowel cramps come later. Meagan: Right? Posterior babies. Becky: Exactly. We got back and I was keeping an eye out for the timing. I saw that they were very irregular. I knew enough that it kind of hinted towards a posterior baby but I was like, “Whatever, we're good.” The midwives said to try to get some sleep. It's not that it was so uncomfortable at that point I couldn't sleep, but it's happening. It's exciting. So I really didn't sleep. My husband didn't really sleep much either. We called the doula. She came around at 5:00 AM or something like that and I started to feel pushy. I knew that that is also a symptom of a posterior baby but also, my mom had quick labors so I was like, “Mmm, I don't know.” It was also a Monday morning, so we decided, “Let's drive to the hospital,” because it was in Midtown. When we got there, I was only 3 centimeters. We went to a hotel nearby. We got a hotel room for one night and I labored there. Things started to get intense there. I mostly liked the shower. Actually, my midwife because she came to the hospital but since I wasn't admitted, she was just kind of waiting for me because she didn't have other patients at the hospital. She actually came to the hotel room and did a check there. Meagan: Really? Becky: Yeah, to see so that I could skip triage. Meagan: Wow. Becky: I hear that is very unusual. She went above and beyond and I was a 7 at that point or something. Meagan: Oh, wow. Becky: I skipped that when we went to triage originally, the midwife had me lay on my back with my legs hanging down. I have learned that is Walcher's. Meagan: Walcher's, yeah. At 3 centimeters, she did that? Becky: Yes. Meagan: Okay. Becky: After that, the contractions stopped. It was easy. I could walk again and everything felt fine. I was like, “This is 3 centimeters with a not-posterior baby versus a posterior baby. It makes quite a big difference.” But she went right back. Anyways, when we went back to the hospital, it was supposed to be intermittent monitoring. I was moving a lot and with the movements I was doing, they couldn't get a clean, 20-minute read. The nurse was very nice. She kept trying to get it, but it kept getting interrupted so it was really continuous monitoring. At a certain point, I started to feel like, “This is not happening.” I started to feel like I couldn't do this. They were like, “You're doing it. You're doing it.” I was on my back and the midwife said, “Why don't I try to direct pushing for you?” She said that she could see the hair. The energy in the room was like, “You're doing it.” I felt like, “I am not.” Then, the energy in the room shifted because the midwife felt the ear. She felt the baby's ear and she said the baby was asynclitic. From then on, the contractions were so close together. I couldn't get rest in between. I had done some pushing that seemed to be doing something, but I was getting tired because we hadn't slept. I also hadn't eaten because I had thrown up what I tried to eat. Meagan: Oh, yeah. Becky: It was everything. Eventually, it was back-to-back contractions. Somebody suggested, “Would you like to try an epidural?” Although I was wanting an unmedicated birth, I was like, “Yeah. I think I need to rest. I can't.” I could feel like I wasn't able to push anymore. Meagan: Well, and if you have an asynclitic baby too, a lot of the time we have to get baby up and reset. Sometimes it can be really hard unmedicated when you are so tired and when time has been going. It's nice to maybe get an epidural and let your positions and rest to really allow that baby to try and reset. Becky: Yeah. Yeah. So I slept after I got the epidural and then when I woke up– my husband later told me that I was only asleep for an hour but I woke up and it was dark already. We had gotten there in the morning. It was late October, so it wasn't that late, but it was probably 5:30 or something. So they were like, “Okay, let's try pushing now.” I was like, “Um, what? What do I push and how and also, why?” I didn't have any connection. I didn't understand how I could possibly push. I was like, “Is this it?” It was clear from their faces that no, it wasn't it. It was not it. I don't know. We tried other things, but eventually, because of the continuous monitoring, they were getting the heart rate and it was starting to look not as good. It was the situation where it was like, “It's okay, but the OB/GYN on call might not be okay with this.” We could try Pitocin, but the midwife was like, “I don't know what Pitocin is going to do for you because your contractions are already really close. It could likely make the heart decelerations worse.” It was like we could continue going as we were going or we could start to talk about C-sections. At that point, I was just like, “Yeah.” We didn't see any other option. We didn't see any other solution. Meagan: Baby wasn't turning. Becky: No, baby wasn't turning. I mean, yeah. So we got ready for the C-section. They gave me some anti-nausea medication. I was like, “I already feel like I'm going to throw up.” They were like, “It's okay. This will help,” but they gave me the medication and I immediately threw it up. They gave it intravenously. We went into the operating room and I asked them if I could sing during the surgery. The reason for this was that I had another weird medical situation where my husband actually suggested singing because I was breathing so shallowly and I was so anxious about it. It really slowed down my breathing and just made me feel so much calmer. I guess, I don't think I had thought about it in advance, but once C-section became a reality, I was like, “I'm going to sing.” Meagan: Do it, yeah. Becky: They were like, “Yes, absolutely.” The energy in the room felt like it was a party. Everybody knew each other. They liked working together and they were like, “Now our patient is singing for us? This is great.” The C-section was really quick. I did not feel that way. I did not feel like it was a party, but I was like, “This is calming myself, so I'm going to keep going.” She came out pretty quickly and she cried quickly, but I guess after the fact, it was not a gentle Cesarean because of all of the things. She was off in the corner for a long time and her APGAR scores were good. She was healthy and I was very thankful that I was singing so she could hear my voice, but it felt like a long, long time before she came onto my chest. Even when she did come onto my chest, the feeling was sort of fear and like, “Um, hi. How are you? Who are you?” Meagan: A bit of a disconnect. Becky: Yes. Part of the reason why I had wanted an unmedicated birth was that I was interested and excited about the hormone cocktail that they talked about. This was certainly not that. But we went into the recovery room and the midwife and the doula were with us. They were like, “Do you want to try breastfeeding?” I was like, “Oh.” I had prepared for the breast crawl. I had prepared for the natural things so I did not know how to do it. I didn't know how to do it. So I was like, “Okay. Go, baby.” She did not know how to do it. So she did not latch. The midwife helped me, but she didn't latch and then she was getting sleepy so it was like, “Okay, we'll try it later.” A nurse or something said, “Oh, we've got to take the baby for some regular checks of some kind.” So they took the baby. My doula left. My husband and I were left in this room and there were other people in this recovery room. It started to be again, a long time without my baby who had just exited my body. I was like, “What's going on?” I really felt like screaming. I felt like screaming like a crazy person, “Where's my baby? Where's my baby?” Meagan: Getting anxious, yeah. Becky: What stopped me was that there were other people in the room and I was afraid of scaring them. That also feels not good that I was not free but also good that I wasn't screaming like a crazy person. I had my husband go find her and she was just chilling out with a nurse. They were just waiting for my room to be ready so it was just sort of a logistical thing that they were like, “Oh, her room's not ready. They're going to wheel her in. We'll just wheel the baby straight to the room with her.” Meagan: Why not just keep her with her? Becky: There was no reason for the separation other than that was the reason. Breastfeeding was very difficult. She did not latch. I did not have good lactation support at the hospital and all of the people that came around were like, “No tongue tie, no lip tie.” Spoiler alert, she had a tongue and a lip tie. Breastfeeding has a happy ending. We got the tongue tie and lip tie revision and she latched by two weeks. We had to do triple feeding. That was rough, but she was breastfeeding by the time she was two weeks and I breastfed her until she was two. By then, she was only doing it at night, but that had a happy ending. I did have a posttraumatic stress disorder really not even from the C-section, I think, but from that postpartum period and specifically from the separation. I struggled, actually, with saying that it was traumatic because it's like, “Well, everybody was healthy and everything was fine.” I was treated with respect. There were no stories of doctors or nurses being snarky to me or whatever but it was just the idea of being separated is still really sad at this point. Now, I can think of it, but for a long time– at first, I would ruminate on it, and then after a while, if my brain started to wander towards the topic, it would be like, “No, no, no, no, no. Let's go over here and think of something different.” My brain wouldn't let me think about the postpartum time. Meagan: Yeah. Becky: But therapy is good. I highly recommend it. I went to the Motherhood Center. They specialize in pregnancy and postpartum things. Meagan: Awesome. Becky: Anyways, I had a lot of trouble listening to people's birth stories. Even with friends, if they shared their birth stories, they were like, “Oh, and then I was pushing.” I was like, “You didn't even do any of the things that I did. I felt like I had prepared so much for this and some people had done no prep or were just doing it. It was very difficult for me to hear birth stories. So what made me know that I felt ready for another baby was that I was interested in listening to The VBAC Link. I wanted to test out the waters and see if listening to a birth story felt acceptable because before, it was like, “No. I can't do this.” And it did. But I was like, “I'm just going to stick to The VBAC Link. That's safe.” I wanted to listen to repeat C-sections to successful VBACs to HBACs and all of that, but it felt comfortable to listen to them so I knew I was ready. Meagan: Oh, that warms my heart. Becky: Yeah. Meagan: That warms my heart to know that The VBAC Link could be a safe space for you. It's not even something that you're going to do, but you're listening. You're willing to go in and you're listening and you're like, “Okay. I can do this.” All of these people and all of these Women of Strength who are telling these stories put power in your pocket. Becky: Yes. It felt good to listen to it and yeah. Meagan: And now you're one of them. Becky: Now, I'm one of them. It's so surreal to be telling this story and also to be hearing your voice and seeing you because I'm so accustomed to hearing your voice and I'm like, “Oh, that's what she looks like.” Meagan: Oh, that's what she looks like. I'm a hot mess all of the time. Becky: Not at all. Not at all. So we moved to the Seattle area during the pandemic. I felt strongly that I wanted a birth center birth because I was at a hospital. First of all, I didn't get the lactation support that I wanted and then you were there and kind of trapped, I felt. I said, “Let's do the birth center because it will be a little bit higher chances of VBAC, but you still have more medical support of some kind.” I quickly learned after reaching out to the birth centers that in Washington state, birth centers cannot do VBACs unless they are birth centers attached to a hospital. So I was like, “All right. Do I want to look into home birth?” It felt like that was two notches of crunchy granola beyond where I was. I'm fairly crunchy granola but I felt like that was just a little bit beyond there. I actually interviewed a home birth midwife and the way she put it was like, “If this happens, you go to the hospital. If this happens, you go to the hospital. If this happens, you go to the hospital.” I sort of felt like there was an additional set of policies that you had to meet. The reason I was interested in out-of-hospital is that I was not interested in being tied down by all of the policies, right? Meagan: Right, right. Becky: So I was like, “No, no, no.” There was one birth center attached to a hospital 20 minutes away. I was like, “All right. The decision is made. I'll go there.” I went there and it is really a hospital. You go to a hospital and it is in a hospital. Yes, there are midwives. Meagan: It's similar to what you had the first time. Becky: Yes. It's similar to what I had the first time. It was just in a hospital. I was like, “All right, I guess.” The midwives were nice. The nurses were nice. I was like, “All right. This is my only option.” So I was going and I got a really, really great doula who they recommended. Part of the reason the doula was so great– I mean, I guess all doulas do this maybe, but she encourages you to do video chats or calls in addition to the regular meet-ups. That was really good because it helped me to feel really close to her. Meagan: Yeah, really personal. Becky: Yeah, emotionally connected. So anyway, things were going fine again. It was a perfectly normal pregnancy except that I got COVID during it. The hospital was a little bit conservative about wanting more checks. I was like, “All right. That's not great, but okay.” Then at one appointment, they were like, “Okay, now you've got to set up your appointment with the OB/GYN just as a VBAC consult. It looks like the doctor you're seeing is going to recommend not a VBAC. You can just ignore that, but she's going to recommend not a VBAC because your VBAC score is 69.5 and I know that doctor only recommends that if your VBAC score is 70 or higher.”I was like, “What? The VBAC Calculator? Are they still using the VBAC Calculator?” I was saying, “Please tell me that at least you are using the version that does not use race.” Meagan: The updated version. Becky: They were like, “Well, no. This one is the older version.” I was like, “This hospital is so behind that they are even using the non-updated version which is racist.” It just sort of was a wake-up call like, “What policies am I going to be privy to that I'm not asked about?” because I was just like, “This is my choice and they are midwives so they're going to be good.” But this is a hospital and there are policies and you have to abide by them or you have to put up a fight. My husband and I are both not prepared for that kind of thing. We just want to go with the flow. Meagan: Well, and what makes me laugh is– okay. Okay, this might sound really rude. I'm not trying to shame anybody who uses The VBAC Calculator. If that's your thing, that's your thing. But who in the hell pulls up a random number like that and is like, “No.” Like, what? And it's 1%? Anyway, I don't like The VBAC Calculator. Again, not shaming anyone who uses it or chooses to. I personally don't like it and I just don't love when they are telling people, “No” based on something that they personally came up with themselves, not something the evidence shows. Becky: Exactly, exactly. I didn't even want to go to this appointment because I didn't want somebody telling me, “I don't think you should get a VBAC.” I just didn't want that in the air. I had done the research. I know that it's safe. You know? Let's not do this. Meagan: You've done the research and you are there making the choice to do that. You are looking for support. It's not that they can't educate you along the way. They should be on both ends. Becky: Yes, exactly. Meagan: But they shouldn't be deterring you based on a made-up number. Becky: Yes. Yes. I talked to my doula at length about it. She really recommended taking this because I was like, “Should I be considering a home birth again? This doesn't feel good. This doesn't feel good anymore.” She was like, “Why don't you take this?” There is a VBAC class with Sharon Musa that everybody has been recommending across the board. She's local to the Seattle area. So I was like, “Okay.” I kept hearing people recommending it so I was like, “Let's just do it.” I took this class and it was very helpful going into all of the specifics about the risks and the benefits of everything and what is the risk. Not like, “You should do this or you should do that,” but “This is the actual level of risk. It is comparable to x, y, z. What are you comfortable with?” Meagan: What risk are you comfortable with taking? Becky: Yeah. I really appreciated that because it was put in such plain terms. But I was also like, “I know that even though this is clear to me now, but also, what is the risk with home birth VBAC versus hospital VBAC?” The truth is there just isn't data for that because not enough people have home births and not enough people have home birth VBACs. I was like, “All right. This isn't helping my decision really.” But she did recommend looking into the hospital VBAC statistics. I was like, “How do you do that?” I tried to talk to the midwife about it. You can't really get hard numbers. You can just put it in Google. I forget what it was, but there was some outside source from Washington State or something. It's probably the same in every state that gives a percentage of people who do VBACs in the hospital versus C-sections. I looked at the hospital where I was planning to go. The percentage, I kid you not, was below 20% for VBAC. It was below 20%. I was like, “This number has to be including people who are choosing to do a repeat C-section. It can't be that low.” The national average is supposed to be 60-70% or even higher than that, right? I asked my doula about it. She looked at the statistics and where I had gotten it. She said, “No. The way they phrased it is for people who go for a TOLAC and get their VBAC.” I was like, “That is an insane statistic. I don't want to be a part of that.” She recommended two other hospitals that had better statistics, but the better statistics, one was 28% and that was closer, and one was in Seattle which was 54%. That was the highest it gets. I called that hospital up. You couldn't get a midwife because, at that point, I was 32 weeks or something. I could go and just have an OB/GYN and you're still probably in a better spot because you're probably going to a place that has better policies, but it still felt like I liked the midwife care. Also, 54% still does not feel pretty good. Meagan: I know. I know. When the overall success rate is between 60-80% and upwards, when you're getting these lower numbers, you're like, “Ah, I don't love that. 50% is half a chance.” Becky: Yeah. Yeah. So I was like, “You know what?” I originally reached out to home birth midwives. There was one that looked really good, but she said that I was outside of their range. Meagan: Zone? Becky: Yeah, their zone. I learned that my doula had worked with them in the past. I said, “Why don't I reach out to them again?” My doula has an in with them. I felt like my doula was the key. She knew everybody. Maybe things are different. Maybe they don't have enough people around that due date. Sure enough, I don't know if it was the fact that they just didn't have anybody for that time or if they knew my doula and felt good about it, but they said, “Yes.”I interviewed them and I felt much better about home birth with them. It didn't feel like now there were more policies, it felt like she knew what she was talking about. She talked about dehiscences which I hadn't even known about before somehow. I felt really emotionally safe with her. I think that's something that people don't talk about, but one of the reasons I chose my doula was that I felt very comfortable crying with her. I'm a crier. I cry a lot and there are times when I'm around people and I cry and it feels blocked and shameful almost. It just feels bad and there are people when I cry around them that it feels cathartic. So I felt like, “Yeah. Let's do it.” My husband was not on board with home birth at first, but he was like, “You know, your emotional health is really important too.” Meagan: I love that he recognized that. Becky: Yeah. Yeah. I mean he had been there during postpartum for the first one and witnessed first hand so he really knew. But no, actually I skipped the dual care part. I liked her but I still felt really like, “Home birth, this is not me.” I was looking around on your website at the blogs and whatever and I came across the term “dual care”. I had never heard about it before and I was like, “Oh my gosh, this is it.” Suddenly, home birth felt comfortable to me with the idea of dual care that if something happens, you just transfer to your regular doctor. The home birth midwife was on board. I went to what turned out to be my last appointment with the midwives at the hospital. It sounded like they were giving tacit acceptance. They were like, “We can't do that because health insurance is not going to cover two appointments. We can't turn anybody away and technically, if you don't tell us that you're transferring care, you're still our patient.” It sounded like this was faux dual care that I would just go to my home birth appointments. I was already 34 weeks at that point. It sounded like I was just going to be able to do it. What I did was I would call them after hours to reschedule my appointment with the hospital midwives, but then when they called me back to reschedule, I would not pick up so then it just would never get rescheduled. Okay. It went like that. The appointments were great. When I missed my 39-week with the hospital midwives, I had three messages from them. This time, two of them were from one of the midwives. It wasn't just the receptionist, okay? I started to feel really– it was like, “We know what's going on.” They were like, “The jig is up.” I started to feel really guilty about it and just uncomfortable with lying. I was essentially lying. I talked to my doula about it. I had a really long nap and I was supposed to call her during then, but I called her after the nap. We decided that I was just going to fully transfer care. It felt better than lying. I would call the next day which was Monday but oops, no. The next day is Labor Day so we won't call then. We'll call on Tuesday. But I did not get a chance because, at 3:15 AM, I woke up with a little wetness. I was like, “That is not my water breaking,” because, with my first, it was a very dramatic, movie-like gush. I went to the bathroom and I smelled it and it was not pee, but I was like, “Nope. It was probably really diluted pee. This is not my water breaking. This is not it. Nope, nope, nope.” Then I lost some mucus plug and I was like, “Okay, yes. That was mucus plug.” With my first, it was two days later that I went into labor so that was a more comfortable timeline for me. My daughter was starting her new class at school the next day on Tuesday. I was like, “Nope, it's not happening now.” I just kept saying, “No, I just have to poop. This cramping is because I have to poop. I haven't pooped in two days. That's all it is.” My husband was like, “Maybe I should call the doula.” I was like, “No, it's the middle of the night. You can text her, but this is not it.” Meagan: You don't need to call. Becky: It was a good thing I was in such denial because had I not been, I would have suspected a posterior baby. But because I was in serious denial, I was like, “No, no, just no.” Things started to pick up. Eventually, we did call the doula. I did the Miles Circuit and it was too intense already. When the doula came, it was like, you know when a horse is whinnying and they are really anxious about something or panicked and whoever is helping the horse is like, “Whoa, whoa, whoa” and calms the horse down? That is what my doula did. Everything took it down a notch. Everything was much calmer. We started filling up the birthtub. Things were getting really intense really quickly. The midwife arrived and she asked if I wanted to be checked. I said, “Yes.” I was already at 8 centimeters. I was very glad that felt good. Meagan: I bet, yeah. Becky: I got in the tub, but in the tub, it felt like I couldn't hang onto anything. It was hard to get a hold on anything. I learned after the fact that I started pushing there. They kept saying I was roaring, but they kept saying, “You're wasting that energy up and you need to send that energy down.” Meagan: So you're bringing it up but not sinking into it. Becky: Yes. Yes. I was sort of like, “What does that mean?” I was told that roaring is good, but I learned that they were right. It's not so much that I was sending it up, it's that I was shying away from down there. I was like, “No, everything is crazy down there.” They said, “Why don't you come? We'll do some directed pushing.” At that point, I was like, “No!” because that's what happened in the first one. My doula was like, “No, no, no. Don't worry. You are already much farther than the first one. This is a different birth.” I had affirmations up on the walls everywhere. She reminded me of one of them. So anyway, we started to do and it was clear that on my back, I was able to push better. Now, this goes against everything I had been taught about pushing and that people talk about pelvic dynamics and everything. I had been getting pelvic floor therapy and my thing with that was releasing. I needed to release. Whenever she did the internal release, I was on my back with my knees out. That was the position where I was doing my most effective pushing because I had inadvertently trained my body that this is the position in which you release. That's what you need to do to push. So just for any of you who are getting pelvic floor therapy and getting internal releases, try to do it maybe in a position where you want to push. After a while, the assistant midwife was like, “Do you want to try knees together?” I was like, “Knees together? I know what that means! That means it's late.” But still, even knees together just weren't as good as knees apart. Something about it with my knees apart on my back was where I had the power to push. I felt the baby's head at one point. I was pushing and it was getting there. It was taking a long time, but it was getting there. The assistant midwife started taking the heart rate of the baby.Meagan: With the Doppler? Becky: Doppler, yes. I sort of clocked that it was varying widely. She told me after the fact that it was totally normal. She was not worried but I was clocking that and I was like, “This should be over soon.” I asked my midwife, I was like, “Can this be the last one?” as if she had the power to grant that to me. She was sort of like, “Maybe.” I was thinking to myself, “Yes. It has to be.” So I did it. This has to be the last one. I pushed and the head came out. I felt either the ring of fire or tearing. He came out and they said, “Now, wait before the rest.” She told me to breathe or exhale or something. Meagan: Like a little blow? Becky: I pushed for 3 hours when the hospital had a limit at 2. She was worried that there would be shoulder dystocia, but there wasn't. He came out very easily after the head. He was just immediately on my chest. He was just immediately on my chest. I kept saying, “You're here.” I had the hormone cocktail that I wanted. It was so serene and beautiful. It was everything I had hoped for. We had that totally uninterrupted golden hour. Totally uninterrupted. It was 10:20 in the morning. It was the day before school started so you could hear kids playing outside. It was really golden. The sun was coming through the window. It was so beautiful.Then I was like, “Huh. Your head is very oddly shaped.” They were like, “Yeah. He was posterior and asynclitic,” exactly like my first but totally because of a different location and a different support team, it's like they always say, “Location and your team are so important,” but they are really, really so important. Meagan: Crucial. Becky: Not only that, but he weighed the exact same amount. They were both 8 pounds, 4 ounces. Meagan: So on your op reports if you have seen them, what was your exact diagnosis on why you had a C-section? Was it failure to progress? Becky: It was failure to progress, yeah. Meagan: Okay, that's what I was figuring. Becky: But it was really failure to descend because she was never down far enough. Meagan: Yeah, and you made it to 10 centimeters. Becky: Oh yeah, I was at 10 centimeters for a long time. Meagan: Failure to progress, yeah. So failure to descend due to a less-ideal position. It may be the way your babies need to come through your pelvis. Becky: Maybe. Meagan: Sometimes baby need to come through in a wonky, less-typical position to get out. I truly believe after knowing what I know now that all of my babies had to come through my pelvis posterior. Every single one. I thought I was going to have a baby the other direction because of all of the contraction pain. Becky: It's like, I would just love to feel an anterior baby and compare. It seems like it must be so much easier. Meagan: Me too. I am with you. I am with you. I am with you. Yeah. Posterior, yeah. It is definitely a little bit different, but you had a C-section for positioning, but then you turned around and had the same position, same pounds and everything, and did it vaginally. Becky: Not only that, he also had a lip tie, but he did latch after that first latch. I also just want to give another shoutout to home birth because my assistant midwife was six months postpartum and she knew about previous difficulty with breastfeeding. She had her pump in her car and she said, “Would you like me to pump a few ounces for you?” I was like, “Yeah.” She found a clean, glass jar and pumped 2 ounces in there and left it in our fridge for us. Meagan: Oh my gosh. Becky: That just can't happen at a hospital birth. Kindness like that– obviously, kindness means a lot to you, but in those first postpartum times, it's just amplified. I'll always remember that. Yeah. I had all of the support I needed and more. I really hope everybody who wants this has it like me. It's very fitting that this is going to come out just before Thanksgiving because I feel very, very fortunate. Meagan: Thankful. Becky: Yeah. Meagan: Oh, I'm all teary, my eyes and nose and I have the chills. I'm so happy for you. I'm so happy for you. Becky: Thank you. Yes. Meagan: Huge congrats. Becky: Thank you. Meagan: Thank you so much for sharing this story with us today. Becky: Thank you for giving me the opportunity. I hope somebody has something that they take from it. I feel like there are so many random bits and bobs that could be helpful. 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

Seemingly straightforward data sets are seldom as simple as they initially appear. And, many an analysis has been tripped up by erroneous assumptions about either the data itself or about the business context in which that data exists. On this episode, Michael, Val, and Tim sat down with Viyaleta Apgar, Senior Manager of Analytics Solutions at Indeed.com, to discuss some antidotes to this very problem! Her structured approach to data discovery asks the analyst to outline what they know and don't know, as well as how any biases or assumptions might impact their results before they dive into Exploratory Data Analysis (EDA). To Viyaleta, this isn't just theory! She also shared stories of how she's put this into practice with her business partners (NOT her stakeholders!) at Indeed.com. For complete show notes, including links to items mentioned in this episode and a transcript of the show, visit the show page.

Today we give you our second pediatric clinical case with Dr. Sakina Butt.  This time she talks about hypoxic-ischemic injury and low Apgar scores in infants and young children, or “littles” as she endearingly refers to them. Show notes are available at www.NavNeuro.com/129 _________________ If you'd like to support the show, here are a few easy ways: 1) Get APA-approved CE credits for listening to select episodes: www.NavNeuro.com/INS  2) Tell your friends and colleagues about it 3) Subscribe (free) and leave an Apple Podcasts rating/review: www.NavNeuro.com/itunes 4) Check out our book Becoming a Neuropsychologist, and leave it an Amazon rating   Thanks for listening, and join us next time as we continue to navigate the brain and behavior! [Note: This podcast and all linked content is intended for general educational purposes only and does not constitute the practice of psychology or any other professional healthcare advice and services. No professional relationship is formed between hosts and listeners. All content is to be used at listeners' own risk. Users should always seek appropriate medical and psychological care from their licensed healthcare provider.]

We are joined today by Dr. Barry Brock, aka “The King of VBAC” along with one of his VBAC-hopeful patients, Kara. Kara and Meagan ask Dr. Brock VBAC-related questions similarly to how we hope you interview your providers during your VBAC preparation. Dr. Brock touches on topics such as gestational diabetes, big babies, preparing for your VBAC, induction, placenta previa, preeclampsia, HELLP syndrome, VBAC after multiple Cesareans, and vaginal breech delivery. Additional LinksNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Facebook CommunityFull Transcript under Episode DetailsMeagan: Hello, everybody. Welcome, welcome. We have a really cool episode for you today, an episode that we have been really anxiously waiting for and so honored to be having. We love having birth professionals on the podcast and today we are so honored to have Dr. Barry Brock chatting with us today about birth and VBAC and all of the things. And then we have an extra special cohost today, Kara Sutton, who is actually one of Dr. Brock's patients. Hello! Kara: Hi guys. I'm so excited to be here. Meagan: So excited to have you guys. I just wanted to share a little bit about the amazing Barry Brock before we get going into all of these amazing questions that this community has asked. Dr. Barry Brock has been a doctor for over 30 years and has experience in obstetrics and gynecology. He has been attending as a doctor at Cedars and I believe Dr. Barry Brock, you had your residency there, right? Dr. Brock: I did. Meagan: That's really cool so you've been there for a while. Dr. Brock is amazing and takes pride in giving quality care to all of his patients. Seriously, one of the coolest things—I mean there are a lot of cool things—but especially with me in the VBAC world, one of the coolest things to me is that you have an outstanding Cesarean rate. It's very low. I think that's one of the things that you are very well known for along with helping people have vaginal breech deliveries which we know is kind of trickling out in the world and vaginal twin deliveries and of course, VBACs. So welcome, Dr. Brock, and thank you so much for being here with us. Dr. Brock: It's my pleasure. Meagan: Oh my gosh. Yes, and as I mentioned, we've got Kara who is a patient of Dr. Brock. Kara, tell us how it is to be a patient. Kara: I am a mom of two. I had an emergency and I had a planned C-section due to PTSD from that first emergency C-section. Now I am four months pregnant with my third baby girl and Dr. Brock is my doctor. I'm excited to try and achieve a vaginal delivery with this one. Dr. Brock has the LA rep as the go-to VBAC doctor if you're trying to achieve VBAC so that is why I am seeing him. I switched doctors specifically for this pregnancy which I think is super important to find the right doctor. I feel really excited and comfortable with Dr. Brock for this particular delivery, especially after the trauma from the first two. For those of you guys who don't know, Cedar Sinai is a really famous hospital in LA. We're in Beverly Hills here today. Everyone from Kylie Jenner allegedly and Jay-Z and Beyonce and all of the people have delivered there so he's kind of a rockstar. So I'm excited. Meagan: Yes. Oh my gosh. It is such an honor. Such an honor so thank you both for being here.Kara: Yeah, so I kind of wanted to jump in right away and wanted to ask Dr. Brock, why do you think the national average C-section rate is so high and why do so many doctors just schedule a C-section? Dr. Brock: Well, the docs are very concerned about a healthy baby and a healthy mother. It takes the stress off of the doctor if there are any problems getting the baby out, but there's no evidence that we've improved the Cesarean section. We have massively increased the Cesarean section rate and we have not improved the fetal outcome. So obviously the system that we're going with here needs to be tweaked a little bit. But they also need experience. To do a vaginal breech delivery, you have to have the skill and expertise to be able to do that and if you're not doing that, you don't have the skills so for a lot of doctors, for them, it's safer to do the Cesarean section than to do a vaginal breech delivery. I understand that. You're not skilled. Among the criteria that the American College of OBGYN recommends is that if you're doing a vaginal breech delivery, you have to know how to do it. Of course, if you don't do it, you don't get it done. Another thing is that doctors are very concerned with fetal monitor tracing and they are concerned about the baby's health and well-being. So when the baby comes out, the other side of the coin is that we do lots of Cesarean sections for fetal distress but most of those babies come out screaming. Well, you can say that we saved this baby from getting in trouble or we did an unnecessary Cesarean section. Remember there is also the mother's health and the baby's health. There's a higher risk to the mother's health– ten times greater having a C-section than a vaginal delivery– but extremely rare. So that's not a major factor. You say ten times greater but the incidence is so low. It's much greater that you walk outside when it's raining and get hit by lightning. But still, in LA, it's a very rare thing so I'm not concerned about that. Doctors want the best for the baby. It seems like this. A lot of the time they can get away with a Cesarean section. Some insurance companies pay for more Cesarean sections. You don't have to go ahead and spend hours and hours in labor. My philosophy is a little different. But you need the skill and expertise. That's when obstetricians can deliver a healthy baby vaginally. Meagan: Yeah. Wow, I love that. I feel like we could do a whole podcast just on this question alone because it is such a big question. Like you said, I love that you touched on what if we've got a Cesarean but the baby comes out screaming? We've had people say, “I've had this emergency C-section but then my baby had an 8/9 APGAR so was my baby in distress?” So thank you so much for touching on that. Another big question that we have that a lot of people ask is the big baby question. What if I'm being told that my baby really is too big to give birth vaginally? Is that really a thing? What's the accuracy on that and how would I know if choosing a Cesarean is the right choice versus going for a vaginal birth after a Cesarean? What's the safety there for the baby?Dr. Brock: Well, a major concern is– the American College addressed that. It is with mothers that are diabetic and have gestational diabetes. If the baby's over 4500 grams, which is a very big baby, then consideration should be for Cesarean section for the risk of shoulder dystocia. But that's it. At 5000 grams, if you do not have gestational diabetes, that's a huge baby. Kara: What is that in pounds? Meagan: It's like 9 pounds. Is it 9?Dr. Brock: 12 pounds or something like that? It's a huge baby. Meagan: Yeah, anything over 11 is an extra large baby, and then at 9 pounds, 15 ounces is where they start paying attention, right? Dr. Brock: Yeah, but the biggest problem with shoulder dystocia is if you have a very large baby and you do a mid-vacuum or forceps, then the incidence of having shoulder dystocia is very high, like 25%. But most of the time, mother nature goes ahead and plants the hat and wants a vaginal delivery. It'll tell you. Maybe it's stuck or something like that. But to me, it's always worth a try because basically, you're saying that mothers who are diabetic would have died in labor. Mother Nature knows what to do. When you give it a chance to prove it, I've seen it all. I've had a mother who had two Cesarean sections for a 6-pound baby so she really wanted a vaginal delivery. I waited and waited and waited and she delivered her 9-pound baby.  Mother Nature knows what to do. Meagan: Right. So for gestational diabetes, maybe if they are controlled and everything is looking good and the baby doesn't look like it's 12-13 pounds or a really large baby, you still feel that it's reasonable to go for a vaginal birth? Dr. Brock: I practically always think it's better for a vaginal birth. I mean, there are exceptions. I do VBACs after two Cesareans. I don't do it after three. The incidence for you to rupture after one Cesarean is 0.5-1% which is very small. For two Cesarean sections, it's 5% but then it climbs dramatically after that so I don't do that. Obviously, you have to look at if the placenta is implanted properly. If the patient is of an abnormal presentation of the placenta with placenta previa or accreta. Accreta is when the surface of the placenta digs itself into the wall of the uterus and that presents a major problem. That's a good idea to get a good center who knows how to handle it. Meagan: Absolutely. Dr. Brock: But Mother Nature– give it a chance. Meagan: Give it a chance. Kara: I'm interested. So why won't all doctors induce VBACs? What's the best method for induction and what should I do if my doctor refuses? Dr. Brock: I induce for medical reasons. When someone has a previous Cesarean section, we don't give prostaglandins because that has shown an increased chance of rupture. I much prefer all my patients to go into labor spontaneously. I sign for a lot more testing after 40 weeks. It depends if we find medical problems but they'll test twice a week to make sure the fluid's normal, the Doppler flows are normal, and the NST are non-stress tests where we see baby's heartbeat. I consider 42 weeks as normal. If someone's, like I said, diabetic, I'll do 40 weeks unless there are other problems. But I prefer them to go into labor naturally because I think it's easier on the mother and it's a higher success for a vaginal delivery. But saying that, this week, I've had a mother who had a baby who was abnormal and it was going to be fine. He needed heart surgery. She had two previous Cesarean sections. We induced her and she had a vaginal delivery. The baby, thank God, is doing fine. We will do heart surgery probably in 3 or 4 months. Each person's different and we have to take everything into consideration. Right now, I like to wait for Mother Nature to do its thing. Keep an eye on Mother Nature, but let mother nature do its thing. Meagan: I love that. Keep an eye on mother nature, but let Mother Nature do its thing. Because we do, we have so many people writing in saying, “My doctor says I have to have a baby by 39 weeks spontaneously or my chances of VBAC are completely out the window and I have to schedule a Cesarean.” It puts people in a fight or flight mode where they are out there trying to do all of the things to try to be induced but it's not working because their body is not ready when really what we need to do is step back and let Mother Nature do its thing. Dr. Brock: Well, there are exceptions. Obviously, someone who is sitting in my office and is 3-4 centimeters dilated and she's 39 weeks then she's an easy induction. If you're closed and high, then don't rush to an induction. Meagan: Right. Right. Dr. Brock: For each person's safety, individually you have to do that.  Meagan: And that is one of the most important things I think any provider out there should view is that everyone is an individual. I'm not the same as Cara and Cara's not the same as this mom that just had her VBAC after two Cesareans. We're all individuals and have different situations. So one of the big questions is breech. If we have someone that is having a breech baby or their baby is breech and not turning, a lot of people just have these repeat Cesareans and we know that you are really big in supporting that. Obviously, there are again, things that have to pan out. But why do you think breech is really going away? If someone is having a breech baby, what can they do to help avoid that C-section if they don't have a provider like you that's maybe more supportive of having a breech delivery?Dr. Brock: Well obviously, because in today's society of birth, people don't have the skills to do a breech delivery. You can't have a breech delivery unless your provider knows how to do it. The first thing I want to do is try to turn the baby. At 37 weeks, we will schedule you. We do it at 37 weeks because statistically if the baby hasn't turned at 37 weeks, there is less chance that he will do that. Also, the fact that if something happens in a version– I've done hundreds of them and I've never had a problem but theoretically if something happens and we do a Cesarean section, baby is at term at 37 weeks. That's the first thing I would do. With the breech delivery, I treat a breech delivery– I don't care if it's a first-time mother or a second. I do the same thing. Just like Kara, when she gets around 6-7 centimeters dilated, which means the active phase of labor– she can labor at home or wherever, but once she gets to 6 or 7 centimeters, I want everything to go quickly. What I mean is that I want her to dilate quickly. I want the butt to settle down quickly and I want to push her out quickly. You're not going to push for 3 or 4 hours. I'll do that for first-time mothers or with any mother head-down but not with a breech. I want it to go quickly. A lot of babies don't do that, but that's where I stay safe because if it flies out, it flies out. The biggest problem with breech delivery is that the head is coming last. The cord is beside the head so you've got to get the baby out quickly. Using those criteria, I've had very good success and no problems, but I've done many Cesarean sections because obviously, I remember one patient who came in. She was 9 centimeters. It was fantastic. She was doing great. She started pushing and all that came down was the testicles. So I sectioned for a 10-pound baby. So mother nature is telling you, “Just because you're committed to a vaginal delivery, you don't drag the kid out.” The idea is to let the baby do its thing. The reason we want butt down, especially in first-time mothers, is that if it's not his feet coming out, the cervix may dilate to 6-7 centimeters and the feet come out and the body comes out and the cervix is not fully dilated when it gets to the head and it gets trapped. The cervix never clamps down. It just never fully dilates. That's why we usually don't do footling breech. We don't do vaginal delivery. There are exceptions, but rare exceptions. If a multiparous patient comes in and the feet are there and the cervix is completely dilated, the baby just falls out. That's really an exception to the rule. The other concern with a footling breech is especially if the mother is dilated, that patient is concerning because if the water breaks and she's dilated and just the feet are there, the cord may fall out. It's called a cord prolapse. That's a contraindication to try to do something at home. If someone is dilated and footling breech, that's the kind of patient I would bring to the hospital and do a C-section for cord prolapse. Meagan: Yeah, which makes sense. There are not a lot of you out there that will support or is trained and educated in vaginal breech delivery and from what we're gathering is that it's not really being taught a ton in medical school anymore. Is that correct? Dr. Brock: Well, not in my residency. I mean, I may offer to do that but it's easier. I mean, you schedule a C-section. You walk in. It's an hour. You're done versus spending 8, 10, or 12 hours laboring this patient. So the incentive isn't there to do that. So the skills are disappearing. I mean, I've offered to come in and assist anyone who wants to do a breech delivery and I've done that but not that often. The residents are always invited. They can do that but just because they do it in residency, it's a big staff to get through. They may do one or two breech deliveries but they don't feel comfortable to keep on going out in the private practice. It is dying out. Meagan: Yeah. It makes me sad. It makes me sad. Kara: I have a question because I have had two C-sections. How long should somebody wait to conceive after a C-section? I've heard mixed things about this. I've been told mixed information about this and I just would love to hear your point of view on that. Dr. Brock: Well, there's some data to show that ideally it is two years apart but everybody's facts come into play. For someone who is much older and has trouble getting pregnant, if someone had a baby at 40 and wants another child if she is waiting until 42, she may never get pregnant. I've not found it to be a big factor but statistically, it does seem to be safe. I would do psychologically what's better for you how far apart you want to have your kids. Besides, mother nature does help. It takes some time to get pregnant as you get older. Kara: Great. Is the thought that the longer you wait, the more healed your C-section scars are and your uterus is stronger or is that not real? Meagan: Like is there less chance of rupture that way? Dr. Brock: Literature is in my mind, not that clear. Statistically, it's probably true but it's like saying you're at a greater chance of dying if you're driving at 58 miles an hour instead of 55. It's true, but statistically, is it really a factor? Meagan: It's not substantial. It's not anything that's a concrete yes or no. Okay, and talking about VBAC after two Cesareans or more, what are the complications surrounding a C-section or even a repeat C-section? We talk here a lot about the risks of VBAC– rupture and things like that– but we don't talk a lot about complications, especially even years later. Are there complications for people who have had Cesareans even years later? Dr. Brock: Years later, I don't know much about that. I do know the higher the Cesarean section rate, you're going to have an increase of abnormal implantation of the placenta from accreta or things like that. It goes up. Instances of rupture with more Cesarean sections go up. I've done Cesarean sections, 5, 6, and 7 Cesarean sections. It depends. The doctor who goes in there with all of the scarring, while it's very, very difficult and dangerous, it may pass on to the next time, but most of the time, it's not a problem at all. I have no limitations per se on how many Cesarean sections someone can have. I have a patient right now. She had a Cesarean section then I did a VBAC. Now she's pregnant again but she wants a repeat Cesarean section because she had anal problems and she had surgery so her surgeon recommended that she doesn't try for a vaginal delivery. I'm not 100% in agreement but I have no problem respecting her wishes and we set her up for a Cesarean section. Each case has to be individual. There are no absolute rules for anything. As far as consequences, most of the time for later on, there is but it's more related to how many times you get pregnant, not how you deliver. Bladder dropping and things like this, each pregnancy puts a toll on that. I think mother nature plans for you to have your first kid when you get through puberty. I think it's a very bad idea for 13-year-old kids to have kids. But mother nature, that's the whole plan. That's the animal kingdom. That's what we do. Of course, for millions of years, you were dead at 20 but that's a different story. Meagan: So kind of piggy-backing off of that question too, we had someone write in talking about how she had a Cesarean and then they went in for a second Cesarean but they didn't use the same incision so she's got two incisions which I had never actually heard of, in her uterus. In the uterus, they cut a different spot is what she said. She's asking– okay, so now she's got two incisions in her uterus. Is that something that would be suggested for her to VBAC because she'd really like a vaginal birth? Dr. Brock: No, that's fine. First of all, the patient doesn't know about the scar on the uterus. It's the doctor. When I go in there unless someone had a vertical incision and there's no such thing as a classical. They call it a classical incision, but that was done 100 years ago and they went up and down incision on the belly and they went up and down incision on the uterus. The top of the uterus is the fundus is what we never do. That's at a much higher instance of uterine rupture. We used to do that. Somebody added, “Once a section, always a section.” That's where that falls. I would say 95% of Cesarean sections are low-transverse. They are very low on the uterus. But when I go down and do that, I see the bladder there. I don't know where the last Cesarean section was. I can't see. I just tape down the bladder and make an incision so I have no idea in the uterus. But we do know that, like I said, during Cesarean sections and repeat, it's not a problem. We do know that.I've given it to patients that had previous fibroid surgery. The American College recommends, what is the indication for the surgeon? Does he recommend you for vaginal? He should tell you that. My philosophy is when I do that, it depends on if I enter the cavity of the uterus and whether I would recommend a Cesarean section. Sometimes the fibers outside of the cavity, I have no problem recommending a vaginal delivery. I've done vaginal deliveries after another doctor did multiple fibroids laparoscopically. They sewed it up and I asked him. He said, “Well, it should be fine. We did multiple scars and she did great.” Yeah, individuals.Meagan: Exactly, yeah. Thank you. Kara: I have a question. I did not have supportive providers in regard to my first two deliveries. I had an emergency C-section and then a planned C-section and nobody brought up that I could deliver vaginally or any of that. I just felt like I had a C-section so I had to have one the second time around. So I wanted to know what are the ways to really help someone find a provider who actually tries for that? I think a lot of women can't find the right doctor who can do that. Meagan: Yeah. Dr. Brock: It's hard to say. Some hospitals publish the C-section rates of their doctors. That's one way to look into it. But blogs and things like this, you have to talk to your doctor and see what's comfortable. You can't force your doctor to do something he's not comfortable with. Many years ago, one of the doctors, an old-time doctor, refused someone to do a VBAC because he had a bad outcome with a baby. Your personal experience comes in. Everyone's trying to do the best thing. They're trying to do what's safe for you and your baby. You just have to find a match that works for you. Kara: When you're interviewing your doctor, what are the types of questions you can ask to get a sense of his or her skill level with it or comfort level with VBAC? Dr. Brock: Well, I've had a patient come in. She had three previous Cesareans sections. She wanted me to do a vaginal birth. I said, “Don't. My limit is two.” They have it out to think that it's the same but it's not. It's about talking to your doctor and asking them personally. “I'm thinking about having a VBAC. What do you think about it?” You want to be comfortable with your doctor and listen to his advice, but there are different opinions out there. If you're comfy with your doctor and you trust your doctor, I have no problem if he feels that he did a section and recommends another section, I understand that. We do know that certain things that change behaviors. They talk about measuring the thickness of the scar, of the uterus, and things like this. A study just came out that found no correlation whatsoever. Meagan: I was going to ask that. That is a huge question too. “My doctor said I can't because my thickness isn't thick enough.”Dr. Brock: Well, there was no correlation. It made me nervous. I had one who had a scar. They said she had a window in the ultrasound. She had two previous Cesarean sections. I delivered her baby vaginally no problem. After that article came out saying there was no correlation, and my experience showed there was no correlation but each case is individualized. I may have a previous rupture and that's a different story. There is no good literature on that and it's probably not worth the risk. Meagan: Right. What about single and double sutures?Dr. Brock: The data shows that I will always use the double closure. The only thing I would make an exception for is that sometimes when they get their tubes tied and it will save some time while having a C-section or vaginal delivery. But no, literature says that double closure has lower chances of rupture. Meagan: Would you support someone wanting to VBAC if they had in their op reports a single-layer suture? Dr. Brock: Yes, I would. A higher instance doesn't mean it's going to happen. As all patients, with this one especially, when you have a previous Cesarean section, I don't want you to deliver at home. *Inaudible* Usually, it's not unreasonable to place an epidural catheter in. Not actively, but if something happens, we can just give you some medication so you don't have to put them under general anesthesia. Just to be prepared.Meagan: Right, right. Be prepared. Kara: You prefer that they labor at the hospital and not at home? *Inaudible*Dr. Brock: Yes, yes. Right, because that's a concern we have. The baby will tell us something. I did a VBAC last night and she's not that tall. She's only about 5 feet. This baby seemed huge but it was way out of bounds. The reasons are that the pelvic, mother nature doesn't know about these Cesarean sections. So first-time babies go down low in the pelvis. The cervix is firm and holds the babies in there prematurely but after the first delivery, the cervix can get soft so mother nature keeps an eye until you go into labor otherwise you'll deliver prematurely. But that's when the head is high. The higher the head is, that's going to put pressure on the scar. I feel much more comfortable as the head drops in the pelvis, it's getting below the scar, and the chance, I think, of rupturing drops dramatically when the head drops. But mothers may not drop until they go into labor. Meagan: Right. Talking about preterm, if someone had a preterm Cesarean birth, are they a candidate in your eyes for a vaginal birth after a Cesarean? Dr. Brock: It depends on how premature. Babies vary with premature. We talk about if she didn't go into labor, and they had to have it done. It depends on the thickness of her lower uterine segment. The doctor goes in. He may feel like there's not enough safe room to make a transverse incision so he has to do a low vertical. The low vertical is associated with a lower instance of rupture. Mind you, before we say you have to find your records and find exactly what type of scar on the uterus it is. But now, American College says, “No. If you had a previous Cesarean section, unless you know that it's a low vertical, then you can try for a vaginal.” If it's a high vertical, definitely. Low vertical, it is a little different but we have to wait and see. I'm not against going for a repeat Cesarean section if someone had a 25-week Cesarean section. If the lower uterine segment was not developed, the doctor did it appropriately. There is no harm to the baby coming out low vertically extended up. Meagan: Right. That makes sense. Cara, did you have another question? I know that we were talking about it before. Kara: I was just wondering if I'm preparing for a VBAC, which I am in four months. Is there anything you recommend that patients should do to prepare for a VBAC? That's something I think about all of the time. Is there anything that patients should do to prepare for that? Dr. Brock: There's nothing. There's really nothing that you can do.Kara: No running?Dr. Brock: You don't want to gain too much weight during pregnancy. The more weight you gain, the bigger the baby so that's a major factor. If you start gaining 40, 50, or 60 pounds, then the baby may be bigger and things like that. Most things to prepare are like with any pregnancy. Get yourself into shape before you're pregnant. Get your weight down before you get pregnant. Those are major things that you can do. Once you get pregnant, we tell you not to gain too much weight, but we don't want you to lose weight. Exercise can always be done during pregnancy, but I always prefer getting into shape before you get pregnant. Kara: No one ever tells you that. I swear. Or at least no one's ever told me that. I think that's a good thing to know. Dr. Brock: Yeah, because you're slim. Meagan: Yeah, well just being healthy overall and overall healthy. That's not even just for VBAC. It's just if you're going to have a baby, try overall to be healthy in general every day. Even if you're not having a baby. Good nutrition and all of that. Preeclampsia is something that is sometimes developed. Is that something that someone could TOLAC and have a VBAC with? Dr. Brock: Yes. It really depends but nowadays, with previous history, we give baby Aspirin and try to lower the incidence of recurring. We keep track of the blood pressure throughout the pregnancy. But yes. If I knew the cause of preeclampsia, I'd win the Nobel Prize. It's the mystery of mankind. We know it's associated with first-time mothers, elderly mothers, and twins, but we don't know exactly the cause. All we can do is keep an eye on it and make sure it doesn't occur. Now if it does occur, unfortunately, the delivery for that and the treatment for that is delivery. Meagan: Right. This is a spinoff but HELLP syndrome. If someone develops HELLP syndrome and their platelets are good and everything, are they still candidates for VBAC or is a Cesarean delivery really safer? Kara: Can I ask, what is that? Dr. Brock: First of all, it's a subset of preeclampsia hypertension *inaudible* where the mother can get elevated liver enzymes and low platelets. That is an absolute indication that we have to deliver the baby. Okay? Now, people go ahead and say, “Oh, well you were *inaudible* delivery. We should do a Cesarean section.” I have nothing against doing that but if a patient is, it may take a long process because she's not ready, but I think that she has to be managed in a hospital, her blood pressure is under control, and she has to go for delivery. Now, it may take a day or two and maybe she's not willing to wait that long or her doctor isn't or things like that, but I have no problem as an independent event to have a vaginal delivery if you have HELLP but it's definitely an indication. Meagan: Yeah, isn't that really the only way to help is to get the baby out? Dr. Brock: Correct. The only way to help HELLP syndrome is to get that baby out. Meagan: The only way to help HELLP syndrome is to get that baby out. Yeah. Okay, that is so good to know. It's not as common in our community, but we have definitely seen people ask and then they worry about the platelets and surgery. They never know what's safe or not. Dr. Brock: The other thing is that if the platelets are low or under 100,000 the anesthesiologist is very leery of putting in an epidural. The reason that over a spinal is because platelets are used to clog your veins and if he hits a blood vessel in your spine putting it in, then it can cause damage and cause paralysis so they really don't do spinals. They do general anesthesia, not regional anesthesia if someone has low blood platelets. I had a patient who had very low platelets not from HELLP, *inaudible* and she couldn't get an epidural. We definitely didn't want to do a Cesarean section because she had low platelets so we did it the old-fashioned way. She didn't have an epidural. She had a vaginal delivery and it hurt. Meagan: Yeah, well that's good to know though. That's really good to know. So as someone who's had a vaginal birth after two Cesareans myself and obviously Kara is preparing, we talked a little bit about how to prepare. But is there anything that we need to know? We talked a little bit about the risk earlier but is there anything that we need to know about vaginal birth after two Cesareans that we may not hear about with just VBAC after one?Dr. Brock: I mean, like you said. The risk is higher. The doctor who might be a little nervous or leery obviously, stress shows that doing a Cesarean section may be higher which I understand. If there are concerns, he may cross-match for blood and have it available in case you need that. That's how the doctor is not the issue. Like I said, labor in the hospital and not at home because if something happens, “Oh, I'm five minutes away from the hospital,” but that's not true. You may be five minutes but you're at least 45 minutes before you can get the baby out. You try to hold your breath for 45 minutes, so that's why in the hospital. But like I said, everything is done before you get pregnant. Try to get in the best shape you can and not gain too much weight and make sure the baby isn't huge. If someone had a macrosomic infant and is diabetic, the doctor may take that into consideration. Meagan: Right. We have a lot of people in our community that don't have the support in their area and do find themselves having to travel long distances to their provider that is supportive. I think a big worry is uterine rupture. We talk about uterine rupture and it sounds really scary. We talked about getting to that hospital as soon as you can. But for those who are driving or are further away, are there any signs or symptoms that you would say, “Okay, you need to seriously deviate your plan and go to the nearest hospital at this point?”Dr. Brock: Well, certainly massive bleeding. If you go ahead and have searing pain, that would be from the uterus. There are no absolute signs of anything, but stars up early, that's why you go in early so these things don't happen. Thank god the instance of rupture is very small. In a hospital setting, even with a rupture, there's no guarantee that the baby is going to get in trouble but it's considered a greater risk. If you're not in the hospital, it's a risk to the mother's health and the baby's health. But the instance is small. But common sense is. If you've had four Cesarean sections and now you decide you want a vaginal delivery, you're putting yourself at greater risk. It's not worth the risk. Babies don't do well if mommies aren't around so you want to make sure you're doing fine. Meagan: Make sure everyone's good. Yes. Awesome. Kara, do you have any other questions, especially as a patient? I'm sure you guys have this time in the office to ask as well. Kara: We have an appointment right after this. No, I just feel really grateful to have found Dr. Brock and I really feel that I wish more doctors were as skilled and as knowledgeable as you are. I am really, really impressed with your experience level and your support of mothers trying to do things the way they want and the way were made to do. I'm just very grateful and thank you for being with us today. I know how busy you are with eight deliveries this week. Meagan: Literally, I know. You just had births last night. I'm sure you'll have births today. It's always such an honor to have birth professionals on the podcast because these people who are listening to the podcast really are in a very vulnerable state and want to get all of the information. So it's so fun to have a skilled OBGYN here answering these questions from the community. It really does. It helps people guide and feel better. Honestly, just hearing the support you have, no wonder you're the VBAC king in LA. Dr. Brock: There are a lot of other people who do VBACs. Kara: You're being humble. He's being humble. Meagan: There are. There are a lot of people out there that do VBACs but it does seem to be harder to find people that do VBACs in the manner that you do like, “Let's monitor mother nature, but let's let mother nature do its thing.” It doesn't seem like you have a lot of restrictions. We have a lot of providers out there that do have a lot of restrictions so it's humbling to hear that you're like, “Hey, let's do this. Let's trust the process. I'm going to be here. I'm going to guide you along the way and I'm going to monitor but I want what's best for you and I want to listen to what you want to do and I want to support you.” Thank you so much for being that person for this community. Dr. Brock: Well, the other thing that I was saying is that for someone who is in labor, I do monitor the baby. It's not intermittent monitoring because that's how I keep track of the baby. The other thing I do when I do the tracing is that a good baby can look bad on the tracing, but a bad baby cannot look good. So you have to understand that. If a baby is a healthy baby and has some variation but it comes back and it's back to normal, that's a healthy baby. But even with the worst tracings, statistics say that 50% of the time, the baby gets in trouble. But just a terrible tracing, follow your doctor's advice and do what he says. But still, hopefully, results will come back good. Meagan: Right. Standard practice all over the world really is continuous monitoring with VBAC because we know that fetal heart dropping and distress are one of the main signs that something, some separation may be happening. If you're listening, know that it's pretty standard. That's pretty standard care all over the world. Dr. Brock: It keeps your doctor's *inaudible*. If you're not monitored, we don't know what's going on. Meagan: Right, yes. Okay, well thank you so much for taking the time out of your day and being with us. We really do appreciate it. Dr. Brock: All right, have a good day then. Kara: Thanks, Meagan. Meagan: You too. Bye, you guys. 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

“Doulas are great. How do I get one?”‘Hope you're rich, bye!'“Wait, now I can't have one?”We are so happy to be joined once again by our friend, Kaitlin McGreyes with Be Her Village. Meagan and Kaitlin talk all about the benefits of doulas and what they love most about being doulas themselves. Not only that– they also talk about how to actually afford one. Every mama deserves continuous support during her labor and birth. Kaitlin has created the platform to make it a reality. Additional LinksBe Her Village WebsiteHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Facebook CommunityFull Transcript under Episode DetailsMeagan: Hello, hello you guys. It is Meagan from The VBAC Link and guess what? We have our friend, Kaitlin from Be Her Village, back. I am so excited to have you, Kaitlin. Kaitlin: I am so excited to be here, Meagan. Thank you so much for having me. I love this little friendship that has burst out of our VBAC love and our desire to get everybody their VBAC. Meagan: I know. Our passion around birth. It's just so cool to see how people from different parts of the world can connect so deeply. I just adore you and love you and I do hope that I get to meet you one day soon in person. Kaitlin: Oh, for sure. We're going to make that happen. Meagan: Oh my gosh. Last time we shared her VBAC story and this time we are going to be talking about doulas. So if you didn't know, we are both doulas. Obviously, we are very passionate and heavily involved in the birth world. We are going to talk about, okay great. That's wonderful. We know about doulas. Now what do we do? We are going to talk about that today so if you are wanting to know more about doulas, the stats around doulas, and how to pay for a doula, you want to hold on and listen to this episode. Review of the WeekBut of course, I have a Review of the Week so we are going to get into that and then we are going to talk all about wonderful doulas. This review is from txliberty92 and it was in 2020 and it says, “From Fear to Confidence.” It says, “When I found out that I was pregnant for the second time, I instantly felt so confused about how to birth this baby. I had heard so much conflicting advice about repeat cesareans and just wanted to hear the facts and hear from people who had been down this road before. I am now 36 weeks into my pregnancy and prepared and totally confident in my upcoming VBAC. I don't know if I would ever have gotten to this point without this podcast and community.” Oh, that makes me so happy. Txliberty92, if you are still listening, because that was in 2020. That was three years ago. If you are still listening, write us at info@thevbaclink.com and tell us how things went. And hey, we want to share your story. Be Her VillageMeagan: Okay. Let's talk about doulas. First of all, I think it's fun to talk about why us doulas become a doula because I know that when I was in high school, I knew I loved babies. I always wanted to babysit. I always wanted to be close to a baby, holding a baby, and then through high school, I was like, “I would love to be a labor and delivery nurse,” because hello, they get to be close to babies and hold babies all of the time, right? And then I started having babies of my own and learned more. I decided that I did love the idea of becoming a labor and delivery nurse but to be honest, I hate math. That's literally one of the reasons why I decided not to become a labor and delivery nurse because they have to do so much math. Kaitlin: There is so much math in nursing, yes. Meagan: So much math and I just hate it so much. For those listening, you guys, I actually had to take Math 1010 three times. Kaitlin: Oh my goodness. Meagan: That is how much I hate math. I hate it so bad. I suck at it. I hate remembering it and still to this day, I've been a doula for over 8 years and I still have a hard time. I have to Google how to calculate mpu's every single time because I hate math. So that is something that steered me away, but the thought of being able to love and support and educate and hold space for somebody and not do the math–Kaitlin: Sign me up. Meagan: It sounded amazing. It sounded so amazing. So through my first birth, after my undesired, unplanned C-section, I definitely had more of a passion for birth, and then after my repeat and learning more about doulas, I was like, “Yeah. This is it.” I remember the fire lit inside of me that day just like, “This is what I'm going to do. I'm going to love people. I'm going to support people. I'm going to educate people and let them know what their options are.” I have loved it ever since and I am so glad to be here today. So where did your fire ignite?Kaitlin: Oh my goodness. My fire ignited from my VBAC actually. I love that your story was like, “I always knew that I wanted to work with babies and mamas.” I had no idea. I was a special ed teacher in New York City. My husband still works as a special ed teacher in the school where we met when we were 22. That was the path. It was getting out at 3:00, working with kids, and feeling good. It was not being a maternal healthcare advocate at all. It was not doula work. It was not changing the baby industry. It was just not any of that. But then I went and I had a baby. My first birth, as you can listen to on the other episode, was on a spectrum from underwhelming on some days. I would reflect that it was underwhelming and other days, it was full-blown traumatic. It really depends on where I am in my head space. But it was kind of awful and the C-section wasn't what was awful about it. It was how people treated me. It was the powerlessness. It was being dictated to and people making decisions around me and not acknowledging me as a human being and as an adult, grown-ass woman who could make decisions about myself and my body. Meagan: We're having another human, right? Kaitlin: Right? How dare they. How dare they disempower me so quickly and then less than two years later, I had this incredibly different VBAC experience that was transformative before the baby ever came out of me. It had nothing to do with the vaginal side of it although that was amazing and kickass and I totally recommend it. But it was really about how I went in. I researched. I decided for myself that I wanted a VBAC first off. I hired a doula. I hired a VBAC-supportive provider, a doctor actually, and I just walked into that birth powerful and in charge. I ended up having a vaginal birth which was spectacular but that was the fire in me. It was sort of, “Wait a minute. How can I have two completely opposite experiences over the past two years?” So that was where I was just like, “I think the doula was a big part of it,” because I took childbirth education. I hired midwives. I did the things I was supposed to do and the doula, having someone in the moment when you're in that crucible where you're just being challenged and tested and you're in crisis, for many of us, and where you have this deep desire for your baby to be safe and for you to be safe yet you know. You know because you're listening to The VBAC Link. You know that this system is sort of rigged against us. How do you make sense of all that? The answer for me was in my doula. I knew that I needed to become a doula so that I could help more people. I have to be totally transparent. I definitely started out with a little bit of a savior complex. I was like, “If you hire me, I can save you from trauma,” which is not true or healthy for any of us. Meagan: It was probably you coping with your trauma. Kaitlin: Absolutely. There was this idea that my doula saved me in my birth so I could save somebody else. But it's true in that sure, we can have an incredible impact but we can't save anybody. You can't just hire a doula and like, “Okay, that's it. It's done.” You have to hire a doula and work with them and ask questions and still be very much an active participant in your care. The doula is the tool to learn how to advocate. The doula is the tool to set yourself up for success and that was why I got into it because I just thought, “Man, I have had two completely opposite experiences and I want to help more people have the second one, have the empowered one, have the voice, have built the team around myself.” So I thought, “I'm going to be a doula.” Little did I know how that would all end up but it's just amazing. It's the best thing there is. Meagan: Yeah, exactly. I would have never told you when I was becoming a doula, or it was nine years ago in September. Right now when we're recording, it's almost June. So almost nine years and I would have never said, “Oh yeah, in nine years, I'm going to have a podcast and be a VBAC advocate and educator and all of these things.” I never would have guessed that, but man. I am so grateful for this journey and where it's led us. You know, we talked about that. Doulas are there to help you. They're not there to rescue you. I think sometimes even I would say if I would be really honest. I was kind of like that too. I would have a client where they would be going in having these really deep goals and I was like, “I am going to make sure that happens.” I would go in and then sometimes if they didn't happen or if births went differently or we had unexpected events or something like that, I remember going home and I remember feeling like I failed as a doula. I felt like I failed them. Kaitlin: Yeah. Oh, it's a horrible feeling. Meagan: A really bad feeling. For your birth workers listening, it's important to know that you are there and you love your clients but we can't save everyone. Just like the clients that are hiring us need to know that we're not there to save but we're there to help educate, guide, love, and help you facilitate the things that you need along the way. It's just an extra crutch. Kaitlin: Yeah. I feel like it's really the work of labor and birth happens in the pregnancy. That's why you should get your doula as early as you can because it is in your doula's ability to help understand what your true desires are and help keep you connected to them because one of the things so many of us do and I'm speaking really about myself here too. I'm projecting my own experience. We abandon ourselves. We know what we want. We know that we want XYZ for our birth and then we sacrifice ourselves because as mothers, this is what we do. We sacrifice our time and our energy and our bodies for our babies but that gets used against us sometimes. It's really great to have somebody dedicated to your team that can sort of continue guiding the entire experience back to you back to those original goals, back to that original desire, and reminding you of what is possible and helping you stick to that. Then if you have to shift away from it, they are helping you navigate that shift in a way that feels intentional and purposeful and that you are emotionally able to shift as well so that we avoid that feeling of, “I don't even know what happened. I felt like I got hit by a bus and now I have a baby and I'm not sure how it happened.” We can't control a lot of things that happen in birth and doulas can't control them either which is a journey we go on as professionals. But we absolutely can help people navigate their births in a way that feels empowering regardless of the medical factors that end up happening. Meagan: Yeah. One of my favorite parts about being a doula is actually helping the partner along the way because I mean, obviously, Mom is the star of the show. She's having the baby and she's a very important person. She's definitely the MVP in that room but guess what? So are these partners. It's so fun like you said to circle around and help these partners feel more a part of birth as well because they sometimes have that same feeling where all of a sudden they are like, “Oh my gosh. My wife has a baby. What just happened?” So it's so nice to help dads and birth partners feel more involved and more connected and in control in a way of their own birth experience as well because it is their birth experience too. Kaitlin: Absolutely. I would argue that doulas are more for the partners in a lot of ways than they are for the birthing person. I personally didn't hire a doula for my first birth and I regret it. I can say pretty blatantly and bluntly that I regret it because I was afraid that it would take away the intimacy. I was afraid that it would be too many people and that I wouldn't have this intimate with my partner but what ended up actually happening is that my partner was so panicked by this mess of labor and by his wife being in so much pain. He wasn't of any help to me. I mean, he was as much help as he could have been. I'm not trying to attack my partner but he was really in this place of being a deer in the headlights. I was flipping out. He was a deer in the headlights. Everything was going wrong and he didn't have the tools. He had never done it before and that's in a birth that was very stressful. Even in a birth where you're not in a medically-induced place, it's still really hard to have the entirety of the responsibility of this experience to see your partner who is for the most part– this is a little stereotypical, but it's true– the women who are giving birth are making the lists and they're choosing the doctors. They're setting up their doulas. They're doing all of the things and they're making a birth plan. They're dotting every i and they're crossing every t and then what happens when they go into active labor? They retreat. Their minds retreat into their bodies and then all of a sudden, they're not communicating much of anything which can be really disorienting to a partner who feels to them that they need to keep their partner and their baby safe. This creates this feeling of alarm and can really not make the whole thing not feel good for everybody. When we have a doula that can come in for the partner and normalize the entire birthing experience whether it's in the hospital really medicalized or at home during early labor to transfer or have a home birth, it's so cool to have somebody who has walked this path before to be able to tell your partner, “Hey, this is all fine.” To have someone not react when you have somebody vomiting or contracting or shaking or all of these things that happen in the throes of labor, can be so relaxing. What is does is that it helps the partner then join his woman or his birthing person with intention and with this presence without all of the anxiety. It actually creates this beautiful expression of love. Not to mention, it's so cool to have someone show you how to touch your partner. One of them when I was teaching childbirth, I remember he was half joking but he was only half joking. He was like, “I just want you to teach me how far away to stand from her,” because he was just so nervous about the whole thing. It's like, imagine having someone come in and be like, “Hey, when she does that, just press here,” and it's like ooh. You get to learn and have a coach that helps you take on that care. It's the opposite of what so many of us think, myself included, was that a doula would replace my partner or get in the way. Really, what we do is help partners get more hands-on in such a helpful way. Meagan: Yeah. Exactly. My husband was really not keen on the idea of hiring a doula. He was like, “I'm not good enough? You're going to replace me?” That's where he snapped too. It's like, “Whoa, whoa, whoa. It's not like that.” But it wasn't until we had a doula that he was like, “Whoa. Okay. I see what you do as a profession. I love this and we would never do this again without one.” So yeah. Doulas are there for you. They're there for your birthing partner, but guess what, you guys? They have actual stats on how impactful doulas can be. That is so cool to me to think that there are stats on the profession that I do. It sounds silly. Kaitlin: It's science. It's science. Passionate science. It's science. Meagan: There are actual statistics that what I do and what I love is helpful. Okay, so let's talk about them. Doulas can decrease pain medication so epidurals, fentanyl, and stuff like that by 10% which seems little, but if you think about all of the people giving birth. Kaitlin: 10% is huge. Meagan: 10% is huge if you have 24-hour labor or more. I was 42. Yeah. It's wonderful. There's a 38% decrease in the baby's risk of a low 5-minute APGAR score. Kaitlin: And that, I really want to pause on that because that's a really big deal. The APGAR is your sign of life. That's literally like do you have muscle tension? Are you pink which means there's oxygen coursing? Do you have a pulse? It's literally, is this baby thriving? The APGAR is an enormous measure and what's wild about this is that doulas are not medical providers. We're not medical providers. I can understand the epidural being applied. It's like, “Yeah, we have some tools and tricks up our sleeve to help you manage pain. That makes sense to me.” But influencing an APGAR? This means that if you hire a doula, a non-medical provider, whatever magic thing that we're doing is not really magic. It's just being present and helping people advocate for themselves, can have health impacts on your baby. That's wild. Who we're not touching, who we're not making medical decisions on. We have no medical training and yet we're impacting medical outcomes. That's a big, big, big deal. Meagan: It's pretty stinking huge. In this study, it doesn't necessarily single out doulas. It's continuous support which guess what doulas do? Continuous support. Kaitlin: Yeah. Well, no other provider is doing that. Meagan: No. I mean, they're in and they're out. Midwives and OBs, we love them all. Kaitlin: Yes, we do. Meagan: But they can't. They can't. Kaitlin: The system is not set up for continuous support. Absolutely. Meagan: They can't. They might be in there for a little bit but then they're in and they're out. So a 31% decrease in the risk of being dissatisfied with the birth experience. Kaitlin: That's a big one. That's a big one. Meagan: You guys! 31%. So one of the things that I love about being a doula– I mean, there are a lot of things– but I want someone to walk away from their birth, even if it didn't happen exactly how they wanted on their birth preference sheet or birth plan, to have a good experience. I want them to look back and say, “You know, I didn't get this or that or this happened and wasn't my ideal but overall, that was an amazing experience and I'm happy with my experience and I don't reference my experience as traumatic,” and just have an overall better view on their birth. Kaitlin: That's the thing though. We all know there are uncontrollables but having respect and feeling in control and feeling like you were part of your birth in a powerful way has ripple effects and implications well beyond that day of your birth. That's a huge metric and that's really, really important. Meagan: Yeah, huge. Another one, I think, that is really cool is that they have one showing continuous support such as a doula can shorten labor by 41 minutes. Kaitlin: Um, yes. They shorten labor. They shorten pushing time and reduce your risk of C-section or surgical birth, forceps, or vacuum, up to 25%. I think there is a saying and I'll have to find the quote but it's like, “If doulas were a drug, it would be unethical not to use them. It is clinically proven that continuous support by a non-family member– that's the doula part, right?Meagan: Yes. Yeah, I want to talk about that. Kaitlin: Yes. Continuous support by a non-family member is wildly impactful not just on your emotional experience but on your pushing time, your laboring time, your surgical birth risk, and your baby's health. It's really something that every single person in the United States deserves to have. I also want to just put this other steed in here that doulas are not the cause of surgical birth. We are not the cause of longer labors or lower APGARs. We're not the root cause of these issues but we are one of the solutions that our healthcare system is looking at. It's hard to talk about this because I do want to talk about how doulas are awesome. Everyone should have a doula. Meagan: They're seriously so awesome. Kaitlin: But we are very much also a bandaid on a broken system so yes. We're all currently giving birth in this system so we all should have access to doulas and that's part of the work that we're both doing is getting people connected to the doulas in their area and getting people connected to the funding to pay for them because that's sort of the elephant in the room. It's like, “Okay. All of these doulas are great and they're highly impactful.” You listen to a podcast like this and it's like, “Oh, that's great. How do I get one?” It's like, “They cost $2000 out of pocket. Hope you're rich, bye!” It's like, “Wait, now I can't have one?” It's all a really messy stage in the American maternal healthcare system that we're in right now, but the idea of having a doula or not having a doula when you think about what we all think about as we are preparing for our birth is, “What's best for my baby?” It's best for your baby to have a doula-supported birth both for their health and for their parents' health and their parents' experience. If anyone's on the fence about it, I hope that this will spark you into researching and talking and looking into it because there are a lot of misconceptions about doulas. They are for everybody even if you are planning a C-section. Even if you're listening to this podcast because you're like, “I don't know. VBAC's not for me.” Even if you're listening because you're a hater. Doulas are for everybody. They're for every kind of birth. You can plan a C-section. You can plan an epidural. You can plan a home birth. You can plan a birth in the middle of the woods and a doula can be really instrumental in being an advocate for yourself throughout that. Meagan: Yes, and I have been to scheduled C-sections. I had two and I wish that I had a doula to be there. So I love that you were talking about, “Okay, wait. We know that doulas are awesome.” Sorry guys, but doulas are awesome. Kaitlin: But we are. Meagan: Okay, where do we find them? There are websites all over. You can search “Doula Near Me”. The VBAC Link has specific VBAC doulas. You just go to thevbaclink.com and search “Find a Doula”. Type in your zip code and boom.But yeah, then what? Then what? How do we pay for $2000 doulas? Kaitlin: Yes. $2000. I'm in New York. $2000 is kind of run-of-the-mill. Medicaid is covering $1900. They're paying out for doulas. That's just the cost of doulas in New York. It really varies according to market but it's expensive. If it's an $800 doula, then that means the salaries in the area and the cost of housing and everything else in that area is low. I think it's safe to say that it is a heavy lift for most people to be able to access a doula and not just a doula, but all of the other care that comes with it as well. Postpartum care, tongue tie clips, breastfeeding care, pelvic floor care, maternal mental health. How many insurance companies are covering those things? There's just an enormous amount of funding that needs to happen in order for us to get the care that we deserve, the baseline of care that is happening in other countries for other mothers. One of the things that I love to talk about because it's sort of my life's work–Meagan: Listen how to solve this problem!Kaitlin: Drumroll, please! It's really your baby registry. It's using Be Her Village which is what I created. It's our platform, our baby registry platform so that you can use this event where all of your loved ones are opening their wallets. They're going to buy you thousands of dollars of gifts. Literally, the stats are 12 billion dollars divided by almost 4 million babies. It's a lot of money, a lot of money being spent by communities and well-meaning, well-intentioned, so generous– everyone wants to support a new mother. Everybody does. But right now, you can just go to baby stores and get a bunch of baby stuff. I don't know. We've all bought gifts before and I guess the swaddles can help but it's not the same as knowing that this gift is going to be impactful. One of the best things that we've done is we've created this platform where you can register for and find the practitioners in your area– the doulas, the lactation consultants, the pelvic floor specialists, the childbirth education, the acupuncturists– everybody who is supporting mothers in their birth and their postpartum time. You can find them and add them directly to your gift registry.Your friends and family can send you funds, cash, cold-hard cash to pay for them so it's totally flexible. We've had $165,000 funded on our platform so far just from communities who are generously opening up. It is such an amazing tool and funding opportunity that is already happening. We already know about baby showers. They're happening. We already know how to use a gift registry. What if we use it to pay for doulas? What if we use it to pay for that care? It's really, really cool so I just highly recommend every single person that's listening to go to Be Her Village. Click on our shopping guide. Click to get started. If you're a doula, add your services there. We're reclaiming the baby shower because the baby shower has become this place where we get carloads of boxes where we get all of this stuff. For me, I had to haul it back to my tiny apartment. I'm like, “Where am I going to fit all of this stuff for my baby?” I was living in New York City at the time and we're really saying, “You know what? Moms need stuff for their babies, sure. We'll find them and how to pay for them but there's this real need for care for ourselves.” It's like the conversation we just had. Who doesn't want a doula after listening to that? Who doesn't want a doula after knowing the stats of how impactful it can be? What better gift than to say to someone, “Hey, I'm going to help you find that so you can have a better health outcome and so you can have a better experience so your entire transition into motherhood can feel better than it would have otherwise.”Meagan: Absolutely. I'm going to pull it up. Seriously, it's so easy. This website is so incredible. You can go and create your registry. You can shop for services. You can give your gifts. Anything, right here. Also, there is virtual. That's something too. Doulas and birth workers, if you are offering virtual courses, help people find your course so they can get more educated. They can go more prepared. There are tons of virtual services. You can go in. There's childbirth education. There's a fourth trimester. There's restoring your body. There's heart and mind. You guys, this is such an amazing platform. To say I'm obsessed is an understatement. It really is an understatement to say how much I love this platform and how genius you are for creating this space for people. I didn't hire a doula with my second baby because get this. You're going to laugh out loud. Everyone's going to die. I thought that $150 was too much at the time. Kaitlin: Oh gosh. Meagan: We didn't have a lot of money. Kaitlin: I get it. Meagan: Yeah. Kaitlin: Meagan, it's all so backward. We have our babies when we're making the least amount of money. Then when we have a baby, for many of us, you stop working. At least temporarily, if not for a long time. Meagan: You do. Yes. Kaitlin: You get squeezed financially and at the earliest time in your career. You're barely established and who wants to wait to be established? I'm 39 and I don't even feel established right now. But it shouldn't be that we have to choose how much care we receive because of our income level or because of the disposable income that we have. It's not enough. My doula cost $1200 and that was nine years ago. It was the same amount as my mortgage. Meagan: Right. Kaitlin: It was a huge lift for us but luckily, I knew. I was so driven for the VBAC. Actually, my VBAC approach was to do everything the opposite. I didn't take the childbirth education. I hired an OB instead of a midwife. I hired a doula instead of not. But it's a big, heavy lift and we have to start thinking about not just, “Can I afford it?” but “I deserve this. How do I do this?” So we have to be more creative as a collective. It's really cool. This baby shower is sort of this untapped area that we've just been going to for decades. You go. You buy the stuff at the store. You give it to parents. They return half of it. It's this thing that we're doing on repeat and I think it's time for some serious evaluation about, “What do we actually need? What does a mother actually need?” If you were to make a list, which we do. We have the top ten things you need on your registry and none of them can be found at a store because it's all about support and care from the community which often looks like professionals as well as friends and loved ones and family members and neighbors. Meagan: Absolutely. I am so grateful for what you do. I encourage everyone. If you are looking to hire a doula and you're just not sure or the funds are hanging over or maybe a postpartum doula. Maybe you're really needing that support educationally or whatever it may be, this is the place for you to go and check out. You could even hire a birth photographer if you're wanting to capture your birth. I mean, you guys. They have everything. So definitely, definitely, definitely check them out at behervillage.com. We're going to make sure to have all of the links in our show notes. Go to Instagram. Follow Be Her Village. You're amazing and I'm so grateful for you. I'm so grateful that your births have taken you on this journey honestly, just like I have with mine. It's such an honor to be sharing this space and this beautiful community with you. Kaitlin: Thank you, Meagan. I feel the exact same way. I'm really, really grateful for you. As much as I hate that we have had these hard birth experiences, it's all worthwhile because of how we are using it and how we're using it to help the next person, so thank you for that. 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

Sydney joins Meagan on the podcast today to share her VBAC story and talk about her experiences going past 42 weeks for both of her pregnancies. Meagan shares a story about one of her doula clients who went past 43 weeks! Sydney and Meagan discuss how due dates are calculated and the flaws behind the method that is so widely used.Meagan shares evidence-based information about the risks involved with being pregnant longer than 42 weeks as well as risks surrounding the choice to induce earlier. Having multiple sources of information along with your personal experiences and feelings will help you feel more empowered to make the right decisions surrounding when to birth your baby!Additional LinksBirthful Podcast Episode on Due DatesEBB: Evidence on Due Dates BlogHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Facebook CommunityFull Transcript under Episode DetailsMeagan: Hello! It is The VBAC Link. My name is Meagan and we have another VBAC story for you today. In addition to the VBAC story, we're going to be talking about postdates. This is a really hot topic especially in the VBAC world because we have a lot of people, I don't want to say forced necessarily, but pressed to induce their labor. I think after the ARRIVE trial came out, it's become even more pressing to have a baby by 39 weeks. I feel like the way we view the new due dates is that 40 weeks is 41. 39 is 40. 38 is 39. I feel like in a lot of areas in the world, that is how our mental state has shifted and we don't really hear 41 weeks or 42 weeks as much anymore. Today, we have Sydney, and guess what you guys? She had 42 weeks and 5 days, right? Is that right Sydney with your first? Sydney: Mhmm, that's right. Yes. Meagan: And then 42 weeks and 3 days with the second. So you are one of those mamas that carry further along than a lot of people. We're going to actually make sure to have it here in the show notes but the Birthful Podcast, I don't know if you guys listen to Birthful Podcast but I love it. I'm not even expecting anymore. I'm done having kids but I still love listening to it because the guests that she has on there are just filled with information. I want to say the guest she had, her name was Gayle I want to say. Don't quote me on that. But she has an episode all about due dates and talking about how the body carries. Review of the WeekWe are going to get some more into that at the end but of course, we have a review of the week and then we will have Sydney share her VBAC story with you. This review is by Rachelmademusic. It says, “Such a gem of a show. Thank you, thank you, thank you, Julie and Meagan, for creating this supportive and powerful space for mamas like me to learn and prepare for our VBACs. I'm currently 33 weeks pregnant and preparing for my own VBAC. I can't begin to express just how thankful I am to have found this podcast. I am truly grateful for this resource and for all of the mamas who come onto this show and share their stories. There is such an incredible strength and collective wisdom to be found here and I highly recommend this podcast to anyone preparing for VBAC or not.”Oh, thank you so much Rachelmademusic. I would agree. This podcast is such a great platform for first, second-time, third-time moms, fourth-time moms, and not even just VBAC moms because there is so much information that is shared on this podcast that talks about how to avoid a Cesarean. When we have a Cesarean in the US, it's almost 32%. That's pretty stinking high especially when it used to be 5% way back in the day. Although our VBAC rates are also going up, Cesarean rates have just skyrocketed. So if we can learn how to avoid an unnecessary Cesarean or undesired which a lot of us have had undesired and unplanned or maybe unnecessary Cesareans, we can start lowering that. I think it could be super impactful to a lot of the world because as part of these stories, we hear these first-time Cesareans or second-time Cesareans and they don't always resonate with positivity. That is hard because we want our birth experiences to be positive. So yeah. I think that it's super important that anybody listens to all of these birth stories. Sydney's StoriesMeagan: Okay, welcome to the show, Sydney. Thank you so much for taking time out of your day to be here with us and share these stories. Sydney: Thank you. Meagan: Are you in Virginia? Is that correct? Sydney: Yep, I'm in Virginia. Meagan: Awesome. We're going to start trying to say where people are because a lot of the times, we'll get messages that will say, “Oh my gosh, I'm in the same area. Is there any way I could get their providers?” So it's fun to be like, “I'm in Virginia. I will listen to this too because I want a VBAC and I want to learn who is supportive or who is maybe not supportive.” Yes, okay. Well, I would love to just hear your story and share this with all of you women of strength listening. Sydney: Yeah, great. Okay, thanks. Yes, I'm Sydney. I'll just jump into my first birth story. I was pregnant actually during the pandemic. My due date was August 8, 2020. Meagan: Okay, in the thick of it, really. Sydney: Yes, right in the midst of it. We were planning to birth with our birth center here locally. I actually was living in Tennessee when I got pregnant then moved about halfway through and started prenatal care with a birth center here so I was planning for a natural birth and just sort of assumed everything would be fine. Women had been giving birth forever. I come from a lot of strong women having a lot of babies so I just did not even think. I assumed it would be fine. Meagan: Yeah, you didn't think anything of it. Yeah. Sydney: Yeah, this is just what people do. I'll be fine. Everything was pretty normal with the pregnancy. I got to 40 weeks and had no signs of labor. I was not really worried about it at that point. Then I started getting to the end of 41 weeks and I was like, “Hmm. Huh. What do I do now?” The midwives were really helpful and gave me of course all of the things to try. I tried all of the things. I was going to the chiropractor multiple times. I tried acupuncture. I was drinking tea. I was pumping and doing all of the things that they told me I should do to try and get labor going. I just was not having much luck. So finally we decided, “Okay.” I was going to be 42 weeks on a Saturday so we thought, “I'll try the big guns, castor oil, on Saturday.” Something happened with the midwife. She wasn't ready for me to do it on Saturday so we had to wait until Monday which was 42+2. I took it first thing Monday morning at 6:00 or 7:00 AM. I could not keep it down. I threw it up so I had to do it again which was horrible. I hated it. I was like, “I'm never doing this again.”Meagan: Did you drink it straight? Did they have you mix it in a concoction? Sydney: They had me do a milkshake with vanilla ice cream, peanut butter, and castor oil. Meagan: Yeah, that's actually similar to what I drank. Sydney: Really? Okay. Meagan: Yeah, with my second. It's gross. Sydney: It was still so disgusting. Meagan: Yeah, yeah. Sydney: I did it a second time. The castor oil did its job. It got some contractions going but I was walking a lot to just keep them doing anything. That sort of continued through Tuesday. I was having just mild contractions on and off. Then by Wednesday morning which was when I was 42+4, they were strong and consistent. The midwives were like, “Okay, we think you're ready to come in. Let's get things going.”I remember they had to meet us at the birth center. It was 7:30 in the morning. I got there and apparently, another mom had beat me there. She was also in labor. So as soon as I walked in, I'm a first-time pregnant mom, she is pushing her baby out and screaming. It was the most terrifying thing I had ever heard. Literally, I think my cervix just closed up and was like, “Nope. Not doing that.” I literally didn't have contractions for a couple of hours after that. It all stopped. Meagan: Yeah. Sydney: That was unfortunate, Meagan: That can happen. That can really happen though. It doesn't even matter. Maybe nothing significant like a woman screaming in labor, it doesn't have to seem significant. It can be just shifting from the car to the hospital or your home to the car or downstairs to upstairs. Something off can calm things down. Sydney: It did, yeah. Meagan: Sometimes it's just your body responding and needing a break. Sydney: Yeah, yeah and that's really what happened. The midwives worked with me all day. We were doing Miles Circuit. I remember that it was August so it was scorching outside. They had me climbing hills and stairs and curb walking. They made my husband stay inside and take a nap because he was exhausted. I was doing all of the things, pumping every half an hour and they were giving me tinctures every 30 minutes. Still, by 5:00, I think I was maybe 3 centimeters but contractions were not picking up. They weren't strong enough and we were both exhausted so the midwives were like, “All right. I think the best plan is for you to go home, drink a glass of wine and take some Tylenol PM. Let's get these mild contractions to stop so you can relax and then you probably need to go be induced in the morning.” Because at this point, we were 42 and 4. I was starting to get uncomfortable. I was just exhausted. They were like, “It probably would be beneficial for you at this point to be induced and have an epidural so you can just rest and relax and let your body do what it needs to do.” That was our plan. We went home and did that. It worked for a couple of hours but the contractions actually really picked up overnight so by 4:30, I was like, “We need to go. I can't do this anymore.” I think we did the wine and Tylenol PM again later in the night and it just was not working. So at this point, I was like, “Okay. We're ready to go.” We ended up going to the hospital. By the time I got there, they were like, “You do not need to be induced. You're already in active labor.” I was like, “Okay, great. Let's do this.” We labored for a while and decided later that morning to try for an epidural so that I could just get some rest because we were so tired. As soon as I got into position for the epidural, the baby's heart rate decelerated so there was panic. There were a ton of people in the room. They were doing oxygen. They wanted to check the baby's position to see if the baby had maybe dropped or something but the baby stabilized almost immediately. They said I was at an 8. I was like, “Oh wow. Okay. Forget the epidural. Let's just do it.” I continued to labor for a couple of hours and they checked me again. This was probably at 11:00 and they said I was at a 4. Meagan: What?!Sydney: I was like, “Huh? What?” I don't know if the first person got it wrong. I have no idea what happened but I was in a different position when they checked me. It was a whole thing. Meagan: It's happened. I've been to births where that's happened where they were like, “Oh, you are 9 centimeters,” and getting the cart out, then getting the provider to come in then the provider comes in and is like, “She's 5 centimeters,” then we're like, “What?” The one provider explained to me and the team said that sometimes if we have a really, really stretchy, favorable cervix, especially during a contraction or certain positions, it can feel thinner than it is or feel like it is dilated more than it is and then they change that or a different person checks and they're like, “Yeah, no.” But man, that's a frustrating scenario. Sydney: I was devastated. So at that point, I was like, “All right, bring me the epidural.” I'm only at 4 centimeters.Meagan: Yeah. Change of plans, let's do that again. Sydney: I cannot go much longer. So they were bringing the epidural. Meanwhile, they decided to break my water because she could feel the water and there was meconium in it so that gave them a red flag. When they went to bring the epidural and I got into position, the same thing happened. Baby's heart rate went this time way, way down into the 20s. Meagan: Like something is being compressed. Sydney: Yeah, so at that point it wasn't even a question. They rushed me out for a C-section immediately. By the time we got to the OR, baby had stabilized but they were like, “You're both exhausted. We need to get this baby out. You've been doing this way too long,” and I was postdated and there was meconium so I think there was a lot of concern. Then they went to give me a spinal tap so I could be awake and it didn't take. They did it twice and it didn't take. Meagan: Did the baby's heart rate react then?Sydney: Not that I know of. Meagan: It's not working. It's not working, yeah. Sydney: So they put me under and I birthed my baby asleep which was a whole thing but she was on my chest not too much after she was born and I was able to nurse immediately. They tried to be really accommodating to me and they were very mother/baby friendly. Meagan: Yeah. Did they bring you back pretty quickly? Sydney: Yeah. Meagan: Like you were awake right after? Sydney: Yes, pretty much. I think they were still working on me while I was awake. Meagan: Okay, yeah. Sydney: And then my husband was able to be there. He got to see her first while they were examining her. It all was fine. We were both healthy and we were okay but it was a little bit of a traumatic experience and not what we were planning for at all from a natural birth to a total C-section. Moving on to being pregnant again, I was like, “All right. What do I want to do now because it feels like the natural birth didn't go well but this time around–” I don't know. I felt like I was more prepared and knew a lot more. There were a lot of choices I made with the first birth that I knew I wouldn't make with the second. I had said, “I'm not going past 42 weeks.” Obviously, I didn't but that was my mindset. I was like, “I'm going to do what I can to have the baby ahead of time.” So anyways, my second baby was due July 10, 2022, so just under two years later. I did decide to go with the birth center again, the same birth center. We had a good prenatal experience there and I love the midwives there. And again, I felt like I was more knowledgeable this time around. I knew that I was getting a doula. I did not have that the first time. I knew that I wanted to set myself up for success as much as I could. So again, I was doing everything I knew to do to shorten the pregnancy. I went to the chiropractor early and I went consistently every week. I drank lots of the Nora tea. I started pumping at 36 weeks every day. I was taking Gentle Birth and walked consistently. Meagan: So great. Sydney: I was doing everything. The pregnancy was fairly normal. This baby was breech at 34 weeks and I was so discouraged because I was like, “I'm a VBAC. A lot of people aren't going to want to do that.” Even my midwives were a little bit hesitant to do that because I had never had a vaginal birth. They usually are good with breech births, but with my situation, they were like, “We're not sure we want to take that risk.” So I knew my chances of VBAC with a breech baby were very low. So I was doing inversions. I did acupuncture. I put frozen peas on my belly. I did everything that people told me to do. He did flip by 36 weeks which I was very thankful for. So anyways, I'm doing all of these things to make sure that this pregnancy is shorter. At 40 weeks, I upped the walking. I started swimming but no signs of labor at all. At 41 weeks, the same thing. Not dilated at all, getting discouraged. And of course, during this time, we're doing a lot of non-stress tests and trying to make sure that baby is still doing well. Around 42 weeks again, I said, “I'm not going past 42 weeks,” but of course when it gets to that point, I'm like, “Just a couple of more days. I want to do everything I can to have the birth that I want.” So at 42 weeks, I was 1 centimeter and we were all so thankful. The midwife did a sweep and I did castor oil again. I tried to hit it with everything in one day. I think I ended up doing the castor oil three times because it wasn't doing anything. Meagan: Oh my goodness. Sydney: So eventually, it worked and I got some contractions at midnight to 3:00 AM and then it just sort of fizzled out. I just kept having really mild contractions. At 42 weeks and 3 days, I decided that there was not much more I can do at this point. I need to go be induced because we really were trying everything. They were not getting strong enough or consistent enough to make any progress. Meagan: Again, post date. Sydney: Right, right. My body is going this long, so do I trust that? I know that the risk goes up significantly after 42 weeks from what I've heard and read so it's weighing that balance of, “I know baby's okay but how long am I willing to wait this out and take risks?” So I decided to go be induced. They put me in triage at 7:00 AM on a Saturday and of course, the nurse was basically like, “You're this huge fish that doctors never see because you're a transfer. You're a VBAC. You're post dates.” Just all of these different things that made me an interesting patient. Meagan: All of the checkmarks against you here. Sydney: Yes. They were able to get us into a room later that morning. It had a tub. The nurse we had was really sweet. She knew that we were from a birth center. She was like, “I have this room with a tub. Someone's in it but if you can wait a couple of hours, you can get into that room.” So we got into the room with the tub. They started me with a Foley balloon and that did not take very long at all and then they started Pitocin at a very, very low level, like a 2 I think. Meagan: That's a really great, nice way to induce. A Foley with a low dose of 2 or 4 milliliters of Pit for a little bit. Sydney: Yeah, yeah. I was able to be in the tub for a little while. I stayed in there for a couple of hours and then I think around some time that afternoon at 3:00 I did ask for an epidural because again, I had been up for days at this point and needed to just rest. Meagan: So tired, yeah. Sydney: The anesthesiologist was in surgery so it was a few hours. I think they didn't come until 7:30 that evening. This time, everything went fine. I was able to get the epidural and get some rest. It was just like, “Wow. I did not anticipate feeling this good right now.” It was such a relief and I was able to get some rest. My doula came around then and was very helpful and sweet. Then around 11:30 that night, I started throwing up. They thought maybe it was the epidural. They said that can sometimes make people nauseous. They were checking all that and my doula was like, “She might be in transition. Why don't we check?” And I was fully dilated which was so exciting. I was getting ready to push and I was happy to finally be doing something and feeling productive. I was pushing for a while. After about an hour or so, the doctor that was with me switched out with another doctor. I think she had another surgery to be in or something. The doctor that came in was the doctor that did my first C-section. He almost immediately– he hadn't been in the room very long but he said that if I couldn't push the baby out that they would have to use forceps or do a C-section. Meagan: Had he been pushing with you at all at this point or did he just bluntly say these things before even assessing? Sydney: Yeah. He had been in there maybe for five minutes. I was so discouraged and my doula just looked at me and winked like, “Don't worry about that.” Meagan: Don't worry. Yeah. Ignore what he just said. Sydney: Yeah. I think it took me– we started pushing around 12:30 and then he was born I think at 2:30 or so. So 2-2 ½ hours of pushing. Meagan: That's not long at all. Sydney: It wasn't too bad. That was really sweet. I finally got to have a vaginal birth. My husband was there. He got to announce the gender and cut the cord. I got him on my chest immediately and it was really sweet. I did have a 3A tear which was–Meagan: 3rd degree, yeah. Sydney: Yeah. It was a tough recovery with that but otherwise, it was a really, really good experience. Again, not in the birth center, not the natural birth that I had envisioned but it went so much better than I could have anticipated. Meagan: Good. Sydney: I'm really thankful for that. Meagan: I want to talk about that a little bit before we get into due dates. Like you said, it wasn't the natural birth you anticipated, but in the end, you had an epidural that truly was such an amazing tool in your labor. At first, you couldn't get it, but then you were able to rest, and like you said, “I didn't anticipate feeling this good.” The world puts such shame on people for both sides actually of, “Hey, if you don't go unmedicated then you're crazy and you're going to have a C-section,” or “Hey, if you go unmedicated, you're crazy and then if you get an epidural then you're crazy and you're going to have a C-section.” It's just not that way. We need to take out these absolute statements of, “If you do this, you won't have this,” because it's not true. I can't tell you enough. We get so many emails of, “I really want to VBAC so badly but I just don't feel I can go unmedicated. It's not my personality. It's not what I desire.” They're like, “It just sucks that I can't have a VBAC because I don't want to go unmedicated.” I'm like, “Wait, wait, wait, wait. If you want a VBAC, you don't have to go unmedicated.” It's the same thing with induction. Are there some things around induction that may increase some risks or some chances? Yes. That doesn't mean it's going to happen though, right? This provider that started you out with this induction is a really great way to induce. Yeah. You had progressed a little bit before with your first so that's also a really great factor, but yeah. You don't have to go unmedicated to have a vaginal birth in general. I mean, look at all of the people that truly don't go unmedicated. It doesn't make you less of a person if you don't have an epidural. Something I love about your stories, both of them, is that you had the discussion with the midwives but you had this thing of, “Okay. We're going to go to the hospital now. I'm making this choice for me, for my baby, and this is what I feel good about.” I think that's important to note too. Sometimes plans change and plans can change. Sydney: Yes, yes. I held it a lot more loosely the second time around than I did the first. Meagan: Yeah. Well, I think it's just because in the world we get a lot of pressure and shame for decisions that we make. My kids are in a lot of sports and I get shamed for my kids being in sports and that has nothing to do with anybody else's life. Yeah. Listeners, you guys birth the way you desire. If that's a repeat Cesarean, that's a repeat Cesarean. If that's an induction, that's an induction. If it's unmedicated, medicated, or whatever it may be, birth the way you want. But on the way to birthing the way you want, make informed choices by getting the education and the knowledge behind every choice that you are making. Okay, so due dates. Here you have two babies that have gone over 42 weeks. Neither of them had many issues or anything. Maybe we had some mec which is common, especially in postdate babies. So I want to talk about what postdate means or what all of the terms mean. An early-term baby is between 37 and 38+6. That's an early-term baby. A full-term baby is 39 to 40+6. A late-term baby is 41-41+6 and then a post-term baby is 42 weeks or later. Technically, you had two postdate babies. I had an early, a full, and a late baby. I had three different ones. One of the resources that we love so much is Rebecca Dekker at Evidence Based Birth. If you guys have not checked out that website, it's so amazing. They turn studies into English for the people who can't understand a lot of these studies because it's really hard. They turn them into English. One of the things that she talks about on this specific blog which we'll have in the show notes is titled “Evidence on Due Dates.” One of the things she talks about, and shame me if I'm pronouncing this wrong, but it's called the Negel's Rule. It's something I had never really heard about until probably a year ago but back in the 40s, a professor in the Netherlands created this rule on how to calculate estimated due dates. She says, “Based on the records of 100 pregnant women, they have figured an estimated due date by adding 7 dates to their last period,” then that is 9 months. It's crazy though because if you think about this world and our periods as women, we are not the same. Nobody. I can guarantee you that I am not the same as my neighbor or my friend or even my sister. We have different cycles and this was based on a 28-day cycle ovulating on the 14th day. That just doesn't happen all of the time. I don't love the method because it can be different. On the Birthful Podcast, we talk about how people sometimes carry longer. That doesn't mean that they're super, super, super overdue. It just means that they have carried longer. In her blog, she talks about a person that had a 44-day cycle so she may have been viewed as 42 weeks or 41 weeks + 2 days, but really, she was 40 weeks. So we were adding a week and two days onto this due date and we're telling people that we're got a higher chance of stillbirth and things like that but really because of her long cycle, she is 40 weeks. It's just so hard. It's so hard. I mean, there is research and this blog is amazing but even then, it's hard. But we do want to talk about the risks of going past your due date. What risks, Sydney, did people tell you about going past your due dates? For you and baby, was there anything said that was very specific like, “If you go one more day, this is going to happen or more than likely to happen?” Sydney: The biggest thing that stands out in my mind is the meconium and the risk of baby aspirating and then also just the general risk of stillbirth going up after 42 weeks were the two obvious things that I remember. Meagan: Yeah. That is correct. The risk of moderate or thick meconium increases every week starting at 38 weeks. It's interesting. We don't know exactly why a baby has a bowel movement in utero all the time. Sometimes it's due dates. Maybe sometimes it's stress or a really fast transition or whatever. They just do. We don't know exactly why all of the time, but it does seem to peak between that 38-42 weeks. It's 3% at 37 weeks, 5% at 38 weeks, 8% at 39 weeks, 13% at 40, 17% at 41 and 18% at 42 weeks. An 18% chance that a baby may have a bowel movement within that 42 weeks. 18% might sound really, really high but to some people, they're like, “Okay, well if it happens.” Then like you were saying, we worry about the risk of aspiration. Sometimes it happens and sometimes it doesn't. If it does, sometimes we have other issues. Another risk for infants is the increased chances of NICU admission. They were the lowest at 39 weeks at 3.9% and rose up to 7.2% at 42 weeks. Again, some people may look at that and say, “That's enough for me to have a baby at 39 weeks.” Some people might be like, “7.2%. I'll take the chances.” It's a totally personal preference. One of the other risks, and when I say risks, I'm really putting quotations around this because it's one of those eye-rollers for me. It's a big baby. A lot of providers will say, “Oh, your baby is going to get way big. You might not be able to have that vaginal birth.” Especially with VBACs, it's like, “Last time, your baby was larger.” Let's say last time your baby was 8 pounds, but this time it could be really big if you keep going. It shows that for greater than 9 pounds, 15 ounces rose during 38 weeks which is 0.5%, and then doubled at 42 weeks which is 6%. But I mean, we recorded a story last week with Morgan whose baby was 10 pounds, 12 ounces. Big babies still come out and they're just fine. It's hard to hear the risk of the big baby because why are we shaming these babies? It's fine if they're big. It's fine if they're chunky. We love when they're chunky. And then some of the risks of having a lower APGAR score or stillbirth. The stillbirth I think is probably one of the most intense risks that we look at. It's the scariest risk for obvious reasons. It says, “Absolute risk is an actual risk of something happening to you. For example, if the absolute risk of having a stillbirth at 41 risks was 1.7 out of 1000, then that means that 1.7 mothers of 1000 or 17 out of 10,000 will experience a stillbirth.” So you hear that and it's very scary. Then it says, “Relative risk is the risk of something happening to you in comparison to somebody else. If someone said that the risk of a stillbirth at 42 weeks compared to 41 weeks was 94% higher, then that sounds like a lot but some people may consider that that actual or absolute risk is still quite low at 1.7 versus 3.2.” We've had a post like this. It actually stirred up a lot of angst because we talked about some absolute risk and some relative risk and actual risk, but really it can be very scary to hear a 94% higher chance than a 3.2% chance. Ultimately, yes. There are risks of stillbirth the longer we go. There are risks of placental issues or infections in moms because there is a whole other category of risks for moms that we a lot of the time don't talk about too much. But yeah. It's just a matter of what is best for you. At the beginning of the podcast, you said, “I haven't met a lot of people who have carried as long as me.” I was telling you that in eight and a half years of being a doula, I have had one client specifically– I've had some 42-weekers at one or two days, but one client specifically who went 43 weeks and 1 day. It started at 40 weeks. Her provider was like, “You have to induce. You have to induce. You have to induce. She was like, “No, I don't want to.” Then at 41 weeks, the same thing happened. “You have to induce.” At 42 weeks, she was like, “I'm over it. I don't want to be here anymore.” She called me and she was like, “I'm changing providers. Does that change anything?” Her home was farther away from me than her hospital location so she was like, “I'm changing providers. Does that change anything to do with you supporting me? Because I need to know if I need to find a provider closer to you or if you'll come to me.” I'm like, “Yeah. I'll go wherever you go.” So she called I think it was the next day. At this point, she was 42 weeks + 1 day. She was like, “I found a provider. She's out here by me. She's going to support me.” I'm like, “Okay, great.” She goes to 42 weeks and the doctor is like, “We're going to do two non-stress tests this week. We're just going to check.” They did and they were like, “Everything's great. No problem. Baby might be on the larger side, but other than that, everything's looking great.” At the next one, she was like, “Yep. Everything's looking good.” She's now at 42 weeks and 5 days. I'm like, “Wow.” This is the first and this is in the very beginning of my doula career. I'm like, “Does this really happen? What is happening?” I was feeling nervous because I still didn't know much then. Anyway, at 43 weeks or the day before 43 weeks, she went to her provider and they were like, “You're really not showing a ton of progress. You're barely effaced. You're maybe a centimeter.” Sydney: Oh my gosh. So triggering for me. Meagan: Yes. Well and for her, she was like, “I'm never going to have a baby.” She said that. She was anxious. She was like, “I think I'm going to be pregnant forever.” I'm like, “No, you're not going to be pregnant forever.” But you can understand where she's coming from. Sydney: Yeah. I just don't believe that people go into labor on their own. I just don't get that concept. Meagan: Yeah because of your situation which I totally understand. Yeah. They were like, “How about you come in tomorrow? Let's do this. Let's induce this labor. Let's have this baby.” So she called me and I was like, “Yeah, do it if you want to.” We went over everything so she was like, “Yeah, okay. I'm going to do it.” She actually started contracting through the night and we were like, “Oh, she's going into labor.” I do think she was actually going into labor because we went in. She had only progressed another half a centimeter but she was contracting. I wouldn't say that they were anything too crazy strong or anything but they were there. But then they did induce the labor with those contractions and at 43 weeks + 1 day, she had a really chunky little boy. Everything was really great. Nothing was wrong. He did have meconium. He pooped. They believe that he pooped on the way out so he wasn't super gray or anything but yeah. It's just very interesting. It's very, very interesting. Due dates are interesting and it might be a hangup for you for a long time. Sydney: Mhmm. I always was so curious about this and they said, “We think you're probably just one of those women that if we let you go, you would naturally go to 43 or 44 weeks. Some women just carry longer. Some women carry shorter. Everyone is different.” Meagan: Yep. Yep. I keep thinking Gayle. Gayle is what is coming to my mind for the podcast with Birthful. She talks about that. Some people just go to 43 and 44 weeks. It's crazy but again, back to what was in that study on Rebecca Dekker's blog is that it's not that she was 42 or 43 weeks. That's where the hangup in my mind comes from. This is where she is based on her last period based on this calculation that Google does or the little wheel. My doctor back in the day had a little wheel to tell me when I was due. That doesn't mean that that's when my baby is due and it doesn't mean that I had that 28-day cycle and I ovulated at day 14. Really, that's my hang-up in my head. What more can we do with these due dates? How can we calculate these due dates better because, in my opinion, induction is also really, really high? We've got a high Cesarean rate, a high induction rate, and a lot of people going in. Induction is just fine if that's what you are wanting but a lot of people are getting that pressure to induce and they are getting these scary things being said. Let's figure out what these due dates and these guesstimation dates really mean. Honestly, there is not enough evidence without induction and stuff like that, I don't think, to really, really, really, really know what the average length of pregnancy is. Sydney: Yeah, that's probably a good point because people just don't go that long. They get induced. Meagan: Yeah, they just don't. In your mind, you're like, “I wholeheartedly do not believe that anyone can go into spontaneous labor. I don't get it,” because you've had two experiences and it makes sense. You're welcome to feel that way but at the same time, it's like what is missing here? Like your midwife said, “You're probably one of those that we would let you go and you would go.” But does that really mean you're 44 weeks? Does that mean you're 41 or are you actually 42 at that point?”Sydney: Yeah. We do plan to have more at some point, but I'm going to track my cycle consistently and track the actual conception date if I can and make sure I know exactly when and probably even do an early ultrasound which I haven't done before just because it's always the question people want to ask. “Well, are you sure about your due date? Are you sure about your cycle?” I can't be 100% sure about my cycle but I can be 100% sure about when my last period was. I know what that is. Yeah. I field that question a lot. Meagan: You know, it's an interesting thing that just popped into my head. Remember when I told you earlier that I've had an early term, a full term, and a late term? With my third baby, we were crazy. We were trying for a boy specifically and my friend was like, “Read this book.” I was like, “I'm going to follow this to a T.” We had two girls and my husband was like, “This is the last. You have one more try to get your VBAC.” He was really, really stern on this one more baby. I was like, “Okay, fine.” I was waiting for him. Before he was ready, I started temping. I mean, going more extreme. It consumed me a little bit but I really got familiar with my body because I really wanted to try for this boy. Anyway, so I had temped and done everything. We conceived. I knew almost the hour. It was ridiculous. It was absolutely ridiculous. I knew exactly when I got pregnant and I was 41 weeks, 5 days but with my first, they said that my due date originally was October 26th and then she was measuring small so then they bumped it up to November 6th, 10 days later. She ended up coming November 4th but then I wondered, “Was I early? Was I late? What was I?” because I wasn't tracking. With my second, she came at 38 weeks, 5 days so it makes me wonder there too because I wasn't really paying attention but I felt very pregnant. But then she was small so they were like, “No, it was totally fine.” I'm like, “She was measuring small from the very beginning.” It always makes me wonder. Maybe I was closer to the 40-week mark or maybe I was almost 41 weeks. I don't know. It's fascinating. Sydney: It is, yeah. Meagan: And it's hard. It's hard because we don't know and we are only trying to do what's best. We are only trying to do what we are given the information on. As always, we have to follow our gut and decide what's best for us. We'll make sure to include those studies. If you guys are listening and you find this interesting too, go down to the show notes. Find it. Read them. Listen to the podcast. It's a really, really great episode. Anyway Sydney, thank you so much. Sydney: Thank you for having me on. Meagan: Thank you for bringing this conversation to the table because it's not one that we talk a lot about. But I'm sure you've got some frustration. Like you said, “It's kind of triggering to hear that.” Sydney: Yeah. It's not fair that I have to do all of this work before I actually go into labor. We'll see what I do for the next one. I've said, “I'm not going to do anything. I'm just going to get induced at 42 weeks.” But I'm sure when the next one comes along, I'll be like, “No, I really want to try and do it naturally.”Meagan: Let's do the castor oil again. There are some ways to naturally induce like breast stimulation or sex and starting sex earlier on or evening primrose oil and things like that. Things that we can start doing at 38 weeks leading up. But even then, it's not a guarantee and sometimes it can be frustrating when you're like, “I'm doing all of the things. I'm taking castor oil and I've puked it back up three times and I'm still not having a baby.” Sydney: Yes. Well at this point, it will probably be a matter of, “I'm just going to trust my body. My body knows. My baby knows when they're ready to come out.” I just need to follow my intuition and weigh that risk like you talked about. Meagan: Yeah. Sydney: Yeah, but we'll see. I don't have to worry about it yet. I'm not rushing it. Meagan: You don't. You don't. You don't have to worry about it but keep grabbing the information so then you'll be prepared. Sydney: Yeah. Yeah. Thank you very much. Meagan: Awesome. 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. 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