Podcasts about arom

SEASON 2 - EPISODE 128 - Deadliest Catch - Arom Starr-Paul & David Reichert In this special episode of the Team Deakins Podcast, we're talking about one of our favourite shows: DEADLIEST CATCH. Executive producer Arom Starr-Paul and cinematographer David Reichert join us for a lengthy discussion and generously answer our many questions about how the show actually gets made. We first learn how both men made their way to the Bering Sea as camera operators and worked their way into their current roles after many years. Later, Arom shares how the show's storytelling evolves over the course of a season and how the crew identifies which storylines to follow out at sea. David also highlights the day-to-day responsibilities of the cameramen and women on the boats and reveals how he coordinates the look of the show across the huge fleet of crabbing boats featured in every season, and we learn how they sift through 40,000 hours of footage down to just 20. Roger also compares his fishing strategies with those in the fleet from the show, and we reflect on the ecological changes in the oceans and in the practices of fisheries. - This episode is sponsored by Aputure

1-¿De qué se trata la nixtamalización, un legado azteca que se usa para procesar el maíz? 2-¿Quiero saber por qué algunas personas no logran morir hasta que les dicen la oración? ¿Hay algo de verdad en esto? 3-¿Sabía que el pasto marino es originario del pasto terrestre? 4-Me gustaría saber cuál es el cuidado que se le debe dar a las plantas aromáticas, ya que a mí siempre se me marchitan. 5-Deseo saber el nombre del insecto que aparece en la foto que les mando. Lo he visto en el patio y deseo saber de qué se alimenta y su función en la naturaleza. (Saltamontes de hora o esperanzas) 6-¿Por qué a Holanda le llaman Países Bajos? 7-¿Sabía que pasar mucho tiempo frente a la pantalla de los celulares viendo redes sociales puede provocar una adicción? 8-Podrían contarnos la historia de Gustavo Doré, el genio del detalle que se convirtió en el más grande ilustrador de la historia y de todas las artes visuales. Programa de radio "Oigamos la Respuesta" del Instituto Centroamericano de Extensión de la Cultura (ICECU). El programa se hace con las preguntas que envían nuestros oyente y las respuestas que se elaboran en el ICECU con un lenguaje claro y sencillo desde el año 1964.

In today's episode, we're revisiting an inspiring birth story featuring Emily Chandler and Taylor Washburn, graduates of the Evidence Based Birth® Childbirth Class. They share their journey of navigating an informed and empowered hospital birth experience, along with the challenges they faced during an extended hospital stay for their newborn's jaundice diagnosis.   Emily, a marine scientist, and Taylor, a teacher and rowing coach in the Boston area, enjoy an active lifestyle filled with hiking, biking, and rowing. While preparing for parenthood, Emily immersed herself in learning about pregnancy, birth, and the state of maternity care in the U.S. This journey led them to take the EBB Childbirth Class with instructor Chanté Perryman, where they gained valuable knowledge and advocacy skills.   Emily and Taylor share how the EBB Childbirth Class empowered them to make informed decisions about their birth plan—including Taylor's memorable experience of “catching” their baby. They also highlight the importance of the advocacy skills they learned, which helped them effectively communicate with healthcare providers and navigate unexpected challenges, such as breastfeeding difficulties and securing the right support during their baby's jaundice treatment.   Be sure to listen all the way to the end of the episode for an exciting update from our guests!   Content Note: This episode covers topics such as extended hospital stays, breastfeeding challenges, jaundice testing and treatment, and the racial disparities affecting Black and Brown infants with jaundice. (00:03:15) Doula Guidance During Pregnancy (00:09:24) Minimal Intervention Birth Plan Worries (00:17:45) Unexpected Labor Challenges (00:24:45) Efficient and Caring Nurse's Impact (00:34:34) Newborn's Breastfeeding and Jaundice Journey (00:40:03) Newborn Care and Feeding Challenges (00:43:17) Optimal Umbilical Cord Clamping Timing (00:47:27) Risk Factors for Infant Jaundice (00:52:18) Jaundice Warning Signs and Emergency Help (00:55:57) Home Birth Journey and EBB Impact Resoures: Get the Evidence Based Birth® Pocket Guide to Newborn Procedures here You can learn more about jaundice here at the Mayo Clinic site, or here at the Cleveland Clinic website. Access the Evidence Based Birth Signature Articles on: The Evidence on Premature Rupture of Membranes here The Evidence on Group B Strep here The Evidence on Pitocin in the Third Stage here Listen to EBB 145- Fatherhood and Advocacy in Birth with JacMichael Perryman here Listen to EBB 244 – Evidence on AROM, AVD and Internal Monitoring here Learn more about Chanté Perryman's EBB Childbirth Class and services here Learn more about the Nest Collaborative here For more information about Evidence Based Birth and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, “Babies Are Not Pizzas: They're Born, Not Delivered!” If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.

Bem-vindos ao podcast Boca de Trapos! No episódio de hoje, conversa com ⁠⁠Fernanda Botelho especialista em plantas medicinais e aromáticas e também escritora. Nota: último episódio da 6ª e última temporada do Boca de Trapos! Obrigada a todos os que estiveram comigo, atentos, desse lado, obrigada a todos os convidados que por aqui passaram durante estes quase 4 anos de Boca de Trapos e obrigada também aos que o apoiaram, das mais variadas formas. Até um dia destes! Mónica Moreira⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Sigam o Boca de Trapos: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ + ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Contacto: bocadetrapos@gmail.com Logo, Intro e Outro: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Alright Creative Studio⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Música "Can't Stop Me", Andrey Sitkov (Humble Big Music Bundle), voz Pedro Barão Dias.

“In that moment, I knew that was the last time I would see her. I didn't know what I was going to do, but I knew I could not go back to her.”How do you feel when you meet with your provider? Are you excited for your appointments? How does your body react? Are you tense or calm and relaxed? Jessica's first birth began with an induction that she consented to but didn't really want. Her waters were artificially broken, and her baby just was not in a great position. After over 4 hours of pushing and multiple vacuum attempts, Jessica consented to a Cesarean. Listen to Jessica's VBAC story to find out what she did when she realized at 37 weeks that her provider was NOT actually VBAC-supportive.Sometimes difficult situations actually work out even better than we hoped!How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome, Jessica, to the show. I am so excited that you are here and excited to hear your stories and actually talk a little bit more about what you do. Do you do it for a living, or is this just your passion project or whatever they call it? Is it your side job?Jessica: It's on the side. It's volunteer. My main job is a stay-at-home mom right now. Meagan: Yes. You're homeschooling, right? Jessica: I am. Meagan: Oh my gosh. One of my best friends homeschools. I just praise you guys. Homeschooling is legit. It is very hard. That seems so hard. Jessica: It's definitely a lifestyle. It's different. It's not for everybody, but it's definitely for us. My daughter is only 5 so we are just getting used to it. Meagan: So Kindergarten?Jessica: She just turned 5 a couple of weeks ago, so we are technically doing 4-K right now. We are just getting into it. I'm still wondering every day, “Am I doing everything I should be?” I know as it goes on, I will get more comfortable and confident with it. Meagan: Yes, you will. That's what I've seen with my friend. She was like, “This is what feels right. This is what we are going to do.” It took a little bit of a learning curve, then each kid added in, but she kills it. Yes, you are just a stay-at-home mom, but a full-time teacher. Holy cow. That's amazing. Then yeah, you are doing La Leche League. Jessica: Yes. I have been a leader now for 2.5 years, just over that. I became certified. I think it was on my due date. I was trying to get everything done before my toddler was born. It's been going really great. I really like it. Meagan: Yes. Tell us more about it because when I was– this was in 2014– pregnant with my second daughter. That's when I heard about La Leche League. Tell us more about it and why someone would want to find their local leader, and then what all the benefits are and how to find them. Jessica: Sure. I first heard about La Leche League when my oldest was maybe about 9 months, so right away in my breastfeeding journey, I had no idea about it. I wish I had because it would have been great to have a community of support. I started feeling really passionate about breastfeeding and knew I wanted to help other moms with it because it can feel really isolating, especially because it was in the middle of the pandemic. I started researching ways that moms can help other moms with breastfeeding because I had no other background in it. I'm not a nurse. I didn't work in the labor world. I just stumbled upon it, and I lived in Madison at the time. I saw that Madison had a chapter. They weren't doing meetings at the time because everything was virtual. But I just reached out, and I said, “I want to be a leader. Tell me what I need to do.” They emailed me back, and I got in touch with another local leader there who had been there for a while. She was surprised. She was like, “You want to be a leader, but you don't even know what we do. You've never been to a meeting.” I just said, “Yes. That is what I want to do.” It was kind of a long process to become a leader because everything was virtual. They didn't know how to go about that. Meagan: Yeah. Jessica: So it took a little bit of a long time to become accredited as a leader. Meagan: Does it now or is it in person? Did it stay virtual? For someone who may want to?Jessica: I think everything is back to in-person. At least where I live now, Madison I know is back to in-person now too. Everything is probably running a little bit more smoothly now in terms of if you are interested in becoming a leader. Basically what leaders do is that we get some training within La Leche League, but we are your cheerleaders. We are here to support you. We are the middle ground between if we need to refer you somewhere for some additional help if it's beyond our scope of practice of basic breastfeeding positioning, latching, or if you have questions of, “My baby is doing this. Is it normal?” That's what we do. We have support groups every month for anybody to really join. Meagan: Awesome. Jessica: It's fun. Meagan: Where can someone find it if they're wanting to learn more? When it comes to breastfeeding, it sounds weird because you don't have your baby yet, so why are we talking about breastfeeding? Why are we thinking about it? But I really believe that connecting before we have our babies with an IBCLC or a La Leche group is so important before you have your baby. If someone is looking, where can they find information or try to search for a chapter in their area? Jessica: You can just look up your state La Leche League. There should be a website that has all of the local chapters. They are all over the world, so you should be able to find somebody near you. Even if there's not one near you, you can contact anybody. Let's say they are 2 hours away. You can still call or text or email. They'll usually, if you want to do something more in person, you can do some type of Zoom meeting. You can definitely find anybody to talk to. You're right. It's really important to get support before you even start breastfeeding if you know that's something you want to do. I always say that breastfeeding is natural, but it doesn't always come naturally. You don't know what to do in the beginning unless you talk to somebody. Meagan: Yes. We will make sure to have the website linked in the show notes too, so if anyone is wanting to go search, definitely go check it out. Okay, now we are going to give a little teaser of what your episode is going to be about today. So, with your C-section, give us a little teaser of what your C-section was for. Jessica: So, my first birth went really smoothly and my pregnancy. I really liked my doctor. I really liked the hospital. It was a group of OBs of all women. I met with each of them. I really liked all of them, to be honest with you. They were all very supportive of whatever you wanted to do.Meagan: Which is awesome. Jessica: Yes, it is. I knew I wanted to have a vaginal birth. That was all I really knew, but I was also really young, I think. I was 23 for most of my pregnancy. I didn't really educate myself beyond my doctor's appointments. I trusted them to pretty much tell me what I needed to know, and that was it. That was my bad. Meagan: Yeah. Hey, listen. That is something I can relate to so much. I was also in my young 20s and just went in. Whatever they said, or whatever my app said, is what happened. I think that's a little tip right there that says, “Let's not do that.” Let's not do that. Then for your VBAC, you had a bait and switch. I'm really excited, when we get to that point, to talk about bait and switch because it is something that happens. It can feel so good and then feel so wrong within minutes. It's really frustrating, but I want to talk more about that in just a minute. We do have a Review of the Week, so I want to hurry and read that, then get into Jessica's story. This reviewer is by diabeticmamawarrior. It says, “A podcast to educate the mind, heal the heart, and strengthen the soul.” It says, “Hi. I am writing this podcast from Seattle. We are currently pregnant with my second baby due in March of 2022.” This was a little bit ago. It says, “My first son was born at 28 weeks via classical Cesarean due to severe IUGR.” For anyone who doesn't know IUGR, that is intrauterine growth restriction.“--and after hearing I would never be able to VBAC, I decided to do as much educated research as I could and to find my options was truly needed. I am also a Type 1 Diabetic and have successfully found an amazing midwife who not only feels comfortable and confident assisting in care through my pregnancy with my diabetes, but also with my special scar, and we are aiming for a successful VBAC. I am also receiving concurrent care with an OB/GYN as well to make sure appropriate monitoring of baby looks good throughout pregnancy. Listening to this podcast was one of the first resources I found, and it was a total GAME CHANGER.” It says, “Thank you, beautiful women, who bravely and shamelessly share your stories so that other women can also feel confident in making empowered decisions for their baby and their body. I am soon to join the legacy of women who have fearlessly VBAC'd happy and healthy babies. Much love, Ellen”. Meagan: Wow. What a beautiful review. Jessica: That was powerful. Meagan: Yes. What a beautiful review. That was a couple of years ago, so Ellen, if you are still listening, please reach out to us and let us know how things went. Okay, girl. It is your turn. It is your turn to share, just like what Ellen was saying, your beautiful stories, and empower other Women of Strength all over the world. Jessica: That review just reminded me that a long time ago, I reviewed the podcast, and you read it on one of the episodes. Meagan: Did we?Jessica: We did. I remember thinking, “This is so cool. I wonder if I could be on someday.” I'm sure you hear this all the time, but it's very surreal being here knowing I listened to this podcast to help me heal. I'm just super excited to share my story. Meagan: I am so glad that you are here, and I'm so glad that we were able to read your review. We love reading reviews. It is so fun when we can hear the review, hear the journey, and then now here it is hearing the stories. Jessica: Yes. Meagan: Yes. Okay, well I'd love to turn the time over to you. Jessica: Like I said, I was introducing my story with my first. I just clicked through a birth course breastfeeding course that the hospital provided for me. I clicked through it to get it done and to check it off my list. Meagan: Birth education– yes, I did. Jessica: That's exactly what I did. I'm prepared, whatever. I'm just going to go into this, and everything will happen like it's supposed to. Mentally, everything was going well in my pregnancy. I wasn't super eager to give birth. I wanted to wait to go into labor on my own. I think what started to bother me or what made me a little bit more antsy was when I was 37 weeks. I agreed to have my cervix checked for dilation, and I was 3 centimeters already. I was so excited, and the doctor said, “I don't even think you're going to make it to your due date,” which made me think, “Wow. I'm going to have this baby in the next 2 weeks. I'm not even going to make it to my due date. This is so exciting.” If any of your doctors ever tell you that, don't let it get into your head because that doesn't mean anything if you are dilated. I was 3 centimeters continuously. Meagan: Yeah. You can walk around at 6 centimeters, not even kidding you. My sister-in-law was at 6 centimeters for weeks, and nothing was happening. She was just at 6 centimeters. It can happen when you are just walking around. Try not to let them get into your head, or to get nervous when you're like, “I could have a baby at any second.” It gets in our heads, and then when we don't have a baby, it's infuriating and defeating. Jessica: That is pretty much what happened. When I got to my 39-week appointment, I was still 3 centimeters. I just expressed how I was frustrated. I was tired of being pregnant. My doctor said, “Well, let's set up your induction.” I had never even thought of being induced at that point. It was never mentioned. It never crossed my mind. It sounded so intriguing at that moment to just get this over with. I don't want to be pregnant anymore. My sisters had been induced, and they had a good experience. It will go the same for me. Everything in my head was telling me, “Don't do this. You know you don't want this,” but I did it anyway because I had it in my mind that I should have had my baby already anyway based on what they told me a couple of weeks ago, so it would go so smoothly. She said, “You are a great candidate. You are already 3 centimeters.” We scheduled it. I think it was that Friday I went. It was Monday, on Labor Day, that we had my induction scheduled for. I didn't have a lot of time to even process that. Meagan: Yeah. Did they say how they wanted to do it, or did they just say, “Come in. Have a baby”?Jessica: They briefly told me that they would start with Pitocin and see how my body responded to that. They would probably break my water which is exactly how it happened anyway. Meagan: Yeah.Jessica: Yeah.They started me with Pitocin at 3:00 PM. They kept increasing it, then by 6:00 PM, my body was just not responding to it. I didn't feel anything. The doctor who was on call wasn't my normal doctor, but I saw her a couple of times. I was comfortable with her. She came in and said, “Well, we could break your water. Is that what you want to do?” I said, “Sure. If that's what you think we need to do, let's do it.” Meagan: Yeah, I'm here to have a baby. What's going to get me there?Jessica: Yeah. She was head down, so I thought, “What could go wrong? She's already head down.” I didn't know at the time that just because she was head down doesn't mean she's in a great position. She wasn't. She was– what do they call it?Meagan: Posterior? Jessica: ROT. Meagan: Right occiput transverse. Okay, so looking to the side. Sometimes, when we say transverse, a lot of people think the body is transverse which is a transverse lie, but ROT, LOT, left or right occiput transverse, means the baby's head is looking to the side, and sometimes, that can delay labor or cause irregular patterns because our baby is just not quite rotated around or tucked. They are looking to the side. Jessica: Right. That was pretty much what the obstacle was because when they broke my water, she engaged that way, so her head never was able to turn properly which we didn't know yet. I feel like the doctors could have known that because aren't they supposed to be able to feel and know maybe a little bit of where they are? Meagan: Yeah. So providers can. They can internally, and it depends on how far dilated you are. If you were still 3 centimeters, probably not as well, but at 3 centimeters AROM, where we are artificially breaking it, that's not ideal. Usually, the baby is at a higher station at that point too. I call it opening the floodgates. We get what we get however that baby decides to come down, especially if baby is higher up and not well-applied to the cervix.If baby is looking transverse and hasn't been able to rotate right during labor, then they come down like that, and then we have a further obstacle to navigate because we've got to move baby's head. I will say that sometimes a baby might be looking transverse and mainly through pushing, a provider can sometimes rotate a baby's head internally vaginally, but you have to be fully dilated and things like that. Can they feel through the bag of waters? If they can feel a good head, yes. Sometimes they can. Sometimes they can't, but again, there are all of these things that as a doula anyway, I help my clients run through a checklist if they are going to choose to break their water. Sometimes within your situation, I'd be like, “Maybe let's wait.” But their view was, “Let's get labor going. We are starting Pitocin. The body's not responding,” which we know is a number-one sign that the body isn't ready. Sometimes we still can break water with better head application and with the water gone, it can speed labor up. That's where their mind was. Their mind probably wasn't, what position is this baby in? Where is this baby at? What station is this baby at? It's like, let's get this baby's head applied to the cervix. Jessica: Yes. I mean, it did work. As soon as my water broke, I immediately when into active labor. The Pitocin contractions were very awful. I felt them immediately because not only did my body start going into labor, but then the Pitocin also was making it worse. Meagan: Yes. Yes. Jessica: So I begged for an epidural right away even though I knew that's not what I wanted. I didn't do a lot of preparing for labor, but I know I didn't want an epidural right away. I remember the very sweet nurse I had saying, “Do you want me to run the bath for you?” I said, “Are you crazy? That is not what I need right now.” Meagan: She's like, “I'm trying to help you with your birth preferences.” J: I know. She was so nice. I apologized to her after later on when I saw her. That was the head space I was in. I just needed that pain to be gone. They ended up turning the Pitocin off eventually because my body just did what it needed to do on its own. Meagan: Good. Jessica: I didn't get much rest after that. I couldn't really sleep. I was too excited. But it wasn't very long until I was ready to push after that. I think at about 7:00 PM, I got the epidural, and at midnight, I was ready to push. I kept trying and trying. 4.5 hours went by until she was just not coming over. I don't know if it was my pelvic bone or something. That's when we knew she was not going to turn. They suggested that we try the vacuum. I didn't know what that was. That was very traumatic because the lights were bright. Everyone was in there. I remember my doctor saying, “Okay, we have one more attempt with this vacuum, and that's our last attempt.” Of course, it didn't work because in my mind, I knew it was my last chance. It was not going to work, and it didn't. I was really upset after that. I remember crying saying, “I don't want a C-section.” I was really afraid of it. But, that is just what we had to do to get her out at that point after attempting the vacuum. I remember being wheeled down to the OR and just being so tired and not knowing how I was going to take care of a newborn after having surgery and being so tired. I had been up for 24 hours. The C-section went fine. I was out of it though. I was passing out here and there just being so tired. They had to tell me to actually look up. “Your baby's here. Look up.” I remember opening up my eyes going, “What?” I was forgetting what I was doing. Meagan: Out of it. Jessica: Yeah. I was very much out of it. But after that in the hospital, I wasn't too upset about having a C-section. I was just so excited about having my baby. It really didn't hit me until we were on the way home from the hospital. I started crying and was so upset. I felt like my experience was stolen from me because I felt like  I was so mad at my doctor for bringing up an induction at that point knowing if she didn't, I would have never asked for one anyway. I had a lot of regrets about everything. In those couple of weeks after having her, your hormones are very up and down anyway. One moment, I would be fine. One moment, I would be really, really upset crying about it. I wanted to redo her birth so badly that it almost made me want another baby. “If we just have another kid, we can try again,” even though I had this 3-week-old next to me. Meagan: Yeah. Jessica: I was not thinking very clearly. Meagan: You were craving a different experience. That's just part of your processing. Jessica: Yes. And looking back, I wonder if I was struggling with some PTSD because I would lie there at night not being able to sleep, and I would suddenly smell when they were cauterizing the wound. I would suddenly smell that again and think I was back in the OR. It wasn't very fun. Meagan: Yeah. It's weird how sometimes the experience can hit you in all different stages and in different ways, but right after, you're like, “No. No, no, no. I need something different. Let's have another baby right now. Let's do this.” So once you did become ready to have another baby, what did that look like? What did that prep look like? Did you switch doctors? You liked your whole practice. How did that look for you?Jessica: Well, we moved. I knew I had to find another doctor. I would have anyway in Madison. I would have gone with a group of midwives that somebody I knew had a good experience with, and after listening to the podcast, I wanted a midwife. But unfortunately, where we moved, we live in Green Bay now. I was so limited on which provider I could go with. In one hospital, one group, that was all I could do locally. I couldn't go with the hospital that everybody was recommending or the midwives that everybody was recommending for a VBAC. Meagan: Why couldn't you go there?Jessica: My insurance was very limited. It still is. We can only go to this one hospital and one facility for doctors. Meagan: Okay, so it was insurance restrictions. Yeah, not necessarily a lack of support in your area. It just was insurance which is another conversation for a later date. Stop restricting everybody. Jessica: I was very surprised because when we were in Madison, I could go wherever I wanted and see whoever I wanted. I ended up just choosing somebody. I liked her. She was initially very supportive of having a VBAC. I had mentioned it in my very first appointment that this was what I want. She said, “Oh, I'm so excited for you. This is going to be great.” I even mentioned that I was still breastfeeding my daughter when I was pregnant. They just seemed very supportive of all things natural and all things birth. Meagan: Everything. Jessica: Yeah. There were no issues whatsoever. I had already hired my doula when I was 6 weeks pregnant. I had already talked to them before I had even saw my doctor. I told them about how I was really limited and this was where I had to go, but I felt very supported knowing I had a doula and knowing I had somebody on my side It didn't really bother me at the time that I just had to pick whatever doctor I could. This was also a practice where the doctor I had wasn't going to be probably who I would give birth with. That also didn't bother me because I thought, “I have a doula. I have support. I know after listening to this podcast what I need to do to defend myself if that time were to come.” Meagan: Advocate for yourself, yeah. You felt more armed. Jessica: I did. I really did. I ended up seeing a chiropractor as well which was very helpful throughout my pregnancy. I loved going to the chiropractor. Not only did it help get her in a good position, but I also just didn't really feel body aches as much as I did, so there were a couple of benefits to going there. I definitely recommend a chiropractor. Meagan: I agree. I didn't go until my VBAC baby. I started going at 18 weeks, and I'm like, “Why didn't I do this with the other babies?” It was just amazing. Jessica: Yeah. It really is. But my doctor's appointments this time were very different. They were very rushed. They felt robotic. “How are you feeling? Great. Let's get the heartbeat. Any questions? No.” I really kept my questions for my doulas anyway because I really trusted them. I don't know. I didn't feel like I had many questions anyway because I knew what I wanted. I knew I wanted to show up to the hospital basically ready to push. One of the red flags, I will say, that looking back now with this provider that I had initially is that she never asked for any type of birth plan. She knew I wanted a VBAC, and I thought it was a good thing that she wasn't really asking details. I felt like, “Oh, she's letting me do my thing.” But looking back, I think it was just because she knew that's not what was going to happen. She knew. Meagan: Yeah. You know, it's interesting. We've had providers who have told people here in Utah. The client will say, “Hey, I really want to talk about my birth preferences.” The provider will say, “You're really early. We don't need to talk about that right now. We could talk about that later.” Or, “Hey, I was thinking I want to talk about this. Can we talk about that?” “No, not today. It's fine. Whatever you want.” Then it comes, and we'll hear more about your experience. I'm sure it will relate to a lot of people's bait-and-switch stories. Jessica: Yeah. They sound so supportive in the moment, and then it's not looking back. It continued on through my whole pregnancy. Even when I was 35 weeks, she suggested a cervical dilation check. I denied it at that point. I thought it was too early. 35 weeks is very early. Meagan: 35 weeks? Yeah. Jessica: I'm really glad that I stood up for myself and said no, because I was having one of those moments of, do I just do it anyway? I said no, and she was very fine with it. She said, “That's fine. You don't have to if you don't want to. We don't have to.” I also thought that was a good sign. Meagan: You're like, “Yes. If we don't have to, why are we suggesting it in the first place?” But I can also see where you're like, “Well, sweet. She's respecting my wishes. I didn't want to. She's saying, ‘Okay'.” Jessica: Exactly. But I made the mistake of agreeing to it at my next appointment because my curiosity got the best of me. I knew that it wasn't important for me to be dilated, but I was trying to compare it to my last pregnancy. At 37 weeks, I was 3 centimeters with my first. I wonder if I'm going to have a different experience this time. Let's see where we're at. I was at 0. I just thought, “That's totally normal. I have a lot of time left.” Her demeanor changed very much. It was like at my appointments before, she was a different person now. Meagan: Oh. Jessica: She said, “Well, if we're not showing any signs of labor by 40 weeks, we need to schedule your C-section.” Meagan: Oh no. Jessica: She must have noticed I was surprised. I said, “But I don't want a C-section. Did you not remember that I'm going to have a VBAC?” She said, “Well, you don't want to risk your baby's life.” Meagan: Bleh. Barf. No. Jessica: Yes. Yes. I knew that was just a scare tactic. I luckily was not phased by it. I was educated. I mentioned something along the lines of, “Well, wouldn't we try to induce me before we jump ahead to the C-section? There's no medical need.” My pregnancies were so boring. There was nothing that would indicate anything, not even an induction, but I thought, “Why not even just mention that before a C-section?” She said something like, “There are too many risks involved.” That was the end of the conversation on her end. She pretty much wrapped it up and said, “It's pretty slippery out there. Be careful,” and walked out. Yeah. The conversation was over. In that moment, I knew that was the last time I would see her. I didn't know what I was going to do, but I knew I could not go back to her. I went back to the parking lot. I was crying. I texted my doulas right away what happened. I said, “I need to figure something out very quickly. I'm 37 weeks. I know I can't go back to her. Can you please help me figure something out?” They were so, so extremely helpful with helping me figure out my options. I thought that at this point– in the beginning of my pregnancy, I knew, “I'll just stand up for myself. I know what I want,” but when you are very big and pregnant, and you are very vulnerable, you don't want to do all of that arguing. You just want somebody who is going to support you. I just knew I couldn't go back to her. I didn't have the energy to try to defend myself or advocate for myself. I just needed somebody who was already going to support my decisions. They encouraged me to look a little bit further out of Green Bay which I didn't initially want to do. I wanted the hospital to be close. I had a 2-year-old. I didn't want to be far away from her. But knowing I had limited options, I looked a little bit farther out. I texted them, “Hey, there is this doctor who I can go to in Neenah. It's pretty far. I said her name. I don't know if I'm supposed to say doctors' names. Meagan: You can. Yeah. You can. People will actually love it so they can go find support themselves. Jessica: Yeah. I said, “There is this doctor, Dr. Swift, who is down in Neenah. That's the only one who is really popping up on my insurance who I can go to.” They immediately texted back, “You need to go see her. She's amazing.” My doula had actually had her VBAC with Dr. Swift. They were like, “You need to go see her. This your other option.” Meagan: Oh, Sara Swift is on our list of providers. Jessica: She is. She's amazing. Meagan: She is. Okay, so you're like, “I've got this doctor's name.” Jessica: I called them to make myself an appointment, and I wasn't able to get in until the following Friday. It would have been after I was 38 weeks. I told doula– Meagan: That's when you had your last baby, right?Jessica: No, actually my last baby was at 39 weeks, but I didn't know what was going to happen. I told them, and my doula was actually personal friends with her. She said, “No, that's not going to work. I'm going to text her, and I'm going to get you in sooner.” I think it was a Wednesday at that time. I was able to go see her Friday. Yeah. Meagan: A week earlier than you would have been able to. Jessica: Yeah. I helped me to feel more relieved knowing that if I had gone into labor before that next appointment, I would have known where to go. I would have had a doctor established. I was very, very relieved to see her. It was such a different experience than my other doctors. I had to bring my two-year-old with me, and at that point, she was getting antsy, so Dr. Swift actually sat on the ground with my daughter and was coloring with her while we were talking to keep her busy. I just remember thinking, “There's no other doctor out there who would do this for a very pregnant patient.” It felt very much like a conversation between friends. It didn't feel like a robotic type of conversation I had with my previous doctor. She very much upfront said to me, “Our hospital has VBAC policies. Here they are. You can deny anything you want. They're not going to allow you to eat food, but if you say you want to eat food, you can eat. They're going to want continuous fetal monitoring, but if that's not what you want, tell them what you want.” It felt like she just was supportive of what I wanted to do. She said something along the lines of, “I'm going to trust you and your body to make the decisions that you need to, but also know that if I need to step in, trust that I'm going to do what I need to.” It felt so mutual there. I was so excited to go back and see her every week. I'm actually kind of mad that I waited that long to see her. Meagan: Yeah. Mhmm. I'm sure you felt like you were breathing in a whole different way. Jessica: I was. I felt very excited. The drive was longer, but it didn't even matter at that point. I went from a 15-minute drive to 45 and it didn't feel like there was any difference. It was all worth it. Meagan: I agree. It's sometimes daunting with that drive or the time, but you guys, it's so worth it. If you can make it work, make it work. I'm so glad. Okay, yeah. So you found this provider. Everything was feeling good. Jessica: It was feeling great. I actually ended up going past my due date. Meagan: Okay. Jessica: I was feeling a little bit– not defeated– I wanted to make it to my due date because I wanted to make it there with my first. I was excited when I got to my due date, and then I thought, “Okay, when is this actually going to happen? I've got a two-year-old.” My in-laws were coming up to watch her when we were going to the hospital. They live 2.5 hours away. I was starting to worry about, how is this all going to work out? But it really did. I felt my very first contraction two days after my due date. It was a Friday night at 6:30. We were getting my daughter ready for bed, and I felt that first contraction. I knew it was different than Braxton Hicks. I just knew, but I don't even know to say if that's when my labor started because that continued all throughout the weekend every 15 minutes. It was not a fun weekend. I kept thinking things were going to pick up, and then they would die down. Meagan: Prodromal labor maybe. Jessica: Yeah, I think so. At one point, I had my doula come over in the middle of the night. I didn't know when to go to the hospital. I didn't know if it was time or whatever. She came to my house in the middle of the night just to help me with the Miles Circuit and just the different position changes I could do. I believe that was on that Friday night that I started labor. I was also able to get into the chiropractor that weekend. They were closed, but again, my doula was very close friends with the chiropractor and texted, “Hey, Jessica could really use an adjustment. She's not in labor, but it's not progressing. Can you help her?” I went to go see them on Saturday and on Sunday just to get things moving. She was in a really great position. Everybody could feel that she was just in the perfect position. It was just that these contractions could not get closer together no matter what I tried. Something told me, “Hey, you need your water broken for this to progress,” because I couldn't do it anymore mentally or physically. I was exhausted. I didn't want to initially because I knew that's what prevented me from having the birth that I wanted in the first place with my first experience, but something also told me, “Hey, you need to go do this.” My intuition was super strong in those moments where I knew. My intuition was strong enough to switch doctors that late in my pregnancy. There wasn't another option. This time also, my intuition told me, “You have to go in, and they have to break your water.” I knew Dr. Swift would be supportive of that because she was supporting any type of birth plan I really wanted. She told me at any point, I could be induced, but that she wouldn't bring it up again. It was my decision. On Sunday night after we got my daughter to bed, we drove to the hospital. We let them know we were coming. Our doula met us there, and we just told them our plans. Dr. Swift, I remember, said, “Well, if I break your water now, you're so exhausted from the whole weekend. Do you want to try sleeping for a little bit and we will do it in the morning?” I said, “I can't sleep. I'm having these contractions every 15 minutes.” It was really funny. She said, “Well if you want to sleep, I'll give you something to help you sleep.” If anybody has ever met her or knows her, she's got a great personality. It was just funny in that moment. It's what I needed in that moment to have a good laugh. I was like, “Yes. Give me anything I need right now to rest just a little bit before the morning.” In the morning, she came back in around 8:00 or 8:30. I don't remember what time it was. She said, “Yep. Let's do this.” They double-checked me again to make sure she was in a great position. At that point, I was actually 4 centimeters. I forgot to bring that up. Meagan: Yay, okay. Great. Jessica: Yes, so those contractions I was experiencing over the weekend were productive. I felt better about that. I didn't want to break my water with being one of two centimeters. I felt good. Again, my intuition was telling me, “You need to do this.” Yeah. They did, and once again, it immediately put me into active labor. My doula was helping me with counterpressure, then they ended up running a bath for me which was very helpful. I was skeptical. I did not think that was going to work. When they were filling it, I remember thinking, “This is a waste of my time. This is not going to work,” but it was very helpful. At one point in the bath, I just remember feeling, “Okay, now I have to get out and I have to start moving around.” As soon as I got up, I just remember feeling things intensify. I got that feeling in my head like, “I can't do this anymore.” I knew that at that point, it was getting close because of that feeling of, “I can't do this anymore.” Meagan: Yeah, mhmm. Jessica: I had just a moment of weakness and I said, “I want an epidural right now.” Even though I knew in my mind that it was too late, I couldn't help but ask them for that epidural. Thankfully, my doula knew that's not what I wanted, so she helped prolong that process. She said, “Well, why don't we start with a bag of fluids and we'll see how it goes from there? We can ask them, but they might be busy.” That's exactly what I needed. I knew that's not what I wanted. Meagan: She knew that, and she knew how to advocate for you, and she knew you well enough what you needed to prolong it. Jessica: Yes. I'm very thankful for that because she could have said, “All right, let's get it right now.” But she knew and I had made it very clear that was not what I wanted to do. We started with a bag of fluids, and at that point, I could feel my body start to push itself. This was about 3 hours after my water was broken. It was a very quick process from then until that moment. While I was pushing, the anesthesiologist did come in the room. I remember the anesthesiologist did come in the room, and I remember he said something like, “Who's ready for the epidural?” My doctor said, “No, we're having a baby. Get out.” He came in in the middle of me pushing, and I feel like I scared every other mom there with how loud I was, but I couldn't help it. Meagan: Sometimes you just have to roar your baby out. Listen, it's okay.Jessica: I really did. I really did roar her out in 20 minutes. Meagan: Wow. Jessica: After that, I don't remember feeling any other pain. The pressure was gone, and I remember just feeling like, oh my gosh. I did it. She's here, and I get my skin-to-skin with her which I didn't get the first time. I get to have this experience. I can't believe I actually did it. Meagan: And you did. Jessica: I did. Meagan: You did it. Jessica: There is so much more than you just having that VBAC. Throughout the journey, you grew. You grew as an individual. You grew as a mom listening to your intuition. You really, really grew, and then to have that baby again placed on your chest, oh, how amazing and how redemptive. Meagan: It was so redemptive and healing. In that moment, I didn't feel any type of way about my C-section anymore. I wasn't upset about it. I really had a feeling that it happened for a reason because if it didn't, I don't think I would have tried to educate myself about birth. I would have probably done it a second time, an induction, if it went well the first time. I also don't think I would have fought so hard the first time to breastfeed because I felt like I had to make it work. I didn't get the birth I wanted, so I had to make this work at least. I personally think that my C-section happened for a reason the first time. In that moment, I remember feeling a wave of, “I'm not upset anymore. I got this experience.”Meagan: Yeah. You know, it's interesting. I kind of had that same view to a point. I do feel a little grumpy with how my births went because knowing what I know now, I am realizing that they didn't need to happen that way. I likely never needed a Cesarean ever. I just probably didn't. But, it's the same thing like you. I wouldn't have focused so hard on this. I wouldn't have done this. I would not be the person I am today. I would not be the birth doula that I am today. I would not be the podcaster today. I don't think I would have ever started a podcast on any other topic because I'm so deeply passionate about this topic and birth and helping have better experiences, so I really hold onto those experiences and cherish them. It sounds weird because it wasn't the birth we wanted, but it's what brought us here today. Jessica: Yeah, exactly. I also wouldn't be where I am today if I didn't have my C-section. I don't think I would have been interested in birth. I love it now. I think in the future, I would love to be a doula. I just recently took an exam to become a certified lactation consultant. I haven't gotten my results back yet, but I don't think I would have gone down that path yet either if I wouldn't have had my C-section and fought so hard for breastfeeding to work. I felt like I found my passion within that circumstance that was very unfortunate, and it shouldn't have happened, but it did. Meagan: But it did, and you've grown from it. We want to avoid unnecessary Cesareans. If this podcast is for VBAC moms, it's just as much for first-time moms in my opinion because we obviously have an issue with the Cesarean rate. We do. It's a serious issue. Jessica: Yeah, it is. Meagan: But with that said, I encourage you if you are listening, and maybe you haven't been able to process your past experience yet, or you are fresh out of it, and it's very thick, and it's very heavy and dark because we know that can sometimes be that way, I hope and I encourage you to keep listening, to keep learning, and to keep growing, because that darkness will become light again. Those feelings– I don't know about go away, but they will lift. I don't know how to explain it. Jessica: You might feel different about it. You might feel different about it than you did originally. Meagan: Your perspective will change. It's going to take time. It's going to take processing. It's going to take healing. It's going to be finding the education, finding the right team, finding the right support system, but it is possible. It is really, really, really possible, and take Jessica and my word right now, because we really have been there. We really understand so many of the feelings. I know that we all process feelings differently, and we're all in different places, especially depending on the types of births that we had. I know that there are way more traumatic experiences that happen out there, but this community is here for you.We love you. We are here to support you. Keep listening to the stories. Find the groups. Find the healing, and know that it is possible to step out of this space and to grow. It's weird to think, but one day, you're going to look back and say, “I might be grateful. I might be grateful that happened.” Yeah. Like I said, I'm not happy. I'm not happy it happened, but I'm going to cherish that. I'm going to try and flip it. I've made it a positive experience that it's brought me to where I am today. It's brought me to be in a place where I can share my story just like Jessica and all of the other Women of Strength before her to help women feel inspired and to avoid those future devastations and unfortunate situations. Jessica: Yeah. Don't let anybody try to tell you not to feel a certain way about it because I've had plenty of people tell me, “But you're healthy. But you have a healthy baby, you can try again next time.” I just said, “You don't understand. You're not in my position. I know there are people who do understand me.” Most of you who are listening will understand that yes, you have a healthy baby and you're fine, but it was still not what you wanted. That experience is so personal. You want what you want. Meagan: You want what you want, and you're not selfish for wanting it. You're really not. I think that's really important because sometimes I think we are made to feel that we are selfish for wanting a different experience especially out there in the world, a lot of people say, “Why would you want that? Why would you risk that? You are selfish. Just be grateful for what you have. Just be grateful that you do have your baby and that you and your baby are okay.” No. No. The answer is no. Last but not least, I really wanted to share a little bit more about the bait and switch and how to recognize that because you guys, it can be hard to recognize. I don't ever believe that these providers are sneakily trying to fool us, but maybe they are. I don't know. I'll tell you, they do. They do fool us. I don't know if that's because our judgment is clouded or what, but I think it's important to feel that inside. What does your heart do when your provider walks in? What do your hands do? Do they clam up? Do they clench? Do they freeze? What does your body do? Are your shoulders rising up? Are they relaxed? Does your face have a smile on it? Really tune into who your provider is making you be. Are they making you a tense ball, or are they making you relaxed and excited?I mean, really Jessica, the way you are talking about Dr. Swift, it sounds like she is amazing. She's like, “Here. Here are the policies. I want you to know these. These are things that you are going to be up against. You might have to fight for intermittent monitoring instead of continuous. You might have to fight for this and this, but hey. I'm here. I'm on your side. We have these policies, but I'm here. Use your voice.” That was just so amazing. Jessica: It was amazing. I'm sad that I'm not going to have another child because I don't get to go see her for appointments then. I really wish I would have met her sooner. That's the type of doctor your need is when you actually want to go see them. That's a big difference. You're not thinking ahead of your appointment, “Well, I wonder if there is anybody else.” Meagan: Okay, I love that you said that. Check in with yourself and see if you are excited to see your provider. That's how I was. I would look forward. I would look at the calendar and be like, “Oh my gosh. I get to see my midwife this week. This is so exciting,” because I would remember the way that she made me feel when I would get there. She would embrace me with a hug. “How are you doing, genuinely? How are you doing? How are you feeling?” We would chat, and it was a conversation like you said, like two friends. It really should be that connection. I know sometimes, providers don't have the actual time, but tune into how you are feeling about seeing your provider. Are you dreading it? Are you worried about what you're going to say? Are you worried that you're going to have to be educated and come at them and say, “Well, I don't want this, and I don't want that”? What are they making you feel? If they are making you feel those genuine warm fuzzies, lean into that. Jessica: You have a good doctor then. Meagan: If you are feeling tense and anxious, I don't know. It's never too late to switch. You were switching later on. You had a further drive. There were obstacles that you had to hurdle through, but it is worth it. It is so worth it. We have a provider list, everybody. If you are looking for a provider, go to our Instagram. Look at our bio. Click on it. The very first block is supportive providers. If you have a supportive provider that you want to share, I was literally going to put Dr. Swift on this because of your testimonial of her, but she's already on it. Jessica: She was already on it too when I checked. Meagan: Yeah. If you have a supportive provider and you checked this list and they are not on it, guess what? We have made it so you can add it. Definitely add your provider because Women of Strength all over the world, literally all over the world, are looking for this type of support. Jessica: Absolutely. In case you're wondering if my other doctor ever reached out to me, I never heard a single word from her ever again. I canceled all my remaining appointments. Nobody reached out to say, “Hey, we noticed that you're not coming back. What's going on?” Anything could have been wrong when you're that pregnant and you just disappear. It was upsetting that nobody said, “What's going on, Jessica?” I was ready to let them have it because I was wanting them to reach out to say, “Why are you not coming back?” But they never called ever. Meagan: A lot of us stay because we are so worried about how our provider will feel or we have been with our provider this long. They deserve for me to stay. No. Do what's best for you. I love that you pointed that out so much. I just want to thank you again so much for sharing your journey with us and all of these amazing nuggets. I know that they are going to be loved.Jessica: Thank you so much for having me. This just feels amazing to be able to share my story when I've heard so many on here before that were so helpful.Meagan: Yeah, and here you are. I love how full circle this always is, so thank you, again. Jessica: Yeah. Thank you for having me.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Today Heidi interviewed Amy Lloyd. Here is a little more about Amy and this episode. In Amy's words: "I graduated nursing school in 2011 and started working in the NICU. I travel nursed and ended up in Denver, CO for 7 years. I mainly worked in the NICU but worked for Nurse Family Partnership for 4 years (an amazing nationwide program for 1st time moms that qualify based on income!)  I got married and moved to Asheville, NC in 2021. We got pregnant on the first try! I did the NIPT and found out we were having a boy! At my first appointment they mentioned I had a bicornuate uterus. Since hearing I had a higher rate of a breech baby I was pretty convinced he would be breech and I would have a scheduled c-section. “Normal” pregnancy. I felt really good. Worked night shift in the NICU until 39 weeks. I got COVID at 26 weeks pregnant. The recommendation then was to have a growth ultrasound. I had one at 34 weeks where they discovered the left side of his heart and aorta were small. I was referred to MFM in Asheville and then onto MFM and cardiology in Charlotte. I was induced at 39.2 at Atrium. I had a good induction…foley bulb, pitocin, epidural, AROM, pushed for 45 minutes. My baby immediately went to the NICU. His echo showed he had coarctation of the aorta and he had surgery at 3 days old! We were in the hospital for 2 weeks before coming home to Asheville. We experienced lots of feeding difficulties. He came home with a NG tube, had reflux, and a weak suck. I was basically exclusively pumping from the start. I weaned off the pump at 9.5 months postpartum. At 3 weeks postpartum I had severe abdominal pain leading me to be readmitted for IV antibiotics. They believe I had endometritis. My baby just turned 1 8/29/22. He is doing great and will continue to be followed by cardiology for life but hopefully should not need any further interventions!" 3 Key takeaways from the podcast that listeners will learn today: Flexibility Advocating for your family 3 Keywords that people would want to search when looking for content that you would provide in this episode: Congenital heart defect Epidural induction Exclusive pumping   Favorite baby product or new motherhood product? Boppy for baby. I usually buy my friends a nice pair of pajamas as everyone is usually focused on stuff for the baby! Summary of guest experience – Currently live in Asheville, NC. Graduated nursing school in 2011 and have worked in the NICU as a RN ever since. Also have my CLC. Please link your contact information for me to share in the episode. Instagram: Amy Lloyd   We have seats available in Birth Story Academy. Join today for $20 off with code BIRTHSTORYFRIEND at https://www.birthstory.com/online-course!    Resources: Birth Story Academy Online Course Shop My Birthing Workbooks and Guides   I'm Heidi, a Certified Birth Doula, and I've supported the deliveries of over one thousand babies in my career. On the Birth Story Podcast, I'll take you on a journey through your pregnancy by providing you education through storytelling. I provide high-level childbirth education broken down to make it super digestible for you because I know you are a busy parent on the go. Plus, because I am so passionate about birth outcomes, you will hear from many of the top experts in labor and delivery. Connect with Me! Instagram YouTube My Doula Heidi Website Birth Story Media™ Website

Hoy continuamos hablando de hierbas, arbustos y más que tienen propiedades medicinales y partes comestibles. Fueron varios los pedidos que me llegaron para que aportara más ejemplos y me compartieron también algunos que no tenía en mi listado. No tomes la información medicinal que te comparto como 100% válida para ti hasta que lo consultes con un profesional de la medicina. PATROCINADOR: ⁠⁠https://personalgardenshoper.es⁠⁠ ACADEMIA: ⁠⁠https://jardingpt.com⁠⁠ WEBS SÚPER IMPORTANTES ⁠⁠https://claudiodoratto.com⁠⁠ ⁠⁠https://jardinesinclusivos.ar⁠⁠ CANAL IMPERDIBLE DE TELEGRAM Jardinería y Paisajismo: ⁠⁠https://t.me/jardineros⁠⁠

Hoy hablamos de hierbas, arbustos y más que tienen propiedades medicinales y partes comestibles. No tomes la información medicinal que te comparto como 100% válida para ti hasta que lo consultes con un profesional de la medicina. PATROCINADOR: ⁠https://personalgardenshoper.es⁠ ACADEMIA: ⁠https://jardingpt.com⁠ WEBS SÚPER IMPORTANTES ⁠https://claudiodoratto.com⁠ ⁠https://jardinesinclusivos.ar⁠ CANAL IMPERDIBLE DE TELEGRAM Jardinería y Paisajismo: ⁠https://t.me/jardineros⁠

5º edição da Feira 4Black será no domingo, 17 de novembro, na Praça da Bandeira.

5º edição da Feira 4Black será no domingo, 17 de novembro, na Praça da Bandeira.

We play Lyric Shuffle, answer questions for ask-us-anything, and more!

We play Lyric Shuffle, answer questions for ask-us-anything, and more!

We play Lyric Shuffle, answer questions for ask-us-anything, and more!

¡A queso fundillo!

I'm so excited to finally share my birth story with you! It was an unforgettable experience—both magical and incredibly intense. In this episode, I dive into all the juicy details, picking up where we left off in the last pregnancy journey podcast. I walk you through the final four weeks of my pregnancy and end with a look at what these first 7.5 weeks of postpartum life have been like.  In this episode, we dive into: ✧How I lived my highest joy the last 4 weeks of pregnancy ✧Letting go of control and surrendering to Leo's perfect arrival time ✧All the juicy details of my birth story, including trusting my intuition to make a surprising change in my birth plan that worked out way better than I expected ✧An inside look at my postpartum journey, covering everything from breastfeeding and sleep to navigating partner resentment and healing—both emotionally and physically. ✧Last 4 weeks of pregnancy  Thinking every day could be the day and it wasn't Didn't want to spend the last moments or weeks wishing it away Focused on living the highest now joy, given what is vs waiting and obsessing over baby arriving.  And when i couldn't stop obsessing, i knew there was emotions/energy that needed to be felt so i'd feel it until i couldn't feel it anymore and on the other side, i'd be at peace with not knowing when baby would come almost daily chats with IV date nights, getting nails done, weekly chiro/massage, baths When you think you've surrendered, surrender more 4 days before going into labor, i started feeling like “omg when is he coming?” again Inner voice said “you feel complete because you are - you literally are completing pregnancy soon”. Haley said same thing. IV also said baby is waiting for best timing: best state of my body, best hospital staff, best state for trevor, all of the pieces i couldn't put together mentally he was waiting until there was the most ideal arrangement Was doing all the things to induce labor starting around 37 weeks Daily stretches, red raspberry leaf tea, evening primrose oil, pumping at 39 weeks, chiro, massage, labor inducing yoga, acupuncture, sex All in alignment Skipped dates because it didn't feel aligned Mild period cramps started around 38 weeks like once a day Felt more emotional around 39/40 weeks Once I passed my due date, I was having very mild period cramps a little more often - a few times a day instead of once and i had to pee constantly 40+1: happy hour with trev on rooftop & helena's for dinner ✧Spam email “from” Leo 2 days before going into labor - felt like sign and message from him saying im coming soon ✧went into labor 40+3 ✧6/30 530am woke up to go to bathroom and had contraction First few were lower abdomen like period cramps, then shifted to lower back Felt like strong period cramps I had to breathe through  Lasting 30-45 seconds  Went on walk like 715 Felt like they were like 10 min apart on walk and getting stronger Had to sit down on walk a few times Every 20 min first 2 hours Then next 2 hours they were 10 min apart Child's pose for every contraction ✧5 min apart: noon-3pm Got sub delivered around noon, couldn't really eat much, no appetite and really had to focus Around 1 called hospital and gave them heads up - they said doctor would call me back but never did Talked to haley a lot On the ball most of this time with tens unit Inside and outside Contraction “I can't do this”, Break “Okay I can do this” ✧3.5-4 min apart: 3-430pm Called hospital again just because i wanted to share what i was experiencing with doctor  ✧430 went to hospital (after laboring at home about 11 hours) Bc decreased fetal movement: was perfect timing Car ride would have been bad any later ✧By time we got there contractions like 2 min apart and was having intense contractions in lobby for like 20 min before they could take me back ✧One nurse walked me up while Trevor dealt with car she rubbed my arm the whole time and said you're doing great and it brought me to tears - just felt so supported and cared for and was so grateful  ✧5cm when they checked after like an hour of monitoring in triage, -2 station  ✧Heart rate wasn't varying (like 150 constant) so they monitored me for a while in triage until like 630 Was really uncomfortable in triage, contractions were very intense and i had to lay down for the monitoring and i didn't know when i'd get a room ✧Was so ready for our private room - big constant noise through every contraction at this point im sure I scared other moms ✧Had to get back on continuous monitoring in the room they strongly advised against intermittent because of his heart rate pattern and the continuous monitors required me taking off my tens unit and I was past the point of having the capacity to test if they would get worse if I stopped it  ✧Labored on ball with continuous monitors and still had decent movement ✧Trevor on counter pressure every contraction - couldn't have done it without him ✧Contractions were back to back from then on super intense in back and no relief in between - next one was 30 sec to 1 min after the last  ✧8 - asked for epidural, felt so clear and good about it, no question it was the right move  ✧830 got epidural (I think I was in or right at transition) ✧Looked at trev after feeling so happy i gave him relief too Trev went to get our stuff Only things that would have been good to have earlier were speaker for music & puzzle mat Hospital bag blog ✧Rested from 10pm-3am, contractions stayed back to back though - they told me from monitors ✧7cm at like 11pm ✧Recommended i break waters - i said let's wait and see what body does ✧AROM 3am 10 cm right after once they could measure  ✧Started pushing 404am Did poop a little at first and could feel it Alternated between on knees hunched over bed and side lying with top leg lifted and bent Delivered on hands and knees Didn't have push urge but felt contractions so pushed with those - felt right and aligned for my body  Prayed to IV right near the end of pushing: IV I need help. Help me get through this as easy and smooth as possible. I need your help now. Baby came very soon after. ✧Born 609am Incredible bliss/relief Held him right away Nothing else mattered - i remember seeing them collecting blood with all the cloths and counting the cloths Very little labia and urethra tearing that they did stitch, no perennial tearing ✧8 lbs 7 oz Baby was measuring > 99% all 3rd trimester (i never made it a big deal and neither did providers - i trusted my body was making the correct size baby for me and my baby. he ended up being 8lbs 7oz.) ✧i think it was back labor (i only felt everything very intensely in my low back, nothing in the front besides like the first 2 contractions) ✧My goal was unmedicated but in the moment, i felt so clear from my intuition it was the right choice and timing for me to get an epidural and had an incredible experience with it. Everything “bad" i thought would result because of the epidural didn't... I thought it would stall labor - it didn't I thought it would make me not listen to my body - i still felt very connected to the process and was able to push in sync with contractions I thought i'd tear more - i didn't tear besides minimal labia and urethra tearing i thought recovery would be worse - i've never met anyone with as easy of a recovery as mine i thought i wouldn't feel the oxytocin bliss and connect to my baby when he was born - i felt the most incredible bliss and connection when he was born i thought i'd have to push on my back - i switched back and forth between all 4's and side lying i thought i'd feel like a failure - but i felt so strong, confident and good about my decision and was so grateful to relieve my husband as well (he was doing counter pressure non-stop basically i thought i'd have to have pitocin and other meds - i only got the epidural ✧Transferred to PP room after like 2 hours Showered after like 5 hours prob Trev got us amazing food Avocado toast, eggs, coffee Sixty vines salad North pizza pasta dinner Avocado toast, eggs, coffee again before leaving  1st night in hospital was the worst part of experience was dying to be home and not be bothered every hour or 2 First night of BF was stressful was so tired and worried he wasn't going to eat and was trying too hard. Lac consult the next day came and told me I was doing great and it was all normal and I was able to completely relax and trust process and it was much easier after that point because I dropped idea that he “should” latch fast or even at all. Left hospital after about 30 hours after delivery ✧First 7.5 weeks postpartum overall really great, definitely very challenging moments but it's amazing how you just do it and now I'm able to do what's required without resistance whereas in the beginning there was a lot more releasing that needed to happen to be at peace with going from doing whatever whenever to basically being on-call 24/7 for another human Postpartum resources blog High first few days on adrenaline Def more emotional/anxious first 2 weeks - allowed myself to cry when i felt like it and feel anything else coming up as best i could like overwhelm, anxiety and resentment  Continued to get better and easier. By 6 weeks I felt a big shift in just feel more grounded, settled and confident overall. SOOOO glad I've been practicing feeling and releasing emotions for a few years now.  I was able to feel really intense emotions come up (more intense than I'd had in a long time) and be on the other side of them sometimes within a few minutes or always within a few hours. Very easy physical recovery overall BF going really well overall Struggled with latch first week but after that it was pretty smooth sailing and has only gotten easier and now it's pretty much effortless, painless and resistance-less If I could go back I would start with my brest friend pillow And tell myself to just trust the process, your best is all you can do, the rest you can let go of, it's all happening as it should and it gets easier Sleep  Night nurse Taking cara babies Crib after a few nights in my room Now sleeping through night sometimes or 1 feeding Partner resentment What I'd say to a friend about to give birth: Speak from the heart

Skoraj ne mine dan, da ne bi mediji poročali o požaru v naravnem okolju, ki se širi kje na planetu. Poleti so na severni polobli v nevarnosti tudi države, ki imajo velike gozdnate površine ali ležijo ob podnebnim spremembam izpostavljeni geografski širini. Slovenija izpolnjuje oba pogoja in požari poleti postajajo tudi naša realnost. Slovenci smo se z njimi srečali verjetno že v prazgodovini, a uspešno boriti proti njim smo se začeli pred nekaj desetletji, ko je gasilcem na kopnem na pomoč priskočilo tudi gašenje iz zraka. O teh prvih pionirjih, ki so se nad požare spustili v krhkih in na silo modificiranih letalih, govori oddaja Sledi časa.

El Mundo de Cabeza - Ana Carolina Maldonado, Té y Aguas Aromáticas by FM Mundo 98.1

Notes del programa Els noms de les espècies i herbes aromàtiques canvien força d'una llengua a l'altra, i avui volem parlar-ne perquè sapigueu com es diuen en català. Som-hi! Taller de llengua Quan hem de dir tastar i quan provar? Resolem el dubte! Bonus La Sílvia explica quines herbes aromàtiques tenen a casa. Transcripció Sílvia: [0:15] Bon dia i bona hora! Andreu: [0:16] Bon dia i bona hora! Com estem? Sílvia: [0:19] Molt bé! Andreu: [0:20] Fantàstic! Doncs jo també. Mira, estic animat perquè l'altre dia vam crear un canal nou al Discord, un xat nou, que es diu Super Easy Chat, perquè… clar, al Discord hi ha aprenents, persones que aprenen el català, òbviament amb nivells diferents, i a vegades potser hi havia una persona, alguna persona una mica tímida que no gosava escriure al xat general perquè potser el nivell era massa… massa avançat, el de la… la conversa, i llavors vam tenir aquesta idea de crear un Super Easy Chat i allà hem parlat de moment de mascotes, i la gent va compartir fotos dels seus gossos i els seus gats… i això, i també de plantes, perquè hi va haver una persona que va dir: "Jo no tinc animals, però sí que tinc moltes plantes". Sílvia: [1:11] No vaig ser jo, que ho sapigueu. Andreu: [1:12] No vas ser tu. Tu en tens moltes, clar! Sílvia: [1:14] Sí. Andreu: [1:15] Tu en tens moltes d'exterior, per això, no? D'interior en teniu, també? Sílvia: [1:18] Sí, també en tenim. Menys, però també. Andreu: [1:21] D'acord. Doncs llavors vaig mirar jo aquí al pis quantes plantes tinc i em vaig adonar que en tinc molt poques. O sigui, pensava que en tenia més. És que en tinc només tres! És molt trist! Sílvia: [1:34] Pensa que les plantes, si no te'n recordes d'elles fins al cap de molt temps, es moren, Andreu. Andreu: [1:40] Sí, sí. Sí, sí, sí, ho sé… ho conec, ho conec. No, però a mi les plantes m'agraden, i si tingués més espai o si tingués un jardí, la veritat és que segur que en tindria moltes més. Passa que aquí, primer, que tinc un pis petit; segon, que l'únic balcó que tinc dona al nord, llavors… no és el millor balcó per tenir-hi plantes. Sílvia: [2:04] Ah, però hi… Andreu: [2:05] Depèn de quines, clar. Sí. Sílvia: [2:06] Clar. Ja està. Andreu: [2:09] No, allà en tinc un parell que viuen bé, però d'altres ho he intentat i no. No, no ha funcionat. En resum, que l'altre dia, doncs, tenia ganes de tenir més plantes i em vaig comprar una alfàbrega, que és una planta aromàtica… Sílvia: [2:24] Alfàbrega de cuina o alfàbrega de jardí? Andreu: [2:27] Alfàbrega de cuina. Sílvia: [2:27] Ah, doncs pots fer el pesto! Andreu: [2:29] Sí, exacte. Aquesta que té les fulles més… més grans. I a mi és que l'alfàbrega m'encanta. O sigui, m'encanta la salsa pesto, m'encanta l'alfàbrega, fins i tot també en una amanida. No? Una amanida de tomàquet, amb burrata, no?, mozzarella i una mica de fulles d'alfàbrega, oli d'oliva i… fantàstic, boníssim! Sílvia: [2:50] Que guai, molt bé! Andreu: [2:52] Doncs això, llavors he pensat que estaria bé també aquí al pòdcast parlar algun dia d'herbes aromàtiques i espècies. Sílvia: [2:59] Genial, fantàstic! Andreu: [3:00] Perquè els noms d'aquestes coses, d'aquestes herbes i… i espècies canvien molt d'una llengua a l'altra. Sílvia: [3:07] Oi tant! Andreu: [3:08] Llavors, podríem anar repassant les espècies i herbes que tenim, que tens tu a casa i que tinc jo, i anem comentant per a què serveixen, perquè els oients entenguin de què estem parlant en cada cas, i si ens agraden o no i a on les posem. Sílvia: [3:23] Vinga! [...] Fes-te membre de la subscripció de pòdcast per accedir a les transcripcions completes, a la reproducció interactiva amb Transcript Player i a l'ajuda de vocabulari. (http://easycatalan.org/membership)

Din ce este făcut viitorul ? Care este materia lui prima ? Treaba asta se rezumă într-un singur cuvânt : inovaţie. A inova înseamnă a face ceva ce nu ai din ceva ce ai. Inovaţia e ceva atemporal, adună laolaltă trecutul, prezentul şi viitorul. Să le luăm pe rând. Trecutul e ceea ce ai la îndemână : materiile de care dispui şi tot ceea ce îţi pune la îndemână trecutul tău şi al celor de lângă tine. De acolo pleci, din moştenirea trecutului.Prezentul e în mintea ta, e ideea pe care o imaginezi acum pentru a te proiecta în viitor. Iei materialele moştenite din trecut şi le pui împreuna în prezent pentru a obţine ceva care există doar în mintea ta, adică în viitor.Viitorul nu este altceva decât promisiunea pe care tu ţi-o faci acum pentru ziua de mâine. Inovaţia rezumă tot acest proces care leagă trecutul de viitor trecând prin prezentul tău.Există companii care cu asta se ocupă, cu inovaţia. Una dintre ele este Expleo, o companie franceză care inovează în multe sectoare industriale şi care numără în jur de o mie de angajaţi şi în România, la Bucureşti şi la Iaşi.Investiţia franceză pune România pe harta inovaţiei industriale şi am invitat astăzi, la emisiunea « Noi venim din viitor » pe Alexandru Mircea, care conduce departamentul de inovaţie de la Expleo.Mai multe despre el şi compania Expleo puteţi afla la adresa : expleo.com

Dr. Jordan Berry // #TechniqueThursday // www.ptonice.com  In today's episode of the PT on ICE Daily Show, Spine Division lead faculty Jordan Berry discusses reimaging the objective examination for patients presenting with low irritability, especially only in specific positions or under specific loads.  Take a listen to the podcast episode or check out the full show notes on our blog at www.ptonice.com/blog. If you're looking to learn more about courses designed to start your own practice, check out our Brick by Brick practice management course or our online physical therapy courses, check out our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. EPISODE TRANSCRIPTION JORDAN BERRYWhat is up? PT on ICE Daily Show. This is Dr. Jordan Berry, Lead Faculty for Cervical Spine and Lumbar Spine Management. Today we're chatting about a topic called Low Irritability Equals Function First. Okay, so I hope you're having an awesome Thursday. We're about to break down just a concept that I think matters when you're thinking about the novice versus the expert clinician and how they're efficient during their initial evaluation. This key concept of when you're thinking about going into the objective exam and you know the irritability is low or at least moderately low, we're always gonna test the functional movements first. Okay, so a few concepts that we talk about during our live cervical and lumbar spine management courses, when we're thinking about the objective exam and what the expert clinician does different as opposed to the novice, one of those things is that they have a very long, detailed, subjective exam, and they have a short, clear, and crisp objective exam. and how as you gain more experience and more pattern recognition, typically that will sway even more lopsided towards being a longer subjective while having a shorter and more dialed objective exam. And then another concept we talk about is that when the patient irritability is low, you have to be really aggressive during the physical exam testing in order to recreate the symptoms, right? Because if you under test, then you might not actually recreate those familiar symptoms to know that the treatment that you're about to apply is going to work and that you're moving in the right direction. And so, one way that you can accomplish both of those things, right, with keeping a short, clear and crisp objective exam, and then making sure that you're going to be aggressive during the physical exam testing when the irritability is low, is always thinking about testing the functional movements first. Okay, so let me give you a clinical example with this, and then we'll break it down and talk about why it matters and why it's important. So, Imagine that you're in an initial evaluation and you've done your body chart and you know that the symptoms are somewhere around the area of the lumbar spine, like we'll say low lumbar into the right glute wrapping around towards the right hip, maybe even like anterior lateral right hip as well. But you know there's some vague diffuse symptoms that are somewhere in the lumbar spine and somewhere in the hip as well. And during this objective, you also gather that an aggravating factor is squatting anything over 95 pounds. And so day one, during the initial eval, you know you're gonna be trying to differentially diagnose if the symptoms are coming from the lumbar spine, or if they're coming from the hip, or maybe both. But primarily, again, the initial evaluation, day one, during the objective exam, we're trying to tease out What is the primary symptom generator? We have to nail that down day one. What a novice would do is as they're going into the objective exam, they would likely just hammer through a battery of tests for the lumbar spine and the hip. So they'd probably have that person hop up and you're going through all the basic stuff, right? You're going through active range of motion, your joint exam, your segmental exam, potentially neurodynamics, your test and hit PROM and strength testing and palpation. You're essentially just working down this battery of tests to try to see if anything recreates the familiar symptoms. And so let's say that you go through that 12, 15 minutes of objective exam testing and you figure out that hip passive range of motion, like internal rotation or fader recreates that familiar hip pain. And so now we have an asterisk sign, right? We've got our, um, let's, let's call it internal rotation is what we're going to retest and we've recreated the familiar symptoms. So you've done a good job, right? You haven't done anything wrong, but I would argue that that is not expert level because number one, it took us a fairly long time to get to that answer of what is recreating the symptoms. And honestly, the patient doesn't really care about any of the stuff that you just tested. So, an expert here is going to look at function first. So, we might do some of the same objective testing that we did just a minute ago with the novice, but the first thing that we're going to do if the irritability is low to moderate is look at function. So, if the subjective exam we found out that anything over a 95-pound squat recreates the familiar symptoms, well, I'm going to look at a 95-pound squat. So I get that person out in the gym, maybe we do a warm-up set, and then we load up to 95, and right when they drop down, right when the patient drops down into the bottom of the squat, they get that familiar hip pain. Now, right then, you have one of your asterisk signs, but we could also modify that movement or try to tease out in real time if we can change the symptoms or affect them in any way. So let's say that person drops down into the squat, bottom of the squat, they get their symptoms, and you grab a big mobility band. wrap it around the hip, and give a big lateral distraction, a lateral pull, while they go down into a second rep of the squat, and the symptoms are completely gone. So think about what you've now done. Number one, you have a better asterisk sign, I would argue, because it's something that the patient actually cares about. It's functional, it's very easy to retest, but you've also clued yourself in on your differential diagnosis. Because if I can do something to the hip, right, do a self-mob to the hip or do a lateral distraction for the hip and immediately change the symptoms that we got with squatting, then I know when I go back to the table and I do my more traditional objective exam testing, I'm going straight to the hip. So maybe on day one now, I can leave all of the lumbar spine testing and maybe hold it off until day two. because now I know that I can affect the hip. Now we go back to the table. We do some of the objective testing and I go right towards PROM and I jam that hip up into IR and fader and recreate those familiar symptoms. Boom. Now we've got our two objective asterisk signs. We've got one passive range of motion. We've got one that's functional, the squat. So now when I apply it to some sort of treatment, I've got two ways that I can retest. SUMMARY So number one, why this matters so much of testing function first when irritability is low is differential diagnosis. It's just a fast way to identify oftentimes where the symptoms are coming from or at least cluing you in as to what direction you need to go in instead of just testing all the lumbar spine stuff and all the hip stuff. Now I've clued myself in that I'm probably going to focus on hip day one. So the second thing why it's important is efficiency. We always say during objective exam testing, as little as possible, as much as necessary. So I only want to test the stuff that's absolutely necessary so I'm efficient, but also I don't risk flaring up the patient with doing a bunch of tests and measures that aren't necessary to begin with. And if I can eliminate a few things right off the bat from that functional testing, why not start there? And then lastly, it's way better buy-in. It's way better buy-in. So day one, you're always trying to have the patient walk out thinking, man, I'm finally in the right spot. This person totally gets my issue. And they're definitely going to be walking out saying that if you're first off testing the functional stuff, the stuff that they actually care about that you pick up in the subjective. No patient cares about hip IR, cares about lumbar AROM, cares about palpation. They don't care about that. They care about the thing that they want to get back to that they love. And if you're including that in the physical exam, the buy-in is going to skyrocket. So think about that over the next week or so. About maybe changing the order of your physical exam if this is not typically how you order things. When the irritability is low to moderate and you pick that up during the subjective exam, then when you go into the objective exam, you make sure that you're testing function first. It's gonna help with differential diagnosis, it's gonna help you be efficient, and you're gonna get way better buy-in. All right, so think about that this week. Next week in the clinic, I'd love to hear feedback on that as well. Just to leave you with a few upcoming courses that we have with cervical and lumbar, this coming weekend, we've got cervical management in Oviedo, Florida, few seats left for that. And then also this weekend, we've got lumbar spine management in San Luis Obispo in California. And then coming up August 3rd and 4th, we've got cervical in Cincinnati, Ohio. And then also August 3 through 4, we've got lumbar spine management in Aspinwall, Pennsylvania. All right. Thanks so much for listening. Have an awesome Thursday in the clinic. And if you're going to be a cervical or lumbar spine management course coming up soon, hopefully I will see you there. All right. Have a great day. Thank you. OUTRO Hey, thanks for tuning in to the PT on Ice daily show. If you enjoyed this content, head on over to iTunes and leave us a review, and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ice content on a weekly basis while earning CEUs from home, check out our virtual ice online mentorship program at ptonice.com. While you're there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.  

Hola Mundo - Ecuador, El País Del cacao Más Fino y Aromático Del Mundo, Pablo Conselmo by FM Mundo 98.1

En #LoncheraInformativa conversamos con Luis quien es estudiante de 3er año del Colegio Bella Vista de Maracay y nos compartió todos los detalles de su proyecto científico de velas aromáticas.

Send us a Text Message.Welcome to the June Q&A with Cynthia and Trisha! Today, we start the episode with all the romantic, hilarious, and random ways our community met their spouses, and we finish the episode with one woman's question to us: "If you were a dog, what kind would you be?" -- you'll hear us reach out to a friend on the spot to answer that question for us. In the regular version of this episode, we answer the following questions:Help! I am losing trust in my body after having experienced miscarriage. What do I do?My midwife told me I that my pelvic shape causes me to have back labor and a posterior baby. Is this true?How can I manage negative comments at work about pregnancy in general?Is artificial rupture of membranes a necessary part of induction for pre-eclampsia?In the extended version of today's episode, available on Patreon and Apple subscriptions, we answer the following:Should you limit time spent breastfeeding to ensure a baby doesn't burn too many calories feeding at the breast?Do I have to be monitored continuously in labor for high blood pressure?Does consuming the placenta or cord tissue after after birth prevent postpartum hemorrhage? My midwife told me this is a biohazard. Is this true?As always, we close with a round of rapid fire quickies! Thank you for your excellent questions and please continue to call them in to our hotline at 802-438-3696 or 802-GET-DOWN!**********Down to Birth is sponsored by:Vitality: An athleisure brand made for women, by women, designed with style and comfort for pregnancy and beyond.Davin & Adley-- The perfect nursing and pumping bra combinedSilverette 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 to nourish yourself before, during, and after pregnancy.Use promo code: DOWNTOBIRTH for all of the above sponsors.DrinkLMNT -- Purchase LMNT with this unique link and receive a free 8-day supply. Be sure to use the unique link to buy yours today. 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.

Mistakes companies do when working with B2B company data.Pietari Suvanto - CEO & Co-founder at Vainu - in B2B SaaS CEOs.We talked about how to work with contact data, social selling as their best lead-generator, the extreme advantage of being a data-focused company, and much more.-Timeline in the episode:2:00 - Who is Pietari Suvanto?2:45 - Vainu's elevator pitch.4:15 - How Vainu is different than their competitors.6:15 - Five quick ones.13:15 - Why he started Vainu.16:15 - common mistakes companies do re. B2B company data23:30 - External question from Hampus Rosencranz at GVO Media: "What would you say are three classic challenges that stand in the way of success for smaller businesses? And how would you tackle those challenges?25:50 - External question from Sebastian Lifvin at Startupcoachen: "What is the latest customer insight that made a difference for your business?"28:00 - Vainu's best lead-generator the last 6 months.30:10 - The best way to do outreach to Pietari.32:10 - Closing questions.-Do you want to book more meetings and increase your sales?Automate your sales with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.Follow Josef Fallesen on LinkedIn: https://www.linkedin.com/in/joseffallesen/Follow Vaam on LinkedIn: https://www.linkedin.com/company/vaam-ioFollow Vaam on Youtube: https://www.youtube.com/@vaam.io-Pietari's company Vainu collect and refine B2B company and contact information, and seamlessly integrate it into your CRM. This ensures that you have the data to succeed in sales and marketing in the Nordics.Read more about Vainu on: https://www.vainu.com/Follow Pietari Suvanto on LinkedIn: https://www.linkedin.com/in/pietari-suvanto-5510064/-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

How you use events to increase your sales.Listen to Mats Nyberg - CEO at Trippus - in B2B SaaS CEOs!We discussed using Event-led as main GTM strategy, small exclusive events vs. big conferences, how you maximize your value from events, and much more.-Timeline in the episode:2:10 - Who is Mats Nyberg?4:00 - Trippus' elevator pitch.6:30 - Five quick ones.11:15 - Event-led as GTM.14:00 - Trippus' customer journey and AHA.21:10 - External question from Malin Björnell at Ulla-Bella: "Let's pretend you're leading a startup that has a couple of customers, but not hundreds yet. What are the 3 - 5 most important things you would focus on connected to Go-to-Market?"25:00 - Trippus best lead-generator.30:50 - The best way to do outreach to Mats.32:30 - Closing questions-Do you want to book more meetings and increase your sales?Automate your outreach with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.Follow Josef Fallesen on LinkedIn: https://www.linkedin.com/in/joseffallesen/Follow Vaam on LinkedIn: https://www.linkedin.com/company/vaam-ioFollow Vaam on Youtube: https://www.youtube.com/@vaam.io-Mats' company Trippus helps you get all the tools for creating successful events - from invitations to reports and everything inbetween.Read more about Trippus on: https://www.trippus.com/Follow Mats Nyberg on LinkedIn: https://www.linkedin.com/in/mats-nyberg-b345814/-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

Episode nr 100! And in this episode Alina Vandenberghe - Co-CEO & Co-founder at Chili Piper - join B2B SaaS CEOs.We talked about US vs Europe, her journey with Chili Piper, their best lead-generator the last 6 months, what she would tell her younger self, and much more.-Timeline in the episode:2:10 - Who is Alina Vandenberghe?4:10 - Chili Piper's elevator pitch.5:30 - Five quick ones.10:00 - Why she and her co-founder/husband started Chili Piper.13:40 - GTM strategy: Brand, influencers and partners.23:20 - Chili Piper's customer's AHA-moment.25:10 - The best way to do outreach to Alina.27:25 - External question from Mikael Arndt at Closers Only:"I would love to hear your three to five best practices for making your salespeople better than the average market. What does the team do on a daily basis to win the battle of having the very best sales reps?"31:30 - Closing questions.-Do you want to book more meetings and increase your sales?Automate your outreach with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.Follow Josef Fallesen on LinkedIn: https://www.linkedin.com/in/joseffallesen/Follow Vaam on LinkedIn: https://www.linkedin.com/company/vaam-ioFollow Vaam on Youtube: https://www.youtube.com/@vaam.io-Alina's company Chili Piper helps you qualify, route, and schedule leads from anywhere — be it your webform, cold calls, campaigns, G2 page, and more. This leads to more meetings booked and more pipeline created.Read more about Chili Piper on: https://www.chilipiper.com/Follow Alina Vandenberghe on LinkedIn: https://www.linkedin.com/in/alinav/-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

How you create human success within your company.Rasmus Holst - CEO at Zensai - in B2B SaaS CEOs.We talked about the biggest difference between the Bay Area and the Nordics, key things to have for a good human success foundation, common mistakes leaders do re. human success, and much more.-Timeline in the episode:1:45 - Who is Rasmus Holst?4:10 - Zensai's elevator pitch.8:15 - Five quick ones.15:05 - The biggest difference between the Bay Area and the Nordics.19:20 - Why he joined Zensai.21:45 - Key things to have for a good human success foundation.29:00 - Common mistakes leaders do re. human success.32:00 - Their best lead-generator the last 6 months.33:30 - The best way to do outreach to Rasmus.35:00 - External question from Emanuel Åkesson at HookThem:"What is your best advice for expanding your service from a Scandinavian country into another country?"36:15 - Closing questions-Do you want to book more meetings and increase your sales?Automate your outreach with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.Follow Josef Fallesen on LinkedIn: https://www.linkedin.com/in/joseffallesen/Follow Vaam on LinkedIn: https://www.linkedin.com/company/vaam-ioFollow Vaam on Youtube: https://www.youtube.com/@vaam.io-Rasmus' company Zensai has built a human success platform that support people in progressing along their success journey. From learning to engagement and performance. On their time and their terms.Read more about Zensai on: https://zensai.com/Follow Rasmus Holst on LinkedIn: https://www.linkedin.com/in/rasmusholst/-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

What you should do to successfully start working with ABM (Account Based Marketing).Markus Ståhlberg - CEO & Co-founder at N.Rich - in B2B SaaS CEOs.We talked about common mistakes companies do re. ABM, the importance of a well-defined ICP, how your competitors "failed customers" can be your best prospects, and much more.-Timeline in the episode:1:45 - Who is Markus Ståhlberg?2:40 - N.Rich's elevator pitch.3:50 - Five quick ones.7:30 - Why he started N.Rich.9:40 - External question from Peter Robson Bohm at IDkollen: "In order to benefit enough from ABM, what is your take on our ARPA, length of sales cycle and number of stakeholders per account?"12:00 - Common mistakes companies do re. account based marketing.22:20 - Three important things connected to a strong Go-to-Market strategy.25:30 - N.Rich's customer's AHA-moment?30:00 - Their best lead-generator the last 6 months.31:50 - The best way to do outreach to Markus.33:30 - Closing questions-Do you want to book more meetings and increase your sales?Automate your outreach with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.Follow Josef Fallesen on LinkedIn: https://www.linkedin.com/in/joseffallesen/Follow Vaam on LinkedIn: https://www.linkedin.com/company/vaam-ioFollow Vaam on Youtube: https://www.youtube.com/@vaam.io-Markus' company N.Rich helps you start and scale your account-based motion easily without compromising on data quality and global reach.Read more about N.Rich on: https://n.rich/Follow Markus Ståhlberg on LinkedIn: https://www.linkedin.com/in/mstahlberg/-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

Speaking about his life, role with the Knights, and the Our Lady of Guadalupe council

How you get going with video for your team.Listen to Viktor Underwood - CEO at Quickchannel - in B2B SaaS CEOs!We discussed why you must start using video, big mistakes teams make when start using video, choosing your strategy depending on the size of deals you have, outbound as their best lead-generator, and much more.-Timeline in the episode:2:00 - Who is Viktor Underwood?2:40 - Quickchannel's elevator pitch.3:30 - Five quick ones.8:20 - Why he joined Quickchannel10:30 - Why should a company use video?12:30 - Powerful metrics connected to using video.15:20 - External question from Frida Olofsson at Flourish: "What's your best tip for getting over the threshold of starting to use video content in our marketing?"18:25 - Big mistakes teams make when start using video.23:45 - Top 3 things re. building a strong Go-to-Market strategy26:30 - The best lead generator for Quickchannel the last six months.28:00 - The best way to do outreach to Viktor.29:40 - His favorite book: Good to Great by Jim Collins.30:20 - His favourite life motto.31:15 - The top things he would tell his younger self.-Do you want to book more meetings and increase your sales?Automate your outreach with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.Follow Josef Fallesen on LinkedIn: https://www.linkedin.com/in/joseffallesen/Follow Vaam on LinkedIn: https://www.linkedin.com/company/vaam-ioFollow Vaam on Youtube: https://www.youtube.com/@vaam.io-Viktor's company Quickchannel helps professionals working with video. A platform that's simple to use, swift, secure and fully compliant.Read more about Quickchannel on: https://quickchannel.com/Follow Viktor Underwood on LinkedIn: https://www.linkedin.com/in/viktorhedstrom/-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

How you can learn about team management and high performance perspective from Formula 1.Listen to Alexander Westlund - CEO & Co-founder of Lynes - in B2B SaaS CEOs!We discussed taking inspo as a leader from Formula 1, the core of their success with sales outbound, outreach done in the best way, time management hacks, and much more.-Timeline:1:50 - Who is Alexander Westlund?6:15 - Lynes' elevator pitch.11:00 - How Lynes was started.15:50 - External question from Josef's co-founder Hampus Persson at Vaam:"What's the main thing or channel that generated the best leads for you during the last 6 months?"18:00 - Sales outbound - the things that has been their core for success.20:50 - The best way to do outreach to Alexander.23:50 - A topic of Alexanders' choice: Formula 132:20 - His best time management hacks.36:00 - His favorite book: High output management by Andrew Grove.37:00 - The top things he would tell his younger self.-Do you want to book more meetings and increase your sales?Automate your outreach with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.Follow Josef Fallesen on LinkedIn: https://www.linkedin.com/in/joseffallesen/Follow Vaam on LinkedIn: https://www.linkedin.com/company/vaam-ioFollow Vaam on Youtube: https://www.youtube.com/@vaam.io-Alexanders' company Lynes helps you unleash peak productivity with calls, messages, data, meetings and integrations that elevates your business.Read more about Lynes on: https://lynes.io/en/Follow Alexander Westlund on LinkedIn: https://www.linkedin.com/in/alexander-westlund/-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

Skip the speculations and stay to the established facts when it come to your Go-to-Market strategy.Listen to Daniel de Sousa - CEO at Rillion - in B2B SaaS CEOs!We discussed speculations vs facts, that every change need to be connected to a relevant story, building a truly collaborative team, enjoying the ride, and much more.-Timeline in the episode:2:00 - Who is Daniel de Sousa?6:00 - Rillion's elevator pitch.6:40 - Why he joined Rillion.8:40 - The top Go-to-Market initiatives they focus on now.24:45 - The core of the Go-to-Market strategy if Daniel would start a new company.28:15 - The best way to do outreach to Daniel.29:30 - A topic of Daniel's choice: Building a truly collaborative team35:15 - His favorite book: Thinking, Fast and Slow by Daniel Kahneman.36:20 - His favourite life motto.37:20 - The top things he would tell his younger self.-Do you want to book more meetings and increase your sales?Automate your outreach with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.Follow Josef Fallesen on LinkedIn: https://www.linkedin.com/in/joseffallesen/Follow Vaam on LinkedIn: https://www.linkedin.com/company/vaam-ioFollow Vaam on Youtube: https://www.youtube.com/@vaam.io-Daniel's company Rillion helps you save time and money with AP Automation.Read more about Rillion on: https://www.rillion.com/Follow Daniel de Sousa on LinkedIn: https://www.linkedin.com/in/danield11/-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

5 SaaS leaders from some of the Nordics' hottest SaaS companies right now about how you build a strong sales process.Listen to when 5 of the previous guests in B2B SaaS CEOs talk about how you build a strong sales process.Timeline:0:45 - Samir El-Sabini (CEO & Co-founder of Juni)6:25 - Rickard Kajson (CEO at Grade)11:00 - Istvan Beres (CEO & Co-founder of DanAds)16:45 - Maryam Ghahremani (CEO at Bambuser)20:45 - Erik Fjellborg (CEO & Founder of Quinyx)-Do you want to book more meetings and increase your sales?Automate your outreach with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

5 SaaS leaders from some of the Nordics' hottest SaaS companies right now about marketing.Listen to when 5 of the previous guests in B2B SaaS CEOs talk about ways to generate more leads.Timeline:0:45 - Mads Fosselius (Dixa)6:35 - Marit Rødevand (Strise)9:40 - Henrik Teisbæk (Veo)12: 50 - Tine Karlsen (Vev)15: 55 - Istvan Beres (DanAds)-Do you want to book more meetings and increase your sales?Automate your outreach with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

Why you should prioritize sleep.Listen to Henrik Teisbæk - CEO & Co-founder of Veo - in B2B SaaS CEOs!We discussed what it takes to scale a supply chain, why you should invest in a viral component in your product, sleep, that you can't control what happen but how you react, and much more.-Timeline in the episode:2:05 - Who is Henrik Teisbæk?3:45 - Veo's elevator pitch.5:30 - The story of Veo.7:30 - 5 quick ones.10:00 - What it takes to scale a supply chain.14:00 - The core of a great GTM-strategy according to Henrik.17:15 - Veo's best marketing channels.22:00 - The best way to do outreach to Henrik.23:00 - External question from Björn Ingmansson at Kognic: "What has changed in your work as a CEO in the rapidly changing technology landscape?"24:30 - A topic of Henrik's choice: Sleep28:15 - His favorite book: Man's Search For Meaning by Viktor E. Frankl and also The Advantage by Patrick M. Lencioni.29:50 - Henrik's favourite life motto.30:30 - The top things he would tell his younger self.-SaaSiest:On April 16-17, it's time for SaaSiest 2024 in Malmö, the largest community-driven B2B SaaS event in the Nordics! 1200 Founders, Executives, and VCs under one roof to share experiences & best practices.Secure your ticket through the link below:https://saasiest2024.com/-Do you want to book more meetings and increase your sales?Automate your outreach with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.Follow Josef Fallesen on LinkedIn: https://www.linkedin.com/in/joseffallesen/Follow Vaam on LinkedIn: https://www.linkedin.com/company/vaam-ioFollow Vaam on Youtube: https://www.youtube.com/@vaam.io-Henrik's company Veo helps you record and live-stream your team sports matches automatically and take your game a level up.Read more about Veo on: https://launch.veo.co/Follow Henrik Teisbæk on LinkedIn: https://www.linkedin.com/in/henrik-teisbaek/-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

In recent years, there has been a lot of buzz around “volcanic wines.” The term makes it sound as if these are wines that are spawned from a volcano, but in reality these are wines that many people believe have special qualities because they grow on volcanic soils. In this show, I define the types of volcanoes before discussing the ecosystems they form. I then talk about the specific regions known to have volcanic wines, but I also point out that these areas have other factors that may create similarities in the wine – proximity to oceans, old vines (unaffected by phylloxera), and high elevations and cooling breezes. These must be considered, despite the fact that many of the volcanic wine groupies say flavor is purely from the soils. Here is the list of wines/places I discuss in the show:ItalyMount Etna, Sicily: Reds (Rosso of the Nerello Mascalese, Nerello Cappuccio grapes), whites (Bianco, mainly of the Carricante grape)Soave, Veneto: Whites grown on specific hillsides (Garganega, Trebbiano di Soave grapes)CampaniaVesuvius: Whites of Coda di Volpe, Caprettone, Falanghina, Greco. Rosés and reds of Piedirosso, Aglianico, Sciacinoso Irpinia: Taurasi DOCG and Aglianico del Taburno DOCG: Reds of the Aglianico grape. I mention Feudi di San Gregorio Fiano di Avellino: May or may not be affected by the volcanic soilGreco di Tufo DOCG: White of the Greco grape, the sulfur and compressed volcanic ash (tufo),and volcanic sand and clay, give the wines an acidity, minerality & flintiness that has clear volcanic influence Basilicata: Aglianico del Vulture. Reds of Aglianico Piedmont: Alto Piemonte. Red blends in Gattinara, Boca, BramaterraUmbria/Lazio: Orvieto. Whites of Grechetto, Trebbiano Toscano______________Greece: Santorini - White of Assyrtiko. Lemnos -Red of LimnioSpain: The Canary Islands/Las Canarias - Whites of Malvasîa Volcánica, Malvasîa Aromática, Listán Blanco. Reds of Listán NegroPortugal: Açores islands (the Azores). Whites: Arinto, Verdelho, Fernão Pires, Terrantez Hungary: North of Lake Balaton in Somló, whites of the Juhfark grapeTokaji – sweet and dry whites of mainly the Furmint grape US:Oregon's Willamette ValleySome parts of Napa, Lake County in California__________________________________________________________Full show notes and all back episodes are on Patreon. Become a member today!Wine Access has an amazing selection -- once you get hooked on their wines, they will be your go-to!  Get 10% your first order with my special URL.  To register for an AWESOME, LIVE WFNP class go to: www.winefornormalpeople.com/classes Get the back catalog on Patreon! Hosted on Acast. See acast.com/privacy for more information.

Hearing about risk is hard. Interpreting risk is even harder, but deciding which risks are comfortable for you is an essential part of birth!Meagan and Julie discuss how to tell the difference between relative and absolute risk, and what kind of conversations to have with your provider to help you better understand what the numbers mean. They also quote many stats and risk percentages around topics like blood transfusions, uterine rupture, eating during labor, epidurals, Pitocin, AROM, and episiotomies.  And if you don't feel comfortable with accepting a certain risk, that is OKAY. We support your birthing in the way that feels best to you!Risk of Uterine Rupture with Vaginal Birth after Cesarean in Twin GestationsJournal of Perinatal Education ArticleWhat are the chances of being struck by lightning?Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:52 Review of the Week06:08 Determining acceptable risk for you and your provider 08:00 Absolute versus relative risk15:21 More conversations need to happen25:29 Risk of blood transfusion in VBAC, second C-section, and third C-section30:37 Understanding the meaning of statistical significance 32:05 “The United States is intervention intensive” 36:27 Eating during labor and the risk of aspiration under anesthesia43:03 Epidurals, Pitocin, AROM, episiotomies, and C-section percentages44:43 The perspective of birth doulas and birth photographersMeagan: Hello, hello everybody. Guess who I have today? Julie!Julie: Hello. Meagan: Hello. It's so good to have you on today. Julie: Of course. It's always fun to be here. Meagan: It really is. It's so fun. When we sit and chat before, it just feels so comfortable like that is the norm still for me even though it has been a while, it just feels so normal and I love it. I miss you and I love you and I am so excited to be here with you today. You guys, we are going to talk a little bit about risk. We know that in the VBAC world, there's a lot of risk that comes up. I should say a lot of talk about risk that comes up whether it be is it safe to even have a VBAC? Is it safe to be induced? What are our real risks of uterine rupture? Is it safe to VBAC with an epidural or without an epidural? What about at home out of the hospital? Is that safe? I don't know. Let's talk about that today. Julie: Let's talk about it. Meagan: Let's talk about it. I think it's really important to note that no matter what— and we're going to talk about this for sure today, but no matter what, you have to take the risks that you are presented and that is given and still decide what's best for you. That risk doesn't mean that is what you have to or can't do. Right? So I think while you are listening, be mindful or kind of keep that in the back of your mind of, “Okay, I'm hearing. I'm learning.” Let's figure out what this really means and then let's figure out what's truly best for you and your baby.02:52 Review of the WeekI do have a Review of the Week so I want to hurry and read that, then Julie and I will dive into risk and assessing. Julie: Dun dun, we're ready. Meagan: We are ready. Okay, holy cow. This is a really long review, so—Julie: You can do it. Meagan: Thank you to Sara R-2019 on Apple Podcasts for leaving this review. I love how Julie was like, “You can do it,” because she knows that I get ahead of what I'm reading in my mind and then I can't read, so let's see how many times it takes to read this review. Julie: You've got this. Meagan: Okay. It says, “A balanced and positive perspective.” It says, “As a physician myself I think it is unusual to find balanced resources for patients that represent the medical facts but also the patient experience and correct for some of the inaccuracies in medicine. This podcast does an amazing job of striking this balance!“I had an emergency C-section with my daughter 2 years ago. Despite understanding that the CS was medically appropriate and my professional experience, I still found the whole experience to be mildly traumatic and disappointing. This podcast was the main resource I used to help prepare for my second child's birth and my plan to have a VBAC. I am now holding my new baby in my arms with so much pride, love, self-confidence, and trust because I had a smooth and successful VBAC.“I am thankful for this podcast which gave me ideas, confidence, strength, and a sense of community in what is otherwise a very isolating experience. I especially appreciate the variety of stories that are shared, including VBAC attempts that result in another C section so that we can all prepare ourselves for the different outcomes. No matter what happens we are strong women and have a welcome spot in this community, even when we may feel alone with our thoughts and fears. Thank you, Julie and Meagan!Julie: Aw, I love that. Meagan: Yes, that was phenomenal. Congratulations Sara R-2019. If you are still listening here, congratulations and we are so happy for you and thank you for your amazing review. 06:08 Determining acceptable risk for you and your providerMeagan: All right, Julie. Are you ready? Julie: Here we go. Here we go. Can I talk for a minute about something you mentioned before the review? You were talking about risk and how it's not a one-size-fits-all because we were talking about this before. We all know that the uterine rupture risk is anywhere between .2%-1% or whatever depending on the study and what you look at. The general consensus among the medical community is .5%-1% is kind of where we are sitting, right? Now, some people might look at that risk and be like, “Heck yeah. That's awesome. Let's do this,” especially when you look at a lower risk than that that it's a catastrophic rupture. Some people might look at those numbers and be like, “This feels safe. Let's go.” Some people might look at those numbers and be like, “This feels scary. I just want to schedule a C-section.” Meagan: No, thank you. Julie: And that's okay. It is okay. However you approach risk and however you look at it is okay. We're not here to try and sway anybody. Obviously, we're The VBAC Link, so we are going to be big advocates for VBAC access, right? But we're also advocates for having all of the information so you can make the best decision no matter what that looks like. But also, I think another very important part of that is finding a provider whose view of risk is similar to your view of risk so that you guys have a similar way to approach things because if you find a provider who thinks that 1% risk of VBAC is really scary, it's not going to go good for you if you think a 1% risk for a VBAC is acceptable. So yeah, I just want to lay that out there in the beginning. Meagan, you touched on it in the beginning, but I feel like provider choice in risk is really important there. Meagan: It is. Julie: For sure. 08:00 Absolute versus relative riskMeagan: It is and also, one of the things we wanted to talk a lot about is absolute risk versus relative. So many times when people, not even just the actual percentage or 1 out of 5 is shared, it's the way it's shared. The way the words are rolling off of the tongue and coming out can be shared in a scarier way so when we say 1 out of 5, you're like, “Okay, that's a very small number. I could easily be one of those 5's.” It's the way these providers sometimes say it.  A lot of the time, that's based on their own experience because now they are like, “Well, I am sharing this number, but I'm sharing a little extra behind the number because I've had the experience that was maybe poor or less ideal.” Does this make sense? Julie: Yeah. Meagan: Sometimes the way we say things makes that number seem even bigger or even worse or scarier. Julie: Right. It really comes down to absolute risk versus relative risk, right? Relative is your risk in relation to another thing that has risk. Absolute risk is the actual number. It's like 1 in 10. That is an absolute risk. You have a 1 in 100 chance of uterine rupture. That is an absolute risk. Your chance of uterine rupture doubles after three Cesareans. That's not true. That's not true. But that's a relative risk. I really like the example that I feel is really common for people to relate to is stillbirth after X amount of weeks. Evidence-Based–Meagan: That's a huge one. Julie: Yeah, it's a big one that gets thrown around all of the time and it sounds really scary when people say it. I love Evidence Based Birth. They have this whole article about due dates and risks associated with due dates and why due dates should really be adjusted and look at differently. They don't say that. They just present all of the data, but what I really like about that is they have a section here about stillbirth and they talk about absolute risk versus relative risk. I feel like that would be a great thing to start with. I'm just going to read it because it's so well-written. They said, “If someone said that the risk of having a stillbirth at 42 weeks compared to 41 weeks is 94% higher, then that sounds like a lot.” Your risk of stillbirth doubles at 42 weeks than if you were to just get induced at 41 weeks. Your baby is twice as likely to be stillborn if you go to 42 weeks. Meagan: Terrifying. Julie: Okay? 94% higher. That's almost double. That is scary. For me, I'd be like, “Uh, yeah. That is super scary.” Meagan: Done. Sign me up for induction. Julie: Right? Sign me up for induction. But when you consider the actual risks or the absolute risks, let's just talk about those numbers. 1.7 per 1,000 births if they are at 41 weeks. Stillbirth is 1.7 per 1000 births. At 42 weeks, it's 3.2 per 1000 so it's a .17% chance versus a .3% chance so you are still looking at really, really, really small numbers there. So yeah, it's true. 3.2 is almost double of 1.7 if you do the math. Sometimes math is hard so that's fine. We have to get out the calculator sometimes, but while it's true to say the risk of stillbirth almost doubles at 42 weeks, it could be kind of misleading if you're not looking at the actual numbers behind it. So I think that it's really important when we're talking about risks and the numbers and statistics to understand that there are different ways of measuring them and different ways of looking at them and different ways of how they're even calculated sometimes. So depending on how you look at them, you could even come up with different risks or different rates which can really sway your decision. We're not talking about a 5%-10% double which is still true. It's still double, but it's just a really small number. Now, I also want to do a plug-in for people who have been in that .3%. It might as well be 100%. I can't even imagine the trauma of having to have a loss like that. I can't. I have supported parents through that. I have documented families like that and documented their sweet babies for them. I can't imagine the pain that goes with that. But I also think it is very important to look at the actual numbers when you are making a decision. Now, maybe that .32% is too high for you and that's okay, but maybe it's not and that is a risk you are willing to accept. I feel like approaching it like that is so much better. If somebody ever says to you, “This risk of that is double” or whatever, I don't know. I'm just going to make up some random stuff here like, “If you drive in your car to school, you have a 1 in 10 chance of getting in a car crash but if you drive on a Wednesday, your risk doubles so now you have a 2 in 10 chance or 1 in 5 chance of getting in the car crash,” so maybe you would want to avoid driving to school on Wednesdays, but maybe you wouldn't. But if you say you're risk is higher of dying in a car crash if you go to school on Wednesdays, they would be like, “I'm not leaving the house on Wednesdays or ever.” I'm not leaving the house today because it's so dog-gone cold and I'm warm in my blanket. I don't know. I feel like looking at it like that. Actually, 1 in 10 is really high for getting in a car crash, but I don't know. I just feel like looking at that is really important for providers telling you, “Oh, your risk of uterine rupture doubles if we use Pitocin so I'm not going to use Pitocin.” Okay, we're looking at a small increase to an already small risk. We know that any type of artificial induction could lead to an increased risk of uterine rupture especially if it's mismanaged, but what we do know is that it's not– I don't want to say that because that might be wrong. When you are presented with the actual numbers, yes. It might double. I don't know what the actual numbers are, to be honest off the top of my head. I feel like maybe it doubles, but if you are already looking at a .2% to a .4% or a .5% to a 1% chance, what's the tradeoff there? What are your risks of just scheduling a repeat C-section instead of doing an induction? Is that worth it to you? What are the risks associated with repeat Cesareans? Are they bigger than that of using Pitocin to induce labor? What is that compared to the other one because there is another that is relative risk? The absolute risk is what the percentage is. I'm not even going to say the number. But if there's a risk of rupture using Pitocin relative to the risks that come with repeat Cesareans, those are risks that are relative to each other, so how does that compare? Because when we talk about it in just that singular form or that singular amount of risk without considering the other risks that might be associated with it because of the decisions we made from that risk– am I making sense here? Then you know, I don't know. I feel like there is just a lot more conversation to have sometimes when we are talking about risk. 15:21 More conversations need to happenMeagan: Yes. There are. There is a ton more conversation and that is what I feel like we don't see happening. There's a quick conversation. Studies show that 7 minutes are spent in our prenatal visits which is not a lot of time to really dive into the depths of risk that we are talking about when we say, “We can't induce you because Pitocin increases–”. This is another thing I've noticed is significantly. You have a serious–. Again, it comes down to the words we are using. Sometimes in these prenatal visits with our providers, we do not have the time to actually break down the numbers and we're just saying, “Well, you have a significantly higher risk with Pitocin of uterine rupture so we won't do that.” When we hear significantly, what do we do? We're like, “Ahh, that is big.” You know? Julie: Yeah. Meagan: We're just not having the conversation of risk enough and again, it's kind of being skewed sometimes by words and emotion. We were talking about this before. I remember we made a post– I don't know, probably a year and a half ago maybe. It seems like a while ago about the risk of complications in a repeat Cesarean meaning you have a C-section and then instead of going for a VBAC, you go for a repeat Cesarean which as you know, if you've been with us, is totally fine and respected here from The VBAC Link. A lot of the time, we don't talk– and when I say we, I mean the world. We don't talk about the actual risk of having a repeat Cesarean, right? Don't you feel like that, Julie? I don't know. As a doula, I feel like our clients who want to go for VBAC know a little bit more of the risk of having a VBAC, but they have not been discussed at all really with the risk surrounding a repeat Cesarean. We made a post talking about the risks of repeat Cesarean and I very vividly remember a lot of people coming at us with feeling that we were fearmongering.Julie: Or shaming. Meagan: Shaming, yep. A lot of people were feeling shamed or disrespected. People would say, “You claim to be CBAC supportive, but here you are making these really, really scary numbers.” Anyway, looking at that post and going into what we've talked about, in some of those posts, we did say things like, “You are going to have a 1 out of 10 chance of X, Y, Z,”Julie: Or twice as likely to need this. Twice as likely to need a blood transfusion or 5x more likely to have major complications. Things like that. Meagan: Yeah. We would say things like that. I remember specifically in regards to miscarriage. It's a very, very sensitive topic, but there are risks there. So a lot of people were triggered. In the beginning, we talked about the way providers say things and the way they put them out on paper and the absolute risk versus the relative and way they do that. We're guilty of that too. Right here at The VBAC Link, we were like, “This is the chance. These are the chances. You are 5x more likely to X, Y, Z.” So know that I don't want to make it sound like we are shaming anybody else for the different ways that they give the message of risk. Am I making sense? Julie: Yeah, and you know what? I feel like sometimes it's just about giving people the benefit of the doubt. We want to give providers the benefit of the doubt just because it's probably something that they've continuously heard and spoken and that's okay because we do it too sometimes. We go on that thing like, “Oh my gosh, maternal death.” I think the risk of maternal death is 10x higher in a C-section than it is in a VBAC which sounds really scary and makes me never ever want to have a C-section again, but when you look at that, it's .00001% to .0001% or whatever is 10x more. It is such a small level of risk, but it is higher. I feel like trying to look at both absolute and relative risk for any given thing together is really, really important. Yeah. Give people the benefit of the doubt. Give us the benefit of the doubt. We are in such an awful cultural climate right now where it's easy for people, especially on social media to jump on the attack train for anybody when we feel triggered or when we feel like people are being unjust to us or to other people and I hate that so stinking bad. Whenever I catch myself with those feelings, I try to take a step back and I've actually gotten pretty good at that, but it's so easy for us to get on that bandwagon of just railing against people who present information in certain ways or railing people without getting all of the information about that person.Before I go off too much on a soapbox in that direction, yeah. I feel like your provider when they are saying those things is probably not trying to coerce you into anything. Our providers, especially our hospital providers are incredibly overworked. They are incredibly stressed. Their time management skills have got to be off the charts because they are so overloaded with everything and they just don't have time to automatically sit down and explain things. But you know what I have found? Most of them, when you stop them and ask questions, they are more than happy to answer and explain. Sometimes, they are just repeating things they have heard all the time or that they have learned at some point or another without giving them a second glance. Do you know what? We all do that too. Me, Meagan, you listening right now. We all do that. We hear things. We regurgitate them. We hear things. We regurgitate them and we don't even think about questioning or challenging those things until somebody else brings it up to us to question or challenge those things. So, don't be afraid to ask your provider for more information or ask them what the real numbers are to those things. I have a really special place in my heart for our CBAC moms because there are lots of things that they are working through, so many emotional things, but I challenge not just people who have had a repeat Cesarean that was unwanted, but people just in all life, when something triggers you online, stop and explore that. Stop and question because that is probably an area of your life that you could use a little healing and work on. It could be a little bit of work. It could be a lot of work, but usually, when something triggers you, it's a challenge to look into it more because there is something that your body and mind have an unhealthy relationship with that needs to be addressed. Julie: Anyways, circling it back to risk. Meagan, take it away. Meagan: I just want to drop a shameless plug on our radical acceptance episodes that we did, so kind of piggybacking off of what she just said. We dive into that a little bit deeper in our radical acceptance episode. It really is so hard and like what she said, our heart goes out to moms that have a scheduled C-section that didn't want to schedule a C-section or felt like they were in a corner or felt like that was the best option, but not the option they wanted. There are so many feelings, but definitely go listen to radical acceptance part one and part two. 25:29 Risk of blood transfusion in VBAC, second C-section, and third C-sectionMeagan: I just want to quickly go down a couple of little risks. Blood transfusion– we have a 1.89% or 1 in 53 chance of a blood transfusion with a VBAC. To me, 1.89% is pretty low, to me, but it might not be to some. I don't know, Julie. How do you say the other? Okay, then blood transfusion in a repeat Cesarean is 1.65% in the second C-section. It's lower. So for vaginal birth, it's higher. I'm not good at math. Julie: No, vaginal birth, yeah. That's true. So 1 in 53 for VBAC versus a 1 in 65 for a repeat Cesarean. Yes, right. Meagan: For a third Cesarean, the chances of a blood transfusion go to 2.26%. Julie: Yes, so it's like 50% higher than if you have a VBAC for the third Cesarean, but it's slightly lower for the second C-section. See? I feel like we could have talked about this before, but I don't know if we say it often enough. When you are talking about overall risk for VBAC versus C-section, when you are looking at just the second birth, right? So first birth was a C-section, what are you going to do for your second birth? The risks overall are pretty similar for vaginal birth versus Cesarean. The overall total risk is pretty similar as far as your chances of having major complications and things like that. But when you get into three, four, five, six C-sections and vaginal births, that's when you really start to see significant changes in those risks. See? I used the word “significant” again, but we're going to talk about where the more C-sections you have, the higher your chances of having complications you have. The more vaginal births you have, your chances of complications actually go down. So when you are looking at if you want more than two kids, that might be something that you want to consider. If you are done with two kids, then that might be something that is not as big of a player in your choices. So yeah. Meagan: Yeah. Then there are things like twins. So when I was talking about it earlier, the word significantly, there was a systematic– I almost said something– systemic. Julie: Systemic review? Meagan: Yeah, see? I can't say it correctly. I can't. Published– oh, I'm trying to remember when it was published. We will get it in the show notes. It talks about the risk of uterine rupture with twins and it does say. It says “significantly higher in women with twin gestation”. That's kind of hard, I feel like because again, like we were saying, some reviews and studies and blogs and all of these things wouldn't say the word significantly. They may share a different one. I'm going to see if I can find the actual– maybe Julie can help me while I'm talking– study. Okay, it says three out of four studies in a group of zero cases of uterine rupture. Notably, the study with the largest patient population reported cases of uterine rupture in both groups and demonstrated a significantly greater risk of uterine rupture in the VBAC group. Meanwhile, the other three studies found no significant difference between rates of uterine rupture among groups 31-33. Nevertheless, the study shows that electing–”Okay, so I'm just going to say. It says, “Electing to have a PRCD reduces but does not eliminate the small risk of uterine rupture.” So what I'm reading here is that in some of them, it showed significantly greater, but then in 3 out of 4 reviews, and I don't even know actually how many people were in each of these reviews, but in 4 reviews, one had a greater risk and three didn't really show much of a difference, but we see that in the very beginning right here. “Uterine rupture is significantly higher in women with twins.” What do you think? If you are carrying twins and you see that, Julie, significantly higher enters into the vocabulary at all, what do you think?Julie: Well, I think I would want to schedule a C-section for my twins, probably. Meagan: Probably. 30:37 Understanding the meaning of statistical significance Julie: I want to just go off on a little tangent here for a second. I think it's really important when we are talking about studies that we know what statistically significant means because sometimes if you don't know much about digging into studies and things like that which I'm not going to go into too much right now– Meagan: It's difficult. Julie: It is difficult. It's really hard which is why I'm not going to go into it because I feel like we could have a whole hour-long podcast just for that. Statistically significant really just means that the difference or the increase or the change that they are looking into is not likely to be explained by chance or by random numbers which is why when you have a larger study, the results are more likely to be statistically significant because there is less room for error basically. A .1% increase can be just as statistically significant as a 300% increase because it just comes down to whether they are confident that it is a result that is not related to any chance or external environmental factors. I feel like it's really important to clarify that just because something is statistically significant doesn't mean that it's big, catastrophic, or a lot, it just means that it's not likely to be due to chance or anything random. 32:05 “The United States is intervention intensive.” Meagan: Yeah. I love that. Okay. There was one other thing I wanted to share. This was published in the Journal of Perinatal Education and it is a little more dated. It's been 10 years or so, but I just wanted to read it because it was really interesting to me. It doesn't even exactly go with risk and things, but it just talks about your chances which I guess, to me– do you know what I”m trying to say? Julie: They kind of go hand in hand. Meagan: To me, at least, they do. So when I read this, I was like, “Well, this is interesting.” I just wanted to drop it here and I think it's more just eye-opening. It says, “Maternity care in the United States is intervention intensive.” Now, if we didn't know this already, I don't know where I've been in the doula world for the last 10 years. Right? You guys, as doulas, obviously, we're not medical professionals, but as doulas, we see a lot of intervention and a lot of intervention that is completely unnecessary and a lot of intervention that leads to traumatic birth, unexpected or undesired outcomes and then they lead to other unnecessary interventions. It's the cascade. We talk about the domino effect or the cascade of interventions, but this is real so for them to type out, “Maternity care in the United States is intervention intensive–”Julie: You're like, “Yeah, where have you been?” Not you, but the writer. Meagan: Yeah, the writer. Yeah. It says, “The most recent national survey–” Now, again keep in mind it is 2024. This has been a minute since this was written. Julie: About 10+ years. Meagan: 10-12 years. Just keep that in mind. But it was interesting to me that even 10-12 years ago, this was where we were at because I feel like since I started as a doula, I've seen the interventions increase– the inductions, the unnecessary Cesareans increase a lot. Julie: Some of them, yeah. Yeah, especially inductions and Pitocin. Meagan: Not all of the time. I cannot tell you that in 10 out of 10 births that I attend, this is the case but through the years of me beginning doula work and what I have witnessed, it's increased. At least here in Utah, it seems that it has increased. It says, “The most recent national survey of women's pregnancy, birth, and postpartum experience reports that for women who gave birth in June 2011-2012,” so a little bit ago, “89% of women experienced electronic fetal monitoring.” Okay. Julie: That seems actually low to me for hospital births. Meagan: It does seem low because to me–Julie: I wonder if there had been a ton of stop and drops or something. Meagan: I don't know, but I agree. 89%. I feel like the second you get into the hospital, no matter VBAC or not, they want to monitor your baby. Julie: Strapped onto the monitor, yeah. Meagan: It says, “66% continuously.” So out of the 89%, it says 66% were continuously meaning they didn't do the intermittent every 30 minutes to an hour checking on baby for a quick 15 minutes to get another baseline, they just left that monitor on them which makes me wonder why. Usually, when a client of mine goes in and has that, they're like, “Oh, your baby had a weird decel so we are going to leave the monitor on longer,” and then they don't say anything. They just keep it on there. Maybe that's– I don't know. It says, “62% received intravenous fluids.” Julie: IV fluids. Meagan: Which to me, is also a lot. 36:27 Eating during labor and the risk of aspiration under anesthesiaMeagan: “79% experienced restrictions on eating.” 79%. You guys, we need to eat. We need to fuel our bodies. We are literally running a marathon times five in labor. We shouldn't be not eating, but 79% which doesn't surprise me, and “60% experienced restrictions on drinking in labor.” Why? Why are we being restricted from drinking and eating in labor unless we have other plans for how labor may go? Julie: That's exactly what it is. They're preparing you for an emergency Cesarean. That's what they're doing. That's exactly what restricting non-IV fluids is. It's not only that, but it is preparing you for the incredibly low risk of you having to go under general anesthesia, and then even people that go under general anesthesia have an incredibly low risk of aspirating and that is what it's coming down to. Don't even get me started on all of the flaws in all of the studies that went over aspiration during general anesthesia anyway because they are so significantly flawed that we are basing denying women energy and fuel during labor based on flawed studies that are incredibly outdated and on incredibly low risk during an incredibly already low risk. I mean, you probably don't want to down a cheeseburger while you're having a baby. I don't know. Maybe me. Just kidding. Even I didn't want a cheeseburger, but I wanted some little snacks, and some water to keep you hydrated. Yes. Oh my goodness. Let's please stop this. Sorry. Stepping off the soapbox. Meagan: You know, there is a provider here. I actually can't remember her name. It was way back in the beginning of my doula career and actually, it was in an area that is not one of my more common areas to serve. It was outside of my serving area. Anyway, we were at a birth and there was an induction. I remember being in there with her and the provider, an OB, walks in and is like, “Hey, how are you doing?” He was so friendly and kind and asked some questions like, “How are you feeling? What are you thinking about this?” Then she was getting ready to leave and she turned back and said, “Hey. I just thought about this. Have you eaten anything?” The mom was like, “No.” She was like, “Uh, you need to eat.” Julie: Yeah!Meagan: She had an epidural at this point. The mom was like, “Wait, what?” She was like, “You need to eat.” I literally remember my jaw falling, but had to keep my mouth up because I didn't want to look like I was weird. Anyway, I said, “That's something I've not usually heard from an OB especially after someone's had an epidural.” She was like, “Oh, I am very passionate about this.” She was like, “When I was finishing up school and graduating,” she had to write some big thing. Julie: Her dissertation probably. Meagan: Time capsule, I don't even remember what it was called. Some really, really big thing. She was like, “I specifically found passion about the lack of eating and drinking in labor.” She was like, “I did all of this stuff and what I found was you are more likely–” Here comes risk. “You are more likely to be struck in the head twice by lightning–” This is what she said. “Twice by lightning than you are to aspirate in a Cesarean after having an epidural.” Julie: I love this lady. Who is it? Meagan: I can't remember. I will have to text my client. Julie: Where was it? What hospital? Meagan: It was up in Davis County. Julie: Oh, interesting. Meagan: It was not an area for me. I said, “Whoa, really?” She said, “Yeah. You need to get that girl some food.” I was like, “Done. 100%.” Julie: More likely to get struck by lightning. Meagan: More likely to get struck by lightning twice in the head than you are to aspirate in a Cesarean after receiving an epidural. That stuck with me forever. Literally, here we are 10 years later. Julie: I love that because first of all–Meagan: I don't have documentation to prove that. She just said that. Julie: That is 100% relative risk. Aspirating during a C-section relative to getting struck by lightning twice. So that's cool. What are the numbers? I know that the numbers are super incredibly low and I feel like when you put in context like that, getting struck by lightning twice, I don't know anybody that's been struck by lightning once and who has been alive to tell about it. I know of a friend whose sister got struck by lightning and died when she was very young. I only know one person in my entire life who has been struck by lightning. Meagan: I just looked it up really quick. I don't even know if this is credible. I literally just looked it up really quickly. It says that the odds that one will be struck by lightning in the US during one's lifetime is 1 in 15,300. Julie: Wow. Meagan: Okay. Julie: So twice that is 1 in 30,000. That's a freaking low risk. Anyway, what I'm saying is that I love that OB first of all. I feel like from what I've read about aspiration under general anesthesia during a C-section seems right in line with those numbers and those chances because it's so rare, it's almost unheard of especially now with all of the technology that we have. It's fine because I'm not going to go on that soapbox. I love that. I love that analogy and that we're talking about that because 10 years from now or when our daughters are having babies, they're going to talk about how their poor moms couldn't eat when they were in labor because of the policies just like we talk about the twilight sleep and how our poor grandmas had to undergo twilight sleep when our moms were being born. I feel like that's just going to be one of those things where we will look back and be like, “What were we thinking?” 43:03 Epidurals, Pitocin, AROM, episiotomies, and C-section percentagesMeagan: Okay, I'm going to finish this off. It says, “67% of women who gave birth vaginally had an epidural during labor and 37% were given Pitocin to speed up their labors.” Sorry, but come on. That also may go to show, that we're going to do an epidural episode as well, that epidural maybe does really slow down labor. Maybe it really does impact the body's response to continuing labor in a natural way, so 31% of those people had to have help and assistance. It says, “20% of women had their membranes artificially ruptured,” which means they broke your bag of water artificially with the little whatever, breaking bag water hook thing versus it breaking spontaneously. Julie: Amniohook. Is it an amniohook? Meagan: Amniohook, yeah. “17% of women had an episiotomy.” I don't know. Julie: I feel like those numbers are probably lower now. Meagan: I think that's changed, yeah. “31% had a Cesarean.”Julie: That is right in line with the national average. Meagan: It is, still. “The high use of these interventions reflects a system-wide maternity care philosophy expecting trouble. There is an increasing body of research that suggests that the routine use of these interventions rather than decreasing the risk of trouble in labor and birth actually increases complications for both women and their babies.” 44:43 The perspective of birth doulas and birth photographersJulie: I believe it. Do you know what? Can I just get on another tangent here because I know that you all love my tangents? I really wish that somebody somewhere would do something and I don't know what that something is, to get the voices of birth doulas and birth photographers heard because this is why. Doulas and birth photographers– I've said this before. We see births in all of the places. We have a really, really unique point of view about birth in the United States because we attend births at home. We attend unassisted births. We attend births at home with unlicensed providers. We attend births at home and births at birth centers with licensed providers. We attend in-hospital births with midwives and we attend in-hospital births with OB/GYNs and some of us are lucky enough to attend out-of-hospital births with OB/GYNs because there are a handful of them floating around. We see birth in every single variety that it takes in the United States. I really wish that someone somewhere would do something to get those voices lifted and amplified because I feel like yes, a lot of that is going to be anecdotal, but I feel like the stories there have so much value with the state of our system in the relationship between home and hospital birth, how birth transfers happen when births need to be transported to hospitals, the mental health of the people giving birth, the providers and the care, and all of that. I feel like, like I said, somebody should do something to do something with all of that information that we all carry with us. I think it could provide so much value somewhere, right? I don't know what yet, but if anybody has an idea, message me. Find me on Instagram at @juliefrancombirth. Find me. Message me if you have any ideas. Maybe write a book or something. I don't know. Meagan: I've wanted to do an episode and title it “From a Doula's Perspective”. We could do that from a birth photographer and all that, but it's crazy. It's crazy. Julie: We see it all. Meagan: There was a birth just the other day with one of our sweet, dear clients where the provider was saying things that seemed scary even though the evidence of what was happening was really not scary, went into a scheduled induction, and the way they were handling it, I felt so guilty as a doula and I was like, “This is going to turn Cesarean. This is not good.” Sure enough, it did and it broke my heart because I was like, “None of that needed to happen,” but again, it goes to us deciding what's best for us. That mom had to decide what was best for her with the facts that we were giving, what the doctor was giving, and all of these things. Again, we don't judge anyone for the way they birth, but it's sometimes so hard to see people not get the birth they wanted or desired, or to have people literally doubt their ability because someone said something to them. Julie: Yeah. Meagan: You know–Julie: Yeah. I agree. It's just interesting. Anyways. Meagan: We are getting off our topic of risk, but risk is a hard conversation to have because there are different numbers. It can be presented differently and like I said, it can also have a tone to it that adds a whole other perspective. So know that if you are given a risk, it's okay to research that and question it and see if that really is the real risk and if that's the evidence-based information. We like to provide them here like we were saying earlier. We may be guilty and I hope you guys stick with us if we share some that might be a little jarring on both sides of the VBAC and C-section, but we love you. We're here for you. We understand risks are scary. They are also hard to break down and understand, but we are here for you. I love you guys and yeah. Anything else, Julie?Julie: No. I just want to say be kind to each other. Give each other the benefit of the doubt. Do everything you can to make the best decisions for you. Trust your intuition and find the right support team. We're all just trying to do our best– us at The VBAC Link, you as parents, providers as providers, and if you feel like you need to make a change, make it. Meagan: Make it. All right, okay everybody. We'll talk to you later. Julie: Bye!ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

In recent years, there has been a lot of buzz around “volcanic wines.” The term makes it sound as if these are wines that are spawned from a volcano, but in reality these are wines that many people believe have special qualities because they grow on volcanic soils.    In this show, I define the types of volcanoes before discussing the ecosystems they form.Here is the list of wines/places I discuss in the show:   Italy   Mount Etna, Sicily: Reds (Rosso of the Nerello Mascalese, Nerello Cappuccio grapes), whites (Bianco, mainly of the Carricante grape)   Soave, Veneto: Whites grown on specific hillsides (Garganega, Trebbiano di Soave grapes) Photo: Mount Etna. Source: Pexels   Campania Vesuvius: Whites of Coda di Volpe, Caprettone, Falanghina, Greco. Rosés and reds of Piedirosso, Aglianico, Sciacinoso Irpinia:  Taurasi DOCG and Aglianico del Taburno DOCG: Reds of the Aglianico grape. I mention Feudi di San Gregorio Fiano di Avellino: May or may not be affected by the volcanic soil Greco di Tufo DOCG: White of the Greco grape, the sulfur and compressed volcanic ash (tufo),and volcanic sand and clay, give the wines an acidity, minerality & flintiness that has clear volcanic influence    Basilicata: Aglianico del Vulture. Reds of Aglianico  Piedmont: Alto Piemonte. Red blends in Gattinara, Boca, Bramaterra Umbria/Lazio: Orvieto. Whites of Grechetto, Trebbiano Toscano ______________   Greece: Santorini - White of Assyrtiko. Lemnos -Red of Limnio   Spain: The Canary Islands/Las Canarias - Whites of Malvasîa Volcánica, Malvasîa Aromática, Listán Blanco. Reds of Listán Negro   Portugal: Açores islands (the Azores). Whites: Arinto, Verdelho, Fernão Pires, Terrantez    Hungary:  North of Lake Balaton in Somló, whites of the Juhfark grape Tokaji – sweet and dry whites of mainly the Furmint grape   US: Oregon's Willamette Valley Some parts of Napa, Lake County in California __________________________________________________________ Full show notes and all back episodes are on Patreon. Become a member today! www.patreon.com/winefornormalpeople _______________________________________________________________   Check out my exclusive sponsor, Wine Access.  They have an amazing selection -- once you get hooked on their wines, they will be your go-to! Make sure you join the Wine Access-Wine For Normal People wine club for wines I select delivered to you four times a year!    To register for an AWESOME, LIVE WFNP class with Elizabeth or get a class gift certificate for the wine lover in your life go to: www.winefornormalpeople.com/classes    

Focus and scalability is the key.Listen to Johan Lind - CEO & Co-founder of Vertiseit - in B2B SaaS CEOs!We discussed the importance of focus, why references and outbound is a great combo, building in scalability in all part of your operations, and much more.-Timeline:1:20 - Who is Johan Lind?2:30 - Vertiseit's elevator pitch3:10 - The story of Vertiseit4:20 - 5 quick ones6:00 - The future of retail9:30 - The opportunities with AI12:15 - Why Salesforce is a big role model14:45 - External question from from Lisa Kruse at HolyComms: "One of your core values is "dare to challenge". How do you build a culture where the challenge of status quo is part of the day to day operations? Can you tell us about certain activities or processes that help your team to deliver on this specific value?"19:40 - The first 3 things Johan would do re. the GTM strategy if he would start a new startup24:20 - Vertiseit's best marketing channels26:00 - Their outbound strategy28:10 - The best way to do outreach to Johan30:10 - A topic of Johan's choice: Scalability35:30 - His favourite life motto36:25 - The top things he would tell his younger self.-Do you want to book more meetings and increase your sales?Automate your outreach with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.Follow Josef Fallesen on LinkedIn: https://www.linkedin.com/in/joseffallesen/Follow Vaam on LinkedIn: https://www.linkedin.com/company/vaam-ioFollow Vaam on Youtube: https://www.youtube.com/@vaam.io-Johan's company Vertiseit is the leading platform company within Digital In-store in Europe.Read more about Vertiseit on: https://vertiseit.com/Follow Johan Lind on LinkedIn: https://www.linkedin.com/in/johanlindvertiseit/-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

We know that unique circumstances in pregnancy can make a VBAC feel farther out of reach. Do your chances of having a VBAC go down if you had preeclampsia in a previous pregnancy or your current one? What if you have a special scar? What are the chances of having a VBAC if you were diagnosed with “failure to progress”? What about fibroids or gestational diabetes? Julie Francom joins Meagan on today's episode discussing evidence-based research around all of these topics. They share personal experiences as birth workers and overall takeaways that can help you confidently navigate your VBAC journey no matter what complications arise during your pregnancy. Additional LinksSpecial Scars StudiesThe VBAC Link Blog: Why Failure to Progress in Labor is Usually Failure to WaitAJOG ArticleNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Timestamp Topics02:54 Review of the Week5:51 Preeclampsia08:57 Ask questions12:51 Special scars17:58 Failure to progress26:15 Fibroids27:54 Gestational Diabetes35:06 Find a supportive provider, ask questions, and educate yourselfTranscriptMeagan: Hello, hello everybody. We are getting out of winter and maybe into some spring weather, hopefully. I always hope for spring weather in March because it's my daughter's birthday and she always wants sunshine, not snow for her birthday. So I'm crossing my fingers that this is the month we have sunshine, not snow. I hope you guys are having a wonderful beginning– well, I guess it's not actually spring, but I hope you're having a wonderful beginning of March. We are kicking off our very first Monday episode for 2024. You guys, we have a little surprise for you. We are going to be sending out two, not just one, but two episodes a week. Make sure to tune in on Mondays and Wednesdays for stories and information. Today, we are kicking it off with Julie. Hello. Julie: Hey. I'm so happy to be here and yes, I'm hoping it's warm or getting there because I am just a popsicle permanently from November to March so let's just thaw out a little bit, please. Meagan: Just a little bit. Even if we just get some little sprinkles, let's have April showers in March. Julie: Yeah. Meagan: You guys, I am so excited for today's episode. Julie and I feel like these are some questions, I am definitely getting these questions on the weekly Q and A's, but these are some questions that are often asked and we want to answer your questions today. We're going to be talking about a whole bunch of things. Julie: A whole bunch of things. Meagan: What are the chances if I have preeclampsia? A special scar? Failure to progress?Julie: Gestational diabetes. Meagan: Gestational diabetes and maybe uterine fibroids. We are going to talk a little bit more about those. What are your chances for VBAC or vaginal birth if you have these things or have had them? Maybe you are not pregnant yet and you had preeclampsia last time or gestational diabetes last time. What are your chances? 02:54 Review of the WeekMeagan: So without further ado, I'm going to turn the time over to Julie for a review and we'll dive right in. Julie: Without further ado, here is Julie. Okay, this review is from Google. It is from Christa and she says, “This podcast is beyond empowering. After my C-section after multiple unnecessary interventions, I knew immediately I wanted a VBAC for my next baby. I found this podcast not long after and have been an avid listener for four years.” Four years, wow! Meagan: That's amazing. Julie: I know. “The VBAC link lifts the veil on birth and allows women to educate themselves and make their own decisions instead of just blindly trusting providers as many of us have in the past. Because of this podcast, the topic of birth/VBACs has become such a passion of mine and I now feel confident in my knowledge and ability to advocate for myself next time. I recommend this podcast to every mom and expectant parent I know. I am now pregnant with my second due March 2024–” Hey, that's right now– “and am already preparing and relistening to every episode and have the honor to have Meagan as my doula–” What?! That's awesome. “Hopefully you'll hear my successful VBAC story soon.” Meagan, this is your client. That's awesome. Meagan: I love it. I love it. Thank you, Christa. Julie: Maybe you'll be at a birth soon for her. Holy cow, that's amazing. Meagan: I know. I love it so much. I love that she said that we lift the veil. That was so cool. Yes. Julie: Yes. Meagan: Thank you. You guys, these reviews, as you can see, we are over here smiling and gleaming on this Zoom podcast. Julie: Smiling and gleaming. Meagan: Yes, we are. So if you wouldn't mind dropping us a review, your reviews truly help other Women of Strength find this podcast and find this platform. You can leave it on Google just like Christa did. You can go to Apple Podcasts. You can go to Spotify. Can you? I don't know if you can on Spotify. Google or you can just email us. Email us at info@thevbaclink.com with the subject “Review” and you never know, you might be read on the next podcast. 5:51 PreeclampsiaMeagan: Okay, Julie. Are you ready? Julie: Let's do it. Meagan: Always, right? Okay. Let's talk about preeclampsia. You had preeclampsia with your first that did end up ending in a Cesarean. However, you went on to have three HBACs. HBAC if you are just new with us is Home Birth After Cesarean. So yeah. I guess right there I want to point out is it possible to have preeclampsia and then go on and have a vaginal birth? Yes. Julie: Yeah. Yeah. Heck yeah, it is. Meagan: Yes, it is. Julie: I did it. You are speaking to the girl right here. Now, preeclampsia is kind of tricky because a lot of research shows according to the Preeclampsia Foundation. You can find it at preeclampsia.org. According to them, there is a suggested risk that you have a 20% chance of having preeclampsia again after you've had it the first time. However, there are some experts that site a range anywhere from 5% to 80% just depending on when you had it in your prior pregnancy, how bad it was, and any additional risk factors that you have. So I have had clients, most of my clients that have had preeclampsia once don't have it again, but I have had one client that has had it both times. My pediatrician had preeclampsia in both of her pregnancies. It really just depends on a lot of different risk factors, but preeclampsia also doesn't exclude you from having a VBAC. You're just going to have to get induced earlier for the safety of your baby usually around 37 weeks unless it is severe. They might want to induce you a little bit earlier than that. But yeah, I just feel like me and Meagan– I'm going to go off on a little bit of a tangent and then I'll bring it back. But me and Meagan were just talking about how a lot of these things– the biggest risk of VBAC is uterine rupture, right? That's what we talk about. But a lot of these other things like gestational diabetes and preeclampsia and big baby and all of these other things, the risks of those or the perceived risk sometimes don't have anything to do with VBAC. It's completely separate. It doesn't increase your risk uterine rupture. Not even big baby increases your risk of uterine rupture. There are no studies that support that. Preeclampsia and VBAC should be treated separately although a lot of times, providers don't treat it separately. They think, “Oh, you've had a C-section and preeclampsia so we should just schedule a C-section.” That is where provider bias comes into play and these perceptions when there are just not a lot of studies and evidence to support any of that, right? Anyways, circling it back to preeclampsia, there are lot of things you can do to make your body healthy overall that may reduce your chances of preeclampsia although I guess we are still not entirely certain about how preeclampsia comes about in the first place. But yeah. I don't know. What do you have to say about that, Meagan? 08:57 Ask questionsMeagan: Yeah. I think it's important to do what you were saying and separate the thought of, “If I have this, I have to do this,” when a lot of providers, especially if it is severe and we've got really, really high blood pressure and we are severe, they may specifically say, “You need to schedule a C-section,” but that doesn't necessarily mean you have to and if you have preeclampsia in general, it doesn't mean you are going to have a C-section. I think that's one of the biggest takeaways from this episode. Julie: There is no “have to” ever. There are no absolutes. Meagan: There is no “have to”. Yes. There are no absolutes. There are things where you may be at increased risk of Cesarean, but that's typically because of those things like induction, right? So yeah. There's really no concrete evidence on what mode of delivery is best if you have preeclampsia. So again, it comes down to your provider. Get a supportive provider. Talk about it. Really ask them. If they tell you, “Okay, because you have preeclampsia, we are going to have to schedule a C-section,” ask them. Do not stray away from getting the evidence and the information that you need. You can say, “Okay. Can we talk about the evidence of why I have to?” Right? Ask questions. Don't feel bad for asking questions. It's okay. If you have that question, ask it. Meagan: So yeah, I think that's kind of it. Julie: Yeah. I think the overall theme of this episode and maybe the whole entire VBAC Link period is asking questions to your provider, talking with your provider, and having a mutual trust with your provider where they trust you and you trust them. Right? It's a two-way street where you guys can collaborate together and create a plan of care that is comfortable with you and comfortable with them. I know that a lot of care is centered around the provider and what they are comfortable with. Some providers are not comfortable with doing VBAC for preeclampsia or after two or more Cesareans or after a special scar or with gestational diabetes or whatever. You need to have a plan that you are comfortable with and that your provider is comfortable with because I promise you that you don't want a provider who is nervous about your care because they are doing something they are not comfortable with. I feel like that's so important to have that mutual trust between yourself and your provider where they trust you that you are not going to do anything dangerous or stupid and you trust them that they are not going to do anything dangerous or stupid. Do you know what I mean? I say stupid loosely. That's a very medical term, “stupid”, but it's important. It's important that there is mutual trust that you can discuss your plan with your provider. If you're not on the same page with your provider, it might be a good idea to look for a different one. Meagan: Yeah, it's also important to ask, “Well, what are the chances of the negative outcomes for a scheduled C-section?” because on the NIH, and we'll make sure to include the links so you can read them, but it did say, “An increased risk of various postpartum complications was found in patients allocated directly to having a Cesarean section including blood loss.” When we have preeclampsia, it seems that we have a higher risk of issues potentially, but bleeding is not a great thing. We have platelets being affected and things like that, we may have increased chances of blood loss which we already know, Cesareans in general have an increased risk of blood loss. So you may want to ask questions about what kinds of risks you have if you do schedule a C-section with a scheduled C-section in general. What are the risks there? What are the risks to you and your baby there? Yeah. Anyway, ask questions. 12:51 Special scarsMeagan: Okay, we're going to talk about special scars. With a special scar, we do have a blog on that and it does have an attachment of a lot of studies and things that our favorite group of Facebook, Special Scars, Special Hope– is that? Am I brain farting? Julie: Mhmm. Meagan: If you have a special scar meaning you have anything other than a low transverse, so a J, a T, and all of those things, definitely check out that group. The unfortunate thing is that the studies we do have are not really up to date. We don't have a ton of concrete studies that are really recent or even large particular studies. So we want to talk about just in general, what are the chances if you have a classical or a special scar? The chances are there. You can still VBAC. There may be slightly increased chances of things like uterine rupture, but it is still possible. We have stories on our podcast even of people who have gone on to have vaginal births with special scars. I've supported a client that had a special scar. All was really well and they just took a little extra precaution. They wanted to make sure that they knew the signs of uterine rupture and they knew which I think everybody should. They wanted to make sure that baby was doing okay and mom was doing okay. All was well and it ended up beautifully. But all in all, I think in the end, it's going to come down to finding the support and finding that support. That can be tricky. What are the chances to have a vaginal birth with a special scar? Possible. I don't have a number for you. What are the chances of finding a supportive provider with having a special scar? Julie: Harder. Meagan: Lower. Yeah. It's going to be lower and that sucks. Julie: It does suck. It does suck. The special scars website at specialscars.org/studies has links to all of the notable studies, but the biggest studies that are out there show that your chances or uterine rupture are less than 2% with a special scar. I feel like that might be an acceptable risk for some parents and that might not be an acceptable risk for other parents. I feel like that's really important to acknowledge that what is an acceptable level of risk is different for everybody and each of your providers is going to have a different level of risk that they are comfortable with as well. The hard thing is that there are not a ton of studies on special scars but special scars are not just about if you have different C-section incisions. It's also about myomectomy, different types of uterine surgeries, and things like that. Basically, anything that is not in the lower uterine segment and has been cut or severed in some way. I don't know the right way, I don't know the nice way to say that, but if you have a history of any type of uterine surgery that is not on your lower uterine segment, that is considered a special scar. That could have absolutely nothing to do with pregnancy. Meagan: Yeah. Yeah. 17:58 Failure to progress Meagan: Okay, let's talk about failure to progress. What are your chances if your last Cesarean was due to failure to progress? Imagine me putting big, giant air quotes around “failure to progress”. You know, I don't know if this is one of those things I take to heart because it personally happened to me and I was told “failure to progress” and it kind of ticked me off, but your chances if you had a previous diagnosis of failure to progress to have a vaginal birth the next time around are pretty dang, stinking high. A lot of the time, failure to progress is due to certain factors like failure to wait, meaning a provider pushed or a mom– maybe you were like, “I'm done being pregnant. I want to be induced,” and your provider is like, “Cool, yeah. Let's do it.” Failure to wait for spontaneous labor or failure to wait for labor to kick in while you are in your induction. However, then they are like, “We've got to start getting this labor going. Let's start Pitocin. Let's start this and they are starting to intervene instead of just allowing the body to receive the induction method and then go forward. I feel like so often in the birth room, I personally, I don't know, Julie, maybe you would say something differently, but I personally see Pitocin being upped way too fast and often too much instead of going 2mL every 45 minutes or so. We are doing 2-4 mL every 30 minutes and we are not really giving our uterine receptors time to fully, fully react. Pitocin is actually usually quick. It can– what's the the terrm, Julie? The receiving time? I don't know. There is a term. Julie; Oh yeah. Meagan: It gets into your body quickly. Julie: Like how long it takes to take effect. Meagan: Yes. You know what I'm talking about. It actually reacts quickly. There is a quick reaction. However, to a full extent, sometimes it can take a little longer than a half hour fot the body to really, really kick in. Or maybe we are like, “Okay, let's start Pitocin then we will quickly break your water, “ and all of these things so we are not waiting for labor to kick in, we are just forcing labor whether it's spontaneous labor and things are going slow, then you get in and they check you in and they are pushing it or you are an induction. So, failure to wait. I personally don't know if there is actually any solid, solid evidence. Julie, you probably would because you are incredible on numbers, but on breaking water too early, I feel like so many times, we will see our clients in our practice be told they need to get their water broken and babies are at -2 station and we're at 2-3 centimeters. We haven't even gotten into a solid labor pattern and now we just open the floodgates. Baby is coming down in we don't even know what position then we have a harder labor. Now we're trying to intervene even more trying to get labor to go because maybe baby came down in a wonky position so labor is not starting and then it's the cascade there. I think avoiding AROM, artificial rupture of membranes, is something that we should particularly pay attention to. Maybe have a checklist of what is my contraction pattern like? What is my labor like? Is it all in my back? Is there maybe a sign that baby is in a wonky position right now? Because if so, it's going to be harder a lot of the time once that water breaks to get that baby to rotate. Not impossible, just harder. Is baby too high? Do we have a higher risk of cord prolapse? We're talking preeclampsia so “pre” is in my mind. Why are we breaking water at 2 centimeters to begin labor? Why don't we do something else and do a low-dose Pit or do a Foley to try and get us to a 4-centimeter state? I think that's something. Failure to wait, inducing too fast, introducing things, and then baby's position. That's another one that I think is a lot of the time for failure to progress. A lot of the time when our babies aren't in an awesome position, it can be harder to put an adequate amount of pressure on the cervix and dilate the cervix properly and in an “adequate time”. Anything else, Julie, that you think about failure to progress? I know I'm probably missing something. Julie: Yeah, no. You pretty much got it. I do have one thing to add though, but first, we have a blog called Why Failure to Progress is Usually Failure to Wait. It's at thevbaclink.com/failure-to-progress. I just want to say I feel like sometimes failure to progress is actually misdiagnosed because ACOG and the Society for Maternal-Fetal Medicine put out guidelines on what constitutes failure to progress. This is what the guidelines are. I'm just going to read it right from our blog. It's quoted right there and there is also a link to the guideline if you want to go to the blog and find the guideline. It says, “The new guideline says that a woman is not considered to be in active labor–” Okay, so first of all, you cannot be a failure to progress until you hit active labor. That's the first thing. Active labor is not until you are 6 centimeters dilated according to all of the guidelines that are out there. I was diagnosed with failure to progress and I was only 4 centimeters dilated so that was a misdiagnosis for sure. It says, “You cannot be considered–”Meagan: I was failure to progress as well at 3 centimeters. Julie: Yeah, for real. Everybody is I feel like. You are not considered to be in active labor until 6 centimeters dilated and “cannot be termed as failure to progress until she is at least 6 centimeters dilated–.” We just said that. “Her waters have ruptured and no cervical change has been made in 6 hours of labor.” Okay? You have to be at least 6 centimeters dilated. Your waters have to have been broken and you have no cervical change in 6 hours. Now, listen. A lot of the time we think of cervical change as only dilation. Cervical change is way more than just dilation, okay? Cervical change is where your cervix moves from the posterior to the anterior position. It straightens out. It ripens and softens which means it gets thinner. It not only opens but it gets thinner so that's effacement. If you go from 80% effaced to 90% effaced in 6 hours, that is cervical change. Meagan: That is change. Julie: That is not failure to progress. It gets softer. It effaces which thins. It dilates which opens. The baby's head rotating, flexes, and molds are all considered part of cervical change and baby is descending. If your baby goes from -1 station to 0 station and you don't dilate any further, that is still considered cervical change because the baby is moving downwards. So I feel like a lot of times, failure to progress is misdiagnosed and lots of other things could have helped progress that baby if like Meagan said, we were just patient and given more time. Meagan: Yes. I wanted to add to that. All of those things that Julie just said and sometimes, we might not be making changes like dilation or effacement necessarily, but our cervix that was really once posterior is now more anterior. Our cervix is coming more forward which to me, is a sign of change and that our body is working because sometimes, our cervix has to come forward to do some work. Julie: Yeah, that was the first thing I said. It moves from posterior to anterior. It straightens out. Meagan: Oh, I missed that. Yeah. I totally missed that. Julie: That's okay. Meagan: I just think it's so important to know that if you're not dilating, it doesn't mean you can't. Sorry, I totally missed your first half. Julie: No, you're totally fine. Meagan: Okay, anything else? Julie: No, I think that pretty much covers it. Like I said, all of the things that Meagan talked about and the link to those guidelines are in that blog that should be linked in our show notes. 26:15 FibroidsMeagan: Okay, so let's see. What else is one of the other ones? We wanted to talk about fibroids. This is something we don't talk about a ton actually but it's something that we get on our– did we talk about gestational diabetes? We did, right?Julie: We haven't yet. Meagan: That's what I want to talk about first. Julie: But fibroids, let's do fibroids because fibroids is pretty much the same as special scars. You have a surgery to remove your uterine fibroids and it leaves a scar. Meagan: Okay, yeah. Julie: And the scar is on some part of your uterus. It just depends on where the fibroids are. That would be similar to your chances of success with a special scar because it is a special scar. Meagan: Yeah, I guess so. I never even thought about it actually like that. A lot of people will be told that if they have a fibroid, they can't have a vaginal birth and there are studies that show you might have increased chances of a breech baby or preterm birth or even Cesarean because sometimes those fibroids can grow a lot and can cause some issues so there may be some increased chances of Cesarean, but that doesn't mean you can't have a vaginal birth. It should never not be considered. Like she was saying, sometimes people will also get those removed before they get pregnant so there's that to consider. Julie: Yeah, for sure. 27:54 Gestational DiabetesMeagan: Okay, let's go to gestational diabetes now. I feel like this one is a really hot topic and if you are listening and you had gestational diabetes with your pregnancy, with your VBAC, we actually are looking for some stories to share this year because it has been one of the most requested stories to get on the podcast. But let's talk about what are your chances of having a vaginal birth after a Cesarean with gestational diabetes. I think it is important to note that even despite you can be the healthiest you can possibly be and sometimes you can get gestational diabetes. We don't know exactly why sometimes. You should never shame yourself for having gestational diabetes. I feel like so many times, it's like, “Oh, I should have just been healthier.” I'm like, “No, no, no, no. That's not what we should be doing.” Then I think with gestational diabetes, sometimes we panic with trying to control our numbers and sometimes we cut eating or we don't necessarily manage the right way. I think with gestational diabetes, number one, try and learn how to manage it properly and to be as healthy as you can with it, but know that you do not have to have a C-section if you have gestational diabetes. However, you may have a provider who wants to induce your labor. When I say may, I don't know if I've ever ran into a client who had gestational diabetes and didn't get induced. Do you, Julie? Have you ever had a client that was not, even controlled gestational diabetes, that wasn't induced by at least 39 weeks? Julie: Yeah, but it was a home birth. I mean–Meagan: Okay. Julie: It was kind of complicated. There is more nuance to it than that, but yes. She had a home birth. Her gestational diabetes was managed well. It was even managed with insulin. That's all I'm going to say about that. Sorry. Meagan: No, that is just fine. That is just fine. Julie: Her baby was 6.5 pounds by the way. Meagan: Seriously, no. You haven't had a gestational client that hasn't had a provider aka a hospital provider I should say? Julie: Well, no. Actually no, yeah. I just had one but she was induced too. Yeah. The nurse I was telling you about. Meagan: She was induced. Julie: She was induced. Meagan: I've never had a client who has not been induced so that is something that you probably need to take note of. If you have gestational diabetes, you may have a discussion coming your way from your provider about being induced. Julie: Well, all of the guidelines and recommendations from ACOG are to induce at 39 weeks right now. Meagan: Exactly. I just want people to know that that could most likely be a thing. It's not that they are not, like she said, following evidence. That is what is suggested by ACOG, but just know that that can be. We know that potentially an induction could increase the chances of C-section because we have all of the things we were just talking about earlier, all of the interventions that could lead to failure to progress or baby in a wonky position or baby is not tolerating it well or maybe your body wasn't quite ready to be induced yet and is not responding properly to the medication that they are wanting to give you. But in a journal by the American Journal of Obstetrician and Gynecology which is an off-shot journal of ACOG, they said, “In a total of 1,957,739 women were eligible for TOLAC across the study period, 386,092 underwent a TOLAC. Overall, 74.0% of non-diabetics, 74.0% of non-diabetic, 69.1% of gestational diabetic, and 58.2% of pre-gestational diabetic mothers achieved a VBAC.” I'm looking at those numbers and I'm like, “Okay, those are pretty good.” It says that in general, there were some lower odds with large gestational for age infants, babies, so we already know that the big baby thing, sometimes providers are scared of big babies or babies coming down wonky or there is whatever, so sometimes big babies will be taken by Cesarean. However, it's also to note that if your baby is suspected as large, that doesn't mean they are large. Also, if they are large, it doesn't mean they can't come out vaginally. We have lots of people who have big babies that come out vaginally. Julie has personally attended a birth. Wasn't it 11 pounds? Her baby? That home birth, do you remember? Julie: Shoot, I'm trying to remember. Which one? I've had several. Meagan: Her name starts with an L. She is little, you guys. Julie: Oh, okay yeah. With an A, not an L. Yeah. Her baby was 10 pounds, 7 ounces I think. Meagan: Okay, yeah. Julie: Her most recent one, but all of her babies– well, not all. One was just a 7-pounder, but 9-10 pounds. Meagan: I totally thought that her other baby was just over 11. Julie: No, not 11. But she is 5'2”. She is little teeny. A little teeny girl. Meagan: Yeah. So it is possible. Knowing that if you have gestational diabetes, you will more than likely be induced, I think that if you do have gestational diabetes, control it as much as you can and prepare for induction and learn all of the things that you can about induction. We will have in the show notes a link for all of the things. We will have the ways to self-induce or all of those things– not self-induce, but induce non-medically and the ways to induce with a provider and the pros and cons on that, so check that out. Julie: Right. Also, I think it's important to note that there are other complications with gestational diabetes besides just big babies. Inducing at 39 weeks has been shown to reduce the chances of these things happening because the more pregnant you are, the higher your chances are of these things.Meagan: Preeclampsia is one of them, right? Julie: Yep. Hypertension which is high blood pressure, preeclampsia, lower blood sugar, obviously, and higher chances of a bigger baby for sure. We just talked about that. Up into needing a C-section as well. There is some pretty sound evidence for inducing at 39 weeks just because it will decrease your chances of developing those complications during pregnancy as well, but yes. Meagan: Yeah, so all around, just doing the education, getting the education, looking at the information, and making the best choice for you. Julie: Yeah. Meagan: Okay. What else do we have? Is that about everything? I think that's about everything. Julie: Yeah, I think we talked about it all. 35:06 Find a supportive provider, ask questions, and educate yourselfMeagan: All around, at the end of the day, I think some of the biggest things to take away from this episode that you can do is find a supportive provider. How often do we stress that? Find a supportive provider. We have, if you didn't know in our VBAC Link Facebook group, we actually have a list of VBAC-supportive providers under the Files tab. If you are not part of our VBAC Link Community on Facebook, check it out, answer the questions, and you go find that file. You can find your state or even country and see if there is a provider on there that is supportive. Also, if you have a name of a provider that you don't see on that list, please send it over to us with their location and name so we can add to that list and help more Women of Strength find the support that they deserve. Ask questions. Asking questions is powerful and it's not done enough. I feel like if I look back at all of my pregnancies, even my VBAC, I don't think I even asked nearly enough questions to statements that were made or just in general, so ask questions. If you are unsure of something or something is being told to you, ask the questions. And get the information. Educate yourself. Education is power. It is so powerful and you need it. You truly need it. Check out our blogs. Check out this podcast. Keep listening to all of these stories. Every single episode that we put out every single week is going to have little nuggets of information for you. You might be blown away to find out how many of these stories actually relate so much to yours. We also have a VBAC course that Julie and I spent a lot of hours putting together and wanted to bring all of the evidence to you in a– I want to say regurgitated form from studies because I feel like we read those studies. You can read them and it's like, “Wait, what?” We regurgitated it back into English and presented these facts to you and gave you all of the things about the history of C-sections, the pros and cons of VBAC, uterine rupture signs, and all of the things, so check out our course. Then, of course, check out our Instagram and Facebook. We are always putting information out there and learning from our community on our Q and A's on Thursdays. Other than that, I just wanted to thank you guys for being here and of course, Julie, thank you for being with me. I always love when I get to see your face and record with you. It's just something I miss all the time. Julie: Yay. Always a pleasure. Perfect, well thank you so much for having me. It's always fun. 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

The most important thing connected to a successful Go-to-Market strategy, how you cultivate a positive commercial team culture!Listen to Johan Jarskog - CEO at NEXT - in B2B SaaS CEOs.We talk about creating a positive commercial team culture, why 50% inbound and 50% outbound is a great mix, what's the most important things in a great sales process, and much more.-Timeline:1:15 - Who is Johan Jarskog?2:15 - NEXT's elevator pitch3:50 - The core of a great GTM-strategy: Cultivating a positive commercial team culture12:10 - NEXT's best marketing channels14:00 - The most important things in a great sales process19:00 - The best way to do outreach to Johan.20:30 - External question from Anna Borgslycka from Rekryteringsmässan Online:"In a future where you don't work at Next anymore - what would you dedicate your time to?"22:10 - A topic of Johan's choice26:45 - His favourite life motto.28:00 - The top things he would tell his younger self.-Do you want to book more meetings and increase your sales?Automate your outreach with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.Follow Josef Fallesen on LinkedIn: https://www.linkedin.com/in/joseffallesen/Follow Vaam on LinkedIn: https://www.linkedin.com/company/vaam-ioFollow Vaam on Youtube: https://www.youtube.com/@vaam.io-Johan's company NEXT helps you manage your construction projects seamlessly with their fully cloud-based tools. Save time & money while boosting the efficiency and coordination of your team.Read more about NEXT on: https://next-tech.com/en/Follow Johan Jarskog on LinkedIn: https://www.linkedin.com/in/jarskog/-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

You should just keep it simple.Listen to Rickard Kajson - CEO at Grade - in B2B SaaS CEOs!We talk about how you successfully scale a team, why you should create a simple GTM playbook, fail fast, and much more.-Timeline:1:30 - Who is Rickard Kajson?2:50 - Grade's elevator pitch.3:30 - The story of Grade.7:30 - External question from Tony Rush at Meetric: "Knowing what we know today about the impact of AI in SaaS solutions, as a leader, if you were to rewind to 2020, what is the first thing you would implement into Grade?"9:00 - A topic of Rickard's choice: Target alining16:30 - The core of a great GTM-strategy: Create a common playbook.22:00 - The first 3 things Rickard would do re. the sales process if he would start a new startup.24:00 - The best way to do outreach to Rickard.26:00 - External question from from Carin Gunnstam at BONI: "What's your best tips for scaling the team successfully, and to keep that startup vibe and culture while dealing with the challenges of growth?"29:00 - His favorite books: Crossing the Chasm by Geoffrey A Moore, and Great by Choice by Jim Collins.29:45 - His favourite life motto.30:20 - The top things he would tell his younger self.-Do you want to book more meetings and increase your sales?Automate your outreach with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.Follow Josef Fallesen on LinkedIn: https://www.linkedin.com/in/joseffallesen/Follow Vaam on LinkedIn: https://www.linkedin.com/company/vaam-ioFollow Vaam on Youtube: https://www.youtube.com/@vaam.io-Rickard's company Grade helps you recruit, develop, and retain employees.Read more about Grade on: https://www.grade.com/Follow Rickard Kajson on LinkedIn: https://www.linkedin.com/in/rickard-kajson-32576312/-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

Why you should find your favourite competitor.Listen to Mads Fosselius - CEO & Co-founder of Dixa - in B2B SaaS CEOs!We discussed why you should find your favourite competitor, Community-led growth, the first three things Mads would do re. the sales process if he would start a new startup, why you should leverage your network when doing outreach, and much more.-Timeline:1:30 - Who is Mads Fosselius?3:25 - Dixa's elevator pitch.6:00 - The story of Dixa.9:40 - External question from from Pontus Bäckman at SEO AI: "Building a large and strong team is often a challenge, what is your best tip for finding and attracting good talent to a growing SaaS start-up?"12:10 - A topic of Mads' choice: Find your favourite competitor.17:30 - The core of a great GTM-strategy.24:40 - The first 3 things Mads would do re. the sales process if he would start a new startup.29:00 - The best way to do outreach to Mads.31:20 - His favorite book: Play Bigger by Al Ramadan, Dave Peterson, Christopher Lochhead and Kevin Maney.32:20 - Mads' favourite life motto.33:50 - The top things he would tell his younger self.-Do you want to book more meetings and increase your sales?Automate your outreach with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.Follow Josef Fallesen on LinkedIn: https://www.linkedin.com/in/joseffallesen/Follow Vaam on LinkedIn: https://www.linkedin.com/company/vaam-ioFollow Vaam on Youtube: https://www.youtube.com/@vaam.io-Mads' company Dixa helps you create effortless service experiences for teams and customers that unlock loyalty at scale.Read more about Dixa on: https://www.dixa.com/Follow Mads Fosselius on LinkedIn: https://www.linkedin.com/in/madsfosselius/-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

Why video is the future of marketing.Listen to Peder Bonnier - CEO & Co-founder of Storykit - in B2B SaaS CEOs!We discussed why you must use video, why the future of marketing is higher and higher frequency, building the product they self needed, Storykit's best marketing channels, and much more.-Timeline:1:35 - Storykit's elevator pitch.2:50 - The story of Storykit.14:30 - 5 quick ones.16:20 - Video: For everything, for everyone.18:00 - The future of marketing.22:45 - External question from Therése Olsson: "I know video is powerful when it comes to sales and marketing, but it would be interesting to hear some concrete numbers regarding exactly HOW much more powerful it is than text?"26:15 - Storykit's best marketing channels28:30 - The best way to do outreach to Peder.31:00 - A topic of Peder's choice: Growth35:10 - The top things he would tell his younger self.-Do you want to book more meetings and increase your sales?Automate your outreach with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.Follow Josef Fallesen on LinkedIn: https://www.linkedin.com/in/joseffallesen/Follow Vaam on LinkedIn: https://www.linkedin.com/company/vaam-ioFollow Vaam on Youtube: https://www.youtube.com/@vaam.io-Peder's company Storykit is a complete AI video creation tool transforming your content into high-performing video.Read more about Storykit on: https://storykit.io/Follow Peder Bonnier on LinkedIn: https://www.linkedin.com/in/peder-bonnier-0a9105a3/-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

How you go from 1 to more than 650 people.Listen to Niklas Hedin - CEO & Founder of Centiro - who has build a successful global SaaS company without external funding!We discussed how you go from 1 to 650 people, getting to the bottom of why your customers should care about you, leadership, the best way to do outreach, and much more.-Timeline:1:40 - Who is Niklas Hedin?3:00 - Centiro's elevator pitch.5:15 - The Why behind Centiro.9:25 - External question from a listener from Richard Coster at Tullify: "You have had a very inspiring journey. What would you say is the worst thing you've gone through as an entrepreneur? And what's the biggest lesson you've learned?"13:45 - A topic of Niklas' choice: From 1 to 650 people.25:50 - The core of a great GTM-strategy.30:00 - The best way to do outreach to Niklas.34:00 - His favorite book: Creativity, Inc. by Ed Catmull.35:10 - Niklas' favourite life motto.36:00 - The top things he would tell his younger self.-Do you want to get more booked meetings and increase your sales?Automate your outreach with LinkedIn, email, phone, and automated personalized video by using Vaam.Try Vaam for free on vaam.io.Follow Josef Fallesen on LinkedIn: https://www.linkedin.com/in/joseffallesen/Follow Vaam on LinkedIn: https://www.linkedin.com/company/vaam-ioFollow Vaam on Youtube: https://www.youtube.com/@vaam.io-Niklas' company Centiro is an innovator of cloud services for managing flows of goods in e-commerce, logistics and industry.Read more about Centiro on: https://www.centiro.com/-The music: Learning - Averro, AROM, Tore Phttps://open.spotify.com/track/5GOQtwi7xTnEoNqHrBOWem?si=4365c043e90e4444 Hosted on Acast. See acast.com/privacy for more information.

SHOW NOTES   If your birth attendant wants to do what's called an "artificial rupture of membranes" also called "AROM" or they may just say they want to break your water...should you let them? Today's episode is going to help you understand what it means and whether you should consent to it.     Helpful Links: ** USE COUPON CODE "BDAY" AT CHECKOUT NOW THROUGH NEXT WEDNESDAY 12/12/23 TO GET 10% OFF THE COURSE OR A MIDWIFE AND ME POWER HOUR AT THE LINKS BELOW!!! **   Now YOU can have access to the entire Christian childbirth course conducted LIVE this summer!  Sign up HERE for the Your Birth, God's Way Online Christian Childbirth Course - Replay Edition!  This is a COMPLETE childbirth education course with a God-led foundation taught by a certified nurse-midwife with over 20 years of experience in all sides of the maternity world.  Learn more or sign up HERE!   Sign up for your PERSONALIZED Pregnancy Coaching Midwife & Me Power Hour HERE These consults can include: birth plan consultation, past birth processing, second opinions, breastfeeding consultation, and so much more!  Think of it as a special, one-hour appointment with a midwife to discuss whatever your concerns may be without any bias of practice policy or insurance policy influencing recommendations.   Lori's Recommended Resources HERE   Sign up for email updates Here   Be heard! Take My Quick SURVEY --> https://bit.ly/yourbirthsurvey   Got questions?  Email lori@yourbirthgodsway.com   Join Our Exclusive Online Birth Community -- facebook.com/groups/yourbirthgodsway   Learn more about Lori and the podcast at yourbirthgodsway.com!   If you die today, do you know where you're going? Can you be sure?  Let there be no doubt!  Let's study together here!   DISCLAIMER:  Remember that though I am a midwife, I am not YOUR midwife.  Nothing in this podcast shall; be construed as medical advice.  Listening to this podcast does not mean that we have entered into a patient-care provider relationship. While I strive to provide the most accurate information I can, content is not guaranteed to be 100% accurate.  You must do your research and consult other reputable sources, including your provider, to make the best decision for your own care.  Talk with your own care provider before putting any information here into practice.  Weigh all risks and benefits for yourself knowing that no outcome can be guaranteed.  I do not know the specific details about your situation and thus I am not responsible for the outcomes of your choices.    Some links may be affiliate links which provide me a small commission when you purchase through them.  This does not cost you anything at all and it allows me to continue providing you with the content you love.

DNS Podcast 207 w/ Dave Crosland & Scott McNally TIME STAMPS BELOW