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Originally aired in June 2019 as our 73rd episode, we still often think back to this amazing first conversation we had with Dr. Stuart Fischbein and Midwife Blyss Young!Now, almost 6 years later, the information is just as relevant and impactful as it was then. This episode was a Q&A from our Facebook followers and touches on topics like statistics surrounding VBAC, uterine rupture, uterine abnormalities, insurance companies, breech vaginal delivery, high-risk pregnancies, and a powerful analogy about VBACs and weddings!Birthing Instincts PatreonBirthing BlyssNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hey, guys. This is one of our re-broadcasted episodes. This is an episode that, in my opinion, is a little gem in the podcast world of The VBAC Link. I really have loved this podcast ever since the date we recorded it. I am a huge fan of Dr. Stu Fischbein and Midwife Blyss and have been since the moment I knew that they existed. I absolutely love listening to their podcast and just all of the amazing things that they have and that they offer. So I wanted to rebroadcast this episode because it was quite down there. It was like our 73rd episode or something like that. And yeah, I love it so much. This week is OB week, and so I thought it'd be fun to kick-off the week with one of my favorite OB doctor's, Stuart Fischbein. So, a little recap of what this episode covers. We go over a lot. We asked for our community to ask questions for these guys, and we went through them. We didn't get to everything, so that was a bummer, but we did get to quite a bit. We talked about things like the chances of VBAC. We talked about the chances of uterine rupture and the signs of uterine rupture. We talked about inducing VBAC. We talked about uterine abnormalities, the desire of where you want to birth and figuring that out. And also, Blyss had a really great analogy to talk about what to do and how we're letting the medical world and insurance and things like that really contemplate where we or dictate where we are birthing. I love that analogy. You guys, seriously, so many questions. It's an episode that you'll probably want to put on repeat because it really is so great to listen to them, and they just speak so directly. I can't get enough of it. So I'm really excited for you guys to dive in today on this. However, I wanted to bring to your attention a couple of the new things that they've had since we recorded this way back when. I also wanted to point out that we will have updated notes in the show notes or updated links in the show notes so you can go check, them out. But one of the first things I wanted to mention was their Patreon. They have a Patreon these days, and I think that it just sounds dreamy. I think you should definitely go find in their Patreon their community through their Patreon. You can check it out at patreon.com, birthinginsinctspodcast.com and of course, you can find them on social media. You can find Dr. Stu at Birthing Instincts or his website at birthinginsincts.com. You can find Blyss and that is B-L-Y-S-S if you are looking for her at birthingblyss on Instagram or birthinblyss.com, and then of course, you can email them. They do take emails with questions and sometimes they even talk about it on their podcast. Their podcast is birthinginsinctspodcast.com, and then you can email them at birthinginsinctspodcast@gmail.com, so definitely check them out. Also, Dr. Stu offers some classes and workshops and things like that throughout the years on the topic of breech. You guys, I love them and really can't wait for you to listen to today's episode.Ladies, I cannot tell you how giddy and excited I have been for the last couple weeks since we knew that these guys were going to record with us. But we have some amazing, special guests today. We have Dr. Stuart Fischbein and Midwife Blyss Young, and we want to share a little bit about them before we get into the questions that all of you guys have asked on our social media platforms.Julie: Absolutely. And when Meagan says we're excited, we are really excited.Meagan: My face is hot right now because I'm so excited.Julie: I'm so excited. Meagan was texting me last night at 11:00 in all caps totally fan-girling out over here. So Dr. Stu and midwife Blyss are pretty amazing and we know that you are going to love them just as much as we do. But before we get into it, and like Meagan said, I'm just going to read their bios so you can know just how legit they really are. First, up. Dr. Stuart Fischbein, MD is a fellow of the American College of Obstetrics and Gynecology, and how much we love ACOG over here at The VBAC Link He's a published author of the book Fearless Pregnancy: Wisdom and Reassurance from a Doctor, a Midwife, and a Mom. He has peer-reviewed papers Home Birth with an Obstetrician, A Series of 135 Out-of-Hospital Births and Breech Births at Home, Outcomes of 60 Breech and 109 Cephalic Planned Home and Birth Center Births. Dr. Stu is a lecturer and advocate who now works directly with home birthing midwives. His website is www.birthinginsincts.com, and his podcast is Dr. Stu's Podcast. Seriously guys, you need to subscribe.Meagan: Go subscribe right now to their podcast.Yeah. The website for his podcast is drstuspodcast.com. He has an international following. He offers hope for women who cannot find supportive practitioners for VBAC and twin and breech deliveries. Guys, this is the home birth OB. He is located in California. So if you are in California hoping for VBAC, especially if you have any special circumstance like after multiple Cesareans, twins or breech presentation, run to him. Run. Go find him. He will help you. Go to that website. Blyss, Midwife Blyss. We really love them. If you haven't had a chance to hear their podcast guys, really go and give them a listen because this duo is on point. They are on fire, and they talk about all of the real topics in birth. So his partner on the podcast is Blyss Young, and she is an LM and CPM. She has been involved in the natural birth world since the birth of her first son in 1992, first as an advocate, and then as an educator. She is a mother of three children, and all of her pregnancies were supported by midwives, two of which were triumphant, empowering home births. In 2006, Blyss co-founded the Sanctuary Birth and Family Wellness Center. This was the culmination of all of her previous experience as a natural birth advocate, educator and environmentalist. The Sanctuary was the first of its kind, a full-spectrum center where midwives, doctors, and other holistic practitioners collaborated to provide thousands of Los Angeles families care during their prenatal and postpartum periods. Blyss closed the Sanctuary in 2015 to pursue her long-held dream of becoming a midwife and care for her clients in an intimate home birth practice similar to the way she was cared for during her pregnancies. I think that's , why Meagan and I both became doulas. Meagan: That's exactly why I'm a doula. Julie: We needed to provide that care just like we had been cared for. Anyway, going on. Currently, Blyss, AKA Birthing Blyss, supports families on their journey as a birth center educator, placenta encapsulator and a natural birth and family consultant and home birth midwife. She is also co-founder of Just Placentas, a company servicing all of Southern California and placenta encapsulation and other postpartum services. And as ,, she's a co-host on Dr. Stu's Podcast. Meagan: And she has a class. Don't you have a class that you're doing? Don't you have a class? Midwife Blyss: Yeah. Meagan: Yeah. She has a class that she's doing. I want to just fly out because I know you're not doing it online and everything. I just want to fly there just to take your class.Midwife Blyss: Yeah, it's coming online.Meagan: It is? Yay! Great. Well, I'll be one of those first registering. Oh, did you put it in there?Julie: No, there's a little bit more.Meagan: Oh, well, I'm just getting ahead.Julie: I just want to read more of Blyss over here because I love this and I think it's so important. At the heart of all Blyss's work is a deep-rooted belief in the brilliant design of our bodies, the symbiotic relationship between baby and mother, the power of the human spirit and the richness that honoring birth as the rite of passage and resurrecting lost traditions can bring to our high-tech, low-touch lives. And isn't that true love? I love that language. It is so beautiful. If I'm not mistaken, Midwife Blyss's website is birthingblyss.com.Is that right? And Blyss is spelled with a Y. So B-L-Y-S-S, birthingblyss.com, and that's where you can find her.Midwife Blyss: Just to make it more complicated, I had to put a Y in there.Julie: Hey. I love it.Meagan: That's okay.Julie: We're in Utah so we have all sorts of weird names over here.Meagan: Yep. I love it. You're unique. Awesome. Well, we will get started.Midwife Blyss: I did read through these questions, and one of the things that I wanted to say that I thought we could let people know is that of course there's a little bit more that we need to take into consideration when we have a uterus that's already had a scar.There's a small percentage of a uterine rupture that we need to be aware of, and we need to know what are the signs and symptoms that we would need to take a different course of action. But besides that, I believe that, and Dr. Stu can speak for himself because we don't always practice together. I believe that we treat VBAC just like any other mom who's laboring. So a lot of these questions could go into a category that you could ask about a woman who is having her first baby. I don't really think that we need to differentiate between those.Meagan: I love it. Midwife Blyss: But I do think that in terms of preparation, there are some special considerations for moms who have had a previous Cesarean, and probably the biggest one that I would point to is the trauma.Julie: Yes.Midwife Blyss: And giving space to and processing the trauma and really helping these moms have a provider that really believes in them, I think is one of the biggest factors to them having success. Meagan: Absolutely. Midwife Blyss: So that's one I wanted to say before you started down the question.Meagan: Absolutely. We have an online class that we provide for VBAC prep, and that's the very first section. It's mentally preparing and physically preparing because there's so much that goes into that. So I love that you started out with that.Julie: Yeah. A lot of these women who come searching for VBAC and realize that there's another way besides a repeat Cesarean are processing a lot of trauma, and a lot of them realized that their Cesarean might have been prevented had they known better, had a different provider, prepared differently, and things like that. Processing that and realizing that is heavy, and it's really important to do before getting into anything else, preparation-wise.Meagan: Yeah.Midwife Blyss: One of the best things I ever had that was a distinction that one of my VBAC moms made for me, and I passed it on as I've cared for other VBAC mom is for her, the justification, or I can't find the right word for it, but she basically said that that statement that we hear so often of, "Yeah, you have trauma from this, or you're not happy about how your birth went, but thank God your baby is healthy." And she said it felt so invalidating for her because, yes, she also was happy, of course, that her baby was safe, but at the same time, she had this experience and this trauma that wasn't being acknowledged, and she felt like it was just really being brushed away.Julie: Ah, yeah.Midwife Blyss: I think really giving women that space to be able to say, "Yes, that's valid. It's valid how you feel." And it is a really important part of the process and having a successful vaginal delivery this go around.Dr. Stu: I tend to be a lightning rod for stories. It's almost like I have my own personal ICAN meeting pretty much almost every day, one-on-one. I get contacted or just today driving. I'm in San Diego today and just driving down here, I talked to two people on the phone, both of whom Blyss really just touched on it is that they both are wanting to have VBACs with their second birth. They were seeing practitioners who are encouraging them to be induced for this reason or that reason. And they both have been told the same thing that Blyss just mentioned that if you end up with a repeat Cesarean, at least you're going to have a healthy baby. Obviously, it's very important. But the thing is, I know it's a cliche, but it's not just about the destination. It's about the journey as well. And one of the things that we're not taught in medical school and residency program is the value of the process. I mean, we're very much mechanical in the OB world, and our job is to get the baby out and head it to the pediatric department, and then we're done with it. If we can get somebody induced early, if we can decide to do a C-section sooner than we should, there's a lot of incentives to do that and to not think about the process and think about the person. There's another cliche which we talk about all the time. Blyss, and I've said it many times. It's that the baby is the candy and the mother's the wrapper. I don't know if you've heard that one, but when the baby comes out, the mother just gets basically tossed aside and her experience is really not important to the medical professionals that are taking care of her in the hospital setting, especially in today's world where you have a shift mentality and a lot of people are being taken care of by people they didn't know.You guys mentioned earlier the importance of feeling safe and feeling secure in whatever setting you're in whether that's at home or in the hospital. Because as Blyss knows, I get off on the mammalian track and you talk about mammals. They just don't labor well when they're anxious.Julie: Yep.Dr. Stu: When the doctor or the health professional is anxious and they're projecting their anxiety onto the mom and the family, then that stuff is brewing for weeks, if not months and who knows what it's actually doing inside, but it's certainly not going to lead to the likelihood of or it's going to diminish the likelihood of a successful labor.Julie: Yeah, absolutely. We talk about that. We go over that a lot. Like, birth is very instinctual and very primal, and it operates a very fundamental core level. And whenever mom feels threatened or anxious or, or anything like that, it literally can st or stop labor from progressing or even starting.Meagan: Yeah, exactly. When I was trying to VBAC with my first baby, my doctor came in and told my husband to tell me that I needed to wake up and smell the coffee because it wasn't happening for me. And that was the last, the last contraction I remember feeling was right before then and my body just shut off. I just stopped because I just didn't feel safe anymore or protected or supported. Yeah, it's very powerful which is something that we love so much about you guys, because I don't even know you. I've just listened to a million of your podcasts, and I feel so safe with you right now. I'm like, you could fly here right now and deliver my baby because so much about you guys, you provide so much comfort and support already, so I'm sure all of your clients can feel that from you.Julie: Absolutely.Dr. Stu: Yeah. I just would like to say that, know, I mean, the introduction was great. Which one of you is Julie? Which one's Meagan?Julie: I'm Julie.Meagan: And I'm Meagan.Dr. Stu: Okay, great. All right, so Julie was reading the introduction that she was talking about how if you have a breech, you have twins, if you have a VBAC, you have all these other things just come down to Southern California and care of it. But I'm not a cowboy. All right? Even though I do more things than most of my colleagues in the profession do, I also say no to people sometimes. I look at things differently. Just because someone has, say chronic hypertension, why can't they have a home birth? The labor is just the labor. I mean, if her blood pressure gets out of control, yeah, then she has to go to the hospital. But why do you need to be laboring in the hospital or induced early if everything is fine? But this isn't for everybody.We want to make that very clear. You need to find a supportive team or supportive practitioner who's willing to be able to say yes and no and give you it with what we call a true informed consent, so that you have the right to choose which way to go and to do what's reasonable. Our ethical obligation is to give you reasonable choices and then support your informed decision making. And sometimes there are things that aren't reasonable. Like for instance, an example that I use all the time is if a woman has a breech baby, but she has a placenta previa, a vaginal delivery is not an option for you. Now she could say, well, I want one and I'm not going to have a C-section.Julie: And then you have the right to refuse that.Dr. Stu: Yeah, yeah, but I mean, that's never going to happen because we have a good communication with our patients. Our communication is such that we develop a trust over the period of time. Sometimes I don't meet people until I'm actually called to their house by a midwife to come assist with a vacuum or something like that. But even then, the midwives and stuff, because I'm sort of known that people have understanding. And then when I'm sitting there, as long as the baby isn't trouble, I will explain to them, here's what's going to happen. Here's how we're going to do it. Here's what's going on. The baby's head to look like this. It not going be a problem. It'll be better in 12 hours. But I go through all this stuff and I say, I'm going to touch you now. Is that okay? I ask permission, and I do all the things that the midwives have taught me, but I never really learned in residency program. They don't teach this stuff.Julie: Yeah, yeah, yeah, absolutely. One of the things that we go over a lot to in our classes is finding a provider who has a natural tendency to treat his patients the way that you want to be treated. That way, you'll have a lot better time when you birth because you're not having to ask them to do anything that they're not comfortable with or that they're not prepared for or that they don't know how to do. And so interviewing providers and interview as many as you need to with these women. And find the provider whose natural ways of treating his clients are the ways that you want to be treated.Dr. Stu: And sometimes in a community, there's nobody.Julie: Yeah, yeah, that's true.Meagan: That's what's so hard.Dr. Stu: And if it's important to you, if it's important to you, then you have to drive on. Julie: Or stand up for yourself and fight really hard.Meagan: I have a client from Russia. She's flying here in two weeks. She's coming all the way to Salt Lake City, Utah to have her baby. We had another client from Russia.Julie: You have another Russian client?Meagan: Yeah. Julie: That's awesome. Meagan: So, yeah. It's crazy. Sometimes you have to go far, far distances, and sometimes you've got them right there. You just have to search. You just have to find them.So it's tricky.Midwife Blyss: Maybe your insurance company is not gonna pay for it.Meagan: Did you say my company's not gonna pay for it?Midwife Blyss: And maybe your insurance company.Meagan: Oh, sure. Yeah, exactly.Midwife Blyss: You can't rely on them to be the ones who support some of these decisions that are outside of the standards of care. You might have to really figure out how to get creative around that area.Meagan: Absolutely.Yeah. So in the beginning, Blyss, you talked about noticing the signs, and I know that's one of the questions that we got on our Instagram, I believe. Birthing at home for both of you guys, what signs for a VBAC mom are signs enough where you talk about different care?.Dr. Stu: I didn't really understand that. Say that again what you were saying.Meagan: Yep. Sorry. So one of the questions on our Instagram was what are the signs of uterine rupture when you're at home that you look for and would transfer care or talk about a different plan of action?Dr. Stu: Okay. Quite simply, some uterine ruptures don't have any warning that they're coming.There's nothing you can do about those. But before we get into what you can feel, just let's review the numbers real briefly so that people have a realistic viewpoint. Because I'm sure if a doctor doesn't want to do a VBAC, you'll find a reason not to do a VBAC. You'll use the scar thickness or the pregnancy interval or whatever. They'll use something to try to talk you out of it or your baby's too big or this kind of thing. We can get into that in a little bit. But when there are signs, the most common sign you would feel is that there'd be increasing pain super-cubically that doesn't go away between contractions. It's a different quality of pain or sensation. It's pain. It's really's becoming uncomfortable. You might start to have variables when you didn't have them before. So the baby's heart rate, you might see heart rate decelerations. Rarely, you might find excessive bleeding, but that's usually not a sign of I mean that's a sign of true rupture.Midwife Blyss: Loss of station.Dr. Stu: Those are things you look for, but again, if you're not augmenting someone, if someone doesn't have an epidural where they don't have sensation, if they're not on Pitocin, these things are very unlikely to happen. I was going to get to the numbers. The numbers are such that the quoted risk of uterine rupture, which is again that crappy word. It sounds like a tire blowing out of the freeway. It is about 1 in 200. But only about 5 to 16%. And even one study said 3%. But let's just even take 16% of those ruptures will result in an outcome that the baby is damaged or dead. Okay, that's about 1 in 6. So the actual risk is about 1 in 6 times 1 in 200 or 1 in 1200 up to about 1 in 4000.Julie: Yep.Dr. Stu: So those are, those are the risks. They're not the 1 in 200 or the 2%. I actually had someone tell some woman that she had a 30% chance of rupture.Julie: We've had somebody say 50%.Meagan: We have?Julie: Yeah. Jess, our 50 copy editor-- her doctor told her that if she tries to VBAC, she has a 50% chance of rupture and she will die. Yeah.Meagan: Wow.Julie: Pretty scary. Dr. Stu: And by the way, a maternal mortality from uterine rupture is extremely rare.Julie: Yeah, we were just talking about that.Dr. Stu: That doctor is wrong on so many accounts. I don't even know where to begin on that.Julie: I know.Dr. Stu: Yeah. See that's the thing where even if someone has a classical Cesarean scar, the risk of rupture isn't 50%.Julie: Yep.Dr. Stu: So I don't know where they come up with those sorts of numbers.Julie: Yeah, I think it's just their comfort level and what they're familiar with and what they know and what they understand. I think a lot of these doctors, because she had a premature Cesarean, and so that's why he was a little, well, a lot more fear-based. Her Cesarean happened, I think, around 32 weeks. We still know that you can still attempt to VBAC and still have a really good chance of having a successful one. But a lot of these providers just don't do it.Dr. Stu: Yeah. And another problem is you can't really find out what somebody's C-section rate is. I mean, you can find out your hospital C-section rate. They can vary dramatically between different physicians, so you really don't know. You'd like to think that physicians are honest. You'd like to think that they're going to tell you the truth. But if they have a high C-section rate and it's a competitive world, they're not going to. And if you're with them, you don't really have a choice anyway.Julie: So there's not transparency on the physician level.Dr. Stu: So Blyss was talking briefly about the fact that your insurance may not pay for it. Blyss, why don't you elaborate on that because you do that point so well.Midwife Blyss: Are you talking about the wedding?Dr. Stu: I love your analogy. It's a great analogy.Midwife Blyss: I'm so saddened sometimes when people talk to me about that they really want this option and especially VBACs. I just have a very special tender place in my heart for VBAC because I overcame something from my first to second birth that wasn't a Cesarean. But it felt like I had been led to mistrust my body, and then I had a triumphant second delivery. So I really understand how that feels when a woman is able to reclaim her body and have a vaginal delivery. But just in general, in terms of limiting your options based on what your insurance will pay for, we think about the delivery of our baby and or something like a wedding where it's this really special day. I see that women or families will spend thousands and thousands of dollars and put it on a credit card and figure out whatever they need to do to have this beautiful wedding. But somehow when it comes to the birth of their baby, they turn over all their power to this insurance company.And so we used to do this talk at the sanctuary and I used to say, "What if we had wedding insurance and you paid every year into this insurance for your wedding, and then when the wedding came, they selected where you went and you didn't like it and they put you in a dress that made you look terrible and the food was horrible and the music was horrible and they invited all these people you didn't want to be there?"Julie: But it's a network.Midwife Blyss: Would you really let that insurance company, because it was paid for, dictate how your wedding day was? Julie: That's a good analogy.Midwife Blyss: You just let it all go.Meagan: Yeah. That's amazing. I love that. And it's so true. It is so true.Julie: And we get that too a lot about hiring a doula. Oh, I can't hire a doula. It's too expensive. We get that a lot because people don't expect to pay out-of-pocket for their births. When you're right, it's just perceived completely differently when it should be one of the biggest days of your life. I had three VBACs at home. My first was a necessary, unnecessary Cesarean.I'm still really uncertain about that, to be honest with you. But you better believe my VBACs at home, we paid out of pocket for a midwife. Our first two times, it was put on a credit card. I had a doula, I had a birth photographer, I had a videographer. My first VBAC, I had two photographers there because it was going to be documented because it was so important to me. And we sold things on eBay. We sold our couches, and I did some babysitting just to bring in the money.Obviously, I hired doulas because it was so important to me to not only have the experience that I wanted and that I deserved, but I wanted it documented and I wanted it to be able to remember it well and look back on it fondly. We see that especially in Utah. I think we have this culture where women just don't-- I feel like it's just a national thing, but I think in Utah, we tend to be on the cheap side just culturally and women don't see the value in that. It's hard because it's hard to shift that mindset to see you are important. You are worth it. What if you could have everything you wanted and what if you knew you could be treated differently? Would you think about how to find the way to make that work financially? And I think if there's just that mindset shift, a lot of people would.Meagan: Oh, I love that.Dr. Stu: If you realize if you have to pay $10,000 out of pocket or $5,000 or whatever to at least have the opportunity, and you always have the hospital as a backup. But 2 or 3 years from now, that $5,000 isn't going to mean anything.Julie: Yeah, nothing.Meagan: But that experience is with you forever.Dr. Stu: So yeah, women may have to remember the names of their children when they're 80 years old, but they'll remember their birth.Julie: Well, with my Cesarean baby, we had some complications and out-of-pocket, I paid almost $10,000 for him and none of my home births, midwives, doula, photography and videography included cost over $7,000.Meagan: My Cesarean births in-hospital were also more expensive than my birth center births.Julie: So should get to questions.Dr. Stu: Let's get to some of the questions because you guys some really good questions.Meagan: Yes.Dr. Stu: Pick one and let's do it.Meagan: So let's do Lauren. She was on Facebook. She was our very first question, and she said that she has some uterine abnormalities like a bicornuate uterus or a separate uterus or all of those. They want to know how that impacts VBAC. She's had two previous Cesareans due to a breech presentation because of her uterine abnormality.Julie: Is that the heart-shaped uterus? Yeah.Dr. Stu: Yeah. You can have a septate uterus. You can have a unicornuate uterus. You can have a double uterus.Julie: Yeah. Two separate uteruses.Dr. Stu: Right. The biggest problem with a person with an abnormal uterine shape or an anomaly is a couple of things. One is malpresentation as this woman experienced because her two babies were breech. And two, is sometimes a retained placenta is more common than women that have a septum, that sort of thing. Also, it can cause preterm labor and growth restriction depending on the type of anomaly of the uterus. Now, say you get to term and your baby is head down, or if it's breech in my vicinity. But if it's head down, then the chance of VBAC for that person is really high. I mean, it might be a slightly greater risk of Cesarean section, but not a statistically significant risk. And then the success rate for home birth VBACs, if you look at the MANA stats or even my own stats which are not enough to make statistical significance in a couple of papers that I put out, but the MANA stats show that it's about a 93% success rate for VBACS in the midwifery model, whereas in the hospital model, it can be as low as 17% up to the 50s or 60%, but it's not very high. And that's partly because of the model by which you're cared for. So the numbers that I'm quoting and the success rates I'm quoting are again, assuming that you have a supportive practitioner in a supportive environment, every VBAC is going to have diminished chance of success in a restrictive or tense environment. But unicornuate uterus or septate uterus is not a contraindication to VBAC, and it's not an indication of breech delivery if somebody knows how to do a breech VBAC too.Julie: Right.Dr. Stu: So Lauren, that would be my answer to to your question is that no, it's not a contraindication and that if you have the right practitioner you can certainly try to labor and your risk of rupture is really not more significant than a woman who has a normal-shaped uterus.Julie: Good answer.Meagan: So I want to spin off that really quick. It's not a question, but I've had a client myself that had two C-sections, and her baby was breech at 37 weeks, and the doctor said he absolutely could not turn the baby externally because her risk of rupture was so increasingly high. So would you agree with that or would you disagree with that?D No, no, no. Even an ACOG statement on external version and breech says that a previous uterine scar is not a contraindication to attempting an external version.Meagan: Yeah.Dr. Stu: Now actually, if we obviously had more breech choices, then there'd be no reason to do an external version.The main reason that people try an external version which can sometimes be very uncomfortable, and depending on the woman and her parody and certain other factors, their success rate cannot be very good is the only reason they do it because the alternative is a Cesarean in 95% of locations in the country.Meagan: Okay, well that's good to know.Dr. Stu: But again, one of the things I would tell people to do is when they're hearing something from their position that just sort of rocks the common sense vote and doesn't sort of make sense, look into it. ACOG has a lot. I think you can just go Google some of the ACOG clinical guidelines or practice guidelines or clinical opinions or whatever they call them. You can find and you can read through, and they summarize them at the end on level A, B, and C evidence, level A being great evidence level C being what's called consensus opinion. The problem with consensus, with ACOG's guidelines is that about 2/3 of them are consensus opinion because they don't really have any data on them. When you get bunch of academics together who don't like VBAC or don't like home birth or don't like breech, of course a consensus opinion is going to be, "Well, we're not going to think those are a good idea." But much to their credit lately, they're starting to change their tune. Their most recent VBAC guideline paper said that if your hospital can do labor and delivery, your hospital can do VBAC.Julie: Yes.Dr. Stu: That's huge. There was immediately a whole fiasco that went on. So any hospital that's doing labor and delivery should be able to do a VBAC. When they say they can't or they say our insurance company won't let them, it's just a cowardly excuse because maybe it's true, but they need to fight for your right because most surgical emergencies in labor delivery have nothing to do with a previous uterine scar.Julie: Absolutely.Dr. Stu: They have to do with people distress or placental abruption or cord prolapse. And if they can handle those, they can certainly handle the one in 1200. I mean, say a hospital does 20 VBACs a year or 50 VBACs a year. You'll take them. Do the math. It'll take them 25 years to have a rupture.Meagan: Yeah. It's pretty powerful stuff.Midwife Blyss: I love when he does that.Julie: Me too. I'm a huge statistics junkie and data junkie. I love the numbers.Meagan: Yeah. She loves numbers.Julie: Yep.Meagan: I love that.Julie: Hey, and 50 VBACs a year at 2000, that would be 40 years actually, right?Dr. Stu: Oh, look at what happened. So say that again. What were the numbers you said?Julie: So 1 in 2000 ruptures are catastrophic and they do 50 VBACs a year, wouldn't that be 40 years?Dr. Stu: But I was using the 1200 number.Julie: Oh, right, right, right, right.Dr. Stu: So that would be 24 years.Julie: Yeah. Right. Anyways, me and you should sit down and just talk. One day. I would love to have lunch with you.Dr. Stu: Let's talk astrology and astronomy.Yes.Dr. Stu: Who's next?Midwife Blyss: Can I make a suggestion?There was another woman. Let's see where it is. What's the likelihood that a baby would flip? And is it reasonable to even give it a shot for a VBA2C. How do you guys say that?Meagan: VBAC after two Cesareans.Midwife Blyss: I need to know the lingo. So, I would say it's very unlikely for a baby to flip head down from a breech position in labor. It doesn't mean it's impossible.Dr. Stu: With a uterine septum, it's almost never going to happen. Bless is right on. Even trying an external version on a woman with the uterine septum when the baby's head is up in one horn and the placenta in the other horn and they're in a frank breech position, that's almost futile to do that, especially if a woman is what I call a functional primary, or even a woman who's never labored before.Julie: Right. That's true.Meagan: And then Napoleon said, what did she say? Oh, she was just talking about this. She's planning on a home birth after two Cesareans supported by a midwife and a doula. Research suggests home birth is a reasonable and safe option for low-risk women. And she wants to know in reality, what identifies low risk?Midwife Blyss: Well, I thought her question was hilarious because she says it seems like everybody's high-risk too. Old, overweight.Julie: Yeah, it does. It does, though.Dr. Stu: Well, immediately, when you label someone high-risk, you make them high-risk.Julie: Yep.Dr. Stu: Because now you've planted seeds of doubt inside their head. So I would say, how do you define high-risk? I mean, is 1 in 1200 high risk?Julie: Nope.Dr. Stu: It doesn't seem high-risk to me. But again, I mean, we do a lot of things in our life that are more dangerous than that and don't consider them high-risk. So I think the term high-risk is handed about way too much.And it's on some false or just some random numbers that they come up with. Blyss has heard this before. I mean, she knows everything I say that comes out of my mouth. The numbers like 24, 35, 42. I mean, 24 hours of ruptured membranes. Where did that come from? Yeah, or some people are saying 18 hours. I mean, there's no science on that. I mean, bacteria don't suddenly look at each other and go, "Hey Ralph, it's time to start multiplying."Julie: Ralph.Meagan: I love it.Julie: I'm gonna name my bacteria Ralph.Meagan: It's true. And I was told after 18 hours, that was my number.Dr. Stu: Yeah, again, so these numbers, there are papers that come out, but they're not repetitive. I mean, any midwife worth her salt has had women with ruptured membranes for sometimes two, three, or four days.Julie: Yep.Midwife Blyss: And as long as you're not sticking your fingers in there, and as long as their GBS might be negative or that's another issue.Meagan: I think that that's another question. That's another question. Yep.Dr. Stu: Yeah, I'll get to that right now. I mean, if some someone has a ruptured membrane with GBS, and they don't go into labor within a certain period of time, it's not unreasonable to give them the pros and cons of antibiotics and then let them make that decision. All right? We don't force people to have antibiotics. We would watch for fetal tachycardia or fever at that point, then you're already behind the eight ball. So ideally, you'd like to see someone go into labor sooner. But again, if they're still leaking, if there are no vaginal exams, the likelihood of them getting group B strep sepsis or something on the baby is still not very high. And the thing about antibiotics that I like to say is that if I was gonna give antibiotics to a woman, I think it's much better to give a woman an antibiotics at home than in the hospital. And the reason being is because at home, the baby's still going to be born into their own environment and mom's and dad's bacteria and the dog's bacteria and the siblings' bacteria where in the hospital, they're going to go to the nursery for observation like they generally do, and they're gonna be exposed to different bacteria unless they do these vaginal seeding, which isn't really catching on universally yet where you take a swab of mom's vaginal bacteria before the C-section.Midwife Blyss: It's called seeding.Dr. Stu: Right. I don't consider ruptured membrane something that again would cause me to immediately say something where you have to change your plan. You individualize your care in the midwifery model.Julie: Yep.Dr. Stu: You look at every patient. You look at their history. You look at their desires. You look at their backup situation, their transport situation, and that sort of thing. You take it all into account. Now, there are some women in pregnancy who don't want to do a GBS culture.Ignorance is bliss. The other spelling of bliss.Julie: Hi, Blyss.Dr. Stu: But the reason that at least I still encourage people to do it is because for any reason, if that baby gets transferred to the hospital during labor or after and you don't have a GBS culture on the chart, they're going to give antibiotics. They're going to treat it as GBS positive and they're also going to think you're irresponsible.And they're going to have that mentality that of oh, here's another one of those home birth crazy people, blah, blah, blah.Julie: That just happened to me in January. I had a client like that. I mean, anyways, never mind. It's not the time. Midwife Blyss: Can I say something about low-risk?Julie: Yes. Midwife Blyss: I think there are a lot of different factors that go into that question. One being what are the state laws? Because there are things that I would consider low-risk and that I feel very comfortable with, but that are against the law. And I'm not going to go to jail.Meagan: Right. We want you to still be Birthing Bless.Midwife Blyss: As, much as I believe in a woman's right to choose, I have to draw the line at what the law is. And then the second is finding a provider that-- obviously, Dr. Stu feels very comfortable with things that other providers may not necessarily feel comfortable with.Julie: Right.Midwife Blyss: And so I think it's really important, as you said in the beginning of the show, to find a provider who takes the risk that you have and feels like they can walk that path with you and be supportive. I definitely agree with what Dr. Stu was saying about informed consent. I had a client who was GBS positive, declined antibiotics and had a very long rupture. We continued to walk that journey together. I kept giving informed consent and kept giving informed consent. She had such trust and faith that it actually stretched my comfort level. We had to continually talk about where we were in this dance. But to me, that feels like what our job is, is to give them information about the pros and cons and let them decide for themselves.And I think that if you take a statistic, I'm picking an arbitrary number, and there's a 94% chance of success and a 4% chance that something could go really wrong, one family might look at that and say, "Wow, 94%, this is neat. That sounds like a pretty good statistic," and the other person says, "4% makes me really uncomfortable. I need to minimize." I think that's where you have to have the ability, given who you surround yourself with and who your provider is, to be able to say, "This is my choice," and it's being supported. So it is arbitrary in a lot of ways except for when it comes to what the law is.Julie: Yeah, that makes sense.Meagan: I love that. Yeah. Julie: Every state has their own law. Like in the south, it's illegal like in lots of places in the South, I think in Washington too, that midwives can't support home birth if you're VBAC. I mean there are lots of different legislative rules. Why am I saying legislative? Look at me, I'm trying to use fancy words to impress you guys. There are lots of different laws in different states and, and some of them are very evidence-based and some laws are broad and they leave a lot of room for practices, variation and gray areas. Some are so specific that they really limit a woman's option in that state.Dr. Stu: We can have a whole podcast on the legal decision-making process and a woman's right to autonomy of her body and the choices and who gets to decide that would be. Right now, the vaccine issue is a big issue, but also pregnancy and restricting women's choices of these things. If you want to do another one down the road, I would love to talk on that subject with you guys.Julie: Perfect.Meagan: We would love that.Julie: Yeah. I think it's your most recent episode. I mean as of the time of this recording. Mandates Kill Medicine. What is that the name?Dr. Stu: Mandates Destroy Medicine.Julie: Yeah. Mandates Destroy Medicine. Dr. Stu: It's wonderful.Julie: Yeah, I love it. I was just listening to it today again.Dr. Stu: well it does because it makes the physicians agents of the state.Julie: Yeah, it really does.Meagan: Yeah. Well. And if you give us another opportunity to do this with you, heck yeah.Julie: Yeah. You can just be a guest every month.Meagan: Yeah.Dr. Stu: So I don't think I would mind that at all, actually.Meagan: We would love it.Julie: Yeah, we would seriously love it. We'll keep in touch.Meagan: So, couple other questions I'm trying to see because we jumped through a few that were the same. I know one asks about an overactive pelvic floor, meaning too strong, not too weak. She's wondering if that is going to affect her chances of having a successful VBAC.Julie: And do you see that a lot with athletes, like people that are overtrained or that maybe are not overtrained, but who train a lot and weightlifters and things like that, where their pelvic floor is too strong? I've heard of that before.Midwife Blyss: Yep, absolutely. there's a chiropractor here in LA, Dr. Elliot Berlin, who also has his own podcast and he talks–Meagan: Isn't Elliott Berlin Heads Up?Dr. Stu: Yeah. He's the producer of Heads Up.Meagan: Yeah, I listened to your guys' special episode on that too. But yeah, he's wonderful.Midwife Blyss: Yeah. So, again, I think this is a question that just has more to do with vaginal delivery than it does necessarily about the fact that they've had a previous Cesarean. So I do believe that the athletic pelvis has really affected women's deliveries. I think that during pregnancy we can work with a pelvic floor specialist who can help us be able to realize where the tension is and how to do some exercises that might help alleviate some of that. We have a specialist here in L.A. I don't know if you guys do there that I would recommend people to. And then also, maybe backing off on some of the athletic activities that that woman is participating in during her pregnancy and doing things more like walking, swimming, yoga, stretching, belly dancing, which was originally designed for women in labor, not to seduce men. So these are all really good things to keep things fluid and soft because you want things to open and release rather than being tense.Meagan: I love that.Dr. Stu: I agree. I think sometimes it leads more to not generally so much of dilation. Again, a friend of mine, David Hayes, he's a home birth guy in South Carolina, doesn't like the idea of using stages of labor. He wants to get rid of that. I think that's an interesting thought. We have a meeting this November in Wisconsin. We're gonna have a bunch of thought-provoking things going on over there.Dr. Stu: Is it all men talking about this? Midwife Blyss: Oh, hell no.Julie: Let's get more women. Dr. Stu: No, no, no, no, no.Being organized By Cynthia Calai. Do you guys know who Cynthia is? She's been a midwife for 50 years. She's in Wisconsin. She's done hundreds of breeches. Anyway, the point being is that I think that I find that a lot of those people end up getting instrumented like vacuums, more commonly. Yeah. So Blyss is right. I mean, if there are people who are very, very tight down there. The leviators and the muscles inside are very tight which is great for life and sex and all that other stuff, but yeah, you need to learn how to be able to relax them too.Julie: Yeah.Meagan: So I know we're running short on time, but this question that came through today, I loved it. It said, "Could you guys both replicate your model of care nationwide somehow?" She said, "How do I advocate effectively for home birth access and VBAC access in a state that actively prosecutes home birth and has restrictions on midwifery practice?" She specifically said she's in Nebraska, but we hear this all over the place. VBAC is not allowed. You cannot birth at home, and people are having unassisted births.Julie: Because they can't find the support.Meagan: They can't find the support and they are too scared to go to the hospital or birth centers. And so, yeah, the question is--Julie: What can women do in their local communities to advocate for positive change and more options in birth where they are more restricted?Dr. Stu: Blyss. Midwife Blyss: I wish I had a really great answer for this. I think that the biggest thing is to continue to talk out loud. And I'm really proud of you ladies for creating this podcast and doing the work that you do. Julie: Thanks.Midwife Blyss: I always believed when we had the Sanctuary that it really is about the woman advocating for herself. And the more that hospitals and doctors are being pushed by women to say, "We need this as an option because we're not getting the work," I think is really important. I support free birth, and I think that most of the women and men who decide to do that are very well educated.Julie: Yeah, for sure.Midwife Blyss: It is actually really very surprising for midwives to see that sometimes they even have better statistics than we do. But it saddens me that there's no choice. And, a woman who doesn't totally feel comfortable with doing that is feeling forced into that decision. So I think as women, we need to support each other, encourage each other, continue to talk out loud about what it is that we want and need and make this be a very important decision that a woman makes, and it's a way of reclaiming the power. I'm not highly political. I try and stay out of those arenas. And really, one of my favorite quotes from a reverend that I have been around said, "Be for something and against nothing." I really believe that the more. Julie: I like that.Midwife Blyss: Yeah, the more that we speak positively and talk about positive change and empowering ourselves and each other, it may come slowly, but that change will continue to come.Julie: Yeah, yeah.Dr. Stu: I would only add to that that I think unfortunately, in any country, whether it's a socialist country or a capitalist country, it's economics that drives everything. If you look at countries like England or the Netherlands, you find that they have, a really integrated system with midwives and doctors collaborating, and the low-risk patients are taken care of by the midwives, and then they consult with doctors and midwives can transfer from home to hospital and continue their care in that system, the national health system. I'm not saying that's the greatest system for somebody who's growing old and has arthritis or need spinal surgery or something like that, but for obstetrics, that sort of system where you've taken out liability and you've taken out economic incentive. All right, so how do you do that in our system? It's not very easy to do because everything is economically driven. One of the things that I've always advocated for is if you want to lower the C-section rate, increase the VBAC rate. It would be really simple for insurance companies, until we have Bernie Sanders with universal health care. But while we have insurance companies, if they would just pay twice as much for a vaginal birth and half as much for a Cesarean birth, then finally, VBACS and breech deliveries would be something. Oh, maybe we should start. We should be more supportive of those things because it's all about the money. But as long as the hospital gets paid more, doctors don't really get paid more. It's expediency for the doctor. He gets it done and goes home. But the hospital, they get paid a lot more, almost twice as much for a C-section than you do for vaginal birth. What's the incentive for the chief financial officer of any hospital to say to the OB department, "We need to lower our C-section rate?" One of the things that's happening are programs that insurance, and I forgot what it's called, but where they're trying, in California, they're trying to lower the primary C-section rate. There's a term for it where it's an acronym with four initials. Blyss, do you know what I'm talking about?Midwife Blyss: No. Dr. Stu: It's an acronym about a first-time mom. We're trying to avoid those C-sections.Julie: Yeah, the primary Cesarean.Dr. Stu: It's an acronym anyway, nonetheless. So they're in the right direction. Most hospitals are in the 30% range. They'd like to lower to 27%. That's a start.One of the ways to really do that is to support VBAC, and treat VBAC as Blyss said at the very beginning of the podcast is that a VBAC is just a normal labor. When people lump VBAC in with breech in twins, it's like, why are you doing that? Breech in twins requires special skill. VBAC requires a special skill also, which is a skill of doing nothing.Julie: Yeah, it's hard.Dr. Stu: It's hard for obstetricians and labor and delivery nurses and stuff like that to do nothing. But ultimately, VBAC is just a vaginal birth and doesn't require any special skill. When a doctor says, "We don't do VBAC, what he's basically saying, or she, is that I don't do vaginal deliveries," which is stupid because VBAC is just a vaginal delivery.Julie: Yeah, that's true.Meagan: Such a powerful point right there.Julie: Guys. We loved chatting with you so much. We wish we could talk with you all day long.Meagan: I would. All day long. I just want to be a fly on your walls if I could.Julie: If you're ever in Salt Lake City again--Meagan: He just was. Did you know about this?Julie: Say hi to Adrienne, but also connect with us because we would love to meet you. All right, well guys, everyone, all of our listeners, Women of Strength, we are going to drop all the information that you need to find Midwife Blyss and Dr. Stu-- their website, their podcast, and all of that in our show notes. So yeah, now you can find our podcast. You can even listen to our podcast on our website at thevbaclink.com/podcast. You can play episodes right from there. So if you don't know-- well, if you're listening to this podcast, then you probably have a podcast player already. But you know what? My mom still doesn't know what a podcast is, so I'm just gonna have to start sending her links right to our page.Meagan: Yep, just listen to us wherever and leave us a review and head over to Dr. Stu's Podcast and leave them a review.Julie: Subscribe because you're gonna love him, but don't stop listening to him us because you love us too. Remember that.Dr. Stu: I want to thank everybody who wrote in, and I'm sorry we didn't get to answer every question. We tend to blabber on a little bit asking these important questions, and hopefully you guys will have us back on again.Meagan: We would love to have you.Julie: Absolutely.Meagan: Yep, we will.Julie: Absolutely.Meagan: YeahClosingWould 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
Series Two: Risk Factors in Childbirth and Who Defines Risk? This series topic was borne from the recent happenings in the world of homebirth in Australia around Professional Indemnity Insurance for Privately Practicing Midwives and the potential parameters that they will have to practice within. Advocacy efforts are underway to ensure that women can continue to choose where and with whom they give birth and that midwives can continue to support them. Homebirth Australia (HBA) are asking people to write to their MPs informing them of how the proposed insurance will impact them personally. Please refer to HBA Instagram for more information: www.instagram.com/homebirth_australia Episode Five: Whose risk is it anyway? Dr Stuart J. Fischbein MD Dr Stuart J. Fischbein MD or otherwise lovingly known as Dr Stu, is a community-based obstetrician and an Associate of the American College of Obstetrics & Gynaecology. He is a published author of the book “Fearless Pregnancy, Wisdom & Reassurance from a Doctor, A Midwife and A Mom” and has published many peer-reviewed papers relating to homebirth and breech birth out of the hospital setting. His research on 100 home twin births has been submitted for publication. After completing his residency at Cedars-Sinai Medical Center in Los Angeles, CA, Dr Stu, spent 24 years assisting women with hospital birthing and, for the next 13 years, was a homebirth obstetrician who worked directly with midwives. Since retiring from attending home births in 2022, Dr Stu has turned his focus to traveling around the world as a lecturer and advocate for reteaching breech & twin birth skills, respect for the normalcy of birth and honouring informed consent. He hosts the weekly Birthing Instincts podcast with co-host Blyss Young and together they offer hope, reassurance and safe, honest evidence supported choices for those women who understand pregnancy is a normal bodily function not to be feared. We talk with Dr Stu about his vast experience supporting breech and twin birth at home, we discuss risk and what it means to different women and different practitioners, and we pick his brain about insurance, the political climate around birth, money, obstetrics, the system and plenty more. Be sure not to miss this one. Dr Stu isn't scared to say it how it is, and we are so grateful and hold the deepest respect for his honesty and knowledge. Links Dr StuInstagram: www.instagram.com/birthinginstinctsWebsite: www.birthinginstincts.comPodcast: www.birthinginstinctspodcast.com Birth TimeWebsite: www.birthtime.worldInstagram: www.instagram.com/birthtimeworldFacebook: www.facebook.com/birthtimeworld JerushaWebsite: www.jerusha.com.auInstagram: www.instagram.com/jerushasuttonFacebook: www.facebook.com/jerushasuttonphotography JoWebsite: www.midwifejo.com.auInstagram: www.instagram.com/midwifejohunterFacebook: www.facebook.com/MidwifeJo BIRTH TIME GIFT CARD: www.birthtime.world/watch-nowTHE HANDBOOK: www.birthtime.world/the-handbookMERCH: www.birthtime.world/shop Enjoying the podcast? Leave a review on Apple Podcasts or Spotify. Thanks for listening, we appreciate every single one of you.
Stuart J. Fischbein MD is a community-based obstetrician and an Associate of the American College of Obstetrics & Gynecology, published author of the book “Fearless Pregnancy, Wisdom & Reassurance from a Doctor, A Midwife and A Mom” and peer-reviewed papers Homebirth with an Obstetrician, A Series of 135 Out of Hospital Births and Breech birth at home: outcomes of 60 breech and 109 cephalic planned home and birth center births. (And currently submitted for publication: Twin Home Birth:Outcomes of 100 sets of twins in the care of a single practitioner.) After completing his residency at Cedars-Sinai Medical Center in Los Angeles, CA, Dr. Stu spent 24 years assisting women with hospital birthing and, for the last 13 years, has been a homebirth obstetrician who works directly with midwives. Since retiring from attending home births in 2022, Dr. Stu has turned his focus to traveling around the world as a lecturer and advocate for reteaching breech & twin birth skills, respect for the normalcy of birth and honoring informed consent. He hosts a weekly podcast with co-host Blyss Young and together they offer hope, reassurance and safe, honest evidence supported choices for those women who understand pregnancy is a normal bodily function not to be feared. Follow him on Instagram @birthinginstincts. His websites are www.birthinginstincts.com & www.birthinginstinctspodcast.com Heads Up Documentary https://www.informedpregnancy.tv/products/heads-up-a-breech-birth-documentary Follow Shari @belly2birth Sign up for my new 'Breathing & Movement for birth workshop' for only $37 + gst AUD Or my 'Journey to Birth' Online Hypnobirthing Program' for only $197 + gst
Where will you hear about home birth story details, the difference between modern and traditional midwifery, what to do when you are inspired to enter birth work and the connection of birth with sexuality and spirituality? This episode of the podcast, that's where! Today we're joined by Blyss Young, LM CPM. Blyss is a home birth midwife, teacher, circle facilitator, energy healer, reiki practitioner, mother, yoga teacher, entrepreneur, breathwork facilitator, placenta encapsulator and natural living consultant. Through her guidance and love centered approach she has supported thousands of families to birth in the ways they feel the most empowered. She is a firm believer in intuition, the sacred and rituals. At the heart of all of her work is a deeply rooted belief in the brilliant design of the universe and our integral part in all of it. You've also probably heard Blyss alongside Dr. Stu Fischbein on their podcast “Birthing Instincts.” We get into so many powerful topics in this episode. Blyss shares her history into birth work, details of her own births, elements of midwifery and advice for current and future birth workers, plus connecting with your sexuality in the birth journey. Links From The Episode: Blyss's Website: https://www.birthingblyss.com/ Byss's Instagram: https://www.instagram.com/birthingblyss/ Birthing Instincts Podcast: https://podcasts.apple.com/us/podcast/birthing-instincts/id1552816683 The Innate Journey: https://www.theinnatejourney.com/ Offers From Our Awesome Partners: Needed: https://bit.ly/2DuMBxP - use code DIAH to get 20% off your order Splash Blanket: https://bit.ly/3JPe1g0 - use code DIAH for 10% off your order Esembly: https://bit.ly/3eanCSz - use code DIH20 to get 20% off your order More From Doing It At Home: Send us your birth story: https://bit.ly/3jOjCKl Doing It At Home book on Amazon: https://amzn.to/3vJcPmU DIAH Website: https://www.diahpodcast.com/ DIAH Instagram: https://www.instagram.com/doingitathome/ DIAH YouTube: https://bit.ly/3pzuzQC DIAH Merch: www.diahpodcast.com/merch Give Back to DIAH: https://bit.ly/3qgm4r9 Learn more about your ad choices. Visit megaphone.fm/adchoices
Jennifer joins us today sharing her HBA3C story! Each birth was a stepping stone that gave her more education and wisdom which ultimately led to her home birth after three Cesareans. Jennifer's first Cesarean was due to meconium in the water, slow progress, and heart rate issues. Her other two Cesareans were scheduled, but her third was particularly difficult because in her heart, Jennifer really wanted a VBAC. After regretting her decision to get her tubes tied during her third Cesarean, Jennifer opted for a reversal and it worked! Once pregnant with her fourth, she traveled two hours each way across state lines to find a home birth midwife. When labor began, Jennifer booked an Airbnb, called in her team, and had the beautiful home birth she knew she was capable of.Jennifer's WebsiteNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:20 Review of the Week05:02 First C-section06:48 Second C-section08:02 Third C-section during COVID10:09 Getting her tubes tied and reversal13:38 Fourth pregnancy16:39 Finding a home birth midwife in another state19:02 Going into labor and reserving an Airbnb24:04 Complete dilation26:37 Pushing and catching her baby31:24 You are worth itMeagan: Hello, hello everybody. This is Meagan, your host here at The VBAC Link and we have our friend, Jennifer. Hi Jennifer. Jennifer: Hi. Meagan: You guys, her story– we were just talking about this before the episode. It has a lot of surprises like, “Oh, I didn't expect that. Whoa.” So I'm so excited to– I've read a summary of her story and am now excited to hear it in her own words. I also thought it was kind of fun. She was just saying her kids are excited to hear her story because they know The VBAC Link podcast too. Jennifer: Yep. It was part of our preparation for the birth just having them hear stuff and hear how births are because obviously, they'd never had any experience. Meagan: Yes, so how old are your kids? Jennifer: 11. 9, 3 and now newborn. Meagan: And now newborn. We have very similar-aged kids. 11 and 9 and then I have an 8-year-old this year. And then we jump. That is so exciting. I'm excited to get into your HBAC after three Cesareans and all of the fun things away. 02:20 Review of the WeekMeagan: But I do have a Review of the Week and this review is from mcgrace. I actually think I know who this is. It says, “Must listen for every mom-to-be.” It says, “This podcast is a must-listen not just for the mom preparing for a VBAC but anyone who is giving birth and has given birth or plans to give birth in the U.S. Meagan wonderfully walks through personal stories while preparing helpful advocacy tips and a solid dose of empowerment in each episode. If you want to hear people discussing their path to VBAC, if you're curious about what giving birth looks like in the U.S., and if you want tips on how to mentally, emotionally, and physically prepare yourself for the best birth, listen to this podcast.” Thank you so much for that review. Jennifer: Totally. I 100% agree. Meagan: That is so sweet. I do agree with her. Yes, VBAC is in the title of this podcast, but it really is for anyone. Jennifer: Totally. Meagan: And everyone wanting to give birth. Jennifer: Definitely. Meagan: I feel like if I had this podcast when I was preparing for my daughter Lainey, that would have changed a lot. Jennifer: Yes. If I had listened before my first birth, I feel like so much would have and could have been different. Meagan: Could have been different. I know. I'm so grateful for all of the Women of Strength who are sharing on this podcast and who are sharing on social media. By the way, we are accepting stories for our social media because we do have a lot of submissions on the podcast and we can't get to everyone. We would love to still share every story possible, so if you are interested in sharing your story on our social media, email us at info@thevbaclink.com with your subject “Share My Story” and we will get that posted. 05:02 First C-sectionMeagan: Okay, girl. Let's dive into all of these stories. They are all– I don't know. I feel like each one is the stepping stone to this final birth. Jennifer: Yes. Yes. Meagan: And I'm not saying you are done having babies. Jennifer: Well, yeah. Most recent. Meagan: I don't want to say final like you are done. But this birth that you are sharing, I feel like each one came with learning and growing and all of the steps it took to get you to this point. Jennifer: Yeah. I feel like I was so young with my first and I didn't have any education at all which is common. Meagan: That's how I felt. Jennifer: But yeah. It was a slow, long labor which is pretty typical for a first. I went to the hospital right away and I just had in my mind, I didn't know about physiological birth. I just knew. I was like, “Oh my gosh. This hurts.” I thought I needed to be in the hospital because this hurts and something must be wrong because it hurts. Then I had an epidural and things were slow. He did have meconium. They broke my water and he had meconium. It was that cascade of interventions and it was just kind of one thing after another. It slowed down after the epidural and at 4 centimeters, his heart rate wasn't looking great and they said, “You need a C-section.” In my mind, it was like it was an emergency. “Oh my gosh, I need a C-section.” So I had the C-section and yeah. That was the first stepping stone like you said. I didn't know anything. 06:48 Second C-sectionJennifer: Then with my daughter, I wanted a VBAC. I heard about VBAC and was like, “Oh, that's a thing.” Someone who I look up to told me the dangers and the big risks. They really had good intentions. They really thought it was dangerous so were trying to look out for me, but I was very vulnerable and they really scared me out of it. They were like, “You'll both die if you rupture within a couple of minutes.” Now, after I've learned more, I'm like, “That's not even true,” but at the time, I was like, “Uh, I just don't think it's worth the risk,” so I just scheduled that C-section. I think each recovery was also more difficult. The first one was a fairly easy recovery and then the second one was a little harder and then my third was that bigger age gap. I had educated myself a little more or at least I knew what I wanted. 08:02 Third C-section during COVIDJennifer: I knew that I wanted a VBAC. I didn't want to deal with the drugs again postpartum and the numbness and everything. I just didn't want to deal with it all with a C-section. That was during 2020 COVID year so that was a whole other level of difficulty added in with that year. That was the one where they did a bait and switch on me. I said from the beginning with my OB/GYN, “Would you let me have a VBAC?” They were like, “Yeah. We can definitely do that. We'll just look at your scar in an ultrasound later on and as long as it looks thick enough, yeah. You can have a VBAC.” Of course, my scar was not thick enough. I've since learned and I think on one of your podcasts you talked about it in great detail. But that test is super– I mean, you talk about millimeters on this fuzzy black screen. Meagan: Yeah. Not necessarily something that should be a determining factor for VBAC. We've even had a doctor on the podcast that was like, “No. The evidence is just not strong enough to go off of.” Jennifer: Yeah. I was still in the mindset then of, “Doctor said no so I can't,” so I scheduled the C-section and that one was really hard. I think it was because I knew that I wanted a VBAC and I wasn't getting it. With the other two, I didn't know I really wanted it so I was like, “Well, this is just how it is.” With the third, I was so anxious during the C-section. I remember my doctor down there and she yelled to the anesthesiologist, “You need to give her something to calm her down,” because I was just crying and yeah. Meagan: I'm sorry. Jennifer: Yeah. It was a rough one. 10:09 Getting her tubes tied and reversalJennifer: And then this is one of the twists in my story. That's when I had my tubes tied. Meagan: The big twist. Jennifer: Yeah. I had my tubes tied during that third C-section. Meagan: Did your provider offer that or suggest it or did you say, “We're done having babies”?Jennifer: No. It was suggested multiple times throughout my care. I feel now like it was a little bit of coercion but it was my choice. My husband and I made the final decision as we were driving to get the C-section. Now I'm like, “You don't decide to get your tubes tied when you are 9 months pregnant.” Meagan: That's a hard decision. Jennifer: That's not when you make that decision. Any decision, but definitely not that one because you are so tired of being pregnant at that point. Meagan: You are vulnerable, yes. Jennifer: So I had my tubes tied during that C-section and then the next day, it was instant regret. I was like, “I cannot believe we did this.” My husband felt the same way. We were both just like, “Ugh, what have we done? Why did we do that?” Meagan: Mhmm, yeah. Jennifer: It was really hard to grieve through that. It felt like a loss even though it wasn't. It felt like I had lost a baby almost because of how intense the grief was knowing that I could never have another baby. Meagan: I understand that so much when my husband got the vasectomy that I didn't want him to get. I felt like, “I'm grieving a kid I've never had but I'm grieving a kid that I had in my mind.” You know? Jennifer: Yeah, totally. It's a very real grief. My husband right away suggested reversal, but I dealt with a lot of guilt about that like, “No. We chose this. My insurance paid for this. We can't go and spend money on getting it reversed. We have to live with this.” I had to work through that guilt and shame and finally, we were blessed to be able to get it reversed two years-ish after. Meagan: How was that? How was the process of that? Jennifer: That was hard. It was like another C-section, the operation itself. It was outpatient but it was a big old C-section scar. The pain and everything was the same and not being able to lift. But emotionally, it was really healing. Meagan: Yeah. Jennifer: Right away, I remember waking up from being under anesthesia after it and I was just crying. The nurse was like, “It's really normal to be emotional.” I was like “I'm so thankful.” Meagan: Aww. Jennifer: I was just so glad. At that point, I didn't even know if it had worked because it was not a guarantee. Meagan: A reversal. Jennifer: A reversal is not a guarantee. There could be scar tissue that blocks the fallopian tubes. Meagan: That makes sense. Jennifer: I think depending on age, they have different success rates but I think it's 80% or something like that. 13:38 Fourth pregnancyJennifer: We did not conceive right away which we always did before, so I was not sure if it had been successful. It was almost a year before we finally did conceive, but we did about a year after I had the reversal. Now, I knew I would have the VBAC. I was going to work for it and try for it and it was during the time before I had the reversal actually that I got really passionate about it. I was like, “This may never come to anything for me personally because I may not ever have a baby again,” but I really grew passionate about birth and physiological births. I read a lot and I got to know about rights. I never had to have a C-section even with the last one when he said the scar wasn't thick enough. I still didn't have to have a C-section. Meagan: But we feel like that when we have providers who go through a lot more training and school than we do just on our Google searches and our classes and things like that. It feels that way. It feels like we don't. They know what's best. We trust them and we should trust our providers. I'm not saying we shouldn't trust our providers, but we put everything that they say sometimes all in a basket and say, “That's my fate,” and it doesn't necessarily have to be. 16:39 Finding a home birth midwife in another stateJennifer: So this time, this pregnancy was with my fourth. I knew I would work for the VBAC. At first, when I had been reading and researching and learning and everything, I knew I wanted a home birth. I was like, “That's so what I desire.” It was just a dream for me that that could be a possibility. I knew it would help with the chances of having a VBAC just with what I'd learned about hospital practices and stuff. So I met with some midwives in New Mexico where we live and they said– I met with several and they all said, “Law here doesn't let us do a home birth after multiple C-sections. We can do it after one but not multiple.” I was just trying to be really open and praying that the birth would be how it was supposed to be. I was like, “Okay. We'll just do the hospital and I'll be ready to stand up for myself. I'll know all of my rights and I'll know all of my info and I'll just say, ‘I'm not having a C-section'”. Then I met with my OB and I was expecting to have a big dialogue. I was like, “Would you support a VBAC after I've had the three C-sections?” I was expecting this back and forth and he was like, “That's a hard no.” I was like, “Oh, okay. I guess we're done.” Meagan: Okay. Jennifer: So I started looking in El Paso, Texas which is just two hours away from us because one of the midwives had said that the laws are different in Texas. We found a really great, experienced midwife there in El Paso. She was very confident and I feel like that's a really huge part of getting your VBAC is your provider's confidence. Not just that they are tolerant, but that they are like, “Yeah. You can do this,” which is how she was. Meagan: How it should be. Jennifer: Yeah. 19:02 Going into labor and reserving an AirbnbJennifer: We did my prenatal care with her. It was a normal pregnancy. Then I went into labor at midnight a week and a day before Christmas. Meagan: You went there. You had an Airbnb, right? Jennifer: Yes. That's the other twist and turn. We were doing this home birth, but we don't live in El Paso obviously, so the plan was to get an Airbnb and birth there. At first, we were going to get it ahead of time, but just planning-wise and money-wise, we decided not to do that. We still could have missed it even if we booked two weeks around the due date. Meagan: Right and that's a lot of money to spend. Jennifer: Yeah. We ended up just deciding to wait until I went into labor and then we'd book an Airbnb. The backup plan was we could do a hotel suite if we couldn't find anything. Yes. Meagan: If it wasn't available. Jennifer: Midnight was the worst time that I could have gone into labor because you check in to an Airbnb at 3:00 in the afternoon and midnight is about as long away as you can get from the afternoon. But it was fine because it did progress really slowly. Even though it was my fourth birth, it was like a first-time labor. Meagan: Yep. The first time you did really– well, I mean you labored. Jennifer: I labored for a little while, but I never got into active labor. Yeah, so it was slow and we had time. We just messaged all of the AirBnbs that would have worked for us and we were like, “Could you let us check in this morning?” They were like, “We have a guest and we have to clean so we can let you check in at 3:00 or 4:00” or whatever. Finally, one was like, “We're cleaning it now and we can have it ready by 11:00.” We're like, “We'll take it.” It was beautiful. It was a great house to give birth in. Meagan: Good. Jennifer: So I labored slowly. It was really slow and then all of a sudden, it seemed like it was picking up. For a minute, I thought people weren't going to get there. I texted all of my support people and I was like, “You need to come now. You might miss it,” but we had plenty of time. I had a doula and my midwife there and my friend, my sister, and my sister-in-law so a lot of support which I ended up just really needing. I felt so in need of support– touch, prayers, drinks, back rubs, and everything that could be. I'm kind of a reserved person. That's not my normal personality, but in labor, it was. I was also really bossy. I was like, “Cover me up right now. Okay, take the blanket off. I need the heating pad. Get me a drink.” I told my sister-in-law, I asked her to change because she had strong perfume and I'm really sensitive to smells. I was like, “Could you please change your shirt? I'm so sorry,” but I just got super bossy in labor. My doula was great. She did lots of hip squeezes and counterpressure. That was so helpful. I remember during the hardest, last few hours, I was like, “How has any woman ever done this? How has any woman ever made it through labor?” I just felt like there was no escape and it was just going to go on forever. My midwife got kind of stern with me which was hard, really hard in the moment because I felt like she was being really mean. My doula told me afterward that she was kind of in the middle range. She's worked with midwives who are really aggressive and with midwives who are really gentle and this was kind of mid-range. I was like, “I guess that's good.” I realized afterward, it was really good. It helped push me through, but she was like, “You need to get out of your head. You need to stop feeling sorry for yourself and do the work.” I was like, “You're being so mean.” Meagan: That is hard to hear when you're going through labor. Jennifer: Yeah, it was. But I think there was a part of me that did feel sorry for myself for going through it. I did need to get the mindset like, “I need to finish this.” Meagan: We're doing it, mhmm.24:04 Complete dilationJennifer: Near the very end, she wanted to check me and I hadn't wanted any cervical checks. I did end up having three total. I had one in the very beginning just to make sure it was really it and then she had checked me sometime in the afternoon/evening and this is why I didn't want cervical checks because I was only at 5 and I was sure I must almost be done. I was like, “I must almost be at 9.” I was only at 5 and I was like, “Ah, how am I going to this much longer?” But then at the end, she wanted to check me again and I did not want to be checked again. She said, “If you're not progressed much from where you were earlier, with the way you are coping, we probably need to go to the hospital and get you an epidural, get you some Pitocin, and move this along.” I found out later that the baby's heart rate at that time was looking iffy. It had been spiking and going back to normal. I don't know if they didn't tell me during the time or if I just don't remember it because of labor, but that's why she was really urgent to check me. I was really resistant to it but finally, I was like, “Okay, fine.” When she checked me, she was like, “There's no cervix. You are ready to push.” Meagan: That's a common thing when babies come down, the cervix opens, and everything is complete. Sometimes babies can do a funky, “Whoa, what's going on here?” with their heart rate. Jennifer: Okay, that would make sense. But I wasn't pushing or anything. I expected– I had all of these expectations. I expected to do lots of different positions and then in the moment, I was like, “I just have to survive in whatever position I happen to be in.” I had expected to feel that real urge to push and there really wasn't. My midwife ended up directing me how to push. She put me on my back propped up on the bed. I didn't want to be on my back because I knew that was not an optimal position for pushing, but I was so tired. This was around 2:00 in the morning the next morning after I had gone into labor the midnight before so it was a 26-hour labor altogether. I was so tired. 26:37 Pushing and catching her babyJennifer: I was on my back and she was telling me to hold my breath and bear down. Pushing was the hardest thing I have ever done. I wanted to blow out and let some of my air out and she was like, “Stop it. Hold your breath.” I could not feel the baby coming down. I felt no ring of fire. I didn't feel any of it. All I felt was the contractions. They were so intense and trying to bear down and hold my breath and not blow out was so hard but it was effective. It was just a few minutes, just a few contractions that I pushed for and then her head came out. I didn't feel her head come out and then her body right after. I had wanted to catch her and my midwife guided her out. She was like, “Take your baby, Jennifer.” Meagan: Aww. Jennifer: So I reached down and pulled her up to my chest. It took a little while for it to sink in that I had the VBAC. Meagan: I bet. Jennifer: I was just in that state of, “This is never going to end.” It was so hard. I was in a wanting to give up state of mind also. I was like, “If they could bring the hospital here, I would take the epidural. I would take the C-section,” at the moment, but I couldn't fathom getting in the car. That was the only thing that stopped me from, “Let's just go to the hospital.” I could not imagine getting in the car at that point of labor. Meagan: Which says something too, right? It says, “It's time to have a baby.” Jennifer: Yeah, totally. Yeah. That was it. It was a beautiful time afterward because everyone in the house heard. It was just me, my husband, and my doula for most of the time in the bedroom, but everyone heard me being very loud when I was pushing and heard her cry when she came out so my kids all came in at 2:00 in the morning and my sisters. Yeah. It was just a beautiful time afterward and was so nice to just be in a home even if it wasn't my home. Meagan: You were in a home. Jennifer: And relaxed and comfortable. We waited to cut the cord until the placenta came out. It was just all relaxed and very beautiful. We named our little daughter Willa which means protection and just signifies how God protected us through this thing that a lot of people think is really scary and really dangerous. I'm very thankful. Meagan: And you did it and there weren't really any complications. How was your postpartum experience with this one? How was healing and recovery? You had three Cesareans. It started getting harder with each one and it can get harder naturally no matter what type of birth because we have other kids to take care of, but how was your postpartum experience? Jennifer: It was really good, much easier than a C-section and really different. There's still hard stuff. Just the pressure and bulging feeling that you have down there, I was like, “Oh, I've never experienced this before. I can't sit up. I have to lay back or lean to the side or something to be comfortable.” Then I kept instinctively putting my hands on my scar area anytime I'd sneeze or cough because that's what I'm used to having to do. Meagan: Oh, interesting. Jennifer: Then I'd be like, “Oh, I don't have to do that.” Meagan: That was probably really nice. Jennifer: That was really nice, yeah. Then not having to be on painkillers afterward. That's a huge thing for me because I feel like it's always dulled or blurred, those first few weeks. You are kind of out of it and both me and the baby were both more alert than I've ever experienced before. Meagan: Absolutely. I would agree. I mean, I was there but it was. It was kind of blurry. Jennifer: Yeah, just a little blurry. Meagan: I was really tired and groggy. You're already tired and groggy anyway after laboring, especially after surgery, but yeah. Jennifer: Yes, totally. 31:24 You are worth itMeagan: I am so happy for you. I am so grateful that along the way you were able to learn and grow educationally. Knowing you personally, you were finding out who you were more personally. You were like, “I have more to offer to this experience” by learning and growing and advocating for yourself. Driving two hours is not an easy thing and to think, “I'm renting. I'm paying for a midwife. I'm renting an Airbnb.” There are a lot of puzzle pieces that have to come together and fit and those can be really daunting. Really daunting, but typically it is worth it. Jennifer: Yeah, so worth it. I've thought about that along the lines of how eating healthy costs more and is a little harder or sometimes a lot harder. It's easy to eat fast food and processed food and stuff, but when you put in the work and the money also to have better health, it's worth it.I felt like that with the birth because yeah. We are paying for the Airbnb and we're paying for the midwife and we're paying for the doula and it was all worth it 100%. Worth it to pay for that. Meagan: Worth it, right? We talked about this many, many times ago. I think it was Blyss Young who talked about how we put so much money and effort into our weddings and things like that, but then when it comes to birth, we're like, “Oh, whatever.” Then we just don't see the value in a lot of these things. So talking about nutrition, eating really good foods, getting the good supplements, even finding the provider, and sometimes we have to pay more out of pocket for that provider or whatever it may be and it's less ideal but in the grand scheme, when everything is done, I feel like it's more unlikely for us to go back and be like, “I regret paying for that childbirth education class” or “I regret paying for a doula” or “I regret finding the right provider and giving birth in a home versus the hospital because that was my dream”. Jennifer: Yeah. You're just not going to. I mean, I don't. I definitely do not regret any of that. Meagan: I definitely didn't either. I remember my husband being like, “You're going to choose the most expensive option.” I was like, “It's worth it. It's worth it.” It's worth it to give back to you. This is a really, really big day. Our wedding day is a big day. Don't get me wrong. It's a day that is amazing, but the vulnerability and the experience that sticks with us from birth I feel like is even bigger. Jennifer: It's just huge, yeah. It really is. Meagan: Yeah. Yeah. Jennifer: It was definitely all worth it to have all of the extras. Meagan: All of the extra, yeah. Not only is it worth it, you are worth it. Women of Strength, you are worth whatever it may be because I promise you in 25 years, you are not going to think about that $5000 that you spend on your midwife or whatever. I don't know how much midwives are everywhere, but you're not going to look at that. You're not going to look at that. You're going to be like, “That was worth it.” Yeah. Do what's best for you and know that you are worth it. You are not selfish for wanting to do things differently or spend extra money or get the education. You're not. It's worth it. Jennifer: Yeah. I mean, who knows but I have a strong feeling it would have ended in a C-section if I had been in the hospital because we passed that 24-hour mark, and now the baby's heart rate is looking iffy and I'm utterly exhausted and ready to give up. I just feel like there's a good chance that it could have ended in a C-section. That's not what is best. I know that's not what is best for me at this point. I don't know if we are done having kids and I know there are more complications with more C-sections. It was definitely worth it to also give myself the location and type of birth and everything that was going to lead more to success. Meagan: Right, yeah. Well, thank you so much for sharing your journey. Jennifer: Yeah. I'm so glad to have been able to. I told you at the beginning that we've been listening to The VBAC Link all throughout my pregnancy and yeah, my kids are so excited that I'm going to be on it. Meagan: I can't wait to hear what they think about it where they are like, “Whoa, that's your voice, Mom. That's your voice!”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 Episode was made possible by Immune Intel AHCC® & WeNatalBirthwork is a sacred calling. And as we accumulate life experience we can become more comfortable and present with birth, particularly when we begin to accumulate direct experience with the death of loved ones. Death and dying aren't words that are typically used in a conversation about birth, but many women and their partners don't experience as radical a confrontation with their own mortality outside of birth, which is a sacred rite of passage. Blyss Young is one of my closest mentors, and she was present for my first home birth, while I was in residency. Having gone through deep losses in succession in recent years, she was gracious enough to share her experiences with me in this very vulnerable and heart-opening conversation
Stuart J. Fischbein MD is a community-based practicing obstetrician and an Associate of the American College of Obstetrics & Gynecology, published author of the book “Fearless Pregnancy, Wisdom & Reassurance from a Doctor, A Midwife and A Mom” and peer-reviewed papers Homebirth with an Obstetrician, A Series of 135 Out of Hospital Births and Breech birth at home: outcomes of 60 breech and 109 cephalic planned home and birth center births. After completing his residency at Cedars-Sinai Medical Center in Los Angeles, CA, Dr. Stu spent 24 years assisting women with hospital birthing and, for the last 13 years, has been a homebirth obstetrician who works directly with midwives. Dr. Stu travels around the world as a lecturer and advocates for reteaching breech & twin birth skills, respect for the normalcy of birth, and honoring informed consent.Follow him on Instagram @birthinginstincts and at The Birthing Instincts Podcast with midwife Blyss Young as he offers hope, reassurance, and safe, honest evidence-supported choices for those women who understand pregnancy is a normal bodily function not to be feared. His website is www.birthinginstincts.comSome Resources mentioned:Moth in the Iron LungCrooked: Man-Made Disease Explained:International Cesarean Awareness Network: https://www.ican-online.org/Step-by-step roadmap to help you plan for your VBAC: Free VBAC Success RoadmapConnect with me, Petra ⤵️Instagram:@birthing_come_trueFacebook: Birthing Come TrueWebsite: Birthingcometrue.comEmail: Petra@birthingcometrue.comDon't forget to subscribe to The VBAC Junkie Podcast for more empowering conversations and insights on all things birth-related.---------------------------------------------------------------------------------------------------- Let's Connect!✨ The VBAC Junkie Website: www.birthingcometrue.com/thebirthjunkiepodcast✨ Follow me on Instagram: @thevbacjunkiepodcast and @Birthing_Come_TrueI'd so appreciate it if you'd rate and review this show wherever you're listening from. I'm grateful you've taken time out of your day to listen, thank you!
YOUR BIRTH, GOD’S WAY - Christian Pregnancy, Natural Birth, Postpartum, Breastfeeding Help
In today's conclusion of my interview with Dr. Stuart Fischbein (from the Birthing Instincts podcast with Blyss Young), we talk about the intricacies of God's design, the new postpartum depression pill, "jabs", exposure to heavy metals, and Dr. Stu's recommendations for how to have the best chance to have a natural birth. Helpful Links: 2 WAYS TO WORK WITH LORI: --> Sign up HERE for the Your Birth, God's Way Online Christian Childbirth Course! 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 conducted LIVE this summer. 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 to give input on future episodes you want to hear --> https://bit.ly/yourbirthsurvey Got questions? Email lori@yourbirthgodsway.com Socials: Follow Your Birth, God's Way on Instagram! Follow the Your Birth, God's Way Facebook Page! Join Our Exclusive Online Birth Community -- facebook.com/groups/yourbirthgodsway Learn more about Lori and the podcast at yourbirthgodsway.com! FREE Bible Study - 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.
In today's episode, HeHe sits down with homebirth Midwife, Blyss Young, to talk about understanding if you are a candidate for homebirth. Blyss shares what type of care homebirth midwives do and how it may differ from what you find in the hospital or a birth center environment. We dive into the power that comes along with tapping into your instincts and spiritual experience of homebirth, plus how to know when youre not a good candidate for homebirth! Does having a high-risk pregnancy automatically rule you out of being a candidate for homebirth? Tune in to hear HeHe & Blyss answers all your questions! Bio: Blyss Young, LM CPM, is a home birth midwife, childbirth educator, placenta encapsulator and natural birth and family consultant. Through her guidance and love centered approach she supports families to birth in the ways that they feel most empowered. She is a firm believer in intuition, the sacredness and ritual of birth and the power of autonomy in birth. She has studied with both Dr. Stu Fischbein (LA's only home birth obstetrician) and many skilled midwives. She has been fortunate to learn the art of midwifery in addition to the unique skills of delivering Breech, Twins and VBACs. At the heart of all of her work is a deeply rooted belief in the brilliant design of the human body and the symbiotic relationship between baby and parent. She continues to strive to support the sacredness of birth as a rite of passage, in the hopes to resurrect lost traditions that can bring connection to our high tech low touch lives. Join The Birth Lounge! Connect with Blyss: https://www.birthingblyss.com/ Listen to Episode 182: Is Homebirth Safer Than Hospital Birth? Listen to Episode 142: The Beginning of Homebirth Thrive Training Institute CPR course, use code HEHE10 for $10 off your purchase
YOUR BIRTH, GOD’S WAY - Christian Pregnancy, Natural Birth, Postpartum, Breastfeeding Help
DISCLAIMER -- The audio on this episode is less than desirable! I was driving home and was too excited to wait to record so i did it while in the car. Please forgive the bad audio and road noise. This past weekend I was honored to be able to attend the first annual Twins / Breech Conference hosted by Nathan Riley, OBGYN of Beloved Holistics in Louisville, Kentucky. I was surrounded by more than 100 midwives and doctors whos entire purpose for being there was to learn more about normalizing vaginal birth for twins and for babies who are breech, AND to practice the skills needed to be able to safely attend these births. There were some absolute legends there. Folks like Dr. Stu Fischblein & Blyss Young of Birthing Instincts, Betty Anne Daviss who is a researcher and midwife from Canada who blazes trails for us, Dr. David Hayes and Rixa Freeze from Breech Without Borders, Gail Tully from Spinning Babies, and so many more! I can't fully process how much I learned and what a lovely and full weekend it was. This episode was recorded during my drive home so the audio is less than desirable. I hope you can overlook it and forgive me. The episode consists of my three main takeaways from the conference that I think will benefit and encourage you. Helpful Links: Did you miss out on our first Your Birth God's Way Christian Childbirth Education Course but still need Lori's help? No worries! Did you know she offers office hours to help you with anything you need? Sign up for your PERSONALIZED Pregnancy Coaching Midwife & Me Power Hour HERE Want to sign up for the next round of the Your Birth, God's Way Christian Childbirth Education Course? Email Lori here with subject line "Wait List Request" and you'll be the first to know when the next class opens up! 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 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.
Show NotesOn this episode of the podcast I chat with Dr. Stu about twin birth, breech vaginal birth, and what the difference is in the care you receive at a hospital versus a midwifery setting. He provides insight from over 40 years in the birth world. This discussion is such an important one, so grab your favorite drink and enjoy listening or watch on YouTube @resourcedoula!Follow him on Instagram @birthinginstincts and at The Birthing Instincts Podcast with midwife Blyss Young as he offers hope, reassurance and safe, honest evidence-supported choices for those women who understand pregnancy is a normal bodily function not to be feared. His website is www.birthinginstincts.com.Resources he mentionedReteach Breech: http://www.birthinginstincts.com/reteach-breechBreech Without Borders: https://www.breechwithoutborders.org/Book: The Vaccine Friendly Plan: https://amzn.to/449UteIBook: Turtles All the Way Down: https://amzn.to/3NIlv7JConnect with Dr. StuFollow @birthinginstincts on Instagram: https://www.instagram.com/birthinginstincts/Listen to the Birthing Instincts Podcast: https://pod.link/1552816683visit the Birthing Instincts site: https://www.birthinginstincts.com/Sign up for a consult or an annual membership herePlease remember that that what you hear on this podcast is not medical advice, but remember to always be an active participant in your care, and talk to your healthcare team before making important decisions. If you found this podcast helpful, please consider writing a positive review in your favorite podcast app or on YouTube! Thanks so much for listening. I'll catch you next time!Support the showSign up for my weekly email newsletter: https://trainat.li/emails Snag your free download here: The Mindful Mama's Guide to Moving better: 5 exercises you can seamlessly integrate into your busy day: https://trainat.li/field-guide Come say hey on social media! Trainer Natalie's Social Channels: Instagram: @trainernatalieh Youtube: @trainernatalie TikTok: @trainernatalie Facebook: @trainernatalieh Twitter: @trainernatalieh The Resource Doula Podcast Social Channels: Instagram: @resourcedoulapodcast TikTok: @resourcedoula Resource Doula Podcast Youtube: @resourcedoula
Blyss Young is a seasoned home birth midwife who has so much knowledge, experience, and a special heart for VBAC. Blyss hosts her own podcast, Birthing Instincts, alongside her cohost Dr. Stuart Fischbein where they normalize physiologic birth outside of the hospital.We asked our VBAC community what questions you have for a midwife who supports home births after Cesarean and Blyss has answers! You will leave feeling inspired, educated, supported, and loved for whatever your birthing choices may be after listening to this beautiful discussion. We absolutely adore Blyss and know you will too!Additional LinksBlyss' WebsiteHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Facebook CommunityFull Transcript under Episode DetailsMeagan: Hello, hello women of strength. It is Wednesday. Actually, it's Monday the day of this episode and we are coming at you with another Cesarean Awareness Episode. I am so excited to be doing extra episodes this month. Today we have our friend Blyss Young. You guys, if you don't follow her and her podcast with Dr. Stu, you need to do that right now. Push pause and go find them because they are amazing. They are a wealth of knowledge. They just make me smile. I feel like every time I'm done listening to an episode, my face hurts because I've just been smiling. Really, though. I remember I fell in love with Blyss and Stu years and years ago. We've been so fortunate to have them on the podcast before and Blyss agreed today to be on the podcast blessing you again with her wealth of knowledge and answering some of your questions. We put out in The VBAC Link Community, “What questions do you have for a midwife?” and we got quite a few surrounding home birth. I know this might sound like a really heavy month of talking about home birth because Julie and I got a little salt at the beginning of April talking about a home birth but it's just such an important topic that a lot of people don't know is an option. Review of the WeekSo we're excited to dive into today's episode with cute Blyss but of course, I have a review of the week that I would like to read. The title says, “Thank You” and it's from cara05. It says, “I just wanted to drop a review and say thank you. Because of listening to some of your podcasts, I felt empowered to talk to my OBGYN about skipping the repeat Cesarean in the event that I go past my due date. This was something I had in my head that I really wanted. Opting for induction to still try for a VBAC was important. She was and just over all of this so supportive.” Sorry, that was a little weird for me to read.“She was so supportive of the idea and totally on board which helped me get more excited about championing–” Blyss, I can't read this morning. Sorry, Cara. “--this VBAC so thank you.” Oh, man. This is where Julie always would come in handy. She would really read reviews really well. So going on and having her VBAC. Congrats, Cara, for feeling empowered and that you were able to talk to your OBGYN. This is something that is so important whether you are a VBAC mom or not. We want to have a good relationship with our provider and we want to make sure that we can have those tough conversations. When they may be suggesting induction or a repeat Cesarean for going past your due date, but if something in your heart is telling you no or you are seeing the evidence and you're like, “That doesn't feel right,” have those conversations. I encourage you to have those conversations with your providers. I mean, is there anything that you would say to that as well with being a provider in the world? I feel like as a provider in my head, I would want someone to tell me their thoughts and feelings. Blyss: My relationship with my clients is very intimate. Meagan: It is. Blyss: Yeah. One of my teachers, Elizabeth Davis, who wrote Heart and Hand is a longtime midwife and teacher. She talks about the more we do prenatally, the less we have to do in labor. So I feel like that relationship that we have and hearing the internal landscape of the client is so important because when we are in labor, our body responds. Our hormones respond to feeling safe and having trust and being able to really relax. That's true for every one of my clients but especially with my VBAC clients because they have another level of trauma many times that they are having to go with. That could be their experience that happened in the hospital or maybe they were transported from a home birth and had a Cesarean. And then there's that level of, “Does my body really work? Can I trust my instincts?” So the more that we can dialog about those things and start to really pull that apart and work with them prenatally, I feel like the better chances we have in having that successful experience. Meagan: Yeah, absolutely. I will never forget it. I transferred to my midwife at 24 weeks with my third, my son, my VBAC baby. I just remember looking forward to those days when I got to go see my midwife because I would be feeling angst and hearing all of the static in the world. I remember just walking and she would always greet me with a hug and say, “How are you doing today? What do we need to talk about?” We talked. We dissected those fears and really talked about the things that were going through my mind at that time. I remember always leaving, going with a weight on my shoulders and leaving just feeling refreshed and more connected to her. Blyss: Yeah. Meagan: I think it's important. I know that it's hard in the system because we have providers that are restricted on time. They have so many patients. They've got bogged schedules. They're tired so it's a little harder for them to be more intimate, but I still encourage our listeners to have those conversations, to let them know where you're at so like you said, you can work through it prenatally so that during the birth, those things aren't coming up. We talk about that in our course. VBAC can be different and need more time prenatally. So yeah. If we don't do those things ahead of time, it can definitely impact us during labor. Blyss: Yeah. You know, expect that kind of care. You're not getting that kind of care if you're not feeling the way that you just described when you leave your provider's office. Start to think about what it is that you really want. I know not everybody has the option to either financially or because of availability be able to work with a midwife necessarily, but plan to have somebody on your team that you do feel can support you that way whether it's a doula or maybe doing some concurrent care with a midwife in your area where she can hold the space for you and give you those positive feelings that can help prepare you for your delivery.Meagan: Absolutely. Talking about that, I did dual care for just a little bit as I was debating a little bit and figuring out logistics. Just doing dual care made me feel so much better. I would go to one place and hear one thing and then go to the other and have to work through that. She did have the time and the resources to provide me with that comfort. I love it. Q&A with Blyss YoungMeagan: Okay, well like I said, we have some questions and I think they are really good questions from our listeners. We'll just dive into those if you don't mind and then feel free if we need to stagger away from them on any other topics or passions. This is one of the questions actually that was put in. We talked about this right before we jumped on. What is a CPM versus CNM or a licensed midwife? There are so many questions that people ask. There is a myth that CPMs are not qualified or able to handle VBAC and especially HBAC. I feel like this is the big myth. If you wouldn't mind, could we debunk this a little bit? I don't necessarily agree with that. Blyss: Yeah. I think it all comes down to what you feel aligns best with your values. Just so you understand a little bit about how we're trained. Certified professional midwives, our licensing body is different across the United States. This is one of the problems with our systems whereas we look at other European countries where midwives are integrated into the medical system, we don't really have it together in that way here in the States. The licensure is different from state to state depending on the local jurisdiction. CPMs' certification is our national certification. I practice here in California so when I take my board exams, I'm licensed by the medical board. It's the same licensing board that licenses OBs that gives me my exams. I take my exam and I take the CPM and the LM. That may not be the case across the country. We learn our bookwork and then we have an apprenticeship. We work side by side with midwives or doctors to learn our hands-on skills and then we take a board exam similar to many doctors and nurses and people like that who have this professional capacity. A CNM is a certified nurse midwife. They are licensed by the nursing board and they become nurses first and then have their specialty added to it of midwifery. As professional midwives, all we train for is out-of-hospital birth. That is our specialty. We specialize in low-risk, normal, healthy pregnant moms and their babies. A mom who has had previous Cesarean labor and delivers exactly the same as any other mom. They have an increased consideration because they have this scar so the integrity of risk has been affected but other than that, everything is exactly in terms of their pregnancy and their labor and delivery. We absolutely are champions for these moms being able to have and experience a vaginal delivery for the healing of all of that trauma that we talk about. And also because of your long-term health as a woman who is delivering maybe multiple babies in your lifetime, it's actually much better for you to be able to have a vaginal delivery than to continue to go and have Cesareans. The benefits for the baby of being able to pass through the biome and have those mechanics that help empty their lungs as they are delivered and all of those things that the baby benefits from having physiologic birth. We are champions for that for these moms and for these families because we know. There are some things that we watch for in case there is a uterine rupture or dehiscence as we would say where the scar opens a little bit. There are things that will be a little bit different than a mom who has not had a previous surgery, but other than that, this mom is just a mom who is pregnant and wants to have her baby. So we're absolutely skilled to be able to support that. If you look at the statistics of success because a mom who has had a previous Cesarean is a TOLAC. She is desiring to have a trial of labor after a Cesarean. I lost my train of thought. Meagan: You are just fine. You were just talking about uterine rupture. We have a small increased risk but we are just having a baby as well so at home we have to pay attention to uterine rupture and dehiscence and things like that. There are signs and then you were going to the statistics. Blyss: Yeah, there are signs that we are skilled to be able to look for. Meagan: Yeah. Statistically, uterine rupture happens at 0.4-1%. It's pretty minimal but having someone who is trained in out-of-hospital birth is a little bit different but it doesn't mean that anyone is less qualified to support someone giving birth after having a previous Cesarean or previous Cesarean. Blyss: Oh, yeah. So what I was going to say and where I lost my train of thought was the statistics in terms of success so actually having that vaginal delivery is much higher out of the hospital with a midwife than it is in the hospital. That is something to consider as well. If that's your desire, you want to put yourself in a situation where you're going to have the best possible support to be able to have the vaginal birth that you are desiring. Meagan: Absolutely. That's what Julie and I spoke about at the beginning of April kicking this special episode series of home birth and the chances of success outside of the hospital. We talked about how I want to say it was 18% of people may transfer. Tell me if you know the stat. I think it was 18 or so percent. But within that 18% of transfers, it was usually exhaustion, needing an epidural, or maybe we've got some scar tissue or something that we can't work through, it's a failure to progress, and maybe we need something else if we can't get a homeopathic way to work. I want to say that was what we found. Is that approximately what you would say?Blyss: That's not my statistic. Meagan: Well, yeah. Your statistic is low.Blyss: I would say for a mom attempting to have a vaginal delivery after a Cesarean is the same statistic as a mom who is attempting a first-time delivery. We treat them in the same way in a lot of ways because they haven't had that pushing phase. They haven't pushed a baby out. Their labor depending on how far they dilated in their previous labors is going to give us some information as well. If a woman got all the way to 10 and was pushing her baby out and then they for whatever reason decided that a Cesarean was appropriate, her labor is going to be more like a multip, so someone who has labored except for that pushing phase. And someone who maybe didn't ever get to have labor– you're raising your hand. Meagan: Yep. Blyss: Or I think one of the questions that is coming up is that you only dilated to so far and you're not sure if you're going to be able to get past that point? Those moms are going to be treated more similarly to a mom who has never had labor before. We are going to support them in that way. You have to really, I think this is what we don't understand. A lot of the studies and statistics that are done when you're looking things up or hearing about things are from a medical perspective. They're from medical perspectives. The way that they treat– and I was a doula for many years before I owned a center. I was a doula for many years before I started doing a private home birth practice. I know what it looks like in the hospital to support a VBAC. I've been there with them. Your provider and their faith in you and the way that you are treated by the nursing staff and all of that has a huge impact on your ability to be able to labor and progress normally. We are mammals so our bodies are going to respond the same way a cat or a dog or a cow who wants to go and be off by themselves and have privacy and not feel like they're being watched. Your hormones respond to that. Labor moving straightforwardly in a normal way is affected by you feeling that way. That's what I was saying when we were talking about the different licensure. It really depends on where you're going to feel the most comfortable but you want to have a team that really believes in you and makes you feel, as we were talking about in the beginning, relaxed, comfortable, and empowered because those are the things that are going to affect your body progressing normally. Meagan: Absolutely. Absolutely. As a doula, I've supported VBAC clients both in and out of the hospital but there are times where there is a lot of pressure and angst that is created. That is not helping our labor. Julie and I mentioned it in our episode. We have to think about it like we wouldn't give birth in the same place where we conceived. We don't conceive in front of a whole bunch of people with bright lights on a bed with things strapped to our bodies, right? Blyss: Right. Meagan: But then we do give birth this way. It's just something to be mindful of for sure. Blyss: I didn't get a chance to say that my statistics for first-time moms are a little bit higher than for moms who have already had a vaginal delivery. That statistic is about 10%. As you pointed out, the majority of those are not emergent transports. Those are transports where we are ready for something a little bit different. Again, this is when even midwives have a different level of comfort in terms of how they care for you. I don't transfer someone to the hospital because I'm ready for them to go. I transfer people to the hospital unless there is a medical indication. If there's a medical indication then obviously, I'm like, “Okay, we need to go,” but in terms of this exhaustion and wanting something different and maybe wanting to rest and get an epidural or get access to Pitocin to augment the labor, those kinds of things, for me, if everything is looking great medically, then this is the mom's choice. This is not something that I'm going to make that decision for her. I had a mom the other day. This didn't happen to be a VBAC mom, but just in a normal labor. She had the pushing instinct. It went away. We labored with her for another nine hours because she had a lip and then she pushed her baby out. All of the doulas who were with us were talking about how if that happened in the hospital, that mom probably would have definitely been augmented, definitely not left alone, given a lot of pressure, a lot of vaginal exams, and then probably would have ended up having a Cesarean or a “failure to progress.” But what that mom needed was rest. She needed to eat. She needed to feel like she was ready for the next level of her labor. It was a very mental thing for her we believe. That's not something that is always given either at home or in the hospital. Sometimes, especially, I was just talking to a VBAC mom right before we got on the phone because she went in to see if she could get a consult with a backup doctor in her local area. I sent her to the most common doctors that are supportive of transport. This doctor said, “No doctor in their right mind would back up a mom attempting to have a vaginal delivery at home.” And this is the best we've got. We got on the phone and we were talking about her feelings about all of that because she would really love to know if she's going to have a repeat Cesarean, she would really like to know the person with who she's having a Cesarean. Meagan: Totally. That's one of the reasons why I did it. Blyss: Yeah. That's a reasonable thing to desire but what she's finding out is that she might not have that option and just being in that doctor's office, she said that the nurse came in and said, “Can you take off your pants so we can do a pap smear?” She said, “I'm not coming in for a pap smear.” Just that was a perfect example of being treated like every other person and not being individualized. This woman was coming in for a consult. But it solidified her desire, “This is why I'm not going into the hospital again. If I need it, then it's a good option but it's not something that I'm feeling like I want to choose.” It's just solidifying her desire to have this out-of-hospital experience. Meagan: Absolutely. I think for those who are doing dual care, it's important to still learn the stats and the facts because they can sometimes inflate these numbers and these statistics then you are left thinking, “Wait, am I making the right choice?” My provider told me, “Good luck, no one is going to want you out there.” It was a little different than what she was told but very similar. No one was going to want me out there. It made me question, “Why? Am I that scary of a patient?” That's just not a good feeling and it's not how you should be feeling during pregnancy and especially not during birth. I'm going to lead into one of the first questions that were actually written. Why is there so much backlash around HBAC? When we were talking about backlash, I think it really just means so much hate and distrust about HBAC. I mean, do you find that a lot of people are coming to you saying, “Everyone's telling me not to do this,” or maybe they're even scared? I feel like maybe by the time they come to you, they are confident in their decision, but do you ever have any clients come to you who are still unsure?Blyss: I think that people can be in care and still feel a little unsure. There is part of the process of just unraveling the experience that you had last time and being with somebody who consistently says, “Everything looks good. You're doing great,” and just normalizing the experience of having a joyful pregnancy. The mom that I just talked to, she's like, “There are risks in everything.” I think that's true too. You can look at a statistic that says, “You have a 1% chance of having this happen,” and you can try and say, “I want to try and take that risk down to zero.” Obviously, there is risk in everything. You can't have no risk, but there are people who look at it and go, “I have a 99% chance of having success.” Meagan: That's what we say. Flip it and be like, “I have a 90.9 or 99% chance of full success.” It's like, “Well, dang. That means I'm pretty high up there.” Blyss: Yeah. That's probably how you look at life in general. So if you're wanting to flip the script for yourself not just about this particular instance but about how you look at life in general because you talk about how the birth of your child is just one day. You're actually going to be raising this baby and they're going to have all kinds of risks. Do you want to spend the rest of that time with this child being worried all of the time about what possibly could happen or do you want to enjoy what life has in store for you? That's a lifestyle thing, but you can have a transformative experience and you have this thing in your life that people are looking at. They are projecting onto you their own fear. You have the ability to ground yourself in your own belief about how you are wanting to take control of not just this delivery but your life in general. I think it can help you move into feeling more confident about your choices in general. Meagan: Absolutely. I think you just nailed it right there. A lot of the time, the people that are feeding the backlash are people that have experienced an unfortunate circumstance or have experienced something personal. They are feeding it out there to the world because that's where they're at. Blyss: Yeah, or not. Or they haven't had any. Meagan: Or they haven't. Exactly, yeah. Blyss: You know, I had a mom one time in my care who was attempting to have an HBAC. Her previous doctor was sending me the records. She was transferring out of care. She was like, “This is so dangerous. How are you going to know how the baby is doing? How are you going to know the signs?” She didn't even know what we do at a home birth. She didn't know that we monitor the baby, that we have all kinds of medications, and the ability to be able to manage things at home. I think a lot of times, there is just ignorance too. There is just not an understanding of the role that midwives play. We're not doing a seance with our incense and our Birkenstocks and just hoping for the best. We actually have been trained to know what to look for. Because we do normal all day every day, that's our specialty. When something is not normal, it stands out. It's like a bad nook. You're like, “Huh. This is not normal.” If there's something going on with the mom's uterus during labor and delivery, there are going to be signs. There's going to be pain in between the contractions near the site that's unusual. There might be bleeding that's unusual. The baby's heart tone might be unusual. The patterns of her labor might be a little bit funky. There are a lot of things that will stand out to us as “This is not normal labor progressing. Something is going on.” If you're being conservative and it's a question mark, “Huh. Does this mean that something is happening with the scar?” then you can conservatively transport to the hospital and be monitored continuously because we use intermittent monitoring. Maybe nothing. Maybe you'll have a vaginal delivery at the hospital, but you have the ability to do that and not wait for something catastrophic to happen. You have plenty of time to get there and do the more conservative management of this labor just in case. Meagan: Right. One of the questions was, what are the stats of transfer for an emergency? Again, everyone's stats might be a little bit different, but what she is saying is that there are signs that indicate a change of plan before there is a crazy emergency.Blyss: Right. Meagan: I do think that what you are saying is that she didn't know what the care was. It circles back to the backlash. I think that a lot of people don't.My mom said some really crazy things. Years later, it wasn't until I really understood the mental process of my mom and everything. She was saying those things out of fear, the unknown, and uncertainty. She didn't know what out-of-hospital birth looked like because she only knew what Cesarean birth looked like. It's so important to learn those things and learn those signs but know like Blyss said, that it's not usually even just one. Blyss, you would know way more than I do. But from my experience, there are usually a couple of symptoms. It's not usually one. It's like, “Okay, we've got this, this, and this” or “We've got this happening. Let's transfer. Let's take a plan of action.”Blyss: Yeah. You were talking about my cohost, Dr. Stuart Fischbein, and one of the things he says– he was a doctor in the hospital for many, many, many years and has now been providing out-of-the-hospital support for families for 12 years now. He has the benefit of both worlds. He talks about when we say that a uterus has a rupture, we imagine a tire bursting on the freeway where it's all of a sudden a pop. But usually what it is, is what we call dehiscence. There's a little opening in the uterus. Oftentimes, that can go without having any real incidence and the only way they would know that happened is if they went in and did another surgery. So a lot of times those things will heal on their own. I think you were saying there's a 6.2% out of the people that do have a dehiscence or a rupture that have something really catastrophic that can happen. The statistics are really on your side but you have to be the one who makes that decision to say, “I would really just rather have another Cesarean,” or “I really want to try,” because there is such a high statistic of having success.One of the things that I was saying to this mom earlier is what I notice and I would consider myself a specialist in VBAC. I really love caring for these women. One is because I feel like their options are limited especially in the area that I am in. There is actually a ban on VBACs in the local hospital where they would deny these women pain relief if they came in to try and have a vaginal delivery. The women in my area are driving 40 minutes to go to a hospital in another town to be able to have this support. I feel really honored to provide this option for people who desire that. It's really important to me. And, I was transported in my first delivery and had a forceps, an instrument delivery. I didn't end up having a C-section. But when I had my vaginal delivery on my own at home after that, the triumph of reclaiming my body and knowing that my body wasn't broken and that it was just a mismanagement of my labor that led to that. I know what it's like for these women to be able to have that redemptive birth after the surgery. What I notice with VBACs is that they're totally straightforward and normal just like another mom giving birth which I talked about earlier or they come really fast. It's like the uterus knows, “I can't do this for very long. I need to be super effective.” I actually just had a woman who had a VBAC after two Cesareans with me and it was so fast that I didn't make it. That's how fast it was. I was so happy for her and her husband because he's a paramedic and he caught the baby and it was absolutely amazing. I was on the phone and on my way there. All the work that we did to prepare her for this and she just popped that baby out like she had done it her whole life. Or we might have a labor that meanders. The uterus is wise in that way too. It's like, “I need to be really conservative with my energy.” So you might have these contractions that are really far apart. Just like I did in that birth when I was telling you that we gave her nine hours to try to have that lip back, nothing was wrong. We weren't getting any signs that anything was wrong. If you're a mom attempting to have a vaginal birth after a Cesarean and you have labor like that, you want somebody with you who is going to honor and respect that your body is progressing, it's just going to take a little bit longer because the integrity of that scar, the uterus knows, “I just need to be smart about this.” If you augment that labor or push that body past what it's saying it can do, that's when you can have a problem. Meagan: Yeah. I love that you said that because I was one of those where my uterus tinkered around for a little bit. I had a 42-hour-long labor. I was like, “This is never going to happen,” but it did and I'm so grateful for that. I think that's just what my uterus needed. It needed to take its time and then it was 6-10 hours to get baby out really quickly. It just took a long time to get there. Blyss: You said you hadn't had labor before, right? Meagan: I labored like a first-time mama. I only went to a 3. My water broke before contractions really started so it had to kick in. There was a lot. Blyss: Yeah, yeah. Sometimes first-time laborers can be that way. I tell my families to be prepared for three days. That's normal. That's normal labor for a first-time dilation and delivery. I don't think that's what you're going to hear from a medical provider because they don't know normal. They only know what they decide as being normal so most of those labors get augmented in some way. Either they're induced or they give them Pitocin at some point or they just call it and say, “Your body's not doing this so we're just going to give you a Cesarean.” Meagan: Yeah. That's what happened with my second. They were like, “Oh, it's just not going to happen.” It hadn't been very long. So it does happen. Another question was going into failure to progress. If we didn't want to transfer and if there was no need to transfer but maybe we're getting tired and we're trying to progress at home, obviously we know time is our best friend. Time, trust, and faith in our body, and sometimes it is going to sleep, getting some food, and maybe doing a fear clearing. I truly believe, I've seen it so much through my own doula work and my own personal self and through the podcast and everything, that clearing your mental fears during labor can change our pattern just like that. It's crazy. But for home birth midwives, are there things that they can do to help things progress? In the hospital, we talked about how you are more likely to be augmented with Pitocin or something like that. Maybe they'd break your water. But are there things that you can do out-of-hospital to avoid a transfer because it's not really necessary at that point but to help progression if we're starting to get tired and things like that?Blyss: Well, I think that when you do have that scar, you want to be mindful of pushing the body like I said. I'm not against augmenting a VBAC but it's something to really give really good informed consent and talk through. I would probably lean more toward, “Let's sleep. Let's take the pressure off. Let's figure it out.” If you're in early labor, sometimes you can take a Benadryl and maybe even have half a glass of wine. Sometimes that can help you sleep. If you're in full-blown labor, it's a little bit harder to do. But like you said, maybe having a conversation about, “Is there something that you're afraid of? Are there people at birth that are nervous and that's affecting you?” Sometimes you have too many people there too early. Your mind can be wanting to take care of those people like, “Gosh, this is taking forever. I feel bad that my midwife is here and that my mom is here.” Send people home. Keep one person there just in case, but clear it out. You can refresh the space. If you've been in labor at home for a long time, sometimes you just change the smells. Clean up a little bit. Meagan: Go outside. Blyss: Go outside. We send our mama outside barefoot in the grass in her backyard. Those things can be really healing. I send people on walks all of the time. I know it's really hard. You don't want to get your clothes on and go outside but this is going to be really good because it takes your mind off of it. Also, going back to that hormone flow, you want to increase oxytocin so do things that can do that. Maybe put on a funny movie and get distracted that way. Maybe you and your husband can go and get in the shower together. You can have a little bit of making out and a little bit of nipple stimulation. If your bag is intact, I know this sounds totally crazy, but I've had people actually have sex and it's very effective. Or if you have a toy or something. I just saw a post the other day talking about how masturbating during labor can bring on the sensation of being able to relax a little bit more. Meagan: I've had a client do that. Blyss: Yeah, totally. Meagan: It totally worked. He did it for her but it totally worked. I was like, “I don't know what you just did and I don't need to know the details.” I was like, “Why don't we all leave? Why don't we grab some lunch? You guys do your thing.” We came back and it was business. Baby was coming. I mean, seriously, baby came three hours later. It can work, yeah. Blyss: Totally, 100%. One of the other things you can do is have a dance party. Change up the music. You don't need the spa music and Hypnobirthing or something the whole time. Put on some fun music and laugh. Shake your booty a little bit. All of these things can be really helpful. Doesn't that sound much better than laying in a hospital bed being monitored and strapped? Meagan: Or hooking up to a pump?Blyss: Yeah. So facilitating oxytocin is another one that can be really, really helpful. But you know, midwives have homeopathy. We have herbs. Our big gun is castor oil. Those things can be utilized. I think it's just a matter of really talking it through. The first thing I would always recommend is respecting the body and respecting that there's a reason why it's having a challenge. If labor really can't get going and you're really tired, then the hospital might be the appropriate place because that again might be your body telling you, “This may not feel the right way for my uterus. There might be something else going on that the uterus is protecting itself from working too hard and causing that scar to maybe not keep its integrity.” Meagan: Yeah. That's a really good point. I want to talk about how you did transfer. You weren't a VBAC. You have transferred. I want our listeners to know that if a transfer takes place, that's okay. That is okay. You're not failing because you left and changed your plan. There is no giving up because you decided that you wanted an epidural. There's no failing in that. It doesn't need to be negative is what I'm trying to say. A lot of the time, people writing in are a home birth turned Cesarean and feel totally deflated like they failed. That's just not how it is. It's not how it is. You are doing an amazing thing. You are birthing a baby. You are birthing a child out of your body. You are giving birth and you are becoming a mother to a human being. It doesn't really matter how you do it or if the plan has to change but like Blyss said, sometimes we need to tune in and say, “What is our body saying right now?” Is our body saying that we need to do nothing? Is our body saying that we need to do something? I think that is one thing that we need to remember. I think sometimes too that people think, “Oh, home birth midwives will do everything they can to avoid a transfer.” I really disagree with that. Yes, they are going to help you get the birth that you want. They are going to do everything they can and they are passionate, but I'm telling you right now listeners, or an OB that helps at home too. We know that those exist with Stu and I think there are some others. They're not going to just do something for themselves. They're not just going to keep you. “You can't leave. Nope. You can't leave because you're going to change my statistic.” It's just not going to be. It's important for you to remember that you are going to be safe. They are going to have these discussions with you and it's okay for you to have those discussions if you're feeling like you need to transfer. If your intuition is saying, “Something is not feeling right,” and not feeling like you are giving up, failing, or disappointing anybody because you're not. You're doing what's best for you. Blyss: Yeah. Again, going back to the work that you do prenatally is going to really help you in labor. The more that you can tune into your own body and know what's important to you and what you need as a sovereign person, the more you're going to be able to tune into that in labor. You don't want to be handing over your power to a provider. You want to be the one who is in charge of what's happening to yourself. They may give you information and consult with you about how things are going from their expertise, but ultimately, it's about you being the one who's saying, “This is really what I want and this is what my body is telling me.” You don't want to just wait until you get into labor to do that. You want to practice that throughout your whole pregnancy. I think that is a really important piece. And yep. Thank God we have medical advances. What I find with my clients is if we end up transferring, we've done all of these things. They've had great prenatal care. They've been able to talk and process all of these things. If they're going to have a repeat Cesarean, what they would like to do differently this time that they learned from their last experience? So if they get to that point, they know that they did everything that they could to give themselves the best chances and they feel empowered throughout the process. I think that the most important thing is that you feel like you weren't bullied or made to do something and that each step of the way, you are making a choice that feels right for you and your family. As human beings, we deserve that for everything. We deserve to be able to make these choices for ourselves. Meagan: Yeah, and I think with being able to make those choices and to feel that empowerment to be able to do that, even if the outcome isn't what we planned on, we're going to have an overall better view from that experience because we aren't going to feel like birth happened to us. We're more likely to feel like we were the active participant in our journey and the leader or the driver in the seat and have a better postpartum experience.Blyss: Yeah. And welcome to life, right? Meagan: Yeah. Blyss: Our lives don't turn out exactly the way that we planned. We ultimately have to meet life on life's terms and know that we are not in control of every single thing that happens. It's how you respond and how you move forward through a challenge that really makes you who you are and gives you the life experience that you want to have because labor and birth and being a mom is the greatest lesson in not being in control of things. It's an important one. It's a really important one. The only thing that you can really have control over is going in and deciding, “I'm going to deliver on this day and have a repeat Cesarean.” That is within your control. But if you are really wanting to trust your body and to have a physiologic birth experience, you have to be willing to let go of that control and ride the waves and see where it takes you and meet each moment with the best that you've got at that time. Meagan: Yes. Oh, I love that. I love that. Ride the waves. That is the perfect ending. I have one more question but I want to just end on that. Ride the waves. Ride the waves. Trust your body. So if I'm having an out-of-hospital birth, what should I be asking? Are there specific questions I should ask my midwife? Do I have qualifications? Are there certain things where you would say, “You're probably not a good candidate for a VBAC at home?” Are there any final tips that you would give as people are researching this option and talking to people?Blyss: Yeah, I think it goes back to what we were saying in the beginning. How do you feel when you are in this person's presence? That's a big one. Telling your story to them, telling them how you feel and what you are desiring this time and then just really feeling into do you feel that this is somebody that you want to have by your side? Ask them about their experience with VBACs. Ask them what would be the situation in which they would require a transport or that they would want to transport? See if that aligns with how you are feeling about this decision and what you would want from a provider. Maybe ask their statistics how many VBACs they have done. What is their transfer rate? When did they transfer with those people? I think that's all really important and how comfortable are they? Are you a mom who has had multiple Cesareans? How comfortable are they with those risks and do you feel aligned with what it is that they are sharing with you about their philosophies? I think that is a big part. Again, your provider and how they feel and how they approach things whether it's in the hospital with an OB or a certified nurse midwife or at home with a CPM, their feelings about it and their trust in this process is going to have a huge impact on your experience because they are going to bring those fears or concerns into the birth room or into your pregnancy and you don't need that. You need someone who believes in you 100% and when you're with them, you feel better than when you got there. That's what you're looking for. If you don't have those options available in your area, find somebody who can provide that for you virtually or find a doula who can be there with you as a continuity of care that you do have that connection and trust and faith with. I feel like that is probably the most important part of the process. Meagan: Absolutely. That's what I was looking for. I had a lot of questions at my visits but ultimately, one of the biggest things I was looking for was how I felt in their presence, their confidence in me, my confidence in them, and yeah. I mean, I liked to know what would happen if I needed to transfer or what would they be looking at to make me transfer so I would know, “Okay, this is happening. She talked about transfer,” but overall, I needed to know that that person was in my corner because I had never been in anybody else's corner if that makes sense. I was in my own corner with my first two babies and I didn't want to feel that way again because it's a very lonely corner. Blyss: Yeah, yeah. The only contraindication would be a classical incision. Other than that, I think that it's just about exploring what the risks are. Let's say it's a short interval or something like that. I think giving true informed consent to that family and making sure they understand the increased potential risk, if this is an option that they want, I would rather be able to support them in this option than send them to the hospital if that's not necessary or having those people maybe do an unassisted birth because no one's willing to support them. That's me. Not all providers feel that way but I believe if this is something that you've researched, you understand the risks, and this is what you're desiring, you deserve to have somebody there by your side. That's what we're there for. Birth is meant to happen with nobody around just like a mammal. We're designed to survive. Our babies are designed to survive. You don't actually need anybody with you, but when you hire somebody to be there by your side, we are there to be able to help you decide when it is time to get support or be able to step in and offer that medical support if needed. So if someone never wants to deal with any kind of complication that may potentially arise in childbirth, you probably shouldn't be a provider because that's our job. We're the ones who are supposed to step in calmly and help you make a decision that's going to keep you and your baby healthy. Like you were saying earlier, us keeping you home when you don't want to stay home, none of us want to have a bad outcome. We don't go to work thinking that we want to force somebody to stay home and have a bad outcome. We all want the same thing, a healthy mom and a healthy baby. For us, there's that additional layer of transformation, elation, joy, rights of passage, and having the family have an experience of understanding that this is how we were meant to deliver our babies. Meagan: I have feelings about the healthy mom, healthy baby. Just like you were saying, I add to it. Healthy mom, healthy baby, and a good experience. That's going to look different for everyone. I hope that as you are listening to this episode, you know you have options. You have options. I know sometimes Blyss talked about financially or maybe even location-wise, you are feeling that those options are stripped or you are feeling restricted. I understand that and I know it sucks. But don't ever hesitate to explore your options or maybe look for those virtual support meetings and things like that. Or maybe drive 40 minutes because deciding what is best for you is most important. Here at The VBAC Link and Blyss, I'm going to speak for you, there's no judgment in the way you birth. There's no judgment. We just want you to have a good experience and know your options. Blyss: Absolutely. Thank you for having me on. I love you and as I said, I love supporting families in general but I have a special place in my heart for VBAC moms and for the work that you are doing so thank you so much for inviting me to have this conversation. I am available for people to come out to Santa Barbara if they feel like they don't have options which I know is not for everybody. I'm also happy to do consults with people over the phone if they just need somebody who can tell them that they can do this. Meagan: Yes, I know it sounds crazy that I'm going to go to another state and have a baby, but you guys, people do it. Before COVID, I had a Russian clientele. People from Russia would come to the states here to Utah. Think about how far that is. It's not super crazy. A lot of the time, people are like, “It's a lot of money. It's a lot of effort. It's a lot of this.” You guys, this is one day in your life that will impact you forever. It really will. I will never forget my births. Money will come and go but your experience will stick with you. Blyss: Forever. Meagan: So if you can make it work, if you have a VBAC ban, or you are restricted or something like that, check out Blyss. Check out midwives in the next state over. Look at these options. Expand your ideas. Expand your ideas and know that you have options. Blyss: Yeah. Take back your power. Meagan: Take back your power. Take back your power and know that it's okay. It's okay to do something that seems weird. People are going to be like, “What are you doing?” but it's okay to do that. Blyss: And that's how change happens. If we all do the same thing, no one is ever able to see that this is possible. You deserve that. You deserve to listen to your own heart and your own instincts and what your soul is telling you is right for you. That's okay if it's not right for everybody. Meagan: Yes. Absolutely. Just like we were talking about earlier, there are going to be different outcomes and that's okay if that wasn't your outcome or if that wasn't your choice. We have people who after learning about VBAC and the statistics, the risk is too much for them and that is okay. That's okay. 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
This episode is a highlight reel from this week's full episode.WANT THE FULL EPISODE?Check out yesterday's episode, or download it directly: https://api.spreaker.com/v2/episodes/50986970/download.mp3What is the driving factor in your decisions?Oftentimes, coercion, systemization, media, and administrations influence our actions whether we take notice or not. Dr. Stu Fischbein, Community-Based Obstetrician, shares the importance of shared decision-making, informed choice, and allowing space for independent, instinctual decisions in his practice as an OBGYN.KEY TOPICS- Independence from institutions as a method of making less-biased decisions- Coercion as an unethical decision-making technique- Not relying on policies or assumed rules to make decisions for you- Informed consent- Shared decision-making- Risk management when making decisionsCONNECT WITH USDecidedlypodcast.comInstagram: @decidedlypodcast Facebook: https://www.facebook.com/decidedlypodcastShawn's Instagram: @shawn_d_smith Sanger's Instagram: @sangersmith MAKING A FINANCIAL DECISION?At Decidedly Wealth Management, we focus on decision-making as the foundational element of success, in our effort to empower families to purposefully apply their wealth to fulfill their values and build a thriving legacy.LEARN MORE: www.decidedlywealth.comInstagram: https://www.instagram.com/decidedlywealth/Facebook: https://www.facebook.com/DecidedlyWealth/Subscribe to our newsletter for weekly decision-making tips: https://visitor.r20.constantcontact.com/manage/optin?v=001aeU_pPBHJPNJWJBdVbaci6bjGIuEJurH12xHBWDEVT_NxyCadMd7wLSZjcEZglkSjDjehuIbTHD8nABOIdV69ctfYpSzg24RCIytetBUrlIPPKgaGzjGZ8DkM0Wp1LMjbErcYUur7PbZGjeVo4gyXlz821AoJGZRJoin us every Wednesday for more strategies to DEFEAT bad decision-making - one episode at a time!MENTIONED IN THIS EPISODEStretch Lab: https://www.stretchlab.com/“The Knees Over Toes Guy”: https://www.youtube.com/c/TheKneesovertoesguyMorgan, the Decidedly Producer and also birth nerd: https://www.instagram.com/morganmckittrick/“A Bugs Life”, Go Around the Leaf: https://youtu.be/qTQJdGp4F34American College of OBGYN, referenced by Dr. Stu: https://www.acog.org/Dr. Emily Oster's book, “Expecting Better”: https://www.amazon.com/Expecting-Better-Conventional-Pregnancy-Wisdom/dp/B08SJDP2CW/ref=sr_1_1?crid=32BF78JHUV89E&keywords=expecting+better&qid=1661107085&sprefix=expecting+bette%2Caps%2C181&sr=8-1Our episode with Dr. Emily Oster, Ep.20: https://api.spreaker.com/v2/episodes/48357122/download.mp3ABOUT DR. STUWebsite: www.birthinginstincts.comInstagram: @birthinginstinctsFacebook: https://www.facebook.com/drstuspodcastDr. Stu's Podcast with Blyss Young, “Birthing Instincts”: https://open.spotify.com/show/5IYrdNqDATUbK7FDAk2EKcStuart James Fischbein, MD was Board Certified in 1989 and became a Fellow of the American College of Obstetrics & Gynecology in 1990. He has been a practicing obstetrician in Southern California since completing his residency in 1986. While well trained at Cedars-Sinai Medical Center in the standard medical model of obstetrics he had the respect and vision to support the midwifery model of care and served as a backup consultant to many home and birthing center midwives for 25 years. In 1996 he founded The Woman's Place for Health, Inc., a collaborative hospital-based practice of Certified Nurse Midwives and Obstetricians in Ventura County, California. In 2004, Dr. Fischbein co-authored the book, “Fearless Pregnancy, Wisdom & Reassurance from a Doctor, a Midwife and a Mom.” For his efforts he has been awarded the Doulas Association of Southern California (DASC) Physician of the year award three times and, in 2008, was the very first recipient of DASC's lifetime achievement award in support of pregnant women. He has spoken internationally on breech and vaginal birth after cesarean section and has appeared in many documentaries, including: “More Business of Being Born”, “Happy Healthy Child”, “Reducing Infant Mortality”, “Heads Up: The Disappearing Art of Vaginal Breech Delivery” and multiple YouTube videos discussing birth choices and respect for patient autonomy and decision making.Dr. Fischbein now practices community-based birthing and works directly with home birthing midwives www.birthinginstincts.com to offer hope for those women who prefer and respect a natural birthing environment and cannot find supportive practitioners for VBAC, twin and breech deliveries. He is an outspoken advocate of informed decision making, the midwifery model of care and human rights in childbirth, receiving the 2016 “Most Audacious” award from HRIC and the Association for Wholistic & Newborn Health. Hear more of his thoughts and advocacy for evidenced-based, reasonable choices on his podcast. He is a preceptor for midwifery students from Nizhoni, NMI, NCM and Georgetown University School of Midwifery. He is the primary author of threepeer-reviewed papers; 1) Homebirth with an Obstetrician, A Series of 135 Out of Hospital Births 2) Breech birth at home: outcomes of 60 breech and 109 cephalic planned home and birth center birth3) Case Report: A Maneuver for Head Entanglement in Term Breech/Vertex Twins. Dr. Fischbein still actively cares for pregnant women while teaching hands-on seminars on breech birth around the globe. He has the goals of improving collaboration amongst the differing professions in the birthing world and the re-teaching of the core skills, such as breech and twin vaginal birth, that make the specialty of obstetrics unique.
What is the driving factor in your decisions?Oftentimes, coercion, systemization, media, and administrations influence our actions whether we take notice or not. Dr. Stu Fischbein, Community-Based Obstetrician, shares the importance of shared decision-making, informed choice, and allowing space for independent, instinctual decisions in his practice as an OBGYN.KEY TOPICS- Independence from institutions as a method of making less-biased decisions- Coercion as an unethical decision-making technique- Not relying on policies or assumed rules to make decisions for you- Informed consent- Shared decision-making- Risk management when making decisionsDon't have time for the full episode?Check out the 15-minute highlight reel from our conversation with Dr. Stu: https://api.spreaker.com/v2/episodes/51017032/download.mp3CONNECT WITH USDecidedlypodcast.comInstagram: @decidedlypodcast Facebook: https://www.facebook.com/decidedlypodcastShawn's Instagram: @shawn_d_smith Sanger's Instagram: @sangersmith MAKING A FINANCIAL DECISION?At Decidedly Wealth Management, we focus on decision-making as the foundational element of success, in our effort to empower families to purposefully apply their wealth to fulfill their values and build a thriving legacy.LEARN MORE: www.decidedlywealth.comInstagram: https://www.instagram.com/decidedlywealth/Facebook: https://www.facebook.com/DecidedlyWealth/Subscribe to our newsletter for weekly decision-making tips: https://visitor.r20.constantcontact.com/manage/optin?v=001aeU_pPBHJPNJWJBdVbaci6bjGIuEJurH12xHBWDEVT_NxyCadMd7wLSZjcEZglkSjDjehuIbTHD8nABOIdV69ctfYpSzg24RCIytetBUrlIPPKgaGzjGZ8DkM0Wp1LMjbErcYUur7PbZGjeVo4gyXlz821AoJGZRJoin us every Wednesday for more strategies to DEFEAT bad decision-making - one episode at a time!MENTIONED IN THIS EPISODEStretch Lab: https://www.stretchlab.com/“The Knees Over Toes Guy”: https://www.youtube.com/c/TheKneesovertoesguyMorgan, the Decidedly Producer and also birth nerd: https://www.instagram.com/morganmckittrick/“A Bugs Life”, Go Around the Leaf: https://youtu.be/qTQJdGp4F34American College of OBGYN, referenced by Dr. Stu: https://www.acog.org/Dr. Emily Oster's book, “Expecting Better”: https://www.amazon.com/Expecting-Better-Conventional-Pregnancy-Wisdom/dp/B08SJDP2CW/ref=sr_1_1?crid=32BF78JHUV89E&keywords=expecting+better&qid=1661107085&sprefix=expecting+bette%2Caps%2C181&sr=8-1Our episode with Dr. Emily Oster, Ep.20: https://api.spreaker.com/v2/episodes/48357122/download.mp3ABOUT DR. STUWebsite: www.birthinginstincts.comInstagram: @birthinginstinctsFacebook: https://www.facebook.com/drstuspodcastDr. Stu's Podcast with Blyss Young, “Birthing Instincts”: https://open.spotify.com/show/5IYrdNqDATUbK7FDAk2EKcStuart James Fischbein, MD was Board Certified in 1989 and became a Fellow of the American College of Obstetrics & Gynecology in 1990. He has been a practicing obstetrician in Southern California since completing his residency in 1986. While well trained at Cedars-Sinai Medical Center in the standard medical model of obstetrics he had the respect and vision to support the midwifery model of care and served as a backup consultant to many home and birthing center midwives for 25 years. In 1996 he founded The Woman's Place for Health, Inc., a collaborative hospital-based practice of Certified Nurse Midwives and Obstetricians in Ventura County, California. In 2004, Dr. Fischbein co-authored the book, “Fearless Pregnancy, Wisdom & Reassurance from a Doctor, a Midwife and a Mom.” For his efforts he has been awarded the Doulas Association of Southern California (DASC) Physician of the year award three times and, in 2008, was the very first recipient of DASC's lifetime achievement award in support of pregnant women. He has spoken internationally on breech and vaginal birth after cesarean section and has appeared in many documentaries, including: “More Business of Being Born”, “Happy Healthy Child”, “Reducing Infant Mortality”, “Heads Up: The Disappearing Art of Vaginal Breech Delivery” and multiple YouTube videos discussing birth choices and respect for patient autonomy and decision making.Dr. Fischbein now practices community-based birthing and works directly with home birthing midwives www.birthinginstincts.com to offer hope for those women who prefer and respect a natural birthing environment and cannot find supportive practitioners for VBAC, twin and breech deliveries. He is an outspoken advocate of informed decision making, the midwifery model of care and human rights in childbirth, receiving the 2016 “Most Audacious” award from HRIC and the Association for Wholistic & Newborn Health. Hear more of his thoughts and advocacy for evidenced-based, reasonable choices on his podcast. He is a preceptor for midwifery students from Nizhoni, NMI, NCM and Georgetown University School of Midwifery. He is the primary author of threepeer-reviewed papers; 1) Homebirth with an Obstetrician, A Series of 135 Out of Hospital Births 2) Breech birth at home: outcomes of 60 breech and 109 cephalic planned home and birth center birth3) Case Report: A Maneuver for Head Entanglement in Term Breech/Vertex Twins. Dr. Fischbein still actively cares for pregnant women while teaching hands-on seminars on breech birth around the globe. He has the goals of improving collaboration amongst the differing professions in the birthing world and the re-teaching of the core skills, such as breech and twin vaginal birth, that make the specialty of obstetrics unique.
How can you help your doula clients feel comfortable advocating for themselves in an environment that pushes total compliance?In this episode, Dr. Stuart Fischbein (from Birthing Instincts) and I will be talking about the many issues within the hospital model of care.It's no secret that there are large systems of power in the hospital system, which is why many doctors keep their heads buried in the sand when they see unethical policies put in place. Dr. Stu has been a practicing OBGYN for the last 34 years. He advocates for informed decision-making and specializes in natural birth for VBAC, twin, and breech deliveries. He founded The Woman's Place for Health, Inc., a collaborative hospital-based practice of Certified Nurse Midwives and Obstetricians in Ventura County, California. He co-authored the book, “Fearless Pregnancy, Wisdom & Reassurance from a Doctor, a Midwife and a Mom.”, and has appeared in several documentaries, including: “More Business of Being Born”, “Happy Healthy Child”, “Reducing Infant Mortality”, and “Heads Up: The Disappearing Art of Vaginal Breech Delivery”. Dr. Fischbein also runs “The Birthing Instincts” podcast with midwife Blyss Young, where they discuss evidence-based decision-making in birth. If you're tired of overreaching hospital policies, then you might want to listen up!Follow Dr. Fischbein on Instagram @birthinginstincts or visit his website: http://www.birthinginstincts.com Resources mentioned:Watch Candace Owens's “A Shot in the Dark”Check out The Highwire with Del BigtreeWatch the “Why Not Home” documentaryLook through Paul Thomas's research Ready to turn your passion for birth into a crazy successful doula career? I've got you. Click here and join me inside Birthworker Academy.Check out this episode's full show notes or read the transcript at www.birthworker.com/4 or follow along over on Instagram @theautonomymommy or @birthworkerpodcastIf this episode lights you up, I'd love it if you'd rate and review the show on Apple Podcasts, Spotify, or wherever you're listening from. After you review the show - snap a pic and upload it here - and I'll send you a little surprise as a thank you.Your feedback helps this podcast grow and I wouldn't be here if it weren't for you!
Blyss Young of Birthing Blyss joins Dr. Stu to reminisce, vent a little and discuss a home birth quandary.In this episode of Birthing Instincts:Background info on modern midwiferyWhy many hospitals interventions are unnecessaryHow unsuccessful home births are technically viewed as a crime scene, and how this differs from hospital birthsRemembering that media headlines often don't tell the full story The fear obstetricians project onto their clientsThis show is supported by:Bamboobies | Go to INSTINCTS to get 25% off your first order!LMNT | Go to drinklmnt.com/birthinginstincts to get a free sample pack!Connect with Dr. Stu:Instagram: @birthinginstinctsWebsite: birthinginstincts.comConnect with Blyss:Instagram: @birthingblyssWebsite: birthingblyss.comThis show is produced by Soulfire Productions
Where will you hear about home birth story details, the difference between modern and traditional midwifery, what to do when you are inspired to enter birth work and the connection of birth with sexuality and spirituality? This episode of the podcast! We're joined by Blyss Young, LM CPM. Blyss is a home birth midwife, teacher, circle facilitator, energy healer, reiki practitioner, mother, yoga teacher, entrepreneur, breathwork facilitator, placenta encapsulator and natural living consultant. Through her guidance and love centered approach she has supported thousands of families to birth in the ways they feel the most empowered. She is a firm believer in intuition, the sacred and rituals. At the heart of all of her work is a deeply rooted belief in the brilliant design of the universe and our integral part in all of it. You've also probably heard Blyss alongside Dr. Stu Fischbein on their podcast “Birthing Instincts.” We get into so many powerful topics in this episode. Blyss shares her history into birth work, details of her own births, elements of midwifery and advice for current and future birth workers, plus connecting with your sexuality in the birth journey. Links: Blyss's Website: https://www.birthingblyss.com/ Byss's Instagram: https://www.instagram.com/birthingblyss/ Birthing Instincts Podcast: https://podcasts.apple.com/us/podcast/birthing-instincts/id1552816683 The Innate Journey: https://www.theinnatejourney.com/ Doing It At Home book on Amazon: https://amzn.to/3vJcPmU DIAH website: https://www.diahpodcast.com/ DIAH Instagram: https://www.instagram.com/doingitathome/ DIAH YouTube: https://bit.ly/3pzuzQC DIAH Store: https://yoursuccessfulhomebirth.com/ DIAH Merch: https://bit.ly/3qhwgAe Give Back to DIAH: https://bit.ly/3qgm4r9
At the end of 2021, I had the privilege of spending an hour with the wonderful Blyss Young, a licensed midwife who practices in California, USA. We chatted about a wide range of subjects, including why she became a midwife, physiological birth, antenatal education, birth partners and more...You can find Blyss here - https://www.birthingblyss.comFollow her on Instagram - @birthingblyss Listen to Blyss and Dr Stu on their podcast - https://podcasts.apple.com/gb/podcast/birthing-instincts/id1552816683If you would like to buy a copy of the book that accompanies this podcast - click here:-Labour of Love - The Ultimate Guide to Being a Birth Partner — https://bit.ly/LabourofloveOr purchase a copy via my website - www.birthability.co.ukFollow me on Instagram @theultimatebirthpartner @birthabilityBook a 1-2-1 session with Sallyann - https://linktr.ee/SallyannBeresfordPlease remember that the information shared with you in this episode is solely based on my own personal experiences as a doula and the private opinions of my guest, based on her own experience as a midwife. Any recommendations made may not be suitable for all, so listeners must do their own research before making decisions.
It's Women's History Month, and what better way to honor women than to discuss one of the most sacred and miraculous acts only a woman can do: give birth.Nature provided us women with everything we need to bring life into this world - our bodies are truly amazing! Somehow along the way, giving birth became a medical event, and the ancient practice of midwifery came under scrutiny and attacked for being unsafe and unable to handle the complications that may occur during the birthing process.Well, that simply just isn't true.Blyss Young, a board certified licensed midwife (LM) and certified professional midwife (CPM), opened the only free standing birth center in Los Angeles and transformed the way birth is managed and perceived in this country. She is an incredible woman and mother who has been helping to bring babies into this world for over 20 years. And she also taught me the correct way to pronounce her field of study, which I completely messed up in the beginning of this episode (uuugh!) it's mid-WIF-rey, just FYI.I learned so much in our conversation today! From statistics about how high the death rate is for women and their babies here in the United States, to the incredibly emotional story of tragedy that Blyss has had to endure and live through with the sudden loss of her teenage daughter to a senseless random act of gun violence.Midwives, part of our history and practice of wise women is alive and well - and definitely needs more credit and attention as a safe and effective option for pregnant women preparing to bring their babies into this world.Learn more about Midwifery and Blyss's practice and services at BIRTHINGBLYSS.COMAnd on socialIG - @birthingblyssmidwiferyFB - facebook.com/birthingblyssand listen to her on her podcast with Dr. Stu at DRSTUPODCAST.COM
It’s an ongoing and classic debate-- home birth versus hospital birth. Trying to decide where to have your VBAC is one of the toughest decisions to make. There are LOTS of opinions out there to navigate. Julie and Meagan sit down with you today to share some pros and cons (and some myth busters!) of each based on their personal experiences as doulas, as well as the most current evidence-based research out there. This discussion is only the beginning. We include tons of resources with even more information about these topics to help you continue your research and get closer to making your informed decision. We hope this episode leaves you feeling empowered and more confident in your birth choices no matter where you end up birthing. Additional links How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ) The VBAC Link Community ( https://www.facebook.com/groups/VbacLinkGroup ) VBAC Link Blogs: Writing a Home Birth Plan ( https://www.thevbaclink.com/home-birth-plan/ ) Natural Birth versus Epidural ( https://www.thevbaclink.com/natural-birth-vs-epidural/ ) Home Birth After C-section (HBAC) ( https://www.thevbaclink.com/home-birth-vbac/#:~:text=Home%20birth%20in%20general,%20and,of%20these%20occurred%20at%20home. ) Laboring at Home ( https://www.thevbaclink.com/laboring-at-home/ ) What to Write in a VBAC Birth Plan ( https://www.thevbaclink.com/vbac-birth-plan/ ) 13 Tips to Prepare for an Empowering Birth ( https://www.thevbaclink.com/empowering-birth/ ) Evidence-Based Birth® article: What is Home Birth? ( https://evidencebasedbirth.com/what-is-home-birth/ ) The VBAC Link Shop ( https://www.thevbaclink.com/shop/ ) Episode sponsor This episode is sponsored by our signature course, How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ). It is the most comprehensive VBAC preparation course in the world, perfectly packaged in an online, self-paced, video course. Together, Meagan and Julie have helped over 800 parents get the birth that they wanted, and we are ready to help you too. Head over to thevbaclink.com ( http://www.thevbaclink.com/ ) to find out more and sign up today. Full transcript Note: All transcripts are edited to eliminate false starts and filler words. Meagan: Hello, hello. It’s Meagan and Julie with The VBAC Link, and today, you just have us. Lucky you. We’re so excited to be with you today. Julie: Woohoo! Meagan: We’re going to actually be talking on a very, very sensitive topic in a lot of areas because this can be one of those lovely debates out there. We’re talking hospital birth versus home birth. Definitely, something that we know some people are passionate about on both sides. That is great, and we love that, but today we want to talk about all the evidence on both sides, the pros and the cons, and how to determine what’s best for you. Julie: Absolutely. I’m excited. We actually have a blog about this, I think. I’m looking it up right now. Meagan: We do. We do. Julie: Home birth versus hospital? I know we have one on Natural Birth versus Epidural ( https://www.thevbaclink.com/natural-birth-vs-epidural/ ). We have Writing a Home Birth Plan ( https://www.thevbaclink.com/home-birth-plan/ ) ; we have an HBAC ( https://www.thevbaclink.com/home-birth-vbac/#:~:text=Home%20birth%20in%20general,%20and,of%20these%20occurred%20at%20home. ) one, Natural Birth versus Epidural. I don’t think we have a hospital versus home birth. We have Laboring at Home ( https://www.thevbaclink.com/laboring-at-home/ ). Meagan: We don’t?! Julie: We need to write one. Meagan: Oh, Laboring at Home. Yeah. Julie: Yeah. So basically, during this episode, we’re going to talk about a lot of things that we cover in our blog, so go to our blog right now and search for “home birth.” It’s going to bring up results Laboring at Home, What to Write in a VBAC Birth Plan ( https://www.thevbaclink.com/vbac-birth-plan/ ) -- that’s for a hospital or home birth. We have-- let’s see. Meagan: Home Birth After Cesarean. We’ve got lots of stories on the podcast. Julie: Uh-huh. We’ve got Natural Birth versus Epidural, lots of podcast stories, How to Write a Home Birth Plan, all sorts of things. And then, we’re going to tell our content writer who tells us what to do about blogs that we need a home birth versus hospital birth blog. Meagan: Yeah, we do. We totally do. Review of the Week Julie: We do. Maybe there will be one there by the time this episode airs. Alright, but should I read a review? Meagan: You should read a review. Julie: Alright. I’ve got one from Google ( https://www.google.com/search?aqs=chrome..69i57j46i39i175i199j0l2j69i60l2.2368j0j9&ie=UTF-8&oq=the+vbac+link&q=the+vbac+link&sourceid=chrome ). We haven’t read a Google review in a long time. So, if you didn’t know that, you can review us on Apple Podcasts ( https://podcasts.apple.com/us/podcast/the-vbac-link/id1394742573 ) , you can review us on Google by just searching for The VBAC Link, and you can review us on Facebook ( https://www.facebook.com/thevbaclink/ ). We love reading and having reviews from all three of those platforms. It keeps us going when the times get tough. This review from Google is from Anne McLaughlin. She says, “These ladies are an absolute joy to listen to on their podcast! I feel so fortunate to have found them on my journey to what will hopefully be a 2VBAC with twins! When I had my 1st VBAC, I felt educated, as I had read through books and websites. Now, I feel empowered! Thanks to Julie and Meagan, I feel more confident advocating for myself and asking the right questions. I recommend you to all of the mamas I come across in other VBAC groups and often refer to specific episodes I've listened to. Thank you for all that you do, you Women of Strength, you!” No, thank you, you Woman of Strength, you! Do you know what? I just saw in our Facebook community a twin birth posted. Meagan: Oh, really? Really, that’s awesome. Julie: I’m going to go stalk her and see if it was that same one. I’m actually in it right now. Meagan: Yeah. That would be fun if it was. It would be super fun. Julie: Anne McLaughlin. Meagan: We’re stalking you, Anne. Julie: Let’s see. Nope. She might not be in our community. Meagan: Speaking of, if you didn’t know, we do have a community, and no, we don’t usually stalk you. Julie: Only if you leave a review. Don’t put your real name on it. Meagan: Only if you leave a review. So, it’s on Facebook, and if you search The VBAC Link Community ( https://www.facebook.com/groups/VbacLinkGroup ) , you will find us. Now, we do have questions that you have to answer, and we are kind of strict on it. So, you have to answer all three or— Julie: Two. There are only two now. Meagan: Oh yeah. There are two now. You have to answer both, or you don’t get added in. Sorry. We love you, but we really want to protect our group and keep everyone safe. So, if you are not with us in that community, definitely check it out on Facebook, The VBAC Link Community. I promise you’re going to love it because these people in this group are just incredible. I am honestly learning from them. Do you find that, Julie? You see a post, and you’re like, “I actually didn’t know that was a thing,” and I go and research it. Julie: Yes, or I make a statement and then somebody else says, “Actually, blah blah blah,” and I am like, “Do you know who I am? I own this community.” Then I go and research it, and I was like, “Oh crap. I was wrong.” Meagan: Oh, that’s funny. That’s funny. Julie: Okay, I found it. Anne McLaughlin in our Facebook group. I am looking at her story. Oh, shoot, wait. Let’s see—growth scans. Oh no, this is on October 26th. Dang, it. September no. Oh well. We will have to see. I’m going to be looking while we are talking, so if I interrupt the episode, you will know. Because she’s new, she should have been due-- or maybe she is still pregnant. I don’t know. Episode sponsor Julie: Do you want a VBAC but don’t know where to start? It’s easy to feel like we need to figure it all out on our own. That’s what we used to do, and it was the loneliest and most ineffective thing we have ever done. That’s why Meagan and I created our signature course, How to VBAC: The Ultimate Preparation Course for Parents ( https://www.thevbaclink.com/product/how-to-vbac/ ) , that you can find at thevbaclink.com ( http://thevbaclink.com/ ). It is the most comprehensive VBAC preparation course in the world, perfectly packaged in an online, self-paced, video course. Together, Meagan and I have helped over 800 parents get the birth that they wanted, and we are ready to help you too. Head on over to thevbaclink.com ( http://thevbaclink.com/ ) to find out more and sign up today. That’s thevbaclink.com ( http://thevbaclink.com/ ). See you there. Hospital birth versus home birth Julie: Anyways, we’re going to be done talking about Ms. Anne right now, and we’re going to talk about hospital birth versus home birth. Meagan: Let’s do it. Meagan: This is something as individuals-- we’ve both had a hospital birth and, well, you had a home birth. I had a birth center, which is kind of like a home birth, right? Julie: Yeah, pretty much. Meagan: Yeah. I mean, out-of-hospital birth. So I definitely know the difference from my personal perspective on birth, but then I have also attended many births as a doula in hospital. In fact, I would say the majority of my clients deliver in hospital, which is something that a lot of people don’t realize. A lot of people think doulas are only supporters for natural, unmedicated birth, and I’m just going to myth bust that one right there. Julie: Boom. Meagan: It’s not. It’s not. And really, I would say, 85 to 90% of our clients are in hospitals. I definitely have seen a lot of hospital birth, and then I’ve definitely seen home birth. I’m excited to talk about the things that I’ve seen and the differences on both. Julie: I’m excited, too. We both have, I think, things that rub us the wrong way that we see some providers do constantly. I want to preface this before we get into it, that these are just experiences that we’ve seen in the birth room, at-home birth, hospital birth, and birth center birth. It’s not to be replaced by advice from your provider. It doesn’t necessarily mean that your provider’s doing anything wrong if they do things that we see that we don’t necessarily like. Some of us like some things that the other one doesn’t like. It’s going to be a fun conversation. I actually found Anne‘s post. She had her babies. They were a TOLAC turned elective Cesarean. So she had a repeat Cesarean after an induced TOLAC. It looks like she chose a Cesarean. She hasn’t written up their birth stories yet, but they look beautiful and well and nice, chunky 8 pounds, 7 ounces and 7 pounds, 7 ounces twins. Meagan: Wow, twins. Those are nice sized babies for twins. Julie: I know, right? Nice chunky little boys. Meagan: That’s cool. That’s awesome. Julie: Well, now, you know. Meagan: Congrats, Anne. Yes. Julie: Alright. I don’t know how to get started. Meagan: Well, first of all, I want to talk about home birth in general. Julie: Do it. Meagan: A lot of people are very, very scared of home birth, right? Because of that fear that is placed upon us. I say the word “uterine rupture”-- two words. Uterine rupture. That is a very scary thing to think of. Doing it at home, and the thought of not being right next to an OR can be scary and intimidating. Really, really hard to comprehend. Is it safe? Is home birth safe after all? There is something on our blog, so I’m jumping into home births first versus hospital. I don’t necessarily suggest one or the other, generally. This is very much a personal decision, but I just want to share this. It says, “Homebirth in general, and especially home birth after Cesarean, also known as HBAC, is growing in popularity. In 2013, 1.4% of U.S. births took place outside of a hospital. Laboring at home is common, but many women also decide to stay home for the birth itself. Surprisingly, 64.4% of these occurred at home.” 64.4. That’s a pretty high number. That is really high. I mean, that was in 2013, so that was years ago. But still, it’s actually more common than you may think, and it’s more safe than you think. So, okay. I’m going to go backwards. I want to talk about-- how do you know? How do you know what to do or where to go? How to decide? How do you know what to decide to do? One, I think it’s really important to write a pros and cons list for yourself because everyone is different. Everyone is going to see different pros and different cons. Some peoples’ pros are going to be those other peoples’ cons. So write a pros and cons list. Be honest with that pros and cons list. If money is a factor, write it down. Money. Insurance will cover it, right? If fear is a factor or a con, then write it down. Fear. Then, let’s break those down. Okay. What is the fear surrounding? What brings this fear? Then, let’s educate on those topics and see if that fear still stays. If that fear still stays and you were like, “Nope. I still feel very comfortable at the hospital,” stay at the hospital. If you’re like, “Oh, well actually, I didn’t know that it was not like that,” then that may change your mind for a home birth. This is something that I’ve stuck with for so long. Honestly, ever since Blyss Young with-- I don’t know if you guys know Dr. Stu’s Podcast ( http://www.drstuspodcast.com/ ) , but Blyss Young-- she said this, and I just can’t even let go of it. I can’t because it’s too good. It’s the analogy of like, okay. For our weddings, we pick out the flowers. We pick out the venue. We go to places. We get comfortable. We pick out the colors. We are picking out the destination, and everything included, right? And then, for some reason, when it comes to birth, which is another very big day of our lives, we let our insurance companies tell us exactly what we’re going to do. I loved that when she said it, I was like, “Whoa. I never even thought of it like that.” So, yes. Money can be a factor, but don’t let someone tell you who you can deliver with, where you can deliver, and how you can deliver if that’s not something you’re comfortable with. You may be like, “I don’t care really where I go; I just want to have a baby.” And that’s okay, too. But just keep that in mind. So, writing a pros and cons list, really understanding the facts, and then following your intuition. I know Julie, and I talk about it all the time but follow your intuition. It’s huge. If your intuition says, “I shouldn’t be there,” then don’t go there, wherever “there” is. Right? And it’s hard to differentiate fear versus intuition. But usually, if you are feeling scared, that’s not your intuition. Right, Julie? It’s fear creeping in. So, talk about that. Julie: Yeah. I want to touch on that. I feel like sometimes we don’t explain enough about what intuition is. I actually made a post yesterday because I wrote about a blog about how to have an empowering birth experience. ( https://www.thevbaclink.com/empowering-birth/ ) Your intuition doesn’t have to be a warm and fuzzy, feel-like-you-get-wrapped-in-a-big-hug, and be 100% confident in your decision. Intuition can look a lot of ways. The decisions that you make because of your intuition or the things that your intuition is telling you can cause a fear in you. In that case, that would be an indication that you need to do some processing and make sure that you enter into whatever decision you made with confidence as much as you can. But sometimes, depending on yourself, acting on your intuition can look like asking questions when something doesn’t feel right to you. It can look like taking a look at the big picture rather than what’s happening at this exact moment. Or checking in with what you’re saying to yourself. Your self-talk, sometimes self-talk, we confuse with intuition. Let’s check-in. Do you say things to yourself like, “Oh my gosh, I’m going to have such a hard time finding a provider.” Well, how can we turn that into a more productive statement? Like, “Alright. I know that I can find the right provider for my birth. I know that I can do the work necessary.” Things like that. Asking for reassurance from others sometimes. I know for me-- oh my gosh, Meagan can attest to this, but I need reassurance big time. If I am making decisions, and I’m trusting my gut, and I’m taking a leap; I need people to tell me that it’s the right choice. Even if they think that I am completely off my rocker, right? Meagan: Yeah, no. Totally, yeah. Julie: I need it. Words of affirmation is my love language. Reassurance is a big thing. Reassurance that I’m trusting myself and that I’m making the right decision based on the things that I know and feel. Not second-guessing yourself. If it was the right decision when you made it, can I keep trusting that that’s the right decision? Also, trust that if changes need to be made, then you will know when and if they do need to be made. Forgiving yourself can be part of trusting your intuition because sometimes we have to forgive ourselves for not knowing what we didn’t know or making decisions that we didn’t know we could’ve made differently when they happened. And allowing yourself to feel negative emotions. Oh my gosh, please, please, please, can we say that again? Allowing yourself to feel negative emotion. Sometimes people think, “Oh, only positive vibes. Good vibes only when I’m preparing for my birth.” But if you do not allow yourself to feel and process those emotions and then send them off to their own little wherever-negative-emotions-go land, then you’re going to be doing yourself a great disservice because they can come up and appear while you’re in labor and birth. It can negatively impact the physiologic process of your birth. Then, just being kind and loving to yourself. Sometimes that is simply what your intuition needs you to do. Just stop and slow down. Take a break and be kind to yourself. But, yeah. I like that. I think that it’s important to clarify that intuition doesn’t just look like a still voice while you’re in a quiet and dark room. Meagan: Right, right. And not allowing all of the outside static to impact it. Because I feel like it kind of just jumbles around, and you’re like, “Wait, what? Now, what am I feeling? Is that intuition? Is that opinion? Is that fair? I don’t know? Oh, what is it?” Do you know what I mean? There is so much. So, yeah. I love that. Perfect. Let’s talk about hospital birth. What are the pros of hospital birth? Let’s talk about them. Pros and cons. Julie: Well, I think the biggest pro of hospital birth is probably the biggest pro of home birth too, is making sure that it’s a space you’re comfortable in. Because some people just don’t feel comfortable, and they never will feel comfortable giving birth at home, right? If you’re not comfortable, then what happens? Everything locks up, and your physiologic process is destroyed. The obvious pros of hospital birth really are if you have an emergency that needs immediate attention, then your baby can be out of your body in 1-2 minutes with a crash Cesarean. I think that immediate access to emergency resources and care is probably the biggest pro about hospital birth. Meagan: Yeah, just having access to that care. Comfortability. Also, I don’t know. I think in some ways there is a pro of having more-- now this could be the pro and a con in both ways, but more resources. Does that make sense? So, say you’re going. You’re 9 centimeters, and there is this lip or whatever. There are other things you can do at home, but sometimes a drop of Pitocin really does help. Or, say you are pushing for hours and hours, and you have a provider that is right there that can help assist with vacuum or forceps. Does that make sense? So, those are little pros that we wouldn’t really think that they are pros because they are not something we want to think of a pro, but it’s there. If we are home and we’ve been pushing for a long time, we have to get in the car and transfer. Or get in an ambulance and transfer. Sorry, I’m getting deep into the not super-- Julie: I know. I feel like we’re kind of all over the place. I don’t know; I just think that with home birth and hospital birth, a pro to one person could be a con to another person. Meagan: Exactly. That’s what I’m saying. It’s so hard. Julie: I think you hit it right exactly on the head when you said, “You’ve got to make your own pro and con list.” I’ve been looking-- if you can hear my mouse clicks in the background-- I’ve been looking for the home birth studies that have been recent. The Canadian home birth study. It’s really interesting. I’m going to go and talk about a couple of different resources about home birth, actually. Evidence-Based Birth® ( https://evidencebasedbirth.com/what-is-home-birth/ ) wrote an article about home birth safety. Here we go. Sorry. I’m just clicking back and forth really fast. So, here’s the thing. The Evidence Based® article was written in 2012. There have been studies that have come out in 2015 and 2017 that haven’t been updated in the study yet. But she has a couple of good references and information in here that I think is important to talk about, just about home birth generally, because she sums it up in a way that would take me 30 minutes to say because you know how long-winded I am. Now, I want to say before I go into it that ACOG does not recommend home birth for a VBAC. With that being said, me and Meagan have both had out-of-hospital births with VBAC. The reason ACOG doesn’t recommend it is because there’s not enough data on the safety of home birth for women with a prior Cesarean. There’s just no evidence to prove whether it’s safe or not, and so ACOG considers it an absolute contraindication, just having a VBAC. However, all these studies support that if a woman is low-risk, she could be a good candidate for a home birth. Being a low-risk includes that you are pregnant with a single baby, and you’ve made an informed choice to birth at home, baby is head-down at term-- although, I would kind of disagree with that one. Breech home birth can be done safely with a provider that is trained and experienced in breech birth. And if you have a back-up plan in place. That’s actually one of the things. At birth, as long as the baby isn’t born before the 37-week mark, the mom has no serious medical conditions like heart disease, kidney disease, blood clotting disorders, type 1 diabetes, gestational diabetes managed with insulin, preeclampsia or excessive bleeding, no placenta previa obviously, and as long as parent goes into spontaneous labor-- although I think that’s also a gray area because there are certain things you can do to nudge and encourage labor to begin that aren’t medical things. What I think the biggest thing is, is that people think that having a home birth midwife, which-- we don’t advocate for unassisted home birth, especially for VBAC. We think it’s important for everybody to have a provider that they can trust, and that is an expert in their type of birth. However, we realize that in some areas of the country and even the world, that’s not an option for you. I’m just going to leave that right there. We can go back to referencing your intuition and the pros and cons list for that. Homebirth midwives are actually highly educated people that have gone through extensive trainings and attended hundreds of births. I know I am a midwife student right now. I am a student midwife and-- oh my gosh, the number of requirements, courses, educational pieces and information you have to learn, and hands-on experience you have to have. You have to have a mentor that will guide you, help teach you, and educate you. It is an exhaustive process to become a practicing midwife. Midwives have lots of supplies on hand and bring lots of things to home birth. I’m just going to go over the list because sometimes people don’t think about these things. They have a handheld Doppler to monitor the baby, sterile instruments for cutting the cord, vitamin K and eye ointment for the baby, suction devices like the squeegee-little-bulb-thing to remove mucus from the infant’s nose or mouth. Oxygen tanks too-- they are required by law to have two oxygen tanks with them and adult and infant resuscitation equipment. They are required to be trained in neonatal resuscitation and CPR. There are so many things in the birth kit. Midwives can do interventions at birth, as well. The interventions they can do is obviously monitor baby with her Doppler, monitor a woman’s progress of labor, perform cervical exams, provide physical and emotional support during labor-- although we absolutely recommend having a doula with you because the midwife can’t do both jobs at once-- being a midwife and a doula. They can perform all the newborn exams required by the state that your OB/GYNs and nurses do in the hospital. They can suture any tears after birth; they can recognize complications and transfer a patient to the hospital if they need to. Most of the time, complications are recognized earlier than they would be in a hospital just because you have a midwife there with you 100% of the time, and they can transfer you before the situation becomes emergent. They can also administer oxygen and emergency medications. Some certified midwives can carry Pitocin, Methergine, and other things like that to help in case of an emergency or hemorrhage. Meagan: They have a lot of holistic things too. Julie: Yes. Yeah, a lot of herbal things. Meagan: They have a lot of herbal and holistic things that can help you avoid having those medications-- Julie: --that decrease your chances for having those things. Yep. They can also start IVs and administer IV fluids. Like I said, it depends if you are a Certified Midwife, or a Direct-Entry Midwife, or what your accreditation is. Each state varies by law on whether or not midwives can carry certain medications. But I think another reason people are kind of hesitant about home birth is not wanting to clean up the mess. That’s what my husband said. Meagan: Yes, it’s dirty. Yes. Dirty. yes, yes, yes. Julie: But midwives do such a really good job cleaning up the mess. In fact, my house was cleaner after my midwives left than before I went into labor on my three home births. Isn’t that funny? I’m like, “You guys should come back.” Meagan: I believe it, though. I know that team. I know that team. They clean very well. Yeah. Julie: “Are you going to clean at my newborn exam? The two-day postpartum visit?” Yeah. They do all the newborn checks and screenings things as if you were at a hospital. So those are some common myths about home birth. Meagan: Yeah. Definitely myths there for sure. I love that you were talking about-- these midwives are not just some random people off of the street. They are trained. They’re qualified. And, I also want to encourage, when you are interviewing these midwives, ask them their credentials. Ask them their experience. Julie: And their training. Meagan: And other training. That’s going to help you. Also, I would say one of the pros of home birth versus hospital is the type of care. Now, I don’t want to say that hospital staff gives less care, or poor care, or anything like that. It’s not what I’m saying. It’s the quality of time that is put into the care. It’s not because these providers in the hospital don’t want to. It’s because they can’t. They can’t. It’s very rare, and there are people out there, but it’s very rare for a provider to be able to sit down and spend one hour with you, and answer your questions, talk about your pregnancy, talk about how you’re doing, talk about your plans and where you’re at in this journey. It’s just unlikely for them to be able to do that. So, that is something that is huge, that was huge for me and my decision to deliver out of the hospital. Because I loved that I could go in and ask my doctor a couple of questions in my prenatal, it felt good to have a list, take it in, ask questions, and then leave and come up with more questions. But I can’t tell you how many times it was like, “Oh, well, this doctor is downstairs at birth, so you’ll have to keep your questions until next time.” Or, I’d ask a question, and he’d look at me like, “What?” Julie: Yeah, or they’re like, “Well, the doctor is just five minutes away, so we can call him in whenever you’re ready, or you have a question.” And then they’re like, “Well, let me go check with what your doctor has to say about that,” and it’s just harder. Meagan: Or like, you call him. You call into the office, “Hey, I have this question.” And like you said, “Oh, let me get a hold of your doctor.” And then the nurse calls you back, not your provider. But guess what? I had a question. I sent my midwife a text message. She texted me right back. She called me. “Let’s talk about this. Hey, okay. This is what I want you to do.” Every single time I would go into a visit, she would sit down, and we would just kickback. It was like two friends at a coffee shop; only we didn’t have a table and coffee. Do you know what I mean? It was just natural. That’s a pro that I could say. You can’t just text your doctor. You can’t just call your doctor, and rarely if you call your doctor, you get your doctor. So that was a really big pro for me is that established, individualized care. And then, guess what? I knew exactly who was going to help me get this baby here the day that I went into labor. One of the cons in the hospital is, you just don’t know these days. Usually, providers work in a group of 5+, right? You just get who you get. You may love them, and you may not have a great relationship, or you may have never met them. For me, and especially for VBAC, I feel it is so powerful to have had that relationship with the provider the entire time. Julie: I think with that relationship too is, you learn to have trust in your provider more, and your provider learns to have trust in you more. Meagan: Totally. Julie: They know your specific needs more. Meagan: Yes. Julie: We need to wrap it up, but I feel like this episode might be more like clearing up myths about home birth rather than the pros and cons of hospital birth. Meagan: Yeah, maybe. Yeah. Julie: This is the thing about hospital birth. I want to just say; we are both 100% for you choosing your birth location with confidence and a provider that you are comfortable with. At hospital birth, you are just going to have to keep your eye out for more interventions being offered to you and know what those interventions are and when or when they may or may not be necessary. That’s really, really important. But then again, there are some homebirth midwives that are really heavy on the interventions, like with herbs and oils, and things like that. I would ask, no matter where you are, what interventions are standard when they would decide something as an emergency, and for home birth, what their transfer plan looks like, what their transfer rate is. With that being said, a high transfer rate doesn’t necessarily mean that a midwife isn’t a good midwife; it means that they are confident in their abilities with what they can and cannot handle. They are, I would say, overly cautious and would rather transfer before things become an emergency and be in the midst of an emergency, have to transfer, and possibly endanger the health and life of mom or baby. So, yeah. Pros and cons. Meagan: Definitely. Yeah. I would say, maybe pros and cons. That’s what this episode is more pros and cons, and just the differences. Julie: I’ve seen really, really awesome hospital births and hospital birth providers, and I’ve seen providers with their fingers in moms’ vaginas for two hours while they push. All I want to do is scream, “Get your hands out of the mom’s vagina!” They’re like, “Oh yeah, that’s a great push. That’s another great push. That’s another great push.” And I’m like, “Oh my gosh, if they’re great pushes, then why are we still just keeping our hands in vaginas?” Meagan: And what are we doing to the pelvic floors? Julie: Yes. What are we doing to the pelvic floor? Then there’s other times when having some fingers in to see how and where mom is pushing can be beneficial. But homebirth midwives can do that too. Meagan: I think it’s more guidance. Because I’ve seen it at home birth, too, I think it’s more guidance for the parent, right? So like, “Hey, do you feel this right here? “I want you to focus all your individual strength right here. And then they’re out. Julie: Yeah. Yeah. But you don’t have to keep them in for two hours. That kills me. It kills me every time. I think I’ve got to do some processing for that. Alright. Well, we encourage you to look at the pros and cons of both hospital birth and home birth. You can find them on our blog like we mentioned at the beginning of this episode. Also, we go way in-depth about hospital birth, home birth, and other birthing locations and providers in our prep course for parents, which you can find at thevbaclink.com/shop ( https://www.thevbaclink.com/shop/ ). So, go ahead. We highly encourage you to take our course. It’s going to make you feel more empowered and more confident in your birth choices, no matter where you end up birthing. Closing Would you like to be a guest on the podcast? Head over to thevbaclink.com/share ( http://www.thevbaclink.com/share ) and submit your story. For all things VBAC, including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan’s bios, head over to thevbaclink.com ( http://www.thevbaclink.com ). Congratulations on starting your journey of learning and discovery with The VBAC Link. Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy
Leslie, a talented poet, writer and fitness specialist and her husband, poet, singer and 'Hamilton' cast member Carvens just welcomed their first child. They join us to share their home-birth story together with their with midwife Blyss Young. Enjoy special offers from our sponsors https://www.doctorberlin.com/sponsors . Learn more about your ad choices. Visit megaphone.fm/adchoices
Midwife, childbirth educator and podcaster Blyss Young talks water labor and waterbirth including benefits and contraindications, tub types, temperature, timing and lots more. Learn more about your ad choices. Visit megaphone.fm/adchoices
SPECIAL EPISODE - Interview w/ Maryn Green, CPM (Instagram and Twitter) Five pearls: 1. The desire from home birth often stems from a desire to follow our physiology as mammals and is particularly focused on mom and baby connection. 2. Listening to women and supporting them, no matter what they desire, is the work. 3. “Radical informed choice” is the way many midwives support women in making choices. They assess their own benefits and risks along with research, intuition and more. 4. Transparency is key in serving women. 5. The world is not black and white (e.g. home vs. hospital) in achieving the best birth outcome. Shout-outs: - Indie Birth Association - Maryn's home birth website - Milo Chavira, MD - Dr. Stu's Podcast (w/ Blyss Young, CPM) - Felicia Sokol, doula (Instagram) - Juli Anderson, CPM (Instagram) - Nick Capetanakis, DO (low intervention OB/GYN in Encinitas) - Madeline Murray, CPM of Believe in Midwifery - Rebecca Dekker, PhD (her book and blog, Evidence Based Birth) - Augustine Colebrook, CPM (Art of Birthing) - Nicole Morales, CPM (Facebook) SHOW NOTES This episode should be paired with the 2018 Macon-Villages Chardonnay from Louis Jadot. Main theme music by my main amigo, Evan Handyside
SPECIAL EPISODE!! No practice bulletin or committee opinion this time. Instead, I interviewed Rixa Freeze, PhD, founder of Breech Without Borders, and David Hayes, MD, during a lunch break at a breech workshop that they hosted near Pittsburgh in September, 2019. I'M REALLY EXCITED ABOUT THIS ONE! We'll cover: - the Term Breech Trial's flawed methodologies, and the worldwide consequences of its publication - literature review of MANY other studies in countries where vaginal breech birth remains the norm - contemporary data on the risks/benefits of vaginal breech birth (it's far more reassuring) - counseling patients who desire breech or who present with breech presentation unknowningly - the difference maker in the safety of breech: experience of the birth worker in delivering breech - (and thus) why we need to re-teach breech birth skills - Nathan gets starstruck ...and much more! Shout-outs: - Rixa's personal website (Stand and Deliver) - Breech Without Borders - Find a breech workshop near you - Dr. Stu's podcast (w/ Stu Fischbein, MD, and Blyss Young, LM, CPM) - Indie Birth Podcast SHOW NOTES Theme music by my main amigo, Evan Handyside
After transporting to the hospital for intense back labor during her first birth, actress Emilie De Ravin planned for a home birth with her second hoping and praying that the back labor would not plague her again. In this episode, Emilie, her midwife Blyss Young, and new baby Theodore walk us through her recent second birth experience. Learn more about your ad choices. Visit megaphone.fm/adchoices
Blyss Young of Birthing Blyss joins Dr. Stu to reminisce, vent a little and discuss a home birth quandary.
Blyss Young of Birthing Blyss joins Dr. Stu to reminisce, vent a little and discuss a home birth quandary.
Early miscarriage is fairly common but rarely discussed. As a result many women and their partners feeling alone during what can be a sad, painful and difficult experience. October is Pregnancy and Infant Loss Awareness Month. Dr. Berlin and midwife Blyss Young sit down and open dialogue about early miscarriage with actress and doula Ashley Williams who shares her personal experience with early miscarriage. Learn more about your ad choices. Visit megaphone.fm/adchoices