Podcasts about cesareans

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Best podcasts about cesareans

Latest podcast episodes about cesareans

Becoming a Mother
Ep. 23: Dayna Ferrer's Motherhood Journey: IVF and a Surprise Pregnancy, 2 Cesareans and Navigating Postpartum as a Working Mom of 2 under 2

Becoming a Mother

Play Episode Listen Later May 8, 2025 75:55


Dayna Ferrer - Mom to 2 toddlers, shares her journey to motherhood, including her struggles with infertility, IVF, pregnancy, birth experiences, and postpartum challenges. Dayna discusses her deep desire to become a mom, her emotional roller coaster during infertility treatments, and the eventual success of IVF.. She also recounts her surprise second pregnancy, which occurred naturally after IVF, and her contrasting birth experiences—a traumatic emergency C-section for her first child and a redemptive “gentle” cesarean for her second. Dayna opens up about postpartum challenges, including breastfeeding struggles, colic, and dairy allergies in both her children. She reflects on the emotional toll of weaning and the importance of adapting plans for the well-being of her family. She also shares insights into the challenges of being a working mom, balancing two young children, and navigating the changes in her identity and priorities after becoming a mother. Throughout the episode, Dayna emphasizes the transformative nature of motherhood, the importance of advocating for oneself, and the need to embrace flexibility. She offers advice to other moms, encouraging them to prepare for unexpected changes, prioritize family time and recognize the rewarding aspects of motherhood, despite its challenges. Instagram: Brittany Olson: @becomingamotherpodcast Dayna Becker: @daynerr157

The Birth Class Podcast
189 | 10cm and still a Cesarean

The Birth Class Podcast

Play Episode Listen Later May 5, 2025 21:39


April was Cesarean Awareness Month — but the truth is, we need to be having this conversation all year long. Why? Because 1 in 3 births in the U.S. end in cesarean… and many of them happen after a mom has already labored unmedicated all the way to 10 cm.In this episode, we're talking about a trend I'm seeing more and more:

Yoga | Birth | Babies
Birth Story: Two Cesareans But Very Different Experiences with Laura Moore

Yoga | Birth | Babies

Play Episode Listen Later Apr 16, 2025 57:50


Today, we're diving into one of my favorite types of conversations- a community birth story. What makes this episode extra special is that it actually includes two birth stories. My guest reflects on both her first and second births, sharing how the challenges she faced during her initial pregnancy and postpartum experience shaped the decisions she made the second time around. To have this conversation with me today on Yoga|Birth|Babies I have Laura Moore. Laura is an Assistant Principal and former math teacher in the NYC department of Education. Even though she grew up in Texas, she feels more at home in NYC, having lived here for 14 years. She has been practicing yoga since 2018. She lives in Harlem with her husband Hal, 3.5 year old daughter Lucy and newborn son Hunter. In this episode, Laura opens up about the intentional changes she made going into her second birth- from choosing a different care provider to prioritizing her mental health and working through the trauma of her first pregnancy. Spoiler alert: Laura opted for an elective C-section the second time around. I especially appreciate how she shares this part of her journey, showing that cesarean birth can absolutely be an empowered, thoughtful choice- especially when you're supported by those around you and feel confident in your decision. Enjoy Laura's powerful and honest birth stories! Get the most out of each episode by checking out the show notes with links, resources and other related podcasts at: prenatalyogacenter.com Don't forget to grab your FREE guide, 5 Simple Solutions to the Most Common Pregnancy Pains HERE  If you love what you've been listening to, please leave a rating and review! Yoga| Birth|Babies (Apple) or on Spotify! To connect with Deb and the PYC Community:  Instagram & Facebook: @prenatalyogacenter Youtube: Prenatal Yoga Center Learn more about your ad choices. Visit megaphone.fm/adchoices

The VBAC Link
Episode 392 Sophia's VBAC + VBAC Prep + What You Need to Know

The VBAC Link

Play Episode Listen Later Apr 2, 2025 46:37


In this episode, Julie welcomes Sophia from Mexico City, who shares her mental, physical, and spiritual journey towards achieving her VBAC. Sophia discusses the challenges she faced in navigating the healthcare system in Mexico, and what she did to find a truly VBAC-supportive provider. While preparing for her VBAC, Sophia had a hard time finding well-documented VBAC stories from Mexico, so she hopes to inspire other women through her story. Sophia and Julie talk about the role of a mother's intuition in the birth space. Making confident decisions when you feel safe and supported is so powerful!Coterie Diapers - Use code VBAC20 for 20% offHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Julie: Good morning, Women of Strength. It is Julie Francom here with you today, and I am super excited to talk with our guest today, Sophia. She is from Mexico City, Mexico, and her VBAC story takes place there as well. I absolutely love hearing birth stories from all over the world, so I cannot wait to hear Sophia's story. But before we get started with that, I do have a really short and sweet Review of the Week. This one is from Google. It's a Google review and she says simply, "Great people sharing great information. They make me feel less alone in my journey to a VBAC". I'm so grateful for that review. I think that that is one of the most important reasons why Meagan and I wanted to start The VBAC Link is because our own journeys felt very lonely at times even though we were connected to the birth world and we had a strong birth community, there are certain parts of wanting a vaginal birth after having a C-section that are just very, very lonely. We are grateful for that review. We hope that whoever is listening now also feels a little less alone in this journey because we absolutely love you, and we are so grateful that you are here with us.All right, let's get going. I have Sophia here today. Like I said, Sophia's from Mexico City, Mexico. I'm just going to sit down and be quiet and listen because I have heard lots of really interesting and crazy and cool things about Mexico City, so I'm excited to hear her birth experience there. Sophia is the mother of Luca and Rio. I just said that. I'm just reading her bio right now. She says,  "I'm a Mexican and live in Mexico City." Perfect. She is a passionate advocate for women's rights and strongly believes in the magic that results from women building together, connecting, and supporting each other. Her motherhood journey has been very humbling and healing, and she is obsessed with talking about birth. Me too, girl. I am obsessed with talking about birth as well, so I'm excited to hear your story. I'm just going to go ahead and let you take it away, and we're going to talk.I'm sorry. I said I'm going to let you take it away, but really, I'm going to keep talking for just a second. I loved reading through your story, sharing about your birth team and prodromal labor and the different things that you did to keep labor going and moving along. I am really excited to talk at the end after we hear your story about some different things that you can do to prepare for a VBAC, both mentally, physically and all of the ways. So now for real, I'm going to let you go ahead and share your story with us. Thank you.Sophia: Well, thank you so much for having me. It's truly a dream come true to be here in the podcast. I'm just really honored to tell my story because, when I was starting to prepare for my VBAC, I found it really hard to find well-documented VBAC stories coming from Mexico and in general, from the global South. So I just hope my story helps other women living in similar contexts. So I guess I'll start with the story of my unplanned C-section. So half a year after my husband and I got married, we were ready to have kids. We met on Tinder. We dated for three years, and both of us really had had the opportunity to travel the world and do amazing things. We felt like we had a good pre-kids life, and we were just ready to start a family. I was 34 at the time, and I always wanted to try to get pregnant before I became 35. I got pregnant really fast actually, like the first try. So we were so shocked and excited and surprised. At the time, we were both working remotely in Europe. We were slowly making our way to Australia because my husband is from Australia. This was 2021 and as some of you might remember, Australia was under super restrictive lockdown. No one could come in. No one could get out, so we had not seen his family for three years, and we were just waiting for the ban to lift to be able to go in and spend some time with them. This is an important part of the story because while I was in Europe, especially in Belgium and in Australia, my pregnancy was taken care of by midwives. Especially in Australia, it's really normal that all healthy pregnancies are attended by midwives, and only those special cases or complicated ones are taken by gynecologists. So my pregnancy was a really healthy, enjoyable one. I am one of those women that really loved being pregnant. I was very lucky with both of my pregnancies. But this experience was so influential because in Mexico, although we have this wonderful history with midwives in Spanish called parteras, and that's actually where the use of Rebozo comes from, this practice continues mostly in rural and particularly in indigenous communities. But in the cities, there is a really concerning high rate of unnecessary Cesareans. There's this narrative that C-sections are the easy way out. I would even dare to say, in the 80s, it became sort of a socioeconomic status thing. Women who have access to private healthcare would just opt for a C-section either because their doctor recommended it to do so or because they just thought it was the easy way out. People would say, "Why would you put yourself under unnecessary pain if you can just go get a C-section?" Like it was nothing, right? So actually, most of the women that I know had a C-section, but having the experience with midwives, I decided I really, really wanted to try to have a natural birth. So I started getting informed. I actually work in philanthropy. I work on social justice issues, so I'm very well connected to feminist and women organizations, especially in Mexico City. I remember that there were all of these colleagues working to defend obstetric rights in Mexico City. I knew that they had a really good network of doulas. It was through them that I connected remotely with my doula, Neri Fernandez, who is amazing. We spoke on Zoom, and we clicked right away. She started preparing me for my return to Mexico. The plan was always to come back to Mexico during the third trimester so I could have my baby here. She started preparing me with the reality that it is to have a natural birth in Mexico City. She told me, "Honestly, there are very few truly labor-friendly hospitals and also very few labor-friendly gynecologists. A lot of them are going tell you that of course they're gonna support you in a natural labor, but around week 37 or so, they're gonna suggest going on a C-section by week 39." So, she gave me this list of questions to ask my gynecologist, the one that I had been seeing for the past five years. So she told me, "Once you get back and you go to your appointment, just use these questions for your conversation with him." At the time, I was very naive, so I was like, oh, I'm sure he's going to support me. I'm not worried about that. Anyway, I came back to Mexico, I went to my appointment, and honestly, in the first five minutes, I noticed that he wanted me to have a C-section for no reason. So I was like, oh, my god. Okay. So I told her, "Neri, I really need to contact another service provider." She gave me a list of labor-friendly doctors. And she told me, "There's this doctor whose name is Adriana. She is a gynecologist. But the way that she works is very similar to a midwife, the way that she treats her patients and the way that she respects the woman's body and everything. I think you're really gonna like her, but you should know that she can be a little bit tough. She's a hardcore feminist, and she truly believes in women's capacity to give birth, so she's not going to pamper you." Anyway, I went in. I met her. I loved her right away. She took me, which I was so appreciative, at the time, taking my case because I was already in my third trimester, and things continued to evolve smoothly. I mention this because since I got pregnant really easy, since everything was going smoothly, that's what I thought it was going to be in the case of my birth. I just thought that things were just going to develop like that.Julie: Oh my gosh. Can I just say that I thought the same with my first? I had the easiest pregnancy. I loved being pregnant, just like you, and then all of a sudden, wham-- preeclampsia, induction, C-section, and I was like, what happened? Yeah, anyway, sorry. I just had to add that in.Sophia: I think it happens to a lot of women.Julie: Yes.Sophia: So anyway, week 40 arrived, and there was no sign whatsoever of labor. And one mistake I made is that I told everyone about my due date. I'm an open book. So I told everyone just out of excitement. But then once the due date passed, people started reaching out, like, "Hey, how are you doing? Is baby here yet? Is everything all right?" That really threw me into a bad mental state. I started to get really scared and doubtful. I was just not mentally well at that time. I was just full of fear. I didn't accept it at the time. I was telling everyone that I was fine, but internally, yes, I was in that state. And now also thinking back, I think I prepared myself a lot physically. I have been practicing yoga for 10 years. I was doing a lot of prenatal yoga, etc., but I don't think I prepared myself mentally enough. Anyway, after week 41, Adriana, my doctor said, "I think we have to start discussing the possibility of an induction. Maybe by week 41.3 we can do a very gentle induction unless something else happens." I think two days after we spoke, I lost my mucus plug, so that was exciting, but then nothing was happening. Then we were almost at week 41.5, and she said, "I think at 41.5, I should induce you." But the night before the induction, I woke up in the middle of the night with a very intense feeling. I went into my living room. I sat on my birthing ball, and my water broke like a big gush like the movies. They tell you that's never gonna happen, but that happened to me. Contractions didn't start. But at that time, I didn't realize what this meant. I didn't know that this meant I was actually going to be on a clock after my waters broke. So I was actually very excited. I thought, okay, by tomorrow, I'm going to have my baby. This is amazing. I told my doctor. I told my doula, and they said, "Okay, well, no matter what, just come here to the birthing center."At the time, my doctor had a birth center, and the plan was always to labor there and then go to the hospital when I was closer to giving birth, because I just feel safer that way. And that was the plan with my insurance, etc. So I went the next morning to check me, and I was only at 3 centimeters. So she told me, "I'm going to recommend that you just go back home. Rest. Eat your favorite food. Try not to think about this too much, and when things escalate, just let me know." The problem then is that nothing escalated for a whole day when I went to sleep. And that night, I didn't sleep out of excitement mostly, but I was already feeling some contractions. I mean, I thought they were intense, but little did I know that they were not the most intense part. And then the second night, I also didn't sleep because now I did start getting contractions, a bit stronger ones. So the next morning, I went back into her practice. She checked me, and I was about a 5. And she said, "Things are progressing, but they're progressing quite slowly, so I'm going to give you a tiny dose of Pitocin just to make sure that things keep progressing." I stayed there in the birth center, and I was with my husband, and I was with my doula. And honestly, I remember that day very fondly. My husband and I danced. We used the shower. We used the Rebozo. We just the ball, the peanut ball and everything, but things were not progressing. It was 7:00 PM, and I was only at 7 centimeters, and we were already reaching 40+ hours. And as you know, once your water breaks, I mean, at least in Mexico, they recommend that you have your baby within 48 hours because otherwise you start risking infections. So I told my doctor, "I just want to go to the hospital. I need a change of scenery, and it's just gonna make me feel better." So we went to the hospital. The hospital did have this birth pool. I went into the water and just things stalled. I didn't progress after that. This whole time, they were checking my baby's heart rate, and it started raising a lot, like, scary a lot. It wouldn't regulate. Fear just took over my body, I think. She looked at me and she said, "Sophie, I think I'm going recommend that we go for a C-section." I looked at my doula, and my doula just nodded. I was so tired and so ready to meet my baby that I said, "Okay, yeah, let's go for a C-section." Once I decided that, it was the longest 40 minutes of my life because I thought, "Oh, well, I'm going to get under anesthesia now." But the anesthesiologist took an hour to get there, so I was in a lot of pain. Then we went into the OR, and to be fair, my gynecologist did everything possible to have a gentle Cesarean. We had dim lights. We had my playlist on. The whole focus was on me. Both my doula and my husband were with me. They were holding my hands. But the one thing that makes me sad about that is that I couldn't stay awake. I was so exhausted, so I was just asleep the whole time. I only woke up when I heard my son, Luca, crying. So exactly on week 42, he was born. I just remember someone in the OR yelling, "It's a huge boy." So he weighed 8 pounds, which is not massive, but for Mexican standards, he's really big. And Luca is a Taurus baby. He's determined, he's stubborn, and you cannot pressure him to do anything. He always does everything at his own pace, and this was just the first evidence of that. So anyway, luckily, he was okay. It was a rough recovery because I was just really not prepared for a C-section. It was challenging to get breastfeeding. He had difficulties to latch. It just took me a while to heal what had happened. But the one thing I do remember a lot is that when I was in my room, the doctor and my doula both came in and they said, "Sophie, we just want you to know that you and your baby are amazing. You did everything right. You just had so many things against you. But if you ever want to get pregnant again and go for natural birth, you can do it." That really stayed with me the whole time. So 18 months after Luca was born, my husband and I decided to get pregnant again. Again, we got pregnant the first try. I mention this not to brag about my fertility or anything like that. I know it's a sensitive topic, but for me, it was important because it was the first step to recover my confidence in my body and believe that I could really do this because once I started getting informed about VBAC, I realized that the healing I had to do was more internal. I really had to believe that I could do it. So I decided to stay with the same service providers, with the same doctor and the same doula, because they knew, they really knew my story. Well. And I called my doula, Neri, and I was like, "Hey, Neri, why are you doing this summer? Do you wanna have a baby with me?" And she was like, "Of course." Both my doctor and my doula recommended that I joined maybe like an online community of VBAC women. I had no idea what VBAC was. So then I found The VBAC Link website, the Facebook group. I took the VBAC class for parents. I found it so helpful. And for me, the fact that it was full of hardcore data, it was just so, so important. So in terms of physical prep, I tried to remain active, but I wasn't honestly doing as much yoga as before because I had a toddler. I was working full-time. I was running after my 2-year-old, and I really loved that my doula told me, "Don't get too stressed about working out. Just play with your kid. Play with your kid on the floor. That's going to be enough activity for you." I also really love that this time around, my gynecologist was not even telling me how much I weighed. I really loved that approach. It was just a really, really joyful pregnancy. Again, it was a healthy pregnancy. I did go to the chiropractor this time, which I didn't do last time. I also went to acupuncture sessions, and I did that the last time. I went with the same acupuncturist because I also thought it was good that she knew what happened before. I also took raspberry leaf tea and dates after week 36. So I did all of that physical prep. But what was different this time, I think it was my mental preparation. So as I said, I really, really tried to focus on healing internally, believing in my body, and believing in myself. So with my doula and also using the some of the guiding questions and stuff from the VBAC class, we started mapping out my fears. So she was like, "What are you afraid of?" And I said, "Honestly, I think what I'm most afraid of is that my waters break again before I start labor." So I remember asking in the VBAC Facebook group, "Hey, does anyone know anything about preventing PROM?" Someone suggested taking vitamin C. So I started doing it. And, this time, I felt so much more connected with my body, with my baby, with my intuition. At week 26, my baby was breech. And I remember asking again in the Facebook group, like, "What would you girls do?" And people told me, "You can do Spinning Babies. You still have enough time for baby to get in position, but it's always easier to move a baby when they're still small." So I did Spinning Babies, and my baby turned. So that was amazing. The other thing that is I consider being part of the mental prep is that I was also in a very different space, spiritually speaking. I am honestly not a religious person. I'm not the most spiritual person in the world, but this time I paid attention to a lot of signs. There was this one occasion that I was in my office, we were moving my office, we were moving to another place. And someone hired a shaman. Like a shaman, but it's an indigenous sort of magic priest because we all wanted to do some cleansing, like spiritual cleansing, before moving into the new space. She told me, "I don't do cleansing of pregnant women because it's not good for the baby, but I could give you a blessing". So I was like, "Yeah, of course." So she did this whole ritual. She told me, "You didn't have a natural birth before, did you?" I was like, "No, I had a C-section, but I'm trying for a VBAC." And she said, "I'm really certain that you're going to get it. I'm very sure that that day when you go into labor, your ancestors are going to be with you. I'm certain of it." And she also said, "There's something that characterizes you and has characterized you your whole life, which is having clarity and determination, Sophia, so this is not gonna be the exception." And she gave me this candle, and she told me, "Please, light this up when you go into active labor just to call your ancestors to be there with you." So I was like, "Okay, great." Then also on week 36-37, I had a nesting party. I invited a lot of friends over to help me prepare the house for baby. A friend of mine brought the tarot cards. She told me, "Do you want to pick a card?" And I was like, "Okay yeah, why not?" So I picked a card. That card was the card for strength. It was number eight of the major Arcana that depicts a woman taming a lion through the application of subtle force. That was so symbolic for me because it was strength. The picture really stayed in my head, and I had to think, obviously, about Woman of Strength. So there were all these symbols out there that just really put me in a very different mental state. So anyway, the day I went into labor, it was just one day before my due date. And this time, I didn't tell anyone about my due date. Only my mom and obviously, my husband knew. So one day before the due date, I started getting contractions. I had two weeks of prodromal labor, and I had that before in my first pregnancy, so I knew what it was. I mean, it can be so frustrating because you start getting prodromal labor, but it doesn't escalate, so you get sad. But I knew this time what it was, so I was trying not to pay too much attention to it and just continue with my life. But that day, I started getting real contractions. I knew that what I had to do was to go rest. I did do Miles Circuit. And anyway, I was pretty happy. But then 24 hours after, labor completely stopped. I was so scared of the story repeating itself, so fears started sneaking in. All the doubts. I started thinking, maybe natural labor is just not for me. I was crying. I was sad. I texted my doula and I said, "Neri, I'm just really bummed. I think this is not going to happen. I think I'm going to have a C-section again." She said, "Whoa, wait, I'm going to your house right now." She lives really close to my house. So in 15 minutes, she was here. This was at 8:00 in the morning of the due date, like week 40. And she said, "I think although baby is already engaged," because we knew it was already engaged, "I think it's not in the most optimal position, so I'm just gonna use the Rebozo." And we used the Rebozo. She told my husband and my mom how to use it. That was pretty magical. And then we also did a lot of Spinning Babies exercises. She said, "But aside from this, just try to relax. Everything's going to be okay." That day, I had my 40-week appointment with my doctor. I went and that was a game changer because she checked me, she checked my baby and she said, "Both of you are fine. Everything is okay. Please try to go home and relax. Do anything that makes you get oxytocin." She was like, "Why don't you go and eat or get a bath or eat cake in the bath?" And I was like, "Okay, that's a really specific suggestion, but why not?" So that made me feel much better. And she said, "I do recommend that you call the acupuncturist and tell her what's happening to see if she can give you an extra session." So I called my acupuncturist and she told me, "I'm an hour away from Mexico City because I'm teaching at a university, but I'm on my way there. I'm going to see you because I know you can do this." It was so sweet of her. She drove all the way here, she gave me a session and she told me, "I never do this, but I want to see you again. This was at noon." And she told me, "I want to see you again at night. Come here at 8:00 PM, and I'm going to give you an extra session that is specific to help baby get in a good position and to descend."So I was like, okay. So I went home. I actually came back and went to listen to Meagan's because I remember that she had a story of failure to progress. I listened to that episode. It was so helpful. So then I went back to the acupuncturist at 8:00 PM, and during the session of acupuncture, I felt a super strong contraction. Because what had been happening is that my contractions were intense, but they were really short. They were only 30 seconds. So when I was there, I knew that was a minute or longer. Anyway, after the session, I came back home, and they always recommended to walk after the acupuncture session. I went walking with my husband, and active labor started. It was clear, and it was so intense. It really started every 15 minutes, then every 10 minutes, then 7, then 5. So at 5:00, I texted my doctor and my doula, and they were like, "Okay. This is fantastic. Let's wait until you are 3-1-1." So every three minutes, one minute long for one hour. But I felt like things were going super fast. So I told Neri, my doula, "Can you please come see me?" Because she always told me the timing between contractions and the duration is important, but it's even more important that I see how you're acting. So she came. And in the meantime, my husband was packing the last things to go to the hospital. I also was pretty relaxed in the sense that my mom was taking care of my toddler, so I was really relaxed about that. My husband had become an expert in helping me put pressure in my hips during each contraction. He was packing and helping me, and he was just a rock star. He was offering me water, and he was my biggest cheerleader. Neri arrived, she saw me and she's like, "Okay, it's time to go to the hospital." So I was like, "Okay. So we went into the car." At this time, I was already in a lot of pain. Contractions were so long. They were 1:20, some of them, a minute and a half. It was super intense. I couldn't see anymore. I was just holding to the back seat. I was sitting in the back, just facing the other way. And here is where all the mental preparation really stepped in because I was remembering all of the affirmations that I was listening to. I was remembering all of the stories that I heard. I was also obsessed with watching birth videos. So all of that was going through my head. I love them so much. My dad, who was my favorite person in the world, passed away seven years ago. I could really feel he was there. It was just crazy. So anyway, I was doing all this mental work during each of the contractions while in the car. And this was at midnight, and we were very close to the hospital. The road was blocked, completely blocked by construction. And we were like, "Oh my god." I was in labor land. I was not paying attention to details, but I could hear in the back my husband and my doula getting a bit worried. My doula went out of the car, and I could hear her telling the police guys and the construction workers, "Hey, guys, we have a lady here that's in labor. If you don't let us through, she's going to have her baby here." And it was like, "Wow. Okay." So they opened the road just for us. We went through. We arrived to the hospital. And it's crazy at that time because you only do the few things that you can do in between contractions. I went into the room. This time, it was a different hospital. The room was so lovely. I remember it being a peach color. We had essential oils. We had my playlist. Again, my husband was my biggest cheerleader. Five minutes later, my doctor arrived, which made me feel so much better. And she's like, "I'm going to check you." I was already at an 8. So that was super exciting because it was already past what I had achieved last time, and then my water broke. My doctor said, "Sophie, I need you to look to me in the eyes and listen to me." So I looked at her and she said, "Sophie, this baby has to be born now, so I need you to start pushing." I was still not at 10 centimeters. I think I was 9 or something. But what they didn't tell me at the time is that my water already had meconium, and my baby's heart rate was starting to have some significant declines. But luckily, he was recovering. I was very thankful later on that they didn't tell me all of this because I was just so focused. So anyway, I tried different positions. First, I went and sat down on what we call a Mayan chair. I did all fours. So I think I pushed for an hour or an hour and a half. I just remember it being very magical in the sense just seeing my doctor, my doula, and my husband working together, cheering me, communicating even without words. Everything was just flowing. But still, baby was not being born, and pushing was so much harder than I thought. And also, I guess because I was not at 10 centimeters yet, I was not having the super urge to push, but they were guiding me to do so, and it was really, really great guidance. So finally I went into throne position, which, honestly, was the last position that I thought I was going to give birth in, but it felt all right. I was a second away to give up and to tell them, "You guys, I think I cannot do this." But then I remembered in all of the podcast stories that I listened to that usually when you're at that stage, it is because baby is about to be born. So then my doctor told me, "Sophie, baby is almost here. Do you want to touch their head?" We had decided this time not to know the sex until birth, so I had no idea if he was a boy or girl. I touched the head and that was so, so, so exciting. So I was like, okay. It just gave me another rush of energy. My doula said, "I really think two more pushes, and you're going to meet your baby." So I pushed once. The little head popped out and then it went back in. And then this whole time, they had been telling me to try not to push with my throat, but with my abdomen. But then they said, "This time when you push, push with all of your strength. If you feel like screaming, scream." So I pushed so hard. I screamed. My baby was born at 2:22 AM and baby started crying right away. I started yelling, "I did it. I did it. I can't believe it." And yeah, just for a few seconds, I had no idea if he was a boy or girl because I right away put him in my chest. And then my husband looked and he said, "Oh my god, it's a boy." And yeah, people asked, "So what's his name?" And we said, "His name is Rio." Rio in Spanish means river. And it also stands for the flow of life. I really, really think it really honored the way that he arrived into this world. And honestly, he's a pretty chill and easy going baby. So it was honestly the best day of my life. And later my doula, my doctor and I just, just went through the whole story. And again, we all said, I think my mental and spiritual state of mind was very different. This time was much more positive. I also really felt held by my drive. I had this chat of my all my best friends in this WhatsApp chat, and they were all rooting for me. And also, remember I told you there was this shaman, like this magician priest who told me that I was going to be able to do it? They gave us a candle. My mom lighted the candle when we went to the hospital, and the candle turned off by itself at 2:20 and Rio was born at 2:22. So that was pretty magical as well.Julie: Wow.Sophia: Yeah. And just the last thing I'll say about the story is that also, my gynecologist and my doula were also in a different state of mind. They had had a lot of VBAC experience which was great. And my doula always told me, "It doesn't matter how your baby is born. What matters is the experience, and that you really feel this connection with your baby. But in this case, Adriana told you to push this baby out, and you understood the assignment. You literally delivered your baby, and you had the baby when you were asked to do so, and that in itself is strength." So, yeah, that's my story.Julie: I absolutely love that. Just all of it. What a journey. I'm sorry. I'm trying to figure out where to start. I took some notes as you were talking, and I just think it's so incredible, all of the different things that you did to prepare. I really like what your doula told you during your pregnancy about your personality that you've always had clarity and determination. It was something like that. She said, "Clarity and determination is your personality." I love that because I think sometimes it's easier to advocate and fight and navigate having a VBAC when that clarity and determination is already something that comes naturally to us. It's not something that comes naturally to everybody. It's not good or bad or assigned into a category. It just is. And like me, I'm incredibly stubborn, and I will fight sometimes harder than I should to get the things that I want or desire. And I think that my stubbornness played a huge part in working towards that. Sometimes it's just easier to advocate for yourself when you already have those strong personality traits.Sophia: So yeah, for sure.Julie: But it's okay because you don't have to have those strong personality traits inherently in order to get your VBAC. There are lots of other things that you can do and lots of other things that are on your side as well. I wanted to touch on some of the things that you did to prepare. You took the VBAC class which is amazing. I love our VBAC class. It's really incredible. Lots of good information. I feel like obviously, it's pretty well-rounded and has lots of different characteristics and addresses all of the different learning styles and things like that. Things for the data junkie like me, and things for the people who are more holistic minded, things that are more mentally mental preparation focused, and things like that. You talked about Rebozo, Spinning Babies, and learning how to relax your mind and your body, the positioning of the baby, acupuncture. You hired a very, very good doula and provider who both had lots of VBAC experience. That was also something that was really important to me. I interviewed, I think, like 12 doulas when I was preparing for my first VBAC because I really wanted a doula who had a VBAC herself and supported lots of VBAC families. I don't think it's necessary that to have a doula who has had a VBAC herself in order to have a really solid VBAC doula. I don't think that's necessary, but that's something that was important for me.Sophia: Yeah, for sure. For me, too.Julie: Yeah. Yeah. I wanted midwives who had done lots of VBACs, and that was really important to me. Now it's not, like I said, necessary, but it's something that you can put in your toolkit to prepare. So I feel like a lot of times I hear people say something to the effect of, "I tried all the things, and I still didn't get a VBAC or I tried all the things and I didn't get a vaginal birth." And you know what? Some people try all of the things and don't get a delivery method that they want. And some people do literally nothing and have a perfect birth. I want to just tell you that birth is inherently unfair. Sophia: Yeah.Julie: Especially with the way our system is set up to handle pregnant women, and babies, and labor, and all of that stuff. It's inherently unfair. Sometimes you can do everything and have a completely unexpected birth experience, and sometimes you can and do absolutely nothing. My sweet sister-in-law is getting induced tomorrow. She knows absolutely nothing about labor and birth and delivery. She has no desire to know anything. She knows absolutely nothing. She's getting induced tomorrow, and I'm just really trying start hard to stay in my role as supportive sister-in-law when I see some choices that she's making that might influence her birth in a way that she doesn't want, but also, I don't think the outcome really matters to her, to be honest. I just don't think how the baby gets here matters. And that's okay. It is. That is okay. I guess my point of all of this is that you don't have to do all of the things. I feel like some people say, "I feel like I don't want to miss anything." What you need to do is learn about the things that are available to you, and then gravitate towards the ones that resonate well with you. Maybe you don't even care about Spinning Babies or what position your babies in, but you really want to focus on nutrition and getting your mind ready and finding a supportive provider. Cool. Do those things.Sophia: I really tried to enjoy this pregnancy because I only plan to have two kids, so I was like, maybe this is my last pregnancy. I just wanna make sure I enjoy it. I even did a photo shoot with my family and stuff. I just really enjoyed it. I know that for some women, it stresses them to think about all this prep, but for me, this time around, it just made me feel good just being informed and things like that. And honestly, to have a VBAC in a context like Mexico is not a minor achievement. The system is so set-up to just go into C-sections. So yeah, it was just a lot of challenges against me, but I was really lucky that I had really good service providers by my side that were supportive. My doula told me, "When we saw that you had meconium, and we saw that your baby's heart rate was descending, I'm sure any other doctor would have sent you to the OR, but Adriana, your doctor, really believed that you could do it, so that's why she decided to just give you a chance and you did it." That's just really important as well.Julie: Yeah no, I agree. If you want to do all the things, if doing all the things makes you happy and helps you feel prepared, then by all means, do all the things. I don't think you should do nothing. Let me clarify that. I think you should do something, at least one thing. But do the things that really resonate with you. I saw an Instagram post yesterday, I think. I'm trying to find it now. I think it was maybe on the account called Trusting Birth or something like that, but basically it said that there are studies that show-- nope, it is not trusting birth. Dang it. Gosh, dang it. I really want to find it. It was something about how there are studies that show that women when they're pregnant, make smart choices. Okay? They make smart choices. That doesn't mean they go deliver in the hospital and have an epidural. It's not a blanket statement, right? They make smart choices, which means they let their intuition guide them. No, not smart choices. Safe choices. Safe choices. And what is safe depends on the parent and the baby and the pregnancy. When you let women guide their own care and give them options, they make the safe choice. Now, the safe choice is different, like we just said, but the choice that is safest for them at the time. There is a study to back that up. And gosh dang it, I wish that I could find it. I'm literally on my phone right now thinking of all the different accounts it could be. I wonder if I liked it. Dang it. Anyway, if I can find it, I will have Paige, our podcast transcriber, link it in the show notes. I'll send it to her. But anyway, it was really interesting because that's what we've been advocating for all along. Trust in your intuition. Trust your gut. Trust your internal guide. You will make a safe choice. And if that's birthing at home, if it's birthing in the hospital or whatever it guides you to, if it's acupuncture, Spinning Babies, massage, getting a doula, not getting a doula, doing a VBAC class or what VBAC class to do. All of those things are safe choices that you can make for yourself. Now, dang it. I just want to hang out here until I can find it. Sophia: No worries.Can I add one more thing?Julie: Yes, please do while I keep looking.Sophia: Yeah. Talking about the safe choices, I think one of the things that made me feel very safe and allowed me to really focus on the contractions and the pushing is just knowing that my birth team was really on my side, like my doctor, my doula, and my husband. Most women who I know in Mexico have to spend a lot of time advocating for their obstetric rights, so not having to worry about that and just focus on my birth just made me feel really safe and just being able to know that they believed that I could do it.Julie: Awesome. Yes, I agree. I agree. Believing in yourself is a big thing. Granted, sometimes you'll believe in yourself. I think when I say believe in yourself and trust yourself and trust your intuition, it's not trust yourself that you can have a VBAC, although that is very important. That's important. But trust yourself that you will navigate the birth in a way that's safe and healthy for you and your baby, and that might be a repeat C-section. It might be a home birth, an unassisted birth, a hospital birth, but trust yourself that you will be able to guide yourself safely through the birth process whatever that looks like. And guess what? I found the post. I had liked it, and I just had to go into my activity in my Instagram history. It's from an Instagram account called Intentional.Birth. Intentional.Birth. And it says that there's a PhD biologist and doula, Sophie Messager who bridges the scientific and intuitive worlds of birth at the induction equation. So I think maybe that's the induction equation. Oh, I guess I don't know what the induction equation is. Anyway, so the post shows though, it says, "Research shows that women make safe choices. Because of the constant communication between the woman and the baby, women tend to know when something is wrong, and they also tend to know when something is right. Ignoring a woman's instincts is a very stupid thing to do." I like that. Women's instincts tend to know when something is right. I hear that all the time. This is what it sounds like.It sounds like, "Oh, my doctor recommended an anatomy scan at 32 weeks, but I just don't feel like that's necessary." Yeah, it's because you know something's right. Or, "I know measuring for a big baby isn't really evidence-based, but I just think I want to do it." That maybe feels like something is right, the big baby scan or whatever. Or maybe that something's wrong, right? "My doctor brought up inducing at 39 weeks. And normally I would say no, but it just feels like the right thing to do." That is your intuition. Or, "My doctor said maybe we should induce at 39 weeks, but I just don't think that that feels. That doesn't feel right to me." And so you wait. That's your intuition. Like those comments, trust that you know when your baby is safe. You know when something's wrong. You know when something's right even if you can't literally define it. Follow those feelings. They're important, and there is science to back it up.Sophia: That's how I felt when my baby was breech. I had this intuition that I'm going to be able to turn it around and, everything's going to go well, and it did. I love that there's this study backing up the importance of following your intuition.Julie: Yeah. So go check it out. It looks like, it links to the study at Sophie. That's your name? No, you're Sophia.Sophia: People call me Sophie.Julie: So yeah, there we go.Sophia: It's all connected.Julie: Yeah, there we go. It's all connected. Sophie Messager. That's M-E-S-S-A-G-E-R. That is the PhD biologist who is linked with the host. I'm going to follow this lady right now. Transformational Journey Guide for Sacred Shifts. Incredible. All right, awesome. Well, thank you so much, Sophia, for sharing your story with us today. I loved talking with you. It's incredible for everyone birthing in Mexico and Mexico City especially, we know there are a lot of similarities between the United States, but there's also some differences, and different challenges to navigate. So we appreciate hearing your perspective and your experience, and I just really enjoyed having you here with me today.Sophia: Likewise. Thank you so, so much.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

The VBAC Link
Episode 390 Johanna's HBAC + PROM + Supportive Provider + Postpartum Planning

The VBAC Link

Play Episode Listen Later Mar 26, 2025 56:15


Johanna is a girl mama joining us today from Canada. She had an unplanned C-section with her first, an HBAC with her second, and was pregnant with her third at the time of recording! Johanna reflects on her experiences with both supportive and unsupportive care during her pregnancies. Meagan and Johanna dive into your options surrounding PROM,  the significance of intuition in decision-making, the impact of provider choices on birth outcomes, and the nuances of VBAC postpartum recovery.The VBAC Link Blog: Home Birth VBACEverything You Need for Your HBACSupportive Providers10 Signs to Switch Your ProviderWhat to Do When Your Water BreaksLabor GuideCoterie Diapers - Use code VBAC20 for 20% offHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. We have our friend Johanna with us from Canada today, and she's going to be sharing her HBAC story. So for those who may be , new to the VBAC world, or just all of the acronyms that the VBAC world has, HBAC is pronounced home birth after Cesarean. So if you are one of those who really wants to look into all of your options for birthing locations, which I encourage everyone to do, definitely listen up here. We're going to be talking about a lot of really great things including picking a provider and PROM knowing that you maybe had a provider that wasn't ideal the first time and more about HBAC. So we are going to be diving into a lot of really, really great, juicy topics. But in place our review today, Johanna and I are actually going to talk a little bit more about picking the right provider. So, Johanna, welcome to the show.Johanna: Thank you.Meagan: I am so excited for you to be with us today and so grateful that you are here to talk about this topic. Because like I was saying before we pressed record, I see daily in our community, every single day, and not even just our community, in other VBAC communities or this is weird, but people's statuses, like my friends and family's statuses on Facebook, where you type like, "Hey, I'm looking for this," or "I'm feeling very frustrated," or "I need prayers." People will seriously say, "I don't know what to do, you guys. Has anybody ever heard of VBAC?" on their own status? But especially in the VBAC groups, I see people and I just want to yell, "Hey, you over there. You're with the wrong provider" or, "Hey, you should move." That's a really hard thing because especially when I type that it can be like, oh my gosh, who is this broad telling me that I'm with the wrong provider and that I chose wrong? I'm not trying to say that. I'm not trying to say you chose wrong. Like, how dare you choose wrong? It's just like, hey, what you're telling us in this community is screaming, you're the wrong provider. So, Johanna, you , mentioned before we press record that you realized after your first birth that you were with the wrong provider. What made you realize that you were with the wrong provider? And were there signs during pregnancy that you recognized and maybe pushed away? Or was it really not something that you recognized until after? Because I know really, it can go both ways.Johanna: Yeah, I think that there were signs during the pregnancy. I mean, one of them, and I just didn't listen to my gut because you don't know what you don't know. I put too much blind faith that it was all gonna work out. But I never felt comfortable with her. I didn't have a good connection with her. I was asking a lot of questions about what I can be doing because my first birth, I really wanted to be a home birth. She basically just didn't give me very much information about what I can be doing. She sent me to your generic birth course through the hospital. Yeah. I didn't really feel like she was really invested in the outcome of my birth. I was just like another one of her patients. So I didn't feel great about that. And then when push came to shove with my birth and things weren't going great, she threw her hands up in the air and just took a step back and didn't really advocate for me or try and help me through things. So I was left with a pretty unpleasant taste in my mouth.Meagan: Yeah, I mean, exactly what you said just a minute ago. You didn't feel that she was invested in the outcome of your birth. And then it proved. It proved to be true when she just threw her arms up. So you had that experience, and you're not alone. There are so many of us out there. Me too, me included and a lot of people on The VBAC Link team included. We have all been in a similar situation where our providers, threw our hands up, weren't invested in our birth and our experience and had to go out there and seek that support that we deserved. So if there's anything we talk about on The VBAC Link, and I'm sure you've heard it, is find the right provider. I mean, seriously, you guys, I say it daily, every single day. If I'm not typing it, if I'm not voice memo-ing it, if I'm not saying it in my mind, it's find the right provider. Johanna, what would you give for tips for our listeners to find that right provider? And how did you find that right provider?Johanna: So I found my midwife that I used for my second birth and I'm actually using again for my third birth because I am 31 weeks pregnant today.Meagan: Oh my gosh. Oh my gosh. Yay.Johanna: I found her actually because when I got pregnant for the second time, the first thing I did was get a doula.Meagan: Uh-huh.Johanna: I asked her for recommendations on a VBAC friendly midwife. She had recommended this midwife. So immediately I was like, yes, I would like to meet her. When I met her, instantly, I felt so much more at ease.So I would say going with your gut. If something doesn't feel right, even if it's the tiniest thing, just look for a new provider. Just find someone where it feels right.Meagan: Yeah. I can relate to that so much because that's how I was feeling. I was searching, I was searching, I was searching. I mean, it was insane. I interviewed a lot of providers, but that's what I was searching for is that immediate like, oh, I'm in the right place. You are my person. And it took me a long time. And that sucks. It sucks that it took so long. I know that in some areas they're really rural and it's almost impossible to find that feeling. But I agree. So just as a reminder for those looking, before we get into the story, I wanted to make sure that you know to ask open-ended questions. Do not say, "Do you support VBAC? Yes or no?" Do not say, "Do you support me to go to 40 weeks? Yes or no?"Let's ask open ended questions. "How do you feel if I approach my due date and I haven't had a baby yet? How do you feel about VBAC? What is your experience with VBAC? How do you support your VBAC clients to make sure patients get the birth that they want? How do you advocate for them?"Asking these big open ended questions and then like Johanna said, diving deep. What is your heart and your gut feeling and saying? If at any point you are questioning, which I think is when people come out on social media, that is when I think they comment and they're writing, "Hey, I'm, feeling defeated. Hey, this is what my provider said." It's because they're doubting. They're questioning. That's their intuition. If that even comes into play at all, it's time to switch. It is time to switch. And first-time parents, if you are out there listening, this applies to you too, right? We have to avoid these unnecessary Cesareans which are happening all over the world. We have to follow our intuition. So that's another thing we talk about until we're blue in the face-- intuition. So follow that intuition. Ask open ended questions. Really dive in deep because your provider really can make an impact.And really, really quickly, we're going to just barely skim the surface on PROM. PROM is premature rupture of membranes. Johanna and I have both experienced it. She's two for two. I'm three for three. Maybe you won't be three for three girl. I don't know. I'm hoping you're not. Johanna: Fingers crossed. Meagan: I'm hoping you won't. But if you are, we know that it's okay. Vaginal birth still happen. But talking about providers, if you have PROM, which means your water breaks before labor begins, and just to let you know, it can take hours, even days for your body to turn over into labor after your water breaks. But if you have PROM and you don't have a supportive provider, that is right there the beginning of a fight. It shouldn't have to be a fight, but that can impact things because they want to get things going. Some providers won't even induce labor or touch you or 12 hours later they're like, "Nope, you haven't had a baby. You have to have a C-section." So yeah. So really quick Johanna, do you have any tips for our listeners who might have had PROM or may have PROM?Johanna: Yeah, it's difficult because especially when I experienced it, I mean, I experienced it for both births and the second time I really felt anxious because I was like, oh no, I'm on a ticking time-clock again.Meagan: Yeah, yeah. Because that's how you were treated.Johanna: Yes. I was lucky that I have a super supportive provider. And she was like, "Baby's fine, you're fine, everything's fine. We're just going to wait it out."Yeah, I mean crucial to have the right provider that is going to give you that grace and give you that time and that space, but just know the facts. Just arm yourself with information that as long as the fluid is clear, as long as you have no signs of infection-- at least here they make you come in for non-stress tests like every, I don't know if it's 12 hours or 24 hours when your water has broken. As long as everything's looking okay, you can wait, I think, up to 72 hours.Meagan: I've actually even had a client wait five days. Johanna: Holy smokes. Meagan: Five days. Close monitoring you guys, really close monitoring. But it was nothing that said a baby needed to be born. So five days is maybe abnormal. This was a home birth transfer to hospital. Even with five days rupture of membranes, the hospital did not "make" her, as I'm putting quotes up, have a Cesarean or do anything different because she advocated for herself. But it really can. 72 hours. It really can happen. So okay, we are going to stop talking about this, you guys. We're going to have links in the show notes to dive deeper into questions for your provider. What about premature rupture of membranes and things like that. So we're going to have those in the show notes if you want to dive more into that. You can dive in. But we're going to take one quick break for the intro, and then turn the time over to Johanna. Okay girl, thank you so much for chatting with me about that. I really do think it's so important.Johanna: I think knowledge about everything is your best friend when you're planning for any birth, but especially a VBAC.Meagan: Right. I know. It does suck that VBAC has to be so much more intense in our prep and our research and all these things because we're just moms going in to have vaginal births. That's all we are. But, but unfortunately that's not how it's viewed. That's just not how it's viewed in most areas of the world. So yeah, all right. Let's talk about that first birth.Johanna: Okay. So I got pregnant with my first daughter Mila in the summer of 2020. So heavy, COVID times. So that was scary enough. Because of COVID and the shift in culture towards socialization and going into hospitals and stuff like that, me and my husband decided to look into home birth which was not really on my radar before, but the more that I looked into it, I was like, oh, this is super beautiful, and I love the idea of birthing my baby at home in the piece and quiet of our own space.Meagan: Yeah. And a lot safer than a lot of people think.Johanna: Yeah. Yeah, for sure. The more I looked into it, the more I was like, okay. This is a totally viable option for us. I had a pretty uneventful pregnancy. I was very lucky. I had very minimal symptoms. Everything went well. I didn't have anything scary happened during the pregnancy. I will say that I didn't take the best care of myself. I am usually a pretty active person and I totally just didn't do much exercise or working out. I think in the back of my mind, I was scared that something bad was going to happen if I overdid it. It was just a lot of first-time mom anxieties.Meagan: Totally get it.Johanna: Yep. I didn't eat the best. I didn't take the best care of myself. I didn't do a whole lot to prep for the birth other than your typical childbirthing classes, bringing baby home through the hospital, generic courses that I think a lot of first-time moms, that's what they do, right? I read a couple of books. I read the What to Expect books, and I think I read Ina May's Guide to Childbirth.Meagan: Great book.Johanna: Yep. But I had no idea what to expect. When it came to labor and birth, I really was going in blind. I will say, I just put my faith in that my provider was going to hold my hand through it. That was a mistake. So yeah, I mean, it was a pretty uneventful pregnancy. There wasn't a whole lot to say other than it was COVID and everything was scary and didn't really know what was going on. When I was 41-ish weeks, my water ended up breaking. It was the middle of the night, and I didn't really know what happened. It was just like a little squirt and went back to bed. And in the morning, it was like when you move a position and a little bit comes out and you move a position and a little bit. It was one of those. And then I lost my mucus plug. So I was like, oh, I better call my midwife. So I gave her a call, and she totally brushed me off. She was like, "No, I think it's probably just discharge. I wouldn't worry about it." So that was another red flag was her just totally brushing off my feelings and what I believed was going on. So I hung up the phone and I was like, well, I don't really know what to do now. I'm fairly certain that my water's broken. So I waited a couple of hours, and it continued to trickle out. I eventually called her again and she was like, "Okay, okay, you can come in. You can come in and I'll check, but I'm pretty sure it's just discharge." So I went in and sure enough, she was like, "Oh, your water did break and it's amniotic fluids. Look at that."Meagan: Interesting.Johanna: Yeah, I could have told you that. So I was like, "Well, what do we do now?" And she was like, "Well, we can wait up to 72 hours as long as everything's healthy. That's fine, so we'll keep monitoring things." She sent me home and told me to just relax. She said, "If labor doesn't pick up today, go to bed and in the morning, do a castor oil induction." I did that. When I woke up the next morning and nothing had happened, I did do the castor oil induction. I will say that I will never do that again because it was horrible. Sorry for the TMI, but it just gave me severe diarrhea, and then nothing happened, and I was super uncomfortable. So that wasn't fun. That wasn't fun. That didn't work.I went in for a non-stress test that afternoon. She decided to check me, and I had made zero progress. I was not dilated at all. I had zero effacement or anything like that, so no progress. I felt super discouraged. My water has been broken for however long at this point-- 36 hours, I think, probably. I've made no progress. The castor oil induction and failed. I had barely slept the night before, so I was tired and I was just stressed. I was like, when is this going to happen?Meagan: But at this point you weren't really thriving with contractions. Nothing was too intense to be telling you that there should be progress, right?Johanna: Literally not a single contraction or anything. Nothing was happening.Meagan: True PROM, and so your defeating feeling is super normal because in our minds we were told our water breaks, we should be having a baby. But if we have PROM, don't expect to be dilated. Right?Johanna: Yes.Meagan: I did too. I expected to be way dilated and I wasn't.Johanna: So I felt super defeated. And like I said, I wasn't sleeping. I barely got any sleep the night before because I was just anxious for birth to get going. I ended up crying in her office about how stressed I was to end up in a C-section because my sister had a long, pretty terrible labor that ended in a C-section. It was just not a great experience for her. I don't exactly remember what my midwife said, but I did not feel reassured leaving that appointment. But we did end up deciding that if I didn't go into labor that night, I was going to be induced the next morning because I was just not sleeping well. I was not able to rest and relax because I was just anxious. So I was like, okay. I guess my home birth plan is out the window, but at least there's a plan. I ended up going home. We had dinner, and I started getting contractions just after dinner which was exciting.Meagan: Yeah.Johanna: But then they petered off after, like, I don't know, an hour or two. So we went to bed, had the hospital bags packed and everything ready to go for an induction the next morning. Labor started around 2:00 AM. It started on its own around 2:00 AM.Meagan: How many total hours is this until labor comes?Johanna: I think it was about 48 hours after my water broke that I had the rupture of membranes that my labor actually started. I will say, it was pretty intense right off the hob. I hear a lot of women say that their early labor is like, "Oh, I took my other kids for a walk. I baked a cake. I did this. I did that to distract myself." My labors are not like that. My labors are intense right out the gate. I tried to eat something for breakfast. A few hours after that, I woke my husband up. We tried to eat breakfast. I got in the bathtub to try and relieve some of the discomfort. I hung out in there for a while. We had rented a birth tub. My husband got that set up. I called my midwife. She came probably around 11:00 AM, so at that point, I'd probably been laboring for like, I don't know, eight or nine hours. I was not coping well. It was very intense and I was not coping well with the pain. She checked me, and I was a 3. I was like, dang it. In my mind, what I know now is that it's not a linear thing and that it's not going to take another 18 hours to go from a 3 to 9. But in my mind then I was like, oh no, I can't do this for however many more hours because I'm already not coping well and I'm only at a 3. So I told her I was totally deflated and I told her, "I want to go to the hospital and get an epidural." She was like, "Okay, if that's what you want to do, that's fine." So I think between the time that she checked me and I was at a 3 and the time that I got the epidural, it was about two hours. That car ride to the hospital, wow, was not fun. But yes. So, in that two hours that it took between her checking me and me getting the epidural, she checked me again right as soon as it kicked in and I was at a 9.Meagan: Whoa.Johanna: Yeah. Meagan: 0 to 100. Johanna: Yeah, when I say that car ride, it was ripping through me.Meagan: Yeah, you were in transition at that point.Johanna: Yeah. When we were in the hospital waiting for the anesthesiologist to come in and do the epidural, my midwife and husband are joking around trying to make me laugh. I'm like, "This is not where are at right now." I was not having it because, obviously, I was in transition, and it just was not where I was at. So yeah, she was like, "Okay, well you're at a 9 now, that's great. So rest for an hour and then we'll probably be pushing." The epidural was heavy. I felt nothing from my ribs down. So an hour went by and she's like, "Hey, you're complete. Start pushing." I felt nothing. I'm trying to push, and she's telling me that I'm doing a pretty good job considering I have an epidural, but baby was still high. And then all of a sudden, I think I'd pushed a couple of times and all of a sudden, all of these doctors and nurses and bunch of people just start run into the room and they're all speaking French because it's a French speaking hospital.Meagan: Oh my gosh.Johanna: So I have no idea what's going on. Nobody is telling me anything. They're all speaking a different language. And I was just like, "Can somebody please tell me in English what's going on?" They told me that she was having late decal every time that I was pushing.Meagan: Okay.Johanna: So between pushes she was fine, but every time I'd push, her heart rate would go down and then have trouble recovering. At no point did anybody recommend maybe trying a position change or anything like that. Like maybe her cord was being pinched in that position. If only I knew now or knew then what I know now.Meagan: Yeah, like hydration, movement, doing something, pushing in a different position.Johanna: Yeah, yeah no. So like I said, my midwife threw her hands up and stepped back and let the OB take over and didn't say anything to me after that. The OB basically let me push three times and then was like, "Nope, this is going to take too long. We need to have a C-section," and she called a C-section.Meagan: Wow. Do you remember how low your baby's heart rate was getting?Johanna: No, I have no idea.Meagan: Okay, interesting. I mean late deceleration are less ideal, right? We don't want them to happen late. We want that to be the recovery period.But yeah, there could have been some things done.Johanna: Yeah, and looking back, it's frustrating to know that maybe if one little thing had been changed, the outcome could have been totally different.Yeah, but you can't blame yourself for that either. It's hard to look back and be like, the what if's. But yes, you did whatever you did in the moment with the information you were given.Johanna: Exactly. So I went in for the C-section. It went fine. There were no complications, but being strapped down to a table in a really cold room and having the shakes and not feeling that, not being the person to get to hold your baby. I mean, everyone listening to this podcast pretty much knows what thats like and how it was demoralizing and traumatizing for sure. But it went fine. She was born healthy. I didn't have any complications. But yeah, the emotional trauma was real and not just for me, but for my husband too. We got discharged about 24 hours after the C-section and going home and seeing the birth tub still set up in our living room was a very emotional experience. We both ended up breaking down crying.Meagan: Yeah.Johanna: So I had to do a lot of emotional recovery from that birth as well as physical recovery because the physical recovery from C-section was also extremely rough. I remember every time I would have to get up out of bed, it felt like I was being ripped in half. It's rough, but I knew right from the moment she was born that I would be VBACing my next baby because we had always planned on having a few kids.Meagan: I want to point out to everyone, too, the importance of postpartum support and postpartum help and planning. We never know the outcomes of birth. I didn't know the outcomes. I didn't realize that it was going to take me 15 minutes to walk 10 stairs up to my bedroom. I didn't realize it was going to take me 15 minutes to walk down the stairs. I couldn't be holding anything. I didn't realize how exhausting it was going to be to get out of bed to go to the restroom let alone taking care of a newborn baby and also thriving as an individual. So it's really important to really try not to ignore the postpartum period. I think it's easy to do because we're so focused on the birth. Especially with VBAC, I think we're so hyper, hyper focused on that VBAC, that outcome, and that experience which I do not shame anyone for being. I just want to plug it in. Don't forget about your postpartum because whether it's physical or emotional.You came back to this space of seeing a plan that didn't unfold the way you wanted it to. That can be very emotional, very traumatic even in some ways. So yeah, having some resources for postpartum as well. I just want to plug that in.Johanna: Yeah, that's a really good point. I did no prep for postpartum for my first birth.Meagan: Me either.Johanna: It wasn't even something that like dawned on me to think about. When I was in postpartum, I was like, wow, this is really intense. Like the sleep deprivation, the recovery, the breastfeeding, everything. It;s super intense. So for sure, don't neglect postpartum plans and getting the support that you need.Meagan: Yeah.Johanna: So anyway, I think from a couple weeks postpartum with Mila, I ended up finding your podcast and absolutely just binging it and trying to intake any knowledge I could get about VBAC natural childbirth-- just anything I could get my hands on, I was consuming because I knew that I was going to VBAC. I knew that I wanted to have a birth that was as intervention-free as possible for my second. So I ended up getting pregnant with my second daughter Bailey in the summer of 2022. The very first thing I did was I hired a doula. I already knew what doula I wanted before we even got pregnant because we had interviewed a few, and the doula that I found was actually a VBAC mom herself. And she just had a beautiful calming energy about her. I was like yep, that's who I want. So with that test, the lines turned pink, and I was already getting her on board. I ended up hiring the midwife that she recommended as well. I was intent on doing everything that I could this second pregnancy to set myself up for a successful VBAC that I could possibly do because I knew that if I did everything that I could possibly do and it still ended up in a C-section, then I don't have to have any lingering questions of well, what if I had done this? So it was like, I was going to do everything I could to set myself up for success. I was super diligent with eating well, exercising, and chiropractic care. I did all of the Spinning Babies' exercises, walking, and yoga. I did a HypnoBirthing course which I really, really liked, and I'm doing again for this pregnancy. I put up my birth affirmations. I did all the things You name it, I did it. My husband was super, super amazing and supportive and he was there with me every step of the way through every appointment and did all the coursework with me and everything like that. I'm very lucky to have a super supportive husband. I had another pretty uneventful easy going pregnancy. Other than a little bit more morning sickness and some SPD, it was pretty easy. I will say there's one thing that they make you do here, and I don't know if you guys have to do it in the US but if you're planning for a VBAC you have to see an OB around 36-37 weeks. Do you guys have to do that as well?Meagan: Yeah, so not if you're out-of-hospital. You don't have to do it. Some midwives still out-of- hospital will be like, "Hey, I want you to consult with a partnering physician," as in, "Hey, this is someone we would transfer to.: I went a consult with them, but with the midwives in hospital they require them to do a VBAC consult, and it's pretty much a visit where the OB is like, "Hey, this is what you're doing. Here is your risk. Do you comply?"Yeah.Johanna: Yes. So I ended up having to do that, and I knew it was going to be a negative experience. I knew it was just going to be fear-mongering and throwing scary statistics out. So I already had my guard up for that. And then it was also at the hospital where I had my C-section, so even just walking into that environment was very triggering.Meagan: Yeah. So I went to that and I was right. She told me, "As soon as you go into labor, you need to go to the hospital and you should have continual monitoring and and epidural just in case," and all of these things where I'm just like, no, that so goes against everything that I believe will lead to like a healthy, happy birth.I definitely didn't tell her about my plans. I actually was hoping this would end up in a home birth. I didn't actually mention this. My plan-- I didn't want to commit to a home birth. I was a little bit anxious because of my first birth ending up transferring to hospital, that I would end up having to do that again and then have that crushing disappointment that it didn't work out again. So my plan with my midwife was that I was going to labor at home as long as possible, and we were going to play it by ear. As long as everything was going well, then I would potentially have her at home. But I just didn't want to have that pressure that I needed to stay home because this was going to be a home birth. Do you know what I mean?Meagan: No, I totally do. I mean, when I was planning my, it wasn't a HBAC, it was a birth center birth. It's like a downplayed HBAC. I mean, I was in a different home. Right. I totally do. I know exactly what you mean.Johanna: Yeah.Meagan: Yeah, yeah.Johanna: So yeah, I definitely did not tell the OB that my plan was to have a home birth because I just did not even did not want to get into that. So I nodded my head and was like, "Yes, sure. Okay, great."Meagan: Yep.Johanna: At one point, also during my midwifery care for the second pregnancy, my midwife was like, "It's standard for you. The hospital wants you to sign a release form with a backup C-section date."Meagan: What?Johanna: And I was just like, "Yeah, I will also not be doing that." And she was like, "That is totally fine. Just sign that you won't do that." Meagan: I do not consent. Yeah, I do not consent in doing this.Johanna: Yeah, yeah. I was like, I don't need that to clock above my head.Meagan: No.Johanna: So again, my due date arrived and passed. I ended up getting a couple membrane sweeps to try and move things along, but they were unsuccessful. And wow, they are very, very painful.Meagan: So can I super quick touch on that?Johanna: Yes.Meagan: Membrane sweeps-- that's a really big question we see as well. And when you talk about them being painful, that's actually a sign that the cervix wasn't ready. Like it wasn't forward. It wasn't open. If a membrane sweep is painful, it's a real big sign-- it's not a guarantee, but it's a real big sign that your cervix isn't ready. So quick rule of thumb, if you are dilated 2+ centimeters, 3 or more is more ideal. Your cervix is really forward, meaning they don't have to reach back and in, and you are effaced at least 75-80%, that's a little bit more ideal and less painful. But if they are going back, a lot of the times is because they have to reach back and in. And so that is, that is that. And then it can cause pain, prodromal labor, things like that and, and frustration because you're wanting it to work and it's not working.Johanna: Yes. So yeah, they didn't work for me, but my midwife did tell me that I was actually 3 centimeters and she could stretch me to 3. Meagan: Great. So you were at least dilated.Johanna: Yes. So despite the fact that it was super painful and didn't work, I was still feeling very encouraged to know that my body was doing something good. Meagan: YesJohanna: Because you'll remember my first birth, I was completely closed and nothing was happening after my water broke. So I was feeling pretty good about that. At about 40 weeks and 4 days, my water broke again before labor started. It was another one of those slow trickles, and it was the middle of the afternoon, so I called my midwife, and she was like, "Okay, come meet me." She asked if the fluid was clear and I said, "Yes." And she said, "Okay, come meet me at the office later, and we'll do the non-stress test and check you out and make sure everything's dandy." So I went and everything was fine. We were just waiting again for labor to start. I felt okay because I had been through this before, and I knew my body would go into labor, but at the back of my mind I was a little bit stressing out because I was like, okay, I'm on a clock again. I went home. Nothing happened. I woke up the next day and tried to get things going with the breast pump. That got contractions going, but they never stuck around. I ended up confiding with my doula about how stressed I was feeling that I was on a clock and feeling like why can't my body just go into labor? She was extremely reassuring. She came over, and we just talked for a bit, and I felt a lot better after that. That was in the evening, the day after my water broke, and I was supposed to go in for a non-stress test. So I went and met my midwife for a non-stress test that night. It was 36-ish hours after my water had broke. Still, everything was looking good. Baby was good. She was happy. I was fine. There was no need to rush into an induction or anything like that. But she could tell I was stressed. My midwife could tell that I was a bit stressed and she was like, "It's fine. We've got lots of time. You don't need distress.: And she's like, "But I can give you these tinctures or whatever if you want to try them." It was like the blue or black. Meagan: Cohosh.Johanna: Cohosh, yes. I was like "Sure, I'll do anything at this point. I'll try anything. I don't care. So they almost look like tiny, tiny little white beads. I don't know if they're always in the same form.Meagan: Yeah, sometimes they're in drops like tincture drops or almost like you said, a pill-like bead type. Johanna: So she was like, "Okay, let's give you one now." She wanted me to take four doses an hour apart.Meagan: Did you put them under your tongue?Johanna: Yeah. So she got me to take one when I arrived for the non-stress test and then when the non-stress test was over, it had been about an hour, so she gave me a second dose, and then she sent me home with two more. So we went home, and then I took one an hour after the previous dose and it was probably 10:30 at night at that point. Contractions started going after I took the third dose and I was like okay, they're probably going to peter out again because that's what they've been doing all day. I'm tired and I want to go to bed and I don't feel like staying up another hour to take the fourth dose. So me and my husband both took a gravel because my midwife told me to take a gravel and go to sleep.Meagan: What's a gravel?Johanna: A gravel is like an anti-nausea medication, but it makes you sleepy.Meagan: I did not know that. I've never heard of that. I don't think I've never heard it.Johanna: Yeah. Interesting.Meagan: Cool. I love learning. A gravel.Johanna: Gravel.Meagan: Yeah. Okay.Johanna: So yeah, she told me to take one and go to sleep because it makes you drowsy. So I think we had fallen asleep for maybe an hour and a half and I was woken up again with very intense contractions. And this time I was like okay, this is it for real. And like I said, with both my labors, contractions were intense straight out of the gate. So I woke my husband up. Taking the gravel was a mistake because we were both super drowsy. I woke him up and I was like, "I think you need to call the doula because this is definitely happening." And so he called her over and I labored in bed. I did my HypnoBirthing tracks. I did a lot of breathing through the contractions and the HypnoBirthing was super, super helpful, I will say that. We hung out for a while and just did that. My husband tried his best to stay awake despite how tired he was. Eventually, I think I waited maybe a bit longer than I probably should have to call my midwife because I was so determined to stay at home as long as possible. I didn't want her to come and be like oh, you're a 3, right?Meagan: See? Your mind. Even in labor we trigger back. We process things as they're happening from how they happened before, and it's really hard to let go. But your mind was doing it too, right? You're like no, I can't do this because I can't be that.Johanna: Yes. So what we waited, I think it was, I don't know. I have no concept of time. But we waited a couple hours or a few hours and my doula was like, "I think we should call the midwife." I was like, "Okay, can you call her?" So we called her and shortly after we called her, I was having contractions so intense that I was having an out-of-body experience. Like very, very intense. I was getting the shakes and hot and cold lashes. In my mind I was like, I'm going through transition. For sure, for sure. I'm going through transition. My midwife was not there yet and she would not arrive for probably like another hour.Meagan: You progress quickly from history.Johanna: Yes. So, by the time she arrived, she ran upstairs to my room. She checked me and she's like, "Okay, you're at an 8, so if you want to do a hospital transfer, if you want to go, we've got to go now." And I was like, "No, that ship has sailed. We're doing this here. As long as Bailey's healthy and I'm healthy, I'd like to stay here." So she was like, "Okay, we're doing this here." And she called over the other midwife because she wasn't actually sure that it was going to be a home birth, so she didn't have the other midwife with her, so she had to call the secondary midwife to show up. It was all very hectic. This time around, I plan on calling them much more ahead of time so that it's not so hectic when they arrived because lights got turned on, equipment was shuffled around and set up and definitely took away from the vibe a little bit. But yeah. So shortly after she arrived, I was complete and I had that very stereotypical moment where you feel like you got a poo.Meagan: And sometimes you just hold back because you're like, oh crap, wait. Do I need go poo first or should I have? Wait, what should I do? I don't know. I want to have the baby, but I don't want to poop.Johanna: Exactly. So I was like, "Oh my gosh, I feel like I have to poo." My midwife's like, "It's okay. This is normal. You're good." She was just encouraging me to just do what I felt like I needed to do. I ended up pushing for probably an hour, give or take, in a sumo squat position with my midwife on one side and my doula on the other side and then my husband would switch out for the midwife supporting me on either side. And yeah, I only had to push for maybe an hour, give or take. Her head got a little bit squeezed at one point when she was coming out, so when she came out, she was in a bit of shock. Because of where I was in my room, and the equipment was on the other side, my midwife had to make the decision to clamp and cut her cord and take her over to their equipment to give her a little bit of help which was very scary. She didn't end up needing oxygen, but they thought that she might. So she ended up being okay, but it was definitely a scary couple of minutes where I didn't know what was going on. But yeah, she ended up being okay. The only thing I was a little bit disappointed in was the second time around, not being the one who gets to be the one to hold my baby and bring her to my chest and missing out on that experience again.Meagan: Yeah.Johanna: But obviously I was amazed that I had done it. I had gotten my home birth, I had gotten my VBAC. I was in shock.Meagan: I can so relate. Sometimes you're so focused on pushing that baby coming out, and then it happens and you're like, am I dreaming that this happen? And you're looking around and you're like blinking and you're like, no, I'm awake. I just did this. I just did this. And you're so excited.Johanna: I was still in La La Land because I had labored so hard for eight hours and yeah, you're out of it and just in disbelief.Meagan: Yeah. Yeah.Johanna: Like, did this really just happen?Meagan: But it did. It just happened.Johanna: Yeah. So that was a really good feeling. Recovery was like night and day. I could immediately just go and have a nice shower and walk back to my bed and crawl into my bed. It was comfortable and I wasn't in pain. I had mobility, and I could lift my baby up. It was a good feeling. Although I will say that without the epidural, the fundal massage was a really unpleasant experience.Meagan: Yes. So for everyone that doesn't maybe know, fundal massage is something that they do after labor and delivery, they essentially put their hand, sometimes fist. Now it's not like they punch you, but think about a fist. Look at the bottom of your fist. They put the bottom of their fist along your uterus, the top of your uterus. They push down and massage. They push down and they massage. And sometimes they do it three or so times. You take a deep breath, they do it. You take a deep breath, they do it. And why they're doing that is because they're checking to one, make sure your uterus is clamping back down to its normal size right after birth and the placenta is out. It starts doing its job and going boop boop, boop, right back down to its normal size. But sometimes it can get a little boggy or bleeding can occur. So yeah, you want to make sure that. Now, really quick tip. If for some reason your uterus is still staying boggy and not clamping down as much, something you can try to do if you are able is urinate. Go to the restroom. That's a really big thing to help the uterus clamp back down. And even if you have an epidural, sometimes you have to get a straight cath. And if you can't go to the bathroom, sometimes you can get a straight cath to release. But yeah, that is not as friendly when you're unmedicated. But take deep breaths. If you can, get that baby on your chest or hold someone's hand-- your doula, your partner, your midwife, anybody's hand and just take really deep breaths and know that it's okay. It's okay. It doesn't last too long. But yeah.Johanna: So going back to our chat about postpartum.Meagan: Yeah.Johanna: So the recovery of vaginal versus C-section night and day for sure. But I will say that my postpartum with Bailey was way harder than with my first. It had nothing to do with the birth. I think she was asynclitic in my uterus. And so when she came out, she had a pretty bad case of torticollis and a tongue tie which made breastfeeding very difficult. I got mastitis twice in the first four weeks, like a really bad case twice in the first four weeks. I ended up with a bad case of food poisoning at three weeks postpartum.Meagan: Oh no.Johanna: And I had some prolapse symptoms as well. I will say that there were a lot of things happening in the first month, month and a half of my postpartum that I didn't expect and were very intense and difficult. I mean, just for breastfeeding, I was in so much pain that there were many times that I wanted to just give up and be like, nope, never mind. Forget this.So having good lactation support was really crucial.Meagan: Oh yes. And get lactation support before you have your baby. It sounds weird. It sounds really strange to connect with someone about breastfeeding before your baby is born. But oh my gosh, you guys, it's so impactful. I mean, we've talked about it before with The Lactation Network and other IBCLC supports. It's so important. I had similar. So my baby was born be a Cesarean. So in a Cesarean, a baby can also develop torticollis too with the way they are and the way they come out. But my baby had torticollis and she had a tongue tie. So very, very difficult. Challenging for sure and frustrating.It can impact things like mastitis and yeah, I love that you pointed that out. My was recovery all around better, but that doesn't mean my experience was all sunshine and butterflies. I really want to just highlight that one more time, you guys. Vaginal birth doesn't mean your postpartum journey is going to be the easiest. Mine wasn't. My VBAC after two Cesarean birth was not the easiest. It just wasn't. So again, get those resources beforehand. Right?Johanna: Yeah. And I will say, I don't know what I would have done if I wasn't with midwifery care and having them on call for the six-week postpartum because I swear, I called them every second day about something that was going on.Meagan: Well, and that's more unique to home birth too because even with the hospital birth midwives, it's not the same. They usually say, "Oh, I'll see you in six weeks," and you can call. You can call any OB or midwife. You can call any provider, but there's a different level of care and follow-up in that postpartum stage and it's very impactful. It's very, very impactful.Johanna: Oh for sure. Yeah.Meagan: Yeah. Oh my gosh. I love everything and I love all these tips. There are so many tips and nuggets along the way. Is there anything else that you would like to drop here for the listeners in regards to home birth or preparing or postpartum or any words of encouragement that you may have?Johanna: I mean, I think that, like I mentioned at the start, just arming yourself with as much knowledge as you can is going to be your best bet to get the outcome that you want and just feel empowered throughout your pregnancy and your birth. So just arming yourself with as much knowledge as you can get your hands on and yeah, getting a good provider, trusting yourself, believing in your body, and setting yourself up for postpartum too because that's an important thing when you're so focused on getting your VBAC is letting the postpartum stuff fall to the wayside.Meagan: Yeah.Meagan: Taking care of yourself afterwards too is important.Meagan: Yes. Taking care of yourself. We don't. We don't take care of ourselves enough, you guys. Really pamper yourself. If that means you have your postpartum doula. If that means you hire a house cleaner to come in every other week. If that means you hire or have family come in to help, just whatever. Light house cleaning or holding baby or playing with toddler. Johanna, she's going to have two, you guys. She's almost on her third, and it's another baby girl.Johanna: Oh, yes. Yes. That's three for three.Meagan: So three baby girls. I mean, you've got your hands full in your postpartum experience.Right. So really do it. I don't want to stereotype women, but sometimes we get into this space of,  we can do it and we don't need to spend money on ourselves and things like that, but this stage of life is so important to invest in yourself. Really, truly invest in yourself because you deserve it. And your sleep and your experience and your mental health, it all matters so much. So yes, you might hire a cleaner and you might be spending that money, but guess what? That's okay. Do it. Johanna: And when you're taken care of, then you're a better mom to your kids.Meagan: Yes, yes. My husband always says, "When mom is happy, everyone else is happy." But really, really, you deserve it. Women of Strength, you deserve to be pampered and loved and supported. So Johanna, thank you so much again for such a powerful episode. I'm so grateful for you. And please keep us posted on this baby number three.By the time this episode comes out, you will have had this little baby girl.Johanna: Yes. I'm due January 4th, so I will definitely be sending you a message when she makes her entrance.Meagan: Please do. Please do. Okay well, thank you so much.Johanna: Thank you.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

The VBAC Link
Episode 389 Kristin from Ask the Doulas Podcast + VBAC Prep + Assembling Your Dream Team of Experts

The VBAC Link

Play Episode Listen Later Mar 24, 2025 52:39


In this special episode, Kristin, host of Ask the Doulas podcast and founder of Gold Coast Doulas,  gives tips on building your supportive birth team. Krisin and Meagan talk specifics on HOW to switch providers if you're feeling the push to do so.Once we have our dream team, we're good and don't have to do any more work, right? Nope! We keep educating and preparing ourselves. That's the way to truly get the most out of that dream team. Kristin's book ‘Supported: Your Guide to Birth and Baby' is a one-stop shop where you can get all of the education you need for pregnancy, birth, and postpartum. Her advice is so valuable for VBAC moms and birth workers, too!Supported: Your Guide to Birth and BabyAsk the Doulas PodcastNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello. Hello. We have a special episode for you today. We have my friend, Kristin, who is actually the owner of Ask the Doulas Podcast on with us today. She is going to be talking about establishing our birth team and the importance of it. We're going to talk a little bit more about what to expect when we might not find a provider that's supportive and how to navigate it. She's going to talk more about her book and so many things. You guys, I'm really excited. Kristin is a woman who has always had a passion for supporting other women both personally and professionally. In college, Kristin served on the executive committee of her sorority and organized events on campus related to breast cancer and other women's issues. After the birth of her daughter in 2011, a new passion awoke within her. Kristin began reading and studying birth from all perspectives, philosophies, and medical approaches. She joined organizations like The Healthy Kent Breastfeeding Collation and used her event coordinating skills to build and promote the organization and create community awareness. You guys, she has done so many incredible things. Kristin's research has led her to learn more about doulas, and in 2012, she hired doulas herself for the support of her second birth. The level of compassionate care and comfort that she received from her doulas ignited a spark within her and led her down the path of becoming a doula herself. And man, can I connect to this because this is exactly what happened to me. When you guys have a doula who inspires you and touches you and motivates you the way it sounds like Kristin did and I did, even though my doula wasn't a hired doula, she was just a nurse that was a doula for the time being, it does something to you. She earned the certification and became teaching sacred pregnancy classes in 2013. But as you'll see, Kristin is a firm believer in achieving the highest level of education available when providing a service. Shortly after, she earned the following credentials-- you guys, are you ready for this? She's amazing. Oh my gosh. Certified Sacred Doula in 2014. She is a Certified Elite Labor through ProDoula. She is the Elite Postpartum and Infant Care Doula through ProDoula. She's trained in Spinning Babies, Newborn Specialist, Mother Ship, Certified Health Service Provider, certified in VBAC. She is certified in transformational birth and a birth coach for the Birth Coach Method. She is a certified pregnancy and infant loss advocate and certified gift registry expert through Be Her Village, who we will talk about. We both love them so much.She is also an author of a book which we will be sharing more about. It's called Supported: Your Guide to Birth and Baby. So without further ado, we are actually going to be skipping a review today and an educational topic because this is such a great episode to be educated and learn more about what Kristin is offering in her community. Okay, my love. Hello. Kristin: Hello.Meagan: We're officially getting going talking about this amazing topic. Tell me what you think about this. I think sometimes people want to assemble this dream team, but they let finances or even partners or other opinions get in the way.Kristin: Yes. Partner comfort level, especially with VBACs is key, or with clients of mine who want their dream is to have a home birth and their partner isn't supportive, so then they say, "Oh, it'll be with the next baby if everything goes well in the hospital." But then if they're a complication, they might risk out of the option of home. I think as consumers, we don't fully appreciate the ability to choose all of our birth and baby team. We can change providers. I switched providers with my first pregnancy early on because I didn't feel like that particular OB was on board with my plans to have an unmedicated hospital birth. I ended up switching to Certified Nurse Midwives and completely changed practices, completely changed hospitals in fact. It's a lot. Meagan: Yeah.Kristin: But it was worth it. And I had the time where it was easier to switch, but I've had clients switch very late in pregnancy. It was harder to find the right office to accept them, but with VBACs, it is crucial to have not just a VBAC-tolerant provider, but someone who is fully on board with your unique desires because we are all individuals.Meagan: Yes. I love that you said your unique desires. Everybody is different. I think it's really important to tell these providers what your desires are. We have a list of questions that we give people in our course and, of course, on the podcast. You can go down that list and check and be like, "Okay, this provider seems pretty supportive," but you guys have to tailor your questions and your provider. You have to tailor it to what your individual unique circumstances and desires are because everyone's is different. I would love to know. You said, I was realizing that this wasn't the right place. What kind of things were you hearing or being told or feeling when you were realizing that maybe your first provider wasn't going to be as supportive and in line with your unique decisions?Kristin: Just when I was talking about my wishes, I could tell that that particular provider liked structure and patience to get that epidural, and so once I started talking about movement, delivering in different positions and some of the things I had researched-- I hadn't yet taken a childbirth class because it was early in pregnancy, but I had done a fair bit of research before knowing what a doula was. I didn't hire doulas until my second. But I could just tell in that gut feeling which I rely on. Again, we're all unique. And yes, I do research, but I make decisions on am I comfortable spending my entire pregnancy with someone who can tolerate me and will say, "Okay"? But I could tell it didn't light her up. So once I found a practice where my nurse-midwife spent time with me, I had longer appointments, I could ask questions, and she was 100% on board with me, and then I was able to meet the other midwives and the OBs who oversaw them throughout the remainder of my pregnancy. I felt very cared for. And again, we are consumers. Whether your insurance pays for everything or you're paying for part of it, you don't get a do-over of your birth, and so it is so important, especially with that first birth to get the care team that aligns with you. That could be everything from a Webster-certified chiropractor, a physical therapist, a mental health therapist to deal with any anxieties that may come up with having a VBAC and getting a lot of fear-filled advice from friends and family members. I find that again, my clients are all unique individuals, and my students in Becoming a Mother Course, and now the readers in my book, have different goals, so I want them to choose the best plan for them. I love that you have worksheets and templates, but knowing that every situation is different whether it's a home birth, a trial of labor, or a hospital birth, that setting is different and the type of provider whether it's a nurse-midwife or an OB practice, how likely is the OB that is very VBAC-supportive going to be attending your birth? Are there 12 providers or are there only 4? And so there's just so many things to factor in when deciding what is important to you.Meagan: Yeah. That point that you just brought up, are there 12 providers? Are there only 4? Does your provider guarantee that they'll be there? These are things that I think a lot of people may not be aware of that because they found their provider. They're feeling good about their provider. They're jiving. They're having the feels, but then they may not be the ones to be there, so there are 11 other options. It feels overwhelming to be like, "Wait, wait. Do I interview all 11?" Yeah, guys. Yeah. You set up visits. It's okay. Go and see if you can meet with those. Make sure that that full team is aligned. It is a lot. That's a lot to take on, but it's okay to rotate and say, "Hey, I saw Dr. Jack last time. I'd like to see Dr. Joe this time," or whatever it may be. Really, really dive in, find out more about your provider's team if they have a team, and make sure that they align with your unique decisions and desires.Kristin: Absolutely. And that goes for doulas as well.Meagan: Oh, yeah.Kristin: So for VBAC clients, I, over the last couple of years, I do all of the matchmaking, I like to call it, between client and the birth doulas and postpartum doulas on my team, in fact. I like to find out what they're looking for. If they are attempting a VBAC, then many times, they're telling me they want a VBAC-certified doula. I have doulas that have gone through your program and are certified through you and other different VBAC trainings. They're not just wanting VBAC experience like in my early days of having Gold Coast Doulas. Now, they're wanting that certification because they know that information is being updated as things change. And there's more evidence for VBACs. They also want more than just, "Oh, I've attended four VBACs." They want the education behind it. So I think that is crucial. I'm not going to match, unless there's no one else available on my team, a client with someone who is not certified as a VBAC doula.Meagan: Yeah, I do the same thing with my group here where they're like, "This is really important to me. I want this specific type of doula." Some of my doulas have taken The VBAC Link course. And so I'm like, "Yep, this would be who I would suggest." But I also want to point out that even if you assemble your dream team doula, and they've got all the education and information on VBAC, and they're up to date, I want to just point out that it doesn't mean that you shouldn't inform yourself that you shouldn't get the information because sometimes I feel like it's easy to want to just hire your provider or your doula or your person and let them who know VBAC kind of help and guide you. But it is really important. You're doing yourself a disservice if you personally do not learn more about VBAC and your options as well and rely only on your provider or your doula.Kristin: 100%. The doula, I mean, unless you're paying her for it, will not be attending every one of your prenatal visits during pregnancy. The education that you have to make informed questions and decisions surrounding your birth plan or birth preference sheet, so those conversations are critical. The more information you have as a patient, the better. And as we all know, unless you're having a home birth, your visits are short even with a nurse-midwife. And so it's important to have those questions and to have time to really express concerns. Or if you're finding that that practice or that provider is not in line with your plans, then you can look at other options. And the hospital-- are VBACs even allowed at the hospital that you plan to deliver at? Are they going to induce? What are the Cesarean rates? And looking at all of the different options, and if you need to consider NICUs, that's always a factor in hospital selection as well.Meagan: Yeah, I'm going to kind of go back to where we were in the beginning where you realized based after your feelings and other things that this provider was not the right provider for you, you then changed to CNMs and had a much better experience. Can you discuss your process of that change? How did you change? Did you find the CNMs, have them request your information from the OB? Did you do a formal breakup with your OB? What suggestions would you give to someone who is wanting to do that? I know that sometimes, you were talking about it, in the end, it's a little harder to find, so that's why we stress so importantly to find your provider from the beginning. But we know that sometimes things change. So can you kind of talk about that process in then assembling that dream and getting the steps to get to that dream team?Kristin: Yes. So for me, I had asked friends about which providers they had worked with. So the original OB, a friend of mine, it was her doctor, and she had a great experience. I just wasn't feeling it. She had a student. We have teaching hospitals in my area, so there was a student in the room. I wasn't feeling like she was 100% on board. I could tell that she was very medically driven. I wanted essentially a home birth in a hospital. So I talked to more friends and did research online, and a friend of mine had used this particular practice. I ended up going with the midwife that delivered her three children, and it worked out beautifully because it was early in pregnancy. That practice had openings. It took me a while because I was changing hospitals and practices completely. My insurance, luckily, covered all of the options. But that's another thing to look into. Does your insurance cover the hospital where the provider you want to switch to delivers that if it is a hospital birth? Of course, you can VBAC at home in certain states. So just looking at all of the factors that would come into play. So for me, it was dealing with the paperwork of switching out of that practice, getting admitted, and going to that initial get-to-know-you visit with a nurse and doing my labs before I got to meet with the midwife that I had wanted to work with. And so it took a bit. I mean, no one likes to deal with the paperwork and the phone calls it takes, but your health is so important and especially again, for VBACs.Meagan: Yeah. So you essentially did all the paperwork and the transfer yourself.Kristin: Yes.Meagan: Okay.Kristin: I made all the phone calls, dealt with insurance and made sure that the initial visit was paid for along with the nurse visit, and then that insurance was comfortable with me.Meagan: Yeah. Awesome. Yeah, I did, when I switched, because I switched it 24 weeks, my midwife just faxed a request to my OB office. It took them a while to send it. We had to ask five times which I think probably would have been faster if I, like you, made the phone calls and did all the things, but I was like in this weird, vulnerable spot of like, I don't want to go back there.Kristin: Right. You don't want to deal with it.Meagan: Yeah, I don't want to deal with it.Kristin: Even just talking to the front desk.Meagan: Yeah, yeah. So we waited for it and they eventually got it. But I think that that's important to note. You guys can make the calls too. You can call and say, "Hey, I'd like to request my records to be printed out or to be sent to this place." Kristin: Yes, and that's what I did. Because otherwise it's six weeks oftentimes or you have to keep calling. They get lost. so I just handled it. But it can be challenging. And as doulas and certainly VBAC doulas, we know the providers who would be not only tolerant but supportive of VBAC. So we get those questions frequently from potential clients and clients of, am I at the right place? And of course, we support whoever our clients choose to have care from. But there's also, if asked, I will tell them about the practice and my own experience as a doula or the agency's experience. And again, in those large practices, there might be four who are so VBAC-supportive. They love it, but then there might be some physicians who are not as comfortable. They feel that a surgical birth might be the better route to go, ad so there's that. So what I like to do as a VBAC doula is to have my clients talk to their provider. Again, go over a birth plan or birth preference sheet and have them sign off on it. That way, if they don't attend the birth, then the other physicians know that this was approved. It's not just a birth plan that is thrown out there, but it has been discussed. It doesn't work all the time, but it has been helpful for my clients no matter if they're a VBAC client or this is their first baby, and again, they have certain goals that they want to achieve like potentially avoiding an induction unless medically necessary.Meagan: Oh my gosh. So I'm just going to re-touch on that, you guys, because that was really, really, really good advice and something I've actually never done or even thought about or suggested to my own doula practice clients. Get your birth preference sheet or birth plans everyone calls a difference. I call it a birth preference sheet, which is a list of all your preferences that you desire. Go over that with your provider, and have them physically sign it. Physically sign it and date it showing that your provider went over it. And like she said, every provider may not be willing to do that, but I will say, if a provider is willing to do that, that says something to me.Kristin: It does. Yes.Meagan: Yeah. Super powerful. Oh, my gosh. Okay, nugget. Grab it, put it in your pocket, everybody. Sign your birth preference sheet so you can have it and keep that in your bag, so if you do have that random on-call doctor who may not even know you or not be so supportive, be like, "This has already been discussed. We were aware of this. My doctor has signed off." Also, you could maybe ask if your provider could make a copy of that and put it in your chart.Kristin: Right. Because yes, it's not just the one that they have on file, but it's also for the ones that you have, that copy that you're bringing and showing the nurse so the nurse and everyone is on the same page. Meagan: Love that. Kristin: And again, with teaching hospitals, you might have residents in and out. There can be some difficult conversations with VBAC and residents who have never seen a VBAC. We're not fully trained yet to support VBAC, and so they might be making suggestions while the provider is not in that check-in. So every state, again, every area is different. I just happen to be in an area with multiple teaching hospitals.Meagan: Same here. We have seen it where I think, I don't want to say this badly. The VBAC world is a world that can have a lot of negativities in it, negative things and big words like uterine rupture. We've got residents who may be coming in and may be training under a provider who has seen a uterine rupture or has maybe molded an opinion on VBAC and is projecting their opinion to that student. Whether or not they're consciously doing it or not, they're saying their opinion, and those opinions might morph that resident's opinion into negative for VBAC. You never know. And so they might be doing things or be more hesitant in areas that they don't need to be, but they are.Kristin: Yeah, it's such a good point. And as you mentioned, I mean, we don't know the traumas that our nurses and medical team, even home birth midwives, have experienced, and they carry that with them. And how can they not? Even as doulas, we witness, but we don't have the liability and the medical training to make it, but we are witnesses of trauma and have our own healing to do to be able to better move on and support the next client. So certainly keeping that in mind that they may have seen something that alters the way they practice.Meagan: Yeah.Kristin: It's not just fear of lawsuits.Meagan: It's really not. It's not. There's a provider here in Utah who is literally so scared of vaginal birth herself. She scheduled all of her Cesareans, even the very first one from the get. She never had trial of labor or TOL. She just doesn't. So can you imagine what her Cesarean rate may be? And she kind of reminds me of the provider you're talking about. She really likes it just so controlled. Come in, start Pitocin, and get the epidural. She likes those things, which we know can sometimes lead to those Cesareans. And so really also discussing with your provider, how do you feel about birth? Have you had babies? And then we have another OB who's like, "I work in the hospital, and I love the hospital, and I trust the hospital system, but I actually gave birth at home with all three of my babies," and so really getting to know your provider, I think, is so good. Okay, let's keep going on this topic of assembling your dream team of experts when planning for birth and baby. What other things would you suggest to our Women of Strength?Kristin: Yes. So as we know, birth is as physical as it is mental, and just the opposite, as mental as it is physical. So preparing with a childbirth class, a comprehensive class, even if you took one before, use the lens of your goal of attempting a VBAC, a trial of labor. And so for us, we happen to teach HypnoBirth at Gold Coast Doulas and that mind/body connection that HypnoBirthing or a gentle birth offers where it's more of using the visualization the way an athlete would in preparing for a marathon or a triathlon, you are using things to reduce fear. You're understanding all of your options. It's very partner involved. I think taking a comprehensive childbirth class, whichever meets your individual goals, is great. That childbirth instructor is a great person to add to your birth and baby team. And then moving your body. So taking a fitness class that is appropriate for pregnancy. So prenatal yoga, there are Barre classes for pregnancy. There are prenatal belly dancing classes, whatever it is. Meagan: Aqua aerobics.Kristin: Yeah, water aerobics are amazing. And so thinking about baby's position and helping labor to go on its own or be quicker. There's acupuncture, acupressure, the Webster-certified chiro for positioning or body balancing experts, so many different options. But I am a big fan of educating yourself and preparing because as you mentioned earlier, Meagan, a doula is not your end all, be all. Just because we have the information and the training, we can't think for you. We don't want to think for you. The more informed you are, the more likely you're going to feel like birth didn't happen to you this time around and you were a direct participant, even if you end up having a surgical birth again.Meagan: Yeah, yeah. Yes. Oh my gosh. So talking about courses, you guys, we have our VBAC course. This VBAC course goes into VBAC, the stats about VBAC, the history of VBAC, the history of Cesarean, the stats of Cesarean, the questions, finding the provider, a little bit more of the mental prep, and physical prep. But when it comes to a childirth education course like with the course that she has, they're on different levels. I actually suggest them both.Kristin: Yes, me too. Absolutely.Meagan: But it's so important to know the information that is in your course. I know you go even past preparing for birth and then birth and then postpartum. You go into all of it. We're going to talk more about it. But you guys, we as doulas, love getting information and we love sharing information. But like she said, we don't want to be the only one that knows the information in a team. When our clients come in, at least here in my group, when our clients come in and they are fully educated and we're like, yes. And then we can come in with our education and our experience and knowledge, you guys, it is a powerhouse team. It is a powerhouse team. We have clients who, when they take child birth education classes like yours, they are able to advocate more for themselves. They feel stronger to stand up and say, "Hey, thank you so much, but no thanks" or "Maybe later," when our clients who haven't had that childbirth education or just any information other than maybe what we're providing, which is great, but not enough in the full length of pregnancy, it's a little harder. We have to try to encourage those clients a little bit more because it's harder for them because they don't know everything. We're there to help guide them and help advocate for them and educate them, but it is very different.Kristin: It is. It's so different. And I feel like, again, partners, especially male partners, want to fix things. They don't want their love to feel any pain, and so they may have the fear of a VBAC. So taking a VBAC class course, having a VBAC doula, giving information is just as helpful, if not more for the partner and their comfort level and to have them fully get on board because they may be resisting and just going along for the ride, but if you can get them to be an active participant in education, then they're going to be able to help you. And sometimes in labor, we get to a point in transition where we can't fully speak for ourselves. But if our partner understands, is educated and on board, and if there's time to talk through the risks and benefits and alternatives with your doula, then yes. But sometimes decisions have to be made quickly, and so for that partner to be informed and educated is crucial.Meagan: So crucial. It's so powerful. My husband-- he was not so on board. He was like, "Whatever. I don't care. You can go to the courses. You can do these things."Kristin: And that's very typical.Meagan: It's very typical. And I did. I did do those things. When I said, "Hey, I'm going to birth out-of-hospital," and he was like, "No," I was like, "Well, sorry. I've done the education. I know this is really where my heart is pulling." We touched on this in the beginning how partners really can influence decision making. And in no way, shape or form am I trying to say partners are terrible or don't listen to your partner or anything like that. That's not the goal of what we're saying is have an educated partner. Know that you can assemble a birth team, like a provider, a chiropractor, a massage therapist, a doula, a PT, or whatever it may be, but don't forget about your partner. Your partner is a huge part of your team, and if they're not educated and they're not able to help guide you through, or if they're not being supportive, find ways to help them be supportive by taking a course with them and helping them realize, oh, VBAC actually isn't that scary. Oh, that chance isn't really 50+%. Oh, okay. Hospital birth, out-of-hospital birth. Yeah. They're both reasonable, and really understanding that.Kristin: Absolutely. And sometimes I find that my students and clients may have not had success with breastfeeding the first time and potentially didn't take a class. So if their goal is to breastfeed or pump exclusively, then taking a breastfeeding class and having that IBCLC as a resource for their dream team in case it's needed because many times, you have the lactation consultant who's teaching the class, at least in my practice, and then they're also available for say, a home visit or a hospital visit, depending on where the class is taking place. And so I think that that's something. Even if it isn't your first baby and maybe you breastfed for a little bit or had supply issues or challenges after a surgical birth, that it is important to consider any education during pregnancy because it's much harder to get that education after you have your baby.Meagan: It really is. I love that you're touching on that, really getting into all the things and having your partner go with you. I remember I was like, I had a C-section, and I was swollen and tired, and I couldn't move very well. I was sore and all the things that sometimes come with C-sections. I'm trying to nurse, and I'm engorged.  I don't feel my letdown, and I'm just so engorged. I don't know. All I know is I have really big, swollen boobs. It's all I could tell. I couldn't latch. My husband was like, "That's it. We're going to the store. We're getting formula." Formula is fine. Not anything against formula.Kristin: He's trying to fix the problem and make you feel better.Meagan: Yep, yep, yep. Trying to fix that problem. But I was like, "No, I really want to breastfeed." At that point, I wasn't able to communicate. Like, I didn't get the birth I wanted. I already felt like a failure because I was actually told that your body failed. That's what I was told. So I was already dealing with this mindset that I failed. I had a C-section. I didn't want a C-section. And now the only thing I could try to do because I couldn't take that C-section back is breastfeed my baby. I wanted to breastfeed my baby. And again, we didn't take those childbirth education classes. He for sure didn't download any apps. I at least had an app trying to help me at that point, but he didn't understand. He didn't understand.And I'm like, no.I'm crying, and I'm like, "Please, just help me. I don't know what I need to help me." And he's like, "No, we're going to the store. Our baby's mad. You're crying." He was trying to fix that problem. But if we had already done that information education before and found that IBCLC before and him understanding how important that was to me, he could have been like, "I'm going to call her IBCLC. I'll get her over here right away."Kristin: Exactly. The last thing you want to do is go into the hospital to see a lactation consultant there if you can even get in.Meagan: Exactly. Yeah. So it just could have been so much smoother. Sometimes I feel like we were against each other at that point because he didn't have any education. With our first, I really didn't have much education. But with our third, it was like he really didn't have a lot of education. and I was over-the-top educated, so I was saying these things, and he was thinking I was demeaning him or saying he was stupid because it was just this weird thing. So if we can just come together with our partners and get all the education and get it all before really, find out a postpartum plan. Find out a breastfeeding plan. Right? Find out what you want. You guys, it just makes the pregnancy journey and the postpartum journey, so much better. It truly makes you feel like you're on that team because you are.Kristin: Yes. Absolutely. And certainly, I mean, you mentioned apps. Not everyone has the means or even lives in an area where they can take a comprehensive five, six, ten-week childbirth class. There are, obviously, online classes. There are some Zoom virtual ones where students are all over the place. But there are watching birth videos and YouTube and in my book, Supported: Your Guide to Birth and Baby, we talk about apps, so count the kicks. Especially for VBACs, doing the self-monitoring if there's fear of fetal movement and any sort of distress during the end of the pregnancy, then really understanding your own body and doing monitoring. It's not just when you're in your provider's office being monitored. You can make a difference yourself. So having some different apps and some education on your own, listening to podcasts like yours to get this information and reading books. So there's more than if you can't afford a childbirth class like HypnoBirthing, there are still ways that you can get educated and your partner can get educated. So yeah, take a look at all of your options and your budget.Meagan: Yeah, and we talk about this all the time because I love them, but Be Her Village is a really great resource where you can go fill out a registry and, hopefully, get some help for these things. Childbirth education classes, doulas, IBCLCS. But I want to dive a little bit more into your book, actually, while we're talking about different resources. We talked about the childbirth education, but can we talk about more about Supported: Your Guide to Birth and Baby and how this came into fruition and what all is included in this amazing book.Kristin: Okay, Meagan. So essentially the book came out of our online course. Becoming a Mother launched in the early pandemic when everything was shut down and our classes all had to go virtual. I was fortunate to be in a state where doulas who were certified were able to work thanks to our governor. So we were working, but there was still a lot of isolation even with our clients' prenatal visits. They wanted a connection, so we launched this course. We had talked about and did three live launches, got VBAC from our students, pulled people in from all the moms' groups before creating the first draft of the course. And then the course just led to the book. So the content in Becoming a Mother is what is in the book in a different format. So in Becoming a Mother, we have expert videos, so VBAC specialists and Webster-certified chiropractors talking about what that is. Pelvic floor physical therapists, car seat safety technicians, cord blood banking donation centers.Meagan: Awesome.Kristin: We have the experts speaking for themselves-- a pediatrician. And so in the book, anything that is medical and out of the scope of a doula, we had expert contributors, so I have a pediatrician friend of mine who contributed a newborn procedure section of the chapter and a prenatal yoga studio instructor, she's also a certified body balancer. She contributed to some of the fitness options in the book, and a mental health therapist who is PMA focused and certified contributed to the mental health chapter. We have an IBCLC that contributed to the feeding chapter, and so a lot of involvement, and then sharing client stories throughout the book and then our own wisdom. We have doula tips and wisdom at the end of every chapter. Meagan: Wow.Kristin: And so as clients were asking me for books over the years, I couldn't find anything that was positive. I felt like there were a lot of, this is your cry-it-out method for sleep because we have a whole chapter on sleep and it's very attachment-focused. It's like, one way for feeding, and we wanted our clients, with their unique choices for themselves, to have a book that supports people who want to plan surgical birth like that OB and that's their comfort level and a book for the same person who wants a home birth. You don't have to buy five different books. It's not always Ina May which is a great book but not for everyone. All of her different-- she's got Spiritual Midwifery and so many different books. It is great for grandparents to read and partners but is targeted to the mother or the mother-to-be and is great in preconception in that early planning. But also, we wanted to make it similar to the course and just as valuable for seasoned bombs as it is for new moms. And again, it's affirming. We tried not to have any fear-filled information in a simple, easy-to-read guide that you can pull out for reference and a lot of different, again, apps and podcasts and books to read and resources and evidence-based information about Black maternal health and where we're at in the country now and how the pandemic impacted birth especially, but also that postpartum time.Meagan: Wow. That book sounds amazing. So amazing. And you guys, you can get it in every form, even Audible. I'm a big listener. I like to listen to books. Kristin and Alyssa actually recorded it. She was telling me they had 10+-hour days recording this this book. You can get it, and we will make sure to have the links for that in the show notes. I found it at goldcoastdoulas.com/supportedyourguidetobirthandbaby.Kristin: It's there. You can find it off that website or it has its own page. It's supportedbook.com. Meagan: Supportedbook.com, okay. We'll make sure that's all in the show notes, so you guys can grab that. Okay, so you know a lot. Obviously, you wrote a whole book and a whole course and all this stuff. Is there anything else that you would like to share in regards to just our final assembling of that powerhouse birth team?Kristin: So don't forget, I know we're talking a lot about pregnancy and birth prep, but don't forget your recovery phase. And you had talked about your own personal struggles with breastfeeding engorgement, recovery after a surgical birth. If you have, well, you do have other children at home with VBACs, and so looking at childcare, postpartum doula support, or what kind of family support you're going to have after, it's more than just meal plans and prepping the nursery. We strongly believe that as part of your dream team, the postnatal team is crucial as well. So whether it's a lactation consultant, a pelvic floor physical therapist, if you want to get back to running marathons again or are leaking. I mean, we can all use pelvic floor physical therapy. It's not just the athletes who they support. Some people, again, with building a home or other life occurrences like a wedding or preparing for college, you look at your budget. You look at your main goals. For a wedding, it might be food. For postpartum, it might be sleep. So hiring a sleep consultant when baby's old enough or an overnight postpartum doula or a newborn care specialist. What are your priorities? And take the budget. What might be paid for by insurance or, a health savings flex spending plan that you need to run down? What might be gifted? Like you mentioned, Be Her Village. There are different ways you can budget. And in the book, we talk about all of that and looking at employer plans, how to navigate that, what questions to ask your HR department about other members, like a chiropractor, could that be covered? A therapist? Oftentimes, we don't know our own benefits and certainly, I don't know my husband's benefits fully, so to be able to investigate that early in pregnancy and figure out what might be fully or partially paid for.Meagan: Wow. That is incredible itself. I feel like that's a whole other conversation of, how to navigate how to do that. So definitely go get the book, you guys, because it sounds like there are just so many things in there that are honestly crucial to know. really, really important things to know. You are incredible. Kristin: So are you.Meagan: I just enjoy chatting with you so much. Anything else? Yeah, anything else you'd like to add?Kristin: And obviously, take taking trainings and courses. If I know you have doulas who listen. It's not just parents.Meagan: Yes.Kristin: As doulas go through The VBAC Link. Get certified as a VBAC doula. Keep up with information that is ever-changing. We all want to be the best doula for each of our clients, but I am a firm believer in continuing our own education and that more and more of our clients are choosing to attempt VBACs, and so the more information you can get as a professional, the better you're able to support. It's just not the number of VBACs you've attended anymore. It's clients wanting that knowledge so you can be busier and also a more effective doula by getting that training and then going through the certification process that you offer.Meagan: Yeah, have a directory actually with birth doulas where people can go and find it because when Julie and I created this company way back in the day, we knew that we were just two people here in Utah. We couldn't change the VBAC world. We could give as much information as we could. We could share the podcast. We could do those types of things. But when it comes to birth workers, we wanted to reach birth workers everywhere. It's so great that we have and we're still having more people come on because they're helping people so much. I mean, we know you have doulas that do it all the time. These doulas do help and there are actual stats on doulas that do it. But I agree. If you're a birth worker, stay up to date. Be in the know. Know what's going on because you will likely need to help guide your client through it. Kristin: Then you can charge more. So take that investment in a training like The VBAC Link, and then you're able to charge more because you're more experienced. You have more certifications. So don't look at like, oh, I don't have any money for continuing education. Look at how that's going to change your career.Meagan: Yeah, and I think sometimes too you can charge a little bit more, take less clients, and be more personal with those clients and dive into it. Especially because we do know that VBAC does take some extra stuff that goes on with VBAC. There's some extra work to be worked through. There are some extra things and so yeah, I love that.Kristin: Well, thank you so much for having me on Meagan, I loved our chat.Meagan: Thank you. You as well. As always, I loved our other chat as well. We have to keep going. I think I'm going to order your book today and get going on that. Even though I'm not a mom preparing, I think this would be such a great book to suggest to all of my clients. So thank you for sharing. Thank you.Kristin: Yeah. My secondary audience is certainly anyone who works with families in the birth and baby space, but it is targeted again, just similar to my podcast. It's like I have the listener of the pregnant individual and family, but also birth workers. The book is similar. Thank you for ordering.I appreciate it. Meagan: Yes. And can you also tell everybody where to find you not just in your book, but Instagram, podcast, and all of the social medias?Kristin: So my podcast is Ask the Doulas. You can find us on all the podcast players and you were a guest recently, so very fun. And certainly, we're at Gold Coast Doulas on everything from Pinterest to YouTube to Facebook to Instagram. I don't have separate social sites for my book because I honestly don't have time for that.Meagan: That's okay. Yeah, it's a package. It comes with everything, so you don't need to have another book page. Well, awesome. Well, thank you again so much.Kristin: Thank you. Have a great day.Meagan: You too.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 VBAC Link
Episode 388 Liz's HBAC After an Unexpected Cesarean Following a Late Hypertension Diagnosis

The VBAC Link

Play Episode Listen Later Mar 19, 2025 65:32


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

The VBAC Link
Episode 386 Dr. Stu & Midwife Blyss Answer Your Questions + VBAC Prep & Uterine Rupture (REBROADCAST)

The VBAC Link

Play Episode Listen Later Mar 12, 2025 57:39


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

The VBAC Link
Episode 384 Maria's Birth Center VBA2C + The Power of VBAC Prep + What Happens if You Can't Pee in Labor?

The VBAC Link

Play Episode Listen Later Mar 5, 2025 56:51


While we can't control many parts of birth, there is so much we CAN do to quite literally change the trajectory of our birth outcome. First: Feel safe with where and with whom you will give birth.Second (but just as important!): Prepare yourself mentally, physically, emotionally, and spiritually. During her first VBAC attempt, Maria hired a midwife. Her second birth had so much more advocacy, progress, and positivity, but there were still missing pieces, new traumas to process, and things she wished had gone differently.You will NOT WANT TO MISS hearing all of the things that changed for Maria from her first two births to her third. The proactive work, the passion, the prep, the healing, the research, the manifesting, the surrendering, the trust, and to top it all off, the beautiful, unmedicated VBA2C outcome. Just like Maria, our greatest hope is for all of you to unlock this birthing power that is already within you, no matter the birth outcome. Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello, you guys. It seems like a common theme lately. A lot of people are wanting to submit their VBA2C stories, and I love it. I love it absolutely so much. We know so many of, these listeners in our community are wanting to know, is it possible? Can we VBAC after two Cesareans? I'm sure you've been noticing the theme in January and February, and now here in March, we have another VBAC after two Cesarean stories coming to you today from our friend Maria. Hello, Maria.Maria: Hi.Meagan: Thank you so much for being here and sharing your stories. We were just chatting a little bit before we got started about kind of where her birth took place, and she'll tell you more. But the VBAC was in Texas, right?Maria: It was. Yes, it was in Texas.Meagan: It was in Texas. So Texans. Texans? I don't know. we have Floridians, Utahns. Is it Texans?Maria: Texans. Yeah. Yep. And you know, Texas is a huge state, so this is central Texas in the Austin area. Yeah, because it's such a big state. It is.Meagan: It is very huge. We know people have to sometimes drive really far away to find support. And when it comes to VBAC after multiple Cesareans, we know sometimes that can be really challenging. And when I say sometimes, it's often. It is often challenging to find that support. So I really like to show everybody where you are in a way because we want people who are in Texas or who can get to Texas or who find it manageable, that they know that there is a supportive provider there. We'll learn more about that. But also, just a reminder, guys, if you're looking for a supportive provider, we have a supportive provider list. How many times can I say "supportive provider" in three seconds? A lot, apparently. Go to Instagram and hopefully at this point we'll have it on our website, so check our website too, but we will have that list.If you want to submit your provider, please let us know. Okay. We have a Review of the Week, so I want to get into that. This is by Whitney Goats, and the review title is "Amazing" on Apple Podcasts. It says, "I've been wanting to write a review for a while, but wasn't sure what I could say that would explain how much The VBAC Link meant to me. I had an unplanned Cesarean with my first and for the longest time, I felt broken and defeated. When I heard Julie and Meagan share their VBAC stories on the podcast, I cried. It was the first time that I felt understood and like I was not alone. Listening to their podcast has lifted my spirits, healed my emotional scars from the previous birth, and given me the confidence in myself and my body again. "I am now 28 weeks pregnant and preparing for my VBAC. Instead of being scared for this upcoming birth, I feel excited sometimes. I never thought it would happen. Thank you, Julie and Meagan, for the work that you have done connecting and educating all these amazing moms, and thank you for reminding me that I am a Woman of Strength even when I doubted it myself." Oh, that gave me chills. That gave me chills reading that. Oh my gosh. We love your reviews. That is amazing. And girl, Whitney Goats, I hope that you had the most amazing birth ever, and thank you for being here. Just like Maria and all the storytellers that have become before her, you guys, they're amazing and so are you. These storytellers are here to do that- uplift you, motivate you, educate you, and find the healing within yourself because it can happen, right Maria?Maria: Absolutely. 100%.Meagan: It absolutely can happen. Okay, you guys, as always, if you do not mind and if you are enjoying the podcast, will you leave us a review? You can go to Apple Podcasts. You can go to Google even and leave us a review there. You can go on Spotify or really wherever you listen to your podcasts, leave us a review. If you feel extra special and the platform that you're listening on can leave a comment, leave us a comment. You never know, it may be read on the next podcast. Okay, Maria, I want to turn the time over to you to share these stories.Maria: Thank you so much, Meagan, and I just want to say again how excited I am to be here. I agree 100% with that reviewer. This podcast was so impactful for me, and I hope that it can continue to be that for other women. I was also so excited that you're getting so many VBAC after two stories because I hope that that will continue to normalize that instead of it being this crazy thing that we're doing. Meagan: Yes.Maria: That's so exciting that it's becoming more common.Meagan: I know. It's actually making me smile so big because in the beginning, back in 2018, we had to search, and I mean search. We had to go on forums and type in "VBA2C" and really look for stories and almost had to seek them out. We had to go and ask, "Hey, would you be willing to share your story on the podcast?" And now we're just getting a flood of submissions which is so awesome. I love seeing it, and I would love to hear even more VBAC after three or four or five Cesareans because it is possible. It's not as easy to navigate through, but it is possible. And yes, there are risks. There are risks with anything that we do including a repeat Cesarean, but I want to help normalize this because, I mean, there are so many women just like Maria and myself who have gone on, done the work, got the education, and been able to have a vaginal birth. So. All right, well, we know with every VBAC or VBAC after two Cesareans, there's at least one Cesarean involved, so let's start with that story.Maria: Yeah. Okay. Thank you. So when I got pregnant with my first baby, this was in 2018, it didn't take me very long to find my way to the natural birth world. I watched The Business of Being Born like a lot of women, and I was fully convinced that I wanted to birth vaginally and naturally if possible. So, when my husband and I decided to move to Costa Rica halfway through my pregnancy, the very first thing I did was research the C-section rate versus natural birth rates in the country. I was pretty disappointed, although I wasn't surprised, to find that the rates there are pretty high. I mean, they're about the same as the US but a bit higher in the private hospital setting which is where I was going to give birth.I didn't want to let that deter me, and I was determined to build my team. From when I was still here in the States, I started researching the best OBs and doctors in the area and hospitals. I found two in the city of San Jose which is where we were living, the two most quote unquote natural OBs.Another interesting thing I found out was that midwives are actually not legally permitted to work in Costa Rica independently.Meagan: Really?Maria: Yeah, at least back in 2018. I don't know if things have changed since then, but they are not allowed to work independently. They are allowed to work alongside an OB. So I was like, okay. I went with one of these OBs, and there was one midwife who practiced in the city of San Jose, and they worked together as a team. And so I was like, okay, all right, well, I guess this is it. I have my team, and I thought I was done. I don't think that I fully understood the intensity of birth or the mental and physical stamina that would be required of me because it was my first baby.Meagan: You don't know what you don't know.Maria: You don't know. Exactly. I took a Bradley birth course with my husband, and I just assumed that everything would be fine as long as I had a good team, and I'd be able to escape the dreaded cascade of interventions that I'd heard so much about. I wasn't informed, but I don't know. I was very intellectually informed, but I didn't really know how intense labor is. So intellectually, I knew what I had to do. But anyway, we were living abroad. I went into labor naturally at 40 weeks, and I had a very long labor which began in the middle of the night which was a common theme in all my birth. They always started in the middle of the night which I think is pretty common. And because it was my first baby and I was so excited, I was unable to really stay calm and rest.I got very ramped up way too soon.I burned through a lot of my energy in the first 24 hours of what I now know was very early labor. So by the time it was actually more intense and I made it to the hospital, I was exhausted because I slept so little. We get to the hospital and my labor slowed down, which again, I know is not uncommon, but I think I was also just not feeling very relaxed. I started actually feeling uncomfortable with this midwife /doula as she told me she was. She said, "I'm a midwife/doula." I later learned that is not a thing. It's like, either you're one or the other. I just didn't feel like she was really supporting me as I expected she would. It seemed to me like she wasn't really a doula. I started realizing, okay, this is not what I was expecting. She was more of a quasi-nurse, really, for the OB and just assisting him. She was like his private nurse, basically. She was sitting there in the room either watching me. She'd come in and give me a position, but then just sit back and she was on her phone. At least that's how I was perceiving it. I just started kind of not feeling very safe with her, and I just shut her out. In hindsight, I think I should have asked her to leave. But at the time, I didn't really know that I could do that, and that I could really advocate for myself in that way, so I just kind of shut her out. She probably felt that it just wasn't a good click. So then I began to feel pressure by the team because I'd been there for probably, what is it, maybe 8 hours or so? They started pressuring me to get things going. And so the OB approached me about using what they call natural oxytocin which is what they call Pitocin.Meagan: Pitocin, yeah.Maria: Yeah. But they're like, "No, no, it's natural oxytocin." And I was like, "Okay, I know what that is." I could already see that I was being slowly kind of backed into this corner. I refused it several times, but I finally agreed to it. Of course, my contractions became excruciating, but I just was just determined to not have the epidural so that I could walk, even though I was already plugged into the IV and really not walking as free as I wanted. Eventually, one of the nurses, after a while, came in and she asked me when the last time I peed was. I couldn't remember. That's when I was like, "Oh yeah, it's been a long time." Nobody reminded me. I just didn't think about it. I had been drinking water, so they had me try, and I just couldn't pee. It's like my body just kind of shut down. So they decided to try and insert a catheter to see if it would empty my bladder and help baby descend. So I was laying on the bed. I had five people around me trying to place this catheter in me. I was on Pitocin, so I was having these intense contractions, and they weren't able to insert it. They said it was because of the way my body was. I guess my urethra was towards the back or something, and they just weren't able to do it. That was really disappointing because I was really hoping that that would be the magic thing that would help baby descend. Finally, the OB came in and was like, "Listen, if you want to avoid a C-section, you should just do an epidural so that your body can relax, and maybe that could help us place up the catheter and then, baby will descend." I was like, "Okay, all right. Let's do it." They did it. It felt amazing for a couple of minutes, and then immediately, my baby's heart rate dropped. The OB basically just called in an emergency, and I was whisked off to the operating room for an emergency C-section. I was traumatized because I legitimately thought I was dying. I thought it was a true emergency. I was like, oh my gosh. I can't believe it. I'm gonna die. Of course, I've learned since then that a baby's heart dropping after an epidural is pretty common.Meagan: Pretty common, yeah.Maria: And that it wasn't really a true emergency that merited a C-section right then and there. That's been a really hard thing to process.Meagan: And frustrating, too, because he was like, "If you want to avoid a Cesarean, this is what you have to do," and then you did that, and then it immediately went that way.Maria: Yeah. I honestly thought he was. I think he was probably just prepping me in advance to just have the epidural so we could just go there.Meagan: Yeah, that's hard.Maria: Yeah. After baby was born, the hospital policy required me to go into the post-op room for 30 minutes to recover, and I would then be rejoined with my baby.Meagan: Oh, so your baby wasn't allowed to be with you?Maria: No. Meagan: What?Maria: Yeah. So my first 30 minutes as a mom, I was separated from my baby. He was with my husband. I was taken to this room where I was recovering alongside other people that I didn't know who were also recovering from other types of surgeries.Meagan: Whoa.Maria: Yeah, so I was like on this bed paralyzed still because of the epidural and shivering. It was a really surreal moment because I felt like, oh my gosh. I just had a baby. Wait, why am I here? What is happening? It was really, really traumatizing, and that was just their policy at that hospital. So it was really traumatizing for me. I was eventually joined back with my husband and baby, but needless to say, it really affected me.I did struggle with postpartum depression and anxiety for a long time. I had a very hard time bonding with my baby for that first year. I felt really robbed of that dream birth I had envisioned, and I felt robbed about the golden hour right after when you get to enjoy your baby and celebrate the fact you just had a baby. I felt like I never got that.Meagan: That would be very difficult. There are a lot of people who get their babies taken away, and it is so frustrating. I just wanted to give a little reminder that if you don't have your baby and you want your baby, it's okay to demand your baby and find someone who will do anything in their power to get that baby back to you.Maria: Yeah, so that was my first birth. So the second birth took place about two years later, and we were back in the US due to the pandemic. As soon as I found out I was pregnant, I was actually in Costa Rica when I found out I was pregnant, and then we moved back to the US halfway through my pregnancy. I just knew without a shadow of a doubt that I was going to try for VBAC. I was extremely confident that I could do it because I felt that if I found a truly supportive provider, there just was no reason why it wouldn't go smoothly. I had a lot of unprocessed anger and trauma that I hadn't fully worked through. I was still very angry at my OB, at the midwife, at the hospital, even though I did do therapy actually in Costa Rica, but I don't think I fully worked through this part. Even though none of it was truly 100% their fault, I still felt really let down, and of course, I felt anger at myself even for my perceived failure of my body to birth my baby. My way, at the time, of avoiding a repeat of this was to just completely avoid the hospital setting and go the complete opposite direction. So I opted for full midwifery care and home birth. I just didn't want anything to do with the hospital. It was traumatic. I was like, no hospital. At the time, we were living at my parents' home in their hometown. I basically hired the only midwife that I knew in town. I didn't really interview anyone else. I just went with her. I think in my mind at the time, as long as you were a midwife, she would be 100% better than an OB. Again, I was very angry at OB at the time. But also, I did meet the midwifery team and they seemed experienced and I liked them, so I felt really confident that everything would work out like it was going to work out. There was no plan B. Meagan: Yeah. Maria: In terms of preparing for my birth, I didn't really do much outside of remaining active. I did prenatal workouts. I walked. I was healthy. I thought that was pretty much what you had to do. I just thought again that not being in a hospital would solve all my problems, and that was the only ingredient I was missing for my dream birth, which, of course, I later learned was just part of the equation.So this time, my labor started actually pretty slowly. I had a premature rupture of membranes. It was a very slow trickle. It took over 24 hours of that for my labor to actually start. That was even after some homeopathic pellets. I don't really know what it was, but my midwife gave it to me and some castor oil that I took. I'm a pretty anxious person, so I was getting very anxious about my labor not starting because I had it in my head that I couldn't go too long without my water breaking. In my mind, I was on this timeline. I don't do well under pressure, so right off the bat, I was already in my head about it.Meagan: Yeah.Maria: I was so antsy to get labor going that I just wouldn't let myself rest. I actually went walking in the middle of the night with my husband instead of trying to rest. I was like, I will get this labor to start. I was just not really saving my energy. I was getting revved up again too soon. So again, once labor got going, I was exhausted.This time, I'd opted to give birth at my parents' home which in hindsight was probably not the best idea because I felt their presence in the home. I'd sense their worry and their concern over me, at least in my head. I was mostly in their bedroom, so I started getting claustrophobic in there. I felt like a caged lion at one point. I was like, ah. Now nobody was actually pressuring me, but I felt it. I just felt like my whole family knew I was in labor. Everyone was waiting for me. Again, hindsight is 20-20, right? I was like, man, I could have asked them to just leave for a while, but I just didn't feel like I could.Meagan: Yeah, it's their house. It's their house. It's their space. Yeah, it's weird. But I will just point out that who you have in your space and where you labor can impact your labor for sure because you're in your head.Maria: Yes, 100%. It took me two labors to learn that. Especially if you're a sensitive person and feel energy and if you're anxious, you have to be really aware of is somebody helping you or not? And if they are re not, then you can say you can ask them to leave. I just didn't know that I could do that.Anyway, I powered through it. Even despite that, I think labor was better in my home than it was at the hospital. I definitely felt more comfortable. I was more free. I was trying all these different positions and shower, bathtub, you know, everything. I felt really powerful. It was really positive at first. It was, despite the fact that I was really tired too. But it was a very long labor. Once again, my body shut down and I could not pee even though everybody was trying to remind me to go. I was trying to go, and there just came a point when my body just stopped wanting to go. We got to that point where they were like, "Okay, well let's try and place a catheter." They were not able to do it. I guess I have a very small urethra or something. Something happens in my body during labor. It's hard to get to it. This was a home birth, so they had their equipment on hand. They didn't have all the options that maybe they would have in a hospital of different sizes or something, so they just weren't able to place it. It was very, very disappointing. They also felt that I was getting weak, and I didn't want to eat anymore. They hooked me up to an IV. They gave me oxygen. This started triggering this fear in me that this was heading in a direction that I didn't like. It wasn't feeling like the peaceful home birth I had envisioned. I eventually got to 10 centimeters, and they said I could start pushing even though I didn't really feel much of an urge to push but I was like, okay, I'm 10 centimeters. I guess I'll try pushing. I started pushing for multiple hours, but the baby just wasn't descending. And at one point, the midwife could see the baby's head higher up, and she actually attempted to pull the baby out with her hands.Meagan: Kind of went in like a soft forceps.Maria: Yeah, exactly. It was very painful. Super traumatic. I was like, oh, my gosh. This is not what I envisioned. But she wasn't able to do it. He was just too high up. After that, I just remember seeing her throw up her hands and with her body just kind of say, I give up. There was nothing more that she could do for me. At that moment, with a surprising amount of clarity and conviction, I decided to call it and request to be transferred to the only hospital in my town that accepted VBAC, any other hospital would have had me go straight for a C-section. So this was my last chance because I wasn't done trying to VBAC. I was like, okay, home birth isn't gonna happen, but maybe VBAC will at a hospital. And so, we got to the hospital. When I got to triage, they checked me, and they actually said I was nowhere near complete and that I was 8 centimeters dilated, and that I was very swollen.Meagan: That's what I was gonna just ask. I'm wondering if you got swollen.Maria: I was definitely very swollen, but they also said I wasn't 10 centimeters. I was like, "What? What do you mean?" Because in my mind, I was like, I'm almost there. I'm 10 centimeters. Maybe all I need is an epidural maybe. Maybe I just need that final little push. At that point, I was okay with drugs. I was like, "Give me whatever." I'm so close, right?Meagan: Yeah, yeah.Maria: But no, they were like, "No, you're 8 centimeters." And also, my contractions had really spaced out, so they gave me an epidural. They gave me Pitocin, and they let me rest.Meagan: Did they give you a catheter and empty your bladder?Maria: Yes, they gave me a catheter to empty my bladder, but baby was just not coming down. And also, the epidural did not sit well with my baby again. They didn't whisk me away to a C-section this time, but they were starting to bring up, "Okay, it's been a long time." They also were pretty concerned that my water had broken two days before, and that was a big red flag for them. They started mentioning C-section as the safest route for me. After, I don't know, probably 8 hours there, I just kind of said, "Okay, let's just do a C-section, and we just went with it." This time was less traumatic because it wasn't an emergency. I chose it. I was also never separated from my baby, and that was very huge.Meagan: Yes.Maria: That was huge. Yeah, 100%. Like, I got to carry him immediately after birth. I was able to breastfeed him. I was like, nobody is separating me from this baby right now, and they didn't. So that was very healing, and I was very grateful for that. That was that birth. After the birth, the midwives did come to see me at my house, and when I asked them what happened, they weren't really able to give me an answer. The final consensus was that my hips were likely too narrow. At the time, this diagnosis actually gave me comfort because at that point--Meagan: It validated you.Maria: Yeah, it validated me. I felt like, okay, I tried everything. It felt like an answer. It was a neat and clean end to this journey. There was a lot of mourning still. It was a heavy weight on me, this disappointment of a failed VBAC and something that I would need to process for a long time because I felt really cheated. I really felt like I'd run an entire marathon, and that I could see the finish line only to find myself pulled back to the starting line again and have to run another marathon.I felt like I had gone through two whole births, the super intense home birth and then C-section. So I felt like, oh my gosh. I was wiped out. So, yeah. Those are my two C-sections.Meagan: Yeah. I mean, lots of really forward-moving progress with the second for sure and still work to be done. But also, you had some validation for you at the time. It felt better. Overall, it went better.Maria: Yeah, yeah, yeah. It definitely was better. It was better, but it was, in a way, almost more frustrating though because I got so close. I was like, I'm so close and yet I was pulled back to the exact opposite birth.Meagan: Yeah. I want to talk a little bit about swelling because swelling can happen. You can be 10 centimeters. Swelling can happen. It causes puffiness and causes our cervix to swell which then presents as not 10 centimeters. There are a lot of different factors like a baby that is maybe not putting equal pressure on the cervix during pushing or pushing before our body is really ready for us or going in there and doing that, I call it, soft forceps. This is just me making this up, but my fingers are a lot softer than forceps. So her doing some soft forceps was in effort to help baby come down and move but could have disturbed the cervix a little bit and then sitting in on the way. So I just wanted to point out that is it possible that you could have been 10 centimeters? Yes. Is it possible that swelling could have caused the regression? Yes, there are some hem-- oh my gosh. How do you say it? Hemopathic. Is that how you say it? Hemopathic. They're little tablets.Maria: Homeopathic.Meagan: Homeopathic. Why do I say hemeo all the time? Homeopathics. Just like they had given you those little tablets that can actually help with swelling of the cervix. So if you have a midwife or you want to look into that and have that in your bag at the hospital, if that happens, you might want to check that out. While you're telling your third story, I will see if I can find the exact name because I cannot place it in my mind right now, but I've seen midwives use it, so that's another thing. And then sometimes Benadryl. A lot of the time, I'll see moms be given Benadryl for swelling.Maria: Yeah, I don't think they gave me any of that. I think at the hospital they were just kind of like, "Oh, 48 hours. Okay, let's--".Meagan: Yeah, the typical.Maria: And yeah. I think they knew from the beginning probably that I'd end up in a C-section. I don't know.Meagan: Might have. Yeah. So baby one, baby two. How did things change with baby number three?Maria: Everything changed. So when I found out I was pregnant for the third time, I, was very surprised and excited. But as soon as I actually thought about the birth you, I felt dread. I knew I was out of options mostly because my fate had been sort of sealed with this diagnosis of narrow hips. I was pretty much certain that my only choice was a third C-section. That really filled me with dread because I had a really rough recovery with my second C-section. I was really unhappy with my scar. I just felt really not looking forward to a third C-section. So I was like, okay. It felt very scary. I decided to approach my husband about trying for a VBAC again. I was sort of certain he would be nervous about supporting me about that. I felt like it was gonna be like, "Maria, you've tried twice. Let's just accept it. Let's move on." But surprisingly, he was actually supportive and he told me to just start with doing some research about VBACs after two and to get some opinions. So I did. The first thing I actually did though was I looked into gentle C-sections because I was like, "Okay, I'm going to get my kind of worst-case scenarios out of the way just in case. If I'm going to have a C-section, I want it on my terms." I looked up the best gentle C-section OB in the area. I was like, "Okay, I've got something there." Then I reached out to my midwife for my second birth and asked for her opinion about going for a VBAC again. I reached out to a few birth centers in the area, and my midwife pretty much told me that she did not think I was a good candidate for VBAC again and that I would end up likely in a C-section. Again, because she was like, "You did everything you could. It just didn't work. I just don't think you're a good candidate." And then most of the birth centers in the area declined me because they only did the VBACs after one.Meagan: After one. Yeah.Maria: Only two birth centers in the area accepted VBAC after two. I was like, "Okay, I'm gonna go see one of them and just get a second midwife opinion."Meagan: Yeah.Maria: When I got there, this place inspired a lot of peace and comfort. It was this really cozy little space. It was a little cottage near hospital. The midwife I met with, her name is Galyn. Can we give you the name?Meagan: Yeah, yeah. Uh-huh.Maria: Yeah. So this is called The Family Birth Center. It's just amazing and Galyn is amazing. So she just was very confident. I told her my entire birth story. I was sure to add every single complication and also tell her what my previous midwife had said. I honestly painted a really dire picture for her. I was like, "I have really long labors. I can't pee." You know, blah, blah, blah. I was prepared for her to tell me that I was not a big candidate. Honestly, I almost wanted her to say that so that I could just close that chapter and go get my scheduled gentle C-section and move on because that felt easier and safer. Yet her response was not a no. It was actually a non-hesitant, "Absolutely, you can do this." I was shocked. I mean, she obviously asked for my op-reports and everything, but she said that she didn't see why I wouldn't be able to. She had a ton of experience with VBAC after multiple C-sections. She even said that she had a very special place in her heart for these mamas because, as she called us warrior mamas, who really, really wanted it. She did not believe that I was too narrow because that's actually quite rare. She thought it was likely that the baby was simply badly positioned. So right off the bat, she was like, "Okay, I would start you on some Vitamin C to strengthen your bag," which I didn't even know a thing. She was like, "Pelvic floor therapy right off the bat, and you need a proper doula." I was like, "Yes, yes, yes." I'll do all those things because I realized I had not really had a proper doula in my previous birth. And honestly, every concern or worry that I brought up, she was able to talk through it with me, provide a solution or just remind me that no birth is the same. She couldn't really control or predict the outcome of the birth but there were lots of things that we did have control over.One of the things that I was really worried about was my inability to pee during labor. She was like, "Okay well, we'll place a catheter." I was like, "Yeah, but they tried both times and it didn't happen." And she was like, "Well, I'll get you a really tiny one." I was like, "Okay." So she didn't seem worried about that. I just went with it and went with her confidence. I think I decided then and there that I wanted her because I just felt really heard and I don't know. She provided lots of practical and realistic solutions that we could control. Anyway, this time around, I hired a doula. Shout out to Jenna, my doula. Also an amazing, amazing woman. I went to pelvic floor therapy. I also did therapy again to process my past births. I worked really, really hard on radically accepting whatever this birth came to be. So unlike my first two births where I had a really rigid idea of what it would be, this time I worked really hard to just sort of surrender to whatever it ended up being. I also read several books, including how to Heal From a Bad Birth.Meagan: Yes.Maria: A really good book, and Birthing From Within which I also loved. It was a really impactful book, actually. I started doing some art therapy just to process some of my feelings and just about this pregnancy and birth. I listened to every single episode you guys had on VBAC after two. I took The VBAC Link course. Honestly, I hardly worked out mostly because I had two little boys under four, and I just did not have it in me. But I was still very active with just normal life and taking care of two little kids. I did walk a bunch and did some gentle, prenatal yoga. I also did some exercises recommended by my doula from Spinning Babies. The other thing which was different was that I was really mindful of my body positioning throughout my pregnancy. I was always trying to listen to my body and be mindful of my alignment. When I was watching TV or sitting at my desk, I'd sit on a ball. I'd sit on the floor. I love to go on my hands and knees. That felt really good on my back. So just kind of listening to what my body was asking me to do and just being more aware of my body. My whole motto was, throughout the whole time was, "Get out of my head into my body." Preparation felt really different for me this time. I felt like I was preparing my body from the inside out physically speaking. Like I said, I was going to pelvic floor therapy. I was also making room in my uterus for my baby with these exercises to be in the best position possible but I was also really focused on my mind, my spirit, processing all my fears, my traumas. It felt just so much more holistic. I did HypnoBirthing with an app. I wrote down my own prayer affirmations which actually became a really central anchor during my labor. I felt just really ready this time in a new way. And not just because of my dream team but because I was really just ready to surrender to whatever was to come. And also, what was driving me was this new goal which was this idea of just giving my body a chance to labor was the best thing both for me and my baby regardless of the outcome of the birth. Even if it ended up in a C-section, I was still doing what was best for my body and my baby. That's what I kept repeating to myself. It just gave me a lot of peace because the success of this birth was not tied to what kind of birth it was. You know what I mean?Meagan: Yes, yes.Maria: It removed a lot of that pressure, a lot of that fear, and that was just such a game changer for me. Yeah, that was the preparation. A few weeks before the birth, I'd been starting to get more intense Braxton Hicks, but nothing really consistent. I was really just trying to practice the art of basically ignoring them because my goal for my early labor was to just pretend like they weren't happening. I didn't want to get too excited too fast. I wanted to ignore them for as long as possible especially if they started in the middle of the night which is kind of a theme for me. It ended up being really great practice to do that because on Labor Day, of course, I started getting my first contraction at 2:00AM and I just denied it. I was like, nope, they're Braxton Hicks. I just wasn't allowing myself to get riled up. I managed miraculously to doze off for 20 minutes at a time until they started coming on stronger. Once I realized that this was early labor, I had decided before that I wanted to labor alone for a while. This was actually something that I'd been wanting to do just to have this early early labor be a sacred moment for me and my baby. I wanted to be able to pray, to talk to my baby and to prepare together for the work which we would be doing together, both of us. I went into the living room. I let my husband sleep a bit longer, and it was a really special time for me. I'm so happy that I did that.Meagan: Yeah, I was just going to say that is a very powerful moment. Our babies are so connected and if you can have any time, even if it's just like 20 minutes. "Hey, I'm going to the bathroom." Take 20 minutes in the bathroom and connect with your baby. I just think it's so powerful.Maria: Yeah. Yes. It was amazing because I did feel connected the whole labor in a way that I did not in my previous ones where I was very disconnected to what was happening in my body. I was in my head a lot. So at about 6:00am, my contractions were getting stronger and I was like, okay, it's a reasonable time. I'm going to go ahead and wake my husband up. I also knew that my boys would be waking up soon, so I wanted my husband to focus on them and get them breakfast. And then I explained to my boys that baby was coming soon, that they were going to go stay with their cousins for a night or two. I knew that I wasn't going to be able to fully relax if they were still in the house. It felt really important for me to say goodbye and to make sure that they were going to be happy and in a safe place. As soon as my brother-in-law picked them up, I just really felt my body, okay, let go and things just started picking up. I took a shower. I had breakfast. I knew it would probably be a very long labor, so I wanted to eat. I called my doula. She came over and her presence was just such a game changer because she was just this calm, comforting presence. Not to say my husband was not, but she's just more-- this is her job. She's more objective. She was able to suggest different positions. She knew when to let me be. She pushed me when I had to be pushed and let me be when I had to be left alone. But the best thing she did was she did not let me head to the birth center too soon. I wanted to go and she'd be like, "Okay, let's just wait for 30 more minutes. Can you do 30 more minutes? Yeah, let's try this position. Let's walk a little bit. Let's do this and that." That was so important because I would have gotten there way too soon. She and my husband were in touch with Galyn, the midwife. Everyone was just super chill and relaxed. Everyone ate lunch. I don't think I did, but everyone else did. It was just a nice day. It was a cool rainy day. And then at about 2:00 PM my contractions were about 2-3 minutes apart. They were lasting about a minute, and they were getting intense. I was like, "Okay, I need to go." They were like, "Okay, yeah, let's go." We got to the birth center. I was just wrapped in this fluffy blanket. I just picked it up like I was in this daze. I was listening to my HypnoBirthing app. And Galyn, she was so relaxed about everything. Everyone was just very relaxed. It was during the daytime. She'd come in. She'd leave. I got in the bathtub at point. At one point, she checked my dilation and asked me if I wanted to know. And I said, "Nope, I don't want to know because I don't want to get in my head." She was like, "Even if you're 9 centimeters?" And I was like, "No." Okay. That was so amazing. That was such a push of encouragement. And so that was very helpful. Once again, I ran into the issue of being unable to pee. Of course, not surprisingly. So Galyn asked me want if I wanted a catheter. I said, "Okay, let's try it," but I was super nervous about it.Meagan: Yeah.Maria: But this time it was super easy. It was amazing. It went in right away. She had the right size. I don't know what it was, but--Meagan: Right size, pelvic PT.Maria: Yeah, yeah, yeah. It was easy. I had a ton of pee. After that I was like, oh, my gosh. I surpassed these two huge obstacles of being really well-dilated and also, an empty bladder. Like, I got this. It's amazing. I felt this new surge of energy. After that, I just focused on one contraction at a time. Each one lasted four breaths for me. Each breath coincided with a short prayer that I would say to myself. The hardest breaths were always breath two and three because it was the peak of the contraction. But I knew the pattern in it, and so I knew what to expect. I just remember opening my hands every time and surrendering and just trying to just relax my body and just accept it, and let it wash over me. I was doing a lot of visualization of my body, my pelvis opening, my baby coming down. I was so connected to my body and my baby. I just remember communicating with her and visualizing her coming closer to me. And this, like I said, was something so new for me, this connection. After about two hours of labor, there I was fully dilated. They had me do some focused pushing. Unfortunately, I never really felt that overwhelming urge to push that I'd read so much about and that I had wanted to feel. My pushing was more directed, but it felt a lot less forced than with my second birth. I decided to push on the bed on my hands and knees. My husband and doula were each holding a hand. Galyn was encouraging me. Every time I pushed and she would feel the baby come down, she'd let me know. That was really encouraging to know that it was productive pushing. I was just so focused. After about 40 minutes of pushing, she told me, "Okay, the next push, you're going to feel a burn." Before I knew it, it was the ring of fire I'd heard so much about. Although it was painful, I was just in awe that I was feeling it. I was like, oh my gosh, this means something. I'm so close. It was surreal. I was experiencing it in this weird, out-of-body way. And then the next push, baby was born. I was just in shock. I couldn't believe it. I couldn't fully believe that I did it. They passed her to me immediately. I was still on my hands and knees. I will just never, ever forget the feel of her body and her skin when I held her for the first time. It was the birth of my dreams. I think one of the other things I just loved was just that time afterwards that I never got to experience and that moment of coziness where we were just laying in this queen bed, my husband and I and my baby, and just eating together, holding her immediately, breastfeeding her like it was just a dream. I got to take a bath with some healing herbs. It was amazing. And then, after several hours, we just drove home with our baby.Meagan: Just amazing. That is what birth is about right there. All of those feelings, all of those smells and experiences and bonding moments. I am so happy for you. Let's just say you debunked the myth. Your pelvis was great. Your pelvis and your hips were just fine. It really just took someone educated to know that your baby was in a poor position and that okay, instead of doing this size catheter, let's do a smaller catheter. It's just these little things that made such a big difference. I think it's really important to vet our providers when we are interviewing them. I love that you were like, I gave her all the bad. Like, all of it. I just laid it on her. I wanted her to know everything that I was being told or that was said or that had been done. And then for her to be like, "Okay yeah, I hear those. I see these op-reports, but still don't believe there's anything that makes you not be able to," is just so powerful. So those are the types of providers, and if there really, really, really is a medical reason, they can back it up. "Okay, let's consider something." But I do love that you just came in with all of it, just all of it, and expecting her to be like, "No." And then when she said yes, you're like, "Wait, what?"Maria: What?Meagan: "Wait, what? Can you repeat that?" We really are getting more of that flack and doubt, so it's so great to hear that there's such a supportive provider out there in your area because every area needs it. I would love to see more support coming in because the fact of the matter is, it can happen. It can happen. It is possible, and really, the risk is relatively low, right? It's low, and it's something. And then we do know that to some people, it's not acceptable, and that's okay. But know that the risk is relatively low and that the world paints it to be so much bigger than it is.Maria: Right. Well and also, nobody talks about the risks of repeat sections. Right? Nobody mentions it. I'm like, why is this not being even mentioned at all?Meagan: We talk about it here because it isn't talked about. We have providers say, "Oh, uterine rupture, uterine rupture this and that," but they're not like, "Hey, dense adhesions connecting to your bladder for life, scar tissue gaining for life, back pain that you may discover in your 50s that is related to your Cesarean adhesions and pain." And then, not to mention there are a lot of things like hysterectomy, increased blood loss. You guys, there are things to talk about and complications that can come forth in the future pregnancies as well. We don't talk about those to scare you. We don't talk about uterine rupture here to scare you. We don't talk about uterine rupture or share uterine rupture stories to scare you. We are here to educate you. We want you to know there are pros and cons on both sides. If you find a provider who is all about sharing the risk about VBAC instead of repeat Cesarean, you might not want to be with that provider because there are risks for both sides so if you're getting a one-sided risk, there are some concerns there.Maria: Yeah. Yeah, exactly.Meagan: Well, thank you again so much for sharing your stories. Congratulations. I'm so happy that you found the right provider. You found the dream team. Everyone was on your side and supporting you along the way.Maria: Thank you, Meagan. Again, I think that's only one part of the equation. We as the moms have that other responsibility of really healing ourselves and our past traumas and doing more than just, I guess, working out. A lot of people don't think about the inner work that we have to make for our pelvic floor and even the uterus with making space for your baby in there for optimal positioning. I never heard of these things before you. All of that knowledge was very helpful.Meagan: Yeah, there's a lot of work. Before we started recording you were like, "With my second birth, I just hired a midwife and put it in her hands and was like, hey, I did the work. I hired a midwife," but there's so much more than that. And yeah, finding a supportive provider, getting the education, but there's so much work. We talk about this in our VBAC course-- mental and physical prep. We talk about it early on in the book because it is such a big part of how things can go and if we don't do those things, it can impact us. That doesn't mean you can't get through it and have a VBAC. I don't want to say if you don't go to therapy, you won't get a VBAC or if you don't do these things, but these things will impact you in a positive way more than a negative. I also want to talk about trauma and birth and going through and working through it from the inside out. It's not even birth. It's life. It's affecting us for life. We hold trauma in our body. We hold emotions. We pent them up and yeah, it's just you. We gotta work through them. We can't just shove them in and be like, "Well, that was that. I'll let it go," because it's not going to be let go. It's inside of us.Maria: Yeah.Meagan: Yeah. It'll show up. It will show up. It might be years. It might be months, you never know, but it's important to work through it. Okay, well I will not take any more of your time because I know you've already been with me for a bit, and I just wanna thank you again.Maria: Thank you so much, Meagan. It's been such an honor.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

The VBAC Link
Episode 382 Alice's Safe HBAC After Healing From an Abusive Relationship + Domestic Violence Support

The VBAC Link

Play Episode Listen Later Feb 26, 2025 30:51


In this powerful episode, we hear the story of Alice, who shares her brave journey through two contrasting pregnancies and the impact of intimate partner violence on her mental health. Co-host Sarah joins as one of our VBAC Link certified doulas to discuss the importance of mental health awareness, especially during pregnancy and postpartum. This episode dives into the significance of having a strong support system and the need for open conversations about postpartum mood disorders and trauma-informed care. Alice is a beautiful example of resilience, healing, and the strength that women possess.National Domestic Violence HotlineNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Women of Strength. Hello. How are you doing? I hope you are having an amazing week. We have another story coming your way today, and we actually have a co-host today, my friend Sarah. Hello, Sarah.Sarah: Hi.Meagan: Thank you so much for being here today.Sarah: Yeah, I'm super excited to be here.Meagan: I love having our VBAC Link doulas on the podcast here and there. It's fun to not only share you with the world and let people know who you are and where you are, but really just to hear from you guys and hear your educational pieces and just have you guys in the story and giving your input, and I just love it. So thank you so much for being here.Sarah: Absolutely.Meagan: Guys, today, like I said, we have an HBAC coming your way. But I did want to let you know that today's episode may have mention of partner abuse and suicide. I really, really, really think it is so important to really not mask stories and share the rawness of people's stories because I think the rawness and the real story is what makes us who we are today and really creates the story to be true. I just wanted to give you guys a heads-up. But I'm going to turn the time over to Sarah. She is in replace of our review today doing an educational piece and actually talking about mental health.Sarah: Yeah. Hi. So again, I'm super excited to be here. I'm Sarah Marie Bilder. I'm located in the upstate South Carolina area and I do birth and postpartum doula work. I really just wanted to cover the topic of mental health because in the story that we're gonna hear today, it's pretty relevant and it's one of those things that aren't often talked about. I don't wanna say that that's not talked about because when we say that it kind of, I feel, diminishes the people that are talking about it. It's important to really highlight when we are talking about it. But a lot of the times when we're preparing for pregnancy, we're focused on the physical aspects or maybe mindfulness or something along those lines, but we don't really dig deep into postpartum mood disorders or when there are mood disorders that are still occurring in pregnancy or even that might exist before we're pregnant that will still continue throughout pregnancy. So it's really important to make sure that we're having these conversations and that we're being open and honest with the people around us. Maybe if you aren't in therapy or have somebody sort of set up along those lines, you still have a close friend or a support person that you can be sharing this information with or really opening up about the feelings that you're having because they are very real feelings, and even into postpartum, it goes more than just the baby blues. There are a lot of different things that can be occurring and happening that it's really important to continue to have those support people. So as a doula, this is something that I make sure my clients are aware of and open to, and I try to be as much of a support person as possible, but knowing when professionals need to step in and when situations need to be handled I think is really key. So making sure that you have people to talk to, making sure when you listen to these stories that you are considering different situations and different aspects and that we're talking to our mom friends too. If you're not the one currently going through it, if you're hearing somebody else going through different situations, we're continuing to stay open and stay together and stay supportive.Meagan: Yes, I love that. Thank you so much for that message. I also want to add through to it that after we have our babies, we are given a six-week follow-up. You do not have to wait six weeks to talk to your provider. If you are feeling these feelings, you do not have to wait until then. You one, can get in sooner. But two, there are other resources, and we will make sure to have those resources shared at the end of this episode and in our show notes. So if you or anyone that you know and love are experiencing these things, please know that there is more help. Okay, Alice and Sarah, thank you so much again for being here today. I want to turn the time over to you, Ms. Alice.Alice: Hello. Thank you so much for having me. I'm very excited to be here and share my story.Meagan: Me too.Alice: So I have had two pregnancies, two births, and they were both very, very different. My first pregnancy, when I think about when I found out I was pregnant with my first, it was the lowest point of my life. I was nine months into being married to my abuser and had really lost my entire sense of self. I was at this point where I just didn't understand how I had gotten there. I didn't understand how I had married him. I found myself hospitalized from a suicide attempt. I also had no social support. I had no family in the area. I had no job. My husband was an attorney, and I relied on his friends and his family for emotional support. I was hospitalized and felt very lost. About a week into my hospitalization, the staff, who were constantly running tests and blood draws, pulled me out of a group where I was learning how to deeply breathe, and to my shock, told me I was pregnant. I had no idea. It was just a very out-of-body experience being hospitalized for mental illness. Some people can find it really helpful in healing, and it can also be a trauma in itself, and it was that for me. So to be in this setting where I had no freedom, and then these people were telling me what was inside of my body. It was-- I couldn't process it. I was very disconnected to my pregnancy at first. The next five days of being hospitalized, I was presented with a lot of information about pregnancy and intimate partner violence. It's information that I think is really important for providers to know, but it was presented to me as a new pregnant person in an abusive relationship in a way that felt really coercive and fear-mongering. They told me that the leading cause of death in the United States for pregnant women was intimate partner homicide. Meagan: Okay. Alice: Yeah. I remember one provider telling me, "Your options are to terminate the pregnancy or to leave him now. It's our professional opinion that if you stay in this relationship while pregnant, it's very likely that he will kill you before you give birth." Meagan: Gosh. Alice: I remember feeling so shocked and afraid. I knew I wanted to be a mom. I think the decision to continue a pregnancy or not when you're faced with, it's always a difficult decision. It was for me because I was afraid, and I knew I wanted to be a mom. I also knew that I couldn't leave yet. The leaving is really complicated, and it's not a direct line to safety. I remember feeling when they were talking to me about leaving, like, "Well, you could go here or you could call this person," thinking like, don't you think I've already thought of this? Don't you think I've thought of every way to keep myself safe? Now I was pregnant, and I wanted the assumption that I was making decisions that were best for me and my baby. My pregnancy was difficult. I had hyperemesis and I had this pregnancy rash that was really itchy my whole pregnancy. They kept testing my bile levels, and they were all normal and never knew what was going on. I have scars on my body from scratching. I'm pretty sure now that it was just stress and breaking out in hives throughout my pregnancy. I had broken ribs in my third trimester. When I think about that pregnancy, I remember it being a time of suffering and fear. I feel sad for myself when I think of myself during that time experiencing pregnancy like that. At the same time, I had an incredible midwifery team based out of a hospital. I can't say enough about how supportive and trauma-informed they were. They never pressured me to leave. They asked questions like, "What can we do to help? How can we make you safer?" They trusted that I was doing everything I could and that I knew how to keep myself safe and how to keep my baby safe. I was living with my in-laws when I went into labor with my first. I had moved in and out of our home depending on how safe it was. I didn't have anywhere to go other than his parents'. I was living with them and my waters had been leaking for a few days and I knew. I was like, I know I'm not peeing this much all the time. I knew that my waters were leaking, but I didn't want to go to the hospital yet because I hadn't started contracting, and I knew they would induce. I started having contractions at midnight. I went in about 24 hours later. It was really slow. I tried everything I could to get things moving, but it just wouldn't speed up. I ended up being induced. I don't necessarily regret the decision to be induced. It did lead to a C-section, but when I went into the hospital, I didn't know what home I would go to. I wanted to be there. I remember thinking, I want to stay here. If that means I have to get induced, that means I get induced. But I felt much safer being in a hospital at that point. They started the induction process. I had a doula come, and I also had my therapist come. She was with me through my entire labor at the hospital and birth for-- she was there maybe 45 hours. We had made a contract and it's pretty innovative to have my therapist there as a support person at my birth. I think it's an induction story that we all know my body wasn't ready. I was on Pitocin for a very long time. Baby's heart rate started decelerating, not tolerating labor, and made the decision to have a Cesarean. It wasn't the birth that I wanted, but it was the safety that I wanted. I had support there. They made sure to tell me specific things that were in my birth plan that were triggers for me. When I was laid on the table for the C-section, someone got very close to my ear and said, "No one's tying you down. I know your arms are out. It might feel like that, but know you are not restrained." At one point, the anesthesiologist started petting my head because he was sitting by my head. The obstetrician who was just there to do my C-section, wasn't there for very long. She had read my birth plan and said to the male anesthesiologist, "She doesn't like her head to be touched." He stopped. I felt very seen. I did skin-to-skin in the delivery room. My therapist was in the operating room with me. It wasn't a terrible Cesarean experience. So postpartum was pretty hard. When I left the hospital, I was living alone with my baby. My in-laws agreed to encourage my husband to live with them so that we could be safe from him during the postpartum time. But living alone after a C-section with no family or friends and no doula was very, very difficult. My husband had substance-use disorder, and he took my pain medication when I got home. I just remember being in a lot of pain. I also was in this haze of falling in love with my baby. It still shocks me that I did not experience postpartum depression with my first. I was depressed through my pregnancy, and I also think I was in such a survival mode during the first year of my first baby's life that I didn't have any space to process or space to grieve. I was surviving. One year after giving birth to my first, I did file for divorce to get a restraining order and safely flee with my child, but it was a very long, difficult road.Meagan: If you are someone who is experiencing domestic violence during pregnancy, postpartum or just in general, there is help. You can reach out to the National Domestic Violence Hotline at 800-799-7233.Alice: So that was my first birth experience. Fast forward to four years later, I've memorialized the day that I found out that I was pregnant with my first because it was such the lowest point of my life. I think of it as this time where I was ready for my life to end. I'm gonna cry, but instead my life doubled and it led to this beautiful little human who I get to be a mom to and really changed the trajectory of my entire life, so I call it my life day. Four years later, on my life day, I was in a loving relationship with the most gentle man. I still am in that relationship. I felt like things were a little wonky with my body. I woke up and took a pregnancy test and saw on the exact same day that the hospital told me that I was pregnant, four years later, I had a positive pregnancy test. I was in a home that I owned, a home that was safe and filled with love and a relationship that was safe and loving. It was just so different. I went and I laid in bed with my then 3-year-old and said, "We're gonna be just fine." And I knew that we were going to be. My second pregnancy was also different. It was very healing. I experienced a lot of sadness again because I think I had space to grieve the first time. It also happened because I got pregnant right around the same time. It was like this weird re-do of my first one now with a loving partner and safety and getting to be pregnant. I think about what I wanted for my body and how to stay healthy. I didn't take a single vitamin during my first pregnancy. I was just focused on, how do I stay safe today? I can't even count all the supplements I was on this time. I knew pretty soon that I wanted a home birth. I feel like I was pretty educated on VBAC. I had been listening to The VBAC Link since I was pregnant with my first. I don't know why because I hadn't had a C-section yet, but I had loved the podcast and I knew the rates of repeat Cesareans. I also work in labor and delivery units and I know that they're very risk-averse. I felt like it was the safest option to birth at home. I also felt the weight of how precious it was to have a safe home that I could birth in. It was very meaningful for me to give birth in a space that was mine and was safe. My partner, who knew nothing about home birth, I broached the subject with him early in pregnancy was like, "I want to let you know. I don't know what you think about this, but I want to have a home birth." And he was just like, "Great." I was pretty surprised that he was so on board, but he trusted me, and he trusted me the whole way through. I did not have hyperemesis the second time. I didn't have the rash problem. I didn't have the broken ribs. I did have a lot of pain from pubic symphysis. Yeah, the second half of my pregnancy was like very difficult to even walk. I broke my pelvis in my teenage years and was a little unsure of how that healed. I broke it in two places. I have had this fear of, what if there's a bunch of scar tissue around a bone and baby's head couldn't get through? So I had that fear as well going into my home birth. My midwife was very skilled and very kind. It was a different experience of prenatal care. I also really loved my hospital prenatal care. I think given that I was in a high-risk situation, I loved my hospital prenatal care. It was exactly what I needed. And in my second birth, my home birth midwife was exactly what I needed. In my second birth, I went over my due date by 11 days which was such a mind game. I was so over it. I was just this crazy person who was doing everything that I could to get this baby out of me, but also was like, "No, I wanna be holistic. I don't to be induced. I'm not gonna--," so there were two parts of myself that were battling each other. But I, finally went into labor. My mother was here as well. My family lives far away, but my mother came to support me this time. It was just my mom and my partner and my three-year-old. I labored at home. I had my music. It was just a lovely experience of laboring and of joining in this experience that so many women have had of pain and beauty and endurance and strength. I felt so connected to the world and to women and to my mom. My midwife came. I started laboring at 7:00 PM. At 2:00 PM the next day, my midwife came. I labored in the tub. I had a blow-up birthing pool. I felt like labor was pretty straightforward until the last five hours that I was fully dilated, but he just wasn't descending. The midwife checked me and said that his head was stuck on my pubic bone. He was stuck there for five hours. It was a lot of pushing, but I wasn't really pushing the right way.It felt like contractions that just weren't producing anything. It wasn't opening anything. It wasn't moving him down. It was just nothing. I started to get really discouraged. We joke a lot about how belligerent I was towards the end. Right before I gave birth, I got very bossy and I decided it wasn't go going to happen. Like, "He's not going to descend. I'm over this. Call 911. Tell them to bring drugs. I need them here now." My midwife was like, "That's not how it works." I was like "No, call the police. Tell them to bring narcotics. I need to stop feeling this." I was being ridiculous. My midwife was encouraging me saying, "He is coming down. I know you're not feeling it, but I feel his head and it's right there. I think you're gonna have a car baby if we get in the car. and I don't want that to happen." I'm not a rude person, but I guess in labor, I am. But I stuck my finger in my vagina, and I was like, "Well, I don't feel him." They were loading up to go to the hospital because I was so insistent that this was not happening. I was standing in the living room and I said, "Wait." My partner was like, "She said wait." I could feel him coming down. It was the first time I really felt his head coming through my birth canal. It was such a different feeling. In 30 minutes, I pushed him out standing in our living room. It was just beautiful and lovely, and he was on my chest. My 3-year-old was there. Baby was on my chest. I was lying on my partner's chest. Nothing else mattered in that moment. Yeah. It was a lovely, beautiful, healing experience to come full-circle. I also gave birth on the four-year anniversary of filing for divorce and getting a restraining order from my abuser. It's like all of these things lined up just to give me this healing experience of new life.Meagan: Yeah. Seriously, these milestones that you're able to overcome from the past and replace with joy and beauty and excitement and healing. Oh, I have chills through the whole episode. How about you, Sarah?Sarah: Yeah. There's just so many parts of your story that are so unique and so fitting. There's so much strength in it, and there's so much emotion in listening and feeling all of the things that obviously you were going through. And some were external, but a lot were very internal. Thank you for sharing your story. The ability to be able to share your story takes so much strength in itself. Yeah.Meagan: We could see that and could see it in your eyes. You had my eyes welling up a few times. I was just feeling all the emotion as you were sharing and all the heartache in the beginning that you were sharing. And I loved how you were like, "I was in this. I was going through this really terrible, scary experience," but you were able to stay in this haze of bonding and you two together, you two thriving and surviving in this really unfortunate circumstance, but I am so glad that you were able to have that and grow and then now have this safe, loving home, and two cute babes.Alice: Yeah, they are cute.Sarah: Yeah. Yeah. And although your story's so unique, it's also in very many of our VBAC stories. We have that traumatic experience and then it leads to that very healing experience. I think it's just one of those things. You had mentioned having that space to process and getting out of that survival mode too. I think that's really amazing to honor that and mention that because sometimes we are just in that survival mode, and we don't allow ourself or we don't have the ability to give ourselves that time to really process what is occurring and what is happening. And a lot of the time we just need to do that, and we need to allow ourselves the time to do some fear-clearing and release a lot of that anxiety and other fears that are happening and going on.Meagan: Also on the end of the story, when you were talking about five hours where baby was just kind of hanging out there and you were stuck there pushing, but not really pushing, but in this weird, funky spot in labor, we have seen this where people are pushing and they're like, "Your baby's not descending." We are actually given a diagnosis of failure to descend as a reason for Cesarean, but then simply standing up and moving-- and I'm sure you were moving and grooving along the way, but it just sometimes is one specific motion. It might have been the quickness of you standing up like, "Okay, I'm going. We're going to do this," that did it. We don't know.I love seeing too that you were saying, "I had a broken pelvis in the past. I don't really know how that healed." In a lot of ways, a lot of providers would be like, "You had a broken pelvis. You don't have a proven pelvis. I don't know. I don't think I'm comfortable with this." But then here you did it, right? But that movement and I don't know, I just feel like there's so much power within our bodies that it's just incredible, and I love seeing that. And then your partner was like, "Wait, hold on. Don't go anywhere. I think we're staying." I love that that is exactly how it unfolded and that your other baby was able to be there with you, and just so many amazing things about your story. Thank you so much for being vulnerable and just being here with us.Alice: Thank you. Thank you for having me.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

The VBAC Link
Episode 380 Kelsey's VBA2C with Polyhydramnios & Big Baby + Staying Strong With Unsupportive Providers

The VBAC Link

Play Episode Listen Later Feb 19, 2025 53:10


If you are looking for VBAC inspiration, Kelsey's episode is a MUST-LISTEN.Kelsey is a VBA2C mom and speech-language pathologist living in Erie, Pennsylvania. You will feel literal full-body chills as she tells her birth stories on the podcast today. As a first-time mom, Kelsey chose a Cesarean over physiological birth thinking it was the safer, easier route. But after experiencing the reality of two C-sections, she went from fearing vaginal birth to trusting in the labor process even more than her providers did. With her VBA2C, Kelsey got just about every type of pushback in the books. She was coerced, persuaded, questioned, and fear-mongered by multiple providers. Yet Kelsey was able to ground herself by listening to VBAC stories on The VBAC Link Podcast, seeking refuge in her doula and Webster-certified chiropractor, and connecting with other VBAC moms. Kelsey knew her body could do it. She just wanted a chance. Going up against a hospital practice that was saturated with skepticism, Kelsey's labor was beautifully textbook. Her labor progressed quickly, and her biggest baby yet came out in two pushes– “like butter” as described by her doula!VBAC-Certified Doula, Tara Van Dyke's WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. We have another amazing story for you today. And actually, it's stories. We have a VBA2C mama coming your way. And as you know, this is a hot topic because lots of people want to know if vaginal birth after two Cesareans is possible. So Kelsey will be sharing her stories with us today. But guess what, you guys, I have a co-host today and it's Tara. Hello, Tara Van Dyke.Tara: Hello. Hello.Meagan: She is one of our VBAC link doulas. As you probably heard back in 2024, we are going to randomly be having co-hosts from our VBAC Link doulas. I think it's so awesome to have them on. I love hearing the topics and things that they want to suggest to talk to you guys about because again, just like we talked about years ago, we just in Salt Lake City, Utah, can't share enough. And so we want other doulas from all over the world to share as well. So Tara, tell us more about where you're from and then your topic on partners and being prepared.Tara: Yes. So thank you for having me here with you. This is so fun to hear a story live. I'm a doula working in the Chicagoland suburbs. I've been doing that for 20 years and now moving to more of childbirth education as well as like a lower caseload of doula work partly because I just welcomed my first grandchild this week, so I want to be available in a different way in my life. Meagan: Congrats. Very valid. Tara: So I do a lot of childbirth education. But along the way, what's always been really important to me and I feel really passionate about is the partner connection with the person giving birth and their preparation. The research supports it too, that a prepared partner makes a really big difference in outcomes too. I know we talk a lot about doulas and increasing the positive outcomes of birth, and that's been shown over and over in studies, but the actual dream team is a doula and a prepared partner.Meagan: Yeah. I love that.Kelsey: I tell the dads who come to my classes that the doula is important, but we are replaceable in this situation. The partner is so important because of that connection because they bring the oxytocin. They bring the safety. They have that history with you already. And what even bumps that up to being really helpful in the birth room is their preparation and their understanding of what to expect and being completely on board. So theres lots of ways for partners to get prepared, but they get left out a lot. So I feel really strongly that partners are so much better in the birth room when they're not feeling anxious about what's going on, when they know what to expect and they have a few good tools in their pocket for how to help.Meagan: Oh yes, I could not agree more. I always talk about, I make things up, and I call it the doula sandwich. So it's just what I call it in my practice of my doula work. One bun has all the oxytocin and all the knowledge of who you are, and then the other side is the doula who has the education in birth work and the ideas of how to help navigate through the birth space, but also can then support the partner in doing that and educating the partner. So then, we've got two really great sides and then we sandwich the doula. We have great buns. We have really great buns. And we sandwich that mom together and with love and support and education and oxytocin. Like you said, it really creates that dream team. I love that so much. My husband didn't educate himself. He was just, "Okay fine, if you want a VBAC, go do it. You do the research." I did HypnoBirthing with my cousin who luckily was pregnant around the same time, but we did that together, and he just really didn't know. When I told him, "Hey, I want to VBAC after two caesareans out of the hospital," he was like, "Yo, what?" because he was uneducated. I truly feel that it is so powerful. That's why I encourage partners to take the VBAC course with, the mom or an education course in childbirth. Really understand what the mom is going through, but also know how you can help because I do feel like a lot of those dads kind of get shoved aside. They want to help, but they don't know how to help, and they don't really know what's going on. Is that noise good or is that noise bad?Tara: Yes. Yeah. And they're going through the birth, too. This is the birth of their child. So they can also feel, as far as traumatized, hopefully not trauma, but they can feel a lot more dissatisfied or upset by a birth if they didn't know that what was happening was normal. So it's good for them, too, to learn how to take care of themselves as well as their partner.Meagan: Love it so, so much. Everybody, get your partners educated. It is so, so important. Thank you so much for that tip. Meagan: Okay, Ms. Kelsey, it is your turn, my love.Kelsey: Okay, so as you know, I had a VBAC after two C sections which I didn't even know was a thing. You played such a huge part in giving me education and the motivation to pursue this. My story starts in October 2018. My husband and I found out we were pregnant with our first. It was really special because it was actually our two-year wedding anniversary. It was that morning that we found out and we had a special trip plans to Niagara Falls, just up in Canada. It's a special place for us. It was where he proposed to me. It was just a really special time. It was also kind of crazy because up until that point, up until just prior to that, we had been together eight years, and we didn't think we were interested in having kids. I'm so grateful that our mindset had shifted, but it was just kind of a lot at once. We had agreed that we did want to start a family, but it happened really quickly, and it was just a lot to process. I didn't educate myself at all about birth. My husband and I took a class in the hospital, but it was pretty much just how do you take care of a baby. It wasn't how to bring a baby into the world.Meagan: Yeah, yeah. Sometimes those can be a little more what to expect after than really what to expect during.Kelsey: Exactly. And, I don't know what it was. I don't know if I just couldn't really picture myself giving birth just because we had just kind of come into this or if I just was not believing in my body, but I just felt the opposite of a lot of people on this podcast. They say, "I never thought I would have a C section. I never expected that for myself." For me, I just went into it thinking I'm intimidated by all of this. A C-section sounds easier and I cringe saying that now. But, I just thought not having to go through labor and not having to push a baby out, I just always had that in my head. That comes into play with how my first ended up. I was told throughout my pregnancy that my baby was big and specifically it was driven home, "The head is big. The shoulders are big." They were telling me about shoulder dystocia, and I didn't know anything. So I'm thinking, oh my gosh, not only am I already intimidated by the idea of birth. I know nothing about birth, but now you're telling me I have this big baby. My OB was really telling me maybe a C-section should be considered. And then she threw it out there. "Well, we could induce 39 weeks and see how things go." And again, I was just trusting her. She had been my gynecologist since I was a teenager. To me, I thought, okay, that makes sense. Baby's big. And again, I hadn't done any research on my own. So we did what I referred to as a half-hearted induction. I feel like it was just done to humor everyone. Like, "Oh, we tried." But I went in the night before at 39 weeks on the dot. Nothing was going on with my cervix. Surprise, surprise at 39 weeks. They did Cervadil and I just lay in the bed. My husband and I watched the fireworks out the window. It was the fourth of July. We were just completely not prepared for anything. Just going along with this and thinking, oh, we'll just have a C-section tomorrow if this doesn't happen. They came in the morning and nothing had happened. So they were like, "Oh, well, we could start Pitocin. We could do this." I just wasn't interested in any of that. I wasn't motivated to have a vaginal birth. I guess that's okay. That's just where my head was at the time. I've accepted that's just where I was at. So we had the C-section. It was a surgery. Just being there and as baby comes out, just hearing everybody in the OR talk about, "Oh, look at her cheeks and look at the hair." It was minutes before I'm ever able to get a quick flash of her around the curtain before they swoop her off. It was just a weird experience, but it was all I knew. I was grateful that it went okay, but it just makes recovery so hard, so painful. When I think back to it, just think about just crying while my husband's trying to do my abdominal binder, not being able to get in and out of bed, struggling to breastfeed, even getting in a position of breastfeed with that searing surgical pain. We struggled, and I ended up exclusively pumping. So it was tough as a first-time mom just dealing with all of that. But again, I didn't know any different. I think that was a blessing that I didn't know what I was potentially missing. For my second birth, we knew he wanted more than one child. You just never know how things are going to happen. We just weren't trying to not get pregnant, and it happened right away. The babies were 16 months apart, so when I showed up to my appointment, my OB, the same one who had said, "You have this big baby, and you should have a C-section or induce at 39 weeks." Oh, the ARRIVE study was hot off the press at that point too. So he was excited to show me the ARRIVE study back.Meagan: Oh, yeah, but you're not even a first-time. I mean, you were a first-time vaginal mom. So the ARRIVE trial, you know. You've been with us. Hashtag eyeball.Tara: Yeah, yeah, it changes. It's changed everything.Meagan: It really has. And I don't know if it really has changed for the better in my opinion.Kelsey: So sorry, that was for my first birth. I forgot to mention.Meagan: Oh, oh, oh, sorry. Yes, that would make sense. Yes.Kelsey: So with the second, it was the same OB, and she's like, "Okay, since your births are so close together, you'll just be a repeat C-section. You can make appointments with me, and I'll do your surgery. Easy peasy." I'm thinking, oh, okay. That makes sense because she's talking about uterine rupture, and they're so close together and I didn't research on my own. Is there another option? How risky really is this compared to a repeat C-section? I just trusted her so much. I had been with her for so long. I figured she must have my best interests at heart.Meagan: Yeah.Kelsey: I didn't even think to myself, my own mother had a VBAC with a 13-month age gap. I was a C-section, and my brother was a VBAC at 13 months 30 years ago. Meagan: Uh-huh.Kelsey: You only know what you know at the time. And so even though I didn't look into it in the ways that I should have, I did know that I wanted the experience to be a little different. So I found out about gentle C-section which I think is a funny term. Meagan: I was happy to see that you could request a clear drape, and you could request not to be tied down to the table. We did implement a few of those things. I had the clear drape. It was nice to see her coming out just for a quick flash before they swooped her away. It was nice not to be completely-- I had one arm free which is funny these things that we consider luxuries when you're having a C-section. So it was a little bit better in that way, but there were things that were also worse. They couldn't get the needle in, and they had a resident doing things. I was having trouble. I was starting to pass out during. They were having to adjust. It was stressful in its own way. I had some things that were a little better. But also, it's just's a C-section. Also, during, my OB made a comment as she has me completely open, all seven layers of me. She said, "Yeah, who was it the did your last C-section?",I told her and she made no comment. I said, "Why are you asking me this as you're inside my uterus?" She said, "There's just more scar tissue than I would have expected." She said, "Hey, you can have another baby if you want, but just wait more time in between. Just not so close together." So that was something that got in my head too. Anyway, we thought there was no way we would ever have a third. It was really hard having two under two recovering from another C-section. It was November 2020, so it was the first COVID winter. It was cold. It was dark. Everything was closed down. Everybody was in masks. It was so depressing. It's like, postpartum isn't hard enough. As if two under two isn't hard enough, then adding COVID.Meagan: Yeah, adding zero support and zero resources. Yeah.Kelsey: Nowhere to get out and do anything. It was a bummer. So anyway, it was a lot, and we thought, no way are we ever going to have three. It was just a hard season. So I donated everything. I put all my carriers and all my stuff out on the porch and said, "Come get it," to the local moms group. I just couldn't see myself having a third. Well, then the years pass, and things get easier. You come into an easier season. All of a sudden, we're not dealing with diapers and bottles. It's like, we could leave the house. Things are opening back up. My husband and I had talked about a third and toyed around with the thought of it, but it's just hard to pull the trigger once you've come into this easy season. The thought of hitting the reset button is intimidating. But all it really took was watching him take down my youngest's crib with her. And it was like, okay, this is something that we want to do. It was a funny conversation that night. I said, "If we were to get pregnant this cycle, we would have a June baby, and that would be really nice." So that's what happened. I was playing it with my third. That's when I realized. I mean, I had thought about it, obviously, but I realized, oh, my gosh, I have to have another C-section, a third C-section. Talk about being years away from it and thinking about how you're all healed. It's been a few years, and to think about them cutting open again and just knowing what that entails, I was just in a whole different headspace. I was thinking, how is there a way that I can avoid this?Before my first appointments, I did a quick Google search, "vaginal birth after two C-sections" just to see if this was something anybody had done or was doing or was even possible. I was so excited to see that people were doing this. It looked like it was actually potentially a good possibility. So I was thinking, I've got to be the right candidate. I didn't even need those first C-sections. I knew this now, reflecting back. Yeah, I had my first screening where they do your intake, and they were asking a bunch of questions. And I had said at the RN, I said, "Would I be able to maybe have a vaginal delivery after two C sections?" And she was like, "Oh, they consider it after one, but once you've had two, you're a C-section for life."Meagan: Oh, jeez.Kelsey: Something about her saying that and the way that she said it, I went from being a little bit curious and oh, this might be good, to no, this is something I'm going to pursue. It just didn't feel right. She didn't know my history. She didn't know why I have my C-sections. So to tell me, "Oh, no. You need to have a third major surgery for sure. No option." Tara: It was this moment when it brings a fight out in you. Like, I am gonna do this now.Kelsey: I'll never forget how I felt at that moment. So I started to have my appointments with the OBs, and I would bring it up. Everything was perfect. It was going really smoothly. So the appointments would be like two minutes, and then at the end they'd say, "Do you have any questions or concerns?" And I'd say, "Yeah, I wanted to see what my options are for delivery." They were like, "Well, we decided as a practice to support VBAC after one C-section, but we actually have a policy against VBAC after two C sections."Meagan: How did I know that was coming? The policy, I swear, every time it's like, "We decided as a practice or as a practice, we--". It's always like, they created this stupid policy that actually is against evidence based care. But okay.Kelsey: I'm thinking to myself, so then what do you do? Anyway, I was just mind blown by that. I went to a couple of more appointments there. You'd go every month and they'd say, "Any questions?" I'd say, "Yes. I'm just really not feeling good about the idea of a third C-section." I said, "The risks of a third Cesarean intimidate me much more than doing a trial of labor." I've never given my body a chance. It's not like I've been through this before and things went wrong. I've never been given a fair chance. They were very nice, but they just look at me and smile and nod and say, "Well, it's gonna be okay. It's gonna be okay," and not even entertain the idea for a second. So I'm thinking to myself, okay. I've gotta figure something out. So at that point, when I had talked to a couple of providers, and they were all very consistent about, "Nope. Nope, not even going to entertain it," I knew something had to change. I'm reaching out. I'm searching in the local moms group about C-sections. Has anybody had a VBAC after two? It was crickets. Nobody was responding. I was looking back years trying to find anybody who had done this, in the area. Wat I was finding is, "No, it's not going to happen in Erie. You need to go to Pittsburgh or try a home birth." And I'm just really not comfortable with the home birth even though I know that's a perfect option for plenty of people.Meagan: It didn't feel right for you.Kelsey: Yeah. It just wasn't what I was feeling like I wanted to do. So I reached out, and I had not known anything about doulas until your podcast. I hardly even knew what they did before listening. I just searched "doulas in Erie." I called the first one I saw. I left a message that was probably pretty unhinged just like, "Help! What do I do? Is this something I can do?" She called back, and it was the first time that I had any validation at all. Up until then, it was just people telling me no, people telling me policies and not safe. It was the first time that I was heard. I was heard. She said, "There's really no reason why you can't have a chance. We'll figure this out." I kept doing my research. I dug really deep, and I found a few people who had referred to providers being supportive. I was reaching out. I was sending people DMs saying, "Hey, sorry to be huge creep, but can you tell me more about your experience?: I found out that at the other practice there were providers who would consider this. So it wasn't looking super promising, but it was better than where I was at. So I kind of took a chance. I switched practices at 28 weeks. Prior to that, I had an amazing appointment at 24 weeks. I had one last appointment at that office with the policy. He was amazing. If you could have just copied and pasted him, he was just like a midwife. I mean, he was very upset about the policy. He said, "How do you even enforce that?" He said, "What are we going to do? What are we going to do, strap you down and take you to the OR?" I wish that he had a podcast episode because he took so much time. He explained to me  the history of C-sections and how, in his words, the pendulum has swung so far from only doing C-sections when they were needed to they're safe now. Let's do them whenever we can. He talked about the whole policy thing and how they met as a group. He said, "Some of these younger JOBs have only been practicing now that C-sections are so common. They haven't seen the success." He said, "You have just as much of a chance of success as a 20-year-old walking off of the elevator because our C-section rate is so high. You have just as much of a chance." He laughed at the fact that macrosomia was in my chart, which I forgot to mention with my first. She was 9 pounds, 1 ounce. She was big.Meagan: Okay. I wanted to ask you though because they had said, "Oh, big baby, 16 months apart." I wanted to ask, but 9 pounds, 1 ounce is actually not macrosomia. It's a bigger baby, but it's not a huge baby.Kelsey: Exactly. It's not 12 pounds, which also, people have done. But anyway, he put so much wind into my sails, and he fully supported me switching. He said, "Honestly, I think this is great. I think this is the best option for you. You need to go for it." He said, "But if you were to stay here, you would face nothing but doubt and bullying and scary." He said, "If you were my wife, I would tell you to switch over to this other practice." So that's what I did. I also forgot to mention in my anatomy scan, the sonographer is going about doing it and she said, "Were your other babies big?" I'm like, no, we're not gonna start this. It was already with the big baby comments. So they had me do a growth scan to switch practices. It was refreshing to be in a place where they entertained the idea. They said that they decided as a practice to follow what ACOG says, but it was also very clear the difference between support versus tolerance. So although I was grateful that they were entertaining the idea, I still had, "Oh, 90th percentile. Oh, you've never labored before. You don't have a proven pelvis."Meagan: Proven pelvis. Tara: Yeah, proven pelvis.Meagan: There's a lot of eye rolls in this.Kelsey: Thank goodness, again, if it weren't for this podcast, all of those little comments would have swayed me. I would have said, "What am I doing? Listen to all these things they're saying. This isn't right for me." Once you know, it's just so hard to listen to the VBAC calculator. "Oh, let's just type your stuff in and see." I think it gave me, like 50% chance. Like, I don't know. So anyway, I'll get back on track. My low point was at 32 weeks. It was with my provider who was convincing me that a C-section or induction was right, and then telling me, "Oh, you'll just be a repeat. We'll schedule it." I was dreading my appointment with her. I knew that I needed to meet with her because she could possibly be the provider who was on call. I wanted to tell her what my plan was, and assess her thoughts. I thought that I was invincible because now I knew all of these things, and I wasn't going to let anybody bring me down. That appointment was pretty terrible. She came in hot. She said, "You're 32 weeks. Baby is 5 pounds, 4 ounces, and he's off the charts." She actually referred to him as massive. She said, "He's massive. He's huge." She said, "Put him in a room with 100 babies, and he is enormous."Meagan: Enormous. Tara: She's comparing him to other babies already. Meagan: And he's not even born. Tara: Can I just add a little tidbit here because there's so much talk in your story about the fear of big babies, and the research has shown that what leads to more problems or interventions in a birth with a big baby is not the actual size of the baby, but the provider's fear of the big baby. They're already getting themselves stirred up, and nothing has even happened. Kelsey: I was really discouraged by that because I had come across those facts too. And looking at the research and looking at what are the real risks of a big baby, that's actually just the providers. Yeah, se was just disgusted with my plan. She said, "Are you sure?" I said, "Yeah." I really stood my ground. I was so proud of how I stuck to my guns. She pulled out all the stops. She just kind of sighed and she said, "Okay." And then she pulled it out of me as I was  trying to justify. I said, "We're not sure how much we want to grow our family." I said, "If I have three C-sections, I'm not going to want a fourth." I said, "I just think it's worth a try." So she took that and she ran with it. She said, "Well, for what it's worth, I would rather do two more planned C-sections. I would do two more planned C-sections on you, and I wouldn't bat an eye. I'd rather do that than have you TOLAC." I thought, oh, my gosh. So again, I stood my ground. She went out. She was visibly upset. I was so proud of myself. But then I spiraled that whole day. It just chipped away at me all day. I came home.  I had been doing nightly walks religiously. That's when I would listen to The VBAC Link. That night, I didn't do my walk. I cried in my bed. I was just so upset. I spent the night then going through the groups I was in for VBAC after multiple Cesareans and The VBAC Link searching "big baby, big head circumference" and screen-shooting all of the success and all of the comments to fuel back my motivation. That was definitely the low point, but I did have some great meetings with providers. I was grateful that where I was living, I was able to find enough support where they would let me go for it. Once I got toward the end, there kept being the comments about "big baby". I had an OB do my final measurement and not tell me what it was. I said, "How is baby measuring? There is a lot of drama about baby being big." She was like, "Well, how big were your other two?" I said, "They were 9,1 and 8,4". My second was almost a full pound smaller. She said, "Oh, if you pushed those out, no problem. You don't have anything to worry about." I said, "That's where the drama was. I didn't push them out. I had C-sections." It was like she saw a ghost. She was like, "Oh, well that is drama." She was just beside herself. I say that story specifically because spoiler alert, she was the one who ended up delivering my baby.Meagan: Oh, really?Kelsey: To give a preface to that. She actually said, "Well, it is what it is." She just was very nervous and very upset. I said, "Have you never seen a VBAC after two C-sections? Have you seen that?" She said, "Well, yeah, but it's usually with people who have birthed vaginally before, and not with a big baby." That's what she said. Meagan: Oh my gosh. Kelsey: I just wanted to talk about that because she was the one who delivered Anyway, time went on. As I got to 39 weeks, I started to stand my ground a little bit more because they wanted to do cervical checks. They'd say, "Okay, undress for the provider." I just was like, "No, thank you. I'm good." I would have been really discouraged if they had come in and checked me. I know that got in my head with previous appointments with things that I didn't think would affect me. At 39 weeks, one of the providers who had been trying to talk about how big my baby was and persuade me to have an induction, she said, "What if we did a growth scan at 40 weeks, and you were measuring 10 pounds. Would that change your mind?" I was like, "No. I'm not doing a growth scan at 40 weeks. I've already done too many scans." So just right up until the end, they were trying to get me. They were talking about the size. Meagan: They were really trying to get you to cave. Kelsey: Yes. So after that appointment, because of my BMI, after 37 weeks and beyond, you have to have an NST and a BPP (biophysical profile) every week. Meagan: After 37 weeks?Kelsey: Starting at 37 weeks, you have to have both of those tests every week. It was just a new thing. I didn't do it with my last. Again, I'm worried about this. I know how the testing goes. Sure enough, I go. This is 39 weeks. I go for the biophysical profile, and they were like, "There is a lot of fluid. You have too much fluid." They were talking about all of the fluid. "Look, here are little flakes." They were talking about the fluid. I thought, I've made it this far. This is something that is going to make it a C-section.Baby wasn't also taking enough practice breaths for her which was frustrating. She even said, "I think he's sleeping, but I want to be on the safe side." I said, "I just had an appointment. She could hardly get his heart rate because he was moving so much." I had driven to Cleveland an hour and a half away the night before to go to a Noah Con concert. I felt him moving the whole time. I was like, "I'm pretty confident that he's okay. I was just checked by my OB five minutes ago." She wanted to send me. I wasn't going to mess around this far on, so I went to triage. They hooked me up to an NST. They wouldn't just let me do it in the office. I'm sitting there. Everything is perfect. The nurse comes in and said, "They're just going to place an IV." I stopped and said, "What did you say?" She said, "They're just going to place an IV." I said, "Why would they place an IV? Everything is looking good. I have grocery pickup in an hour. I'm not trying to be here for long." She said, "Just for access." I said, "No, thank you. Please let me out." That was weird.She said, "Okay. We're just going to watch you a little longer." Then this OB who I'd never seen before who was apparently just newer to the practice comes in. I'm like, "How are things going?" At this point, it had been 45 minutes. I'm trying to get out. He said, "Things are looking really good." I could see his wheels turning. He said, "But, since you are 39 weeks and you've had two C-sections, we can do a C-section for you today." Meagan: Oh my Santa. Tara: Here you go. How did you manage all of this pressure, Kelsey? It's extraordinary. Meagan: It is. Kelsey: I should mention that I had an amazing doula, so after these appointments, I would text her a paragraph. She was constantly lifting me back up. I was going to Webster chiropractic care. The chiropractor I saw, shout out to Tori, she's amazing. She's a doula also. She was pregnant going for her VBAC, so we would have these appointments, and it was a mini VBAC therapy session. We would talk about what we were up against, and just the different providers because she was going to the same practice as me. It was just so nice to have her. I was doing all of the things. The chiropractic care. I was eating the dates and drinking the tea because I wanted to know that if I was doing this, I was going to try everything and then I couldn't look back and say, "What if I would have done chiropractic?" Anyway, I basically tell him, "Get out of my room. I'm going." He just was awful. He did all of the scare tactics and all of the risks but none of the risks of a third C-section of course. Only the risks of the very low uterine rupture that he was hyping up. Anyway, that was bizarre, but again, I stood my ground. I was so proud, but then I got home, and I spiraled. I was packing my hospital bag. I was crying. I said to my husband, "I let them get in my head. I shouldn't even bother packing any of this stuff." I had the little fairy lights and things to labor. I was like, "I shouldn't even bother packing any of this VBAC stuff. They're just going to find some reason to do a C-section. Look at this. This whole time, they wanted to do the C-section." Again, another night of spiraling. As he left, he said, "They're going to want to see you tomorrow and repeat all of this testing." Meagan: For what? If everything was okay, what was the actual medical reason? Kelsey: Exactly. It was just out of spite because I shut him down. They were like, "They're going to want you to come back tomorrow." I'm like, "Okay. If it gets me out of here and gets you out of access to an IV and a C-section, fine." Meagan: Seriously. Kelsey: The next morning, I'm on my way to my appointment. I was on the phone with my mom and I told her, "I'm having these weird feelings I've never felt before. I don't know if maybe they're contractions." It was very strange. It was something I never felt. I never had a contraction and had never gone into labor. So I go to my appointment and passed the BPP with flying colors. I'm like, "Well, what about the fluid?" She's like, "Yeah, there's a lot of it, but it's fine." I got an 8 out of 8 score.  I go for the NST. Well now, baby's moving too much, so his heart rate, they can't keep it on because he's moving, and she kept having to move it. So again, I'm just very frustrated that I'm even there. I'm so close to the end. This is now 39 weeks and 4 days. And so the tech says, "I'm going to bring this to him. He might not like the drop offs, but I'll explain to him that the baby's moving a lot."I said, "Who's he? What OB is this?" She said the OB who was in triage the day before who tried to have me do the C-section and I was just like, "Oh my god. He's going to see my name and have any reason to send me back." Sure enough, he comes sauntering in the room and he says, "We meet again," as if I'm this problem child, as if I wasn't just having all these normal tests. He says, "I can't be confident that these aren't decals. You need to go back to triage." I was just again, so frustrated. It's like just a constant of all of these things coming up and none of it being real. It'd be different if it was like, oh, this was actually a risky thing. But again, I'm so close to the end. I know what I know. I knew that the OB that I had seen the day before in the office, I wanted to talk to her about the fluid because I had searched, and I saw that the polyhydramnios could actually be a thing. If your water breaks, there's the risk of cord prolapse. So I knew that that wasn't something that was completely to be ignored, so I wanted to talk to her more about that. I humored him, and I went in. Well, all the while, I'm feeling these sensations more and more consistently. They get me hooked up, and I explain the situation. I said that I was just here yesterday not really for a reason, but I'm back now also not really for a reason. They hook me up. Of course, everything looks good. But she's like, "Are you feeling these contractions?" I'm like, "Is that what they are?" I was excited. They were just cracking up because she's like, "These are pretty consistent and big contractions." I just couldn't believe it. I was just so excited my body was doing it. I'd only ever, at 39 weeks, been cut off and then never been given a chance. All I needed, I guess, was a few extra days. I'm just so excited that I'm having contractions. The nurses are laughing. "We've never seen somebody so excited to have contractions." Anyway, at that point, my OB comes in, the one who had been trying to get me to be induced. She's plenty nice, but the one who said about if we did a scan of 40 weeks and 10 pounds, would you reconsider? So she said, "Kelsey, do you know what I'm going to say? This is the second day you've been in here in two days." I'm like, "Yeah, but for nothing."Meagan: And because you asked me to come in here.Kelsey: Yeah, trying to humor everyone and see that yep, everything's fine. See? But again, I was having these contractions, and as I was there, picking up. She wanted to check me. I said, "Okay, I'll let you check me," because I'm having contractions I never have before, and I want to see what's going on. I went to the bathroom, and I had bloody show, which again, I had never had. So things are really happening. I come out and I told her, "There's blood and I'm having contractions." She's like, "Yay, let's check you," and I was 1 centimeter. She was one of the OBs who was comfortable with a balloon. So she said, "I'll tell you what. You've got a lot of fluid. Things are happening. Let's work on moving things along."Meagan: So she induced you?Kelsey: She wanted to.Meagan: She wanted to. Okay.Kelsey: So she's like, "Let's get you in. I'll do the balloon. We can get things going because you've got a lot of fluid. It's time, Kelsey." I'm like, "Okay." I said, "Well, I'm gonna go home."Meagan: Good for you, girl.Kelsey: Get my kids off with my mom and get my dog off. She sunk when I said that. I said, "I promise I'll come back. I'm not gonna run it. I'll come back just in a little while. Like, maybe this evening." But she said, "Okay, I'm here till 4:00, and then it's another OB coming on who won't want to do the balloon." So just come in before then. Of course, I wait until exactly 4:00. But as I was home, it just kept picking up, and I started timing. The app is like, "Go to the hospital. Go to the hospital." But I've also know from listening to this podcast that that happens. My husband's freaking out because he would see me stop and pause, and he's like, "Let's go. Let's get out of here." I was grateful that everything maintained through the car ride. I got there, and contractions were still happening. My doula met us there because I hear about people going too early and the contractions stop, and then there are problems there. Yeah, things just kept happening. We got in a room. My doula was amazing. We were just hanging out and just laughing. I couldn't believe just how happy I felt to feel my body doing it after all these years of just, "Your babies are too big, and you can't do this," and then all of this pregnancy saying that. It was just amazing.  I definitely had my guard up. The nurse was talking about the IV and the monitors, and especially with being overweight, I was worried about a wireless monitor. That happens. They can't get a good reading, and then they think baby's heart rate's dropping. I was just so worried about any reason, because I knew that they would. They would take it and run, so I was so grateful that the wireless monitoring worked perfectly. I was on my feet. Things just kept getting more intense, but I'm just laughing and smiling through it all. My doula was amazing. It was just such a great vibe in the room. My nurses were amazing. Every little thing that went right, I just embraced. I was so happy that this was happening. My water broke while I was on a video call with my friend. Again, it just like, "Oh, my gosh, my water broke. That's never happened." There was meconium in the water. So again, I'm like, oh, no. You know, any little thing. I was quickly reassured. It was very light. It wasn't anything to be worried about. I labored and stayed on my feet. My doula was amazing with suggesting things I never would have thought or never would have thought that I would enjoy. I was in the shower at one point on a ball. They had this little wooden thing with a hole in it so that it keeps the ball from slipping out and keeps the drain from plugging. I'm just listening to my guilty pleasure music while my husband's outside the shower eating a Poptart laughing. It was just such a funny thing. I was just so, so excited about it all. Things were really picking up. My water just kept breaking and breaking. I mean, it was true. I had so much fluid. It just was just coming out and coming out. I couldn't believe how much there was. I got into the bed on my side, my doula said, "Try to take a break," and then I felt a water balloon in me. I could feel it burst. Just when I thought surely I was out of fluid, it just gushed out. And then immediately it was like, "Oh, my gosh, this is really intense." I handled that for a while. I was squeezing the comb. I was working through contractions, but I tapped out at about 1:00 AM I'd say. So we got into the hospital around 4:00, and the time just flew. They came to do the epidural, and he put it in. I just kept waiting for relief because I felt like I just didn't have a break. They were kind of on top of each other. It was one of those things that if I knew I was only going to have to do that for a short amount of time, but just not knowing how long, I just felt like I was suffering through them at that point. I wasn't trying to be a hero. I was just trying to avoid what I know sometimes happens and just trying to avoid interventions as much as I could. I kept waiting for this relief because I'm like, "I think I just need to rest. I feel like I'm close." The last I've been checked, I was 5 centimeters, but that was before the water broke and before struggling through contractions for a while. I had no idea how dilated I was. The relief never came. I was hoping to be able to relax and maybe take a nap like sometimes I hear. I could still feel my legs. I could have walked around the room if I wanted. I kept pushing the button. I don't know if it was in the wrong spot or what happened. I don't know if maybe there was something that was working because instead of feeling crushing and just defeated through the contractions, I was feeling like I can survive that. I can get through them. There was just no resting, it was just still having to work through contractions. And then my doula at one point said, "Maybe we should call him in and have him redo it." But then I was in my head, "Well, what if he redoes it, and then I'm too numb and I can't push?" So I just went through it. I'm so glad that I did, because it wasn't long after that that I was checked, and I was 8 centimeters. My  nurse kept checking and there was a lot going on down there and a lot coming out. Eventually she checked me and she said, "Hi. Hi, buddy. I just couldn't believe it." She said, "Do you want to feel him?" I got to reach down and feel his head. It was just also surreal. She had me do a practice push once I was dilated enough, and she's like, "O, oh, okay, okay, okay." She said, "I'm gonna go make a phone call."Tara: Wow, that's impressive.Kelsey: And the OB came in. I forgot to say that when I got to the hospital, the OB who was gonna do the Foley balloon, I totally left this out. She checked me, and I was already 2 centimeters. She said, "Your body is doing it on its own. We're just going to let you go."Tara: That was my question, Kelsey. I was wondering this whole time if they did anything to augment. There was no Pitocin. This was all you? Kelsey: Yes. Yes. I can't believe it.Tara: That's amazing.Kelsey: I got there, and I got the monitor placed. She came in. She checked, and she said, "You're 2 centimeters. We're just going to let you go. We're going to let you do your thing." That was just music to my ears just knowing how things sometimes go. Also, the OB coming on, I had told you, was really nervous about my plan. My husband and I joked that she did something to calm herself down before she walked in because she was just like, "You know what? I'm going to do something crazy. I'm just going to channel my inner midwife and do something crazy and just let you go and leave you alone." My doula is like, "Good. Please let us go." Yeah, I forgot to mention that is not only did I not need the induction, but then I had the OB surrendering and saying, "Go ahead, just let's do it. It's fine." So she literally did not come in. I think was as far away as she could pretending it wasn't happening, I guess. When the nurse called her, she came in and she got her gloves on. I just kept waiting for something to happen still. I'd been so, so scared by providers this whole time. So I'm like, okay. She instructed me on how to push. We did it through one contraction, and his head came out. I was like, "Oh, my gosh. This is crazy," and then, during the second contraction, I did it again, and the rest of him came out. It was unbelievable. It was five minutes from start to finish. My doula described it like butter. He was 9 pounds, 3 ounces.Meagan: So biggest baby. OkayKelsey: Biggest baby, enormous head. I didn't have any tears. I had what the OB described as grazes, like little spots that were bleeding. She put one or two stitches on the walls from where there were these grazes and I can't even describe it. I was sobbing. I was like, "We did it. We did it." He came right to my chest and to get to see him, it was unbelievable. It all happened so fast. Going from not believing in my body and just going for these C-sections, I'm so glad I didn't know what I was missing because in that moment, I probably could have done this before. Again, I didn't know what I didn't know and who knows would have gone? But it was just unbelievable to be in a normal room to have him come out and just right to me where he belongs and getting to see him with his cord still attached and he's crying. It just was such a beautiful moment and I just couldn't believe that had after all of that, here he was. It was beautiful. They asked about cutting the cord, and we hadn't even discussed that. I was like, "Can I do it? I really want to do it." I wanted all the experiences that I could never have gotten in the OR. I cut his cord. My doula got an awesome picture of that. I was considering having that be my picture for the podcast. It was just unbelievable, and I was just so happy, too, that that OB was the one who was there because seeing how nervous she was, I'm so glad that she got to experience. Look what you almost deterred me from doing just seeing how perfect it was. Now I'm hoping that if somebody comes to her in the future, she'll remember and say, "Hey, we had this baby, and it was just such a great experience." I was just so grateful for every second. I couldn't believe how things ended up.Meagan: I am so happy for you. Like Tara was saying, I'm so impressed. Standing your ground the way that you stood your ground after just constant-- I'm gonna call it nagging. They were just nagging on you and trying so hard to use the power of their knowledge that we know that they hold. We as beings, and it's not even just in the birth world, just as humans, we have this thing where we have providers, and we know that they've gone through extensive amount of schooling and trainings, so it's sometimes easy as you said, you spiraled when you got back to spiral and be like, wow, they're just all pushing this really hard. Maybe I should listen. Tara, have you experienced this within supporting your clients or just your own personal experience?Tara: You mean the pushback from the providers?Meagan: Yeah, the pushback, and then for us, should we doubt our intuition? Should we doubt what we're feeling and go with what they're saying because they know more?Tara: Yeah, I mean, that's the hardest thing, because you hire them. Like you said with your first provider, you trusted her. You'd known her since you were young. You've built this trust. She's gone to school. It's so hard to stand up against that as just a consumer and as a person who cares about the health of your baby and your family. But then the multiple times that you had to stand up for yourself even in small things like not getting the IV, not getting the cervical exam, those are not small things. You were protecting yourself from having more of that pushback. I am amazed. We struggle with that as doulas too, because we're helping advocate for our clients. It sounds like your doula was a rock for you and a place to feel validated and heard. I'm so glad you had her.Kelsey: Me too. I say to my husband, "No offense, you're great, but what would be done without our doula?" I mean, she was unbelievable just bringing the positive energy. My husband and I were so nervous and we were so worked up. We were third-time parents, but it was our first time doing any of this. My husband wouldn't have really known. He's never seen it before. My doula, she's done this so many times. She was right in there with the massaging and the side-lying. She did the, she called it shaking the apples.Tara: Oh, yeah. Yeah, that's a good one. But Kelsey, it's against all odds. I just think it's amazing because we talk about the power of oxytocin and feeling safe and not having stress hormones going on, and you had all of that. You should be so proud of your body coming in in the nick of time and just proving against all of this. I'm just gonna go ahead and birth this baby, and a bigger baby than your other two which is such a triumphant moment.Meagan: Seriously.Kelsey: His head was 15 inches. That was another thing because they had talked about his head circumference being off the chart. That was another thing I had been searching is people who've had the big head circumference. Those groups, this podcast and just groups and having access to so many stories and people overcoming all of these obstacles because every time I came up against something, I had heard it before. I said, "Oh, this is something that I've heard time and time again with these stories. They make you feel like you're the only one with the big baby and, oh, this is a problem. But it's like, no. They're saying this to so many people. It was just amazing going into this being so informed and motivated and having that confidence that I never would have had. I just so grateful for this podcast and for all the information.Meagan: Well, thank you so much. It's one of the coolest things, I think, not only just the VBAC, but to see where you came from at the beginning of, "We're not having kids. Okay. We're having kids. Okay. This is what I'm thinking. I'm kind of scared of this. Let's do this. Okay. Doctor said this. Let's do this." to this. I mean, you came so talking about the pendulum, right? And what that provider was talking about. You came from one side over here to not even wanting kids or wanting a vaginal birth to swinging so far to the other side and advocating so hard for yourself and standing your ground. When we say that you should be proud, I am shouting it. Be proud of yourself. Girl, you are incredible. You are such a great example. Women of Strength, if you are listening right now, I want you to know that you can be just like Kelsey. You do not have to be bullied. You do not have to be nagged on every single time. Know what's right. Know your gut. Know your heart. Do what you need to do, and you can do it. You can do it. It is hard. I know it's hard. It is not easy, but it is possible. Girl, you're amazing. I thank you so much for sharing your story today and empowering all the Women of Strength who are coming after you and needing the same encouragement that you needed not even years ago. How old was your baby?Kelsey: So he is four months old.Meagan: Four months. Yeah, so a year ago when you were listening. I mean, really, so so amazing. Thank you so much. And Tara, it's always a pleasure. Thank you so much for being here. I couldn't agree more with your advice. Get your partners educated. Create that true dream team.Kelsey: Thank you.Tara: Congratulations, Kelsey.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 VBAC Link
Episode 378 Episode 378 Susan's Empowering CBA3C + The Benefits of Laboring

The VBAC Link

Play Episode Listen Later Feb 12, 2025 38:48


Join Susan on our podcast today as she shares her journey to a beautifully empowering CBA3C! Susan had three C-sections that didn't have anything to do with her body. They just happened to be circumstantial. All three of her births had been traumatic emotionally and did not go how she wanted at all. As far as making decisions for herself and doing what she really wanted to do, that was not present. But with her fourth baby, Susan had a lot of firsts. It was the first time that she was really able to voice what she wanted. She was able to make decisions out of peace and being educated instead of making decisions out of fear and being told what to do. That was the first truly empowering step in her process.Our mission at The VBAC Link is to make all births after difficult Cesareans better, and Susan's episode shows exactly that. Coterie Diaper Products, Code VBAC20 for 20% Discount How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. It is Megan, and I am joining you with my friend Susan. Hello, Susan. How are you?Susan: Hi Meagan. I'm doing great. How are you doing?Meagan: I am so great. You are from South Carolina, and at the time we're recording, even though this is now going to be in February, South Carolina has had crazy weather. How has everything been with you guys?Susan: Everything has been great. We're actually extremely blessed with the area that we are in. Initially, I thought it was something to talk about because I had a tree fall in the back of my house, but once I saw everything else going on in the area and just seeing the devastation that people had gone through, we are incredibly blessed with, the minimal damage with it just being a tree.Meagan: And this was Hurricane Helene?Susan: Hurricane Helene. Yeah. So all of our neighbors are pretty rough right now, so keep them in your prayers and help out where you can.Meagan: Seriously? Oh, we will be. We're actually recording right now in October, and today is the day that Florida is scheduled to be hit with another really crazy hurricane. So, yes.Susan: I've been thinking of Florida non-stop too.Meagan: Seriously, if you guys are listening, even though this is in February, oh my goodness, I hope all is well and everybody is okay.We do have our Review of the Week, so I definitely want to get into that before you share your four CBAC stories. We have people question, "Why is it called The VBAC Link, but then you share CBAC stories?" But I think the solid straight answer is because not every birth ends in a vaginal birth, and not everything always goes as planned. And you know what? Also, sometimes VBAC isn't desired, and CBAC is something that we don't want to forget about. In fact, if you didn't know, we have a CBAC Link Community. We have The VBAC Link Community on Facebook, and we also have a CBAC Link Community which is just the most amazing group as well. It's actually run by Paige, our transcriber, who I absolutely adore and just had her fourth Cesarean, which was a Maternal Assisted Cesarean. I still can't even believe all of those things happened. It's so amazing. But you guys, if you are looking for a CBAC support group, go to The CBAC Link Community on Facebook, and we'll make sure you get in. We have a review. It is by Jamie Poor. It says, "The absolute best." Thank you. That is so sweet. It says, "After having a scheduled C-section in 2016 for my son being breech, he flipped between 38 and 39 weeks, so he came as quite as a shock. I knew I wanted to VBAC for my next birth. Fast forward to 2019, my second pregnancy with our daughter, I found your podcast and obsessively listened to every single episode. It motivated me and educated me leading up to my due date. It even made me look forward to my long commutes to work. I hired a doula. I drank red raspberry leaf tea, ate the dates, did the Spinning Babies and really did all the things. And guess what? With the help and the education and advice provided on this podcast, I got my VBAC. I learned how to ask for what I wanted and advocate for myself with my doctor and when my body cooperated and went into labor, I felt prepared. My daughter was born in January 25, 2020, and I have to say her labor, delivery, and birth was the most healing, empowering experience of my life. Thank you, ladies, for providing this podcast for all women preparing for birth." Thank you so much, Jamie Poor, for your review, and congratulations on your amazing, empowering birth experience.Women of Strength, no matter how you birth, we want you to have a better experience. That is our goal here at The VBAC link to make birth after Cesarean better. A lot of first Cesareans are unexpected, undesired, unplanned, and do sometimes bring trauma. That doesn't mean even future Cesareans have to have trauma or be unplanned or be unprepared for. We want to learn all the ways we can make birth after Cesarean better no matter how that ends. Okay Susan, ending that review, we were just talking about no matter how birth ends. When you filled out your form, there was something that you said that things sometimes don't go as planned, but learning how to advocate for yourself and know that every birth is different is going to leave you feeling better. So I'm excited for you to share your four stories with us today, and I am excited to hear how you learned and grew and had better experiences with each one.Susan: Okay, so the first birth, I was 19. I was really young, and I didn't know a whole lot about birthing in general. I just did what I was told. I went to the hospital. I did what the white-coat man told me to do, and I didn't question anything. I was just a good patient all the way around. I had an amazing birth. I walked 8 miles before my induction date because I was a week over just trying to get things going and nothing was going. But you know how they are at the hospital. You know, as soon as you hit that 40-week mark, they want something to happen as soon as possible. So around, 41 weeks, I went "overdue" according to the medical standards. I went into the hospital and was super excited. They started the Pitocin drip, and my baby did not respond to that well at all. I was actually watching It's Always Sunny in Philadelphia, and I was laughing so hard while the Pitocin was going that his heart rate actually dropped to zero, his fetal heart rate. I remember all of the nurses came rushing in. They were freaking out, and they were pulling on stuff and readjusting me. It was really scary. They stopped the Pitocin and then they restarted it, and then it happened again. So his fetal heart rate dropped scarily low two times. The doctor came back in and he said, "You have two options. You can probably go home and labor for days and days and days, or don't know how long it's going to be."Meagan: He made it sound hard though.Susan: Yeah. He made that sound not appealing at all. And then he said, "Or we can just go to the back and get a C-section and get this baby out." And I was like, "Let's do the C-section. Let's get him out asap," because I was just scared, and I was young, and I just wanted him to be okay. So we went back for the C-section, and it was a perfect recovery. I didn't really think much of it. I was just glad that I had a healthy baby.The second birth came along, and I was actually in a pretty tough situation at the time. I was faced with a choice of what am I going to do with my pregnancy? A choice that many women face. Whenever you're not in the most ideal spot to have a child at the time, no decision is easy. The decision that I chose for myself at that time was to do an adoption. I chose to go the adoption route. Whenever they had asked me about what I would want to do as far as the birth goes, I was just thinking of the adoptive parents and what would be best for them. It was a completely sacrificial thing that I did. I didn't think about myself at all or what would be best for my body or my health or anything like that. I just wanted to make sure that his adoptive parents would be there. To assure that, I just elected to have a repeat C-section. Fast forward a little bit later. I'm starting to learn a little bit more about natural birth and what that can mean in a woman's body and the benefits of it. I don't know too much, but I went to my provider on my third birth, and I mentioned, I said, "How would you feel about me trying to have a natural birth?" He just looked at me with disgust, and he was like, "Absolutely not. We're not gonna do that." I just really didn't know too much, and I just felt so defeated and like that really was the only option, and I wanted to do the right thing. I really didn't fight for myself. I think I may have mentioned it to one other person just briefly, and then I just dropped it. That was the third C-section. So at this point, I've had three C-sections that really didn't have anything to do with me or my body not progressing or anything like that. It just happened to be circumstantial. It really wasn't empowering. So far,  all three of my births had been traumatic emotionally and did not go how I really wanted at all. I mean, thank God the three babies were healthy, of course, but as far as me making decisions for myself and doing what I really would want to do, that was not present. So, fourth baby. So the fourth baby, I had a lot of firsts. So it was my first baby with the marriage that I'm in now. It was my first girl, and it was the first time that I was really able to think clearly and be able to voice what I wanted and be able to make decisions out of peace and being educated instead of making decisions out of fear and being told what to do. That was the first step that was super empowering in this process.Meagan: Yeah. I think when you start feeling empowered, that's where it begins, the second you start that. Yeah.Susan: Yep. So I went to my first appointment just to have the pregnancy confirmed. They were just pushing. The only thing they were really doing was making sure I got vaccinated. "Oh, your blood pressure's high, so you're probably at risk for preeclampsia." They're already putting me in all of these little boxes on my first visit. They're telling me to take aspirin because I had high blood pressure. I had high blood pressure, a lot of it due to white-coat syndrome just due to the trauma of being in the hospital. I was completely not at peace. I hated being there. I did not want to be at that doctor's office. And so I got in the car and I immediately am talking to my husband. We call his cousin because he comes from a family where it's really common to have home births and to use midwives and to use alternative ways. I was so blocked off that I really just couldn't see, but we started talking to his cousin and she was telling me, "No, this is actually totally possible. I know some midwives who are able to do it." I'm still clenching up with fear, but I want to let it go. I'm on Google and I'm like, "vaginal births after C-sections three times", and your podcast was actually the first one to pop up. I went on there, and I specifically looked up a story that had to do with a woman having a vaginal birth after three C-sections.  I just started to listen and my heart started to open and the fear started to dissipate. I was like, "I can do this. I can at least make a huge attempt to do it." And so I started to call different midwives and see what their availability was like. A good portion of the midwives don't want to work with you if you've had over three C-sections because they're contracted with the hospitals and are contracted with the state in some way to where they can't legally do that. It was really hard because I called around and called around, and either they weren't available or they just couldn't do it. But I finally found a midwife that was willing to work with me. Me and my husband met with her, and we sat down and talked. It was the first time I had ever had a conversation with "providers" where they actually believed in me, and they believed in my body, and they believed in my ability to give birth. It just meant so much to me to be looked at as a human and as a woman that can do this and not just as a patient who you want to push through and make money on and just get the C-section and be done and not have any risk involved. But there is risk involved having a C-section after three C-sections. There's risk doing it any way, and it's just like, what risk do you want to take?Meagan: Yeah. It's interesting, but what you were saying, "I just wanted someone to sit me down and talk to me like I'm human and have this feeling." I mean, I interviewed multiple providers, and it took me a long time to find that, too. That is what breaks my heart about this community. We have to go into these situations where we're searching for support that feels like a diamond in the rough.Susan: Yeah. And I want to just point out that even though this did end a Cesarean, and we all know that. There's no suspense there. There are so many points along the journey where I did have that healing. I did have that empowerment. It doesn't have to lead to a Cesarean in order to have that healing is what I really want my story to say. You can still make decisions and advocate yourself for yourself in a way where it doesn't necessarily have the VBAC.Meagan: Yes, yes, yes.Susan: Because I'm in the Facebook Community, and I see stories of women being so defeated and so sad when it doesn't end in the VBAC. I just want to inspire people that it doesn't have to be that. The empowerment can come in so many different forms. I was just completely elated after I spoke with her, and I just felt like it was meant to be. I loved her. I loved her energy. She had been a midwife for over 26 years. She had over 1100 home births and not a single maternal death.Meagan: Wow.Susan: Yeah. I just felt totally confident in her, so I went ahead and hired her to be my midwife. Just being able to go to her house and have the prenatal visits was so nice. That was another huge thing that was just amazing and not having to go to the hospital and fight every time. We did all of our prenatals there.She didn't beat around the bush. If there is an issue and I needed to address it, I would address it. I had a little bit of issues with my blood pressure, so I tweaked my diet and I was able to monitor that that way. Towards the end of my pregnancy, I had issues with my hemoglobin being low. I tried everything in the book, by the way, and the thing that helped me, just in case anyone's having issues with their hemoglobin, is I actually froze raw beef liver. I froze it, and then we cut it up into little tablets. I took this raw beef liver every morning because it gives you energy. Don't take it at night before you go to bed because you'll have trouble sleeping. But I took it in the morning and my hemoglobin went from like 9 to 11 within a week which was amazing because nothing else was working.Meagan: Yes.Susan: Yeah.Meagan: And I was going to say that frozen wheatgrass shots is another thing that can help with that. Yeah.Susan: Oh, I did not try that. I said I tried everything, but not that. Meagan: Liver and wheatgrass. Make a delicious smoothie.Susan: The things we do to stay healthy. So, yeah, sometimes people will try to make you feel like you're being irresponsible by not doing it the way that they've been programmed to do it. I'm just saying, it was totally responsible. If not, it was even more responsible because she may have picked up on things and was able to give me advice from a nutritional standpoint which is usually always the issue. It's something to do with your nutrition in your diet that someone in the hospital wouldn't tell me because all they wanted to tell me was to take an aspirin. Yeah.I went over. I was 42 weeks and 4 days, I think.Meagan: 42 weeks and 4 days?Susan: Yes.Meagan: Okay.Susan: So another thing I want to tell people, if you're planning on doing a home birth or doing a natural birth, even if you're planning on going to the hospital, I would recommend saying your due date is actually a month after it actually is to people just so you're not hounded at that like 39, 40-week mark because that was really hard mentally. Especially if you're planning to do a natural birth, it can be such a mental battle especially right there at the end and to have to deal with people know, being like, "Is she here yet? Did you have the baby?" It's just another thing to have to deal with. I would recommend saying it's a month after your actual due date. Yeah. I did absolutely everything you can think of to be the perfect student as far as home birth goes. I read every single book I can think of to prepare you for a natural home birth. I went into HypnoBirthing. I practiced the meditations and the exercises. I had the birth ball. I did all the exercises on the birth ball with my pelvis. I took all the right supplements. I did the pre-birth tincture. I was doing it beyond. People would try to talk to me being like, "You could die. You could bleed out," and I would cut them off. "I'm not having fear-based conversations. I'm not entertaining this. Yes, I'm going to do this because I want to do this. I'm not committed to this to the point of death for me and my child. If something goes awry I have no problem going to the hospital but this is what I'm doing. Leave me alone."Meagan: Good for you.Susan: Yeah. Yeah. So I was really proud of myself because they say it's like preparing for a marathon giving birth. So I really prepared. I had my mucus plug come out around maybe 42 weeks exactly. I was like, "oh my goodness, something's happening," because previously, I haven't experienced any signs of labor. I don't know anything. I've never had a contraction before.Meagan: Right.Susan: Even though this is my fourth child, I have no idea what any of this feels like. So I'm really excited. I'm like, "Wow, this is exciting." Actually, my water broke really shortly after that. I was sitting down on the couch, and I just started having gushes of water and gushes of water. I was talking to my midwife the whole time being like, "This is what's happening. There's so much fluid. There's so much." I had never had my water break before, so that was all new. I was scared. I was excited. She just reassured me. She goes, "No, this is just your water breaking." And she had told me that she's going to treat me like a first-time mom because I never have actually had a baby come through my birth canal. So a lot of times you can expect a long, strenuous labor when it's your first.Meagan: Yeah.Susan: So she said, "Your water has broken. That could either mean that it's going to speed things up and the baby will be here soon, or it could mean there's still a long road ahead." My midwife was really good about keeping my expectations very low as far as when the baby would be here.Meagan: Hey, I think there's something to that. We know that labor sometimes can be slower.Susan: She just didn't want me to stress out about it not happening sooner than later. She was just so good, so calm, so peaceful, and confident. I love her. She's the best midwife ever. I recommend her anytime I hear about people in the area wanting to have a home birth.I was starting to have contractions and then it would be like, go, go, go, and then everything would just stop. Because my water had broken, the chance of meconium was there. I had some meconium in my fluid, but it was yellow. It wasn't a high-alert type of meconium. It was just like, "Okay, we kind of need to get things going." So we talked and we decided to drink some castor oil. So I drank a tincture, the Midwives' Brew if you look it up on Google. I did that.Meagan: A lot of midwives will suggest that.Susan: Yes. So I did that, and it did throw me into really intense labor. We just got things going. I had my contraction timer going, and I had my sister and husband here. I really didn't want many people there at all at my birth. It's just such a private and intimate thing. That was just what I felt comfortable with. It would just be that. It would be a series of contraction after contraction, and then things would die down a little bit. I did every type of position you can think of. I went to the bath. I took baths. There was so much stuff I would do. I even found if I put my feet in really hot water, it would help take away from the pain of the contraction because I hate my feet being hot.Meagan: Oh, okay. Yeah.Susan: It would help me think more about my feet being hot. I would just do anything and everything I could to just help the process and help my body relax. As much HypnoBirthing as you do and as much meditation you do, every birth is different. At that point, I was like, "All of that is BS. All of that is crap." Hey, if it works for some people, great. I really tried to do it, but I had a lot of pain happening no matter what meditations or affirmations I was giving myself. I was talking to my midwife about that too. That's another thing I want to point out is that we all might have this vision of this really peaceful birth where the baby just slides out into your hand and you catch it and yay, everything is great.But also, I just want to everyone to give themselves permission to have a chaotic birth. If that's what your body needs to do, if you need to scream, if you need to shout, if you need to look like a hot mess, if your hair needs to be frazzled, let yourself do that. Sometimes just allowing yourself to let go a little bit can really help. I was laboring for three days.Meagan: Oh wow.Susan: I got to 7 centimeters dilated. I was so happy because my cervix was folded under.Meagan: Folded under?Susan: Yeah. So it was like a posterior cervix.Meagan: Oh, it was posterior.Susan: Yeah, yeah, yeah, yeah.Meagan: Oh yeah. It starts posterior and through the labor process, it comes anterior and aligns well with the birth canal and opens and dilates and all that. Yeah.Susan: Yes. So, by the time I got to 7 centimeters, that had finally come forward.So we checked myself, and I was 7 centimeters. My cervix had come forward, and I was so happy and I cried for joy. I was like, "This is it. I'm at 7 centimeters. It's go time." And typically, that's when they have-- what do you call it when there's that shift?Meagan: Well, active labor. When active labor kicks in, is that what you were thinking?Susan: Well, I had already been in active labor. But the shift when you're at the final stage, almost? Because you know how labor will get to one stage, and your body will adapt to that, and then it'll get to another stage and another stage?Meagan: So from 6 centimeters on is statistically like that active labor stage.Susan: Okay.Meagan: I'm trying to think of what other word you're meaning, but it turns into active. Transition? is that what you're thinking?Susan: Just the most intense part. Yeah. Maybe.Meagan: Yeah, so you transition into that stage. Susan: Yeah. Okay. So, I did not go into that transition. I stayed at 7 centimeters. And even though I was having extremely hard contractions, they were not productive contractions. There was a point where I was on my toilet because that was my most comfortable place to be. I felt the safest on my toilet because I was scared of pooping. That was a fear of mine, and I wanted to be on the toilet just in case.Meagan: Were you having back and butt labor at all?Susan: I was having some back labor. I mean, it was the most pain, and it was such a journey because  you're in so much pain, and you're like, "Wow, this is the worst thing ever. How am I gonna do this?" And then the contraction goes away, and you're like, "Wow, I'm so grateful. I'm so grateful to be here. I'm so grateful my baby's almost here." And it's just an emotional roller coaster.Meagan: It is. Yeah.Susan: So nothing was really happening as far as the progressing. My midwife comes to me while I'm on the toilet, and she goes, "All right, Ms. Madam. Let's get your pretty dress on, and let's go for a walk." I looked at her like, "Are you crazy?" But I did it. I got my dress on, and I went for a walk through my neighborhood. I walked probably 2 miles, contracting throughout my neighborhood trying to get something going.Meagan: Wow. Susan: Yeah. And then I come back in the house, and there was two midwives there. One of them said, "If I could do my labor over, I probably would have just walked and walked and walked until the baby got there and would have tried my best not to be scared of the pain or let the pain stop me from really pushing into the contraction." So that's what I did. I started walking circles around my house, and I was telling myself, "No pain is too great to bear for my baby to be here." And I was even talking to my baby like, "Let's do this. Let's go to the next phase." I got to a point where I looked at my midwife, and I just said, "I'm exhausted. I have to lay down." I lay down, and I woke up, and my sister was lying with me. I started to just feel shivery, like really shivery. I started to get chills. It was just like I felt like I had nothing left in me. As soon as the shivers and the chills started, I knew I probably had a fever. I was looking at my sister and I just said, "I really don't feel like I can keep doing this." She said, "Well, is there something else on your mind?" I said, "Yeah, I need to go to the hospital." I'm about to start tearing up. The midwife came in and I just told her. I was like, "I need to go to the hospital. I feel like that the next step is that I just need to get in the car, and if on the way there I change my mind and I want to come back home, I'm going to give myself permission to do that."She goes, "Well, let me just check you, and let's see what's going on." It was 12 hours since my last check. It was 12 hours, and I was still at 7 centimeters. I hadn't progressed at all. I immediately just got out of my bed. I put my dress on. I don't think my husband was quite ready to go, but my midwife was, so I just started walking to her car. I'm like, "I'm going to the hospital now." I just had made up my mind, and that's what we were going to do. It was a very peaceful ride to the hospital. I had my little Depends on. She put a little pad under me. I remember asking her, "So has anyone ever peed in your front seat before?" Everything was just starting to get a little haywire. I just couldn't hold it in at all.Meagan: Yeah, yeah.Susan: We were just having a fun conversation on the way there. We got to the hospital. Well, the farther we got to the hospital, the more at peace I felt. The thought of going home was terrifying to me. As soon as we got there, I saw the nurses in the ER, and it was like beams of light were beaming through their heads. I knew I was at the right place. I got there, and they were just so sweet and so supportive. I still wanted to entertain the idea of having a vaginal birth if possible. It was just that I had to get an epidural because there was nothing left in me. I had nothing else to give in my body.Meagan: Yeah.Susan: I wanted to entertain that. And they go, "Well, yeah." They were like, "Were you hoping to have a VBAC?" And I go, "Yeah, actually I was hoping to have that," but I wasn't so committed to it to where I wouldn't have had a C-section. I already knew that I'm just going to do what's best for whatever the situation is after they assess me.But they were actually willing to let me have an epidural and have a VBAC. They were like, "Yeah, that's totally fine if that's what you want to do." And I was like, "Really?" And this was a separate group of providers that I had never experienced before. So yeah. It was absolutely amazing being talked to and being actually asked what I wanted to do.Meagan: Yeah.Susan: So they were doing all of my vitals. And as soon as I got to the hospital, that's when everything went berserk. My blood pressure skyrocketed. My heart rate went up. I was preeclamptic, and I was septic from meconium being in my uterus for that long. As soon as she was checking me, my daughter, Carrington, actually had scooted her head up a little bit to kind of show us what was going on, and the meconium was green. So as soon as I saw that there was green meconium, I was like, "Take me back for a C-section right now," because we all know that's infection. They were so relieved when I was totally fine with having a C-section. They gave me the spinal, and I just remember that being like the best feeling ever having no pain after being in such turmoil and in pain for so long.As soon as they pulled her out of me, she took another massive poop. So if I would have waited any longer, she would have been in that as well, and her chances for aspirating on it would have been really, really high. So yeah, that was it.I felt really great about the C-section. It was empowering because even up until that moment, I still was making decisions for myself and making decisions for my daughter. The decision that I made at the end was to save myself and her. To know that I made that decision and wasn't so committed to an outcome that I was able to make the right decision was like, "Wow. Yeah. I did that." Even though this is something that I wanted more than anything, I was able to let that go and save myself and her.Meagan: I love that you pointed that out of like, I had this empowering healing experience because I was really able to make the decisions along the way. You made the decision to get in that car. You made the decision to continue laboring. Then things changed. You made the decision to call it. And I think that is where a lot of the healing and growing comes from, is when we are able to make the decisions. The trauma, the fear, the hurt is when providers are coming at us and telling us what we are doing. "You are going to do this. I will only allow you to do this. You can if..." and then they give their restrictions. I think that you just nailed it on the head. You were able to make your decisions and be in control of your birth. And no, it wasn't the original outcome that you wanted. You wanted that vaginal birth. You were going for that vaginal birth. Things were really looking great, and when they weren't, you changed your mind. I just think, Women of Strength, take this with you today and know that you are in charge of your birth. Yes, babies and births can throw twists and curves and hurdles and all the things along the way, but you are the one who can make the decision for you. You do not have to be told what you do and do not have to do. Now, we also know that there are true emergent situations. There are true, true, true emergent situations where we maybe don't have a lot of time to sit and think and ponder and wonder what we should do and then follow that. It's just we have to say yes or no right then because it's an emergency situation. Susan: And being able to trust yourself that you are going to know if you need to call it and when to call it.Meagan: Yes.Susan: And that your intuition and your ability to just be in tune with your body and your baby is there.Meagan: Yeah. Absolutely.Susan: Yeah. And you'll know.Meagan: You will know. We talk about the intuition all the time. I mean, I don't know. I would say if not every podcast, probably every other or every couple other, we talk about this intuition. It is so real. I mean, Susan had this intuition. She felt it. She really did. Everybody listened to her. It's so important to be heard and to trust that intuition. So I applaud you, Susan. I'm so grateful that you were able to follow your intuition and be heard and call the shots of your own birth because you did deserve it. I am so happy for you. I know everybody else in the world cannot see your sweet baby, but I can and she's beautiful. I'm just so happy for you that you're able to have these experiences, and you have grown through each one.Susan: Mhmm, mhmm. And just the preparation of having a natural birth and what goes into it physically and mentally is worth it in itself to just give it a try if that's what you're wanting to do. And then allowing yourself to go into labor so all of your body's hormones are released in active labor, even if you do end up having a C-section, that's super valuable for your health and your baby's health.Meagan: Yeah, I was actually going to ask you that question. Yes, it ended in a Cesarean, but would you still have gone for the VBAC?Susan: Yes. I wouldn't have traded any of it for anything. I 100% would have done it again even if I knew what the outcome was going to be.Meagan: Yeah.Susan: Yeah.Meagan: Well, thank you so much for sharing your stories today.Susan: Thank you for having me here and thank you for doing this podcast and being in the business of releasing fear among women because it's like a pandemic of the mind almost.Meagan: Seriously though, we are being told that we have to be scared day in and day out. I mean, we hear these stories. I recorded a story earlier today and it was just like constant fearmongering every single time she was there. That stuff gets really tiring and it's hard to stand up to. But again, it comes down to education, learning these stories, learning your options, and then again following that intuition. So yeah, Women of Strength, you are amazing.Susan: Thank you. You're amazing too, Meagan.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

The VBAC Link
Episode 377 Melanie's Induced VBAC Turned CBAC + Controlling What You Can + How to Heal Birth Trauma

The VBAC Link

Play Episode Listen Later Feb 10, 2025 46:24


We have two beautiful CBAC stories for you on the podcast this week! Today's episode is with our friend, Melanie. Her first unexpected Cesarean was in April 2020 at the beginning of the COVID-19 pandemic. It was a very lonely and traumatic experience. Melanie found healing through a birth trauma therapist who helped her process her story and prepare for her second birth with a strong mindset. She took charge of what she could while making peace with what she couldn't control. Unfortunately, many things out of her control did happen, and Melanie faced another Cesarean. All of the healing work paid off though, as Melanie was not traumatized but empowered instead. “Birth stays with you forever. It's not something you ‘move on from'. My first birth was 5 years ago and still barrels me over from time to time. Likewise, the pride I feel in how I advocated for myself during my second birth continually gives me strength.”IMG_6660 (1) - Melanie Doyle.jpgCBAC Support - The VBAC Link CommunityBirth Story MedicineNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: This is actually the week that we are kicking off CBAC week. This week you'll hear two CBAC stories. If you haven't caught on yet, every month we have one week with a couple episodes that is a more specialized episode. So if you're looking for CBAC stories, this is your week, and we have our friend, Melanie, with us today.Hello everybody, it's Meagan. I have my friend, Melanie, with us today. Melanie is a 31-year-old mama of two who had two C-sections. While she struggles with birth trauma from her second birth, an emergency C section, it was still quite healing, she said. I love that you're talking about that. You still struggled with this, but it can still be healing. That was how I was. I wanted a VBAC with my second birth. I really, really, really wanted a VBAC, but it didn't happen. It didn't go as planned, and I had a CBAC. I walked down to that or and I had that second C-section, and it was not what I wanted. There was still trauma involved and lots of feelings, but it was still one of the most healing experiences for me. Weirdly enough, I think it's what he needed. I needed that to help me heal from birth one and birth two.So let's talk a little bit about CBAC, and how it can be as a mom who is wanting a VBAC and it doesn't go as planned. Do you have anything to say on that?Melanie: Sure. Thanks, Meagan. Yeah, I have a lot of things to say on that. Honestly, like you, I wanted the VBAC. I did all of the things to try to get that VBAC. I did the yoga and the teas and the stretching and the chiropractor, and the acupuncture. I did it all, and it didn't happen. It wasn't meant to be.I guess I'll get more into that when I dive into my story. But the CBAC was healing because even though I didn't get the outcome I wanted, I was much more empowered throughout the whole process than I was in that first birth. Through a lot of healing and therapy, I realized that it was that empowerment piece that caused a lot of the trauma from my first birth. It wasn't the C-section itself. That wasn't what instigated all of those feelings and all that hurt, but the way I was made to feel, the way I was treated the doubts and insecurities that were planted in me from that experience that took away my power. Even though I did not get that outcome in my CBAC, it undid a lot of that in a way. I was able to of regain some strength and some autonomy. That's lasted a lot longer. I think in this kind of healing journey, it's still hard sometimes. I still feel like I'm just barreled over by the grief that's wrapped up in both of those births. Even though I have two wonderful, beautiful, healthy children, it doesn't all disappear, but it did help me regain a lot of confidence in my ability to advocate for myself and know what I'm capable of.Meagan: Yeah, I love that you pointed out that, that it was a more empowering experience, and you felt more empowered. I really think that along these journeys, if we can be educated and feel empowered, even if it doesn't go the exact way we want it, and that doesn't even just mean Cesarean and VBAC. I didn't want an epidural, and I got an epidural. I didn't want Pitocin. I got Pitocin.Melanie: Right.Meagan: There are all these different things that can happen that we didn't want. But if we can feel empowered and involved and educated and like we are making the decisions too, and sometimes we can't make them. Sometimes our babies make the decisions, and that's frustrating. That's hard. It's like, well, what could I have done? And we go down these real big spiraled, spaces. But if we can really feel empowered along the way, even though we still might not agree with wanting, the outcome of what we wanted, we can feel empowered and have more healing to come.I wanted to talk more about that too, because we see this happen in the VBAC group where it's like, "Hey guys, thank you so much for being with me along this journey. This group has been amazing. However, I feel like I just have to leave now. I can't be here. I don't feel welcome here because I ended in a Cesarean." One, Women of Strength, I want you to know you are always welcome. You are always welcome. And you are incredible. You do. You were not less than anybody else just because you've had a Cesarean. And two, we actually have a CBAC group. I wanted to point that out to any mamas who have maybe gone for the VBAC route or even decided not to VBAC and wanted to have a Cesarean to go into that CBAC group. It is so, so special. It is led and run mainly by the very own Paige on our VBAC team, who is incredible. I just love that group so much. It creates this just abundant amount of love and support that I think everyone deserves. I don't want you to feel alone because I know. I was one of them. When I had my CBAC I was like, I can't keep seeing these people have these VBACs. I wanted a VBAC. I didn't get a VBAC. There were so many feelings, and I didn't feel welcome there. It wasn't even because they didn't make me feel welcome. I just didn't categorize myself as qualified to be in that group. Yeah, so check out The CBAC Link Community on our Facebook and know that Women of Strength, you are incredible. Whether you have a vaginal birth or not, you are incredible. Melanie: Okay, you guys, we're gonna dive into Melanie's stories, I should say. There are two. There are two stories. So, yeah, let's start with birth number one.Melanie: Goodness. So my first birth, my daughter, who is about 4.5 now, was born in April 2020. So it was right at the beginning of the COVID-19 pandemic lockdown which really set the scene in the most terrible of ways, as many of listeners probably remember, especially for anyone who had a baby during that period. I mean, it was so challenging those final weeks of my pregnancy. Every doctor's appointment I would go to alone. There was just new bad news being delivered to me about the restrictions that were being put in place. And I was very depressed. It was a heartbreaking time. Those final weeks of my pregnancy, I imagined nesting and being cozy with my husband before we had our first baby, and it was just all kind of ripped away like so much was during that period of time. I became really disassociated from my pregnancy and the joy that was meant to be coming. If someone had approached me on the street and said, "We can get that baby out now," I probably would have said, "Sure." I was really in a place of not caring, I guess, about what happened. I was just so desperate for this baby to be born before the restrictions got worse and before my husband wouldn't be allowed to be at the birth. So I was disassociated, I think, is the only way I can describe it. And then, of course, I went overdue because my kids don't come on time. This will be a recurring thing.Meagan: And with your first baby, that is also very common. Just saying. A lot of people carry over that 40-week mark, right?Meagan: Yeah. They don't tell you that when you get the handbook at the beginning of the pregnancy. I was overdue and was desperate to be induced. I went into this prior to the pandemic and everything, being pretty knowledgeable. I had attended a birth before. I had seen things go wrong and had originally had ideas about what I wanted my birth to be like. But at that point, I really was just desperate. The induction started really well. They placed Cervadil, and it kickstarted things like rapid-fire. It worked super well for me and I thought, "Okay, this might still be okay despite the induction. Despite all this, this might still go fine." Given the COVID-19 restrictions at the time, my husband wasn't allowed in with me until I progressed to a certain degree in my labor.Meagan: Wait, what? Melanie: Yeah. Meagan: Not at all until you progress to a certain point?Melanie: So around 7 centimeters, they were going to give him a call.Meagan: What was the difference of you being there at one point over the other?Melanie: Oh, it was tragic. So he waited in the car in the parking lot.Meagan: Oh, poor thing. Poor you. Melanie: So I was alone. And it was terrible. My contractions just came on so super fast because of the Cervadil. I started dilating really quickly and I thought, "Okay, they're going to get him in here. It's going to be okay." It Wasn't. I started to panic. I had not wanted an epidural, but I was obviously experiencing a lot of pain. They got the Cervadil out because of how I was reacting to it. The nurse asked if I wanted an epidural, and I said, "No, I'm okay for now. I'm coping." I waited a while longer, and I was still alone. They still hadn't called my husband, and I just couldn't do it alone anymore. The nurse talked me into the epidural, and I didn't want it, but I felt a little pressured. Yeah, pressured. That's the word. And again, in looking back on that, I recognize that a lot of the birthing people on the floor at that time were also alone. The nurses did what they could in those situations. But, yeah. I still hold a little bit of resentment, I guess, for those moments where I was my most vulnerable and by myself.Meagan: Yeah, understandably. That makes sense.Melanie: Yeah. So I got the epidural. My husband was allowed in shortly after, and things were still okay. I was still progressing fine. Then labor just stalled, which is the start of many stories. So we waited through the night. At some point, they started Pitocin. I was moving in all these ways. I should say that my doctor is a saint among humans. She's incredible. She was on with me all night. She did everything she could. She wasn't on when I first got admitted, but she came on later in the night, and she was phenomenal. She did everything she could to get things going again. And then her shift ended the next day, and somebody else came in. By that time, I had that pesky little cervical lip. My baby's head was OT. She couldn't make that last. I was 9 centimeters, but she couldn't get that last turn because of the tilt. I was swelling. There was meconium. Her heart rate was doing some wonky things, and off to the OR we went. I was okay with it initially.It felt like, "Okay, this is what happens." It was fine, really. I had a pleasant Cesarean experience. I wasn't nauseous. My husband was able to be there with me for the birth, and I had a lovely surgeon, so it was okay. I felt okay for the most part afterward.But again, because of the COVID-19 restrictions, my husband was only permitted to stay two hours after the birth. She was asked to leave and not allowed back until we were released. It was just me and my beautiful baby girl who was 8lbs, 9oz alone for 2.5 days after I was just recovering from major surgery.Meagan: Wow.Melanie: Those first few days were challenging. Breastfeeding was a disaster. A had terrible edema from all the fluids during the C-section. I was huge trying to breastfeed. I was just so puffed up. Everything was impossible. And again, because all the birthing people on the floor were without their partners, the nurses were run ragged. It was very difficult to receive care, to put it politely. I think honestly, a lot of the trauma that I have from that time came from my hospital stay afterward and how I was treated or how I felt kind of neglected and was again alone, in some of the most formative times of my motherhood experience. Meagan: Yeah. Melanie: So that was that really. That was my first birth. As the days progressed, and I got home and I just felt so defeated by and let down by how I was treated and not even how I was treated by people but by the situation. I mean, a lot of it was beyond anyone's control.Meagan: Yeah, that time, I have a lot of feelings. I was not a, mom birthing, but I was a doula supporting couples and saw a lot of really stupid stuff to say that didn't make sense at all. But everyone was so restricted and rules were changing literally by the day and even by the hour. Right?Melanie: Yeah.The hospital I gave birth that has since it kind of acknowledged that they took it a little too far. Laboring people shouldn't be alone. Who would have thought?Meagan: Women in labor should not feel deserted. Yeah.Meagan: So some of that was nice to hear but it was just a little too late for my own benefit. The more that all settled with me, and when we had our first baby, we didn't know down the road if we wanted more kids. I'm an only child. I love being an only child. So I thought, maybe a family of three is fine. But I remember sitting with my doctor at one of our follow-up appointments, and I just broke down by the whole experience and I was like, "I can't do that again. Regardless if I want to. I just can't." She was crushed by that. She just couldn't let me Live with that feeling. "If you don't want more kids, great. You don't. You do you. But that, that can't be how we leave you." So she recommended a therapist to me who has become one of the most dearest people in my life. She's also a doula. And all of her therapy practice focuses on birth trauma, infertility, infant loss, and things of that nature. She was a godsend once we decided that we were ready to have a second baby. I don't think I could have done any of the rest without her. So then moving on to my second birth, it took a while to come around to being ready for that. After that first experience, there was a lot of therapy and a lot of trying to recognize that what I went through wasn't my own fault.Meagan: Yes.Melanie: There was nothing. The choices I made and giving in to the epidural, that wasn't a moral failing on my part. Being alone wasn't that I was not deserving of care, it was just the situation of the time. So a lot of that took some time to reckon with. And then as I began, I knew right away that I was going to try for the VBAC.My doctor was, "Yeah, of course. If you want to 100%." She felt because I did labor so well once we finally got things going, she was pretty confident that things might go okay for me the second time. So she was a great support. But once I started looking into a lot of the VBAC literature in the VBAC world, there were so many pockets of it that I really struggled with. Some of the language around how we can prepare was really off-putting to me. It felt like if you know enough and if you do enough, you'll be okay. It just felt really focused on blaming people for whatever went wrong the first time, if you had known more, if you had advocated for yourself more, if you had breathed more or meditated more, things would have gone better. So I really tried to avoid some of that in preparing for my second birth. I was really focused on the things I could control. My doula/therapist/friend really helped me with a lot of that. A lot of what we focused on and preparing for that second baby was focusing on things that would be true regardless of how that birth happened.  I became really into this series of affirmations. That is not my thing. I'm not into that normally, but they became very treasured to me and still kind of are. I really prioritized creating ones for myself that would be true regardless of what happened. It wasn't about birthing my baby vaginally because that might not happen. I knew that going in. It was more about acknowledging that my body is strong and capable. That's true regardless of what happens. So those sort of sentiments really echoed through my whole pregnancy and leading up to the birth. For the most part, I had a pretty uneventful pregnancy except for the fact that in my 20-week anatomy scan ultrasound, they discovered that my placenta was low. It was partially covering my cervix. My doctor was great. She was like, "Yeah, don't worry about it. It'll move. We're not going to worry about that until we have to. That often happens. We're not going to let that slow us down right now".So that was fine. And then later in my third trimester, I was measuring gigantic. I'm a very small person. I'm barely 5 feet. I'm petite, and I grow big babies. I was measuring quite large. We re-screened for gestational diabetes. I had a weird borderline response. I was doing these funny diet things and trying to get that under control, but I was still measuring pretty large. But again, my doctor wasn't really discouraging about that. "I know people have big babies. The bony pelvis, it moves, don't worry about it." So I still felt pretty good, and I kind of loved the idea of tiny little me having this huge baby. it seemed like I'd be pretty proud of it. But I had to have a follow-up ultrasound to check on the placement of my placenta to see if it had moved enough. And it did. Fortunately, it seemed like it was in the clear. My doctor, who was lovely, indicated that this was not a growth scan. We were just checking the placenta. But of course, the maternal-fetal unit loved to check the size of that baby. So of course, he was huge. They were trying to really say, "Are you sure you still want to do this? Because he's going to be quite a large boy and all that." I mostly tuned that out. I was like, "Yeah, I know. No big deal. I know I can't do anything about that. That's not within my control at this point. I'm 32 weeks pregnant." We carried on as normal. At this point, I was going crazy. I was walking so much. I was seeing the chiropractor. I was doing prenatal yoga. I was curb-stepping everywhere. I lost my mind a little bit in terms of all the preparation I was trying to do trying to get everything right. I became super obsessed with the baby's positioning just knowing positioning had factored into my first birth. I don't think I lied on my right side for months. Basically, I was just really focused on trying to keep things where they should be. Get that baby low and in the right angle. It became a bit of an obsession, but also the thing I'd look back on in a really positive way. I got really good at feeling where he was trying to pick out a spine and what way he was facing. And in retrospect, it made me feel a lot closer to him than I had with my daughter in some ways when I was pregnant. I became very in tune to his movements.Meagan: Yeah.Melanie: So I look back on that and I'm thankful. But yeah. So things were fine. I was growing a big baby, but all seemed well. I felt like I had a great team who supported me and were progressing the way we wanted to. We kind of expected this baby would also be "late" just given my first was. So we kind of prepared for that. We talked about the ways we could induce if needed or how long I wanted to wait until an induction.At the hospital near me, it is standard of practice to be automatically booked for an induction one week past your due date. You get that letter in the mail regardless of whether you want it or not. So as my due date approached, I got that letter. I called my doctor. She canceled that. That was not our plan. We were going to wait and see. So she was great in terms of letting me make the call, I'll say. But at a week past, or I guess just a little over, I did have to have a biophysical. That was the condition which for me turning down the induction was to have the biophysical. And again, my doctor was great. She gave me the heads up that like, "It's pretty easy to fail these and you're 41+ weeks over too." So she was advocating for me that we were not going to jump the gun here. But it was the requirement of their unit to have that. So I went in for my biophysical at 41 and change. I can't remember the exact day. And lo and behold, we failed. I think we had a 6 out of 10. His heart rate didn't do the right things in the right order or whatever the scoring is. I can't recall. And he also didn't score for the seeing the breathing movements. I knew just from my own reading that a score of 6 was a gray area. I wasn't too worried about it. But the staff in the maternal field was like "Oh, well, you're having this baby today." I was like, "Well, no, I'm not. This is not my plan." I know they see the worst cases. That is their space, but I already had the conversation with my doctor so I felt pretty well-informed. I knew that I was not ready yet. I also knew that my doctor was on call that day.So I did go up to labor and delivery which is what they had recommended. She did another biophysical up there and then did a third non-stress test. I also failed the second biophysical but the non-stress test turned out okay. We needed some time, a bit of a walk, some water, and things seemed okay. So I went home and waited for another couple of days. At this point we were, we were really cooking. We were looking at 42 weeks. I did agree to have the induction on a Thursday. I was disappointed that we were going to have to have the induction. I forgot to mention this. I wasn't followed by an obstetrician during my pregnancy. I was with a family practice group. We don't have midwives in the area where I live, but we do have a family practice group who have delivery privileges but they can't perform Cesareans, obviously. So I was followed by this lovely GP who would have delivered had my babies been born vaginally. Because I had to transfer temporarily to the obstetrics unit for the induction, I knew I was going to  encounter some more pushback than I had faced to date with my current doctor because she was so lovely and supportive. I went in and prepared for that. And the OB on that day of my induction was quite-- I don't know how to put it politely. He was very blunt. I don't think he thought I was an overly smart person to be looking at 42 weeks still insisting on trying to have this very large baby vaginally. But to his credit, he respected my autonomy and was like, "Yeah, sure, we'll give it a shot. I think it's the wrong call, but it's your call to make." So I have a love/hate relationship with him to some extent. So they did another non-stress test and things looked okay. And then I think he left and a resident came in to start the induction. I was a little dilated, so they were going to try the Foley, which they had initially some trouble getting in. It was the worst pain I've ever been in that didn't compare it all to labor on my first. But that Foley was like, whew. As soon as the resident got it in, all hell broke loose. My husband was by my shoulder and just turned white as a ghost. The resident looks up and she's like, "I think that's a little more blood than we would expect." Meanwhile, I can just see it pouring onto her shoes. I'm just hemorrhaging. Meagan: Whoa. Melanie: I'm hemorrhaging. So she runs out. There's a nurse there trying to mop things up and I'm still holding whatever sort of contraption they used to hold the Foley in. The OB comes in with an ultrasound machine. They're, of course, fearing my placenta is beginning to rupture or whatever. So he's checking the ultrasound. The heart rate monitors plummet. The baby's heart rate drops into the 60s. The room fills with people and I'm petrified. I'm just shocked. The OB's trying to move me and trying to get the Foley out. It felt like an hour. I'm sure it was only a minute that the heart rate recovered, but the decision is made like, "We're going to the OR." They didn't know what the source of the bleeding was. I was still hemorrhaging. I asked the OB like, "Can I just talk to my husband for a minute?" And he said "No, we don't have time. We're going."So we go to the OR and it was really quick. It was so much faster than my first birth. I don't even think the terror really caught on to me until later when they finally gave me the baby and the OB ensured me, "Oh yeah, no. He wasn't without oxygen for any extent. He checked out okay. He's fine." And I'm not sure it hit me that that was ever in doubt that it could have gone a way that he wouldn't have been fine. So it was a lot. It was a lot. To say it wasn't what we were expected would be an understatement. To say I didn't get my VBAC was an understatement because it just became a conversation of so many greater things. Fortunately, my doctor happened to be in the hospital, and she took care of us. We only stayed there for a day. Fortunately, that was the main thing on my birth plan that regardless of what happened, to get me out of the hospital as quickly as possible. So we were released the next day. The baby was fine, and I was fine. We were all healthy. There was no great source of the bleeding outside of that they suspected that my placenta was still a little too low compared to how it showed on the scans from in my third trimester. So when they inserted the Foley, things shifted enough that it tore a teensy bit or something, and hence the blood, but not enough to cause damage to me or my son. But that, the proximity of my placenta to my cervix wasn't quite clear on that ultrasound in my third trimester. So, yeah, that's my birth story.Meagan: Oh my gosh. Oh, my gosh. You know, birth sometimes can unfold in those really wonky, unexpected ways. And like, I have questions too. Like, could they have torn your cervix from placing the Foley? Could the Foley have nicked your placenta if it was too low inside? Right? There are all of these questions, and we tend to go that way, wanting to know the answers, but sometimes we just don't know the answer. We've talked about this a long time ago in our radical acceptance. Julie and I did a radical acceptance episode, which if you haven't checked that episode our, I really highly suggest listeners check it out because sometimes there is not an answer. The answer is unknown and it will remain unknown. Sometimes not knowing the answer can consume us, and it can leave the trauma, the doubt, the fear, and all the feelings that come with. Sometimes that means we have to let it go. We're not getting the answer. We just not getting the answer. Letting it go helps us grow, helps us heal, helps us move on to that next stage.And when I say move on, I don't mean just ignore it, wipe it out, or it never happened. It's accepting that it happened. Accept that where we were then is where we were. We made the decisions we made with the information that we were given, and now we're moving on. You did the best thing you could do for your baby by saying, like, "Okay, yeah." And like you said, it didn't even happen or occur to you until later that, "Wait, my baby couldn't have been okay?" I'm sure that sat really heavily.Melanie: Oh, my gosh. Yeah, hugely. Right? It was. It all happened so quickly. There was so much blood. Again, you're on your back. You can't really see well, but when you see it just as when the resident leaves the room, and t's on her shoes. I'm not okay. There's a problem there right now, right? Yeah. And, you know, my son was big. He was 9 pounds, 15 ounces. I don't think his size had anything to do with this part of the conversation, but in my mind, I think I've somehow accepted that I think he was going to be born via Cesarean regardless of what happened in my first birth. My placenta was low right from the start. That was a known thing that I was going to deal with, C-section or not. I know there's obviously some evidence to show that the way placenta can attach can be influenced by previous C-section scars, of course. But, I think that's how I've been able to make peace with a lot of that. It was just always going to be this way for him. I don't know. Because I was empowered through some of the decisions I made, and because I felt genuinely supported by the people around me, except for maybe that kind of cranky OB besides him, it's much easier to come to terms with what happened. And in a lot of ways, even though, my second birth is the much scarier of the two situations, I don't have nearly as much trauma associated with it. It was a crappy birth. I'll be frank about it. But it is what it is. It was scary, but it's not what keeps me up at night sometimes still, like that first birth where I felt disempowered and disenfranchised and ignored and neglected. That is the lasting problem. While I've done a lot to overcome that, I think it just goes to show how we treat people in these moments can really have a lasting impact. It's not just about the physical pain, the physical trauma, and the health emergencies that cause trauma. It can be a lot of the emotional harm as well.Meagan: I love that you pointed that out and you mentioned this along the way with some of your prep you're like, "I am not the affirmation type. It's not my thing. I don't connect to it." But you did. I think affirmations are so powerful whether or not you are an affirmation person or not. I really think having those on your side can be impactful. Like you said, you're like, "I still kind of like, hold on to them and cherish them today."Melanie: I really do. I have a list of them on my notes app on my phone. They're the same ones. They were the ones I wrote when I was pregnant with my second baby. Sometimes when I'm having a bit of a bad day or when you see another one of those photos, like the people you referenced earlier who don't associate with the VBAC groups anymore, they don't see themselves every now and then, when a photo of a super strong, awesome person with their fist up in the air celebrating their VBAC. Some of those will just hit me the wrong way one day. I'll go back to those affirmations and remind myself that my body is strong and accomplished and whatever I need to hear that day. They do have a long-lasting impact. Another one that got me through a lot was, "I'm strong enough to face what comes." Whatever that is.Meagan: Strong enough to face what comes. I love that. Yeah.Melanie: Yeah, it's been a bit of a journey. My kids are 4 and 2 now. We're not sure if we're done.Meagan: Yeah.Melanie: But despite all of these experiences, I would still 100% go for another VBAC.Meagan: Yeah.So I was going to ask you that too. Do you feel at this point that you would rather just do Cesareans? Would you have said, "Looking back, I just wish I would have scheduled it at 40 weeks, or are you feeling pretty content and empowered with the choices that you made?"Melanie: That's a great question. I think about it a lot. I'm fairly positive I wouldn't have just scheduled the C-section. And partially because despite being alone for part of my labor with my first birth, I kind of loved labor. Before I got the epidural, I have never felt so strong and so awesome in my whole entire life. I was like, "I am woman. Hear me roar." Maybe that is just in retrospect, but I also have a couple of selfies from those few hours. I'm enjoying a lot of it. So when I was preparing for my second birth even knowing that maybe this will end up in a C-section, I kept thinking, "Oh, well, at least I'll get to labor again. I'll have that. That would be great." And I didn't. I didn't get any of that. I'm not turned away from that. I'd be very much open to trying again. I think if we were to have another, I would not do all the things I became so obsessed with making sure I was getting 12,000 steps or whatever it was, and the curb-walking and the squats. I did so many squats, and I ate so many dates. I would just let go of a lot of that because I think a lot of that was the pressure of, "You need to do everything you can to get this right." And I don't have that pressure on me anymore. Maybe because I'm older than I was then, or because I was maybe foolish. I think I know a little more, but I think I would just. Let's just try. Let's see what happens.Melanie: Yeah.Meagan: You know, I want to talk a little bit about that. You talked about how you did things that you could control, but then you also focused on how you went down that path of-- I call it obsession. The path of obsession.Melanie: It was.Meagan: I was once on the path of obsession as well with my second, my second that I wanted to VBAC that went Cesarean. I ate the dates. I drank the tea. I did all the things too, and then it didn't unfold exactly how I wanted it. I don't think the things that I did or the things that I didn't do, as far as the prep goes, really impacted as much as I didn't choose the right provider. But with my second, I let go of some of the things, but then hyper-obsessed with some of the other things. I didn't sit on a couch for nine months. I sat in a car really, really straight up paying attention to my sway back and my pelvis.But I did the things that I could control that felt right for me. I went to a chiropractor. That made me feel better. I was like, "All I can do is go and hope for the best. Right?" I drank my tea. I let go of the dates. I couldn't eat another date for a very long time. I do now. I actually add them to oatmeal and things, but I couldn't even stomach a date. There were things that I did and I didn't do. So try not to go down the path of obsession because I think sometimes it takes away from our pregnancy. Do all the things that you can do within your control that feel right. So eat well. Hydrate well. Get a good prenatal. Process your birth. Process your past birth. Know what you want. Hire a doula if you want to doula. Find your right supportive provider. But also, if it's too much and you need to be like, "You know what? I'm going to do what I can over here, and I'm just going to let it unfold over here," I don't think there's any shame in that. I don't think anyone should be like, "Well, but you're not doing x, y, z." Yeah, I'm not because right now it doesn't feel right. It doesn't feel right. Melanie: That's exactly right. I think I was just so afraid if my birth didn't go well, if I would think that, "Oh, there's something else I could have tried." That was, I think, my mindset in preparing for that second birth. But I'm glad you mentioned the feeling right because I did actually give up the acupuncture at 40 weeks because I hated it. I hated going. I didn't like the way it made me feel. It made me groggy. I felt like I was sleepwalking.Meagan: Not right.Melanie: Not right, but yes, letting that go. But again,  initially, I felt guilty for it. Almost like I'm not doing everything I could. But sometimes we need to let that go if it doesn't feel right for us.Meagan: Yeah, I agree.So really quickly, to wrap this up, we asked for a secret lesson, and then we asked for your tips. I wanted to read what you wrote. When I said, "What is a secret lesson or something no one really talks about that you wish that you would have known ahead of time when preparing for birth?" Your answer was, "Birth stays with you forever. It's not something you just move on from." Like we were just saying, it isn't. It's not just something that you move on from and you forget about it. It's just gone. It's not. It really does stick with you, and it can impact future births. So know that that's a thing, and you need to work through that if you have trauma. She says, "My first birth was nearly five years ago, and the trauma still barrels over her." Likewise, the pride that you feel and how you advocated for yourself during your second birth continuously gives you strength. So I love that secret lesson. I think it's very empowering.And then when I asked, "What is your best tip for someone preparing for VBAC?" There's a lot here, and I'm just going to read exactly what you wrote because so it's all so good. And you also kind of talked about it within your story, but I just wanted to write what you wrote. It says, "Preparing for a baby and birth is a mental, emotional and cognitive journey, not just physical. I did so much work with the support of a wonderful doctor, doula, therapist and partner that all helped me cope with this birth. I did chiropractic care, pelvic floor PT, acupuncture, yoga, massage, but it was the mental work and preparation that I did that really made the difference." And then you said, "If someone is into affirmations, find or create some that will be true regardless of whatever happens." Again, pointing out what you said earlier. I think it's important to note. Women of Strength, you can prep. You could do everything, and sometimes when I think we do everything and then they don't unfold exactly how we think, "We did everything. And it sucked. It failed me." It's not true. You did everything that felt right for you, and you have to embrace that and congratulate yourself for that and say, "I did what I could." But I love that you talked about the affirmations that can stay true. I love that so much. Your body is strong. No matter how you birth your baby, your body is strong. So, there's something that you did through therapy and healing that I would love to talk on before we go. Is there any way you could dive into that a little bit?Melanie: Yeah, sure. So it's a practice called birth story medicine. I'm not an expert in it by any means, but it is the train of schooling that my therapist, who's also a doula, specializes in with birthing people who have birth trauma. It's really a part of a birth story. Listening. So having someone reciprocate in the dialogue of your birth story, really similar to what goes on in this podcast in a lot of ways, where you are being heard when you tell your birth story. But through that process, over months and months of the telling and retelling of my birth story, particularly that first birth, my therapist was able to really help me get to a place of re-seeing it. That's when I began to re-see my role in that. It really centers around this idea that through discussion and through sharing, that can be the medicine we need to heal emotionally. So it's again, not always about those physical scars we're left with, but emotionally what we carry and giving value to those, having those be heard in a space where they're not often heard. When we go into a hospital or a birth center, we don't always create space or are not always given the space to have those feelings and that trauma heard. That birth story medicine approach really helped me re-see my experience for my first birth.I love that you talk about this. We actually have something similar in our VBAC course when it comes to mental and physical prep because I think that's honestly where our course starts as mental and physical prep. I truly believe that's where this journey starts. But I talk about the senses. So when we are processing our birth or going through this birth medicine journey, I suggest doing things where you write your birth story. Physically write it. Read it, so you're seeing it. So you're physically doing the action. Now you're seeing it and you're reading it. Okay? Read it out loud to someone so you're hearing it being said and someone else is hearing it. Receive validation. Okay?Really walk through those five senses because I truly believe that it helps you heal. But hearing it, seeing it, writing it, being validated. I guess it's not even the five senses. We can't smell our birth, but we talk about that like taking yourself back, putting yourself in that feeling, hearing those sounds, smelling the smells and processing those is so empowering. It's a little different, but kind of similar. I love it. I love that so much. Is it birth medicine? Is that what you're calling it?Melanie: Birth story medicine. I can't remember the woman who wrote the book quite literally, but I recommend everyone check it out.Meagan: We're going to find it, and put it in the show notes. Birth story medicine. Here we go.Okay, really quickly before we go, will you give us two or three affirmations that really stuck with you if you have them? If not, no worries.Melanie: Oh, sure. I still do. So one that I don't hold on to as much now, but it was really important to me leading up to that second birth, especially given my first was, "I am not responsible for starting labor when it starts." I tried, but I had to remind myself, "I am not responsible for starting labor." Another one was, "My baby will be born. I will birth my baby."Meagan: Yes.Melanie: However that happens, I will birth my baby. The final one may be that again, I think because of the trauma I had from my first birth during the pandemic was, "I am not alone. My baby is with me."Meagan: Love those so much.Melanie: Oh no, I'm very emotional.Meagan: I'm sorry. I did not mean to make you emotional, but I really thank you so much for all of those and for your words. I am so happy that you were able to come through on the other side of this experience with the mindset that you have. I know it's not easy. I know it hasn't been easy. The journey is really a journey and like you said, it sticks with you forever. I will never forget all three of my births.As of the day of this very recording, my daughter turned 13 yesterday. My first C-section was 13 years ago yesterday. Let me tell you, I reflected deeply. I had a lot of emotions. I cried. I smiled. I had so many feelings that it, literally makes me emotional thinking about it right now. But you guys, I was amazing back then. I didn't fail. I didn't fail. I think that's just so important that we know that no matter how our baby is born, we are going to be with our baby. Our babies will be with us, and we didn't fail. We did the best we could, and you were incredible.Melanie: Thanks, Meagan. You too. 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 VBAC Link
Episode 376 Chrissie's Healing CBA2C + Researching Birth Rights & Applying Them

The VBAC Link

Play Episode Listen Later Feb 5, 2025 38:50


Chrissie always dreamed that the birth of her babies would be the happiest days of her life. But with her first two births, they were among the worst. In today's episode, Chrissie expresses the heartbreak she felt after doing everything to prepare for a VBAC and not get it. Though she wasn't sure how her third birth would go, the healing, research, and advocacy she did made all the difference in her experience. She called the shots, listened to her intuition, and ultimately saved her baby's life by being so in tune with herself and her body. And finally, the birth of her third baby was the most beautiful, joyful, and happiest day. Coterie DiapersUse code VBAC20 at checkout for 20% off your first order of $40 or more.How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. We have a CBAC after two Cesareans story coming your way today. This is a story that we felt we should share because it is so important to document our CBAC stories as well. Even though there are a lot of things that are going to unfold within our guest, Chrissie's story, it's so important to see how much she has grown and healed over each experience. Listening to her, a few things came up in my mind as I was listening. It was intuition. We've said it for years, honestly since 2018 when this podcast began. Intuition is so powerful, and sometimes it's hard to turn into and understand what your intuition is or what fear is, but I challenge you right now to start tuning into that. When you're getting the feelings, is it your intuition? Really, really connect with that intuition because it is so powerful. Another thing that I felt was a big takeaway from her story was how much she researched and gained knowledge of her own rights and her own ability to say no or to say, “Not now, not yet. No, thank you.” Women of Strength, I know it's hard, and it's really hard when we're in labor. I know it. But you always have the right to say no. You can always say no. Chrissie really did such a good job at researching and educating herself and arming herself up with the knowledge that she needed to so she could confidently say no when she needed to but also confidently say, “Hey, this is something that needs to change,” and stand up for herself in that time. I do have a Review of the Week, so I want to jump into this, and then turn the time over to Chrissie. Okay, this review is hseller. Hseller, I think is how it is. It says, “Life-changing. I don't even know where to begin. This podcast has honestly been life-changing. I am currently 9 months postpartum after my first Cesarean birth, and I've already binged every episode. I honestly believe The VBAC Link should be a resource for every birthing person, not just VBAC, on how to prevent a Cesarean to begin with. This needs to be part of basic birth education.”Oh, girl. I am with you on this. I am with you on this. It says, “I have shared this podcast and the blog with every friend of mine who is expecting because I wish I would have known about it before my first birth. Listening to the podcast reminds me that I'm not alone in my experiences and that this is possible and to have an amazing, empowering birth is possible. Julie and Meagan deliver facts, stories, and inspiration in such a wonderful way. Hearing their voices when an episode comes on puts me in a happy place. My husband and I have already been talking about baby number two. I can't wait to share my next birth story because with an education and support I now have, I know it will be beautiful and healing regardless of the outcome.”Thank you so much, hseller, for your review. You guys, these reviews really do mean so much. It is now 2025, and we do need updated reviews. You never know. It may be read on the next podcast. We are switching things up this year with educational pieces and topics of reviews and things like that, so you never know. But please, please, please leave us a review. It means the world to us. Meagan: Okay, you guys, I'm seriously so excited. It's always so fun to have multiple people on the show and cohosts, but it's also really fun to have doulas sharing the story or listening to the story with their clients and giving their tidbits. So Chrissie, I'm going to turn the time over to you and then of course, Sarah will be hearing from you, I'm sure along the way as well.Chrissie: All right. Hi, I'm Chrissie. I live in Greenville, South Carolina and I'm going to tell you about my three birth stories. All VBACs and repeat Cesarean stories start with your first C-section. Julian was our first C-section.He was conceived during my husband and I's fourth month of dating. My husband and I both knew marriage and kids were our desire with each other almost instantly, but it was still crazy to think about how fast it happened. Everything was going fine until about 30 weeks when I started to be measuring about a week behind and was scheduled for a growth scan which we couldn't get into until about 32 weeks.During that scan, it was confirmed that Julian was measuring close to the lower 10th percentile and that I, from that point, would be scheduled for regular non-stress tests every week for the rest of the pregnancy. His check at 36 weeks was non-reactive which is not what they like to see. I was sent for a biophysical profile. He was graded so low that I was told to immediately go to labor and delivery and not eat or drink anything, which as a nurse, I know that means they were assuming I may have surgery in the very near future.I was planning to go to work right from my original appointment, so I reported to work, but then went right upstairs and burst into tears of fear. I was given fluid, and he woke up because of the scare. But because of the scare, I was scheduled for an induction at 39 weeks and because I didn't know any better, I was just excited to meet him a week early.On the day of my induction, I showed up bright and early, ready to get things going. I had done no preparation, assuming that my high pain tolerance and grit would serve me well. I wasn't against pain medication, but I was ready to test my limits. Julian passed the non-stress test, so they started Pitocin, and he was doing fine, so they decided to insert a Foley bulb to speed things up.When they inserted it, my water broke, so that kind of put me on the clock. Once I got to about 4 centimeters 12 hours later, I was somehow feeling discouraged and tired and asked for the epidural. My husband said as he was holding my hunched over body that a huge teardrop fell out of my eye as the needle went in and the zing sensation went down my leg.I, was already giving up, but had no idea what I was setting myself up for.Over the next four hours, Julian's heart rate would drop with every contraction while Pitocin was going. They would turn it off, and he would be fine. And then when they restarted it, he would have the non-reassuring heart tones again. I was not explained to why I needed to wear oxygen or keep flipping from side to side or what low heart tones meant. All I know is that at 1:00 AM, they called for a C-section because we were getting close to the 24-hour rupture of membranes.If I had known then what I have learned since then, I would have tried to steer my birth in so many different directions. Unfortunately, birthing people are not given this kind of information upfront, which is. Why I think The VBAC Link is so important for any pregnant person as it could potentially help 1 in 3 women who end up consenting to a C-section to this day. I was devastated. I never thought the dramatic push and bringing baby to my chest at long last was something that wouldn't happen for me, let alone I would mourn missing out on it. I was wheeled into the OR. My arms were strapped down to either side of me. My arms were shaking and pulling uncontrollably to the point that when my Julian was given to me, I was too scared to hold him thinking I would drop him since my arms felt like Jell-O. I've since learned that because my epidural was converted for the C-section that I would feel extremely unpleasant sensations of my innards being pushed and pulled out of my body. All I could think about was my dad saying, "It was the happiest day of my life when you were born," and somehow this was feeling like one of the worst days of my life. I felt a double loss. It took me a long time to get over feeling like a sham for not giving birth the real way, but on the table, they said we gave you a double stitch so you can VBAC the next time. Over the next five and a half years that became an overwhelming objective and purpose in my life. When Julian turned 1, I had my IUD removed. I still had not gotten my period back but was hopeful it would return soon since had started to wean him from breastfeeding. When it did return, it was not normal. I would be spotting for weeks afterward and had a strange dull pain on and off constantly. I was so desperate to get pregnant so that I could get my VBAC thinking that all the horrible feelings I was having would go away. Or so I thought.After what felt like the longest four months ever, I did conceive our daughter, Ellie. It was January 2020. To this day, there are so many songs, books, and kids' shows that I cannot watch because they remind me of the early days of the pandemic. My son and I both got flu A and flu B during the first three months of the year, and it was terrifying to be relieved by a positive flu test.As an ER nurse, I was put on furlough since no one was coming into the ER, and many of us were sent to New York City and hard-hit areas to help where help was needed. I had to tell my manager earlier than I would have liked that I was pregnant and scared to be around some of the symptomatic COVID patients because we did not know what would happen. Sometime in the spring when people couldn't stand quarantine anymore and were going out and socializing again, the patients in the ER spiked, and I went back to work at six months pregnant. Even though it was terrifying, I was glad to be out of the house with somewhere to go and have a purpose.Those winter and spring months were some of the most depressing and hardest to get through in my life up to that point. I spent a lot of the time doing all the things that you can do to achieve a VBAC. I took a mindful birthing course over Zoom because they weren't doing any in-person things at that point.I read several books, did Spinning Babies exercises, hired a doula, etc. The thought of finally getting my VBAC was at times my only motivator to get up and do the things some days, other than the bare minimum to keep my one-year-old and me alive as horrible as that sounds.When I reached 37 weeks, I went into quarantine, and the waiting game began. I walked miles and miles and practiced mindfulness techniques to get through the pain. I was scared that the epidural had led to my son being in distress. So by this point, Ellie had passed all of the extra growth scans. She was head down. Everything looked perfect. By 40 weeks and five days, I became extremely stressed out. I had an induction scheduled for 41 and three days that was making me so nervous. My husband and I attempted to speed things up, breaking my water in the process.As soon as I felt the gush of fluid, I felt my heart sink and was overcome with fear and regret. It was starting just like the first birth I did with the premature rupture of membranes and what I believed would be an inevitable cascade of interventions that would lead to a repeat C-section.The rupture occurred around 3:00 PM, and I decided I should try to rest and wait for things to ramp up. By 10:00 PM, things were regular but not painful. I decided to try and go to sleep, but because of my trauma from the first birth, I wanted to make sure that she wasn't having issues with deceleration. I got my stethoscope out and listened to her heart rate as I had done several times before that point. It sounded normal and I listened to it through a few contractions.Every time, I could hear her heart rate slow very noticeably. I didn't know what to do. I didn't want to go to the hospital because I knew what they would say. I didn't want to tell my husband because I knew he would want me to go to the hospital, but I was genuinely concerned for her. So I let my husband listen, and he started getting dressed immediately to go. I knew it was over.When you arrive at L&D, they ask for a reason for you being there. As a nurse, I knew what I was about to say was going to sound insane, but I said, "I think my baby is having distress. I heard her decelerations on my stethoscope at home."I could see the amusement in the triage nurse's eyes as I said this. But she said, "Okay, let's get you hooked up and see what's going on." Sure enough, she was already having category 2 decelerations, and I was only 1 centimeter dilated. The resident said that my contractions were only about 5 minutes apart, but that because of the decelerations, she would be admitting me right away.She said we could try fluids and some position changes, but it was looking like the C-section was going to be the only safe way to get her out since I was so far from 10 centimeters.Before she left the room, she said, "I know this is going to be very disappointing for you since you wanted to VBAC, but you may have saved your baby's life by coming in when you did. It's amazing that you knew to listen and could interpret what you heard."Long story short, nothing worked, and I was prepped for the C-section. My COVID test was negative, so my husband was going to be allowed to come into the OR. Tears were streaming down my face the whole way. I walked into the OR and sat myself on the table for the epidural. I was still in the clothes I had walked in wearing. That's how fast things were going. The epidural was placed, and they started prepping me after a few minutes. They still had the fetal monitor attached for some reason, and we heard her heart drop into the 70s and not come back up. I could hear the sense of urgency on the other side of the drape. And suddenly, I felt several sharp pricks across my abdomen. I was lying there with so many thoughts running through my head. But thankfully, one of those thoughts was, "I wonder why they just poked me like that. Oh, I guess they're checking to see if I was numb. Wait, I felt that."I yelled, "Wait, I felt that."And they were like, "What? Was it dull or sharp?" I yelled, "It was sharp." They poked me again and again, and I kept saying, "It's sharp." We could all hear her heart rate in the background getting slower and slower, and I yelled, "Just put me out. Just put me out."The pre-oxygenation mask went right onto my face, and the last thing I heard before I went out was, "Someone page the STAB team," which is the group of medical providers they call when they're assuming that a newborn is not going to be doing well. I woke up in a daze when I realized where I was and what had happened. I burst into tears again and asked, "Is she okay?"And she was perfect.They actually said she was screaming before they even pulled her out of me fully. Very strong and healthy baby Ellie. But another day that was supposed to be the happiest day of my life which instead was a day even worse than my first birth. I felt completely defeated, hating myself for all the time, effort, money, worry, hope, and mind space that I had put into something that I still didn't get. A few minutes after I woke up, the surgeon came up to me and said, "Your original scar did not heal right. It was defective, and because of the urgency of the situation, we had to cut through a higher area of your uterus so we wouldn't accidentally cut any arteries because the anatomy was obscured by the first scar. We realized while repairing the uterus that it was in the contractile tissue, and you will never be allowed to VBAC again."I didn't really care because I thought we were done having kids, or so I thought. But it made me feel really bad about myself hearing the words "defective", "obscure anatomy" and "not allowed" hung with me for a long time. I wanted to get out of that hospital as soon as I could. All I could think about was my failure and how all the feelings that were supposed to be fixed by this birth were only made worse at my follow- up appointments. At the 6-week check and the 12-week for IUD insertion, I had to actually be let out the back door both times so that the people in the waiting room wouldn't see me hysterically crying. I honestly didn't even want to go to these follow-up appointments because they just further cemented to me that I had failed. And I'm not someone who can be told that I can't. Even though I was for sure believing we were done having kids, I joined the Special Scars group on Facebook just to see if anyone had had a similar scar as mine.I didn't think we would have more kids, but I still wanted to know if I could. Unfortunately, over the past few years, I've only spoken with one other woman who had a similar scar as mine. The fact that it was so uncommon made me hate it even more because I couldn't find any answers about what it meant for me. I did seek counseling following these events, and eventually, I felt better but I still thought about what happened daily and could not stand to hear anything related to birth.Several months later, I started having pelvic pains. I went to be evaluated for an ovarian cyst, but when they didn't find one, they did see how crazy my first scar had healed. Because of the pain, they had agreed to do an exploratory laparotomy surgery to repair the scar thinking it could be the source of my pain and definitely a reason for the spotting I'd had between cycles. During the surgery, they found a large surgical hernia as well that they had to remove momentum from and recommended surgery to fix it in the future. Whatever the reason for the pain was the scar or the hernia, my pain was gone following the surgery and two weeks later we moved to Greenville, South Carolina. Everything seemed fine.Trying to settle into a new house that needs lots of fixing up with a one and a three-year-old takes time. I knew I didn't have an IUD in at that time, but my period hadn't come back yet since my one-year-old would not take to the weaning and I was still nursing her. I wasn't that worried.In August, my period did come back, and I decided to use ovulation strips to see how long after ovulating I was spotting to see if I could figure out if my cycles were in the normal range again. Strangely, the first strip showed up very dark along with the next several strips I tried and I was like, "Oh great, things are out-of-whack still." But that's when I remembered people sometimes interpreting ovulation strips for pregnancy since LH and HCG are such similar-shaped molecules. I decided to use one of the pregnancy strips that comes with the ovulation pack and sure enough, it was also darkly positive. I was inexplicably excited, and I sheepishly told my husband who was also very excited. We went to our eight-week appointment, and there was nothing on the ultrasound. My HCG was high, but the progesterone was low and they called it a blighted ovum. I eventually did pass whatever was in there. This left my husband and I with a new resolve to a third child and crossed the bridge of a third C-section when we got there. I started listening to The VBAC Link again-- something I had to erase from my memory in the past as it was another reminder of my failure to VBAC and not getting to submit my story of healing and success. There was an episode I got to where I really liked what one of the guests was saying. She was a doula named Sarah, and believe it or not, she was based out of Greenville.I knew that if we conceived again, she would be my doula.A year later, after a chemical pregnancy and a loss at 10 weeks, we conceived our second daughter, Leah. I had established care with the midwifery practice for the first few months until they saw my surgical records and transferred me to the OB practice across the street. Additionally, because I was 37 years old at this point, I was sent to maternal-fetal medicine for my 20-week anatomy scan to double-check that everything was looking normal, which it was.At my first appointment with the OB group, the doctor sat down across from me and said, "Well, your anatomy scan looks great. We will also do a growth scan at 32 weeks and 36 weeks because of your previous history of IUGR."And I said, "Sure, that's fine."He went on to say, "So you understand why the midwives transferred your care to us and that you're not allowed to have a vaginal birth, right?" By this point, I'd done some research on my birth rights, special scars, and hospital regulations, and answered calmly, "Actually, you can't tell me I'm not allowed to let something happen on its own. You're not allowed to force me to have a surgery that I do not consent to."He responded, "Well, I'm not sure anyone in this practice or any practice would be comfortable allowing you to VBAC."And I said, "Well, I'm not comfortable just going straight for a C-section at 36 weeks and not at least seeing how things go." I left the appointment pretty upset and even more determined to decide my own fate. As the appointments went by, each OB would say, "You understand that we would like you to schedule a C-section?"And I said, "Yes, but I'm not ready to make that decision yet. I'm still doing my research. What I have found is that the highest estimated rate of rupture after a classical scar is around 15%, but other studies estimate it to be much lower. Additionally, some studies don't distinguish between true rupture and dehiscence. Furthermore, most ruptures are not catastrophic, meaning loss of life, permanent disability, hysterectomy, and so on. Only about 2% of ruptures end this way, and they're often caught through monitoring or other symptoms before they can progress to anything beyond the risks of a typical C-section." Having done this research on my own, I became more confident in my decision to continue on the path of letting my body decide what it was going to do. Sarah, my doula, gave me more confidence. I had told her everything that had happened in my past and she said I had valid feelings and thoughts, and had made logical decisions based on my research.She sent me along her usual workbooks and resources for creating a birth plan, birthing positions, pain management, Spinning Babies, tea dates, etc. I told her I appreciated it, but I'm not going to do those things. I had done all those things and more and that had ended up being one of the hardest parts of my first repeat C-section having realized it made no difference at all. The last thing I wanted to do was spend time trying to be mindful and stretching instead of being mindful with my kids and family who were already there.This ended up being a decision I was very thankful to have made and Sarah was on board and fully understood my reasoning.Weeks went by. At every appointment, the OB would say, "It looks like you've been counseled on this before, and there's no need to go over everything again. Are you ready to schedule your C-section yet?" And I would say, "No, not yet."Looking back, they really didn't go over anything with me. All they said was because of my special scar and lower segment surgery, I was too high risk and not allowed to VBAC.I had done my own research and there are no actual numbers on a high transverse scar which is just above the lower segment, in the upper segment, or on the lower segment scar resection, which is what they classified my surgery as. I feel it's important to get these numbers as C-section rates continue to rise, more versions of special scars will occur and more people could possibly end up with scar revision surgeries before they're done growing their family.At my 37-week appointment, with some encouragement from Sarah, I finally got an OB who would talk to me about my options. She said, "I know we can't make you have surgery that you don't want. You're right. You're in a gray area. We don't really know the numbers for your kind of situation. I think it's reasonable for you to see what happens. If you show up in labor, we will admit you." And I was overcome with relief. Finally, someone was being honest with me. She knew I had done all my research and was overly informed of my rights. I told her that I just didn't want to be harassed or threatened if I came in because that would discourage me from coming in when I would have liked to which is right when labor started. She said I could come in as soon as I thought anything was going on and I would be treated with respect. Circling back to what I learned about EMTALA, the Emergency Medical Treatment and Labor Act, it basically says if a hospital wants to receive reimbursement from Medicare patients, they may not turn away anyone seeking treatment regardless of their citizenship, legal status, or ability to pay.If a pregnant person arrives in active labor, they must be treated until the delivery is complete or a qualified medical personnel identifies that she's experiencing false labor.Furthermore, the person in labor can only be transferred if there's a hospital that can offer a higher level of care. The hospital I was going to was equipped to deliver VBAC and had a NICU. So I knew they were equipped to handle uterine ruptures, which they do about once a month, I've learned.I did agree to schedule a repeat C-section at 40 weeks and four days. At 40 weeks and one day, I got anxious and tried a half dose of what's recommended for kickstarting things with castor oil. It definitely kickstarted some things, and within about six hours, I was having contractions every four minutes.About two hours later, I was getting anxious to go to the hospital because they just didn't feel right. I felt them from my belly button down, and they didn't feel the same way. I remembered with the Pitocin, they weren't really crampy. They're more burning and sharp. I suddenly started feeling an urgency to get to the hospital so they could do the C-section. I texted Sarah to say, "We're going, but don't worry about coming just yet." My answer for why I had come to the L&D department was painful contractions. I already couldn't talk through them. I was hooked up to the monitors, and we could see that Leah was already having Cat 2 borderline Cat 3 decelerations.It's determined by how much the heart rate drops as a percentage of the baseline heart rate when not in a contraction. We tried some position changes, but I had already felt at peace with the idea of going back for a C-section, and my intuition told me it was time. I was extremely nervous to be strapped down, shaking uncontrollably, and not being able to enjoy my baby again.To my surprise, the spinal worked amazingly. I was calm, my husband was next to me, and I got to make all the decisions. I didn't feel pulling or pressure or tugging at all. It was the first time that I got to cry tears of joy after seeing my baby for the first time. I was informed that I'd had a small rupture and I had a very thin lower segment-like tissue about halfway up my uterus, which is not normal. I ruptured. It wasn't a big deal. We caught it. I knew something was wrong, and I had made the decisions that healed me, and I got my baby here safely. After my second was born, I remember sadly walking around our neighborhood, lost in the thought that I'd met all the important people in my life already and something was not sitting right with that. Never would I have ever imagined that a third C-section would heal everything.What I want people to take from my story is that you have to accept that you might not get your VBAC and work that into the process of attempting a VBAC. You can't put all your eggs in one basket for working towards that VBAC and ignoring the basket that needs some attention in case it doesn't happen.Making your own decisions and being confident in your reasoning makes all the difference. Yes, I did have a third C-section, but I know there's nothing I could have possibly done any differently that would have changed the outcome. I encourage people to do their own research, not just on rupture rates but on birth rights and patient rights.You cannot let your provider decide for you what they think is best for most patients because you're an individual and sometimes there isn't a perfect box to put you in.Your fate should not be determined by a doctor wanting to check a certain box and use that to make decisions that make themselves feel comfortable.Of course, ideally, you can find a supportive provider, but if you cannot, that does not mean that you can't call all the shots. You may rupture it, but it's not always, in fact, not usually some dramatic event. My most dramatic birth was before my special scar and surgery. So keep an open mind. Use the knowledge that you gained to instill confidence in yourself. Not getting your VBAC as a disappointment, but if you go in with the right mindset, it can be beautiful and meeting my third daughter was finally the happiest day of my life.Meagan: Oh, my goodness. I love hearing that. That whole end, I just closed my eyes and can hear you speak. And I was like, yes, all of these things are so, true. And I love that you point out that yes, you had a third C-section. Was it what you wanted in the beginning? Would you have wanted a vaginal birth? I'm sure you did. But, this is what I felt and you followed your intuition yet again. I feel like, along the story, but all stories of, intuition, intuition, intuition. And then hearing that you can have a healing experience. I think that is so important to point out that it can be healing. It can be absolutely healing. And I love that it was for you. I love that you were able to have your husband there and look back and be like, "No, I'm amazing." And you should be really proud of all the work you did, all the research you did advocating for yourself. It's not very easy to advocate for yourself. And I love the message that you gave to the other Women of Strength. Like, learn and advocate for yourself. Know the patient's rights.Chrissie: Yeah. Sarah: I think that's what was so unique and so awesome about your story, Chrissie, because even from  us starting to work together from the beginning, you just knew what you wanted, and you weren't afraid to say that. And you told me kind of like, "Hey, look, this is fine." Like you said, I gave you my packet and all of my welcome stuff for my normal clients. And you were like, "Look, I've done this before, and I know exactly what I want, and I know how I want to go forward with this birth." You were just so empowered and confident on your own, and I was just so excited to be along with you. And obviously, like, every birth doula wants to be there for the physical birth, but we also have to listen to our clients and respect their choices and decisions. When you were like, "Hey, we're going to the hospital, but don't come yet," it's hard to hear that. I was like, "Okay," but you knew exactly where you stood and what you want it. And, you know, I think that's just really awesome and amazing to have clients like you who are totally aware of, like Meagan was saying, your intuition and how you were feeling. So, you know, I think you have such an empowering story, and our stories can really go a long way, and you're gonna be that voice for people who are feeling so similar.Yeah, absolutely. It's hard to hear sometimes. Cause you're like, "That sounds so amazing. I would want to do that, but it can't." I think that's how a lot of people think. "Oh, that's good. She must have a strong personality." You don't have to have a strong personality to stand up and advocate for yourself in a lot of ways. I think a lot of it stemmed from you being informed along the way. You were informed. You knew your rights, you knew the evidence along things. I mean, here you are talking about them, and that's super important. It comes down with that education, because I do feel like the education is what helps us feel empowered enough to stand up and say what we do and don't want.Chrissie: I really don't have a strong personality at all. I was always very intimidated, trying to pump myself up for the next week of whatever week it was, visiting the OB practice, like, "Oh God, who am I going to see today?" But I just approached it with full knowledge of everything that's out there, as far as I know, because I've been researching it for a long time and just knowing my rights, I guess, I know that they know what they can and can't do to me.You can't force someone to have surgery if they're not ready for it. A C-section is a major surgery so I just knew to stand my ground in a polite and respectful way. Eventually, at the end of the wire, someone stood up for me in the practice, and I was very grateful for her because she gave me the last final push I needed to just wait for things to happen.Meagan: Yeah. Yeah. Well, you should be so proud of yourself and I'm so happy for you.And how was this postpartum? How's it been?Chrissie: It's been like, nothing.I mean, I have a third newborn, but I don't for some reason with me, subsequent C-sections, the debilitating pain is not there from what I experienced with the first one. I don't know if there are just so many nerve endings that are not there anymore or I don't know why. It's been super busy. So I don't even have time to think about what could have been or any feeling or thoughts. Thoughts about how I wish I could be feeling differently. But, yeah, very busy with the third and just so happy to have her with us today.Well, I'm so happy for you. Congratulations. I'm glad that even though you maybe didn't have Sarah during your birth, you had her along the way because I truly do feel like having that sounding board in that doula and that support along pregnancy can really impact and motivate people to learn how to trust that intuition and learn what they need to do and what's right for them.Chrissie: Yes, and she's actually helped me since birth because I didn't ask her to come during it. She has come and hung out with my kids and me so I could do certain errands or tasks. Our kids are actually obsessed with each other now, so it's kind of nice. Yeah.Sarah: Yeah. We bonded even more postpartum and now our daughters are movie night buddies, and they all like to play together.Meagan: That is so fun. I love hearing that. That is something that I tell my clients when they hire me. I'm like, "Hey, listen, you do not have to be my best friend, but I want you to know that I'm your lifelong friend." I feel like that just right there sums it up. Like, really. No, not everybody's going to be having their kids play together but I love that relationships can form and create in this manner.Sarah: Yeah. Yeah.Meagan: Okay, you too. Well, thank you again so much for being with us today.Chrissie: Thanks for picking my story.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Birth As We Know It
78-Mariela Guerra-3 Births-Cesareans-NICU-PMAD-Twins-Breast Cancer Diagnosis-ZacarÍas, Serafina & Magdalena

Birth As We Know It

Play Episode Listen Later Feb 5, 2025 88:14 Transcription Available


Send Kiona a Text Message!Mariela expected to have one child and be done. Little did she know that getting pregnant for a second time unexpectedly 9 years later would lead her to twins and a breast cancer diagnosis. Tune in to this episode to hear Mariela talk about her journey of discovering she was pregnant with twins, that she had breast cancer as well as discussing the importance of mental health. birthasweknowitpodcast.com/78 Disclaimer: This podcast is intended for educational purposes only with no intention of giving or replacing any medical advice. I, Kiona Nessenbaum, am not a licensed medical professional. All advice that is given on the podcast is from the personal experience of the storytellers. All medical or health-related questions should be directed to your licensed provider.  For another story about a twin birth for a second pregnancy tune into episode 64-Melissa Llarena-3 Vaginal Births-Twins-Gabriel, Noah & Nicholas.Resources:Perinatal Support of Washington: https://perinatalsupport.org/ Postpartum Support International: https://www.postpartum.netBreast Cancer During Pregnancy Hope for Two: The Pregnant with Cancer Network  Definitions:Identical vs Fraternal TwinsOvary Removal Pregnancy at Age 35 or Older/Advanced Maternal Age (AMA)Cold Capping 4min Podcast (English)Welcome to 4minEN – the English version of a multilingual podcast that delivers the...Listen on: Apple Podcasts SpotifySupport the showThank you so much for tuning in to this episode! If you like this podcast, don't hesitate to share it and leave a review so it can bring the podcast to the attention of others. If you want to share your own birth story or experience on the Birth As We Know It™️ Podcast, head over to https://birthasweknowitpodcast.com/ or fill out this Guest Request Form. Support the podcast and become a part of the BAWKI™️ Community by becoming a Patron on the Birth As We Know It Patreon Page! And don't forget to join in on the fun in the Private Facebook Group!

The VBAC Link
Episode 373 Brielle's VBAC Homebirth Transfer in the Dominican Republic + Tools to Prepare for Birth

The VBAC Link

Play Episode Listen Later Jan 27, 2025 54:12


Brielle Brasil is a mama's coach, breathwork facilitator, and somatic trauma resolution therapist. She shares her two birth stories as a foreigner living in the Dominican Republic. Brielle's first birth was an unexpected, traumatic C-section. After putting in the work to heal, Brielle felt ready to explore birth options that she thought were unattainable. She was creative and intuitive throughout the entire process.Julie and Brielle also dive deeper into how trauma is stored in the body, how somatic trauma resolution can help, and why it's important not to try to heal trauma on your own.How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Julie: All right, Women of Strength. You are listening to The VBAC Link Podcast. This is Julie and I am here with a very special guest today, Brielle. I am really excited to hear her stories. She gave birth in the Dominican Republic twice, both her C-section and her VBAC. We were just talking about that because my previous guest who I just recorded with in episode 370 also lived in the Dominican Republic. She had her babies back in the States. She flew back to the States. It was just such a coincidence. I am mind-blown. What are the chances?Brielle: So wild. Julie: I know. Brielle had both of her babies there. I'm so excited to hear about her stories and her experience, but before we do that, I am going to read a Review of the Week that Meagan texted me this morning if I can find it in all of our text messages. Okay, here it is. This review is on Apple Podcasts from janaerachelle. She says, “I am so happy I found this incredible podcast. After having two prior C-sections, I was convinced I would have to have another C-section for my birth this November. I feel empowered, educated, and hopeful I can do this. Thank you for all of the true facts in a safe space where we can all talk about our birth trauma in a space where we don't sound ‘crazy' for doing something that God created our bodies to do.” I love that so much. I think that the birth world is so interesting in lots of different ways and lots of different things. It can be incredibly wild to desire something that can be considered outside of the box. I'm glad that VBAC is becoming more and more common and that we are talking about it more. Sometimes, when I'm so deep in this VBAC world, it can be easy to forget that some people think it is the wildest thing ever. Brielle: Yeah. Absolutely. People in the Dominican Republic for sure fall into that box of, “What? You can actually have a baby vaginally after having a C-section?” People didn't know that was an option.Julie: Yeah. People just don't know. All right, let's get to it. I am so excited to hear your stories. I am really on the edge of my seat right now. Before I have you get into those, I'm just going to introduce you a little bit. This is Brielle. She is a Mama's Coach, breathwork facilitator, and somatic trauma resolution therapist. She helps postpartum and pregnant women heal from their previous birth trauma, forgive themslves, their bodies, their babies, and their previous team so they can go into their next birth confident, free, and in tune with their motherly intuition fully trusting themselves, their bodies, their babies, and birth.I have lots to say about this, but I'm going to wait until the end because I don't want to start going off on too many tangents too soon. But I'm excited. I want to hear more. We will definitely talk about that after the birth stories, and I'm super excited. She lives in Virginia, and we are both commiserating about how things are shifting to the chilly side of the weather today, but I am going to sit here cozy in my blanket while I am listening to Brielle's stories giving birth in the Dominican Republic. Go ahead, Brielle. Take it away, and I am excited to hear. Brielle: Awesome. Well, first of all, thank you so much for having me on here. It's such an honor, and it feels really surreal because I listened to this podcast a ton during my second pregnancy. Yes. I am not Dominican. I am American, and I was a foreigner having both of my babies in a foreign country. As you mentioned about the woman you recorded with earlier, most foreigners who are in the Dominican Republic don't have their babies in the Dominican Republic. I was part of an international community, and my husband was an international teacher. It was just assumed that if you are not Dominican, you are going to go back to wherever your home country was to give birth. Right after that, the fact that I was deciding both pregnancies to give birth there because the most important person for me to have at my birth was my husband and the only way to have him at my birth, because it wasn't a summer baby and he was a teacher. It was an April baby, and then a May baby the next time. The only way to have him there was to have our babies i the Dominican Republic. I'll just start off with the first birth. I went into it very fearful having a baby abroad where the language spoken is not my first language. Spanish is not my first language. It was fearful solely for the fact that I was doing it in a foreign country not even really realizing the fears that I had around birth itself until later. I found a doula, and I really liked her. I didn't know much about the OB/GYNs there. She had recommended a couple of them to me and the one that she had used for her births which were all Cesareans, but she said he was a great doctor and he spoke English fluently. I went to him. I stuck with him. Right away, I didn't feel anything initially wrong. He was very knowledgeable. He was up to date on what seemed like a lot of research. But then as things would progress, he would start to question me asking questions to him which was odd, but at the same time, I was like, “Well, he's fluent in English. I feel comfortable in that regard. My doula recommended him.” It was my first time doing this, I was just going to stick with him. Then at about 37-38 weeks pregnant, I started to get the real red flags. Red flags as in him starting to talk about induction already and I'm only 37-38 weeks pregnant. At that point, I just felt like, “Well, okay.” It was clear to me that these were red flags, but I also felt like I didn't have another option. I felt like at that point I was too far along. It was too late in the game. I had seen him my whole pregnancy. I just needed to stay with him. I had prodromal labor for about a week. During that week, this was weeks 39-40. During that week, I went into that office every other day. It was a lot. We were just a little bit obsessive over the time and the clock and everything. I went in several times. I got three membrane sweeps which were all pretty painful. We were trying to “get things to start naturally” and as natural as possible. I know membrane sweeps aren't really, but we were trying to help things along because I was having that prodromal labor. I would have contractions for hours, and they would stop for hours. Also, my husband and I were trying to have things happen naturally as well, so we were having a lot of sex that last week around the clock. Somewhere, I think, from probably the amount of sex we were having and making sure to go to the bathroom right after, I ended up getting a UTI. I think it was the day before my due date when I started to get sick. I started to get a fever. I started to get a high fever. My husband was like, “We need to go into the doctor.” I didn't want to because I was fearful of knowing what he was going to say. At that point, I didn't feel like I trusted him because of the red flags that were coming up. I begged my husband, “Let's not go. Let's see if it goes away.” We waited 24 hours, and it didn't. He was like, “I don't feel comfortable.” I was like, “I get it. Okay, we'll go.” We went in. Of course, they checked the baby's heart rate which was a little bit high. I just felt pretty much like shit. The fever kept coming and going. Because I had the contractions going on and off, he was like, “We need to get labor underway.” They didn't know yet it was a UTI. They were like, “We need to test and see why you're sick and run labs.” He was like, “I recommend that you go to the hospital and get induced. We will run all of the tests.”He was afraid I had COVID actually, but it wasn't that. He was like, “We just need to run the tests, get you induced, and get this thing going on because that shouldn't be happening.” I didn't know anything about prodromal labor or any of that. I was scared. I was in a foreign country. I just wanted my baby to be healthy. I was like, “Okay, yeah. Let's go.” We all went. I got induced that morning. Looking back on it and having done the healing work I did, I can see that I just wasn't ready. My body wasn't fully ready yet. My baby wasn't ready yet. It was just a rushed timing scenario because I got induced that morning. They did the test. They found that I had a UTI, so they were treating me with antibiotics while pumping me with Pitocin. On and off all day long, my fever would go away, then it would come back, then it would go away, and then it would come back. I would pick up contractions and be in labor. That was hard to deal with when I was sick. I felt zero energy hardly at that point being sick. That was at 9:00 in the morning. I got induced. It went on and off all day. The contractions were doing the same thing all day. They would pick up for a few hours, then they would stop for a long while. What was interesting, I noticed, is that every time my doctor would come into the room to check me, my contractions would completely stop around him. Looking back, I can tell I didn't feel safe with him. I just had past trauma with males. I shouldn't have ever had a male provider personally. I could tell those things in hindsight, but it was just all happening. By the end of the day in the evening, he was like, “You haven't made any progression dilation-wise. The baby's heart rate's really high, so I suggest we go into a C-section.” My husband and I were just like, “Yeah.” Like I said, we wanted our baby to be healthy. We were fearful. We went into C-section, and we had him. I was just numb through the whole experience because I had really desired everything of my first birth to be natural. I actually wanted a home birth my first go around, but I thought it was illegal in the DR because I didn't know there were any midwives. There were no birthing centers in the DR. Nobody I had ever talked to had ever had a home birth in the DR, and I was actually told, and my doula actually thought home birth was illegal because it was so, so, so, so rare in the DR. I was just under the impression that it was illegal, so I didn't plan a home birth. But I tried to plan a hospital birth that would hopefully be as natural as possible. Instead, I got the opposite. I had a lot of the cascade of interventions that I didn't want to have at all. I wanted things to happen spontaneously and to have minimal time in the hospital. I wanted that skin-to-skin right after, and my baby was taken away from me right after he was born which was very traumatic. I had to work really hard to heal all of that. But nonetheless, he was born. He had pooped himself inside of my womb, so there was meconium there. They told me that his cord was wrapped in a way that he couldn't progress, and that's why I wasn't dilating and he wasn't descending. It's like they tried to give me some reasons why that was the right way. It's not that I don't believe that, but in hindsight and after a lot of the healing work I did, I can see why everything went down the path it did because I felt rushed at the end of the day. I felt like that word “induction” was being thrown around so much and I didn't want that. I had to take matters into my own hands and try to do all of the “natural” inductions. Also, at the end of the day, my son was born the week before Semana Fante in the Dominican Republic which is Holy Week which is a huge, huge holiday week, so I did also find out that some of the members of the birth team had plans for Easter week and travel plans, so I knew that there was a bit of a rush from that end which made me feel rushed and just made the whole process one that I needed to heal from in big, big ways. So after I had my son, postpartum was really, really hard. Breastfeeding was hard. Everything was hard. I realize everything was so hard not only because I was a new mom and didn't have the support I needed, but because my birth was incredibly traumatic– and I didn't think of it that way at first because I was like, “My son is born. He is healthy.” But then 6 months after I had my son, I was still having physical pain at my scar site. I got it checked out. Nothing medically or physically was wrong with it, but what I know being in the line of trauma work that I do is that our body holds trauma, and everything is connected physically and emotionally within our bodies and within ourselves. About 6 months after I had him, I was still having that pain. I decided to work on my birth trauma. I worked on it from all different levels. I worked on it from the physical level. I started seeing an osteopath who I worked with for the next several months. Within a matter of weeks, a lot of the pain was gone. I also started working on it with a traumatic somatic trauma coach who is also a birth attendant. I found her because she was in the same trauma certification group that I went through. I worked with her for 6 months to heal everything from that birth and all of the trauma that it caused to forgive myself, to forgive my baby, to forgive my team, to feel safe again in my body, to feel at peace, to feel at home in my body, to connect back to my body, to connect to my baby, and just a number of things that we did together somatically and through breathwork to really peel back all of the layers of my birth, and not just my birth, but all of the births that came before me in my lineage to heal and heal deeply. It was a big, big work that we did together. It was not a small undertaking, but I will say that I feel. I feel that the work that I did to heal my first birth spiritually, emotionally, mentally, and physically was the best catalyst I could have had on my side for my next pregnancy and my next birth. So I got pregnant in August of 2022, or sorry, 2023. It's interesting because I had thought about home birth the first time, and because of the timing, we were again going to have our baby in the DR. Is home birth a thing there? Sure enough, you put it out in the universe, and I started to meet people who were having home birth, mostly foreigners who were having home births in the DR. I think three, which was huge because before, I had not even heard of it. I was like, “​​Wow, okay. This is happening here. This is allowed here. This is legal here. What are you guys doing? What are you guys going through?” I started getting the right contacts of the right people and found out that there is a midwife in Fountaindomingo, one. I met with her. I was so excited because I was like, “​​This is great. She gets to be my midwife.” Then she told me that her dad was sick at the time, and she was going to be helping him. She told me, “I'm not going to be working during the time of your due date.” I was like, “​​Okay, so we just need to look at other options.” Right off the bat, everything I did for my second pregnancy was a 360 from my first one. With my first one, I was like, “Okay, it's this one guy. It has to be.” I was very narrow because I was scared.With the second one, I was like, “​​Okay, it's not her. I'm going to keep my options open. I'm going to keep my mind open. We'll find someone.” My husband just did a Google search of traveling midwives in the US. We had a call with my midwife, Brittany, who is from Texas. Right after the Zoom call, I looked at my husband. I was crying because I felt such a connection with her. I was like, “​​She's it. She's the person who has to be at my birth. I feel so safe with her. I feel so seen and supported. She's everything I would look for in someone to deliver my baby. She's both nurturing and has a calming presence, but she's also direct and not going to sugarcoat things. I need a beautiful blend of both.” I was really excited. We ended up signing a contract with her, and in the meantime, I got my prenatal care from an OB/GYN office throughout my pregnancy, and of course, to have a backup option in place. I switched OB/GYNs three times this pregnancy, and the last time I switched, I think, was as late as 32 weeks pregnant. I had been with the second gal. The first two OB/GYNs I was with– they were all women– were from recommendations from the midwife who wouldn't be working during my birth. She had recommended the first two. The first one, I loved, but she wasn't fluent in English, so neither one of us felt comfortable in terms of communication and being able to fully communicate when it comes to birth. I was bummed, but that one didn't work out. I went to the second one she recommended. This one was a lot more fluent in English. I could communicate with her fine, and she was direct, but her bedside manner was so direct that she didn't have that calming and nurturing confidence. She was confident, but she didn't have the calming, nurturing side that I also wanted. She said a couple of things that didn't vibe very well with me. It was so direct that it was hurtful. At 32 weeks, I was like, “​​You know what, babe? I love my first choice for my team, but if something happens, I don't love my second choice.” I was determined. I just kept looking, and through one of the girls who had a home birth, she had heard of the woman that I went to as my third option. She had recommended, “If you decide to have it in the hospital, here are a couple of people I have heard good things about through friends.” I went to this woman, Lini Capalon, from 32 weeks. I didn't tell her I was planning a home birth. I decided not to tell her. I told the second lady. She had gotten a little iffy about it because it's not illegal there, but again, it's so uncommon there that it's hard for them to wrap their head around it basically. I'll put it that way.With the third woman, I didn't tell her, but she knew I wanted to have a VBAC. She had done a number of VBACs herself, and she had told me before I even started talking to her, she was like, “​​Look. We want this birth to be as natural as possible for your highest chance at VBAC.” She was like, “​​You need to go into labor spontaneously. We don't want to interfere at all. I don't want to interfere with you. I don't want to give any interventions.” She was like, “​​You can go until you're 42 weeks and 3 days before we'll then talk about induction.”I was floored because I didn't think this existed in an OB/GYN in the DR. First of all, that they're doing VBAC, and secondly, that they're for it. We were talking about this, Julie, a little bit before we hopped on that the C-section rate in the Dominican Republic is 90%. 9-0 in private hospitals, and public hospitals are really, really not great. If you have the choice, you wouldn't want to birth in a public hospital. You are already going into a private hospital with a 90% chance of a C-section.Julie: That is so wild. It is so wild. Brielle: Yeah. Yep. Yeah. I learned that through the midwife who was in Santo Domingo. Julie: Well, and I almost wonder if the 10% who are not Cesareans are the ones who go so fast or are on accident. Do you know what I mean? Brielle: Yeah. Yeah. Or just everything progresses, I don't want to say normally, but quickly.Julie: Quickly, yeah.Brielle: Quickly. You're not “late” at all. I did have a friend who actually had a vaginal birth in the DR about a month after me. That was very hard for me as well and very triggering because she also had the same doctor as me the first go-around.Julie: Oh no. That's hard.Brielle: That was a big part of my healing journey too. But yeah, her water broke. She went into labor. She progressed quickly and had the baby. There was not anything out of the “norm”. Anyway, that's how it needs to happen if you're going to have a chance. The fact that I had found her, then she was pro-VBAC and had VBAC experience was really rare because I was also saying that VBACs are unheard of in the DR. After I had my second baby, people were like, “​​What? You had your baby vaginally? Didn't you have a C-section before?” They didn't know that was possible.I went with her for my backup option. Then, here we go. I was 38 weeks and 5 days pregnant. My midwife is scheduled to come. She has her flight booked for the day before my due date. I'm still 10 days out before she's supposed to come. I lose my mucus plug, and I have my bloody show. Of course, I message her. She's like, “​​Well, here's the thing. You could go into labor anytime now. It could be tomorrow, and it could be 2 weeks from now. We just don't have any way to predict that.” I was like, “Okay, cool. Great.” But another thing that I had worked largely on this pregnancy and a big reason why I kept changing OB/GYNs and a big reason why I said no to a lot of things during my pregnancy and started speaking my voice is because I found my intuition or re-found it, and really listened to it every step of the way. Any time anything felt the slightest bit off, I was like, “​​Nope. We're not doing that.” It took an incredible amount of tuning everything out, tuning out all of the noise and opinions and everything that's out there and really just listening within. After that happened, I lost my mucus plug. She wasn't supposed to come for 10 days. She tells me, “It could be tomorrow. It could be 2 weeks.” I slept on it, and then the next day, I was like, “​​Brittany, I think you need to get here sooner. When's the soonest you can come?” This was Friday. She was like, “I can come this Sunday in two days.” I was like, “​​Great. Can you change your flight?” She was like, “​​Yeah. Can you pay the difference?” I'm like, “​​Yeah, that's fine.” She changes her flight to Sunday. Her Airbnb was on the street that I live on. She gets to her AirBnB at 3:00 PM on Sunday. That night, I had about three or four days of prodromal labor before that. That night, at 7-8:00 PM is when I finally started having regular contractions, and my water broke that night at about 11:00 PM the day that she got there. Julie: Your baby was waiting. They just knew. Brielle: They knew. I knew. I was like, “​​You've got to get here sooner.” Baby Alana was waiting. Everything was happening in perfect timing. I told her that my water broke. She came over. Labor started. My contractions were regular. I let my husband sleep because I also didn't know how long it was going to be because I had prodromal with this one too. I had it for a week before. I'm like, “​​I don't really know for sure if it's the real thing. I'm going to let him sleep for now. He supposedly has to work tomorrow, but we'll see.” Things were regular, active, and intense all night long. He ended up waking up at 4:00 AM and coming up and setting up the birthing tub at that point. I didn't know if I wanted a water birth or not, but I knew I wanted to have it as a comfort option and I wanted the option should I want to birth in there when the time came. So he set up the tub, and my doula came over. I had pretty intense contractions until Monday morning. Our nanny came over because my son, my 2.5-year-old was just 2 at the time, he woke up and he had school. She was getting him ready for school. He woke up, and even though the nanny was with him, that slowed my contractions down a little bit because it's hard when your son's not there to be in mom mode somewhat. Things slowed down a little bit while he was getting ready for school. He went to school. I was feeling a little frustrated because things had slowed down. My husband was like, “​​Let's go outside. Let's go for a walk.” We left the apartment. We went for a walk. My husband had me doing squats which I wish in hindsight I had reserved that energy. I didn't know how long labor would go on. I was hunched over. Cars were stopping, “Are you okay?” as we were walking down the street and people were on their way to work because things were picking up again.I'm like, “​​Okay, I think we need to get back to the apartment.” He helped me. We get back to the apartment. We get back inside. Things got really intense again. It was Monday morning. I'm in and out of the birthtub. I'm on the birth ball listening to HypnoBirthing tracks using my breath. I'm a breathwork facilitator, so it wasn't hard for me to tune into different breath patterns that were feeling good and supporting the intensity of everything. Monday afternoon came. My son got off to school. He came home. The same thing happened. They slowed down a bit while he got lunch and got ready for his nap. He went for his nap, then things really picked up. My midwife knew I didn't want to be checked because of the whole thing before of, “You're 1 centimeter,” and a week later, “You're 1.5 centimeters. You're not progressing,” type thing. I knew I didn't want to be checked, but I think she could tell by the intensity and by the look in my eyes that I must be close to needing to push.She said, “I know you don't want to be checked, but do you mind if I check you and not tell you the number just to see where things are at?” This was Monday afternoon. I'm like, “​​Sure, that's fine.” She checked me. I was like, “​​You can tell my husband where I'm at, and he can decide if I should know.She checked me, and then a bunch more of my water gushes out, and then she blurts out, “You're fully dilated. You're ready to push.” I was like, “​​Really? That's awesome. Great. Sounds great to me.” It had been a little over 12 hours at this point. I was like, “​​Okay.” But I also told her, “Really? I don't feel the urge to push. I don't feel like I need to push.” She explained to me that VBAC patients sometimes don't feel that urge. That's possible that you might not feel the urge. I was like, “​​Okay.” I leaned on her a little bit more for what positions to try and stuff like that and the actual mode of how to push because again, it wasn't coming naturally. It wasn't coming instinctively because I didn't feel that urge. For the next, I think, 4 or 5 hours, I pushed at home. I pushed in the tub. I pushed out of the tub. I pushed on my bed. I pushed on the floor. I pushed in kneeling, hands and knees. You name the position. I feel like I probably tried it. I was absolutely exhausted because, of course, I didn't sleep the night before. Eating was hard. I wasn't getting what I needed nutritionally to keep up energetically with how long the labor was getting and how long the pushing was getting, but I also didn't want to eat. I felt like I couldn't get hydrated. I was exhausted. There were a number of times I looked at my husband, and I looked at my doula, “I can't do this anymore.” They were encouraging me, “Yes, you can.” I got on my hands and knees and prayed. I was listening to my tracks. I had my crystals that I work with, and I'm just talking to my spirit guides and all of this stuff. After 4 or 5 hours, I was beat. I was so defeated. I was beat. My midwife was like, “​​Why don't we give it a rest for a little bit?” She was intermittently checking our baby's heart rate and checking me. All of that was fine. The baby was fine. I was fine the whole time, so she kept saying, “Both of you are fine. You can stay here longer. There is no rush because both of you are fine. There is no need to go to the hospital if you don't want to. If you want to, that's an option, and it's fine.” I was like, “​​No. I'm just going to take a break from pushing, and try to rest.” Of course, I'm in active labor, so trying to rest is hard, but I just stopped with trying to push for a couple of hours, then it was getting into Monday night. My son had gone to bed for the night. It had been a few hours of this “resting”, but really intense contractions, and she asked me, “Do you want me to check you again? Do you not? Just to see what's going on. I don't know what's happened.” She checked me.She said, “I have bad news.” I was like, “​​Okay, give it to me, I guess.” She explained to me that there are two layers of the cervix, the outer and the inner. When she had checked me before I pushed for that 4 or 5 hours, she realized she could only feel one layer. The layer that she felt was fully dilated, but then when she was checking me this time Monday night, she was feeling the other layer, and it wasn't fully dilated. It was around a 7. She said that was why our baby– she had been sitting so low for this whole time. She was there, but couldn't get around that other layer which is why the pushing wasn't really doing anything to get her out. I was like, “​​Okay.” It was hard to hear, but also kind of relieving to hear in a way because I was like, “​​Well, I just did all of that work for nothing? What?” That's what it felt like, but then it also felt like, “Okay, well, at least there is a reason why I was pushing, and it wasn't happening. It just wasn't.” I trusted the timing. I was so trusting in this birth. I was so trusting of the timing. I was so trusting of my baby. I was so trusting of my body and myself. I had done so much work around that to trust myself. I was like, “​​Okay.” I rested some more. Everything was fine. I continued to labor at home until about midnight. I was in the birthing tub, and at about midnight, I started to feel absolutely terrible, just incredibly weak. I had now been up for over two days and had two nights with no sleep. The four days before that was bad sleep because it was prodromal labor. My body was really exhausted. I was emotionally exhausted and mentally exhausted in every way.It was midnight. I was going through the second night now. I was just like, “​​Guys, I don't feel well. I feel really bad.” She checked my vitals. Everything was fine. I was like, “​​I feel like my blood pressure was really low. I felt like I was going to pass out.” She was like, “​​Have you eaten any protein today?” I had eaten a lot of carbs and was staying hydrated. I was like, “​​No, I guess not.” She was like, “​​Let's try some protein.” I absolutely didn't want that, but my husband was force-feeding me a ton of chicken. My husband does acupuncture as a side thing. I was like, “​​Can you give me acupuncture to progress things or help with this terrible feeling I have to give me some energy?” He did acupuncture on me. He was force-feeding me chicken. Right after that, I got back in the birthing tub. I projectile vomited everywhere. After I threw up, I was like, “​​Oh, I feel better now.” It was so bizarre. I was going through a whirlwind at this point. I was like, “​​I feel better. I feel like I can continue now.” This was midnight now. My midwife said, “Okay, you can continue.” I continued the next four hours in and out of the tub, on the birthing ball. My husband was asleep at this point. My doula had to leave because her daughter was sick. I'm dozing off in the tub between every contraction which was only every 15 seconds because I was so tired, then the contractions would come. They'd be level 100, insane intensity. They'd be a minute and a half, then I'd get to fall asleep for 15 seconds then wake back up and do it again, and do it again on repeat for 4 or 5 hours. Then it's 4:30 AM. I know it's getting close to rush hour. There's a lot of traffic during rush hour in Santo Domingo. If we tried to go to the hospital during rush hour, it probably would have taken us 2, maybe 3 hours to get there. I told my midwife at 4:30 AM, “Can you check me?” She checked me, and that same layer was still at a 7. It was maybe a 7.5. I told her, “I'm ready to throw in the towel.” What I meant by that was, “I'm ready to surrender to this process,” which means I'm not going to do it here at home anymore. Intuitively, that felt very right to me to go. It was time to try something different. I had been home for 35 hours at labor. We had worked with everything that was there. I had all of my tools that I had, and I felt like something needed to change.Julie: You were so tired. You worked so hard for so long. An exhausted body is just exhausted and not effective at laboring.Brielle: No, not at all.My midwife and my husband packed up my bag. My midwife ended up having to stay at our house because my son was sleeping. Our nanny couldn't get there until 6:00 or 7:00 AM. My doula, her kid was sick, and she had to go home. My husband and I had to go to the hospital. The next two hours were insane. Once I decided I was going to the hospital, I basically had no breaks in my contractions. The time that they were packing my bags, and then we were going down to the car and driving to the hospital which was quick because there was no traffic at 5:00 AM. Those 15 minutes, we thought we were going to have the baby in the car. At this point, I was having zero breaks. The intensity was through the roof. We walk into the hospital. My husband has to do paperwork, so I'm all by myself. I'm just roaring like a lion at this point. I'm barreled over. This is so intense. I don't have my tub or my ball or anything at this point. I didn't have any pain relief medically, but I didn't even have the things I had at home to help me. I'm just barreled over and roaring and screaming and super primal. My doctor finally showed up. He finishes the paperwork. That whole thing was probably 2 hours of me not having any type of relief, really, just to get to the hospital. That was the toughest part, I think.Then my OB/GYN, Leni, comes in. She checks me, and she's like, “​​You're fully dilated. You're ready to push.” She didn't know I had been at home. She didn't know everything that was going on and that I was planning a home birth. I said, “I am not pushing this baby out right now.” I said, “I pushed at home for 5 hours. I've been in labor for 35 hours. I haven't slept in 3 days. I projectile vomited everything.” I'm not saying this. I was huffing and puffing through this, but I looked at her, and I'm just like, “​​Give me an epidural now. I'm not doing this anymore.” She was like, “​​Technically, we're not supposed to. You're fully dilated.” She was like, “​​Okay, all right. We'll get you the epidural.” They wheeled me up. They gave me the epidural. My husband didn't go into the room with me. I thought I was just getting the epidural in this room, but it was the birthing room. I didn't know because I hadn't done the full tour of things beforehand. I mean, I did a little bit, but I didn't put it together at the time where I was getting the epidural. I thought I was going to have a break to take a nap. I was going to get the epidural, then I was going to take a nap, then I was going to push the baby out. That's not how it went. They were like, “​​All right, whenever you feel the next contraction.” I'm like, “No, I can't. Where's my husband? My husband's not here.” They were like, “​​It's hospital policy. Nobody can be in here with you.” I was like, “​​What?”Julie: No.Brielle: Yeah. I lost my shit. I lost my shit. I am like, “​​Absolutely not. Get him in here now! I'm not doing this without him. He's been here every minute beside me for the last 35 hours, but also for the last 7 years of my life. I'm not doing this without him.” They were all looking at each other, like, “​​Look, when it gets close and when he is crowning, we will bring him in.” I was like, “​​Okay,” so I pushed when the contractions came. I was surprised I could still feel the contraction, but after the epidural, thank God. It was what my body needed at that point. I was like, “​​Thank you for modern medicine. There is a reason it exists.” But after 30 minutes of pushing, they just randomly asked me, “Do you have a doula?” I didn't say anything about my actual doula, but I said, “My husband is my doula. Get him in here.” They were like, “​​Okay, okay. We're going to bring him in now.” They brought him in. He started coaching me like a drill sergeant or a CrossFit coach or something, but he was like, “Just do it!” He knew me so well, and he knew in that moment that I wanted a VBAC so badly, and he also knew everything I had been through that previous 35 hours. He knew we needed to do this. He knew we needed to get on with it. He was coaching me and basically screaming at me. It was exactly what I needed in that moment. After he came in, 30 minutes later, I pushed her out. She was born. They brought her to my chest. Everything my OB/GYN told me, she stuck by her word. She was like, “​​You will have skin-to-skin. You will have that hour.” They asked me, “Can we take her to do x, y, and z?” I was like, “​​No, not yet. Don't take her yet.” They did the things they needed to while she was on top of me. Everything they had promised, they fulfilled. That, I feel like, was why I just felt intuitively really good about both options, my first option and my backup option. I went with that, and it was exactly the way it was supposed to be. Julie: Yeah, I love that. I think being able to trust is such an important thing in the birth space, being able to trust yourself, your care team, your partner, all of your different options, your birth location, and all of that is just so connected to how our bodies can work and trust that process, and yeah. That was great. So good. Brielle: Yeah, that was a huge part of my experience. It was learning to trust myself, the timing, my baby, and my body fully. Healing my experience and just following my intuition completely.Julie: Yeah, I love that so much. Do you want to talk a little bit more about what you did to prepare with the breathwork and the somatic trauma work? I mean, did you get into that before or after? I'm assuming before because your baby is pretty young. How old is your baby now?Brielle: My baby was 5 months the other day. In between pregnancies, and I was not pregnant. I was 6 months postpartum from the first one that I started doing it personally for myself. Do you mean as a practitioner when I got into the work? Julie: Mhmm. Brielle: As a practitioner, I got into this work 5-6 years ago. I was already facilitating breathwork and coaching people for trauma, but not birth trauma. I had gotten my trauma resolution coaching certification and my trauma-informed breathwork certification before I ever had kids. I was really excited to get to use my breathwork and all of my tools and everything for my first birth, but that ended up going a completely different way. I did still use it, but it looked a lot different than I thought it would. I got into this work. I was coaching people on their trauma through a somatic way. Basically, trauma lives in the cells of our body, and it stays in the cells of our body unless we somatically move it through our physiology. There are two major ways we can do that. One is through a type of somatic coaching that I do, and the other is through breathwork. They are both somatic practices, but one is using the breath in a very intentional and activating way to help move that trauma through our cells and out. The other one is using a very hands-on– they are both body-based, but one is more of a visualization. I take you through an experience where you are feeling where things are living in your body. Basically, you are attuning to where there are certain activations in your body as I take you through a lived, traumatic experience. We are finding where that trauma lives in your body with a somatic coaching so I'm able to use a lot of tools to help you visualize it and then move that out.Then with breathwork, it's similar, but we are using the breath. The breath is automatically going to the spaces energetically where the trauma is living to help move it out.Julie: Yeah. I love that. I love that so much. It reminds me. I've done a lot of therapy work. My therapist would ask. I've done lots of group therapy, individual sessions, and all of the things. One of my therapists who would lead our group sessions would say, “What do you feel and where are you feeling it?” We would take turns identifying what in their body needs to be addressed. You've got to describe it. What does it feel like? Does it have a sensation or a taste or a smell? Is it heavy or is it light? Does it have a color? Where in the body is it?I hated it, to be honest. It was the worst thing ever. Brielle: It's really deep.Julie: It's crunchy. Yeah. It's deep, and you have to be comfortable getting uncomfortable, and reaching and stopping and being in tune with your body. I hated it so bad for a very long time, but even now, I don't do those group sessions or anything or anymore. Every once in a while, I'll scan my body. “Okay, what do I feel and where am I doing it?” I try to get my kids to do it, and they're like, “I don't know what the freak you mean, Mom.” They're still young, but I know what you are talking about with that work. What is it? Moving it out, how to release it. That's so important. Brielle: It's so great. It transcends as I work with a client. They feel it. They see it in a certain way. It has textures, colors, and shapes, and we stay with it. We don't stay with it beyond the point that they feel they can stay with it. If that's super uncomfortable for them, we go back to our resource which I do at the beginning of the session.I'm not taking them through an experience in a way that is beyond their capacity to move through it. The body won't ever take them through something that they don't feel ready to handle. I think that's really important to specify because if you're just talking about this work and you have never heard of it, that can sound really scary.It is deep work, but at the same time, because of my trainings and with breathwork as well being trauma-informed, I never take a client to a place that their body is not actually physiologically ready to go into. Julie: Yeah, that's really important. It's such an intuitive thing. You talked a lot about intuition too. One thing I wanted to say before we close out the episode is that you mentioned earlier in the episode about learning to forgive yourself. That was something I don't think we talk about a lot or think about a lot, but it's something that I had to go through as well after my C-section. My thing was forgiving myself for not knowing what I didn't know going into my birthIt can sound kind of silly. What do I need to forgive myself for? But sometimes, we focus a lot on forgiving others in the situation and our team or our partner or whatever, but we don't often direct that inward. I think that's such an important part to give yourself grace and mercy and love and forgiveness and go through and not judge yourself too harshly or hold yourself to an unrealistic standard especially when you didn't have the information then that you have now.So I think that's an important part of the process as well.Brielle: That's a big amount of the work I do with my clients as well is that self-forgiveness piece and really forgiving their bodies because a lot of them feel like, “My body failed me or my body is broken.” That was a lot of work I had to do myself personally after my first birth to realize, “No, my body didn't fail me. My body's not broken. Nothing was wrong with me.” But if we don't do that forgiveness work for your body to yourself, that trauma is still going to be living in ourselves and still expecting. I'm not going to say it's going to give you a repeat experience, but we're still having that physiological presence where like attracts like. That's still in there. That's still the drawing factor of something that your body is expecting. It's still holding that past experience.Julie: Right. Yep. That makes a lot of sense. I encourage everybody to do the work, but also, I think's important to mention this a little bit is to find somebody trusted that you can do it with. It's important to not dig too deeply into past traumas or things like that unless you have a solid support around you like a therapist, any mental health professional, an energy worker or people like that to help guide you through it so you don't get too deep into things that you are not prepared to handle or heal.Brielle: Absolutely. That's what I do as well through the lens of breathwork and somatic coaching. Julie: So where can people find you?Brielle: Yeah, it's definitely not something I recommend doing on your own. Have somebody to hold that space for you who knows what they're doing. People can find me on Instagram. It's just my name at Brielle Brasil. Brasil is with an S. You can reach out through there, and that's where I'll be.Julie: Perfect. We'll link that information in the show notes for anybody who wants to go give her a follow as well.All right, well thank you so much for sharing your story. I really appreciate it.Brielle: Thank you so much. Julie: It's so cool to hear your story and your journey and your process. Thanks for being here. Brielle: Awesome. I appreciate you. Thank you so much. It was an honor.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

The VBAC Link
Aisha's Special Scar VBA2C After "Failure to Progress" + Uterine Dehiscence

The VBAC Link

Play Episode Listen Later Jan 20, 2025 58:45


Aisha's episode is full of wisdom and inspiration! With her first two births, Aisha worked so hard to deliver vaginally, but ultimately had two undesired Cesareans. She was told in the operating room that she had uterine dehiscence, was given a special scar, and should never try to deliver vaginally. But her intuition was telling her a different story. She dove into research. She found a community and listened to podcasts like The VBAC Link. She knew a VBA2C was possible, and she knew she had to try. Aisha's VBA2C journey involved interacting with supportive and very unsupportive providers, hiring a fantastic doula, being proactive with labor comfort measures, planning for the unexpected, staying firm in her desires, asynclitic positioning, and pushing her baby boy out in just 45 minutes with a nuchal hand!Aisha's WebsiteThe VBAC Link Blog: VBA2CNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. It's The VBAC Link, and we have a VBA2C story coming your way. Have you ever wondered what VBA2C means? If you haven't noticed, in the VBAC world, there are a lot of acronyms. VBA2C is one of them. That means vaginal birth after two Cesareans, meaning that you have had two Cesareans and want to go for a vaginal birth. Big question, what are the chances of having a vaginal birth after two Cesareans? Is it possible? The answer is simply, yes. It is totally possible. Myself and Aisha are living proof today that it is possible. In fact, your chances of a successful VBA2C are similar to those of just a VBAC with one Cesarean. ACOG recommends that VBA2C is a safe option, so today, I want to quickly go over a little bit more instead of a review about some education on vaginal birth after two Cesareans and share a little bit more of our blog. Like I said, ACOG recommends that vaginal birth after two Cesareans is actually a safe option. They say, “It is reasonable to consider women with two previous low transverse Cesarean deliveries to be candidates for TOLAC.” Now, again, there's another one of those acronyms. TOLAC- trial of labor after a Cesarean. I know that is triggering for some. It is pretty much just the medical term of saying that you are having a trial of labor after a Cesarean, so try not to let it impact you too much. But, “for TOLAC and to counsel them based off of the combination of other factors that affect their probability of achieving a VBAC.” There are lots of things that people might go look through to see if you are eligible for a VBAC after two Cesareans. Now, I'm sure you have probably heard this before, but proven pelvis. If you haven't had a proven pelvis, meaning that your baby has come out vaginally before you've had a vaginal birth or a Cesarean– now when I say this, sometimes we have a vaginal birth, then we will have two Cesareans, and someone wants to go for a VBAC again, so they would be considered a proven pelvis or cervix to a medical staff. But if you haven't had a “proven pelvis”, I hope you guys can imagine my air quotes right now, that doesn't mean that you shouldn't be considered as someone who should have a VBAC. It says in our blog, “More important to note, there is no mention of a requirement to have had that previous vaginal delivery.” I wanted to point out that it really is not a necessary thing. I hadn't had a vaginal birth before. My cervix also hadn't made it to 10 centimeters before, so just know that it is still possible. Quickly, there are things that you can do to reduce uterine rupture, and there are also things you can do to increase your chances of VBAC. Again, it's going to be in our blog. I'm going to send you over there after the episode so you can go and read more about it, but some of the things that you can do to minimize the risk of uterine rupture is staying away from induction. Now, can VBAC be induced? Yes, they can. Yes, yes, yes, yes, you can, so I don't want you to totally freak out right now. But, staying away from induction for VBAC is better than going to get induced. It does increase our chance of uterine rupture, and it does increase our chances of other things like interventions that are unnecessary. Unless it's absolutely necessary or totally desired, try to stay away from induction. Avoid augmentation of labor so things like Pitocin and other drugs to cause the uterus to contract more than it naturally would. Okay, let's see. Avoid providers who aggressively intervene or want to manage your labor or come at you with fearmongering tactics. You guys are going to hear some of that here, and honestly, I think it's a common thing with these stories. We are getting a lot of fearmongering here. Providers, if you are listening, knock it off. Goodness gracious, we do not need to add fear to something that has been looming over us because VBAC has such a bad rap in the world, and it's so scary. Again, air quotes, guys. Just stop with the fearmongering. Avoid providers who are going to build you up with things– I should say tear you down, but fill you up with things like, “Your baby is looking too big. I don't know. We should probably induce. I don't know if your baby is going to be able to come out because you are really small, and that baby is looking really big. Oh my gosh, you have to have an epidural. Oh my gosh, you have to have your baby by 39 weeks.” There are so many things. It's annoying. Okay, going back to avoiding rupture. Avoid or delay things like getting an epidural until at least the end if possible because we do know that sometimes when we get an epidural early in labor, it can bring things like interventions, and we are getting Pitocin that is too high and other things like that. There are so many other things here, you guys. I'm going to make sure that the link is in the show notes. I don't want to take too much of our time, so we can make sure that Aisha can share her beautiful VBAC after two Cesarean stories and all that she had done to lead up to this experience. You guys, it's a good one. Something that is very different about this episode is that she actually had a dehiscence with her second which in a lot of the studies and literature for rupture, a dehiscence is often confused or combined with uterine rupture.I really love that this is a different type of story here, so gear up and enjoy. All right, Aisha. Thank you again so much for being here. As we were talking about earlier, VBAC after two Cesareans is so highly requested in our community. So without further ado, I want to turn the time over to you. Aisha: Thank you so much for having me. This is surreal. I feel like this pushed me in some ways. It was a goal of mine. I'm like, “If I make it and do my VBAC after two Cesareans, I'm going to send my story to The VBAC Link.” Yeah. I've listened to you guys. It's been literally almost four years listening to you guys all of the time trying to visualize my birth after hearing other people's stories. It's such a blessing, and I'm honored to be here to be honest. Meagan: Well, thank you so much. Aisha: Of course. Yeah. I mean, if we start from the beginning with my whole birthing journey, I got pregnant in 2018. I really wanted to try out the whole natural route, so I went with a midwife here in Canada. It's covered by the government so whether you go to a midwife or OB/GYN, it's honestly the same thing. It depends on what type of care you want to have. I chose to go with the midwife, and I chose to give birth at a birthing center for my firstborn. Labor started. I never ended up giving birth naturally obviously. I ended up having a 60-hour labor. Yeah. After 60 hours, they declared me failure to progress, and I think my cervix was a bit swollen at that point. The baby had made the meconium in my tummy. Meagan: Oh, yeah. Stressing out is common. Babies poop sometimes, and it doesn't always mean an emergency or anything like that, but when it's happening and other things are happening–Aisha: Exactly. I think I started having a fever and other things like that. At that point, they came to see me. They were like, “Before things turn into an emergency, let's go and have a simple C-section.” I felt very defeated. I worked very hard for a natural birth. I did 40 of those 60 hours all-natural, but after seeing I wasn't progressing– when I was with my midwife, I was 2 centimeters after 40 hours, and at that point, I requested to be transferred to the hospital to get an epidural. When I got the epidural, it worked a little bit on half of my body, but I was having back labor. My baby was posterior, so it did not do much for those pains there. I can say in the moment, I was quite relieved to have the C-section, so everything could be over, but I know afterward, I know womanhood is not defined by how you birth your baby, but I think at that point because that's what I envisioned, I never envisioned a C-section ever in my life, and it affected me. It affected my self-esteem a little bit. Right after that, me being me, I'm such a planner and such a researcher. I researched to see if it's possible to have a vaginal birth after a Cesarean, and I discovered the whole VBAC world. I signed up in all of the Facebook groups that I could find about VBACs all around the world. I was reading stories. I discovered The VBAC Link at that point. I started listening to the podcast. I also requested, through my midwife, my notes to see what happened. Meagan: Your op reports. Yes. Aisha: I'm like, “Okay. I need to know why I had a Cesarean, why a Cesarean was made, etc.” I checked. I sat down with my midwife at six weeks postpartum. Honestly, it wasn't anything really. They just said it was failure to progress. I had dilated to a 7, and that was that. She was like, “Okay. You can come back when you get pregnant again. You need to wait 2 years or 18 months before you get pregnant again.” Meagan: Mhmm. That's very common.Aisha: That's what I did. I got pregnant when my firstborn, I think, was 15 months. I gave birth exactly two years later almost to the dot. That labor started. Everything was going great. I remember for that pregnancy, I tried to always sit leaning forward, doing all of those exercises because my baby was posterior. I wanted a good posture. I did all of the things. It was in winter here, and in winter, Canada is not the best. I wasn't walking as much and it was COVID too. It was the COVID lockdown. With my first, I was going to the mall a lot, but during the lockdown in 2021, all of the malls were closed. I wasn't going outside much, but I was doing rounds in my house going up and down the stairs and stuff like that. When labor started, I really tried to focus. I think I was doula-ing myself. I never got a doula, but I was doula-ing with all of my research what I knew to do. At some point, I felt like it was time to go to the midwife. I was going there. They checked me. I was at 2 centimeters again. After laboring for 15 hours, then I was a bit defeated. I was like, “No, the same story is going to happen twice.” I continued laboring there. At some point, the contractions were back-to-back with no breaks. At that point, I was like, “Let me be a smart girl and get the epidural again.” She checked me. I was at 3 centimeters. I wasn't progressing fast enough for me. I think I was just in too much pain. I wasn't getting any breaks.I went to the hospital. I think the car ride there did something because it was a 20-minute car ride from the birthing center to the hospital. I was 7 centimeters. Meagan: Whoa. You went from a 3 to a 7 in 20 minutes? Aisha: In 20 minutes. Then I was like, “Okay, it's happening.” I got there. My midwife had already called the hospital and sent my papers. The anesthesiologist was waiting for me. I got the epidural within 5 minutes. They checked me. I was at a 9. Yeah, it went really fast. I was like, “I'm getting this VBAC.” Everybody was excited. I was giggling and laughing. My midwife came in. We were waiting for the last little bit. They checked me. I was 9.5, but baby was stationed pretty high. They were like, “Okay, let's try to bring baby down.” They made me change positions, but as they were doing that, the baby's heart rate dropped. It wasn't picking back up. At that point, it turned into an emergency C-section. The doctor looked at me. She was like, “Your baby is in distress. We don't know why. Nothing is going on. Nothing is changing. We are bringing you to the OR and get baby out. We don't have a choice.” I was so sad. I was at 9.5. I was almost there, but it did not happen. When I was in the operating room, the doctor screamed to me, “Aisha, never do this again.” I'm like, “Why?” She never gave me any more explanation, so me being me, when I was done giving birth, I requested the notes again.Meagan: Hey, listen. This is what I would suggest for anybody and everybody who has had a C-section. Go get your notes. Go get your notes. Aisha: They give so much insight because nobody knows unless this is the only thing that remains with you. You don't have the people to talk to. I saw the notes. I saw that my C-section scar had started to open. I think they called it a dehiscence. Meagan: Dehiscence? It was past a window. It wasn't just stretched. It actually had dehissed. Aisha: Yes. My midwife was like, “Probably that's the reason why she told you to never do this again and not to go for a VBAC again because the uterus had started to open.” Because it had started to open, when she cut me up, it gave me a J-scar so my scar–Meagan: You have a special scar too. Aisha: I have a special scar too. At that point, I'm like, “Okay.” My midwife told me, “If you have a third baby, unfortunately here, we can only follow a VBAC after one Cesarean. We cannot follow a VBAC after two C-sections so you will have to go the OB/GYN route.” Then I got scared because I'm like, “My God, I'm going to have to go to the medical professionals. They're going to turn me down,” and stuff like that. Me being me, I contacted my own personal OB/GYN. I went to see her. I wasn't pregnant or nothing. I wasn't planned on being pregnant anytime soon, but I knew I wanted a third child. I went to him. I was like, “Listen. This is my story. This is my situation. I really want to try for a vaginal birth. I know it can happen.” I went on the Facebook groups again. I registered in all of the VBAC after multiple Cesareans. I went and checked VBAC special scars. I went into all of those groups. I saw it was possible. Women were doing it all over the world. I was like, “Why not me? My body is also capable. Plus, I got to 9.5. That means my body is working. I just had unfortunate circumstances.” That's what I thought. My doctor was like, “You know what? Get pregnant. Come back, and we'll talk about it.” She wasn't closed off to the idea. Fast forward, I got pregnant earlier in 2023. I lost that baby due to miscarriage. I got pregnant again in September. That was a surprise pregnancy. I wasn't really planning for it. When I got pregnant, I was like, “Okay, this is it. This is it. We're going to try to do everything we can to make it happen.” I know for the first 20 weeks, I also tried to relax and release. I felt like my body held so much tension, and I feel like that can hold up to birth. I was trying to go and deal with all of those traumas and things like that that I hadn't dealt with in my previous births. Meagan: Traumas, triggers, past experiences, the tension that is being harbored in our body. It's weird to think that, but really, we can harbor tension whether we relate to it as trauma or not, and it can really impact us. Aisha: It can really impact us. After my second birth, I had gone to pelvic floor therapy. I had been to that for a couple of months, then stopped 6 months prior to getting pregnant officially with my last baby. When I got pregnant, I went back to see my pelvic floor therapist. I'm like, “Listen. I'm pregnant. This is what we are planning. Right now, I just want to make sure that my muscles down there are okay. I want to do the exercises. I don't want to do too much, but just prep my body slowly and surely.” We did exercises. That was the first 20 weeks. The second 20 weeks, I'm like, “Okay. Now is the time to ask the questions.” I would see her every 6 weeks, and within those 6 weeks, every question that would come in my head, I would write in down in my notes and go and ask her the questions so she could answer. I asked her to review my op reports so I could have another opinion. I was asking her a lot of questions about VBAC after two Cesareans. I got that my doctor wasn't VBAC-friendly, but I think she's pro-women's choice. She goes with what you want, and she supports you wholeheartedly in your decisions. I remember asking her questions about VBACs after two C-sections. She kept telling me, “Aisha, I think you need to realize that new studies have shown that there is not much risk after one or two Cesareans. It's almost the same. The percentage doesn't go up. There's not much difference. If you've had a C-section, you have the same chances as if you've had a second C-section. That's what the studies are showing.”I asked her about my dehiscence, and she's like, “A lot of women who didn't have a C-section can have a dehiscence, but with some women, we don't see it because they're not getting opened up.” She's like, “It happens more than you think. It doesn't mean that it's because of your scar that you had the dehiscence. It could have been that's just how your body reacted.” After all of those affirmations, that reassured me a little bit. I was not risking my baby. At the same time, you read stories, and you just don't want to make foolish decisions even though in your heart, you know what you want. When you listen to the outside world, it can influence a little bit of how you are thinking, and you are trying to make a wise decision. That was me in that second part of my pregnancy. However, the one thing she told me was, “The one thing that can make or break your VBAC, though, is getting a doula.” Every time she would see me, she was like, “Did you get your doula? Did you get your doula? Did you get your doula?” So I went. I got a doula who also had a VBAC. It was very important to have someone who had the experience of having a VBAC. I feel like when your team knows how badly you want it and what it means to you, I feel like it changes a lot for your game. I remember having my little prebirth classes with her, and she kept telling me, “You need to build a team who believes in your goal more than you believe in your goal because at some point during the birth, you're going to doubt yourself, and you need people who are going to reinforce you with confidence and positivity.” Meagan: Positivity, yes. Aisha: Yes, and that you can do it and that your body was meant for this. Of course, within that too, we also prepped for the occasion of a possible C-section, how to have a gentle C-section, and things I wanted to have. For me, it was very important for me to see my baby's being born. That's something I never experienced with both of my daughters. I heard them cry, but it was this wall in front of me. I never saw them come out of me. We also prepped for that, but yeah. We did a lot of prepping. She suggested that I go see an osteopath. With my second daughter, and my first VBAC, I had seen a chiropractor, but she told me that an osteopath might help loosen up some muscles. I went to see that person. It felt good, then I did acupuncture at the same time which I think was maybe just to release and relax and let go. I think there were a lot of little things that I did in order to just not hold on to all of the stress– writing letters and closing up chapters. I feel like it allowed me to just let go of the traumas that I had. Fast forward to my due date for my second baby. I lose a good part of my mucus plug. I sent it to my doula. She was like, “Okay, I think your body is starting to work.” Now, I can say I was starting to have contractions, but my way that I think I handled this birth was denial. The whole time that I was having those contractions, I kept saying, “They are painful Braxton Hicks. They are painful Braxton Hicks, and that's what we are going to do.” I kept walking a lot and every day, I was taking an hour walk. During those hour walks, that's when I was listening to the podcast and listening to stories and literally looking for VBAC after two Cesarean stories and hearing what women went through and their tips and tricks. That happened at my 40-week due date. Then the contractions kept going. During the daytime, they would spread out a little bit. At night time, they would be every 10-15 minutes. They would wake me up from sleeping, so I knew deep down that something was going on, but I was not trying to put my heart into it. I'm like, “They are just Braxton Hicks.” That kept on going for two days. At 40 weeks and 3 days, I had my doctor's appointment. I remember waking up that morning and being like, “Oh, those Braxton Hicks are really pushing.” I remember my husband was like, “Do you think we should go and drop of the girls at their godmother's?” I'm like, “You know what? No. I don't think this is it.”I had my appointment that afternoon. I have a friend of mine who lives next to my doctor's office. She had a 6-month-old baby at that time. I'm like, “Let's drop the girls off at my friend's, then afterward, I can snuggle up the baby because I heard oxytocin might help everything get going.” I went to see my doctor. My doctor asked if I wanted to get checked. That's one thing too, I went through the whole pregnancy not wanting to get checked. I knew that dilation means nothing. Meagan: Yes. Aisha: There is also how effaced you are and the baby's station. Those are also other things that you must know. You can be at a 10 and be stationed at a -2. It doesn't mean your baby is still coming. There are a lot of little details that I discovered. Meagan: We don't talk about it. We don't talk about it. We focus so highly on that big 10 number when there is so much more. It's funny because with my clients, they'll be like, “Oh, I got checked, and I was only this centimeter.” I'm like, “I don't even care about the centimeter. What were you effaced?” They're like, “I don't know. They didn't say anything.” Next time you get checked, ask because that number is a cooler number. Let's get effaced. Let's do that. Even then, we know that can change. We can go from thick, hard, and posterior to completely open and thin. It all varies, and it varies quickly, but there are so many other things to focus on than just that big 10 number. Aisha: Exactly. That's why I never asked to get checked the whole time. I'm like, “I'm going to go like that without checking. That will be bad.” When I got there, my doctor knew. She was like, “You're not getting checked, right?” At every appointment, she would ask, and I'm like, “No, I'm not getting checked today.” She asked, “Are you having contractions?” I'm like, “I lost my mucus plug last night. I'm having painful Braxton Hicks.” She's like, “How painful?” I'm like, “Well, people contract and call it Braxton Hicks.” She's like, “Keep doing what you're doing, however, when you go to the hospital if ever you don't give birth by 41 weeks, we have to send you to do a non-stress test to the baby, and the hospital will read your report, and they're going to force you to have a C-section. Be ready.” She was prepping me. She was like, “I'm going to write in your file that it's VBAC after two Cesareans. We've talked about it. You're going to do a trial of labor. I'm letting it go.” She was okay with letting me to go at least 41+5 and 42 weeks. Meagan: Or what evidence shows, okay. Aisha: She wasn't giving me any stress. She told me that the one thing that was giving me confidence was the fact that my body went into labor twice, and my body knows what to do. I left that appointment. I went to my friend's house. I snuggled up with the baby. Every time I would take the baby, my contractions, the painful Braxton Hicks, would be every 5 minutes. They would come more often than not. The moment we left her house, I'm like, “Okay, I don't have the baby no more, but the painful Braxton Hicks keep going.” In the car ride, it was a 20-minute car ride to my house. I got to my house. I didn't say nothing to my husband. I took my daughters. I went to give them a bath. I was showering with them actually. It was a shower. I was showering with them. I was on my knees, and at some point, I had to stop and be like, “Okay. Those Braxton Hicks are quite painful.” I gave the girls a shower. I dressed them up. They went to bed. I came downstairs to my husband and was like, “You know what? Yeah. The Braxton Hicks are becoming more and more painful.” He was like, “Okay. Do you want me to pack up the car?” I'm like, “No, they are still Braxton Hicks. We are not there yet.” Then what really made me believe that I was in labor was whenever I am in labor are my bowel movements. I think my body releases and cleans out.Meagan: Common. That's very common. Aisha: I went to the bathroom twice in the span of 30 minutes. I looked at him, and I was like, “I think we're in labor.” That's the moment I used contractions for the first time. The contractions were there. I just went to the bathroom twice. Okay. Eat and drink because those are two things I never did with my previous labors. One thing my doula told me during the prep was, “You need to hydrate your body because the muscle that is dehydrated is a muscle that is going to contract even more. Maybe that's why you were contracting and your contractions with your second labor were back to back with no breaks.” I'm like, “Yeah, I wasn't drinking water. I was so dehydrated. My lips were all cracked. I was not drinking an ounce of water.” When my husband heard, “Okay, labor is starting,” we started drinking. I ate dinner. It was around 9:00 PM. We bought those maple waters because we heard maple water is filled with electrolytes. I started drinking that. Then we went upstairs. I'm like, “I'm going to get some rest and try to sleep a little bit since it's nighttime.” I went to bed. It wasn't comfortable. I stayed for 15 minutes, then I'm like, “Okay, I'm going to go in the shower.” My husband ran a shower. It wasn't helping. We ran a bath. I went in the bath. I stayed there for maybe 30 minutes. It was not comfortable, then I got up. I went to pee, and then I had my bloody show. Everything was out. I sent a photo to my midwife and my doula. She was like, “Okay. Get ready. I think your body is really doing a lot right now.” In my head, I'm like, “Since my body is doing its work right now, let me help it. I'm going to sit on the toilet.” I heard it's a dilation station, so I'm like, “I'm going to sit there, then hopefully, if I'm in pain, let me make it effective.” I go. I sit there. Believe me or not, that was the best position for me. Meagan: I loved it too. I loved it too. Aisha: I loved it. I was at peace. I had the light turned off, the rain sound going, and I was literally sleeping. When I say sleeping, I was snoring. I was waking up slightly just for contractions, then I was going back to bed. I never timed any of my contractions. We were not going to focus on timing. We were going to go with how we feel, and the sounds and stuff like that. Yeah. I stayed there, I think, for 2.5 hours or 3 hours on the toilet. Meagan: Wow.Aisha: It felt so good. I had a pillow. I slept there. At some point, you can hear in my sound that it was a bit more there. My doula was hearing me. She told my husband, “You know what? I think this is time. You guys need to pack up the kids and go to the hospital.” We are about 35-40 minutes away from the hospital, so we had quite a drive. My husband packed up the car, and around 2:00 AM, we left to the hospital. I remember prior to labor, I told myself, “I'm going to give myself a coping mechanism. As long as I'm home, I'm just going to do nothing and try to take it in.” Once I'm in the car, I bought those combs. I was going to have the combs in my hand for the car ride, then once contractions are really unbearable, I'm going to grab the second comb. In the car ride, I had that one comb. I took it.  We went to the hospital, but the contractions were so great. I had time to do curbside walking around the hospital when we got there. My girls' godmother came and met us at the hospital so we could transfer the girls. While they were doing that transfer, I was doing curbside walking. I was taking photos. I was like, “I need to take photos of my girls.” I was in such a happy mood. The contractions were spread out which was a first for me because with all of my other labors, the moment I got to the hospital, it was an emergency and I could not control myself. We got there. We got to the hospital. I was able to give them my name and fill out my papers. I was really clear-minded. I went into triage and I was a bit scared because with my other labors, when I got checked, I was at 1 centimeter or 2 centimeters. I was going to see what I am, but you know what? We can handle it because the contractions were still spread apart. If I was a 2, I would still be good. I lay down. I got checked, and they told me I was at 5 centimeters. I thought, “Oh my god.” I asked, “What is the station and how effaced am I?” Then they were like, “You are 80% effaced, and you're at the station -2.” I'm like, “Okay. This is it. We're doing it.” They were like, “We are admitting you. You're not going to go home.” I was so excited. However, that's when the battle started. They took my file and came back. Meagan: Darn it. Aisha: They said, “We see you had two Cesareans already. Usually, you need to have a C-section after two C-sections.” I'm like, “I discussed with my doctor, and she was okay with me doing a trial of labor. They were like, “Well, no. This is not usually how things go. We usually don't do that. There's a lot of risk for your baby.” I'm like, “Yeah. I know the risk and I'm okay with it. It's something my doctor and I discussed. We are very at peace with it.” Then they sent me the doctor on call. The doctor came, and she was like, “I need to explain to you the dangers of what you are about to do. Your baby might die when you have a second C-section.” Then they brought up the dehiscence. “After a trial of labor, you had a dehiscence. This is not good for your body to have a dehiscence. You are more prone to uterine rupture.” All of those notes were observed by my doctor, and she was completely fine with it. Literally, the doctor looked at me, and she was like, “I can see nothing I'm going to say will change your mind. You're quite informed.” I'm like, “Yeah.” She was like, “I'm going to have you sign these release papers so you can release the hospital of anything.” At that moment, you feel like you're doing something not great because you're like, “They're making me sign this paper.”Meagan: Yeah, you feel like you're pushing against everyone in the professional world who have done multiple years of school and what they are suggesting. It feels off. Aisha: It feels off, but you what? That's why I was talking about releasing and really listening to me. That made me feel so much more at peace because I'm like, “I have to listen to that voice inside. Aisha, you can do this. You have prepped for this literally for four years in the making since your first C-section. You're educated. You know the risks. This paper is not going to make the risks change. You were okay with it before they presented that paper to you. You can still be okay with it after.”They gave me the paper. I signed everything, and then they asked me, “Well, we need to keep you monitored, however. We need to keep you monitored, and we need to have the easy access port installed in case.”Meagan: The hep lock, mhmm.Aisha: I told them that I didn't want it because it wasn't in my birth plan. I was like, “I don't want that.” I also had a super cute pink, floral hospital gown. I was like, “I'm going to wear that. I don't want to wear their hospital gown.” I think it was just mentally to feel like you are the birther, and you are the principal actor in the event. I didn't want to feel like a patient.They came. They were like, “You need to change.” I'm like, “I don't want to change. I want to keep my gown.” I had to sign a release paper that it was okay if they cut off my gown. I said, “Listen, the gown is made for that. There are buttons all around the back, but if you have to cut it off, cut it off, but I'm keeping this on.” At the end, I felt like I had to be somewhat political a little bit and give them a little so they could stop bugging me because they were breaking my bubble with the constant questions and the constant arguing.Within all of that, I was still having contractions. I'm like, “You know what? I'm going to let them monitor the baby, and I'm going to let them do the easy port so they can stop casting their opinions on my VBAC.” I know my doula was a bit scared especially for the monitoring because they were like, “The second the heart rate drops, they're going to use it as a way to send you to the operating room.” I know the second they put the monitor on, the baby's heart rate went down during the contractions, and it went right back up after. One of the nurses was like, “See? Your baby's heart rate is already going down. This is why we need to keep it.” I had the doula on the other line. She was coming to the hospital. I asked, “The baby's heart is going down.” She was like, “Aisha, it's normal that your baby's heart rate is going down during a contraction. He's literally getting squeezed. It's just normal practice. If it comes back up, it's completely fine.” Every time, they would pass those comments. The baby's heart rate dropped a couple of times, probably 7-8 times over the whole labor process, but every time, they would make a comment, “Oh, see? It dropped again. Oh, see? It dropped again.” But it kept picking back up the whole time.Anyway, I got admitted to my room. They tried to do the easy access port. I have small veins, so it literally took the anesthesiologist to do it. The whole nursing team failed to do it. I kept telling them to do it in one spot that people usually have better luck. They did it everywhere else, and in the end, it was that part that functioned.By the time they did the easy port access, it was around 7:00 AM. I got to the hospital around 4:00. It was around 7:00 AM. I asked to be checked again because, at that point, I was doing dances. The contractions were so intense, I was not happy. I was not laughing no more. I was still having breaks between them, but it was really taking everything out of me. At that point, the whole time before that, I was really enjoying the contractions. They were coming. I was like, “Oh, this is nice. I'm getting to meet my baby.” I loved the feeling to be honest. People find me weird when I say that I love contractions, but at that point, it was not fun anymore. I was going against the wall and doing those squat dances and moving my body left to right. I requested doing a check. They checked me. They were like, “Oh, you're at 9.5 and 100%.” However, baby was still stationed at -2. I'm like, “Oh no, baby is pretty high up.” My doula and I started to do some positions to get baby down. We did those for 30 minutes, but like I said, the contractions were really, really, really pushing it. I requested to get checked again. I know my doula was like, “Nothing probably happened.” She was right. Nothing happened. It was still the same, 9.5 and effaced at 100%, and still stationed to -2. At that point, I'm like, “Okay, I'm going to request the epidural.” I was seeing stars. Every time I would go through a contraction, I would see stars. At that point, I was literally, I think, mentally checked out. I was fighting against the contractions because every time a contraction would start, I would tell myself, “Okay, now you need to survive this next one.” It was no longer about enjoying it. Meagan: Surviving it, yeah. Aisha: It wasn't, “You know what, Aisha? It's four breaths. Take four deep breaths and it's done.” It was more of a survival mindset. I was like, “I'm going to take the epidural and be calm and be good.” They came. They gave it to me. They gave me a very tidbit because I was still walking. I could still feel. Yeah. I was still walking with the epidural. I could still feel everything. It just took off the edge. I think the contractions and the pain was in the front of my belly, and the back pain was gone, but I could still feel the pressure. While the anesthesiologist was giving me the epidural, my body was starting to push. I would have that feeling and everything. I think he gave me a tiny bit. Anyway, the second epidural was done, it was already shift change, so the night nurses were gone. The new nurses were in, and I think when I say the team makes a difference, they were angels sent. They were so kind. My doula went to see who was the doctor on call for the daytime, and she came to see me. She was like, “If you didn't have your own personal OB/GYN, this is the one who you would have wanted to have. This one here, that doctor here.” Then she came. She was super happy.She was like, “Okay, I see you're trying for a VBAC. The whole floor, when I heard about your case, they were saying that you had a uterine rupture. I'm like, ‘That's not right. Her doctor wouldn't have let her do a trial of labor after a rupture.' I went through your file, and I saw that you only had a dehiscence. It's very common.” She literally repeated the same thing that my doctor said. She was like, “A lot of women who didn't even have a C-section end up having a lot of dehiscence. It's just that we never know because they are never opened for a C-section to mark it down.” She was like, “It's completely common. We're going to do this.” She was like, “You've been at 9.5 for 2-3 hours, and your baby's station hasn't descended. Let's see what's going on.” She brought an ultrasound machine, and she performed the ultrasound on me. She literally saw that it was the baby's head's position. His head was slightly crooked to the left. Meagan: Asynclitic, mhmm. Aisha: Exactly. That's when I'm telling you that I love these people. I'm still having butterflies thinking about them. They came with the Miles Circuit. They came with the sheet with the images, and they're like, “We're going to do those.” I'm like, “The Miles Circuit!” They're like, “Yes.” I'm like, “Oh my god. You guys are my people.” We started doing the Miles Circuit. I did every movement for 30 minutes. I held it for 30 minutes. I did the cowgirl, I think they call it. Meagan: The flying cowgirl. Aisha: Exactly. Then after that, they came back. My doctor thought the baby's position had changed, but my water hadn't broken yet. She was like, “I'm going to break your water. The worst case scenario is that your baby's heart doesn't handle it, but I think that's going to make us go to the next level.” She broke my water. Literally, within the time she broke it and went to check, I was ready to go. That was literally all it took. She was like, “Okay, we're going to start pushing.” I know in my birth plan, I said that I was not going to push on my back lying down. I went on my four knees. I went first in my knees. I was holding onto the bed, and I was pushing that way. But I was so tired. I hadn't eaten in a while. I was still drinking, so drinking was good, but I hadn't eaten. My doula gave me candy. That helped me, but I remember in that exact moment, in my thoughts, “Aisha, your baby did it. This is your time now to help your baby. This is it. You've waited four years for this moment. This is it. This is all you've wanted. You need to find strength somewhere and make it happen.” I looked at them. I'm like, “I'm going to lie down.” I laid down, and my doula gave me this blanket. They attached this. Meagan: Mhmm, some tug-of-war. You did some tug-of-war, mhmm. Aisha: I was pulling on it when I was pushing, and my mom and a nurse were pushing my legs up. Yeah, then I pushed. I pushed. I pushed, and at some point, my body was pushing automatically whenever the contraction would come. It would literally do that. I would bear down by myself. I know the doctor kept looking at me. She was like, “Wow. This is awesome.” Yeah. I think I pushed for 45 minutes, and then he was born. My husband is actually the one who caught the baby. Meagan: Oh, yay. Aisha: That's what we wanted. We caught him. We did not know the gender, so it was really fun to see that it was a boy after two daughters. Once he was born, they put him on my chest. Everybody was crying. I know the nurses were crying. The doctor was crying. I've never had a hug from a doctor, and she literally came to my bedside and hugged me. She was like, “This is the moment. We don't see this often, so thank you for letting us experience this.”I know for a lot of the nurses, it was almost the shift change. It was almost 3:00 PM when he was born. One of the nurses looked at me. She was like, “My shift is ending in about 30 minutes. I need to see this. I need to witness this happening.” Then, yeah. He was born, and I think I had a first-degree tear, but it was on the outer labia. It was because when he was born–Meagan: Superficial. Aisha: Yeah, he had his hand on his face like a Superman. Meagan: Oh my goodness, so you had a nuchal hand, too? Oh my gosh.Aisha: Yeah, in the photos of it, it's so precious. My doula took photos, and you can literally see his hand coming out. Yeah. It was great because that evening, that night, the doctor came back on her shift. She heard that I gave birth. She came to apologize, literally. She was like, “I heard that you gave birth vaginally. Congratulations. I'm so sorry for not supporting you in that sense. There is a risk, and not every woman ends up having great stories like yours.”Meagan: Oh gosh. Aisha: “But we are happy for you.” I was just happy that I proved them wrong and that I made history in that hospital having a VBAC after two Cesareans. It happens. It's possible. I'm just happy that I listened to that voice inside, and that all of the noise around me did not affect my initial desires. Meagan: Yeah, and overall, your final decision, right? We've talked about this. I call it static. There's a lot of static that, I feel like, looms over VBAC moms. At least it did for me, and I do see it sometimes with my clients. It's their friends, their family, their providers, or whoever it may be, they are looming with this unnecessary static. Aisha: Yes. Meagan: A lot of it is, “Well, there's risk and what if's.” Oh, you name it. So many of these things, and really, I took a whole bunch of notes of little nuggets of your story. I can relate in a lot of ways with your story. It's similar to mine with how things unfolded. From the very beginning, you started off right. You started off right. You found the provider. You found the team. You got the support. You got the education. You dove in, and like you said, this was four years in the making. It took you four years to learn and grow and have this experience that you wanted. Sometimes, it takes one time to try. I say “try” with quotes, but to go and have a trial of labor, and it maybe not work out like mine and your situation. And then, okay, we learned from those two situations. Now how can we learn and grow from those situations and change and develop this next situation? It's so weird. My mind right now is really heavy on my daughter's reflections. They do reflections at school. It's a big art thing. Her topic is overcoming imperfections. Sometimes, in the birth world and especially as women, as you were saying earlier in your story, we have this thing that if we don't do it this way or if it doesn't happen this way, maybe our motherhood is stripped away, or we failed, or our baby failed. We can go as far as our baby failed us or whatever it may be. Overall, no situation is perfect. There are just always imperfections, and what do we do with the situation to grow and transform?I mean, really. I went over some of it, and then just learning more about hydration and how important food is and fueling our bodies. Aisha: Yes, yes. It's a marathon. You cannot run a marathon without an ounce of water or without food. You see it when you see people doing half marathons. There are people on the sidelines giving them water. Meagan: They're fueling. Aisha: Right. They're fueling. It is important and necessary. Knowing that the providers, as much as yes, we do have faith in them, they are there to help us, and they are there. I don't want to say this in a bad way, but they are working with us and for us. Do you know what I mean? They don't have the final say. We have the final say. That doctor who was there, when I told you about the dream team, she never ever does hospital rounds. She usually just does prenatals. Even the nurses said, “We usually see her once or twice a year. She never comes.” That ended up being the one time a year that she came. She looked at me and said that she is a pro-choice woman. She was like, “When a woman makes a choice, even if they fail, she will be happier, and she will be able to cope with the results way better than if someone strips her of that choice and obliges her to do something she did not consent to do. The outcome of that will be way harder to overcome than if she is the one who made the decision regardless of the result. That is way better.” Meagan: It's so true. Aisha: I wholeheartedly believe that. I know I had to really see in myself if that doesn't work. I know sometimes, we go into labor very naively. I feel like every first-time mom and even second-time sometimes, that can happen especially if let's say you were going for a vaginal birth, then you have a C-section, then you're trying for another vaginal birth, it's still in some sense the first time that you are going to experience this sort of experience. You're still going into it naively and blindly. Like I said, I never knew a C-section could be an option. The second time, I'm like, “It cannot happen to me twice.” After it happened to me twice, I planned for it. I planned in the circumstance that there would be a C-section, what do I want to happen? I knew I had my guidelines, and at least it wouldn't be a shocker and a hard pill to swallow. I would have been okay because I had my trial of labor.At the end of the day, your baby does decide how they want to be born. I feel like one thing I would advise all mamas and even fathers or partners, we need to include them to that. I feel like talking to your baby makes a whole lot of a difference. I got that advice from my osteopath where he told me a story about his wife about to be wheeled into a C-section. He came. He spoke to their daughter who was in the womb. He was like, “This is your moment. You decide. If you want to go to a C-section, do it. If not, this is the moment to change things.” His wife ended up having a vaginal birth right at the moment that they were going to. I pulled my husband up at some point I remember when I was starting to push. He came and saw the baby, then he was like, “This is your moment. You decide how you want to be born. You choose, and your mama is going to help you do this.” I feel like having that communication, our babies sense everything, so being connected to that too is so important. It's so important. Meagan: Absolutely. Absolutely. Circling back really quickly, if we do all of the things, if we take the VBAC education course, listen to the stories, learn more, read more, learn the stats, hire the team, and all of the things, we do our fear clearing processing about past experiences and all of that, and then we go in and be fearmongered like they were trying with you, and fearmongering by definition is that “it causes fear by exaggerated rumors of impending dangers”. There were big things that were said, but if you hadn't done the research and the education, you easily may have been fearmongered. Sometimes, it's even easy to be fearmongered even with the education. I will say that straight up. When you are being told that your baby could die, that word is very, very triggering. But you were able to have the education and be like, “No. I understand what you are saying. I respect what you are saying. I am going to continue moving forward this way.” But if we would be fearmongered and not have the education and then later learn the education, overall, our experience and view and our feelings postpartum would be a little bit rougher because we are learning these things that we could have learned before. That's why education is one of the biggest tips that we can give because you need to be educated along the way because it is easy for someone to come in. Look at you, Aisha, “No, no, no, no.” How many times did you have to say, “I understand, but no, no, no, no.” It sucks that that's the reality, and trust me, it ticks me off so much. Aisha: It is. Meagan: I wish it would change, but if we aren't educated and armed with that team, with that power, with our experience, then we are more likely going to fold in those situations. Aisha: It is completely true. At some point, even one of the nurses told me when they were trying to do the easy port that I needed to stop moving because this was going to end up with a C-section, and they really need to do the easy port. I had to tell her to never repeat the word “C-section” in front of my face. It sucks that for women or people experiencing multiple Cesareans or even one Cesarean when they are trying to do a vaginal birth that they need to constantly fight for it. Meagan: Yes.Aisha: But you do need to stand your ground and really focus on what you want. The fears will come, but that's a moment where you need to rely on the education that you have and all of the process. You spent 9 months preparing yourself, and all of those months must count for something. You're not going to be that one person. That's what I was telling myself. In the case that yes, the unfortunate happens, I was at the best place at the best time, and I had the best team. That was my thing. I trusted in my team that everything would be fine. But no, definitely. Yeah. You need to believe in yourself and in your project. Meagan: Yes. Oh my gosh. Well, this episode is just jampacked with all of the nuggets of information, guidance, suggestions, and empowering feelings. Oh my gosh. Thank you so much for being here with us today and sharing with us your beautiful story.Aisha: Thank you. Thank you for having me. Thank you so much. It's a dream. Meagan: Oh my gosh. Well, congratulations again.Aisha: Thank you so much.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.  Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

The VBAC Link
Episode 370 Sheryl's 2VBACs + The Unpredictability of Birth

The VBAC Link

Play Episode Listen Later Jan 15, 2025 38:09


Sheryl's first baby was five days late. Her second baby was five days early. From the first contraction to a surprise car birth, Sheryl's third baby was under an hour! Not only were the methods of delivery very different with each baby, but Sheryl's life circumstances were too.Julie and Sheryl chat about preparing yourself not only for the long, marathon labors, but also for the possibility of the fast and furious ones! How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Julie: All right. Good morning, Women of Strength. This is Julie Francom, and I am so excited to be here with you today to share with you a very exciting story. One of my favorite types of birth stories, people might think I'm crazy, but– oh, do you know what? I'm not going to tell you what the story is, but if you have been listening for a minute, you might know when I say what my favorite type of story is, but I'm going to leave it to be a surprise. We are going to go ahead and read a Review of the Week really quickly, then I'll introduce my guest of the day. Okay, let's see. This review is from Apple Podcasts. It's from ccm57, and she says, “I am so thankful I came across this podcast and know it was an invaluable tool when educating myself regarding VBACs and the birthing process in general. My first son was born via Cesarean due to his stubbornness and refusing to turn from his breech presentation. Leading up to his C-section, I was devastated that I wouldn't be able to experience the natural birthing process I had always wanted. “I am in the medical world. I knew about VBACs, and it was never even a thought I wouldn't try for one in my next pregnancy. I found The VBAC Link halfway through my second pregnancy, and it was so addicting. I listened to every episode, sometimes multiple times a day, until my delivery. Every woman's story was amazing and truly helpful to me personally. “Thank you, Meagan, for being as passionate about VBACs and educating women all over the world. I can excitedly say that God was so gracious, and I had my beautiful VBAC this past August. Thank you to every woman who have shared your story on the podcast and for all of the women who are listening and expecting a sweet baby, I am cheering you on.” I am so excited to hear stories and reviews like that. It's really incredible what can happen when you get a group of women together to share stories and to help uplift and inspire each other. I'm grateful to this reviewer today and to all of you listening, to everyone who has shared their story on the podcast, and to everybody who helps spread the word about VBAC and helps increase access to people all over the world, really. All right. Well, guess what? It is very cold today. It's been a very nice 70s and 80 degrees here in Utah for the last little while, but it is now mid-October at the time that we are recording this, and it is raining and freezing. There is supposed to be snow dumping up in the mountains today, and I am just wrapped up tight in my big, poofy blanket and very, very excited to talk to our guest today. Her name is Sheryl, and she is going to share her Cesarean and VBAC stories with us. I am really excited. I am really excited for this story, you guys. I'm not going to tell you what we are going to talk about at the end because I don't want to ruin the surprise. It's going to be a great episode, and I am just going to go ahead and give it over to Sheryl and let her pick it up. Oh, first, hold on. Let me read her bio. I am still getting into the swing of things. Sheryl: Sure. Julie: I need to remember that. Let's see.Oh, yes. Sheryl is a mom of three. She has been married for 10 years to her husband. They live in Sugar Creek, Ohio. I love the Midwest except in the winter. It's getting ready to be not so fun out there. It's beautiful in the spring and summertime. Anyway, okay. She recently returned from living in the Dominican Republic for the last two and a half years which is really cool. I feel like everybody needs to have an experience living abroad. Sheryl: For sure. Julie: You just learn so much when you are in a foreign country experiencing different things. I feel like it's very valuable. Anyway, that was a little bit of a tangent. But now, for real, we are going to give it over to Sheryl. Go ahead, Sheryl. Sheryl: Okay, well thanks so much for having me on. This is super fun.Julie: Of course. Sheryl: Yeah, I'm not sure where you want me to start, but I have had two VBACs and very different experiences with both. My first was a C-section. I'll start with his story a little bit. He's 6-years-old, so six years ago, I knew I wanted to have a natural birth. I took a natural childbirth class. I felt like I had prepared, but I don't think I had mentally prepared for birth very well. I think if I could do it again, I would definitely have hired a doula just to help with the mental aspect. I was five days late. I told my husband, “I'm not going to work tomorrow.” It was Sunday night. I was like, “There is no way I'm going to work tomorrow. I will go into labor tonight because I can't go to work tomorrow pregnant.” He was like, “Okay.” We went on a truck drive on a bumpy road. We played mini-golf. We were like, “Okay.” We started watching a movie. I was like, “I think I'm cramping a little bit. Okay, this is great.” We finally went to bed, and yep. Sure enough, a few hours later, I woke up with contractions, and I was so excited. I was very taken back by how painful they were. Now, looking back, it was like, okay. Those contractions weren't even that bad. It was going to get so much worse. I was progressing great. I think I went to the hospital when they were 3.5-4 minutes apart. I think I got there. I think I was dilated to a 4 or 5, so they were like, “Yeah, you're progressing really well. This is great.” I figured it was 7:00 in the morning. We would have a baby by noon. At 11:00, I said that I wanted to get in the birth tub or just labor, but I wanted to get out to have the baby. I was in the tub. Now, looking back, I think I was in transition. I ended up vomiting a little bit and just being so nauseous and in so much pain. The water did help, then they came and checked me and were like, “You are an 8.” They were like, “You should get out if you don't want to have your baby in the water.” I was so excited. They came and got things ready, then I really got fearful at that point. I was just very scared about what was going to happen and all of the things. They came and checked me, and they were like, “Oh, no. You're not dilated that much. You're maybe a 7.” I just tried to keep laboring on. We ended up doing some different pain management. I was just not progressing anymore. At this point, I think it was 14-15 hours, so I was just exhausted. I was very thankful. One of the midwives at the practice that I was at was off that day. She had actually been on vacation. They let her know, “Hey, just so you know, Sheryl is at the hospital. She is having a really hard time. We can't figure out why she's not progressing further.” She was like, “I'm going in.” She came in. She was so kind, and she worked for hours trying different positions and everything possible. Finally, she was like, “Okay.” I think it was 8:00 at night. She said, “You are exhausted. Let's do an epidural,” which I didn't want because I was like, “I don't want needles. I hate needles.” I got an epidural. I got a little bit of a nap. It worked for about an hour, then it stopped working. The pain came back, but then obviously, there's nothing you can do except lay there. I was at a 9, and it wouldn't go any further. She kept trying different things even with the epidural. Finally, she was like, “Okay, he's actually gone back up. He was down, and now he's back up.” She said she was going to go talk to the doctor and see what he thinks we should do. They came back. It was 10:30 at night. They were like, “I think it's time for a C-section. We don't know why he's going back up, but typically, it's a sign that things are not going well, so we're going to do a C-section.” At that point, you're just so tired that you're like, “Okay, yeah. Whatever we have to do to get him out.” They ended up doing a C-section. I was so tired that I was falling asleep while they were doing the spinal tap. I was just exhausted. The C-section went very well. My postpartum was hard. I think just as a first-time mom with a C-section and all of those, and then feeling like a failure. That was a really challenging time, but right away, the doctor told me that they were one in the area that was known for VBACs. They had successful VBACs. He told me and my husband right away, “You will be able to have a VBAC. There is no doubt in my mind that you will be able to have a VBAC for your next.” Julie: Oh, I love that. I love that they said that to you right from the get-go.Sheryl: Yeah. It was so great, so it was like, “Okay. We know that the next one will be a VBAC.” We actually had a miscarriage between baby number one and baby number two. That was really challenging. It was a surprise. At that point, we had committed to move to Haiti. We weren't planning on getting pregnant, but we got pregnant, then 10 weeks later, we miscarried. Julie: Wow. Sheryl: It was definitely a difficult time, and it was the year 2020. I don't think I need to say anymore than that. It was February 2020 when I miscarried. Julie: Oh, Sheryl. COVID ruined everything. It really did. Sheryl: It was definitely a challenging year. We were ready to go on a mission. That got delayed until we ended up moving to Haiti in March 2021. We were there for almost 6 months, and then their president was assassinated, so the country became really turmoiled and it was becoming unsafe for Americans to be living there. Our mission board thought it would be best to pull us home. At that time, we had planned, okay. We moved in March. If we start trying for baby number two in June, we would have been in Haiti for a year. We'll start trying. We had kind of started trying, then we got pulled out in July, so it was like, man. Do we keep trying? Do we not? We were like, like, “You know what? We'll keep trying. We'll see what happens.” Yep, sure enough, in August, we got pregnant again with our second baby, our little girl named Felicity. Right away, I had that confidence that, “Okay. I'm going to have a VBAC.” I did a really good job, I felt, of preparing mentally. I read so many books, so many podcasts. I decided right away, “Okay. I'm going to have a doula.” I was just really prepared. But during this time, we were planning on going back to Haiti. It's so many details, but long story short, we weren't able to go back to Haiti because it ended up getting worse, not better. So our mission board was like, “Hey, let's find someplace else for you to serve in the meantime before you have your baby back in Ohio.” We connected with a mission in the Dominican Republic and ended up going to the DR. That was a great experience, but also, I waited to come back from the DR until I was 35 weeks pregnant. It was crazy to be in another country and know that you're going back. I definitely did not want to have a baby in the Dominican Republic. If listeners are familiar with the DR, they have the highest C-section rate. I looked at the number really quick. I was actually surprised it wasn't higher, but 58% of births are C-sections. Almost all of their natural births, they do episiotomies. That's just what they do.Julie: What?Sheryl: Yeah, it's nuts. So it's like, there's no way I'm going to have a baby in the Dominican Republic. Thank the Lord, I didn't have a baby int he Dominican Republic. I was very ready to do this. I had affirmations. I had prayers written out. I hired a doula and all of the things. I spent a lot of things praying for very specific things asking the Lord, “Okay, I don't want to go late. I don't want to have a long labor, and I want this certain midwife.” Her name was Leanne. I wanted her to deliver me. She's delivered two of my sisters' children, so she was a family friend. She's known us for 20 years. Those were my prayers that I kept praying. I asked family and friends to pray.I went in at 39 weeks. She was like, “Hey, you're dilated to a 3. You're 50% effaced. Do you want to do a membrane sweep?” I was like, “Yes, let's do it.” We did that. I went home. I felt fine. We did some food prep. I finally got my husband to pack his hospital bag that next day, then I guess I went to the doctor when I was 39 weeks and 1 day, but the next day, my husband was supposed to be working 2 hours from where we lived. He was like, “Should I go?” I was like, “Well, I think so. I don't think I'll feel anything tonight. Let's plan on going. I'll wake up when you wake up and make sure I'm not having any contractions.” He woke up at 5:00. I was like, “Yeah, I'll get up.” I went to the bathroom. “No, I'm fine. No contractions. Go on to work. You'll be just fine.” 6:30 rolls around. Whoa, that's a contraction. “Okay, I'm going to go back to sleep.” At 7:30, a contraction woke me up, and my little boy at the time would have been 3, almost 4. He woke up ready to have breakfst, and I was like, “Oh, that's a contraction.” I tracked my husband, and he wasn't even to the job site yet. I'm like, “Oh no.” Julie: Oh my gosh. Sheryl: Oh no. I made breakfast. I got in the shower. I was like, “Surely, they'll slow down.” At this point, they were 4-5 minutes apart. I was like, “They aren't slowing down. Okay.” My sister texted me. She was like, “Hey, how are you feeling this morning?” I was like, “I think I'm going into labor.” She FaceTimed me. I'm braiding my hair and trying to get ready. She's watching me, and she was like, “Have you let Javen know yet?” I was like, “No. I was trying to let him get some work done.” She was like, “Sheryl, are you timing them?” I was like, “Yeah.” She was like, “That's every 3.5-4 minutes apart. You should probably call him.” I was like, “Okay, yeah, you're right.” I called him, and he immediately knew. He was like, “Ah, she's in labor.” He hopped in the work truck and headed toward me, but there was no way that I could sit here and wait. We had three people lined up to take Riley for us. Unfortunately, those two people both did not pick up their phones, and one was sick. I called number three, and she was like, “Hey, I will come and get you and take you to the midwife office.” They were going to check me there before I went to the hospital just to make sure I was progressing. She had three kids in the car. She added one more of mine in. It was an interesting 30-minute drive trying to labor while there were kids in the car and a lot happening. I got to my midwife practice, and she was like, “Okay, yep. You're dilated to a 5. You need to get to the hospital.”Thankfully, my husband met us there. We headed to the hospital. We got to the hospital. I was a 6. My doula got there at 12:00, and things were just progressing really nicely. At 1:00, I think it was 1:00, my doula was like, “Hey, why don't you go to the bathroom to see if you need to pee or anything?” I did, an at that moment, my water broke. They checked me. They were like, “You're a 9. You're almost there. Two more contractions. Okay, you're ready to push.” So I pushed for an hour, and she was born at 2:15. It was really an amazing birth. It was everything I had prayed for. It was less than 12 hours which I had specifically prayed, “Please, Lord, no more than 12 hours.” It was told, “Oh, you'll probably push for 2 hours,” and I pushed for an hour. It just felt like God was very faithful, and He answered my prayers. The one thing I didn't pray about, and this time I did, was for no tearing. I did tear pretty bad, so that made postpartum pretty rough. After Felicity, we returned to the Dominican Republic and were there for 2.5 years. We'll fast forward to last year, and were like, “Okay, maybe it's time for us to head back to Ohio.” We really loved it in the DR. We had a great community and great friendships. The ministry we were serving with was wonderful, but we felt like, “Okay, this is what we are supposed to do.”We came home for Christmas. We hadn't been home for over a year, so it was really exciting to come back to Ohio and see family. While we were here, I just was like, “Man, I'm one day late,” and I'm never one day late. I had said, “Okay, I'd better get that taste just in case.” I took it, and sure enough, we are expecting another baby. It was very surprising, but also, it was just like, “Okay, we were planning on coming home, so now we are definitely coming home.” We moved back to Ohio in June, and we were due the end of August, August 27th. I think I should have mentioned that with Felicity, our second baby, I was 5 days early. I was 5 days late with the first one, and 5 days early with the second. I think just with this pregnancy, it was so different because we were just in a different phase of life. I didn't prepare as well. I felt like in the last few weeks, I was scrambling mentally. I was feeling anxious and not prepared. I actually listened to The VBAC Link one day. I was really struggling. I was like, “I need to hear some positive stories.”I was driving to the airport to do an airport run, so I just kept listening to episodes, and it was like, “Okay. Other people have done this. I can do this to,” so that was super helpful. I would say that overall, the practice was really great. It was one midwife and one OB/GYN, but I did not love this time around. They were not as supportive as I felt. They were like, “Hey, we are not going to let you go past 40 weeks no matter what. That's our policy. You can't go past 40 weeks.” I was just like, “Aw, well, I don't want to be induced. I don't want Pitocin. I don't want to be induced.” They just kept pressing that, especially the doctor. I just didn't feel super supported. We decided not to do a doula this time. The last few weeks were kind of rough. I didn't feel great. It was the summer. We transitioned. We had two kids. Our second one, Felicity, is two, so it's a lot different being pregnant with a 2-year-old and an almost 4-year-old. Yeah. I kept going to the doctor. At 38 weeks, they checked me. They were like, “Yeah, you're not dilated at all.” At 39 weeks, they checked me, and they were like, “Yeah, there's no way we could do a membrane sweep. You're not dilated at all.” So at my 39-week appointment, they were like, “Yeah, we think it's time to schedule that induction.” They did an ultrasound at 38 weeks, and they were like, “Yeah, you look perfect. Baby is healthy. Not too big.” All of those things. It was frustrating to me because I was like, “If everything is fine, why do I need to be induced?” We were contemplating fighting it, but then me and my husband were like, “Hey, is the stress of fighting the practice worth over going into an induction with a positive attitude?” We decided, “Hey, we're going to schedule the induction. We're going to do our best to do everything we can in the next week to make it happen on our own.” Lots of walking. We tried everything. My induction was scheduled for Thursday, the 30th, I believe, or the 29th. The 29th. I went in on Monday and had an appointment. I was like, “Hey, I just want to get checked one more time. Can I do a membrane sweep? That worked well last time.” I think my appointment was at 2:30 in the afternoon on Monday. They tried, and she was like, “Nope. You're not even dilated more than a 2, and he's way far up. Yeah. You're just going to have to be induced on Thursday.” I was just so devastated. I left so sad, and I was just like, “Okay. We're going to do this. I need to just be positive.” But then that night after we had the kids in bed, I had a little bit of a breakdown. I told my husband, “I'm just so sad. I really thought I could do this. My body is failing me.” You know, all of those things. He was like, “Hey, let's just pray about it.” That night, we specifically prayed that I wouldn't tear, Leanna would get to deliver, and that it would go really quickly. That was at 10:30 at night. We quickly did a lap around outside, just trying to calm me dow and then hopefully a walk would start something. Finally, we went to bed at 11:30. As I was climbing into bed, I felt a contraction. I was like, “Oh wow. That's been the most painful one I've ever had. Okay, I'm going to go to bed.” I had another one about 8 minutes later, but didn't think anything of it. I finally fell asleep, and I kept feeling them, but I was still sleeping. I didn't really worry about it. Again, in my mind, I have to be induced on Thursday. There's no way I'm going into labor. I woke up at 1:30 to an extremely painful contraction. All of a sudden, I felt a pop. I feel like I heard it too, but I felt a pop, and I was like, “That's my water.” I woke Javen up. I'm like, “Javen, my water just broke, and the contractions are very painful.” He quickly called his mom to come over and watch the kids. He called the doctor's office to let them know. I was yelling, “Hey, tell them that Leanne's supposed to deliver.” I got in the shower. I tried to start getting cleaned up, and I'm realizing that the contractions are every 3-3.5 minutes. But in my mind, my water just broke. I'm sure I had plenty of time. I was only dilated to a 2 yesterday. My mother-in-law got there. I got out of the shower and got dressed. Neither me or my husband were in a hurry, but I walked from the bathroom to the kitchen table. Contraction to the kitchen. I couldn't walk more than a few steps without having a contraction. I looked at my mother-in-law and I was like, “Man, I've never had my water break this early. These contractions hurt really badly.” She shook her head and was like, “Uh-huh. Yeah.” She looks at Javen, and she was like, “You need to get her to the hospital.” She's trying to get us to the car. I'm in so much pain. She was like, “You've got to get to the hospital.” The hospital is a 40-minute drive. We left for the hospital at 2:00. I actually rode on a birthing ball in the back of the car which now, I'm like, “Yeah, that probably didn't help slow the progress down,” but that was the only thing that was comfortable. I had my worship playlist going. I was in a lot of pain. I had a few friends who I had told, “Hey, I'm going to text you when I go into labor so you can be praying.” I texted a couple friends. I texted a sibling, “Just so you know, I'm going to the hospital. My water broke.” My one sister does some night work. She was actually still awake, so she started tracking me on my phone. We got halfway to the hospital, and I told Javen, “Javen, we're not going to make it. I need you to pull over. He's coming.” He was like, “No, just wait 20 minutes. You can wait 20 minutes.” I was like, “Nope. There's no way. You need to get the car pulled over right now. He's coming out.”I quickly got off the ball, and within 2 minutes of getting the car pulled over, Javen moving the driver's seat forward, and opening up the door, and calling 9-1-1, we had our baby boy. It was the most crazy experience. I say he came out in three pushes, but really, I didn't push at all. To experience my body just taking over is just an insane feeling. Julie: Oh my gosh. Yep. Sheryl: Yeah. The ambulance was headed our way but they were pretty far away because we were in the middle of nowhere. We were actually pulled over into an Amish farm. We live in the heart of Amish country in the middle of Ohio. I'm praying, “Please don't come outside and watch me give birth.” Luckily, no. We found out who the owner was and through back and forth, they were like, “No, we didn't wake up. We didn't hear anything.” So praise the Lord for that.I actually delivered my placenta before the ambulance got there. Julie: Oh my gosh. Sheryl: Baby Casey was healthy and just immediately had a head full of hair. He was the most beautiful baby boy. I held him on my chest. Javen caught him and handed him to me. Just to hold him, it was such a whirlwind. It was crazy. I got into the ambulance and realized that yes, not only does he have a head full of hair, but he has a head full of red hair. He has very, very red hair. He was just a surprise from every point. We got to the hospital. The midwife came to check on me. She was like, “How did this happen? I just saw you not even 12 hours ago, and you were not ready to have a baby.” Every prayer I prayed was answered again. Now I know, and I'll tell listeners, if you're going to pray, you need to be specific. Be specific when you say, “Get me to the hospital and not in the car.” I learned that. Julie: That is so funny.Sheryl: I did not tear, and that was something I had prayed for which was really cool because my midwife is older, so I think this was baby number 1900 for her or in the 1900s. She had always told me, “Hey, when you go to push, don't push the head out. Just breathe it out. Don't push and you won't tear.” As he was coming out, that's all I could hear in the back of my head was Leanne saying those things. It worked. That was really special. She was really, really proud of me for remembering that. Julie: I love that so much. Okay, you guys know I love a good car birth story. It's my favorite. It would be my dream birth. People might think I'm crazy, but man, I just dream one day of following somebody as they rush to the hospital in labor and then pull over to the side of the road, and I get to document a car birth. Anyway, probably not what you would use to describe it, but what happened when you got to the hospital? I'm assuming you got into the ambulance and drove over. They checked you out. You didn't tear and everything. Did you go home or did you stay in the hospital? Sheryl: We stayed in the hospital because they were like, “It's not necessarily you, but the baby. We have to monitor the baby for 24 hours.” My husband and I looked at each other. We were like, “We have to be here for 24 hours? We should have just gone back home and had somebody check on us there.” But yeah, it was great. I got in the ambulance. My husband had my phone. I looked down, and like I said, my sister was tracking me. I had a text message that said, “Did you just give birth on the side of the road?” I responded, “Yes, I did.” She said that as soon as she saw the car stop moving, she kept refreshing and the car did not move. She just knew. That was fun. I started nursing. I'm laying there in the ambulance, and I'm like, “Well, hand him to me. I want to see if he's going to nurse.” He latched immediately. They were surprised. Also, two of our EMTs were Amish guys, so that's fun. To live in Amish country, you do have Amish EMTs then, so that was fun. Julie: Yeah. Wow. That is so crazy. I think that is just such a way to highlight how every birth is different. We talk about how every person is different. Every pregnancy and birth is so different and unique in and of itself. You had three very different birth experiences. I love that. I was trying to do the math in my head about how long this was from when you woke up at 1:30. What time was baby born?Sheryl: 2:20. Julie: Oh my goodness. Girl. Sheryl: Yes, so less than an hour. I never would have thought. We did joke a couple times, “Hey, if you want your VBAC, just have it in the car, and you for sure will get it exactly how you want it if you don't want Pitocin and all of that.” We joke about that, but now we know that you probably shouldn't joke about that. It might happen. But honestly, I never thought. I'm a little bit crunchy, but not super. I didn't want a home birth or a free birth, but now, I get it. It was super empowering. I had so much adrenaline and just to be like, wow. My body did what it was supposed to do. I can trust it. It knew when to go into labor. Obviously, it doesn't always go that way, but this time it did. It knew what it was supposed to do.Somebody told me that their doctor said, “I never trust third babies.” Julie: I always say that too. Sheryl: Yep. It's definitely true. Julie: I always say that I don't trust babies. I especially don't trust third babies. It's just so unpredictable especially when you let babies do their thing. There are times when interventions are needed. There are times when Cesareans are lifesaving. There are times when induction is necessary, but I feel like the biggest majority of the time, if we just let the body do what it knows how to do, things will happen just beautifully and perfectly. Like I said, there is nuance there. It's important to acknowledge that, but a lot of amazing things happen when we just trust and create space for the body and the baby to do their beautiful labor dance and let things happen as designed. I think it's really neat. I think it's all neat. I'm a birth nerd. I think birth is neat. Birth is cool, and I think there are lots of really cool things to say about all of your stories. I do think it's really important that with VBAC especially, you can have a VBAC in lots of ways. You can have it in the hospital, a planned induction, a planned epidural, planned unmedicated, in-hospital, out-of-hospital, or however you want. A free birth, unassisted or whatever. You can do it all of the different ways, but I think it's really important. We talk a lot about, especially with VBAC, laboring like a first-time mom and being prepared for the long haul. Plan for a 20-hour labor or longer.But I feel like maybe it's a disservice to not talk about the other side when things can pick up and start really fast and go really fast because I feel like the perfect length of labor is a nice 8 hours. 8 hours is a good amount of time where it doesn't railroad you. You don't have to catch up and process. You don't feel defeated because it's taking so long. 8 hours is a really great length. I think it's a disservice to talk about that would happen if there is not time to get to the hospital or if there's not time to get an epidural. Sometimes parents rely so much on not getting a medicated birth that they don't think about what would happen if there is not time for that, then being railroaded by a fast labor and not being prepared for the intensities that come with that can cause birth trauma in and of itself even though the body is doing its thing and we trust the body. It can cause trauma by having something that you didn't prepare for or expect of plan for. I would encourage everybody that if you are planning a home birth, if you are planning a long labor, cool. That's great. It's great to be prepared for things. I always say to prepare for the worst and hope for the best, but sometimes, it's good to prepare for the other things too. Prepare for the things that are opposite of what you want or what you are hoping for or what you are preparing for because at least if you acknowledge them and make a plan A, a plan B, and a plan C, then you will be less likely to be unprepared or caught off guard or have the opportunity for trauma to be introduced to your story. I think it's really fun to explore all of these different things and hear all of the different stories and how different everybody truly is. I love that. What would you say? Sheryl: As far as that, a lot of people were like, “Oh man, my husband could never do that.” One, so many instincts just kick in. So many people said, “How did you know what to do?” One, I've had a baby before. Two, my body knew what to do. I just listened to the cues. Okay, what should I do? What feels comfortable? But then again, my husband was amazing. No fear. He caught the baby. He drove to the hospital with bloody hands, but he is a hunter and a farmer, so he's like, “Yeah, no big deal.” He's known as a cool, calm, collected guy, and he even is when he is delivering his own baby in the back of a car. The other funny thing was that since we had just moved back, we had bought a new vehicle. I had dreamed of being a minivan mom almost my whole life. I had always wanted to be a mom. Finally, my husband got me my first minivan. Baby number three on the way, we finally get a minivan. Luckily, it came with really good mats in it that had a wide lip around the edge. Everybody was like, “What a mess that must be.” Lucky for us, everything stayed right there. The next morning, Javen went and got me breakfast. On his way to get me breakfast, he stopped by the car wash and dumped it out, rinsed it off, and we were good to go. Julie: Perfect. Sheryl: The doctor at our practice was like, “You really should write that company and do a review for them.” Julie: That is amazing. Sheryl: If you are thinking of having kids, you should put that in. Julie: Maybe you'll get a free car. Did you hear the story about a guy who had a Stanley-insulated tumbler in his car, and his car caught on fire? After, he was going back through the wreckage. The car was literally on fire. He has a video of this car. He's looking through it. It's charred and burnt, then he opens up his Stanley cup and there's still ice in it. Then Stanley the company gifted him a new car. Sheryl: Oh, wow. Oh man. Julie: The natural advertisement for that. Can you believe it? Sheryl: Maybe I need to reach out. Julie: Do it. Sheryl: As we were sitting there in the hospital, we can't sleep after that. It takes hours for you to calm down after that much adrenaline. Life for the last four years, really, has been crazy. I think we've lived in six or seven different houses. We have been back and forth to three different countries basically. That part of our story is coming to a close. It was like, yep. Okay. This is a really great way to end this chapter of our life with a carbirth. Our life will continue to be interesting and crazy in other ways. Julie: That is amazing. It sounds like you have quite an adventurous life for sure, and what a story. What a story to tell. Thank you so much. Oh wait. Before we wrap it up, I want you to tell us your best VBAC advice. What is one thing you would tell anybody preparing for a VBAC? What should they do? Sheryl: Yeah, great question. I would say to prepare like it's a marathon mentally. Really think about what you want. What to you is a part of birth? If you follow the Lord, ask Him those things because He does want to answer our requests. He does delight in giving us what we want. Sometimes, He doesn't always answer that, but in my experience, when I've asked in this specific area, He has given me what I wanted. Really pray about it. I know that with every birth, I have gone and gotten a massage. For that hour, I have focused on, “Okay. What is an important part of birth to me?” That would be my advice. Really focus mentally on feeling strong and capable. Julie: I love that. I love that. Well, thank you so much for joining me today, Sheryl. It's been such a joy to listen to your stories. Yeah, so fun.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

The VBAC Link
Episode 365 Goodbye to 2024 + VBAC Prep Info From This Year + Plans for The VBAC Link in 2025

The VBAC Link

Play Episode Listen Later Dec 30, 2024 12:22


We can't believe we have arrived at the last episode of 2024! This year has brought so many incredible and empowering births. We loved hearing how each of you fought for your birth goals, magnified your voices, and showed your strength. In today's episode, Meagan sums up The VBAC Link's 2024 achievements and shares some of the exciting things she has in store for 2025. The VBAC Link Supportive Provider ListThe VBAC Link Doula DirectoryHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hey guys, it's Meagan. Guess what? Today is our last 2024 episode. I cannot believe it is the end of the year. I absolutely cannot believe it. It feels like just yesterday that we started doing two episodes a week, and here we are 11 months later. We started in February. You guys, it has been such a great year. We have had so many incredible episodes from placental abruption, faith over fear, breech VBACs, post-dates, what hospital policies mean,and National Midwifery Week. One of my favorites, well actually, two of my favorites because he came on twice, was Dr. Fox. We had Dr. Fox a couple of times. We've had doula tips from VBAC episodes. We've had some fun episodes where we've had some VBAC Link-certified doulas as cohosts. Oh my gosh, so many great things. I don't know if you noticed, but in October, we started doing a themed week. Every two episodes in one month was a theme. For October, we had midwifery. It was National Midwifery Week so we talked about midwives and the stats about midwives. We had CNM Paige come on with our very own Lily who talked more about midwifery care, what does it look like, how to choose, can a midwife support VBAC, and all of that fun, fun stuff. And then in November, it was Veteran's Day so we had some military mamas on there and more about how to navigate that. We talked a little bit about Tricare and tips about navigating birth as a servicemember or as a significant other. That was really, really fun.This month, we touched on uterine abnormalities. We had Flannery talking about her bicornuate uterus and more about specific types of uteruses and what that means. It's so weird to think, but there are different types of uteruses, you guys. That doesn't mean that if you have a different type of uterus that you can't VBAC. It may mean that you may be faced with some challenges like a breech baby or something like that, but we wanted to share more about that because that's not talked about. But it's not going to stop. We have got that coming all year. 2025 is going to have a lot of really fun, specific episodes. The reason why I did this is because I wanted to have a whole week in two episodes where people could come and just binge two specific episodes that they may be looking for. We have a lot of people writing in saying, “Hey, I'm looking for VBAC after multiple Cesareans. Hey, I'm looking for breech stories. Hey, I would like to hear more healing CBAC stories or planned Cesarean stories.” We wanted to have it so they could just do two episodes back to back.Then of course, there are episodes throughout the whole podcast that we have that you can go back and find, but this way, you can find it in one week, two episodes back to back. We've got things like CBAC coming, VBAC after multiple Cesareans. We've got breech. We've got OB week. That's going to be fun. Oh man, I'm trying to think. So many other things. Special scars. We have a special scars month. We are just going to have months where it's typically going to be that second week where it will be a specific theme and topic. Don't forget to check that out coming up in 2025. Like I said, we started that up in October. Okay, so some other really fun and exciting things coming up, I do have a surprise for you, but unfortunately, you're going to have to wait until 2025. I'm really excited for this series. Yeah. It's going to be so good. Make sure to come back next week in 2025 to learn more about a surprise that I have coming your way. Then, in addition to that surprise and our themed weeks, I'm actually going to be rebroadcasting some of our old episodes. As you know, we are getting up there. We are at 365 episodes today which is so dang exciting. I cannot thank you guys enough for continuing to support this podcast, for coming back, listening, downloading these episodes, and just being here with us. We see you in our community on Facebook. We see you on Instagram. We see you downloading and listening. We are getting messages in regards to these stories and how much they are connecting with people.You guys, these stories are incredible. Just a reminder also, we are always accepting submissions. Now, we can't get to every submission because we do get a lot of submissions which is so fun to go through. We share them on our social media if we can't sometimes share them on the podcast, but please, if you have a story that you would like to submit and share them with other Women of Strength who are coming after you and are wanting to hear these empowering messages, go to thevbaclink.com/share, I believe, and submit your podcast story. Okay, going back. We are rebroadcasting episodes. I have gone back and listened to probably 10 or 12 episodes. Some of our really, really amazing episodes, and I've found some nuggets after re-listening that I'm pulling through and giving tips. We're going to have extra tips, extra links, and also if there have been updated things or updated studies from 2018 that have now been updated, we want to make sure that we freshen up these episodes and bring them back to more recent episodes. If you have a favorite episode that you would like to hear rebroadcasted or one that you listen to on repeat, will you let us know? Email us at info@thevbaclink.com and let us know what your favorite episode is and why, or if you are looking for some more information or want us to elaborate more on a topic that maybe we have discussed but didn't go too far into detail that I can maybe go into deeper detail about. Okay, I'm trying to think, you guys. We've had so many amazing things this year. Blogs– we have been pumping out blogs like crazy. There are so many things from preparing for your VBAC, 5 things to do before you get pregnant, recovering from a Cesarean birth. You guys, if you've been with us for a while, you know we absolutely love and adore Needed. We wholeheartedly love and trust everything they produce. We love them. They have really been so gracious to offer us a wonderful 20% off discount code, so don't forget that. That is still valid. You can go to thisisneeded.com and type in VBAC20 and get 20% off your order. We talk more about why prenatal nutrition matters. We talk about creating your ideal hospital environment. We talk about C-section scar massage and why it's important. That is a big one that isn't talked about enough. We talk about hiring doulas, things to put on your registry, more about red raspberry leaf tea. We talk about heartburn, Tums, and also what else Tums can do to help us in our VBAC. So many things. We talk about positions and using the ball. Oh my gosh, just so many incredible things. We've got so many blogs coming at thevbaclink.com/blogs so make sure to check out the blog and learn more about these topics. Membrane sweeps, VBAC after multiple Cesareans, uterine rupture, if you're looking for that VBAC provider, definitely check out that blog about how to find out if you need to switch your provider. Then of course, we have our VBAC course. You guys, I love our course so much. Another big reason why we are going to be re-airing our episodes is so that we can keep updating our course. Birth in general is updating all of the time. This course– Julie and I created it a long time ago, and it is my baby. I am so excited for this course because I have seen so many people get the information that they need, feel more empowered and equipped to have a VBAC, then we actually have a birth worker course. The birth worker course is to certify VBAC doulas, our birth workers, and it is accredited. It is 8 ICEA credits, so if you have a doula that hasn't been in our course yet,  maybe suggest that to them or if you are a birth worker listening, I highly suggest it. We have a VBAC Link Doula directory, so if you are looking for a doula or, like I said, you are a birth worker and you want to be found, we want to help you be found. You can find a doula at thevbaclink.com/findadoula, and if you are a birth worker, you can check out your area. California, I know needs more doulas. Texas, there are a lot of states that need more doulas. We would love to add you to your family.Okay, you guys. I'm trying to think what else. Oh my gosh. I could not leave without saying this. This year, we updated our provider list. It is on Instagram. You can go the The VBAC Link at Instagram. Click on our linktree in our bio, and it is the top one to find a supportive provider in your area. Now, if you have a provider that should be on this list or if you are a provider and wantt o be on this list, please email us at info@thevbaclink.com or you can email us on Instagram so we can get your provider listed. We really need providers who accept VBAC after multiple Cesareans, breech VBAC, and who are just VBAC supportive in general. You guys, it is so stinking silly and stupid how hard it is to sometimes find a provider. Please check out that form. If your provider is supportive, please, please, please let us know so we can get them listed. Okay, you guys, I think that is about everything. It has been such a great 2024. I am so grateful again for you guys. I hope you will continue to join us for 2025 because we do have more incredible episodes coming your way from a lot of VBA2Cs. We have polyhydramnios (high fluid). We have HBACs. We have CBACs. We're going to have a couple of OBs actually and special scars. So many great things. We will catch you in 2025. I hope you guys have a fantastic new year. 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 VBAC Link
Episode 362 Marlene's VBA3C + Fighting for Healing

The VBAC Link

Play Episode Listen Later Dec 18, 2024 32:02


Marlene joins us from California sharing her journey to a VBAC after three C-sections. She was a teenager with her first, and her doctor suggested scheduling an elective C-section for convenience. Marlene didn't even know what a C-section was.She became more educated with each birth experience. Still, when it came time to advocate for her physiological VBA3C birth, there were no hospitals, doctors, midwives, or doulas who would support her. Marlene decided to free birth at home with her husband. During labor, she made the call to transfer to the hospital. She arrived at 9.5 centimeters dilated and pushed her healthy baby out in just two pushes. Though she experienced resistance all along the way, Marlene kept fighting for the vaginal birth she knew she could achieve!Marlene's Doula Website: Designed to BirthHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. We are a week away from Christmas. I just cannot get over how fast this year has gone and how many incredible stories we have heard. I cannot wait to hear more stories next year. Today's story is a VBA3C story. These are stories that we get requests for daily. On Instagram, we get people writing us saying, “I need more stories of VBAC after multiple Cesareans. Is VBAC after two Cesareans possible?” Yes. The answer is yes. We have Marlene here with us. Hello, Marlene. Marlene: Hello. Meagan: She's going to be sharing her story just showing you how possible birth is. We have a Review of the Week. We're going to get into that, then we are going to turn the time over to Marlene. This review is by Rachel, and it says, “11 out of 10. Would be best friends with these ladies.” I love that. You guys, we feel like we are best friends, too. Even though we haven't met half of you, we just love this community so much. We feel like we are best friends. It says, “Amazingly knowledgeable doulas with a passion for compassion and birth. Funny, kind, smart. Specialized in VBAC. If humans are exiting your body, you want them by your side.” I love that. That is such a fun review. Thank you so much for your review You guys, if you have not yet, please help us kick off the 2025 season with some new reviews. You can go to Google and just type in “The VBAC Link” and you can leave us a review there, or you can leave us a review wherever you listen to your podcasts. Meagan: Okay, Marlene. Welcome to the show. Marlene: Thank you. Meagan: I'm so happy that you are here and excited to hear more details about these journeys of yours that led you to the final VBAC after 3 C-section point. Marlene: Yeah. Sorry if I say “like” or “um” so much because I've been on a few podcasts, and it never gets easier. For some reason, I am always so nervous. Meagan: It is hard. This is episode 300 and something, and I still say “like” and “um”. It happens. Listeners, just know it happens. Picture yourself sharing your story and thinking about what you're sharing and who you're sharing it too and what you need to share for them. It just happens. “Um” slips out.Marlene: Okay. So, I'll get started. I really want to tell my VBAC after 3 C-sections, so my fourth story, but I will get into a little bit of my first three because that paints the picture of how I had my VBAC after 3 C-sections. I was 18 when I had my first. My son is now 15. He's going to be 16 in November. Man, time flies. Meagan: Oh my goodness. It really does. Marlene: Yeah. I grew up in the LA area in Norwolk, so the outskirts of LA. I grew up with my grandparents because my parents were drug addicts and in and out of jail. The social workers took us and put us with my grandparents. There were 7 of us. We were fortunate to be together with family and my grandparents. My parents came when I was 16. I'm the youngest of 7. My parents came when I was 16 years old in the middle of my junior year of high school and were like, “We're clean. We want to take you back.” My grandparents were old. They already raised all of their kids, and they raised all of us, so they were like, “Just go.” They were tired. I understood, so I was like, “Okay.” I went with my parents. They moved me about an hour away from all of my friends and all of my family. It was just us. Probably a year later or 6-8 months later, they started doing their stuff again. I got pregnant. I didn't have anybody to ask. I wasn't educated. I didn't know. I was just like, “I'm pregnant. I'm going to go to the free clinic. I'm going to go to the doctor.” Being a sheep, this is what we do. I go to the doctor and the free clinic. My pregnancy was fine. My son was fine. I'm fine. There were no complications. It was a beautiful, good pregnancy, but towards 38 weeks, on my 38-week appointment, my OB/GYN was like, “Aren't you so uncomfortable? Wouldn't you want to have your baby on your due date? Most first-time moms go to 42 weeks.” In my head, I was uncomfortable. I was super swollen, but I didn't have preeclampsia. He didn't even mention preeclampsia or anything, but my ankles and my legs were probably 3-4 times the size of normal. I was very uncomfortable. I had back pains and stuff. He was like, “You want to have your baby on your due date?” I'm like, “Yeah.” He was like, “Okay. Let's schedule you for you C-section on November 12th.”Meagan: Wait!Marlene: I didn't even know what a C-section was, and not even an induction. Now that I think about it, no. It was straight to a C-section and I'm over here like, okay. I didn't even know what a C-section was. I thought this is how the process was. I was just so uneducated. I trusted him. I was like, he was the “expert”. He knows best, so I'm just going to trust him. I showed up at the hospital on the time and date that he said. They prepped me for a C-section.Meagan: Wow. Marlene: Yeah. Now, in hindsight, now that I know, I'm like, that's crazy. I could have probably sued him or something, but anyway. 4.5 years later, I'm 23 years old. I get pregnant again, and I didn't educate myself still. I was young and living the party life. I was not really caring and not educating myself. I did plan this one though. The first one was unplanned. My girl was planned. We planned to have her, but I still didn't educate myself. I just knew I wanted a VBAC because I wanted to experience birth the way women are naturally supposed to. I just went. I went to a different OB/GYN in a different city. I came back to Norwolk because I'm an adult, and I have my own place now. I went to my sister's OB/GYN. She was like, “Oh, he's good.” I'm like, “Okay.” I just go with him. He was fine. I actually got to go into spontaneous labor this time at least at 39 weeks. My water broke, and straight to the hospital I went. Meagan: Yeah. Marlene: I just went straight to the hospital because that's what I was told to do. I got there, and my pregnancy was fine. There were no complications or anything. I got there, and they were like, “Okay. You're not even dilated, but we'll keep you here since your water is broken.” They let me labor. I didn't feel anything. 12 hours passed, and they were like, “Oh, there's a risk of infection. We have to get this baby out. There is failure to progress,” blah, blah, blah, and this stuff. I'm like, okay. I trusted them again, so they gave me another C-section.6 years later, so this is 2019 right before the pandemic, I got pregnant. It was probably actually 2018 because I had my second daughter in August 2019. I got pregnant, and I was like, “This time, I'm a little more educated.” I found the Free Birth Society. I was listening, and decided to do more research. My husband opened my eyes to, “Oh, we shouldn't be vaccinating our kids.” He had been telling me before, but I was like, no. I was so brainwashed. My family is more medical-minded and stuff. Now, I'm the total opposite. My husband opened my eyes to things. I started doing more research. I can't just trust the doctors now and stuff. Now, I'm in Fresno, California when I was pregnant. I searched high and low for a good, VBAC-supportive OB/GYN, and a lot of them told me, “No, we can't do a VBAC after two C-sections.” This one told me that we could do it. She was truly VBAC supportive. I got to decline all of the things. I didn't even do the diabetes test. I didn't really do anything except for a little bit of bloodwork. I declined everything, and she was okay with it. Then she told me, “You don't have to have a C-section. You could try for a VBAC, but I might not be the doctor who is on call. Who's to say that the doctor who is on call is going to be VBAC supportive.” She said, “Just to warn you, you might have to stand your ground, and fight for your VBAC and stuff.” I was like, “Thank you for being straightforward with me.” My water did break. I went into spontaneous labor again. I went to the hospital right after again. I mean, it wasn't as fast this time. I took a shower. I ate dinner, and maybe an hour or two later, I went to the hospital. I didn't get a VBAC-supportive doctor. The whole time after I got there, she was like, “Okay, you can try for a VBAC.” She was telling me all of these things that I can't do. “You haven't done it before. What makes you think you can do it again?” Just all of this stuff.This time, I did feel contractions. I was in labor longer than 12 hours, but after the 12 hours, she started saying, “Oh, infection.” I had to keep fighting them off, the nurses, and the doctors. I was exhausted from labor. I believe I got to 6 centimeters or so. Those contractions were pretty hard. She just was like, “Oh, I'm about to switch shifts. Don't you want me since you've already been working with me? Wouldn't you feel comfortable if I gave you the C-section versus some new person?” They were doing whatever tactics. I was standing my ground, then finally, I threw the towel in because I was having to fight all of the nurses off while I'm laboring naturally. I had monitors, and the IV, and everything else. I was stuck on the bed. They wouldn't even let me move or anything like that. I was just like, “Whatever.” I educated myself a little bit more, but I wasn't fully educated. I didn't know that I was the authority. I thought they still were. I did educate myself a little better, but not as much as I should have. They wheeled me off into another C-section, and then not even a year later, I got pregnant again. It was probably 6 months later. I got pregnant again. It's funny because my two boys were unplanned, and my two girls were planned. I didn't plan to get pregnant with my fourth. When I found out, especially because it was in the middle of the pandemic, they had pretty much just announced the pandemic when I found out I was pregnant, so I was bawling when I found out. The future was so uncertain. My husband and I just finally, because my husband wants a big family. He wants 7 or 8 kids, and I'm like, “You're crazy.” I finally got him to say, “Okay, we're done. We don't have to have any more kids,” then I get pregnant again, and everything that was going on with the pandemic, I was bawling. I was like, “I can't believe this, but whatever. I'm pregnant. I don't believe in abortion. I'm just going to suck it up. I'm having a VBAC now,” especially since none of them were medically necessary. They were all unnecessary. I started doing way more research, reading books, reading articles, listening to podcasts, then finally, I did hear about the Free Birth Society before, but I really dug in and listened to every episode. They were the ones who made me want to do it and believe in myself. Finally, I tried to go look for a VBAC doctor though, and I went back to my other one who was truly VBAC supportive, but she was like, “Oh no, VBAC after three C-sections, we can't do this.” I'm like, “Okay, then,” so I went to look for midwives in my area. I interviewed them all, and they were like, “Nope. We would lose our license. Sorry, we can't do it.” I'm like, “Okay, I guess I'm just going to have to have an unassisted birth or a free birth, so I'm going to look for a doula.” I looked for a doula all in my area, and all of them told me, “No, we can't be your doula because it's going to be an unassisted birth.” So I'm like, “Okay, then. I guess I'm going to do it all on my own.” Like I said, I started reading all of the books, doing all of the things. It comes to the day. My due date comes. My water breaks actually on my due date. I'm like, “Okay.” But it was a normal day. I was cooking and stuff. But with my two girls, when my water broke, it was a full gush. This time, it was a little trickle. It might have tore. I knew about it. I was like, “Okay. It might replenish. I'm not going to panic. I'm going to go about my day.” It wouldn't stop trickling, so I had to put a diaper on, a big pad or a diaper, and I just went about my day.I never felt contractions. I went to sleep, then the next day was a normal day. That night, I went to put my kids to bed, and my husband and I laid down. I started to feel these sensations. They were pretty hard. They weren't hard enough that I had to get up and walk around, but they were hard enough to keep me up. They were not consistent, but they were happening all night. I didn't sleep all night because of them. In the morning at 6:00 in the morning, they totally went away. I had another normal day. I went back to sleep, and I got to sleep that night. Then again, I put my kids to bed. Me and my husband laid down. I felt these sensations, and they were a little stronger. The same thing, I dind't even tell my husband. I was just laying next to him. I put in my Christian Hypnobirthing. I tried to listen to it and breathe through them. They weren't consistent, then the sun camp up, and they went away. The same thing happened every night for a week and a half. Meagan: Whoa. You were still having trickling and stuff or no?Marlene: No. I wasn't having trickling. It was just that one day. My water never broke again. I think it really was broken for that week and a half. Meagan: Oh, okay. Marlene: It's playing with me. I was just like, “Man, is this real? Is it not? Is it prodromal labor? What's going on?” I'm like, “What's going on?” Then finally, the day comes, and I had been up all night the previous night, then I had a normal day, then I went to bed, but at 3:00 in the morning this time, I woke up with strong, and they kept getting stronger, faster, and more consistent. I'm like, “Okay.” I couldn't even lay down like the other day. I had to get up. I didn't wake up my husband. I went and took a bath. I was like, “Oh.” I didn't have a pool because I didn't want to make more work for my husband. I was trying to be not selfish. Even though now, I wish I did have a birth pool, I probably wouldn't have gone to the hospital if I did. I went in the bath. It was hard and small, so I'm like, “I can't be in here. I've got to get out.” I went to the living room. I was pacing back and forth. I was on the ball trying to watch TV to get my mind off of things, then at 6:00 in the morning, my husband wakes up. He always wakes up early. He woke up, and he was like, “Are you okay?” I'm like, “Yeah.” I was like, “I think it's the real thing this time though.” He's like, “Okay, well I'm going to go to Home Depot.” I'm like, “No, babe. Don't go. I need you. It's really intense. The baby is going to be coming soon.” He's like, “No, I'm just going to go.” I'm like, “Okay, whatever. Just go.” He goes, and I go to the restroom. I try to check myself because I never educated on myself how to check myself because I wanted to trust my body, and I didn't want any cervical checks, but in the moment, I wanted to see how much longer even though cervical checks don't really tell you how long you have, but in my head, I was like, “I've been going through this for a week and a half. I want to know how dilated I am.” I stuck my fingers up there wrong. I only went up to my first knuckle, but now I know you have to go put your whole hand in there and go way high up there. I only felt no opening, so I'm like, “Oh my goodness. How much longer am I going to have to go through this?” I started getting blood dripping down my leg. Meagan: Bloody show?Marlene: It was drops of blood dripping down my leg. My cervix was opening so it wasn't bleeding a little bit. It wasn't too much. It was just a little bit. I call my husband. I'm like, “Adam, get home.” That's my husband's name. “Take me to the hospital. I need an epidural.” He comes home 20 minutes later, then when he gets here, the first thing out of his mouth, “Are you sure you want to go to the hospital? Because you told me that unless it's an emergency, don't take you to the hospital. You told me this.” I'm like, “Shut up, and take me to the hospital.” I'm all mad at him because he left me, and he was not helping me. We drive to the hospital. It's a 15-minute drive, and I get there. I'm like, “Check me. Check me. I want to know how far along I am.” They check me, and they're like, “You're 9.5 centimeters.” My whole mentality changed, and I'm like, “I should have stayed home. I'm here. I'm not going to take that horrible car ride again. I'm guess we're going to have a baby here.” But when I got there, they were like, “Okay, let's prep you for a C-section,” because this was the hospital that I had established care with my third, so they already knew I had three C-sections. They were like, “Okay, let's prep you for a C-section.” I'm like, “I'm not having a C-section. I'm pretty much pushing this baby out. I'm 9.5 centimeters. I'm there.” They're like, “Okay,” so the  nurse went to get the doctor 10 minutes later. Now, I'm pretty much complete. They didn't check me any other times, but they were like, “Okay.” They just wanted her to tell me that I needed a C-section. I'm like, “Lady. I'm not having a C-section. I'm pretty much pushing this baby out.” She goes to my husband and says, “Your wife needs a C-section or her or your baby could die.” He's like, “Lady, get out of here. We're not going to do a C-section. She's pretty much there.” Then she leaves, and then 10 minutes later, she gets more fierce. “You need a C-section, or you and your baby will die. Do you understand that?” I'm breathing through my contraction, closing my eyes, and ignoring her, then she goes and tells my husband the same thing. He's like, “Lady, don't come back. We're not having a C-section.” So she leaves and doesn't come back. I pushed the baby out in only two pushes. Meagan: Oh my gosh. So was the doctor even with you?Marlene: A different doctor which is the doctor who I had seen for my third, came. Actually, I forgot to mention this earlier. I did establish care with her, but since it was the pandemic, I had only seen her about three times throughout my pregnancy. I wanted to make sure I didn't have placenta previa, the placenta wasn't in the way, everything was fine. I went a couple of times to the doctor. I told her at the last one around 34 weeks or 36 weeks– I can't really remember, but towards the end in the last trimester, she was like, “Okay, let's schedule you for a C-section.” I'm like, “No, I have to talk to my husband and ask him for his schedule.” The whole time, I told her, “Okay, I will have a C-section,” but in my mind, I was planning that I wasn't going to.She was like, “Well, we could schedule it now, then if it doesn't work for your husband, then you can reschedule.” I was like, “No, I'll just not schedule it, and I'll call you once I get his schedule.” She's like, “Okay,” then a week passed, then she calls me, but I didn't answer, and they just left a voicemail, “Hi, we need to schedule your C-section.” I heard nothing from them after that. She never tried to call back. I never tried to call her back until I saw her in the delivery room. That was the lady who delivered my baby.Yeah, when she saw me, and I was pushing, she was like, “Hi, Marlene.” I'm like, “Hello.” She had a look on her face.Meagan: You're like, “Yes, I've been ignoring you” Marlene: Yeah, it was funny. It was amazing. I told them I wanted delayed cord clamping. I didn't want any vaccines. The whole time, she said, “You're bleeding a lot. We need to cut the cord.” I did bleed a lot for their comfort, but I felt fine. It was a lot of blood, but I didn't need a transfusion or anything. I didn't feel dizzy. I felt fine, but in their case, I was hemorrhaging. I knew some women don't bleed a lot. Some women don't bleed at all. Some women do bleed a lot. It's just different for everybody. I told them, “Leave the cord alone. Leave the placenta alone.” I still had to advocate the whole time because they were trying to cut the cord sooner than I wanted. They were trying to put the ointment on the baby's eyes, trying to vaccinate, and then before I left, they told me, “CPS came to visit me because of medical neglect.” I didn't see my OB/GYN too many times throughout my pregnancy. I used the pandemic. I was like, “I have three kids at home. Nobody could watch them. I can't take them to the doctor with me. What do you expect me to do, leave my three young children at home unsupervised? I don't know anybody around here to watch them.” They dropped everything. It was crazy.Meagan: What was that process like with CPS? We hear it happening. What did they do?Marlene: I guess they have somebody in the hospital, like a CPS worker working in the hospital for cases like mine or whatever. Meagan: Interesting. Marlene: She just came in. She was really sweet. She was like, “I have to come and check.” She was like, “Can you tell me why you didn't go to the doctor? You only went three times throughout your whole pregnancy. You didn't make it to every appointment.” I said, “I have three young children at home. Nobody is willing to watch them, and I can't take them to my appointments.” She was like, “Okay,” That was it. She was like, “Okay, case closed. I just needed to do my job and ask you.” Meagan: It was like, “I'm going to take this baby away from you because you didn't go.” This is the hard thing for me. I'm going to get a little salty. Providers need to do better. Hospitals need to do better. If they don't want people having free birth or unassisted birth, stop pushing people to do that. I also don't judge anyone who does a free birth. Everyone has their own thing. We've shared free birth stories on here, but if they're going to give people so much crap and call CPS on them which is completely ridiculous because these people are just trying to do what's best. Stop making people go that route. Providers, if you are listening, please change your ways, and do better because you can't shame someone for going out of the hospital or not having support from a provider if you don't offer the support that they deserve in the first place. We're restricting midwives out-of-hospital. Providers are restricting after two Cesareans, and sometimes even after one. We have to do better in the medical world in order to see change. Then people who decide, “Okay. I'm going to do what I feel is right, and I'm going to free birth or I'm going to go unassisted, or I'm not going to be hounded about everything that I don't want,” right? It's so aggravating to me that people put people through CPS and things like that because they made the best choice for them when they were pushed away. You had three unnecessary Cesareans. You were failed from the beginning, right? In your very, very first birth, a provider set you up for failure that they had no idea maybe what the repercussions would be in the next few years with how much you'd have to go through to find the support and to get the support. It's just frustrating to me. Marlene: Yeah. I totally agree. Honestly, that's what made me, because I'm a doula, become a doula because I want to try as best as I can. I'm just one person and not a very important person in the medical world, but I try to educate my clients on not getting an unnecessary induction or unnecessary C-section. I'm not against them if they are an emergency, but if they are unnecessary, they're handing them out like Oprah. “You get a C-section. You get an induction.” That's how they're handing them out. In my area, that's what I see. And also, because the ladies who want to have a free birth like me, if I would have had a doula to support me, then I would have probably done it at home. I'm that doula who I was looking for. I support free birth. I'll be there if you're free birthing and you can't find any other doula. Meagan: Yeah, and there are a lot of doulas who feel uncomfortable with it, a lot of it because maybe they are uneducated on it, but I do think it's important for people who do decide to free birth just to make sure you are educated. You know what you are doing. You have a backup plan. You have the support. It is good to hear that you and other doulas are able to go and support still. Everybody has to decide what's best for them and what feels best, but support is needed, so I'm glad that you are willing to support your community. Marlene: Yeah. Honestly, I've noticed that the ones who decide to free birth are very prepared and educated even more so than the ones who are doing it in the hospital and stuff because they have to, in my experience at least. Meagan: Yeah. They do. They do have to. I do believe that those people who decide to free birth don't take it nonchalantly. It's a very serious thing that they take. We talked about that in the last episode. It's important to note that. These people are very educated. It's not just, “Oh, I'm going to go have a baby by myself in my closet.” It's not like that. Really, these people are educated. I'm so happy for you that you were able to fight through this, and to grow through each of your pregnancies and your births because you deserve that support. I'm sorry that you had to fight so hard in the pushing stages. Big eye roll. Again, we need to do better. We need to do better. Marlene: I agree. I'm grateful for podcasts like yours and other ones to get the story out there because we do learn as a community through storytelling and stuff. That's actually what helped me a lot.Meagan: Yeah, they do. Thank you so much for coming on and sharing your stories today. Marlene: You're welcome. Thank you for having me. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

The Birth Hour
953| Meagan from VBAC Link shares her Birth Stories: Two Cesareans + VBA2C - Meagan Heaton

The Birth Hour

Play Episode Listen Later Dec 17, 2024 64:23


Sponsor: Use code BIRTHHOUR for 20% off your first order (including their already discounted plans and subscriptions) at thisisneeded.com. The Birth Hour Links: Know Your Options Online Childbirth Course (code 100OFF for $100 OFF!) Beyond the First Latch Course (comes free with KYO course) Access archived episodes and a private Facebook group via Patreon! 

Pregnancy & Birth Made Easy
From Fear to Empowerment: Meagan Heaton's Journey to VBAC

Pregnancy & Birth Made Easy

Play Episode Listen Later Dec 17, 2024 56:20


This week, Stephanie interviews Meagan, a birth doula and VBAC advocate. Megan shares her personal experience with two unnecessary Cesareans and her triumphant VBAC afterwards. The episode explores VBAC logistics, preparation, and mental readiness while addressing common questions from listeners.Where to find Megan:InstagramWebsitePodcastLinks Mentioned:My Essential Birth CourseMy Essential Birth Postpartum CourseMy Essential Birth Instagram GET IN TOUCH!

Birth, Baby!
Birth Stories: A Redemptive Vaginal Birth After 2 Cesareans (VBA2C)

Birth, Baby!

Play Episode Listen Later Dec 17, 2024 36:18


In this episode of Birth, Baby! Podcast, hosts Ciarra Morgan and Samantha Kelly welcome their past doula client, Danielle Sanchez, to share her unique journey of having a Vaginal Birth After 2 Cesareans (VBA2C). Danielle discusses the challenges she faced, including gestational diabetes and pressure from healthcare providers. She emphasizes the importance of preparation, advocacy, and finding the right support team. The conversation covers her first two labors and births as well as the emotional rollercoaster her final of labor, and the joy of postpartum recovery. Danielle offers valuable advice for others considering a VBAC, highlighting the power of self-belief and community support.Please feel free to reach out to us with any recommendations for show episode ideas. If you'd like to be a guest, email us with some information about yourself and what type of podcast you'd like to record together. Thank you for all of your support and don't forget to follow and review our podcast, Birth, Baby!Instagram: @‌BirthBabyPodcastEmail: BirthBabyPodcast@gmail.comWebsite: www.BirthBabyPodcast.comIntro and Outro music by Longing for Orpheus. You can find them on Spotify! (00:00) - Introduction and Disclaimer (01:12) - Danielle's Unique Birth Story (04:39) - Preparing for a VBAC (07:59) - Navigating Healthcare Providers (11:08) - Induction Decisions and Experiences (14:23) - The Induction Process (19:10) - Pushing and Delivery Experience (21:06) - Postpartum Experience and Recovery (29:10) - Reflections on the Journey (32:54) - Advice for Future VBAC Candidates

The VBAC Link
Episode 361 VBAC Prep with Meagan & Julie + What do the Facts Say?

The VBAC Link

Play Episode Listen Later Dec 16, 2024 43:37


In this episode, Meagan and Julie tackle hot topics like the VBAC calculator, epidurals, and uterine rupture. What does the evidence actually say? And why do providers give such drastically different statistics from one practice to the next? When you know the facts, you are equipped to take charge of your VBAC journey!VBAC CalculatorACOG: Deciding Between a VBAC and a Repeat CesareanVBAC Calculator Online LibraryEpidural Side EffectsVBA2C PubMed ArticleEvidence Based BirthⓇ: The Evidence on VBACUterine RuptureHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Julie: Welcome, welcome. You are listening to The VBAC Link Podcast, and guess what? We have a special guest for you today, and that is me. It's Julie Francom. I am here today with Meagan, and I am joining her for a really cool information-packed episode debunking some common misunderstandings about VBAC and showing you what the evidence is and where you can find more evidence-based information about VBAC. Without further ado, your host, Meagan. How was that?Meagan: Oh my gosh. Thanks Julie for the amazing welcome. Oh, so fun. It's so fun. Yes. I am so excited for this episode because it's one of the last episodes with you and I. No, it's not one of the last episodes. It is the last episode of you and I of the year which is so crazy. It is so crazy. Julie: This year has flown. Time is wild. Time is wild. Meagan: It's so strange to me, but that's okay. We will welcome in 2025, and we will say goodbye to 2024. We want to say goodbye to it with, like she said just a really great evidence-based packed episode for you guys.I feel like all year we have gotten messages like, “I had a C-section. I'm being told I can't ever have a vaginal birth. Is this true? Is VBAC safe or possible?”We've had, “I've had one and two C-sections. I've had three C-sections. Is VBAC possible? My provider gave me a 20% chance to VBAC. Is that true? Can I VBAC? Do I really have that low of a chance?”How about this one? This one was more recent that I've heard from our last recording. “You have a 60% chance of uterine rupture if you choose to VBAC.” Ugh. Seriously, so many things that we have heard along the way where it's just–Julie: Lies, lies, lies, lies. It's lies. Let's just call it what it is. Meagan: Aggravating. Julie: For the most part, I do not think providers mean to spread lies or misinformation. I do think that there is a lot of information related to birth in general, but especially VBAC about how this is the way we've always done it. They are just regurgitating information that they have heard from some unreliable source somewhere and aren't really taking the time to keep up with the actual facts about VBAC, about birth, and about anything in general. Also, our system is not set up for continuing educating all of the providers in all of the things. Our hospital providers, I feel like in some capacity we have to give them some grace because they are incredibly overworked. They work crazy hours. They see lots of things and deal with a lot. The medical system is that way. But I also feel like who's responsibility is it to make sure that you are providing the best care? But how can you when the system is working against not only the parents but also the providers and the nurses and everybody. It's really hard because it puts the responsibility on you, the parent, in order to really dig and discover what your options are so that you can make the right choices that benefit you because the system is not set up to support you in any other way besides their hospital policies and following their rules, etc. So, yeah. I don't want this to turn into a provider-bashing episode. I don't think it will either. Sometimes, I think with me talking especially with me being more salty now, it can come across that we are anti-provider or whatever which we are not, but the system is just really frustrating. It takes everybody's efforts to try and change it, everybody's efforts. Not one part of the system can be passive if we want to change it and we want to influence it for better.Meagan: I agree so much. Like you said, we don't want to ever shame the hospital system or providers, but a lot of times, the things we are saying definitely does happen. But it's because there is a lot of fault. There is a lot of fault in these areas. Like you were saying, a lot of these things are lies. The biggest and hardest thing that I found when I was going through my VBAC journey. Julie, I wanted to speak for you and probably say that is the same for you, and that's why we created The VBAC Link: How to Prep VBAC Course is because we didn't know what was right and what wasn't. We just didn't know, and there were so many avenues on Google that you could go down, and you could actually find truth on both sides sometimes even. Julie: And trying to figure out which is true and credible and which is not sometimes is really tricky.Meagan: It's really, really tricky. We want to talk more about that today. We recently talked about hospital policies and what that means and how to go about those, but along with hospital policies come a lot of other things that providers do or suggest or say, so we've got this random policy that was created over here, then we've got all of these random things that are being said over here. We want to know our options. We know hospital policies are what they are. If you haven't listened to the episode, go listen. It's back in November, last month. Go look for it. But today, we are going to be talking about what is the evidence. What are the facts?Let's talk about the VBAC calculator. Let's just start right there because this is where a lot of providers actually begin to determine someone's ability or qualifications if they can VBAC. They'll pull out this list, this calculator, that is online. You can actually get it online. If you want to play around with it, I'll try and make sure to put the link in our show notes because I actually find it very interesting to play around with. We used to do that when we would do in-person courses. We would have everyone pull out their phones, type in the calculator, and type in different scenarios. It was pretty mind-blowing to see how much it could change based off of the answer that you give this computer. You want a VBAC. You have determined that a VBAC is something you want to explore. You want to learn what you can do to have a VBAC. You go to your provider and you go, “Hey, I've had a C-section. I don't want that experience this time. I want a different experience. I would like to have a VBAC,” or what they would call a TOLAC, a trial of labor after a Cesarean. And they're like, “Great. That's wonderful.” Then they're like, “Let's talk about it.” They pull up their calculator and they ask you questions like what, Julie?Julie: They ask you questions like, hold on. I was just digging into the history of the VBAC calculator a little bit more because I was curious about it. They ask you what was the reason for your previous Cesarean? How much do you weigh? It used to ask what your ethnicity was then they docked you if you were black or Hispanic. It also asks, let's see. Meagan: It asks if there was an arrest of descent. Arrest of descent is if you needed a Cesarean because your baby didn't come down. It asks about your history as in have you had a vaginal birth before? Have you had a VBAC? What was the reason for your previous Cesarean? It even asks if you've been treated for hypertension. Interesting. Julie: Interesting. Meagan: Yeah. So height, weight–Julie: Oh, because the chronic hypertension requiring treatment is what replaced the race. When they replaced the race question with do you have chronic hypertension requiring treatment? It may serve as an obvious proxy for race and appears to function similarly in the revised calculator in terms of statistical performance. Meagan: Oh my gosh. Yeah, it says that right on the website. “The information on this website describes the outcome of vaginal birth after Cesarean in term pregnancy for population individuals who receive care at hospitals within (blah, blah, blah) network.” It says, “The information on this website is not intended to be the only basis for making care decisions for individuals nor is it intended to be definitive,” meaning it's not going to be yes, you have to have this or this is the exact chance of you having a VBAC, but yet we have so many providers who go off of this as in point-blank fact.Julie: Like it's the law and like it's a crystal ball. Meagan: Really though. It's so frustrating. Sorry, what were you going to say before?Julie: I just sent you this link from what I was digging into. It's so interesting about the VBAC calculator. It's interesting because first of all, a couple things. The likelihood of the VBAC calculator being accurate for you, the higher percentage of having a successful VBAC, the more likely it's going to be. It's more accurate when the predicted success rates are above 60%. The lower success rate, the more likelihood it is to be inaccurate. Do you know what that tells me? That tells me that most people who attempt a VBAC are going to be successful. That's what that tells me. It's just so stupid because I mean, the development of the calculator was in the early 2000s. From the outside, it actually looks like a good sample size. There were 11,856 people with one prior Cesarean between 1999 and 2002. It was analyzed whether they had a successful VBAC or an unplanned repeat Cesarean. It was analyzed retrospectively. Retrospectively means they looked back on births. It doesn't mean that they did the study when people were pregnant. They looked at it after it had already been done. I like retrospective studies because there's a lot. It really removes the chance for bias related to the study. The interesting thing is that the risk factors that they chose were related to BMI, if you're overweight, age, history of prior vaginal deliveries– so did you have a prior vaginal birth or not– if the prior Cesarean was because of labor dystocia, so that's stalled labor, or your race– black or Hispanic ethnicity. They used these criteria to determine whether or not you were going to be successful in having a VBAC. Here's the stupid thing about this. What it doesn't take into account is the bias in our system against people of color and against people who are overweight. It does not take into account the bias and the different ways people who are overweight and people who are not white are treated in the system. I mean, there are just so many flaws against it as well, but also, I don't know. It says here– sorry. Before I get to my also. It says here– first of all, there are only 19 academic hospitals that were included, so I feel like the sample size of 19 academic hospitals, so university hospitals, and it's between 1999 and 2002. Also, there was a lot of backlash from all of the controversies surrounding uterine rupture in the mid-1990s from that carrying over into that as well. If you didn't know this, they started inducing VBACs with Cytotec in the mid-1990s. It increased the risk of uterine rupture like crazy. I'm not going to do a history lesson right now, but this was only 4 years after all of that. There was probably still a lot of fear and everything related to uterine rupture and everything during all of the time that they were collecting this data. Sorry, I'm probably really nerding out right now. But the thing is that when the predicted success rate was over 60%, it tended to be more inaccurate when it was less than 60%. Accuracy of lower estimates was mixed but generally decreased as predicted success rates declined. I said this before and I'll say it again. My first client ever as a doula had a predicted success rate of 4%, like the number 1-2-3-4. You count to 4. That was her predicted success rate, and she pushed her baby out in 20 minutes. So, I think the VBAC calculator is garbage.  Also, ACOG says in their most recent guideline, actually for the most couple VBAC bulletins that they have put out, is that a low chance of success is not a good reason to exclude somebody from attempting to have a VBAC. But yet, there are so many providers who will not take you if your predicted chance of success is less than 60%. But what did we just say? We just said that if your predicted success rate is less than 60%, it's less likely to be accurate. Isn't that stupid?Meagan: Yes. The other thing I have noticed from providers who do the VBAC calculator is that not only if they say your chances are lower, if they are doing it and it is lower than 50-60%, they automatically go in their mind and they're like, “Oh, she has a lower chance.” They may start being tolerant, but I think it's something to watch out for. If your provider is pulling out this calculator and putting too much weight on the calculator, it might be something to watch out for and understand that there may be a bait and switch coming up or that provider may not end up feeling comfortable with you being able to VBAC or TOLAC. We've talked about this with other providers where they say they are uncomfortable. That is a really good time to say, “You are not comfortable with this. I am comfortable with this. We are not a good match.” Julie: Yes. Don't let your provider dictate how your birth goes. I love that you brought that up, Meagan, because I'm in a member of a Facebook group for labor and delivery nurses. There are 12,000 labor and delivery nurses in there. I'm mostly quiet. I mostly watch because I like to see the climate of the profession and the attitudes around VBAC, birth photography, doulas, etc. There was a post actually this morning in there. The nurse asked, “What is your hospital's protocol around vaginal breech deliveries?” I was like, “Oh, this is going to be good.” I went through the comments, and I was stalking the comments because I know that having a vaginal breech delivery in a hospital is a freaking unicorn. It's a unicorn. You don't usually see it. It was interesting to see the labor and delivery nurses' comments. One of them stuck out to me. I almost commented back, but I pulled myself back. I was like, “This is for labor and delivery nurses. I don't want to stir the pot. I'll stir this pot in other places, but I don't want to stir the pot in this community most of the time.” One of the nurses said that vaginal breech delivery carries risks, and it is up to the provider and patient to decide what risks are safest and what risks to assume. I rolled my eyes at that because it should be like that. It should be the provider AND the patient together to decide the risk, but how often is it the provider only who decides the risks that these patients are going to take on? No. It's not the patient and the provider. It's the provider deciding. It's the provider deciding. Nowhere in the normal, typical, standard conversation does it include providers and patients making decisions. Not real ones. Not when they disagree. Not when they want a little flexibility or not when they want to go against hospital policy, right? Meagan: Yeah. Julie: I mean, there are sometimes, but it's really rare. Meagan: This comment reminds me of the many scenarios that I see or hear within my own clients here in Utah of, “Hi, I really want a VBAC. I met with my provider, and they said they would let me do.” It reminds me of the “let me”. This provider looked at me, read my history, and said that this is what I can and cannot do. This is what they let me do. Julie: Or they led me to the calculator.Meagan: Yeah. We're losing that conversation. Women of Strength, I encourage you to go forward and have conversation with your providers, especially if you are getting this kickback and especially if you are not being told the risks for both VBAC and repeat Cesarean, and you're just being told, “Oh, you have a 46% chance of VBAC based off of this calculator, so I'll let you try, but don't count on it.” Seriously? If I hear anymore providers, ugh. It's so frustrating.Julie: They're doing you a favor. “We'll let you try. Okay, you can try.” Or they say, “But you have to go into labor by 40 weeks or we'll schedule a C-section, but we won't induce you.” Come on. Come on. They're trying to be this savior. We'll let you try, but…Meagan: Don't stand for that unless that's what you're okay with. I can't tell you, “No. You can't see anybody like that.” That's not my place, but I will say that if you're having a provider in the very beginning pull out this calculator telling you that they'll let you try, but the chances are low, your pelvis hasn't done it before, don't know if it will do it again, your cervix didn't dilated to 10, these are problems. These are red flags.  Okay, so the VBAC calculator, we talked about it. We talked about the stats. We talked about our rant. Now, let's talk about uterine rupture. This is a big one that I feel like hovers. It's that dark cloud. Julie: The elephant in the room. Meagan: Yeah. It hovers over people and their fear. I see it daily within our community. “I really want a VBAC. A different experience is so important to me, but in the end, I'm so scared. I'm so scared of uterine rupture.” Valid. I just want to validate your fears right now. It's okay that you feel scared. It's valid that you feel nervous about it. Julie: Mhmm. Meagan: It's also understandable that you may feel extra nervous about it because the outside world talks so poorly about it. Julie: Mhmm. Meagan: They make it sound scary. It is scary. Julie: It can be, yeah, when it happens. It is. Meagan: When it happens, it can be, but the chances are actually quite low, you guys. We want to talk a little bit about it. I know we've talked about it in the past, but I feel like you can't talk about uterine rupture enough. Julie: Yeah, it keeps coming up, so we'll keep talking about it. Meagan: It keeps coming up. It keeps coming up.Okay, so let's talk about one C-section. You've had one C-section. Your baby didn't come down. You pushed for 2 hours. You had a C-section. You dilated to a 5. You didn't progress. They did all of the interventions. You had a C-section. You got an epidural. Your blood pressure dropped. Your baby didn't do very well. Decelerations. You had a C-section. There are lots of scenarios of why we have C-sections. One C-section– Julie, let's talk about the evidence of uterine rupture after one C-section.Julie: So here's the thing. There are multiple studies out examining uterine rupture and things like that. It's interesting because I feel like it does vary. There are some studies with very small sample studies that have 0% uterine ruptures in their studies, and there are some studies that show higher rates. Now, what I have found as I have been digging is that the studies that are the most credible and most reliable will usually have a rate of rupture between 0.2%-0.9%. I feel like if you have anybody telling you that your chance of rupture is half of 1% or you have a 1% chance of rupture or that the chance of uterine rupture is less than 1% or 1 in 200 or 1 in 100, all of those, I feel like, are pretty accurate representations of what the actual risk of rupture is. Now, there are lots of things that contribute to that of course, but I feel like if you ever have a provider tell you, “Oh, it's about 1%”, that's pretty cool. Meagan: Yeah. Yeah. That's pretty reliable to know that they are within–Julie: Within range.Meagan: They are looking at some study that is within accurate range. Julie: Or I think 0.4%. One of the bigger studies that we cite in our course is 0.4% or 1 in 250. Those are all that for me, personally, I would feel that yeah, you are presenting the data pretty accurately. Yeah. I feel like you're trying to lead this a certain direction.Meagan: No, I'm not. That's exactly something I wanted to talk about is how it can range. You may see something that's 0.2% and you may see something that's 0.47, and you may see something that's 0.7, so I love that you pointed that out. Julie: Yeah. I think that's why the more I go on, I used to say 0.4% or half of a percent whenever somebody would ask me, “What's the rate of uterine rupture?” Those are the numbers I would go to, but now, I feel like it's a little more fluid, and I feel like there's more nuance to that. Meagan: Yeah. I usually say around 1%. What about people who are wanting to VBAC after two C-sections? Because this is another big ask, then it gets even stickier.Julie: So sticky. Meagan: And when we talk about 3+. The evidence after two C-sections– again, everyone has different reasons, but I was told slightly over 1%. Julie: Right.Meagan: 0.7% to 1.1-1.4%. Julie: Well, here's the thing, too. There are not a lot of studies about VBAC after two Cesareans. There's just not, but there are two large studies in the ACOG VBAC bulletin that ACOG cites, and it actually says that– I'm actually going to quote the guideline right now. It says, “Women who have had two previous low transverse Cesarean deliveries should be considered for a trial of labor after Cesarean (TOLAC). However, other factors should also be considered to determine the likelihood of successful VBAC.”Now, here's the thing. It cites two studies in their bulletin as far as risk of uterine rupture. One study that they cite shows that there is not increased chance of uterine rupture from one to two Cesareans. There is one that shows no statistical differences. Now, the other study that they reference shows double the risk of rupture. So, what? 0.5% to 1%? I think it was 1.2% is what the ACOG bulletin says. I'm not sure. I don't have the actual bulletin pulled up right here in front of my face except for that. Meagan: This is another thing where it depends on what you're reading. Some of them are 0.1-1.5% or 1-1.5% and that's even on the higher end of the chances. Julie: Right. The interesting is that ACOG even says that, yet people are going to go say double and triple, or whatever. They're going to make up all of these crazy statistics. Now, gosh dangit. I literally had that guideline. Do you have it open?Meagan: No. The ACOG? No. I don't.Julie: I'm going to find it exactly because we've been called out for this. We literally quoted the exact phrase from ACOG and got thrown under the bus for spewing misinformation when it was literally a quote from ACOG, but whatever. Meagan: While you are finding that, there is an article showing vaginal birth after two Cesareans There was a systemic review and a meta analysis of the rate of adverse outcomes in a VBAC after two. It talks about how the VBAC after two success rate was around 71.1% and the uterine rupture rate was 1.63%, so that is within this. We will have all of these here. If we are quoting something, we're going to make sure that we have it here in the show notes. Please, please, please make sure to go down and check it out. You're going to want more information. We don't have all the time to go over all of these, but I think these are such great reads.  Sorry, have you already found it?Julie: Yep. Meagan: Okay, go ahead. Julie: Excuse me while I clear my throat and crack my knuckles. I'm ready. Let's go. Oh, do you know what? This is actually a pdf from an actual publication, so it's not going to be the exact page that I said. There is a whole section called, “More than one previous Cesarean delivery”. Now, what it says about the studies, I'm going to quote it exactly. “Two large studies with sufficient size to control for confounding variables reported on the risks for women with two previous Cesarean deliveries undergoing TOLAC. One study found no increased risk of rupture, 0.9% versus 0.7% in women with one versus multiple prior Cesarean deliveries whereas the other noted a risk of uterine rupture that increased from 0.9% to 1.8% in women with one versus two prior Cesarean deliveries. “Both studies reported some increased risk in morbidity in women with more than one prior Cesarean delivery, although the absolute magnitude of the difference in those risks was small.”Meagan: Mmm, send me the link so I can put the exact link in the show notes so everybody can go read more.Julie: Yeah. Yep. It also says, “The likelihood additionally retrospective–”. Remember, retrospective is looking back on data that already exists. “Retrospective cohort data has suggested that the likelihood of achieving VBAC appears to be similar for women with one previous Cesarean delivery and women with more than one previous Cesarean delivery. Given the overall data, it is reasonable to consider women with two previous low transverse Cesarean delivers to be candidates for TOLAC, and to counsel them based on the combination of other factors that affect their probability of achieving successful VBAC.” Meagan: Hey, see? They're even saying that it's reasonable. Here we are. It's reasonable. But then, there are so many people who are like, “Nope. Out of the question. It is not acceptable. We will not support VBAC after two C-sections.” Julie: Actually, I don't think you are supposed to publish this. You might not be able to distribute it. Meagan: Oh. Julie: Because you just do a search on the dark web for ACOG VBAC bulletin 205 pdf and it will pull up. I promise. Meagan: Okay. There you go, everybody.Julie: I just don't want you to do anything illegal. Meagan: Yeah. Get on a search. Get on a search. I do want to talk when it comes to three. When it comes to three, the hardest part for me with three C-sections being shut down is that the evidence is still not there. The concrete evidence is not being studied that much. Julie: Mhmm. Even the studies that do exist, they don't have super large sample sizes. They are very old. They are 20+ years old, so that's the best data that we have to use. Sometimes those studies are just automatically disqualified because of their age, their smaller sample sizes, and things like that so it's hard to make any definitive statements about its safety or risks. Meagan: Yeah. Then there is evidence with induction. Increasing around 1.1% if you use Pitocin. A lot of people say, “We can't use Pitocin. It increases it astronomically.” I mean, to some, 1.1% and having that be their rupture rate, that may make sense, but for a lot of people, 1.1% is still quite low. I did just want to throw it out there that the risk of uterine rupture is not dismissed because you schedule a C-section. It's not. Julie: That's true. In fact, you are more likely to undergo a uterine rupture during the Cesarean than you are by attempting a VBAC. Meagan: You are? I thought it was 0.06. Julie: No, it's in our course. I have the charts from the National Institute of Health. Because of the pressure during the surgical procedure, your uterus is more likely to rupture. Now, granted, it's probably “safer” to have a uterine rupture on the operating room table because baby is already coming out, but there is data that shows it. I'm pretty sure there are graphs and charts in there from the National Institute of Health. Meagan: Yeah. I'm going to go find it. I was reading about it. It was 0.02%. It's just really important to know that it's not just eliminated. Your risk is not just eliminated. Okay, let's talk about– and anything else you want to talk about with that?Julie: Mm-mmm. Meagan: Let's talk about epidurals and the risk that we have with that. Julie: Not ugh about epidurals. That sound was not about epidurals in general. It's about how I know where you're going with this. Sorry. Meagan: No, it's okay. I just want to talk about the risk with epidurals because a lot of people don't know that some of the things that happen after epidurals can be placed or things to do before if you're planning to get an epidural like hydrating and making sure that we're good there. I want to talk a little bit about epidurals. Epidurals can do a few things. They can lower our blood pressure. That's one of the most common that I have seen right out of the gate. But it's given, and the blood pressure drops. Mom's blood pressure drops. Baby's heart stops responding. Julie: Baby's heart rate drops a little bit too.Meagan: Yeah. In fact 13 out of 100 women have epidurals cause low blood pressure. Epidurals can also increase infections. Now, yes. Infections are in our back and stuff, but I'm actually talking about vaginally because I feel like the vagina is an open door. Once an epidural is placed–Julie: Then you have the catheter too. That will give UTIs. Meagan: Yep. Yes. We've got a catheter, then it's like, “Oh, I can check you. You can't feel that.” We keep introducing bacteria. Julie: More cervical checks. Meagan: Yes. Julie: Increased infection.Meagan: Yes. It also can cause problems urinating because we've got this catheter. It can sometimes be placed for hours and hours.Julie: Yeah. 24 hours sometimes depending on how long you're in labor.Meagan: Yes. Approximately 18 out of 100 women will have urinary issues because of cather and things like that. It's kind of interesting. Epidurals can also cause itching. Is there morphine in epidural? I think that's why.Julie: Fentanyl.Meagan: Okay. It wears off, and it can cause itching. It can cause you to go so numb that you're unable to move and groove. Julie: These are small risks. They are small risks. It's okay to have an epidural. Don't be scared out of having one if that's what you want. You can still have a VBAC with an epidural.Meagan: I want to talk about that. I'm still going over these risks. Going into what you were saying, there's an article that I'm reading right now. It says that 75 out of 100 women who had an epidural and they were very satisfied with the pain relief that they received. 75 out of 100 is really great. That's really great. It says, “50 out of 100 women who were very satisfied with the pain relief.”Of opioids, sorry. It says, “Compared to 50 out of 100 women who were very satisfied with pain from opioids.” There are risks to epidurals, but there's also a lot of great things that come with epidurals because we can be more present and have less trauma. It comes to a point sometimes where labor– we talk about pain versus suffering, and if you're suffering, that's not usually going to lead to a positive experience.But, let's talk about the just-in-case epidurals. We have talked about this before. Julie: That's what my sound was for.Meagan: I had a feeling. The just-in-case epidurals are frustrating. We've talked about them before. It just doesn't make sense to me. It doesn't make sense. One of these days, I would like someone to sit down and try to make this make sense. It doesn't make sense to me. Is there anything else you would want to share?Julie: Just-in-case epidurals. I just want to do the math on it though. Just-in-case epidurals don't make sense. It's not logical. The idea is that a lot of hospitals will have a requirement that you have to have an epidural placed but not turned on. If you don't want to have it turned on, you don't have to have it turned on, but you have to have it placed just in case of a uterine rupture so they can give you an epidural quickly and go get the baby out without having to put you under general anesthesia because general anesthesia is riskier. That is true. The problem with that is that in order for an epidural to be dosed to surgical strength, it takes 15-20 minutes to be dosed to surgical strength even if it is turned on already. If you have a catastrophic uterine rupture where baby needs to be out in minutes, 15-20 minutes is not going to do it. You're going to be put under general anesthesia anyways. Even if you have an epidural, and baby needs to be out in seconds or minutes, then you will be put under general anesthesia. If there is time to wait, there is time to do a spinal block in the OR. It takes effect in 5 minutes, and boom. You don't have to be put under general anesthesia. So the math isn't mathing there whenever they do that.I've had clients ask when they say, “Hey, just-in-case epidural,” and my clients will be like, “Even if I have the epidural turned on and need the baby out immediately, how much time would it take to get to surgical strength or would I have to be put under general anesthesia anyways?” They'd be like, “Well, we'd probably have to put you under general anesthesia if it's a true emergency.” Every time you ask somebody, the math doesn't math. You can't explain it. Anyways, that is my two cents about that. I think that is the most nonsense VBAC policy ever because you can't make it make sense. It is not even make it make sense. You have people say that about everything nowadays. Make it make sense, but this one literally doesn't make sense.Meagan: Yeah. It's a tricky one. It's a really tricky one. There are risks to getting an epidural, but don't be scared of getting an epidural. It's still okay. It's still okay. Just know, if you are getting an epidural, do things like hydrate. Wait as long as you can. Make sure you go to the bathroom. Eat before. Get your blood sugar up. I'm trying to think of all of the other things. Don't think that just because you get an epidural, you have to get cervical exams anytime they want. Julie: Yeah. Meagan: Yeah. Yeah. It's okay to turn your epidural down if you decide it's too heavy. Julie: There are also some providers who will tell you that you can't have an epidural with a VBAC because then how will they know if you have a uterine rupture? Anyway, the hospital policies that we see are just so different. They change and they are so drastically different even from one hospital to the next in the same area. Anyways. Meagan: Okay. Anything else that you want to cover or think that we should cover? Julie: No. Is there anything else pressing? I feel like we intended to cover more things, but we just keep chatting about it, but that's okay because there are some good stuff in this episode. Meagan: No, I think it's great. So if you guys have any questions or if you have any studies that you have found that contradict anything that we are saying, share it. Julie: Yeah. Send it over. Meagan: I would always love to read it. There are times where we miss updates studies or there are studies that we haven't seen, so please, if you have a study that either contradicts or goes along or says something slightly different, share it with us. You can email us at info@thevbaclink.com.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 VBAC Link
Episode 357 Paige's Maternal Assisted Cesarean in South Korea

The VBAC Link

Play Episode Listen Later Dec 2, 2024 89:30


One of our team members, Paige, joins us today to share our first maternal assisted Cesarean story on the podcast! Our favorite Julie joins too sharing her perspective as Paige's birth photographer. Paige tried three times to have the vaginal birth of her dreams. Each time ended in emergency Cesareans due to nonreassuring fetal heart tones. Each time, she missed the golden hour that she so desperately craved. Each time, she learned more and more about birth.With her fourth baby, she exchanged her VBAC dream for a new one. After hearing about maternal assisted Cesareans, she decided to do all she could to pursue one fully knowing it may not happen. But when it did, it was everything she hoped it would be and more. Paige's Full Birth VideoHoum ClinicDayana Harrison Birth ServicesJulie Francom Birth PhotographyYouTube Video: Maternal Assisted Caesarean Section - The Birth of Betty MaeThe VBAC Link Podcast Episode 220: Dr. Natalie Elphinstone & MACsThe Birth Hour Episode 875: Nicole's Maternal Assisted Cesarean in MichiganBaby Baking & Kid Raising Podcast Episode 6: MACs with Lauren BrentonAustralian Birth Stories Podcast: All Maternal Assisted Cesarean EpisodesYouTube Video: Nottingham University Hospitals Maternity Gentle C-sectionCBAC Support Facebook Community How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Oh my gosh, you guys. Today is a very special day. It's a very, very special day. We have our own team member, Paige. If you guys haven't already seen the video floating around, go to Instagram today and watch what we've got posted. We have Paige, and we have Julie, and they are actually in Korea. Now, Paige lives in Korea. Julie flew to Korea to be the photographer for Paige. I was over here in Utah having FOMO as they were Marco Poloing me when she was in labor. You guys, I am so excited. I can't explain to you the love that I have for Paige. She has been on our team for so many years. I'm getting emotional. I have seen this woman transform into the most amazing, strong individual. She has created something so special for her family, and I think, for Korea. This is our first official Maternal Assisted Cesarean story on the podcast. Seriously, my eyes are all watery. I just cannot wait to hear this story. Julie was just saying how she's been dying wanting to call me this week while she has been in Korea, but she didn't want to share her story because it is Paige's story, but I love that I get to have both of them on the show. So hello, you guys. I'm sorry. I just am rambling. Paige: Hi. Meagan: Oh my gosh. Okay. We have Paige. We have Julie. You guys know who they are. Julie, obviously, has been with The VBAC Link for a long time, and so has Paige.Julie: Been with The VBAC Link for a long time? Yeah.Meagan: Yeah, sorry. You created it. Julie: We created it. Meagan: Yeah, sorry. I'm thinking of Paige. Paige has been with The VBAC Link for a long time. If you didn't know, she actually heads the CBAC group, the CBAC Link Community on Facebook, and she transcribes all of these incredible episodes. So thank you, Paige, and welcome everybody.Paige: Thank you. So yeah, I'm just sitting here in my little corner of The VBAC Link team doing my transcribing which I feel like maybe is just a little drop in the birth world bucket until something more happens for me. I've been with The VBAC Link for the last 4 years, and I feel like it's my way of preserving these stories. Spending time with the women on the podcast is such an honor, and it's just one of my favorite things to do. I've learned so much, and truly, we'll get into it, but I wouldn't have had this birth experience in the same way if it were not for The VBAC Link and for being on the team. So truly, thank you to both of you. You've changed my life. All right, what's that?Meagan: I was going to say that you've made our life better. Paige: Aw, thank you.Julie: Yes, absolutely. It is so cool to see this. Me and Paige were just talking last night about this and how it's kind of a full-circle moment. We were going over her other births and how we got here and how she got here. It's just so cool. I am so thrilled about how everything played out. There were so many little miracles. I think miracles is not the right word. There were so many special blessings and things that led her to this point. I cannot wait to hear all of it from her perspective. It's so fun to be here and share on the podcast and really, this story is going to change lives. It's going to change lives. It's going to change birth. It is going to be something that people talk about and use as inspiration and hope as they prepare for their own births, no matter how they birth because there's a lot of advocacy involved. I think that's the biggest thing. There's a lot of advocacy. Paige did a lot of advocating for herself and what she wanted. It doesn't have to be literally the same way that she birthed for anybody to take inspiration from it, so I would just encourage everybody to listen because she is such a good example of fighting for what she wants, and shifting and rolling with the punches. I am just so inspired by Paige. You mentioned it too, Meagan. I am just so inspired by how she has approached all of this. Yeah, there are lots of life lessons. Lots of life lessons in this birth. Meagan: Yes.Julie: Stay tuned, everybody. It's a good one.Meagan: All right, Ms. Paige. We're turning the time over to you. Let's hear it because I cannot wait. Paige: Okay, so I'm going to start with a brief overview of my first three births. I'm a mom to four boys. I never thought that would be my story, with four C-sections. I never thought that would be my story, but it is, and it's beautiful. For my first birth, I got pregnant in September 2015. We were living in Hawaii at the time, but moved to Lawton, Oklahoma. I received prenatal care there at the Army hospital. It was pretty straightforward, just the What to Expect When You're Expecting type prep. They have this program called the New Parent Support Program which is really great for new families.  A nurse comes to your home, educates you, and gives you resources. I did that. That was really nice. I had a friend who was a doula. We took a hospital childbirth class and watched things like The Business of Being Born, but other than that, I was mostly just really afraid of childbirth in general. I was afraid of dying. I just wanted to survive. I didn't really have any specific birth preferences. I have struggled with anxiety and panic attacks throughout my life, so I thought that if I could just survive, that would be a big win. My OB was a family friend, and I felt very safe with him. He had a great bedside manner. I didn't really push any questions. I just trusted him fully and completely. At 34 and 6, I noticed that I started leaking fluids. My New Parent Support Program nurse had advised me that if I had noticed any kind of new discharge or anything like that– colorless, odorless fluid to go and get it checked out immediately. So I did. My husband drove me. I remember I had not eaten lunch, but it was lunchtime. I was like, “Oh, just drop me off. This will be fast, then we will go get lunch.” The midwife there tested the fluids and confirmed it was amniotic fluid. I remember my OB walked in. He said, “You are leaking amniotic fluid. We need to have this baby today. The baby will be fine at 35 weeks, and it's better for the baby to come than for you to stay pregnant basically and risk an infection.” So I was like, “Oh, okay. Yeah. I trust you.” I got a steroid shot for lung development at 35 weeks. Then they started me on an IV with antibiotics because I didn't have my GBS test back yet. Then he also told me that the Army hospital there did not have a NICU to support a 35-weeker and that I would need to be transferred to the civilian hospital in town. So I would have to be transferred. Since I was already on an IV, they were just going to do it via ambulance. It was my first time ever riding in an ambulance. He also said that he legally wouldn't be able to deliver me, but he would go with me and help me make decisions. That was really nice of him to go, but still just the sheer fact that I was going to be riding in an amublance for the first time, I was going to be having the baby that day, and then I was going to have a completely new doctor, was just sheer overload going into a birth that I was already afraid of. Yeah, it was not the best circumstances for a successful induction. I arrived at the hospital. I met the doctor very briefly. I called my doula friend. She came and helped me. We did what we could, but ultimately, my body was just not showing any signs of being ready. I had no contractions at all. I was completely closed and not even soft. No dilation. My cervix was just not showing any signs of progress. After about 14 hours on Pit, they came in. I remember I had the dull cramping from the Pit, but nothing really intense. I also just remember being so painfully hungry, and they wouldn't let me each. But since I hadn't had lunch, I was just so hungry where you get the body chills and stuff. Anyway, the doctor came in, said he was having decels. He recommended having a C-section because my water had been broken for over 12 hours. I consented. I was so afraid. I remember when they were putting in the spinal, I was just heaving sobs into this poor nurse. You go in and prep. The C-section itself was fine. My arms were strapped down. I didn't feel pain, but I remember it was like an elephant was sitting on my chest. It was like, “Oh, it just feels like somebody's sitting on my chest.” It wasn't horrible, and I was pleasantly surprised by that. But then, he was whisked away to the NICU. I briefly saw him swaddled with a hat on, then he was whisked away. No skin-to-skin for my husband or me, obviously. He was 4 pounds, 14 ounces at birth. They wouldn't let me go see him until I felt ready to go. I was just so swollen from all of the fluids. I was so nauseous anytime I would sit up. I just was not ready in any state to try to go walk or be wheeled to the NICU. Finally, 36 hours after delivery, I was able to meet him. We named him before that over FaceTime, but he was in the NICU for 7 days. I wasn't traumatized because I survived and that was my goal. I met my goal, and I was really proud of myself for facing the fear, but hoped for something different the next time. With the second birth, I got pregnant in July of 2017. I had a subchorionic hemorrhage early on that resolved. We were in Texas at the time. It was Fort Hood back then, but I met with many different OB providers at the Army hospital on base there. I felt okay with it because I had a neighbor who was going for a VBAC after two C-sections. She was really supported, and then she had a successful experience there. Because of my 35-week PPROM, they suggested that I go on the Makena progesterone shots once a week from 16 to 36 weeks. I did that. They worked very, very well. I switched to the midwife track because everything was going fine. The midwives were really great. They were really holistic. They supported inducing a VBAC if needed, but they also supported me going into spontaneous labor past 41 weeks. I made it to 41 and 5. The VBAC Link was not a thing back then yet, so I did not have that resource, but I did read Ina May's Guide to Childbirth and the Natural Childbirth the Bradley Way. I read The Birth Partner. I kind of started dipping my toes into real birth education. I was learning about the physiological process of birth, learning how to do it without being afraid, and learning to trust my body. It was really empowering. It was the prep that I needed at that time. I didn't know about bodywork. I ended up having prodromal labor for about a week. It was pretty intense, but I didn't know anything about positioning, posterior, or Spinning Babies. I did find that out right at the end as I was going through it, but I didn't do chiro or any of that. I finally went in for an induction at 41+5 in April 2018. I ended up having to go with an OB on call because the midwife didn't feel comfortable with the NSTs that she saw, so she didn't want to take me on. I was like, “Oh, dangit.” The OB who was there was one who I wasn't really super comfortable with. But he was like, “Oh, well I know you really want a VBAC. We'll try to get that for you.” I was like, “Okay.”I got a Foley. I was barely a 1, but they got a Foley in and I progressed very quickly. I got to a 5 within a couple of hours. Things were going really great. They were very normal labor patterns. I felt like I was managing the contractions really well. I did consent to artificial rupture of membranes, then labored a little while longer. I got an epidural at 7 centimeters. I was told, “Oh, we just had a mom who got an epidural. She relaxed, and the baby came right away.” You hear that and you're like, “Oh, I want that. Yes.” So I did that. I got the epidural at about 6:30ish, and then between that half hour, his heart just wasn't doing well. They were flipping me. I got an amnioinfusion. I got a fetal scalp electrode. I got an IUPC, all the things. Then they gave me oxygen. It was probably about 7:00. He had a prolonged decel. I was lying flat and there were people all around me. The nurse was just like, “We need him now. Do you consent to a C-section?” I was like, “Yes.” Then I surrendered and let it go. I was like, “There goes the VBAC. This is just what needs to happen.” He was born at 7:09, and I was born under general anesthesia for that one. His APGARS were 8/9. My husband was left alone during that surgery. We do have pictures of him holding my son and doing skin-to-skin at 7:27, so about 20 minutes after he was born. I woke up and got to hold him at about 8:45, so about an hour and a half after he was born. I remember it was just really hard to talk after being intubated, but they let me breastfeed right away. I was disappointed, but I don't feel like I had a lot of trauma from that just because I was so empowered. I ended up ultimately making it to an 8. It was so fun for me to see what my body could do. I was like, “Oh, this just means that I was meant for a VBAC after two C-sections. That's what it meant.” Right then in the OR, or I guess it was the recovery room. I committed that that was going to be my story. I was like, “Oh yeah. That's just what it's meant to be. That's why it didn't work out.” I was so empowered. Then when I got pregnant for the third time in September 2019, we were in Germany. We had just moved there. I hit the ground running. I hired a doula right away and a backup doula. The prenatal care was at this small, tiny clinic in a town called Parsberg. I chose not to get progesterone shots. I was like, “I was 41+5. I think I'll be okay without them.” Yep, that's when I discovered The VBAC Link and all of the birth podcasts. I just became obsessed listening all the time, taking notes. I did the bodywork. I watched tons of birth videos. I did cranioscral therapy, chiropractic, and Spinning Babies. I took The VBAC Link Parents Course. I read lots of books. I switched my insurance. I took vitamins. I consumed it all, and I loved it. Every time I did something, I felt like my intuition was confirming that I was on the right path. I specifically would manifest, visualize, and pray, and I just was on this high every time. I feel like that's your intuition confirming to you that you're on the right path. If you feel those things, that's a good sign. You do want to follow that. Meagan: 100%. Paige: I did. Then, COVID. It was September 2019 when I got pregnant. Things were fine, fine, fine, and then COVID started happening. In March, I flew home to Denver to stay with my in-laws. We were supposed to move to Colorado in the spring anyway. My husband was not allowed to come with me. There was a travel ban for 90 days. I just did not want to get stuck in that, so I flew out very quickly with my boys– my two boys. I was 27 weeks pregnant and was living in my in-laws basement. That's a whole thing. COVID was a whole thing for everybody. But it was a scary time and stressful. I didn't know if my husband would be able to make it to the birth, but he was granted an exception to policy leave where he was able to come home. He would have to go back. That was the contingency. But I had rebuilt my team. I had found new bodyworkers. I found a new doula and a new backup doula. I found a team of midwives who were really VBA2C supportive. They were saying things like, “When you get your VBAC,” not if. They really supported all the things, so I felt really comfortable with them. I lost my mucus plug and had bloody show on June 8th. I was 40 weeks. That was my due date. My water broke that night at 11:00 PM. I had a small pop, so it was just a litte bit. I was laboring at home. Nothing really was picking up, but on June 9th, at 40+1, I went into the hospital around 3:00 PM. Labor started picking up pretty quickly after that. About an hour and a half later, my waters gushed everywhere which was really thrilling for me to experience the big gush. I was not very far along, though. My progress is just very slow, but they were not rushing me at all. They were like, “We'll stay patient. We will stay very patient. There is no rush. As long as baby is doing well, we'll just let you do your thing.” My doula was there. After my waters broke, my contractions started coupling on top of each other and getting very intense. They were quite long. I started feeling really lightheaded and dizzy. I tried to sit on the toilet and just felt like I was going to pass out. I threw up a few times. I knew it was time to get some pain relief. They offered the walking epidural option which I took at about 8:00 PM. Baby was doing great. I was really worried about getting the epidural again because I felt like that's what had caused the craziness before, but he was doing great. At 2:00 AM, he started not doing great. He wasn't tolerating the contractions well. I was like, “Oh, not again. What?” I was only 4 centimeters. I just knew that we needed to go in again. I didn't know why, but I was so sad. I didn't want another crash, so I did want to prevent another crash. I knew that if it was going to be a heart thing, I didn't want to mess with that. Especially knowing the signs of pain and coupling contractions and things like that, it just seemed like he was telling me that he needed to come. I consented to the OR and to the C-section. I was wheeled to the OR. I remember as I was being wheeled in, I was just thinking, “This is not what I want. This is not what I want. This is not what I want.” I was so sad. He was born about an hour later. I was so drowsy. I was so tired. I was not present at all. I did not feel strong enough to hold him. My husband held him. I briefly brushed his face. He was wearing his little hat and was swaddled, then they took him to the recovery room. The doula was not allowed in the OR. It was actually a miracle she was allowed at all because they had just lifted the doula ban the week before for COVID. I was like, “Okay, the baby will be in there with her.” I'm not sure why they wouldn't let the baby just stay with Sam, but it's okay. I needed his support. I was really happy that he was there. Closure took longer than usual. They said I had pretty thick adhesions, so I was just laying there trying everything to stay awake. I was fighting so hard. I remember reading words on the light and looking at the letters and just going over the letters in my mind and trying to stay awake. I was fighting so hard to stay awake. I finally got to hold him at 4:00 AM in the recovery room. It was still about an hour after he was born. I missed the golden hour again. I was so sad. I was so sad for a third time to miss it. That recovery was really hard. In the hospital, I was so heartbroken. The trauma this time really hit me emotionally and spiritually. It was physically a lot more traumatic on my body for whatever reason. I mean, just the sheer labor was so intense. My incision was black and blue and puffy. I couldn't walk normally and I didn't feel normal for 5 or 6 weeks, but I also feel like it's because I was so sad. I think how sad you are really does affect how you feel physically. Meagan: Yeah. Yeah, for sure. Paige: I do remember specifically too, my first shower there. My husband had to really help me walk over. I was so sticky from all of the sensors and monitors. He was so tenderly trying to help me wash them off. I was just sobbing. I was so sad. I felt so broken and so vulnerable. It was a beautiful time for my husband to be there and carry me because he knew how badly I wanted the VBAC that time and for him to just carry me through that. But going home, I went home to my in-laws' basement. It was dark. I didn't have a support village because it was COVID. COVID moms know what that was like. Anyway, ultimately, I did reach out to Meagan and Julie. That's when the CBAC group was started. I was like, “Is there any way we could start a CBAC support group where CBAC moms can connect?” You guys were so warm and welcoming. Immediately you were like, “Yes! Why hadn't we thought of that?” Julie, you were so gung-ho about that. I was able to connect to other moms through there which was so healing. Anyway, that was the third story. Then the time between three and four was really, really pivotal for me. The healing that I felt I needed before even thinking about trying to get pregnant was where I feel like this all really starts. When you don't get the birth that you hoped for or when you don't get a VBAC, you just feel embarrassed. You feel ashamed. You feel broken. You feel like your intuition doubted you. You feel dumb. I've seen many women comment how family members would be like, “Oh, I knew it wasn't going to happen for you.” It's hard. It's really hard. You feel very, very broken.I knew that I had to show up for myself and still give myself grace. For this birth, it was good for me because I was able to face not failure, but being wrong. I was able to face being wrong and show myself that I could still be there. Anyway, I started physically diving into healing through pelvic PT and doing a lot of scar adhesion work. The dolphin neurostimulation tools if you haven't heard about those are fantastic. I feel like they worked much better for me than scar massage. I wish I had a provider here now who would do it. I think maybe that would have helped this pregnancy and birth, but it helped my recovery so much.I started having really bad panic attacks and postpartum anxiety, so I went to talk therapy. I got on medication. I went to a chiropractor again. The thing that really, really helped my healing was joining a gym and falling in love with exercise again. I got into all of the things, the yoga, running, learning how to lift, and started really pushing my body again and trusting my body again. I didn't expect exercise to heal that relationship with my body, but I feel like it really did. I learned again that I am physically strong which was really, really nice. I started signing up for some races. I ran my first half marathon. I had a lot of emotional releases during yoga. There was one song that came on one time during a yoga practice. It said, “You can't rush your healing. Darkness has its teaching.” I loved that so much. I just started crying. I was just like, “Let it out.”Part of healing is welcoming the grief when it comes, processing it, and taking it a little bit of a time. It's such a process. You get little glimmers of understanding, but as you keep committing yourself to looking for that and looking for the understanding, it does come. I truly believe that. Anyway, life went on. There is a four-year gap in between my third and my fourth which I really needed. We moved to Korea in that time. We moved to Korea last June, and it's just been lovely. We knew that we wanted one more. I knew I was so happy with the prep and how vigorously I did it. I was proud of myself for that and I knew that I wanted to do it the same way.I knew that after everything I learned, even if it was going to be a C-section, I couldn't just show up to the hospital and have them take my baby. I knew too much. I was like, “I know that there are better ways. I know that providers practice differently from place to place. I know it's not all equal. I know every provider does things differently, even with C-sections.” I started watching videos, and I saw that even the way they performed their C-sections was not the same. I wanted to be really actively involved in how they practiced, and how I was going to be a part of it. My goals for this time were not necessarily VBAC or C-section. I never closed the door completely. I was like, “You never know. Maybe VBA3C, maybe that's my story. Who knows?” However, I did find the episode by Dr. Natalie Elphinstone. As I was transcribing that one, my fire for birth that I held felt for VBAC was coming to life again. That intuition was speaking to me, and I had not felt that fire in a long time. That was the first whisperings of, “You should try this. You should go for this.” The goals that I had for this baby were to be very intentional. I wanted the golden hour. I had to have the golden hour. I had to hold my baby first or within an hour. Please, oh my gosh. I carried so much guilt for not having that three times over. I also wanted to be treated like I mattered. I did not want to be part of a rotation. I wanted continuity of care. I did not want to feel like I was just being shuffled through a system. Whether it was a hospital or not, I knew that I wanted to feel special. Lo and behold, did I know how special I would feel at my sweet birth center. Okay, so with the intention thing, just the pieces of this birth story with number four started falling into place so specifically. I can't deny that spirituality was a big part of this because with number three, my prayers had been very, very specific. I knew that God knew what I wanted. I knew it. I knew that because I didn't get it, there was a specific reason why. That's the only thing I could cling to. As things specifically started falling into place, it started to confirm to me that this was my path and these were the reasons why the other things happened the way they did. But anyway, I got pregnant very quickly with this baby. It was the first time that it wasn't a total surprise which was really fun. I had been taking tests since I knew the day that I ovulated, and then I was just taking tests watching, watching, and watching. I was able to see the first faint line which was so fun. I had always wanted that. I had wanted that moment of, “Oh my gosh, I'm pregnant,” where before it was like, “What? I'm not quite ready,” but I was still excited. That was really fun for that. The Korea birth culture here is very intense. The C-section rate is 50-60%. There are constantly stories being shared on these local pregnancy pages of women just having the most traumatic experiences and my heart aches for them. It's very routine for doctors to suggest first-time moms to, “Go have a C-section. Your baby is big,” and not even trying to labor. Most of it is because there is a doctor's strike going on here. There is a limited number of providers. They are stressed. They don't allow husbands typically in the OR, and very routinely, they are under anesthesia. Then after birth, babies are typically taken away to nurseries, and then postpartum recovery is in an open bay type thing. Meagan: Like, combined? Paige: Exactly, yeah. Your C-section stays are typically about 8 days. I wanted to explore options. We have an Army hospital here that is pretty big and does provide labor and delivery services, but they're often maxed out so you're referred off post. I did not feel comfortable going to any of the places that they typically referred to just from stories I had heard. That's all it takes for me now. I just hear one story and I'm like, “Nope, no thank you.” I know my red flags very quickly now. I went to a tour at this birth center called Houm. It's spelled H-O-U-M. At 8 weeks, I went to go tour it. I noticed a lot of green flags, not red ones where I was just like, “Oh, I'm just going to take a note of that.” Some of the green flags from my tour as I walked in were how I felt right when you stepped off the elevator. It's this calm energy. The lighting is so beautiful. It's such a lovely set up right when you walk in. You take off your shoes because you are in Korea. You take off your shoes, then multiple staff members greeted me with a hug. That's when I met Dayana Harrison who I later ended up hiring as my doula, but she also served as my midwife. She is a student midwife working there right now. She took me on the tour. They have queen-sized beds in their labor rooms. The whole floor was dim and so quiet. It did not have a hospital vibe at all, but they do have an OR on site. I was like, “Oh, this is lovely.” They offer epidural. They have huge birthing tubs with the rope attached from the ceiling. They are so beautiful. Yeah, it's in each room. Then the OR on site does not feel like a hospital OR. It's smaller. They keep it warmer. It feels like– I don't know. It just had such a homey feeling. That's the best way I can describe it. Then some of the things I asked about, in their routine gentle Cesareans, moms routinely get skin-to-skin immediately. They have a little cut open in the curtain where baby is slid through right on your chest. They routinely would keep the placenta attached to the baby in the OR which is–Meagan: Almost not heard of. Paige: Since posting that video, I can't believe how many messages of, “How did you do that?” That's revolutionary in itself. That was a huge green flag where I was like, “Oh my gosh, what?” Typically, what is it? Why do they say you can't do that? Is it because the incision is open too long?Meagan: Yeah. They don't even allow delayed cord clamping most of the time. They just milk it because it's a major surgery. The more time the mom is exposed and open, the higher chance they have of things like infection. Once baby is out, they really want to wrap it up and finish it to be complete. Yeah. To actually leave a placenta attached to a baby is unheard of. It really is unheard of in a Cesarean. Paige: Yeah. So that was super awesome. Then they let you keep the baby. He encourages C-sections past 39 weeks. That's not a routine hard and stop final date. He encourages going into labor before saying that it's good for the baby. He encourages breastfeeding in the OR. The head OB, his name is Dr. Chung. He is also an IBCLC which I thought was so awesome. So he supports breastfeeding.Julie: Wait, wait, wait. Time out. The more I learn about this man, the more I love him. Paige: Did you not know that?!Julie: Oh my gosh. Meagan: I want to meet him. Julie: I want to put him in my pocket and take him with me to deliver every birth I ever go to ever. I love him. Paige: I've literally said the exact same thing, Julie. I wish I could just keep him with me forever. That's the thing. Throughout this whole process, I kept taking note of these green flags. I'm thankful for my other experiences because I don't think a lot of people recognize how green these flags really are. I was like, “Okay, the shoe's going to drop. The shoe's going to drop. There's something.” I'll keep going.Meagan: Can I mention too? You had Marco Polo'd me, “I'm on my way,” then you would leave, and you were like, “This is amazing.” You were just like, “This is right,” every single time. The more you went, the more it verified that you were in the right place. Paige: Yep, yeah. You just know. When you know, you know. During that appointment, he came specifically and talked to me three times. Three times. He shook my hand. I'm like, “Are you not busy? What? Three times, you have time to see someone who is just touring?” He only sees 15 patients. He is very VBAMC supportive and experienced with it. He supports vaginal breech birth. They do ECVs on-site. I didn't even bring up VBAC after three. I just mentioned that I had three C-sections, and he said something like, “Oh, do you want a VBAC? Do you want to try again?” I was like, “Oh, I mean, I don't know. I'm thinking about it.” Then, he made me cry. This was at the tour. He made me cry because he said, “I'm a different doctor because I listen to moms. I listen. They tell me how they want to birth. If you want a VBAC after three C-sections, I will support you. You can do it. You choose how you want your birth to go and I will worry about the bad.” He was like, “You don't need to worry.” I was like, “Oh my gosh,” and I started crying. I was like, “Okay, I'm going to go now.” I was not composed, and then he hugged me. I was like, “What? Who is this guy?” I didn't just jump over there. I did give the Army hospital a chance. I went to a couple of appointments there, and that was kind of all I needed to know for what I wanted. I'm so thankful they are a resource there. I'm thankful that they are here. But I did ask about their routine Cesarean practices and their VBAC practices. It was important to me to find a doctor who supported VBAC even if that wasn't what I was planning to go for. I still love VBAC so much. I think it's so beautiful and such an important option for women to have. I'm so passionate about it. I always will be. They didn't even humor the idea at all of VBAC after three. They were like, “Oh, no. You're going to have a C-section. Of course.” The idea was laughable. The C-sections only allowed one support person, no breastfeeding in the OR, no photographers. Arms are strapped down. I just was like, “Okay.” I was very gently asking questions, but then was like, “Uh-uh. Red, red, red flags.” My biggest piece of advice, and we say this over and over again, is to find a provider whose natural practices align with the things that you want. Julie: That is it. That is it so much. Sorry, I don't want to interrupt again, but let's put bold, italics, emphasis, and exclamation points on what you just said. Say it again. Say it again for the people in the back. Paige: Find that provider whose routine practices align as closely as possible with what you want. Julie: Preach, girl. Preach, girl. I love it. Paige: Because we're not meant to fight. You do not want your birth experience to be a place of fighting or stress. Julie is learning that I am a people pleaser. I'm not anything special. I did not stand my ground. I'm going to do this. I did not come blazing in. I found a provider who I felt very, very safe with, who I felt safe asking for this from, and he said yes. I knew that because his practices were so close to the MAC, he would be the most receptive. But there's a chance that he wouldn't have been, and he was. That's why ultimately it worked out because he was receptive. I couldn't have forced him to do it, but because he practices closely to it already, it wasn't as much of a push. If I tried to go to that Army hospital and introduce this idea, they'd just shut it down. Meagan: You know, that's what is so heartbreaking to me. Providers all over the world really just shut that down if it doesn't match their normal routine and their everyday thing. It's like, well, hold on. Let's listen. Why are people requesting this? Just like Dr. Natalie, she saw this and was like, “This is something that means something to people. Why don't we change the norm and create something different?” Providers, if you are listening, please try and make change in your area because it matters, and it doesn't have to be exactly how it's been. Paige is living proof of this. It just doesn't have to be that. But we can't make change if no one puts forth the effort or allows it. Paige: Dr. Natalie said that exactly. She said, “Let's make every birth the best possible version of that birth that it can be.” Meagan: Yes. Yes. Paige: She said, “If there's a way to make it better, why not? Why not?”Meagan: Why not? Because like it or not, birth impacts us. It sticks with us. You're now explaining four different stories. It's not something we just forget. We don't just walk away from these experiences. They stay with us. Now, we might process and are able to move forward in a different direction, but it's not like we forget, so why can't we make this change? It actually baffles me. Julie: Well, and the mode of delivery is the same. I really want to emphasize that. She has had four C-sections, and they were all very different. But the only one where she left walking out of it really feeling empowered is the last one where she chose a provider who aligned with what she desired for her birth, she had a say in her care, and she felt loved and supported the whole way. She felt like the staff cared about her needs.But also, time out. She didn't just feel like the staff cared about her needs. They did. They did actually, genuinely care about her needs and her experience. I feel like that's such a big difference. Meagan: Mhmm. Mhmm. Yeah. Sorry, Paige. You can continue. We got on a little soapbox. Paige: You're good.Julie: I feel like we're starting to tell the story before the story is told. Paige: No, it's great. We're getting close. I switched to them officially at 20 weeks. My first appointment was the anatomy scan. That's when I also proposed the idea of the MAC officially. After every ultrasound, he comes in, talks to you, looks at it, then you go into his office area where you just chat and ask any questions. That's just the routine setup of the appointments. I had this video prepared, and I was really nervous. It's scary. It is scary to ask your provider for something new and different. I had this video. It's on YouTube. It's by Olive Juice Photography. Everybody should go look at it. It's the birth of Betty Mae. It's the video that I watched over and over and over again because it's the only video I could find of the process from the beginning to the end including all of the prep and including how it was done. I was like, “I saw this online. I was wondering if you could watch it and tell me what you think.” That's how I presented it. It's a long video. It was like, 5 minutes. He just sat there patiently and watched. Then after, actually one thing he did say was, “I don't like how he's using forceps.” I was like, “Oh, green flag.” Then, he asked, “Is this what you want?” I said, “Yeah. I think it would be really special if it could happen.” Then, he said, “Then, we can do that.” Then, he thanked me for giving him the opportunity to grow and try something different. He said, “Will you email that video to me and any other resources?” I emailed Dr. Natalie, and she sent over a MAC PowerPoint that she had prepared of the procedures because from the episode, she was like, “Anybody interested doing this, reach out to me.” She is true to her word. She will do that. If you are interested and you want to contact her, she is very responsive. She sent me also her MAC hospital policy which I forwarded to him. I have to share what he said. He's so cute. In the email response, he said, “I watched the video you sent again. If necessary, we will contact Dr. Natalie to prepare for your perfect Cesarean delivery. Thank you so much for this great opportunity to serve you. I am excited to help your birth and confident it will be a great opportunity for further growth for us.” I was like, oh my gosh. Meagan: That literally just gave me the chills. Paige: I could not believe it. Dayana, who is also a student midwife there at home, told me that she had been planting seeds for maternal assist for a while. They had just been waiting for a mom to ask for it. That was also the time that I hired Julie. I was like, “Julie, that would be so fun if you could come out.” Then Julie was like, “Okay, let's do it.” Then I'm like, “Okay.” Then it happened, and Julie was just so brave to have the gumption to come out. Fun fact, she was previously stationed out here with the Army. It does seem like it all kind of worked out that Korea wasn't so out of touch for her, maybe. Julie: Yeah, no. It was really cool. You had mentioned it briefly, then I was like, “Oh, I wish I could make that work.” Then, I remember I was in the CBAC group. I was like, “Oh, I'm so excited for you,” or something, then you said something like, “I really wish you could come and document it. We would cover your travel out here and everything.” Then I was like, “Oh my gosh, really?” So then I talked to my husband about it. I was going to be gone for a while. He would have to hold down the fort and everything. I talked to him and he was like, “Yeah, I think that would be okay.” I was like, “Oh my gosh, Paige. My husband is fine with it. Let's do this.” I remember the day that you booked my flights and officially signed my contract and locked in and everything, then I told my husband and he was like, “Oh, this is really happening then?” I was like, “Nick, I gave you the change. I gave you the chance to eject. It's too late now.” He's been doing really great. He's a really great dad. The on-call life means he has to just take over the house at random moments. We are set up to where we can do that. It was just really funny. I'm so excited that we could make it work. Paige: This is my public thanks to Nick and all of Julie's children for allowing her to be here because it did require sacrifice on their part, truly. I'm just so thankful. I also found out, Dayana told me that she had been asked to prepare a whole presentation for the staff on MAC which she did. She prepared it for nurses, midwives, and anesthesia walking them through. The fact that she had that connection to Houm and that experience, she served as my doula but so much more. She was so much more as my advocate having that inside access to the staff. We scheduled a surgical rehearsal for 35 weeks. At 35 weeks, this was one of my favorite things. He personally was there to walk me through every step of what it would look like for my security, but I don't feel like I really needed it because I was very, very familiar, but for the comfort of the staff and everybody else too. I got to the appointment. My husband was able to be there with me on that one. The way it's set up– we'll post our video then you can visualize more of what the layout looks like. There's the prep room, then literally 10 steps across is the OR right there. In the prep room, they had a gown ready for me. They had the washing bins ready. So the way that it works, you go in. You put the gown on. You have the IV. They showed me where they would place the IV. Then you scrub up your hands. You wash with the sterile solution, and then they put gloves on top. This was the way that they did it. Then they walked me into the OR. They showed me how I would go sit up on the table, how I would receive my spinal through anesthesia, then they practiced laying me back down. They did everything step by step. It wasn't new to me. I've had C-sections before, so I knew, but it was just so sweet that they were so thorough. They showed me how they would insert the catheter. He showed me exactly how he would lay the drapes over my body. He showed me when the curtain would go up. The way they do it, you're not just watching the whole thing the whole time. You could, I guess, opt for that if you wanted to. You have the drape up, they do the initial incision, get the baby out up to his head, and then they drop the curtain. That's when they pull your arms down. The other thing too, the reason why they do strap your arms down is in case you impulsively reach down and touch your incision and breach the sterile field. That's the reason why arms being strapped down is even a thing. But for MAC, your arms are not strapped down obviously. They have somebody holding their hand on your hands which I don't think I even had. Looking back, I don't remember anybody touching my hands or my arms. But that wasn't an issue. It wasn't something that I impulsively wanted to do, to reach down there. Anyway, then the drape goes down. They guide your hands up and over to put your hands under his armpits. Come up. Bring your baby to your chest. The curtain goes back up during closure, and then they talked about how I'd be transferred back to the recovery room– not the recovery room. No recovery room. You go to the postpartum room immediately. I felt on such a high after that. It was just so beautiful how he did that. At 38 weeks, I had an ultrasound. They do ultrasounds at every appointment. I don't know that there is a perfect practice out there that aligns with absolutely everything you want. But they do routine ultrasounds. I wasn't really concerned about that, but they did flag something called kidney hydronephrosis. It's basically the swelling of the kidney. They had been monitoring that. It had presented late in the third trimester, but it was severe enough that they were starting to get really concerned about it. Basically, it can mean that there is an obstruction, and if it's really severe, it can mean that the baby needs to be evaluated within 48 hours of birth by a pediatric urologist which clearly they don't have on site. It was a whole thing. If it really is severe and there is an obstruction, then they need to do surgery really promptly to prevent kidney damage early on. That was the thing. He did suggest that I could deliver somewhere else, and then the baby would be able to be there and we would be together in the same facility. That's when I felt like the shoe dropped. I was like, “Why would he suggest that? He knows that I would not want to deliver anywhere else. Why would he even bring that up?” I was all a mess. I was alone at that appointment. I felt a little bombarded and ambushed. I was like, “This isn't going to happen. I'm not going to get it.” That night, Dayana called me. I was getting ready to reach out to her, but she called me. She was like, “I just wanted to check in.” I had emailed Dr. Chung a clarification email. I think that's really important too. If something doesn't sit well with you in your appointment, it's okay to follow up in an email just to clarify what happened. Can you lay out these options? Can you lay out what we went through? Can I have a record of the ultrasound and what you saw? Because then you're not just swirling these things in your mind. You're actually looking, then you can do your own research. I dove into research. I dove into studies. I compared the numbers that he gave me versus what I saw, and it all did align. She called me and she was like, “No, don't worry. He is comfortable moving forward. He thought that you would be concerned, so he wanted to present you with more options to deliver somewhere else, but he is very happy to deliver you here still and sticking with our plan. He does want to see you at a follow-up ultrasound at 39 weeks,” which I was comfortable with. I was like, “Sam, you've got to come with me. I can't go alone.” She promised that she would be there. That's another thing. When you have a team that you trust, make sure that you are supported, and it's not just you and your doctor. If there's something that doesn't sit well, it really helps to field it with other people not just in labor, even in your prenatal appointments or anything like that. If you feel like you need some extra support, it does really help to bring some people with you who you trust. So at 39 weeks, we all met as a team and asked lots of questions. We felt comfortable with a care plan moving forward. We ultimately decided that we would move forward with the C-section at 39+5 which would be Monday. I'm trying to think what day that was. Meagan: The 7th. Paige: Monday, the 7th. Meagan: That's what I had in my calendar. Paige: Monday, the 7th was the day. We talked about moving it up. All his colleagues were like, “No, you should deliver this baby now. What are you doing? You're crazy keeping her pregnant.” I was like, “I am comfortable waiting, and I have to wait for Julie, so it can't be until Friday. It can't be until Friday.” She gets in on Thursday. That was Wednesday, at 39 weeks. Thursday was 39 and 1.Julie was on the plane, and then that morning on Thursday, I lost my mucus plug at about 8:00 AM. I was like, “Oh, no.” I wasn't really having contractions or anything, so I was like, “Okay. We'll still make it until Monday. It's fine.” Then, Julie got in at about 7:00 PM. I started having some baby contractions. We were sitting around my kitchen table, and Julie was like, “Are you contracting right now?” I was like, “A little.” She was like, “Go take a bath.” Then, we went to bed. I took a bath, and then I went to bed. I was for sure just contracting. I was like, “But what about these logistics? What is going to happen?” Anyway, my childcare plan was going to be turned upside down and all of the things. I was stressed about the logistics. But then, I was woken up at about 10:00 PM by contractions. They were about 6-7 minutes apart, but they were definitely real. I thought they were prodromal, so I was just waiting for them to just go away. They started getting closer. They were close enough to about 4 minutes and sometimes 3. I was having more bloody show, so I was like, “These are kind of doing something.” The intensity increased. It got to the point where I couldn't lie down. I was on my hands and knees. I was standing up, bracing myself against the wall. I was trying to do different positions. Maybe it was just a positional thing. “Let me try to do flying cowgirl. Let me try to do Walcher's”. I was trying to do different positions to try to stop them. I tried to take a bath at 3:00 AM, and they weren't going away. I was like, “Okay, I can't do this. I can't risk it. We've got to go.” I woke up my husband. I was like, “Today's the day. He's just telling me that it's the day. It's time. I don't know why, but it's Friday. It's supposed to be.” At 4:00 AM, he packed his bags. At 5:00 AM, I felt so bad because Julie had just gotten in from this huge international flight. It was a 12-hour flight plus some because you had a connection. I was like, “Julie, we're going to go,” she was like, “Okay!” She was so excited. “Okay, let's go!”Julie: I wake up to a knock on the door, and they're all dressed and ready to go. I'm like, “Why did she not wake me up sooner? I could have supported you.” Paige: I felt so bad. Julie: Yeah. It was wild. It was so wild. I was ready. It was awesome. Paige: So at 5:00 AM, we left for the birth center. At 6:00 AM, we got there. I messaged my team. Dayana said she was on her way. They led me to my room which is just a beautiful suite. It's right next to the OR. They led me to my room. They said that the anesthesiologist would be ready at about 10:00 AM, so between then, I would be laboring. Dr. Chung came in, and he said, “You need to be prepared for a VBAC to happen. You might have this baby just right here.” It was so funny that he was supportive of that idea even. It was so cute. I labored. It was getting intense, but they weren't super close together. Dayana came. She jumped in, and she immediately just respected the space which was so beautiful. She started doing all of her– she's a Body Ready Method practitioner. She's done some training with Lynn Schulte and the Institute for Birth Healing, so she's very familiar with the specific way to give you comfort measures. She was so great. I felt so safe. We labored, and my husband gave me a beautiful blessing. She said the more beautiful prayer that really invited heaven into the space and made it so spiritual and special. We were playing music, then at 9:00 AM, the head midwife, her name is Joy, came in. She started the IV.Dr. Chung came in and walked me to the prep room. In our rehearsal, I was going to be scrubbing myself, but he just picked up my hands, and he started washing my hands and scrubbing my hands for me. It felt like such a selfless act getting ready to go into this procedure. It felt like he was so respectful, and then I even had a contraction during the washing. He stopped what he was doing and was so respectful of the space. It just felt so Christlike having him wash my hands going into it. Then we walked into the OR, and they got me ready for anesthesia. They put in the spinal, and then they laid me down. They did the pinprick test. They gave me a new gown that was sterile. I'm trying to think of what else. They inserted the catheter. I could kind of feel a little bit with the pinprick test, but the catheter insertion was just pressure, so I felt comfortable moving forward. They got started. We played music. They had ice ready for me on my face because I told them when I get nauseous or anxious, I tend to get a little lightheaded. They had ice ready for me. That was something I had requested, and that was so nice. They started the surgery, and it was very, very intense. I do want to be candid that it was probably my most painful surgery. I had to work through it with labor-coping stuff. I was vocal. I did mention that I was feeling pain. It got pretty intense. I don't know if in Korea in general– I know that they are a little bit more stingy about anesthesia, but it was okay. I don't feel like I was traumatized from that. The baby came out at about 10:24. That's when they say he was born. We were listening to music. I was vocalizing, then Dr. Chung says– what did he say? “Let's meet your baby,” or “Come grab your baby”, or something like that. They lowered the drape, and it was so fast. I bring the baby up onto my chest, and everything just melted away, and this instinctual, primal– all of these emotions I didn't know I had just poured out of me. I lost any sense of composure that I had. I was shrieking. In any other situation, I would have been so mortified, but that moment of not having it three times over, it was this release and this justification or this validation of finally having it. I just got to hold my baby. I was a little nervous about seeing a new baby for the first time without being swaddled and how they would be wet and slippery, and if that would freak me out a little bit, but I wasn't worried about that at all. I was just so happy that I had him and so relieved. During closure, that was also intense too. They put the curtain up. They pulled out the placenta. They put it in a bowl, and then they put it in a bag, and they rest it right there next to you. The cord was so lovely and so beautiful. There is something about a fresh, new cord. It is so awesome to see. I thought it was the coolest. I had my husband. I was squeezing his hand. Honestly, I felt like having my baby in my arms and holding my husband's hand was the best pain relief. In that moment, it was keeping me calm, keeping me steady, and getting me through the closure and the rest of the surgery.Then they transferred me to my postpartum room, and they just let us be there. They didn't push cutting the cord. Dayana gave me a placenta tour. I was like, “When do we cut the cord?” She was like, “Whenever you want.” It ended up being about 2 hours of us just enjoying it and talking about how cool it was. Yeah. She gave us a tour. I was able to wear gloves and touch it and go through it, then Sam was able to cut the cord for the first time which was so awesome. That's the gist of it. Meagan: Oh my goodness. I started crying. I've gotten chills. I have so many emotions for you just watching your video. I've literally watched it 10, maybe 15 times, and I can't wait to see Julie's entire thing that she caught. But I am just so– there are no words. I'm so happy for you. I'm so proud of you, and I've talked to you about this. I've Marco Polo'd you crying before where I can't explain it. I am so insanely proud of you and happy for you that you got this experience. Thinking about, “I've never seen a gooey baby. I've never had that opportunity. My husband has never been able to cut the cord,” and you were able to have this beautiful experience where you got to have all of those things. It took four babies to get there, but you got there. You got there because you put forth the work. You learned. You grew, and you were determined. I think as listeners, as you're listening, sometimes that's what it takes. It's really diving in, putting forth that effort, and finding what's true for you. I know it's hard, and I know not every provider out there is like Dr. Chung. He is a diamond in the rough from what it sounds like on so many levels. But they do exist. Again, going back to what you were saying, sometimes it just talks about Paige going in and saying, “Try to have an open mind. Look at this video. I would like for you to view this. Just take a look at it,” and left it in his hands. Sometimes, it just takes something so simple. But, oh my gosh. I can't believe it. We were Marco Poloing about episodes, you guys, before she was in labor. We were also Marco Poloing about social media posts. She was like, “I just don't want to say anything until it happens.” I think sometimes even then, I wonder if that's where that ultrasound had come in and maybe there was doubt. I don't know. It seems like maybe that aligns pretty well with the time that we were messaging and that. Maybe we were Marco Poloing or texting. I don't know. It's like, could this happen? Is it really going to happen? You want it to happen so bad, and then to see it unfold and to have it unfold in such raw beauty, oh my goodness. I cannot believe it.So in the OR, they let Julie in there, right?Paige: Oh, yeah. Dr. Chung is a photographer himself. Julie had asked me to ask him if she could move around or if she had to be stationary. He was so open to her walking anywhere and having free range of movement and having multiple sources of video and photo. Julie: Yeah, it was really cool. I want to speak a little bit to that side of things if that's okay for a minute. Being a birth photographer is kind of complicated and sometimes logistically crazy especially as the baby is being born because everybody has a job to do. Not every provider and nurse is supportive– maybe not supportive. Not every provider and nurse is respectful of the fact that I also have a job to do and that these parents are paying me not a small amount of money to come in and do this job. That is very important to them to have this birth documented in a special way.It can be tricky navigating that especially times ten when it comes to being in the operating room. I have about a 50% success rate of getting in the OR back home. Some hospitals are easier than others. It's always an honor and a privilege, I feel, when providers create a way for me to go in the OR because Cesarean birth is just as important, maybe even more important to have documented because it comes as a healing tool and a way to process the birth especially when most Cesareans are not planned. It was really cool to hear ahead of time about how supportive Dr. Chung was and how amazing he was going to be to let this happen. When we were in there, I don't think I've ever moved around an OR as much as I have in that OR. Providers will tell you, “Oh, you're not allowed in because the operating room is so small. Oh, the sterile field, we want to make sure you don't pass out when you're in there.” I think all of these excuses that people give are just regurgitating things. They don't want another person in the OR. It's just kind of dumb because that was the smallest OR that I have ever been in. I still was able to document it beautifully. I respected the sterile field. I wasn't in anybody's way. People were in my way which is fine because they had a way more important job to do to make sure Paige didn't bleed out and that the baby was born and that Paige's needs were met and things like that. I'm okay. I'm used to navigating around people in the space. I'm perfectly comfortable with that. It was so beautiful. I was down at her feet. Paige, I've actually been going through your images and choosing ones to include in your final gallery while you've been talking. I cannot wait to show you this. I have images of Dr. Chung pulling his head out, still images, of the head being born through the incision. It's like crowning shots. It is this beautiful image of this baby's head being born. Obviously, you've seen the one of his head all the way out. I just think it's so beautiful. I consider it such a privilege and such and honor to have as much freedom in that room. I was literally at her feet, Meagan, documenting while he was cutting her open the adhesions and all of those things. There is video. There were images. I have chills right now. And then as baby was born, I was able to move up by her shoulders and document that and her reaching down for baby. I have all of that. I think that is such one more reason why Dr. Chung is amazing. It is such a rare gem, a diamond in the rough, because Paige now has the documentation for this beautiful story, and it's just one more thing where we have work to do. We have lots of work to do, lots of work to do, and lots of advocacy with people asking for this. I just think it's so important and so cool. It's such a rare thing. I don't even think I would have been able to do all of this back in the States. Meagan: No. Julie: I just think it was so cool. I'm determined to get these images to you before I leave so we can look at them together. I cannot wait for you to see them. I can't. I'm just so excited. Paige: Well, it just makes me think of how often you've said, “If you don't know your options, you don't have any.” The purpose behind this, and why I felt I really did want to go for this option, and what was pulling me to it, is because I want to create options for women and to show them what's possible. That's why I wanted Julie to come. I wanted her. I told her specifically, “Document every step of the process so that women have more resources to see the ways we do it.” I didn't do it exactly like the Olive Juice photography video. There are little variances between it, and that's okay. But it was still so beautiful, so wonderful, and then also, I asked her to document the surgery itself because so much of it is going back and trying to process it in your mind while you're going through it. I'm so glad she did. We walked through it last night, just the moment when I was in the most pain. It was actually really wonderful to see what he was doing which I wasn't in the space to see at that time, but to go back and see, “Okay, that makes sense because he was maneuvering so much,” and to connect it. The connection piece was so valuable. For every Cesarean, I'm so passionate now that you need a doula. You need a midwife in there. You need a birth photographer. You need everybody in there. I knew it, but now, I'm so passionate that we need to advocate for ourselves just as much for planned Cesareans. Meagan: Absolutely. I still can't believe it. I'm so happy. I love this story so much. I believe everyone should hear it because like you said, we need to be educated so we can apply what we need. We don't know what we don't know. This is what we've heard for so many years, but we can know. We can know our options, and it does take us doing it most of the time. The medical world out there is trying sometimes. Sometimes, they are not trying as well. But they are trying. They are also capped in a lot of ways with resources and with time. There's just a lot that goes into it. So, dive in, you guys. Learn. Follow what you need. Follow what your heart is saying. If your heart is saying, “I want a different experience, it's okay to push for that different experience.” Paige: Yeah, definitely. I'll attach a lot of the resources that I used to help me in my prep. But I did just want to cap off by saying that I don't feel like I'm anything special. I am not a birth worker. I am not a nurse. I don't have a history of medical stuff. Dr. Chung was so cute. He was joking that I was a surgeon and getting ready to go do the surgery, but I've always been squeamish at blood and things like that. Don't feel like you don't want to go for it because you're afraid that it will be a scary thing. It is such a natural, beautiful thing. It doesn't feel as medical as it might seem. And even if you are scared, I was scared. It's okay to do it scared if you think that it might be something beautiful and if your heart is, like Meagan said, calling you to it. We're just moms, and moms are powerful, and that's enough. Meagan: I love that. Julie: I love that. I think it's really important. Paige, first of all, you are special, and this is why. Not everybo

The VBAC Link
Episode 356 Jessica's VBAC + Switching Doctors at 37 Weeks + Bait & Switch + Our Supportive Provider List

The VBAC Link

Play Episode Listen Later Nov 27, 2024 58:13


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

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

The VBAC Link

Play Episode Listen Later Nov 13, 2024 50:57


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

The VBAC Junkie Podcast
73. Sabina's empowering Freebirth after 2 cesareans (FBA2C)

The VBAC Junkie Podcast

Play Episode Listen Later Nov 7, 2024 63:03


Sabina shares her freebirth after 2 cesarean story and she chats about why educating yourself is the key to an empowered birth experience and once a c-section does not mean always a c-section! Your intuition is THE MOST IMPORTANT tool you have and should always be listened to Some highlights from the episode:

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

The VBAC Link

Play Episode Listen Later Nov 6, 2024 30:10


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

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

The VBAC Link

Play Episode Listen Later Oct 28, 2024 56:26


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

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

The VBAC Link

Play Episode Listen Later Oct 23, 2024 42:23


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

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

The VBAC Link

Play Episode Listen Later Oct 16, 2024 32:20


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

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

The VBAC Link

Play Episode Listen Later Oct 14, 2024 53:09


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

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

The VBAC Link

Play Episode Listen Later Oct 9, 2024 44:16


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

The VBAC Junkie Podcast
69. Raquel's breech homebirth after three cesareans with a bicornuate uterus

The VBAC Junkie Podcast

Play Episode Listen Later Oct 9, 2024 38:32


Get out your tissues, this one gets emotional! Some highlights from the episode:

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

The VBAC Link

Play Episode Listen Later Oct 7, 2024 47:17


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

Birth Journeys Podcast
Mariah's Journey: The Determination to Have a VBAC After Two Cesareans

Birth Journeys Podcast

Play Episode Listen Later Oct 7, 2024 95:59


Join us on this episode of the Birth Journeys as Mariah shares how after her first two births both ended in unplanned cesareans, she educated herself and had the determination to do whatever it took to have her third baby vaginally.  This episode covers cesarean birth, pre eclampsia, postpartum pre eclampsia, repeat Csection, and VBA2C  Resources: Bridget Taylor YouTube: https://youtube.com/@bridgetteyler?si=CcV-MBHyrlsIsCYF VBAC Link Community Facebook Group: https://www.facebook.com/share/g/H7hUmu1TL6EVk3Rh/?mibextid=K35XfP VBAC Link Podcast on Spotify: https://open.spotify.com/show/36bVxqOGd1EYcR0oJteF5n?si=gh9ymqruQm6kzTiUZ9hH9Q Induction for VBAC: https://www.thevbaclink.com/the-best-induction-for-vbac/ Info on VBAC Calculator: https://www.thevbaclink.com/vbac-calculator-acog/

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

The VBAC Link

Play Episode Listen Later Oct 2, 2024 55:22


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

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

The VBAC Link

Play Episode Listen Later Sep 23, 2024 76:41


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

The VBAC Link
Episode 334 Susana's VBA5C Story

The VBAC Link

Play Episode Listen Later Sep 11, 2024 52:35


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

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

The VBAC Link

Play Episode Listen Later Sep 9, 2024 53:26


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

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

The VBAC Link

Play Episode Listen Later Sep 4, 2024 20:13


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

The Tranquility Tribe Podcast
Ep. 290: Could Catheters be causing Unnecessary Cesareans? with Dr. Douglas Wood, OBGYN

The Tranquility Tribe Podcast

Play Episode Listen Later Sep 4, 2024 60:13


Dr. Wood joins the show to discuss his groundbreaking new invention aimed at reducing unnecessary C-sections. The conversation explores the evolving trends in epidural use, the importance of patient autonomy, and effective coaching during labor. Dr. Wood elaborates on the issues surrounding 'failure to progress' and introduces his innovative catheter designed to mitigate common complications associated with Foley catheters during labor. This informative episode sheds light on improving maternal and infant health outcomes and offers insights into the future of obstetric care.   Epidurals: Trends and Practices Coaching During Labor Failure to Progress: Understanding the Issue The Role of the Foley Catheter Innovative Catheter Design Addressing Failure to Progress Managing Foley Catheters: Challenges and Solutions Discussing Pitocin: Usage and Misconceptions Innovative Medical Device: Development and Challenges Crowdfunding for Medical Innovation   Help Dr. Wood Prevent The Primary Section | C-section Reduction Project (Powered by Donorbox)   About Dr. Wood: Dr. Douglas Wood is a highly accomplished Obstetrician and Gynecologist with over 24 years of solo practice experience, managing and delivering more than 9,500 pregnancies. He serves as a Laborist and Hospitalist at UPMC, OBHG, and VeloSource, bringing a wealth of clinical expertise to these roles. Dr. Wood is also a product developer and patent holder, contributing to advancements in the field of obstetrics by reducing the US c-section rate. He holds academic appointments as OB/GYN Clinical Faculty at several institutions, including Baptist Health-UAMS Medical Education Program and New York Institute of Technology College of Osteopathic Medicine. A decorated military veteran, he was deployed to Saudi Arabia and Kuwait with the Arkansas Army National Guard, where he served as a Lieutenant Colonel. Dr. Wood is board-certified in OB/GYN and has been recognized for his excellence in teaching with the NYIT Outstanding Preceptor Award in 2021.   SOCIAL MEDIA: Connect with HeHe on IG  Connect with HeHe on YouTube. BIRTH EDUCATION: Join The Birth Lounge here for judgment-free childbirth education that prepares you for an informed birth and how to confidently navigate hospital policy to have a trauma-free labor experience!   Download The Birth Lounge App for birth & postpartum prep delivered straight to your phone! LINKS MENTIONED: Thank you to EISCO for the quality of their models. We'd like to give recognition to hBARSCI.  hBARSCI is the distributor that helped supply us with the model.  For any potential customers, hBARSCI Help Dr. Wood Prevent The Primary Section | C-section Reduction Project (Powered by Donorbox)      

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

The VBAC Link

Play Episode Listen Later Aug 19, 2024 57:19


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

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

The VBAC Link

Play Episode Listen Later Aug 14, 2024 51:20


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

The VBAC Link
Episode 325 Failure to Progress: What It Isn't and What It Is...

The VBAC Link

Play Episode Listen Later Aug 12, 2024 34:15


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

The VBAC Link
Episode 323 Lauren's 2VBAC + Special J Scar

The VBAC Link

Play Episode Listen Later Aug 5, 2024 59:59


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

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

The VBAC Link

Play Episode Listen Later Jul 22, 2024 41:57


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

The VBAC Link
Episode 318 BadassMotherBirther + How to Make Change

The VBAC Link

Play Episode Listen Later Jul 17, 2024 62:46


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

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

The VBAC Link

Play Episode Listen Later Jul 15, 2024 53:16


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