Podcasts about Cholestasis

Jennifer Johnson is a wife, mother of two, and a Registered Nurse in Ontario, Canada. With the last sixteen years of her career in the emergency room of big and small hospitals all over Ontario, Jenn has personally witnessed heartbreak, drama, ghostly encounters, bullying, and life to death moments. Unexpected gifts were developing intuition and learning to trust it along the way. Jenn's experience in being of service to patients and family also extends to those in the nursing profession with her books dedicated to their support.Amazon.com: Jennifer A Johnson RN books

Aubrey shares her three birth stories that tell of resilience, healing, trust, and miracles. She has had a vaginal birth, a crash Cesarean, and a VBAC– all of which presented cholestasis. Aubrey's first birth was a long but routine induction. Her second birth was a traumatic whirlwind including a complete placental abruption, general anesthesia, and her baby miraculously surviving 15 minutes without oxygen. Though her third pregnancy had many complications, the open and honest relationship Aubrey had with her provider is what ultimately led to her TOLAC and successful VBAC at 37 weeks and 6 days after another medically necessary induction. Aubrey is proof that no two births are the same, and miracles happen even when circumstances threaten to say otherwise. **Aubrey also wanted to mention that after her VBAC, she was readmitted to the hospital for postpartum preeclampsia. She had a headache every day, decided to eventually buy a blood pressure machine, and it was through the roof. She took herself to L&D, and they put her on magnesium. Aubrey had no idea it was even possible to get it postpartum and wanted to share!Managing Cholestasis SymptomsHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. It is almost Christmas, and I am so excited to bring another story your way. This is a VBAC story from a mama who is from Louisiana. She had quite a few roadblocks within her pregnancies that could have easily stopped her from having a VBAC, but she really established a good relationship with her provider even though her provider wasn't actually as gung-ho or excited about the VBAC specifically because she was nervous, together they communicated their feelings and understood where each other were, and came up with a plan to ultimately have a VBAC.I just respect that so much. It's important to know. We talk about providers all of the time. Providers are so important, and they make such a big impact on our outcome, but this provider, even though she wasn't really comfortable with VBAC, she truly believed in our guest, Aubrey, today. You'll have to hear it from her own words. It's awesome to hear how everything unfolded. We also have a topic today that maybe isn't shared a ton. It's called ICP or cholestasis that we are talking about. It is a liver condition that can occur during pregnancy and cause a range of symptoms. A lot of the times, it is baby being born that is the thing to end cholestasis. We are going to talk a little bit more about that, but I wanted to go over some of the symptoms. We've got dark urine, pale or light gray stools, and she'll talk about this. That is definitely something that is not normal in pregnancy, so if you are seeing that, that is a reason to contact your provider. Nausea, she described some other symptoms there. Decreased appetite, pain in the abdomen, or jaundice. These are some things to look out for. Now, there is a website called icpcare.org. We're going to make sure to attach that in the show notes, so if you have had cholestasis before or you want to learn more about cholestasis and how to manage the symptoms, and what types of things like healthy diet, they have so many amazing resources on their website. They even have recipes and different types of healthy fats and grains and legumes and things that we can focus on. We know that all of the time in pregnancy, really what we are putting into our body is so important. Definitely check out icpcare.org if you want to learn more about ICP and managing symptoms and resources and community support and all of the above. We do have a Review of the Week, so I want to get into that, and then turn the time over to Aubrey. This reviewer is reneekc89. The review title is, “A Turning Point”. It says, “When I was pregnant with my first, I was one of those ‘whatever happens is fine' moms about birth. Then I had an unplanned Cesarean after a stalled induction. It wasn't until I saw family members and friends so easily have vaginal births that I knew I had to try something different the second time around. I found this podcast through a local mom's group and immediately binged every episode. I continue to listen every week even after my successful VBAC in October 2020.”It says, “Listening to what seemed like every possible outcome helped me release my fear that I might have had. I felt emotionally prepared for anything that might have come my way. I switched hospitals and advocated through my entire 25-hour labor in the hospital, and felt like every decision was a conversation between two adults rather than demands.” Oh, what a powerful thing right there, you guys. She says, “I advocated throughout my entire 25-hour labor in the hospital and felt like every decision was a conversation between two adults rather than demands.” That is how it should be. It says, “I have to thank this podcast for helping me gain that kind of confidence. Thank you also to the Facebook Community for always answering my questions.” Oh my gosh. Thank you, reneekc89, for that review. Just a reminder, you guys, if you have not found us on Facebook yet, check us out. You can find us at The VBAC Link Community. You have to answer a few questions to get in, and then you'll get into this amazing community. We have the community on Instagram, and Facebook, and in this Facebook group. I believe so much that this Facebook community will empower you along the way. Like she said, you can ask questions, share pictures, and share concerns, and share triumphs and feel that love and support along the journey. I also wanted to throw out that we have a CBAC group, so if you are going for a TOLAC and it does end in a Cesarean, or you choose a Cesarean birth after a Cesarean, this group is here for you as well. You can find that at The CBAC Link Community on Facebook. Meagan: All right, Ms. Aubrey. Welcome to the show. Thank you so much for being here. I know you've probably been waiting. I feel like there are so many times when people are really excited to record their story, then I'm like, “Hey, you're going to be aired this much further out.” You have two months to wait. You're recording now, and then in two months, you'll be airing on, but I'm so glad you are here to share your three stories. You had a C-section, then two VBACs, right? Aubrey: I had a vaginal birth, then a C-section, and then a vaginal birth. Meagan: That's why I'm thinking two vaginal births. So vaginal birth, then Cesarean, then vaginal birth. You've got all sorts of different things added to your story. Aubrey: So many. Meagan: Cholestasis is one of them, right?Aubrey: Yes. Meagan: Okay. I'm excited to talk about that, because I think a lot of people think with cholestasis, there's only one answer. We're going to be talking about that, but I'm going to turn the time over to you.Aubrey: Okay. I guess we'll start with my first birth. Heads up if I cry at all during it because I just do that sometimes. Meagan: That is okay. That is okay. Aubrey: My first pregnancy was totally normal. I had no complications. I was big and miserable, but that was about it. I did have SPD, so my pelvis hurt really bad. I didn't know enough about it to go to a chiropractor to fix it. That was really my only thing until right at 38 weeks, it was that night at about 11:00 at night. I started itching on my feet. I couldn't scratch the itch. I got my husband's socks, and I put gel ice packs inside of them and wore them. That helped, then the itching started in my hands. This had been going on for about 2 hours, so I got in a really cold bathtub. The itching had started to spread more. It wasn't just my hands and my feet. It wasn't a normal itch. It was coming from underneath my skin. It was like my blood was itching. Meagan: People have described it to me as an unreachable itch.Aubrey: It is. It's the most miserable. Meagan: You touch the spot, but you can't get to it.Aubrey: Yeah. It's like when the inside of your ear itches. You're like, ugh. It's like that but all over. Nothing helps. I called the after-hours line at probably 4:00 in the morning. The doctor on call was like, “Pregnancy can be itchy. Take some Benadryl.” I was like, “I've already taken Benadryl. It's not helping.” She was telling me to take some creams, and I knew something else was wrong. I spent the rest of the morning researching. I came to the conclusion that I was 99% sure that I had something called cholestasis, and that I was going to have to be induced.One thing that solidified that was that there were other symptoms that I didn't know about. My stool was white. It was really weird. It just was white-colored. I had this really violent episode of vomiting beyond anything I had ever experienced in my life. That's one of the things. It's this uncontrollable exorcist-style vomiting. Meagan: I actually did not know that. Aubrey: Yeah. It was unnatural. I remember thinking, “That was so weird,” but it was a couple of days before that, and then the next day or so was when I had the weird white-colored stool, but again, I had never been pregnant, so I was like, “I guess this is just pregnancy,” then the itching. That's when I put it all together, and I was like, “Well, I've got cholestasis.” My husband was working that weekend, so I got my best friend to bring me to the hospital. When we got there, I was scratching all over. I was saying, “I'm pretty sure I've got cholestasis.” They clearly didn't believe me. They weren't being ugly. They were like, “All right. Let's see what's really going on here.” They put me in triage, and the on-call doctor came in. She is a lovely person. I don't mean anything bad, but she walked in. She said, “Okay, here's why you don't have cholestasis.” She starts listing off all of these reasons. One of them was that I wasn't jaundiced. Later on, in my research, there's only 30% of women who have elevated bilirubin levels when you have cholestasis. I wouldn't have been jaundiced because my bilirubin wasn't elevated. I said, “Okay. I understand all of that, but can you please just run the labs?” She was like, “Okay, if you want me to run them.” She brought the lady in there. They did the labs, and about 30 minutes later, she came back in, and she was like, “Okay. You were right, and I was wrong. You have cholestasis, and we are going to induce you right now.” I was like, “Okay.”Meagan: Oh my gosh.Aubrey: I called my husband and told him he needed to leave work. At about 5:00, I think– I guess it was about 5:00. They put misoprostol. Meagan: Mhmm, misoprostol, yeah. Cytotec. Aubrey: Yeah, they inserted that. After the first dose, they determined that my cervix was not tolerating it well. They decided to not continue it. They went straight to Pitocin. I didn't know then that what they were doing was really, really fast, but they were upping it every 15 minutes 2 milliunits. Meagan: 15? Wow. That is really fast. Aubrey: It is. Now that I know. At the time, I was like, “Okay.” During my birth, I prepped. I read books, and I went to classes, and I did the Bradley method, and all of the things, but I didn't prepare for induction because I had no idea that I would ever need that, so I knew a lot about birth, but I did not know anything about induction. I was like, “Okay, if you say we're going to do that, we'll do it.” I think I felt my first contraction. It wasn't that long after the Pitocin, but it wasn't that strong. I had contractions off and on for several hours, and the nurses would come in and say, “Oh, are you okay? That was a really strong one.” They didn't feel that bad to me, so I was like, “Oh, I can do this.” That went on for a while, and I guess once I got going more, It just felt like I was always contracting. I didn't know any different, again. I didn't know any different. I just thought this was what it was. Sometimes, it would be more intense, but there was always a contraction. Even on the monitor, you could see that it never dipped down. She asked if she could break my water at 7:00 that morning. It was my doctor. I don't know if she came to check on me or if she happened to be on rounds. She asked to break my waters. I told her I didn't want her to right now. She came back later, and I was okay with her breaking it, so the floodgates opened. I had so much fluid. We did not realize how much fluid I had. That was that morning or maybe the mid-morning. That evening, I hadn't slept in two days at that point because of the itching the night before, and then the contractions. I asked the nurse, “If I get an epidural, will I sleep?” She was like, “Probably so,” then I was like, “Then give it to me. I am so tired.” I did. I slept like a baby. The nurse, I wish I knew her name, but she was so sweet. She came in the night. She put a peanut ball in between my legs. I was only 4-5 centimeters at that point. She put a peanut ball in, and she would come in every 30 minutes. She would flip me from one side to another while I was sleeping. I woke up the next morning at 6:00 in the morning. I had been in labor at that point for 39 hours. I got the epidural at 30 hours. Meagan: Wow. Aubrey: Yeah. She came in the next morning, and the doctor was like, “Okay. You're ready to push.” I was like, “I am?” The epidural was so strong. I couldn't wiggle my toes. I had no idea. She came in, and set everything up. I pushed her out in 15 minutes. Meagan: Whoa. That's awesome. Aubrey: 14 minutes actually. My doctor was like, “That's the best I've ever seen a new mom push.” I was like, “Wow, yeah. Okay.” Meagan: Go me!Aubrey: Yeah. I didn't have any reference. For me, I was like, “This is taking so long, but apparently it was very quick.” Now I know it was pretty quick. Afterwards, my uterus would not contract back. My placenta wouldn't come off. Now I know it's because afterwards, she told me that my contractions never stopped. There was never a break between contractions, so my uterus was just completely exhausted. Meagan: Uterine atrophy, yeah. Aubrey: Yeah, so she had to manually go in there inside of me and start my uterus to contract again which was not pleasant, but she just basically had to shock it. Meagan: Stimulate it, yeah.Aubrey: Yeah. Eventually, it did, and my placenta just fell out. That was that. When they broke my water, I forgot to say, they did find meconium which is common in cholestasis. It was very light, and she wasn't worried about it. It wasn't an automatic C-section because of the meconium. It was really light. She did have to be suctioned, but other than that, she was perfectly fine. We didn't know any of the genders for any of my babies, so it was fun to find out that she was a girl. That was birth number one, and that was in 2018.A year and a half or whatever it was, I got pregnant right before COVID became a big thing. I was pregnant all through the COVID scare. I was due in September, at the end of September. Again, it was non-complicated. I forgot about this. I had a subchorionic hemorrhage around 16 weeks which I didn't know about. I didn't have any bleeding or anything. They just found it on the ultrasound, and then by the next time I went, it was resolved. I was considered high-risk though the whole time because of the cholestasis, so I had frequent scans all the time. That was really the only thing that was weird. We had tested for cholestasis. There were a couple times because anyone who has had cholestasis knows that anytime you itch, you're like, “It's back.” There were several times I had her test me, and there were no elevated levels. Right before 39 weeks, I told her about some intense itching on my foot. I told her that this time was it. It was the itch. She was like, “Okay, well because of COVID, and we're not sure what the hospital bed situation is going to be like, we're going to go ahead and test your blood and find out if it's present, but in the meantime, let's go ahead and schedule your induction to make sure you have a place if we do have to induce, then you're already there.” She wanted me to induce that day. I couldn't because my husband was gone for the Army. I said, “I just need a few days for him to get back in town.” That was on a Thursday or Friday, and I was induced either Monday or Tuesday. It was on September 1, 2020. I went in for my induction. This time, I had not prepared at all. I was like, “Oh, it's like riding a bike. I've done it once. I can do it again.” I want to say upfront that anything they did during the induction, I was totally a party to it. I agreed. I never said no. I never asked questions. I was uninformed or unprepared or whatever, but I never spoke up, so I don't blame them for anything that happened because I could have spoken up, but I didn't. They always asked me. They never told me, “This is what we're doing.” They asked me my permission for everything. We got there. They did not do Cytotec because it hadn't worked before. They went straight to Pitocin. Again, the same 2 milliunits every 15 minutes. Meagan: Is this just their way?Aubrey: I think it was. I don't think it is anymore, because it was different when I went for my VBAC, but yeah. Meagan: Well, I wonder if that's because you were a VBAC though. Aubrey: No, because one of the conversations I had with one of the nurses, I asked her if we could start slow. She was like, “Well, our policy is to go 2 milliunits every 30 minutes.” I was like, “I'd like to go slower than that.” I think they must have changed their policy. I don't know. That's what my hospital records say is that they were doing 2 milliunits every 15 minutes. I got those thanks to y'all. I was like, “Let me go see what that says.” Meagan: It's nice to see what it says, yeah. Aubrey: Yeah, it is because in my situation especially with what happened to my son, it was so amazing to read what really happened and to know my son is where he is. I'll get to that. Anyway, so she came in around 7:00 in the morning. My doctor was on shift. She asked if she could break my waters. I was like, “Sure, go ahead.” She broke my water. So far, it had been a pretty uneventful induction, nothing to write home about. I didn't have an epidural. I didn't feel like I needed one. I was going to try to do it without one if I could, but that might have been at 8:00 or 9:00 in the morning. I don't know. It was in the morning. Around lunchtime, they started saying that the baby was wiggly and that they couldn't really get a reading of his heart. He had been wiggly before, and so they were like, “Is it okay if we insert an IUPC?” I had that with my daughter. It doesn't harm the baby. It didn't hurt me. I didn't mind them putting it in, which is for those of y'all who don't know, it is a–Meagan: Intrauterine pressure catheter. You've got it. Aubrey: It measures the contractions from the inside so you can see how effective they are and all that. I was like, “Fine, yeah.” My nurse, whose name is Becca, she's lovely, inserted the catheter into my uterus, and the tube that comes out is clear, and it filled with dark red blood. I knew something was wrong. I said, “That shouldn't be red like that.” She said, “It's okay. Sometimes we have a little bleeding.” I said, “Not like that. That's red.” She was trying to calm me down. Meagan: Yeah, and sometimes they can knick the cervix and it can cause bleeding, but you were like, “No. Something's not right.” Aubrey: Yeah. I just knew something was wrong, but before that, I had no symptoms. I had no clue that anything was wrong. I didn't feel bad. I didn't feel any pain. Nothing. I was like, “You need to take it out. Please take it out. Please take it out.” She called my doctor who was in her clinic down the hospital, and she said, “It's okay to take it out if she's not comfortable with it.” When she took it out, blood just came shooting out of me. It was gushing. Meagan: Really?Aubrey: I know it was blood mixed with fluid, so that's why it was so much, but it looked like it was pure blood. It was so dark. I mean, I was like, “Okay, I need the doctor.” Becca was so sweet. She said, “Okay, just give me one minute. I'm going to go outside and get the doctor.” She was so calm. I was freaking out. She went out there. My doctor was in my hospital room within a couple of minutes. I think she was across the hospital in her office. She was there within a couple of minutes. She had an ultrasound machine. There wasn't a lot of time for talking about what was going on. She just got the ultrasound machine, looked for a second, pushed it up against the wall, and my doctor has the most wonderful bedside manner with the way she talks even when she is stressed out. She said, “Okay, Aubrey, we're going to have to go back to surgery now. Brandon, I need you to tell your wife goodbye.” As she's telling him that, they're pulling my jewelry off. The other nurse handed me a consent form for a C-section. They were prepping me as we were talking. Then they ran me down the hall. It felt like Grey's Anatomy. They pushed this poor woman up against the wall. I remember her head hitting the wall. It was that fast. We were running down the hall. We got into the OR, and I just remember them prepping my body and prepping the room. They were getting the instruments lined up. There was no time for anything. I didn't have an epidural, so they didn't have time to call an anesthesiologist to my knowledge. They started putting the lidocaine where my incision was or was going to be. I started hyperventilating. The nurses threw a bedsheet over my head. They popped up under there with me. They were like, “I'm so sorry, but this is the best we can do. We don't have time to put a sheet up. We're going to have to stay under here. We'll stay here with you.”Meagan: Oh my lanta. Aubrey: Yeah, it was really scary. I remember right before they threw the sheet, I could still see the door swinging. That's how fast everything happened. They eventually, she was like, “You have to calm your breaths down because the baby needs the oxygen.” Little did I know that it really didn't matter how much breath I took. He wasn't getting anything. Eventually, they put me out with gas. Meagan: Did they put you under general?Aubrey: I had to be gassed out. I was hyperventilating. They were like, “We need you to be still.” At the time, they were literally about to cut me before they threw the sheet over. I remember the very last thing that my doctor said to her nurse was, “There's no fetal heartbeat. There are no fetal tones.” I knew at that point that he was dead. Meagan: That's the last thing you heard. Aubrey: Yeah. I woke up. I don't know how much longer it was. It was pretty quickly after surgery because I don't think they anticipated me waking up so early. I was in a hallway. I wasn't in a recovery room. Because I wasn't out all the way, I don't know, but I woke up, and two of the nurses, because there were like 18 people in the room with me when everything happened. The nurses' backs were to me. I said, “Is my baby alive?” One of them said, “Oh, she's awake.” They turned around. One of them said, “They're doing everything they can.” I passed back out. Then I woke back up in the recovery room. My doctor was waiting for me. It was COVID, so my husband wasn't anywhere near any of this. Meagan: Yeah, I was wondering. You said his name was Brandon, right? They were like, “Bye, Brandon. We have to take her.”Aubrey: Then he was just left alone in the labor and delivery room freaking out. Meagan: No one talked to him?Aubrey: He told me later that my doctor had come in after the surgery to tell him everything that happened. Immediately afterward, she came in there to tell him. She is the best doctor in the whole world. Meagan: But he had to wait. Aubrey: Yeah, he had to wait. There wasn't any time for anybody to tell him anything. Meagan: How scary for him. Aubrey: Because come to find out, my placenta had spontaneously 100% completely detached from my body in a matter of a couple of hours. If anybody has ever had a placental abruption, it starts slow. It comes off a little bit at a time. Mine came off in a couple of hours. It was completely detached. We didn't know why at the time. It was very unexpected. She was there. I woke up, and I said, “Is my baby alive?” She said, “Do you want to know what you had?” I said, “Is the baby alive?” She said, “He's alive, and he's a boy.” Then she told me what happened. He was dead when he was born. He was dead for 15 minutes. Meagan: Wow. Aubrey: Yeah, 15 minutes. He had no blood flow or oxygen flow to his brain. A lot of his blood had been drained out of him because my placenta had pulled it out of him because it was detached so quickly I guess. He was not completely exsanguinated, but he lost a lot of blood and he had no heartbeat. According to my hospital records, they tried compressions. They tried the electrode things. They tried an epinephrine shot, and they tried an epinephrine drip, and nothing started his heart, and then after 15 minutes, his heart just spontaneously started by itself. Meagan: Wow. Aubrey: Yeah. That's why it was so cool reading back my hospital records to see. My doctor and everyone involved was like, “We can't believe this. I cannot believe he is alive. I cannot believe you are alive,” but reading it and seeing how amazing it really was was really cool. She told me that the surgery had happened in just a few minutes, and that because of how quickly she had to perform that surgery, that my recovery was going to be really intense, and that most people who have a C-section would not be in as much pain as I'm going to be in because they literally had to rip my body open to get him out, but she said, “Your incision is fine.” Luckily, she's a really skilled surgeon. She did all of that perfectly. She said, “I don't expect any trouble with you healing or anything with your scar.” He was put on a cooling blanket and intubated and given maybe six blood transfusions. If anybody from the hospital is listening, I'm sorry if I get the numbers wrong. But it was a lot. There were six little stickers missing from his transfusion bracelet. He couldn't eat. We couldn't pick him up. We couldn't touch him. I couldn't see him for the first 24 hours because I couldn't move, so the nurses had taken pictures of him and brought them to me so I could see what he looked like. They didn't show me the really scary ones until later because there were some at the very beginning that were very scary-looking. My doctor came in the next day to check on me. It was her day off. She just came in to check in on me to tell me how grateful she was that I was there. I know it traumatized her too because she said she had never opened up someone and seen their placenta floating inside of their body. My nurse, Becca, came to see me. She was also pretty traumatized. But anyway, it was a lot. Once he was in the hospital, they put him on the cooling blanket and all that. He had to be on the cooling blanket for 72 hours, and then they were going to be able to test him to see how significant the brain damage was because we knew that he would have some. I mean, after 5 minutes, you start to have brain damage, and then we knew having been out for 15 minutes that we were looking at something pretty significant based on science. That was the thing that I think was different about me then than now. My background was in physiological psychology. That's what I studied in grad school. My immediate thought was, “I know what science says. I know the probability is of my baby,” and that's what I was looking at. What do we need to do to take care of this baby with significant brain damage?We waited, and on the second day, the day before I was released from the hospital, I had a really cool encounter that was just the way that God changed everything for me which came into my VBAC later because of the faith that it gave me, but I had dragged myself to the shower that morning. It was so painful. My husband was still asleep on the couch. I got in the shower, and the water was cold. That made it even worse pain because it was cold. I was in the shower, but I couldn't get up because I was frozen in pain. I was like, “Why is this water in the hospital cold? It shouldn't be cold.” I sat in there for about 15 minutes. The water stayed cold, and it never warmed up. Finally, I said, “God? If you can't save my baby, can I at least have some hot water?” The water turned hot. I just started laughing and crying at the same time. I just knew that my baby was okay. I don't know how I knew. I just knew that even if he wasn't going to be perfect, whatever was wrong with him was okay. It helped me to get through the next few days because it was hard to see him just laying there. Finally, when they were able to do his tests after 72 hours, we had to go to a different hospital. He had to go in a little ambulance and go over there. We had one of the best pediatric neurologists in the area, Dr. Holman. She's not known for her bedside manner, but she's an incredible, incredible doctor. I say that in a way that she's very to the point. She doesn't sugarcoat anything. My sister, who is a nurse, warned me, “I'm just telling you that she's the best of the best, but she's not–” Meagan: She's blunt. Aubrey: She'll give it to you straight. That's what we were expecting. They did his little scans, and when she came back she said, “I don't have a medical explanation, but your baby is perfect. There's not a single spot on his brain. The cooling blanket does incredible things, but I should see something, and I don't see anything.” Meagan: Wow. Aubrey: She said, “Your baby's going to be perfectly fine.” She told us that he's probably going to have some issues from being in the NICU and being still. He would have to have physical therapy to help his muscles and all of that, but as far as his functioning as a human being, he was perfectly fine, and nothing was wrong with him. Meagan: Yay. What a miracle. Aubrey: Yeah. That's what she said. She said, “Your baby is a miracle, and I don't get to say that with what I do very much.” Meagan: That's awesome. Aubrey: Yeah. So that was his birth, and after that, that day, my husband left and went back to the Army. I recovered from that. I recovered from that pretty much alone which was almost as traumatic as what happened in the hospital because I was in so much pain, and I had a 1.5-year-old and a new baby who screamed all the time which was one of the things they warned me about after the NICU. They said, “He's going to cry a lot. We don't know why, but coolant babies just scream a lot.” He did. For hours and hours and hours, he would scream. It felt like torture in a way because it was like I couldn't do anything. He would scream and scream and scream. My friend, Ashley, and my sister were the only way I made it through that. I would call my sister, Kelly, and be like, “I need to come over,” at 3:00 in the morning. She was like, “Come on.” She would hold him while he screamed so I could go in the back and sleep because I was so sleep-deprived and in so much pain. Then my friend, Ashley, would come over and help me clean. She helped me with my daughter. They helped me through that part. My husband was gone for the first 6 months of Amos' life. About 2 years later, I got pregnant again. I was really scared of having to have another C-section. I was on a pregnancy app, and I asked, “Has anyone ever had a vaginal birth after they've had a Cesarean?” Somebody on there was like, “Oh, you should try this thing called a VBAC. There is a place called The VBAC Link.” I was like, “Okay.” I had no idea. I had never heard of The VBAC Link or the term “VBAC”. I found The VBAC Link, and like everybody else, I became obsessed. I listened to every episode, read every article, and every post. By the time it came time for my first appointment with my doctor, I knew that I was going to at least give it my best try. When I told my husband that I wanted to have a VBAC, he was not okay with that. He was really freaked out because, I mean, everybody involved was traumatized. He was. The nurses, the doctors, everybody. He was just like, “Are you sure that's safe?” I was like, “Yes, actually. I am sure that's what is safest.” I got on The VBAC Link, and I was like, “How do I make my husband understand?” They were like, “Enroll in the course and show him the course.” Meagan: Yes. Take the course with him. Aubrey: We did. By the end of it, he was like, “Okay. If that's what you want to do, we will do it.” That's what we planned for. I was really hoping that I didn't get cholestasis for the third time. There's not really anything you can do to prevent it, but I was just really hoping that somehow it wouldn't show up. About, I guess, 20 weeks, I was told that I had complete placenta previa, so that was super fun. My maternal-fetal medicine doctor explained it, and this is for everybody who gets diagnosed with that. It made my brain so much more calm. He told me that your uterus is a muscle. It's juicy, and it has all of these blood vessels. Your cervix is a connective tissue. It doesn't have all of that. Naturally, your placenta is going to gravitate toward where it can get the most nutrients. It almost always resolves itself because it's not going to get what it needs off of your connective tissue. I just banked on what he said, and by 28 weeks, it had gone so far up that it wasn't a concern at all. Around 24 weeks, I started seeing a chiropractor for severe SPD. My pelvis was on fire. It was grinding, and all of the things. It was worse than with my daughter. I didn't have it at all with my first son, but man, it was back with a vengeance with my third pregnancy. The chiropractic care helped so much. If anybody is in the Natchez, Mississippi area, my chiropractor moved to Natchez, Mississippi after she helped me. But anyway, that's where she is if you're near there and you need a good Webster-certified chiropractor, she's amazing. Her name is Dr. Ashley Edwards. She helped me. Then she helped me with positioning and stuff. She's really good. That was 24 weeks. I started that. Early on in pregnancy, I had been coming from one doctor to the other in the same building, and I was really huffing it. My blood pressure was high. They let me sit for a minute and retest it, and it was fine. I didn't think anything of it until later on in pregnancy when that happened again. My maternal-fetal medicine doctor freaked out. He was like, “You've had two high blood pressure readings. We need to test you for preeclampsia.” That was in my third trimester at some point. I'm probably skipping around. He kept pinching me to see, and asking me if the swelling was normal. I kept telling him, “That's just my ankles. I just have big calves and ankles.” Every time, he would be like, “Is this swelling always like this?” I'm like, “That's not swelling. It's just what my ankles look like, but thank you.”Meagan: Oh my goodness. Aubrey: That was fun. I had to carry around my urine for 24 hours to the urine test. He said that I did have protein in my urine, but it didn't meet the threshold of preeclampsia, so I was not preeclamptic, but they were going to watch me for it. Toward the end, I did get, “Your baby's really big,” not from my OB, but from my maternal-fetal medicine. My OB– I guess I should rewind. I didn't even talk about how we had that conversation. My OB from the very start was so amazing. When I first came in, she was like, “I'm so excited for you.” She was like, “Is it okay if I tell Becca (my nurse from before)?” I said, “Yeah, you can tell her.” She texted Becca and told her. Becca and I stayed in touch through everything. She texted me, and she was excited for me. But I told my doctor that I wanted to try for a VBAC, and she said, “I'm perfectly fine with that. I don't see an issue.” She was like, “The only thing that could possibly present an issue is if your cholestasis comes back, and it's early on. But for now, let's plan for a vaginal birth, and that's the goal. If something changes, then we'll talk about it when it changes.”She's a very great doctor because you can talk to her, and you can be open with her and be honest and never feel like she's judging you for telling her how you feel. I can't tell you how many times I cried just with her telling me all kinds of different things. She just listens and never judges. We went through most of the pregnancy with that as the goal until at the end, around 32 weeks, my itching came back. They tested me, and I had elevated bile acids, so I was considered to have cholestasis. They put me on ursodiol. I only itched for a few hours, but I knew what the itching was. It's so different. I knew what it was. I never itched again the whole pregnancy. Even before I got on the medicine, before I had even picked up the prescription, the itching had stopped. I still took it. At that point, they were like, “Okay. We can't let you go into labor naturally. We're going to have to induce,” because that is an automatic induction. Then the whole thing with the preeclampsia came around a little bit after that, so my maternal-fetal medicine doctor was talking about, “We might need to do this at 35 or 36 weeks.” I was like, “I don't think I'm comfortable with that.” My doctor was like, “We'll see, but if you have preeclampsia, that changes everything.” My doctor, my OB doctor– I was talking to her about everything, and she was like, “The reality is that what you have could potentially be dangerous for baby. So every week from about 35 weeks on, we're just going to have to determine if baby is safer in or if baby is safer out, then at that point, we can determine how we are going to deliver the baby because we don't know what your body is going to be doing. We just have to see.” She said, “I'm not telling you that you can't have a VBAC. I'm just telling you that we need to be open to the possibility that it could turn into a C-section if this doesn't go the way we want.” She said, “I feel like as your doctor, I wouldn't be doing you any service if I didn't at least have this conversation with you because if it came to the point that we had to have a C-section, and we had never talked about it, then you would be like, where did this come from? I don't want you to feel blindsighted.” I appreciated it. I did leave really discouraged from that conversation. I cried because I thought that secretly she was trying to bait and switch me. But I should know that my doctor really is great. Anyway, so we went through the next couple of weeks where she would tell me, “Baby is safer in, so baby gets to stay in.” I had scheduled a lunch with Becca. I had asked her if she would be at my new baby's birth. She said she would be my labor and delivery nurse. We'd get to try it again. She was like, “I'm going to help you have a VBAC. You can totally do this.” We had lunch. I told her about the conversation that I had with my doctor. I said, “I just want the opportunity to try. If I get to try and something happens and it doesn't work out, then I'll be okay with that. I just want to try because I know my body can birth a baby.” I said, “I don't have to have the epidural, but if that's what makes her comfortable, I'm okay with that because I've had the epidural before. It's not like I'm anti-epidural. I'll have it if that makes her more comfortable.” I've realized that she is a person with trauma, and I knew that what I was asking her to do was scary for her because of what happened and because probably most people don't know, but cholestasis comes with the risk of placental abruption. It does something to the vascular structure, so it's not that it causes it, but it makes you more susceptible to placental abruption. I knew that she was worried about that. I knew that everything else that had popped up and popped up and popped up, she probably was like, “I don't think I want to do this anymore.” I told Becca all that, and she said, “Have you ever told your doctor that?” I said, “No,” because she knows her. She works with her. She said, “I think if you have that conversation with her, and you tell her just like you told me that she would feel a lot differently about it.” The next appointment was the appointment where we were going to do my first cervical check. We needed to know what my body was doing, so if I had to induce, they knew. Meagan: Where you were at. Aubrey: Yeah. It was one that I wanted and that I needed, I think, in that situation. Before she checked me, I knew that this time if she checked me and it wasn't doing anything that she was probably going to be leaning more toward C-section because I was going to have to be delivering within that week or a few days after based on everything that was going on. When I got in there, I said, “Before you check me, I want to tell you something.” I said, “I just want to tell you this so you don't think that my response to whatever happens in the check is me begging or anything like that. I just want you to know that this is how I feel.” I told her everything I told Becca. I told her that I wanted to meet her halfway and do whatever made her comfortable as long as I got to try. She said, “Okay. Let's just check you and see what's going on.” She checked me, and she said, “You're soft. You're 1 centimeter dilated, and we can have a VBAC.” She said– hold on. Let me get myself together. She said, “I'm uncomfortable with this, but the reason that I'm okay with this is because I trust you. I trust you enough to know that when you tell me your body can do this, I believe you. I know that you trust me enough to know that if I tell you it's time to call it, then you'll believe me and we'll call it.” She said, “The reason that we're doing this is because we have a mutual trust and understanding. We can be honest with each other.”I just sobbed and sobbed and sobbed. I mean, I was just so excited. On the way home, I got into a wreck. I totaled my car. Meagan: Oh my gosh!Aubrey: Yeah. It wasn't as bad because it was totaled because my airbag came out, but it was in very slow bumper-to-bumper traffic. I had to go back to the hospital. She was on-call, and she was like, “Why are you here?” I had to be monitored for that, but everything was okay. Saturday at midnight was my induction. I came in, and they started my IV. It took them a while because I have really weird veins and they are hard to stick. Eventually, they called in an anesthesiologist to use his machine to find my veins. If anybody has hard-to-stick veins, you can use an anesthesiologist, and it works like a charm. He got my vein, and we started fluids. About 30 minutes later, it was probably at 2:30 or so whenever the Pitocin was in. I had my first baby contraction. Rebecca– a different Rebecca, but her name was Rebecca– said, “Okay, here's the schedule we're going to go on.” I forgot to mention this too, but right before my induction, my husband surprised me with his VBAC certification doula course. He had gone through the doula course. Meagan: Oh my gosh!Aubrey: He went through The VBAC Link doula course. He was like, “Surprise! I can be your doula.” Meagan: That is amazing. Aubrey: It was cute. My husband, when she starts telling me the schedule of how we were going to do everything, was like, “Excuse me, I think we need to not be going every 30 minutes. We need to be going every 45 to an hour.” He was so well-educated about the whole thing. She did. She did it slow at first, then we did that through the night. I don't remember if I slept or not, but Becca came on her shift at 7:00. She was like, “Okay. You're doing good, but here's the reasons why I think that we need to increase the interval. We were having contractions, but we need to get a pattern going.” She told me why. I agreed with her that I was okay with it as long as it didn't go faster than 30 minutes. We did that, and that started to actually get a pattern which was really nice. She is a brilliant nurse, and she knows what she's doing. She was like, “We're going to get you moving. Come on. Get up. We're getting out of bed.” She had me walking down the hall, and with the peanut ball, and sitting on the ball. My doctor came in around 9:00. She told me that she thought we needed to break my water. I was really nervous about that because in my research of what happened to my placenta, I had found that it was likely that I had a placental abruption due to the rapid decompression of my uterus. My doctor agreed that that's probably what happened, but when they broke my water, because my vessels were already weak, the pressure suctioned it off. I was really worried about breaking my water. She was like– I've never seen her be so stern with me before because she's always so calm and nice. She said, “Aubrey, I'm very uncomfortable right now. I do not want to see you have a rupture. I do not want to see your placenta detach. We need to be real about this.” She said, “You have a lot of fluid. If we do not let some of that fluid out, your baby is not going to drop. You have a lot of fluid.” I did. I guess I forgot to mention that. I wasn't quite poly, but I was pretty close to having poly.Meagan: Borderline. Aubrey: Yeah. I told her that I was scared. She said, “You cannot make decisions based off of fear. You have to make decisions based off of what is happening and what is fact. The facts are that your baby is high. Your body is contracting. You have a pattern, but your baby is not dropping. There is a reason, and it's likely because of the fluid level.” So, she said, “I can break your water in a way that is not aggressive. I will just cut a tiny little slit and let it come out on its own, then it will come out.” I agreed. I mean, when I step back and look at it, I was like, “She's right. Scientifically, the baby is buoyant and is just floating there.” Come to find out, I definitely had poly. I had so much fluid. When it finally came out, Becca was like, “I don't think I've ever seen that much fluid come out of somebody.” It was the exact thing that the baby needed. He came down, and immediately, I went from 4 centimeters to 6 in an hour. I could feel my body doing very differently. It was changing differently than it had before. I started to get nauseous and shaky. I knew that I was probably getting closer to go-time. I told Becca, “You might want to get the guy to come give the epidural now. I promised her I would get the epidural, and if we're going to get it, we're probably going to need to get it now.” She was like, “Yep. Let's go ahead and get it put in.” She had him put it in really light though so I could still move my legs and wiggle my toes. I could even put pressure on my legs which was nice. That was maybe at 2:00 in the afternoon or 3:00. Oh no. I got the epidural at almost 5:00. I was way off on the time. It was almost at 5:00 that I got my epidural. I had been between a 6 and a 7 and about 70% effaced. After the epidural, they had to go to an emergency, her and my doctor. They came back afterward, and me and my husband were playing Scrabble. I started throwing up. I had the bag, and I was like, “I need to throw up.” Becca came in and she was like, “You're throwing up? This is the best!” She was like, “It's time. It's time.” I was like, “How do you know?” She was like, “I'm telling you. I'm telling you.” She checked me, and then Dr. Barrios came in, and she was like, “Okay, Aubrey. We're going to have this baby.” My husband caught the moment. He has a picture of me the second that she told me I was going to have my VBAC. It was just the least flattering picture I could possibly have, but it's so cool because it's a live picture, and I could see the wave of emotion washing over me. I could feel pretty much everything. I mean, I'm sure if I had no epidural whatsoever, and I think Becca said she turned it down, but I'm sure it was way more intense if I was doing it without completely. I could feel everything. I could feel the ring of fire. I could feel opening up. To me, it didn't feel like I had to poop. It felt like I had a bowling ball just sitting there. They were still setting up while I was trying to push. They were like, “Wait. Let somebody get there, so we can catch it.” Right as they were finished setting up and getting dressed and everything, I was like, “Okay, we're pushing now.” I pushed. I don't remember how many times I pushed, but I felt the head come out. I said, “Is that what the head feels like?” She was like, “Yep. That was the head. We just need one more push and we can get the body.” I pushed. He was out in 4 minutes. Meagan: Wow. Aubrey: Yep. It was crazy. I had to go back and make sure I was not crazy. I looked at the timestamps of the pictures because I was like, “There was no way that it was that fast. It felt like an eternity.” It was 4 minutes. Everybody cried. My husband got a picture of the first time they put him on my chest. As soon as I pushed him out, it was like all of the trauma and everything from before just washed off of me. It was so amazing. Meagan: I bet it was so healing for you to see that you could have a different experience. Aubrey: It was. Meagan: Even though you had a different experience with your first, after having that experience the second time, I'm sure that weighed over you for sure.Aubrey: Yeah. I love the fact that both my doctor and my nurse from the time before were there and we all got to do it again. Meagan: Yeah. Yeah. I was going to say that. I bet this was really healing for your provider and your nurse, and not even just healing for your provider, but something that stepped up her experience to see that birth could go a different way after a very traumatic experience. Aubrey: Yeah. Yeah. I think so. I hope that. I would say she's not, “Woo, I love VBACs.” She was not anti-VBAC at all, but I would like to think that it helped her see VBACs in a more positive and more probable light. Meagan: Mhmm, exactly. I think you probably did a lot for her that she may not have even known that you did. Aubrey: She did a lot for me. She's the best. The sad thing is that I have different insurance now so if I got pregnant again, I can't have her. But she's incredible. She really is. My baby– we didn't have a name picked out. One of the other nurses, Jordan, who helped me deliver my baby was like, “I know you don't have a name picked out. You don't have to use this if you don't want to, but I was just thinking that y'all wanted a cute, short name that started with A, and Becca's last name is Anders, and it would just be really cute.” So we named our son Anders.Meagan: Cute. Oh my gosh. That's adorable. I bet Becca is so happy. Aubrey: Yeah. When she left the hospital that night, because she charted forever and she left at 11:00 that night, we still hadn't picked out a name. Jordan came in after she had left. She suggested it, and we were like, “That's it. That's his name.” I sent her a picture of the announcement with his name on it. She said, “I had to pull my car over on the road. Don't do that to me while I'm driving.” Meagan: Oh my gosh. That is so cool and so special.Aubrey: Yeah. There were so many times on The VBAC Link where I see people who are like, “I don't know if I should do it. I'm scared.” Just do it. Just try. If you succeed, it changes you. It's so, so powerful. Meagan: It really is. It's hard to explain. It's so hard to explain that feeling that you get after having a VBAC. It's unreal. It really is unreal. We just had a client the other day who had to be induced due to some pretty severe preeclampsia, and she was a VBAC. The second she found out that she had preeclampsia and needed to be induced, I think a lot of her faith slipped and her belief that it was going to happen slipped. We too have a very raw, beautiful, live photo of the second she saw her baby and her hands reaching down to grab the baby. It tells the whole story within that and that one image tells her whole story. It's incredible. It's incredible. Aubrey: The picture that I submitted to y'all is a picture of right when they put him on my chest, and I mean, it was so surreal. Another thing that I think I didn't really mention is that there was a point when– because I had so much going on. I had all of these different complications and week to week. We don't know if you're going to have a baby this week. It was so stressful. Eventually, I just had to say, “Okay, God. You healed my baby. You started his heart. You healed his brain. You can make my body do what it's supposed to do. I can only do so much. I can eat the dates. I can drink the tea, but after a certain point, there's nothing else I can do other than just walk it out and just trust that God's going to walk me through that.” I had to keep reminding myself of that with every single step because it got really hard. There's a community called “Labor Nurse Mama”, and I was a member of that community too. There's a doula on there. Her name is Lamay Graham. I think she's in Milwaukee. I'm going to tell you where she is, but she's a doula, and she's incredible. We would have these live chats and Zoom calls. They would talk to you.She would help remind me, “You can only do so much, Aubrey. You're doing everything that you can. Stop putting it on you because your body is going to do what it's going to do, and you're not going to change that the more you stress yourself out. You have to just trust God.” She is one of the reasons I kept being able to come back to reality. It was because she would remind me, “You have to just remember. Stop trying to do it all yourself.” Meagan: Yeah. We have to trust, have faith, and do everything we can within our own power, but then understand that there are going to be other things, and you have to have faith in those things. The more educated we are and prepared we are, we can navigate through those things. Well, I am just so stinking happy for you. I can see the emotion. I can hear the emotion. I saw the pictures. If you guys are listening right now, go over to our Instagram or Facebook page, and check out this beautiful image of her just holding your baby. You've got Jordan in the background, your nurse Jordan. I mean, really, it's so beautiful and I'm so happy for you. Congrats. Aubrey: Thanks. I'm sorry I was kind of all over the place. Meagan: No. Listen, that's okay. That is totally okay. I'm just so happy you are here to share your stories. Aubrey: Thanks. I appreciate 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

Send us a textWelcome to the October Q&A with Cynthia & Trisha. What's the most absurd thing that you've ever heard said to a woman in labor or to you? Today, we kick it off by sharing your anecdotes and our responses.  In our regular episode, we answer:If I am planning a free birth how do I know if I have a placenta previa and what should I do? I am twelve weeks pregnant and have extremely sensitive nipples while breastfeeding my toddler. Will this get better or should I stop breastfeeding?How often do home births transfer to the hospital?Why do so many women planning unmedicated hospital births end up choosing to get pain medications?In the extended version available on Patreon and Apple Subscriptions (always ad-free) we address the risk of uterine rupture after a VBAC for a planned home birth, what, if anything, can be done to avoid induction if you have Cholestasis of pregnancy, what gentle sleep training (or support) means, and if you can decline induction with well-controlled gestational diabetes. In our Quickies segment: Is body odor postpartum is it normal? Why is a VBAC called a TOLAC? Should home birth midwives always carry oxygen? Plus caffeine in pregnancy, postpartum dryness, birthing the placenta in the tub, leaking and letdowns, infant percentiles, and how we take our coffee plus whether our own children appreciate the work we do in the world.Ep #229 The Risk of Risk-Based Approach with Sara Wickham**********Our sponsors:Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort.Needed -- Our favorite nutritional products for before, during, and after pregnancy.Use promo code: DOWNTOBIRTH for all sponsors.DrinkLMNT -- Purchase LMNT with this unique link and receive a free 8-day supply.  Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

It's such a pleasure to welcome Heidi back onto the show. You can listen to Heidi's first two births in episode 126. Today, she shares the journey of her third pregnancy and birth, offering a unique perspective as a nutritionist and dietitian. Heidi opens up about the long road to conceiving her son, Philip, emphasising how important it was for her to feel both emotionally and physically prepared to welcome a new life into her family. We're celebrating Spring with a spring time sale! Enjoy 20% off our online courses: The Birth Class was $249 now $199 The Birth Bundle was $349 now $279 Discovering Motherhood was $119 now $95 Welcome to the First Trimester was $67 now $53 Just use code ‘SPRING24‘ at checkout. Hurry – this offer is only valid until 31 October 2024.See omnystudio.com/listener for privacy information.

Today on the Natural Birth Podcast we have Kirsty. Kirsty is a first time mama from Scotland. She works as a renewable energy lawyer and is very passionate about the environment and the outdoors and recently moved to her new home in the rural highlands with her husband, where they aim to full fill their life long dream of homesteading and growing as much food as they can on their small plot of land. In this episode she tell us all about her pregnancy and late pregnancy cholestasis diagnosis and how that threatened to derail her plan of having a home birth.  Luckily with the right research and support from a number of amazing women, Kirsty was able to manage her cholestasis diagnosis naturally and holistically which resulted in her having her baby with just her partner in the bathroom with a single candle for light. Her husband caught their baby boy on his way out and she was so happy to have had a completely unmedicated birth at home- Curious about Kirsty? Find her on instagram as @kirsty.may3 Find Anna's Website, The Village and about her Mentorship & How to Work with Her, as well as all Links & Resources she mentions in the episode here: www.sacredbirthinternational.com/links-podcast

Katelyn's first birth was relatively quick - a low-intervention vaginal birth in a private hospital. When she discovered she was pregnant again, she booked in with the same obstetrician but at her eight week scan, she found out she was pregnant with twins, and her obstetrician refused to support a vaginal birth. So began Katelyn's informed pregnancy and birth journey, which led to changing care providers at 25 weeks. She takes us through this experience - the fear and doubt - but mostly the thorough understanding of twin birth, the faith she had in her own body and her determination to birth intuitively. She also discusses her challenging breastfeeding experiences in detail and really highlights the importance of having a lactation consultant by your side. This is a brilliant episode that's both informative and empowering. __________ Today's episode is brought to you by Bliss Birth. Bliss Birth is founded on the belief that women's bodies are incredible things, and that when it's safe, choosing natural options makes for the best outcomes for mums and babies. That's why Ariel has developed a range of products to support your natural birth experience. Introducing the most advanced natural pain management device for labour available in Australia – The Elle TENS Plus. TENS stands for Transcutaneous Electrical Nerve Stimulation and it is the ultimate birth tool as it maximizes your body's natural pain-fighting abilities. Bliss Birth offer both 4 and 8 week hire periods, Pre-addressed, prepaid return (No printer needed). The ‘Mama Bag' valued at $10.95 is yours to keep! You can enjoy 10% off Bliss Birth with the code ABS24. Head over to BlissBirth.com.auSee omnystudio.com/listener for privacy information.

In today's episode I speak with a woman who enjoyed a completely healthy pregnancy...until she didn't-- when cholestasis shows up. Cholestasis of pregnancy, I learned this week, is an issue with the liver that sometimes arrives in the second or third trimester.We hear about how it's managed outside the hospital, and some of the surprises that awaited her in the postpartum. What follows is the first part of our conversation.

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

If you're looking at the title of this episode thinking, “I've never heard of cholestasis”… you're not alone! That being said, it's important to know about as it can occur in 1-2 in every 1,000 pregnancies. So let's talk about cholestasis in pregnancy- the symptoms, the treatment, how it is diagnosed, and how one can deal with this in pregnancy.  To have this conversation with me today on Yoga | Birth | Babies, I have Donna Benavides. Donna is a mother who experienced Cholestasis of Pregnancy and is now blessed with two healthy teens, Branden & Evan, and her angel baby Jorden. She's dedicated her time and advocacy to Intrahepatic Cholestasis of Pregnancy (ICP) and is the Founder of ICP Care 501(c)(3) nonprofit. She is also a registered prenatal yoga teacher! Donna has had ICP in all 3 of her pregnancies, and she graciously shares the knowledge and experience she's gained on the diagnosis through our honest conversation. If you have ICP or it comes up later on in your pregnancy, we want you to know how to advocate for yourself in order to find the support you need in guiding you through a healthy pregnancy. **CW: In this episode, there is mention of a stillbirth. This experience is shared about within the first 16 minutes. Please feel free to skip ahead, because there is so much good advice offered throughout the rest of our conversation as well.** 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

Join Sonia and Jessica for this inspiring HOPEisode sent in by Kathee, a Mama who endured fertility issues, disappointment and devastating heartbreak before finally being blessed with her miracle babies. She also shares why she decided to wait before having children and her thoughtful advice for women who are still on their journey to motherhood. Sonia and Jessica open the episode with life updates including their latest ‘feral toddler' stories, Jessica's foundation application tips and what's been keeping Sonia somewhat calm over the last couple of weeks with minimal childcare. Enjoy! Thanks for listening! Please subscribe and follow us on instagram and TikTok! For a full list of resources mentioned on this episode, visit the show notes here! Topics Discussed on This Episode: Topics discussed in this episode: 3:14 Feral Toddlers on the Loose! 13:13 Rosé Tinted Glasses 16:57 Jessica's Skincare & Foundation Tips 19:48 Final Life Update, We Promise! 22:34 Welcome to this HOPEisode! 22:51 Kathee's Story! 23:17 Cholestasis of Pregnancy 29:27 What Kathee Loves About Being A Geriatric Mama And Why She Waited 29:45 Kathee's Advice for Women Who Are Still on Their Journey to Motherhood www.geriatricmamas.com  

In this informative episode, we sit down with Donna, a brave mom who shares her journey through pregnancy loss and her diagnosis of Cholestasis of Pregnancy. Donna opens up about the emotional challenges she faced and provides valuable insights into this liver condition, discussing its symptoms, risks, and the importance of early diagnosis. She offers practical advice on approaching healthcare teams, asking the right questions, and ensuring proper support and care. Through her story, Donna emphasizes the significance of self-advocacy.For more information and resources:Website: https://icpcare.orgFacebook - https://www.facebook.com/icpcareInstagram - https://www.instagram.com/icpcareTwitter - https://twitter.com/icpcareYouTube - https://www.youtube.com/user/icpcareSupport group page https://icpcare.org/icp-community/supportgroups/ Subscribe to the Twiniversity Email Newsletter! Expecting twins? Twiniversity has you COVERED with online classes on:Breastfeeding TwinsTwins After SingletonsBaby Safety (CPR, First Aid, Car Seat Safety, Childproofing)Click here to sign up for a class!Follow us on:YouTubeTwitterInstagramPinterestFacebook

Episode 19 - Stacey Beer - Nutrition in Liver Disease and Liver Transplant.In this episode of Nutrition Pearls: the Podcast, co-hosts Melissa Talley and Jen Smith speak with Stacey Beer on nutrition in liver disease and liver transplant.  Stacey Beer is a pediatric dietitian specializing in Gastroenterology, Hepatology, and Nutrition at Texas Children's Hospital, the largest pediatric liver transplant program for the past 15 years. Stacey has presented posters at national conferences related to pediatric transplant. Stacey serves as a member of the NATCO Nutrition Board and was instrumental in the creation of the Certified Clinical Transplant Dietitian certification. In 2022, Stacey was awarded the inaugural NASPAGHAN CPNP Dietitian of Excellence Award and in 2023 she was awarded the Jeanette Hasse Transplant Dietitian of the Year award. Most recently, Stacey has created a transplant education program in transplant nutrition which is available for dietitians all over the world to learn more about transplant nutrition. Stacey's research interests are pediatric transplant, pediatric liver disease and parenteral nutrition. Nutrition Pearls is supported by an educational grant from Reckitt Mead Johnson Nutrition.Resources:Beer SS, Vega MW. Malnutrition, sarcopenia, and frailty assessment in pediatric transplantation. Nutr. Clin. Pract. 2023;1–18. DOI: 10.1002/ncp.11105.Boster JM et al. Malnutrition in Biliary Atresia: Assessment, Management, and Outcomes. Liver Transplantation. 2022(28)483‒492.Kamath BM et al. Fat Soluble Vitamin Assessment and Supplementation in Cholestasis. Clin Liver Dis. 2022(26)537–553.Degrassi I et al. Fat-Soluble Vitamins Deficiency in Pediatric Cholestasis: A Scoping Review. Nutrients. 2023(15)2491. https://doi.org/10.3390/nu15112491.Health Well: https://www.healthwellfoundation.org/fund/alagille-syndrome-vitamins-and-supplements/FDA Post Transplant: https://www.fsis.usda.gov/sites/default/files/media_file/2021-04/at-risk-booklet.pdfPracticum Link (applications for the fall program are due July 3, 2024): https://www.texaschildrens.org/health-professionals/education-and-training/conferences/pediatric-transplant-nutrition-practicumProduced by: Corey IrwinNASPGHAN - Council for Pediatric Nutrition Professionalscpnp@naspghan.org

This episode of Kiwi Birth Tales is proudly brought to you by Huggies NZ.In this episode of Kiwi Birth Tales, I speak to Courtney. Some of the topics we cover:Coming off the pillChanging midwife at 10 weeksLocal Antenatal course Cholestasis of Pregnancy (itchy hands and feet first symptoms) Gestational Diabetes Stretch and Sweep Induction after spontaneous waters breaking EpiduralQuick Pushing Positive Induction stories Cystic Fibrosis diagnosis after newborn checks with Luca Please seek support for any mental health concerns, some helpful links are below:Mental Health in PregnancyPerinatal Depression and Anxiety Aotearoa Plunket - Dads Mental HealthLittle Shadow - Private Counselling NZYour Birth Project Online Hypnobirthing CourseFind me @kiwibirthtales and @yourbirthproject Hosted on Acast. See acast.com/privacy for more information.

Links: Download the FamilyAlbum app in the app store or Google Play to enjoy this free photo sharing app with unlimited storage! Know Your Options Online Childbirth Course (code 100OFF for $100 off) Beyond the First Latch Course (also comes free with KYO course)  Support The Birth Hour via Patreon! Get access to hundreds of additional birth stories in from our archives and join our private Birth Hour facebook group - a great place to get questions answers and make friends!

Sponsor: Find peace of mind about your prenatal nutrition with the Genate Test by SNP Therapeutics. Learn more at genate.com and Use code BIRTHHOUR15 for 15% off your order. The Birth Hour Links: Know Your Options Online Childbirth Course (code 100OFF for $100 off) Beyond the First Latch Course (also comes free with KYO course) Support The Birth Hour via Patreon!

Links: Get your breast pump, lactation support, and maternity compression garments for free at aeroflowbreastpumps.com/birthhour and use promo code BIRTHHOUR15 at for 15% off supplies and accessories. Know Your Options Online Childbirth Course Beyond the First Latch Course (comes free with KYO course) Support The Birth Hour via Patreon!

Today Sarah gets to talk with Francy, a Hearth & Home client who had her first and second babies at home. If you haven't listened to Francy's birth story, do that before listening to this one! We're so grateful we got to hear Francy's stories and some of why midwifery care has mattered so much to her family. --- https://hearthandhomemidwifery.com 

Like many of us, Brande characterizes her labor as traumatic. Induced at 37 weeks due to Cholestasis, she was in labor for five days before receiving an epidural. After birth she suffered from PPD which led to suicidal ideation. She credits her pilates practice and community for helping her out of that time. We also chat about hypothyroidism and Hashimoto's. Find her @thebrandeshow and @aerialspiritdance   Subscribe to the Blog by Wrap Your Head Around Silks Roll It Out Registration Order your copy, ebook or audio book of UNDERSTANDING AERIAL SILKS on Amazon Reach me on Instagram @kerrywee1 Greener Grass Podcast HERE Part of the Digitent Podcast NetworkSee omnystudio.com/listener for privacy information.

The midwives answer listener submitted questions on the following topics:Preventing cholestasis and preeclampsia in pregnancyThe root cause solutions for eczema in pregnancy (and beyond)Tracking your cycle with Fertility Awareness when sleep is not consistentLooking for a homebirth midwife when there are not a lot of options in your area… and MORE!Links to all the extra good stuff:Click to check out the Beautiful One Membership experience! NOW OPEN!Free Seed Cycling E-bookManski's Seed Cycling Packs (Use Code HAPPYHORMONES10 for 10% off)Join our email community + get instant access to our awesome Sleep Freebie: HEREBrowse all our favorite women's supplement recommendations: HERESubmit your answer-on-the-show questions: HERESubscribe to the podcast to catch every episode. Follow us on Instagram for all the extra education and antics in between episodes at  @beautifulonemidwifery

This week on The Mommy Labor Nurse Podcast we're going to address itching during pregnancy and cover what's normal and what's not! The thing about itching in pregnancy is that it might be nothing, but it might actually be a sign of something more serious – which is why I wanted to do an episode about this! During pregnancy, your body goes through so many changes. The changes can be physical, emotional, psychological, or a combination of all three! It can be really hard, especially if it's your first pregnancy, to know whether or not something is normal and when you need to notify your provider. You are probably familiar with the big red flags: vaginal bleeding, severe pain, and decreased fetal movement, but itching isn't one of those things that we typically think of as being concerning during pregnancy. And it actually can be! Want to erase anxiety and actually feel excited about birth? Get instant access to my FREE Birth Workshop to learn tons of pain-coping strategies and actionable tips today! Have an even better birth! CLICK HERE to learn more about our online birth classes that will help you feel prepared and in control - no matter how you deliver. And be sure to follow @mommy.labornurse on Instagram to join our community of over half a million for education, tips, and solidarity on all things pregnancy, birth, and postpartum! Related Episodes EP107: Let's Chat Third Trimester FAQs Resources from this Episode Grandpa's Pine Tar Soap  

Join us as we celebrate the arrival of Stu's first grandchild, and finally cover a topic that has been highly requested: cholestasis. This is a lesser-known health issue that affects a significant number of pregnant women and usually results in interventions once it is discovered. You'll walk away from this episode with a deeper understanding of cholestasis - from its potential treatments, its impact on the liver, and whether or not it is as scary as it is sometimes portrayed.We dissect the risks and benefits of various treatments for cholestasis, alongside a poignant story from a listener who was diagnosed with this condition. We don't shy away from examining the harsh realities, but also shed light on the real facts of what different bile levels mean and their corresponding risks. We further delve into the medical model of treating cholestasis, highlighting the need for an individualized approach that takes into account the woman's unique experience and not just the medical perspective.Not only do we discuss cholestasis, but we also tackle topics like the potential risks of placental pathology and the controversy surrounding forceps usage in childbirth. We pull back the curtain on the medical world, questioning the incentives behind the non-disclosure of placental pathology by hospitals, and revisiting the debate on the induction of labor. This episode is packed with valuable insights, personal stories, and expert advice - an invaluable resource for anyone seeking a comprehensive understanding of cholestasis and its management during pregnancy. Tune in and let's grow together!The Biology of Aging and FertilitySensitivity of Hands and FeetReevaluating Induction Practices in ObstetricsCholestasis in Pregnancy and Risk FactorsPreeclampsia Risk in ICP PatientsAntepartum Testing in Intrahepatic CholestasisLikelihood of ICP RecurrenceObstetricians' Approach to Risk and IndividualityRespiratory Distress Syndrome in Cholestatic PregnanciesEpisode resources:Statistics: Risk of Stillbirth with Intrahepatic Cholestasis of Pregnancy: What do Bile Acid Concentrations Tell Us?This show is supported by:LMNT | Go to com/birthinginstincts to get a free sample pack with every orderNeeded | Use code BIRTHINGINSTINCTS for 20% off your first month or first 3 months of a one-month subscription at com.BIRTHFIT | Go to com and use the code INSTINCTS1 for a discount on the Basics Prenatal program, or INSTINCTS2 for a discount on the Basics Postpartum program.Connect with Dr. Stu & Blyss:Instagram: @birthinginstincts / @birthingblyssWebsite: com / birthingblyss.comEmail: birthinginstinctspodcast@gmail.comCall-in line: 805-399-0439

Welcome to this episode of the podcast where we dive into Maria's birth stories. A first birth story which left Maria feeling broken and traumatized followed by a healing and empowering experience of birth with her second child. Maria talks about the importance of good support in healing from birth trauma as well as recognizing it as such in the first place. This episode is for anyone who has had a challenging first birth experience and maybe wants to hear that it's possible to birth with positivity in consecutive births. I hope this episode gives you hope and encouragement to understand the things that can make a big impact on your laboring experience to make sure that it is indeed a positive and empowering experience that leaves you feeling strong and capable as a woman and mother. Let's get started on this week's birth story with Maria. Thank you for being here. Links: Spinning Babies: https://www.spinningbabies.com/ Evidence Based Birth: https://evidencebasedbirth.com/ The Positive Birth Company: https://thepositivebirthcompany.co.uk/ More info on Cholestasis: https://icpcare.org/ Podcast episode by Birth Kweens on healing from birth trauma https://www.birthkweens.com/birthkweens-ep71/ Healing After Birth: Navigating Your Emotions After A Difficult Childbirth Book by Jennifer Summerfeldt MACP https://www.adlibris.com/fi/kirja/healing-after-birth-9781999497200 Birthing from Within: An Extra-ordinary Guide to Childbirth Preparation. Book by Pam England and Rob Horowitz https://www.adlibris.com/fi/kirja/birthing-from-within-9780965987301

Hello everyone! We are back with our April Q&A episode, and it is loaded with your excellent questions! Don't forget you can subscribe on Apple podcasts Patreon to hear the extended, ad-free versions.  Here's what we are talking about today:Is it safe to plan a birth center birth if someone has a history of pre-eclampsia, HELLP syndrome and a postpartum hemorrhage?Is it appropriate and/or expected to tip your doula?Other than placenta accreta, what other reasons are there for retained placenta?Can I take beef liver supplements in pregnancy? And do I need to worry about getting too much Vitamin A?  What is safe and what is not?In the case of surrogate and adoptive mothers, who should hold the baby first after the birth?I am experiencing postpartum rage and resentment toward my partner. How long does this last?And in our extended version (available on Apple subscriptions & Patreon):What can I take for after birth pains?If I have an elevated fasting blood sugar and a diagnosis of Gestational Diabetes, is my baby really at risk? If so, what can I do without going on medication?Is being over age 35 really a risk factor in birth?Is there anything you can do to prevent Cholestasis in pregnancy?And of course, everyone's favorite: Quickies!Thanks for joining us, and remember you can call our phone line with your questions 24/7 at 802-GET-DOWN. (That's 802-438-3696)**********DrinkLMNTLove Majka Products Silverette Nursing Cups Postpartum Soothe Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

Dr Irene Chang and Dr An Dang Do explain how an infant presenting with cholestasis and liver disease kept them guessing, and how the abnormal biochemical findings gave them new insights into other conditions. Elevated oxysterol and N-palmitoyl-O-phosphocholineserine levels in congenital disorders of glycosylation An N. Dang Do, et al https://doi.org/10.1002/jimd.12595

This week I'm coming at you with an "Ask Me Anything" episode based on questions my listeners submitted on our new podcast hotline! My plan for 2023 is to do more "Ask me Anything"-style episodes, and to make it even more fun, I want to feature voices from the community! So, if you've got a burning question about pregnancy, birth, or postpartum that you'd like me to answer on the show - all you have to do is call: 919-213-8719 and leave a voice message. If chosen, I will play the question on a future episode and answer it right here on the show! In this episode, I will be covering questions about cholestasis, placenta encapsulation, epidurals, and more. If you love episodes where it's just me answering questions, do yourself a favor and go listen to the most embarrassing questions about pregnancy and birth on Episode 161 and Episode 162. Overwhelmed by the amount of pregnancy info out there? CLICK HERE to get helpful and supportive tips, info, and resources from an L&D nurse sent straight to your inbox every week, and never sort through search results again! Have an even better birth! CLICK HERE to learn more about our online birth classes that will help you feel prepared and in control - no matter how you deliver. And be sure to follow @mommy.labornurse on Instagram to join our community of over half a million for education, tips, and solidarity on all things pregnancy, birth, and postpartum! Related episodes and resources Episode 161: Your Most Embarrassing Birth Questions Answered - Part 1  Episode 162: Your Most Embarrassing Birth Questions Answered - Part 2 Pine tar bar soap Cholestasis research article Sponsor Are you in search of the perfect pump for your breastfeeding days? Proven to provide more milk in less time, the Motif Luna is a powerful breast pump that's built for modern motherhood and covered by insurance. With a battery-powered or non-battery version, the Luna is perfect for today's busy mom. Click HERE to learn more about Luna and order one for your breastfeeding and pumping journey. And as a special offer for MLN podcast listeners you can get 15% off site-wide, including the Luna plus all supplies and accessories with code: MLN23. Some exclusions may apply.

In this episode I speak with Heather, who takes us through her struggles of trying to conceive. She tried for 12 months unsuccessfully when she finally went and consulted with a fertility specialist who discovered she had a blocked tube and rather than going through the process of rectifying the issue, decided IVF would be the path they would take. Unfortunately, she had to go through 5 rounds of IUI before her insurance would cover her IVF treatment. But luckily for her, Heather fell pregnant on her first round. The struggles didn't end there though, she was diagnosed with gestational diabetes, had a bleed at 28 weeks and later developed cholestasis which resulted in the induction of her son, but not the end of her harrowing journey. Right after birth, her son was rushed to the NICU and the following morning had to be airlifted to another hospital to be put on life saving machines, where he stayed for the first 30 days of his life. Heather has since had 3 unsuccessful embryo transfers and has discovered she has scarring in her uterus. She has one embryo left, but is still undecided if they will go ahead and try again.Make sure you follow the Messy in the Middle Instagram page: https://instagram.com/_messyinthemiddle_?igshid=NTdlMDg3MTY=And if you want to share your story, please get in contact with me either through the Instagram page or email me at messyinthemiddle.fertility@gmail.com

In Episode 23- I sit with my client Jana and chat about how she changed her pregnancy outcome with the bean protocol. Jana had two pregnancies before that had ended in Cholestasis, and she wanted to avoid it this time and hopefully have a natural home birth!I loved out chat and I am super excited to share it with you. I hope Jana's story inspires you along your healing journey!Here is a note from Jana that lead us doing this podcast episode together.Hello,I just wanted to send a note of gratitude for the session and support you provided me in my pregnancy and health journey this year. On 10/4, I delivered a healthy 9 lb baby girl, Lyla, home at 40 weeks and two days.Having had Cholestasis with my other two children, I had experienced having to be induced at 37 weeks. Although everything was ultimately ok, I experienced a loss of the births I had wanted, developing preeclampsia and my son having to be in the NICU for high bilirubin levels.My experience was a catalyst to digging deeper into what was impacting my liver. It was a proud moment to avoid Cholestasis when both OB and midwives told me it was almost guaranteed I would likely get it again. More so, to have kept my baby safe and to see how strong and healthy she is has been such a comfort. I learned so much more about my body and supporting my liver through this process, and I am so thankful to the bean protocol for what it taught me and the empowerment it has provided.Thank you so much!JanaBean Curious?You can use my CODE: BEAN20 for a discount on my e-course.Connect with Unique on Instagram - https://www.instagram.com/uniquehammond/Find out how to work with Unique - https://www.youregreat.com/Learn more about The Bean Protocol -https://www.youregreat.com/the-bean-protocol

This episode covers obstetric cholestasis.Written notes can be found at https://zerotofinals.com/obgyn/antenatal/obschole/ or in the antenatal care section of the Zero to Finals obstetrics and gynaecology book.The audio in the episode was expertly edited by Harry Watchman.

Hello everyone!  It is Wednesday, and we are back with our monthly Q&A!  In this month's extended Q&As (always ad-free and available to all by subscribing to Down To Birth + on Apple or joining our Patreon community) we discuss an interesting situation reported by one mom regarding  her "retained placenta" - or was it? How would you know if it's really a medical situation or a failure to be patient? We also respond to one mom regarding the quality of European versus U.S. formulas, we discuss how to really know when to go to the hospital in labor, and whether it is ok to push without an urge - should you do it or wait for the go-ahead? Finally, the question so many parents can relate to: How much should I worry when my breastfed baby has plummeted on the growth curve?In our regular Q&A version (non-extended), one mother inquires about her bedroom temperature being too cold for her newborn but necessary for her own sleep comfort - what's too cold for a newborn and what's the risk? We also discuss petite mothers' abilities to vaginally birth babies, because one woman has received plenty of unsolicited negativity about her body size, despite that she's fit and healthy. We also discuss one provider's comment about having to keep women on their backs while pushing "in case" she needs to utilize the McRobert's position in the event of shoulder dystocia. Is that legit? Cholestasis is the special circumstance faced by another mom, who wants to understand the risks and isn't thrilled it'll most likely mean induction. One Home Birth After Cesarean (HBAC) mom is concerned about whether she should get an ultrasound to ensure her placenta has not attached over her scar - should this be routine for VBAC and HBAC women?  Other moms are asking:"Is it normal to feel nauseous when breastfeeding"  "Do babies need to be burped after feeds?"  and more.Thank you for all of your awesome questions and for being part of this fabulous community! Call 802-GET-DOWN any time to submit a question for our next Q&A. And remember to join our Patreon community to attend our two educational, interactive livestreams every month!**********Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

On this episode of the Innate Wisdom Podcast, I'm honored to welcome Dr. Ray Peat. Dr. Peat is a Ph.D. in Biology from the University of Oregon, with an emphasis in physiology. He has taught at several schools including his alma mater, Urbana College, Montana State University, National College of Naturopathic Medicine, Universidad Veracruzana, the Universidad Autonoma del Estado de Mexico, and Blake College. His work has particularly revolved around the work of Progesterone, Thyroid hormone, and others, and the notion that energy and structure are interdependent, at every level. His approach focuses on how our environment influences development, regenerative processes, and an evolutionary perspective by combining biophysics, biochemistry, and physiology. And he shines a light on how we can use energy-protective materials to not only reduce aging, but to thrive.Listen to Hear More About:- How to support fertility & egg quality- The connection between body fat & fertility- Pregnancy loss & miscarriage- Placental antibodies- Trying to conceive into older age- DHA & infant brain development- Low-carb diets for pregnancy- Pregnancy complications including gestational diabetes, preeclampsia, cholestasis, anemia, placenta previa, etc.- Supporting breast milk production- Navigating infant intolerance to breast milk- Essential oils and estrogen- And more!Episode Links & Resources:- Dr. Peat's Website: raypeat.com/- Dr. Peat's Newsletter & Ebooks: Send an email to raypeatsnewsletter@gmail.com- Bioidentical Progesterone Supplements: us.onasnatural.com/?rfsn=6261957.8b473c (Coupon INNATE provides 10% off)- Vitamin E Supplements: lifeblud.co/?ref=eyXpcB54G_nYu (Coupon INNATE provides 10% off)More Resources

How fitting that I'm releasing my birth story with Reagan on her due date! My sweet baby was brought into the world abruptly 3 weeks ago due to a diagnosis of severe ICP (Intrahepatic Cholestasis of Pregnancy ). Tune in to find out more about the liver disorder I developed in pregnancy as well as my positive induction story that brought our sweet 6lb  9oz baby to us 20 days early. For show notes, head to www.brandwelldesigns.com/thepodcast/episode81.Follow BrandWell on Instagram.Save 50% off your first year of Honeybook using this link!  

Donna Benavides is a mother who experienced Cholestasis of Pregnancy and is blessed with two healthy children Branden & Evan and angel baby Jorden. Her time is dedicated to her family, work and passion to raise awareness of Intrahepatic Cholestasis of Pregnancy (ICP). Her journey with ICP began with her first pregnancy in 2003 with her son Jorden that tragically passed away in utero at 37 weeks & 5 days due to the high-risk pregnancy Cholestasis. In 2008, she began her work with the itchy mom's website and in 2012 became the Founder of ICP Care 501(c)(3) nonprofit. She has a Bachelor's of Science degree and has practiced Yoga for 12 years completing her RYT® 200 Yoga Teacher training in 2018.  She has enjoyed teaching to pregnant mothers since 2019 as a certified Prenatal Yoga Teacher RPYT®.  Website: https://icpcare.org/   Facebook- https://www.facebook.com/icpcare Instagram- https://www.instagram.com/icpcare Twitter- https://twitter.com/icpcare YouTube- https://www.youtube.com/user/icpcare   Support group page https://icpcare.org/icp-community/support-groups/     For more information about Michelle, visit www.michelleoravitz.com The Wholesome Fertility facebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/ Instagram: @thewholesomelotusfertility Facebook: https://www.facebook.com/thewholesomelotus/

Michele joins us again to share her very recent 4th birth story with us. This episode is packed with information from Covid positive at 34 weeks, Cholestasis, induction, being proactive prenatally with breastfeeding and much more. --- Support this podcast: https://anchor.fm/frombumpstobirth/support

Are you looking for an inspiring hospital VBAC induction birth story? Then you're in luck! In this episode of theVBACpodcast, Doula and Childbirth Educator Abby Williams shares her journey into motherhood as a doula, how becoming a doula changed her perspective on cesareans and vaginal births, how she planned a home birth despite having a complex medical history with multiple surgeries including back and hip surgeries AND having diet-controlled gestational diabetes. Abby went on to have a homebirth cesarean for her second birth due to breech presentation and an unexpected cholestasis diagnosis, then had a birth center turned hospital induction VBAC with Cholestasis.  Abby shares her birth story and insight as a birth worker on how she utilized the Three Pillars of Confidence for more positive birth experiences. Abby also shares insight on keeping a flexible birth plan as you prepare for your Vaginal Birth After Cesarean.  Follow Abby on Instagram & Facebook @abbythebirthworker    Get Instant Access to the Free Combating Fear During VBAC class: www.littlebearlactation.com/links  Apply to be on the podcast: www.littlebearlactation.com/podcast    Connect with Jaimie to process your cesarean & prepare for VBAC: www.littlebearlactation.com/contact    Don't forget to rate & review the podcast if you're loving it!

Alisha shares her story about having hyperemesis and cholestasis in her first pregnancy. She discusses her overall health, being nutrient and mineral deprived, and what she is doing now to nourish herself to prepare for a future pregnancy.    Give Alisha a follow at @sacredmotherphotography on IG.      JOIN B! Community- a lifestyle community for women by women with a focus on fitness, education, and connection!    Resources and Links:   Hyperemesis  Brewer's Diet    Cholestasis  Returning to Homeostasis in the Face of Cholestasis of Pregnancy by Tonya Bridges 8 Natural Treatments for Cholestasis Top 15 High-Selenium Foods   The supplements Alisha's taking to support her liver & health:   Earthly's Liver Love  https://www.earthley.com/product/liver-love-herbal-tincture/   Cod Liver Oil:  Rosita Earthley    Perfect Supplements Desiccated Liver https://www.perfectsupplements.com/Perfect-Desiccated-Liver-p/desiccatedliver120.htm Vitamin E (PUFA protect) https://www.mitolife.co/products/pufa-protect-vitamin-e  

On this episode, I'm talking to my friend Karen about her struggles with cholestasis during her pregnancy and giving birth to her daughter with a skull complication called encephalocele. We hope that this episode sheds more light on these conditions and teaches you how to be your own advocate and get the support you need during tough times. REMINDER: We aren't medical professionals! We are purely talking about Karen's experience. Please consult your doctor for your specific situation. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

MyLin and Lindsay started their lives together after marriage with the hopes of expansion. When they decided to have more children, they were not fully aware of the obstacles they would encounter. The sticker shock regarding Intrauterine Insemination (IUI) expense steered them towards traditional or old-school insemination with a known donor. Patience over almost two years and a devastating anembreyonic pregnancy would lead them to the full-term pregnancy and consequent birth of their first child together.Lindsay chose to carry the baby, and they managed their insemination personally with advice from a fertility specialist. The fertility specialist validated their concerns and guided them through the most straightforward ways to help them. Despite having PCOS, she could make adjustments in their fertility journey and conceive. Her pregnancy was amazing, and there were no issues until the end of the pregnancy. She presented with itchy hands and feet, which was one indicator of Cholestasis. Cholestasis can affect the liver and can be dangerous for mom and baby. An induction was ordered at 37 weeks to avoid complications to their health and after two days of labor, Lennox would join the family. Shortly afterward, Lindsay developed preeclampsia and would need additional monitoring.Postpartum for Lindsay included healing and challenges with breastfeeding. Thankfully, MyLin had started the induced lactating process prenatally with the hopes of sharing the work of feeding the baby. She was able to nourish the baby while Lindsay worked through latching issues with Baby Lennox.MyLin's pregnancy required more preparation as she wanted to deliver at home. They were able to have all of the birth-related services to make her dream homebirth come true with the generous support of the Victoria Project, a nonprofit organization serving Southern California. The Victoria Project provided full financial support for a midwife (not the deposit), chiropractor, pelvic floor therapy, hypnobirthing, and childbirth education.MyLin labored with her family and doula as they awaited the intensity of active labor. Lindsay busied herself preparing the tub for her but found her work was futile. MyLin found herself in “labor land” and talked her baby out as he quickly slipped out. The midwife would arrive later and attend to the newly expanded family. She had four postpartum midwifery visits and was able to spend a lot of time in bed, healing physically and mentally.Finding the right avenues to expand their family was pivotal in their birthing experiences. MyLin and Lindsay share their knowledge with other same-sex couples to make themselves an accessible resource. Patience, grace, and softness are essential aspects of their continued parenting journey. Resources:Victoria Project | supports access to holistic maternity care, specifically pregnancy, birth and postpartum services provided at home or at a birth centerSugar Heal | a collective of Black healers offering services in various disciplinesHypnoBirthing | classes for parents who strive for gentle, calm, and natural childbirth

Links Today's episode is sponsored by Premama Wellness. Use the code BirthHour25 for 25 percent off your purchase! Know Your Options Online Childbirth Course - Use Code 100OFF for $100 off Beyond the Latch Course Support The Birth Hour via Patreon!

In this special episode of the podcast, I share my labor story and how Roman came into the world, my postpartum experience so far, and a few pieces of advice that I wish someone had shared with me prior to giving birth.A couple of notes:+ my birth story is traumatic, that does not mean yours will be. I hope yours is absolutely beautiful. I'm sharing mine because some of you have asked and I want to be transparent.+ no matter your birth experience, the end result is worth it. My son is the light of my life and I would do it all again.+ I'll be sharing on Instagram some products that have made the first month postpartum easier on me and Roman, so check that out if you are on the hunt.PRODUCTS MENTIONED...RITUAL VITAMINS:Ritual.com and use code: JACLYNSTEELE for 10% off your first 3 monthsRYZE SUPERFOOD MUSHROOM COFFEE:https://www.ryzesuperfoods.com  and use Code: JACLYN at checkout for 15% offCONNECT WITH JACLYN:+ Website: jaclynsteele.com+ Instagram: @jaclynsteele+ Youtube: officialjaclynsteele+ Facebook: jaclynsteeleinternational+ Clubhouse: @jaclynsteele+ Sign up for THE SCOOP & get the skinny on the latest wellness, beauty, & self development trends, as well as exclusive email-only content.TEXT ME:+1 480-531-6858 or follow this link. :)SUPPORT THE SHOW:PaypalLight, Love, & Peace,Jaclyn SteeleSupport the show (https://www.paypal.com/donate?hosted_button_id=7SLKVGC37E8SU)

Dr. Samantha Do returns to discuss intrahepatic cholestasis or pregnancy, more commonly called ICP or cholestasis. She describes this as a “pregnancy specific” condition in which the liver produces excess bile. Dr. Do explains why this causes uncomfortable symptoms like intense itching as well as an increased risk for stillbirth.

This week Amanda & Katie talk with Emily about her Enhanced Recovery After Surgery (ERAS) Cesarean. She also talks about her previous miscarriage, pregnancy with her rainbow baby and dealing with Cholestasis of pregnancy.

Heidi chats with Kjirsten all about cholestasis and the warning signs of normal vs. not normal itching, miscarriage, getting pregnant after a miscarriage and good epidurals! Kjirsten is the CEO of Teeny Talkers and focuses on helping get your littles talking. You can find her online course at www.teenytalkers.com and follow her on IG at instagram.com/teeny_talkers Pre-Sales begin for Birth Story Academy on 12/1/21. Use code BIRTHSTORYPODCAST for 50% off. 

Intrahepatic cholestasis of pregnancy (ICP or IHCP) is characterized by itching and an elevation in blood bile acids, that usually develops in the late second and/or third trimester and can be a high risk issue in pregnancy.  Check us out on our website or social media! www.truebirthpodcast.com Maternal Resources Social Facebook: https://www.facebook.com/maternalresourceshackensack |nstagram: @maternalresources Subscribe to the podcast on Apple Podcasts, Spotify, Google Podcasts, & Stitcher and leave a review!  

In today's birth story episode we have Alex. Alex is an oncology pharmacist at her local cancer center. She joins us today to share her experiences with loss, pregnancy during Covid, a rare complication, and induction without an epidural. This episode is an example of why it's so important to have a pain management plan. You don't know what options will work for you until you try. You need lots of tools in your toolbag which is why educating yourself is so important. You can take my new, quick quiz to assess your knowledge about managing pain in labor. In this Episode, You'll Learn About: -Why Alex's doctor recommended against a D&C (dilation and curettage) after miscarriage -How Alex's co-workers helped mitigate the risks of working in a cancer center -What cholestasis is and how serious it can be -How listening to birth stories helped Alex prepare for a non-epidural birth -Why Alex's doctor induced her in response to her cholestasis -How quickly Alex's pain level escalated and why she regrets utilizing nitrous oxide -How effective pelvic floor therapy can be for myriad purposes Full website notes: drnicolerankins.com/episode131 Register for my free birth plan class - How to Make a Birth Plan That Works. Check out The Birth Preparation Course Take a quick, fun labor pain quiz

Understand why midwives and doctors worry about itching in pregnancy and what it might mean. Learn a bit about the latest research into treatment and how you might access support if you develop this liver condition in pregnancy.Want to know more?https://www.rcog.org.uk/en/patients/patient-leaflets/obstetric-cholestasis/https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg43/https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32323-7/fulltexthttps://www.icpsupport.org/index.htmlYou can find out more about me on Twitter @FWmaternity & @TheObsPod as well as Instagram @TheObsPod please check out #MatExp matexp.org.uk for ideas about how to improve maternity experience.   My beautiful artwork is thank to Anna Geyer www.newpossibilities.co.uk

Today, we're going to talk about how your liver could potentially cause stiffness in your body. If the liver isn't working right, it may cause joint stiffness to the point where you feel like you have arthritis. Cholestasis is a condition where your bile is backed up and not flowing freely through the bile ducts. There is a combination of too much cholesterol and not enough bile, causing the bile to back up, which then causes inflammation. If there is a problem with the bile ducts, you can experience a lot of pain and stiffness, especially on the right side of the body. If you don't have enough bile, you also won't be able to absorb and utilize vitamin D, which is a powerful anti-inflammatory. Other fat-soluble vitamins will also not be available to you, which can lead to pain, stiffness, and other issues. The best potential remedies for stiffness: • Purified bile salts • Get on the Healthy Keto diet • Do intermittent fasting • Eliminate omega-6 fatty acids from your diet The Egoscue Method: https://www.egoscue.com/ Dr. Berg's D3 & K2 Vitamin ➜ ➜ https://bit.ly/37A2oXE Bile Salts Recommended ➜ ➜ https://bit.ly/2XggGe1 DATA: https://www.ncbi.nlm.nih.gov/pmc/arti... Dr. Eric Berg DC Bio: Dr. Berg, 51 years of age is a chiropractor who specializes in weight loss through nutritional & natural methods. His private practice is located in Alexandria, Virginia. His clients include senior officials in the U.S. government & the Justice Department, ambassadors, medical doctors, high-level executives of prominent corporations, scientists, engineers, professors, and other clients from all walks of life. He is the author of The 7 Principles of Fat Burning. Dr. Berg's Website: http://bit.ly/37AV0fk Dr. Berg's Recipe Ideas: http://bit.ly/37FF6QR Dr. Berg's Reviews: http://bit.ly/3hkIvbb Dr. Berg's Shop: http://bit.ly/3mJcLxg Dr. Berg's Bio: http://bit.ly/3as2cfE Dr. Berg's Health Coach Training: http://bit.ly/3as2p2q Facebook: https://www.facebook.com/drericberg Messenger: https://www.messenger.com/t/drericberg Instagram: https://www.instagram.com/drericberg/ YouTube: http://bit.ly/37DXt8C

Our understanding of Intrahepatic Cholestasis of Pregnancy has changed just over the last 5 years. What is the best laboratory test to help diagnose this condition? At what level of total serum bile acids is the risk of fetal death greatest? What does the SMFM say about induction of labor for these patients? In this episode, we will highlight and summarize the latest clinical brief on ICP from the SMFM (2021). This is SMFM consult series # 53.

In this episode Mathusha and Adriana talk about their experience with gestational diabetes and cholestasis. For more information, check our FB page, Coffee and Bottles for helpful articles. --- Send in a voice message: https://anchor.fm/coffeeandbottles/message

After her first labor stalled and ended in a C-section, Carlee remembers leaving the hospital so grateful for her healthy newborn, but also confused, exhausted, and longing for a “birth redo.” When she became pregnant again, Carlee planned mentally, physically, and emotionally for a dreamy HBAC. She also prepared thoroughly with a super supportive team at a nearby hospital if needed. At the end of her pregnancy, Carlee presented a severe case of cholestasis and her plans suddenly changed. Carlee began her low and slow induction at 37 weeks with no signs of labor and an unfavorable cervix. But the patience of her birth team, the support of her doula, and her ability to make decisions regarding her care all set her up for a nice, healthy VBAC. When plans changed, Carlee's preparation still set her up for success and empowerment. Carlee is proof that a medically necessary induction doesn't mean you have to go right to a C-section. When working with an early induction, patience is the key. With the right mindset and a patient birth team, you have a good chance of having a great birth experience and an even better chance of having a VBAC. Additional linksThe VBAC Link on Apple PodcastsHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Meagan: Happy Women of Strength Wednesday. You are listening to The VBAC Link and this is Meagan and Julie and our friend Carlee. She is from Arizona and she is going to be sharing her VBAC story today. There's something interesting about her VBAC story. If you have never heard of cholestasis, then you want to listen up because we're going to talk a little bit about it, and what it is, and why it's important to actually get the baby here sooner rather than later when it is present. We are going to dive into her story. As always though, we have a Review of the Week and Julie will be sharing that with us.Review of the WeekJulie: Yeah. I'm going to share a review. But before I share a review, I'm going to congratulate Meagan for saying “cholestasis” right.Meagan: I know. I always call, in my head, I'm like, “Choleo--”Julie: Cholestasis.Meagan: Yes. And I just, it says it all the time. I'm like, “Choleostasis.”Julie: You didn't even stutter. It was just nice and smooth off the tongue, so I was very proud of you. I had to let you know.Meagan: Perfect. I am growing up.Julie: The things we mature on by running a podcast. All right, so this review is from Apple Podcasts and it was left by “natashahoff”. This is one we can Facebook stalk, except it was just left a couple of weeks ago. But I am going to read it. The title is, “So empowering.” She said, “I found this podcast after I had a Cesarean birth with my daughter almost two years ago. I knew I wanted a VBAC and I wanted to hear birth stories from women who have had ‘success'. Little did I know all of the incredible, evidence-based information that Julie and Meagan share on each episode and on their blog! I now feel like I have a wealth of information to help me achieve my goal of a VBAC, from choosing supportive providers to preparing my body for birth, all the way to what to do if my plans don't go the way I would like. I'm so excited now that I am pregnant with my second baby to be able to put these plans into action and begin my journey to a beautiful VBAC in October 2021!Meagan: That's coming up.Julie: First trimester. I know.“Thank you, Julie and Meagan, and all of the wonderful moms who have shared their stories!Sincerely, Natasha Hoffstater”I love that she signed her name. Gosh, we should have waited to read this until October so we could go to Facebook stalk her and see if she had her VBAC. Oh well, we will come back to you Natasha. I promise.Meagan: Yes, I was going to say. Natasha, keep us posted along the journey because we love hearing. We love it. We truly love when we get the messages and we are like, “Oh wait, you were the one we talked to way back when.”Julie: We are getting old enough now, and I mean mature, not old, although we are old as well. Well, not Meagan. I'm just the old one. But where we are coming full circle with a lot of the stories and it's really, really fun. It's really cool because I love when people share that the podcast educated them and helped them have lots of information. Can I do a little shameless plug-in here for our VBAC prep course?Meagan: Yeah.Julie: Because the podcasts are definitely lots and lots of information, but you have to listen to-- what are we at now? 170-something episodes in? That's 170 hours of information that you have to listen to. That's why we created our VBAC prep course because it is condensed. It's just the nitty-gritty, need to know, absolutely everything covered that you need for your VBAC, but hyper-focused in this six-hour course in easily digestible video segments with corresponding text and set up all really nice and easy, so you don't have to listen to all 170 podcasts. You can just go and instead watch a six-hour course. It's set up so you can stop and go, and stop and go, and stop and go. It can take you a while or you can do it all in one day. That way, you don't have to sit and listen through every single podcast. It's just a nice sweet, Saturday afternoon with your husband and your little toddler running around, and then you can get empowered and educated in one day.Meagan: Yay.Julie: So, I love that. Either way, we've got your back. Something for everyone here at The VBAC Link.Carlee's storyMeagan and Julie: Alright.Julie: Ope, jinx.Meagan: Are you ready to get into this story? I know, right? We are so excited for Carlee's story and oh my gosh. Okay, Carlee. We are not going to take any more time. This is your time. Let's turn the time over to you.Carlee: Okay, awesome. Thanks, ladies. I am super excited to share my story and hope that someone can learn something or take something away. Starting from the beginning I guess, growing up, I was never really afraid of birth. My mom had four natural births at the hospital, but nice, smooth, easy birth,s and both of my sisters had natural births at the hospital as well. So I just thought, you know, my grandma, everybody just all had easy, nice, easy, natural births, so I was like, “It's going to be okay whatever happens to me when the time comes. I will read a couple of books and I will be good.”It turns out it was a little trickier than that. I got pregnant about after seven months of trying. My husband and I started trying after a year and a half of marriage. I was diagnosed with PCOS when I was 16. Doctors always said, “You'll get pregnant, but most likely with help, with Clomid,” or whatever types of fertility treatment. So after seven months and getting pregnant naturally, I was super excited and super grateful. I remember that first call to the first doctor, “Um, I think I am pregnant. I got the positive on the pee stick. What do I do now?” I don't know if anyone else has ever done that. But I was just like, “Oh, what do I do?”With that doctor, I had an ultrasound with them, but I didn't really vibe with the doctor and so I was like, “I think I'm going to switch to someone else,” which I'm super glad I did. I went to a group of midwives that deliver at a more natural hospital here in the area. My sister had used them for her first birth and so I was like, “Okay. They are going to be great.”Throughout the pregnancy, I met all seven of the midwives. I found two that I enjoyed more and felt more connected to and so I had always hoped that they would be on-call when the time came. For the most part, pregnancy went really well. I went to all of the regular appointments. I turned out to be GBS positive, which I hadn't really looked into, so I was like, “Okay. I guess antibiotics is my fate.”Towards the end of my pregnancy, I was due in September and during the summer, we lived in Boston for my husband's work. We left out of town and then came home in August to start student teaching at 36 weeks. It was my senior year of college and I didn't drop out. I just decided to do it. So I student taught from 36 weeks up until I went into labor, and then the plan was to have four weeks off and go back into student teaching. So it was a hectic time of my life for sure. Birth wasn't quite the forefront of my mind and I do think that definitely played a part.When I was 40 weeks and 1 day, I made it all the way to the end. I started feeling period cramps around 4:00 p.m. and I was like, “What? Am I starting my period? This can't be.” I don't feel like anyone ever told me that period cramps are the start of contractions, so that was shocking to me.Around 8:00 p.m., they kicked up again, so I was like, “I am going to go to bed.” At 11:30, I woke up and got in the tub. I was just like, “I am just going to try and relax through this.” 20 minutes later or so, my water broke and that was the craziest sensation. I just remember feeling this “pop” and then a gush of water. I was like, “Uh, I think my water broke.”So, I got back in bed. I knew I shouldn't rush anything, so I put the blanket down on the bed and laid down and tried to rest, but I was really just on the app counting contractions. Don't do that, anyone, in the future. It's not worth it. I just felt like I should have really--Meagan: It's like watching the pot boil.Carlee: Yes.Meagan: If you just sit and watch it, it never boils. The second you walk away, you're like, “Oh. What's that noise? Oh. It's boiling.” I agree, “Rest. Just rest.”Carlee: Right. So. I wasn't. I was so giddy and excited. I called the midwife and it was one of my favorite ones. I was so excited and she said, “Take some time.” Contractions were 5-7 minutes apart, which I feel like is kind of close, but I think I was probably counting them wrong. I don't know. I was all confused right then.So she said, “Take some time, but we do you want to come in to get on the antibiotics so you can get your two doses,” and so, we got in. We went to the hospital around 3:00 a.m. and contractions were pretty good. They were coming. I got to triage, which I think is the worst place ever. I do not like triage. I got checked there and I was 1.5 centimeters. I was just like, “Oh, you have got to be kidding me.” I got into a room. They took my blood. The guy came in to give me an IV and I asked them, I was like, “Hey, I really don't like needles. Could you be nice to me?” And he was like, “Oh, deal with it,” basically. I was like, “Oh, okay.” So I think right from the get-go, I just did not feel comfortable in the hospital. I felt out of place. I don't like hospitals to begin with. Just from the get-go, I was like, “Oh, I don't like this. I don't feel comfortable.” I think I shut down a little bit. They had tubs there though, in the hospital, that you could labor in, not deliver, but labor. And so, I spent a lot of time in the tub. I didn't have a doula, so it was just me, and my husband, and the information I had read from Ina May. I just tried to work with what I knew to do, so I would be in the tub, try different positions, change around. The nurses would come in and check baby's heart rate. The midwife would come in and see how I was doing, but then contractions really just spaced out and after about 15 hours of my waters being ruptured, they suggested Pitocin. I just really wanted to do natural and so I was like, “Maybe not yet.”They decided to give me half of a pill. I don't remember what it was called.Meagan: Probably Cytotec?Carlee: Yeah, something to help the contractions, I think. Is that what it is?Meagan: Cytotec, yeah. It's like your cervix wasn't super primed and ready. It's, yeah. Something that can help effacement and dilation. The contractions usually kick in a little bit with that as well.Carlee: Okay. I took it orally. Is that the same thing?Meagan: Uh-huh, yeah. They do it vaginally and orally.Carlee: Okay, because I have heard of the vaginal one. But, okay. So that got contractions a little bit closer together, but they still weren't-- they were 7 to 10 minutes apart. Just not ideal. And then, they checked me and I was 4 centimeters. So still, not really-- progress, but not as much as they wanted, you know? And so, we decided to go ahead and start the Pitocin. Oh my goodness. Wow. Those really amped up. And so, I wanted something, I needed something to help me relax, but I was so against the epidural. So they gave me something. They said, “It will last two hours. It may make you hallucinate. I don't know what it was called, but it did exactly that.”Meagan: Maybe fentanyl?Julie: Fentanyl?Carlee: Yeah, probably. Okay.Meagan: It makes you feel, a lot of people are like, “I feel high.” And like, “Whoa.” Like out-of-body and sometimes nauseous.Julie: Loopy or drunk.Carlee: Yeah. I was definitely, at one point, I was running down the street in The Lego Movie. I have never seen The Lego Movie, but I was a Lego person running. It was so weird.Julie: Oh my gosh, that's awesome.Meagan: That's the cutest.Carlee: It was crazy. So it was the middle of the night. My husband was trying to sleep and I'm trying to get some rest, but you could still feel the contractions. And so, I was getting out of bed every seven minutes and asking my husband, “Come hold my hips. Squeeze them.” So, making him get out of bed and just a rollercoaster of just-- it was awful. Once I woke up out of that hallucination, weird, daydream stuff, the nurse came in and said, “Baby's heart rate kept dropping while you were on that, so we had to stop the Pitocin, but we want to try it again.”So we tried it again and then baby's heart rate dropped again. You know, that whole stop and go, stop and go. At this point, I am 7 centimeters. I had stalled at 7 centimeters for a while. I think this was hour 30 and so, that was the first time I really considered a C-section and realizing that this was probably what might get my baby here. I still wanted to wait and they did let me wait. My midwife, I just have this vivid memory of her standing, like leaning against these cupboards, her arms crossed around her chest, her feet, ankles crossed over. She is standing up, leaning against this, and just so leaned back and not even caring. Just kind of like, “Yeah. I mean, we can do this, or we can do this.” Right? I'm just sitting in this bed like, “Oh my gosh, help me.” You know? I'm trying everything I possibly can, but I just don't know what to do. Me and my husband are just confused, not sure what to do. She was just like, “Yeah.” I was like, “Well, should we try the epidural before a C-section?” She was like, “Yeah, you could, but you'll probably just end up in a C-section.” I am like, “What? You guys are these natural-minded midwives. What?” I don't know. So that's why I was just like, “I guess the epidural won't really work.” And then, they started saying like, “What if something is wrong with your baby? What if something is stopping your baby from coming like the cord or something like that?” And so at that point, I was like, “Well, I probably shouldn't keep going. Maybe it just would be better to get her or baby, here safely.” We didn't know she was a girl yet. Get baby here safely rather than potentially having a crash Cesarean and maybe NICU time or whatever.So we did. We decided to call around 5:30 in the morning and it ended up being about 35 hours from my water breaking to go into the OR. Everything in the OR was great. Everyone was really kind and understanding. The anesthesiologist was super nice and the nurse held me while I got the needle in my back, which I was terrified of. I think probably the lowest point though, was lying naked on that table with the lights. For sure. Like, awful. But my husband came up and he got to be there. The surgeon let us know when baby was coming. We didn't know the gender, and so we wanted my husband to call out the gender. The surgeon held up the baby and he was like, “It's a boy, I think.” Everyone just laughed and helped him out. It had been a really long time, so we had to give him some slack. He was exhausted. But it was a girl and my heart was just bursting. I just wanted to hold her so bad. I was like, “That baby needs to be over here right now. They did once they did all their stuff over at the baby station.”They brought her to me and I got to hold her in the OR, and then they got me back to our room pretty quick and I got to breastfeed. Everything honestly did turn out pretty good. I still have happy feelings driving by that hospital. It's not an awful place or anything, just kind of disappointing. I remember asking my midwife before the C-section began, I was like, “Can I have a VBAC? I know my body can do this and I want to do this. I want more children.” I wasn't sure if C-sections for life were going to be my fate. But she did say, “Yes. You totally can.” I just remember driving away from that hospital with my little baby right next to me in her car seat and just thinking, “What just happened? I want a re-do. I need a redemption on this birth.” That's what propelled me into trying for a VBAC. I had all of the thoughts of, “Why is it so easy for other women? I thought I had done everything. I didn't get an epidural. Usually, it's an epidural, right, that causes a C-section? But, no.” This experience just had taught me a lot.After I had graduated from college and once my baby was a year old, we started trying for another one. I just wanted to make sure I had reached that 18 months of like, “You want your babies to be 18 months apart for an ideal VBAC chance.” I started reading books and listening to podcasts. I found this podcast which I absolutely loved. At the end of my pregnancy, I would just listen to it every night. My husband knows your guys' voices and all of that.I started to envision what I really wanted and that was ultimately no interventions. I just wanted a natural birth and I realized that the first intervention really is leaving your house, and so I really wanted an HBAC. I wanted to have a home birth. I got pregnant about four months after we started trying and I started interviewing some midwives here in the area. I interviewed one-- I just knew I needed a supportive provider.If The VBAC Link has taught me anything, it's that a supportive provider is key. And so, I interviewed one and got super excited at how supportive she was with her VBAC, or with HBAC, and thought, “Oh my goodness. This can actually happen. People actually do this.” But we didn't super connect and my husband-- we got out of the interview and he was like, “Well, that was kind of weird, but if you feel comfortable, I am comfortable.”And so, I decided to interview with another midwife here. We were playing phone tag and she called me back and said, the first thing she said when she answered the phone was like, “I cannot wait for you to push your baby out.” I don't think she could've said anything better to me at that point. I was just like, “Oh my goodness. That is exactly what I want.” That was the support that I needed and wanted. And so, we built a relationship super quick. I just felt so loved by her and trusting of her. Pregnancy went really well. Nothing too crazy, except COVID. At 20 weeks, everything shut down. It was pretty crazy, but everything was mostly at my home. She did home visits with me and then her office. Nothing had really shut down for my care, except the 20-week ultrasound kept getting pushed back. I had it at 24 weeks.But everything looked good and I was just preparing for my home birth. I made a birth goal sheet in case I did end up having to transfer. I tried to envision all different types of scenarios. I think the biggest scenario that I was envisioning of having to transfer was if I was just stalling out, labor was taking forever again, and that I would go to the hospital and get an epidural. That was fine with me. I was like, “I will do the epidural this time. No big deal if I need to. I am fine with that.” So I had all of these, just prepping for this home birth. My midwife actually works with an OB in Phoenix and transfers to him. They have a really good connection. She had suggested, “Maybe do a phone consultation with him just to get to know him and just in case you have to transfer that you will have a record with him. He will know you and you will know him.” So I did. I did that and I loved him right away. He was for super informed consent. He told me, right at the first phone call, he said, “I will never check you. I will never tell you that you need to be checked because that's assault. I will only check you if you want me to check you.” I was like, “Wow.” So that made me feel really comfortable.Meagan: That's awesome. Yeah.Carlee: Yeah. Isn't it awesome?Meagan: It is awesome. Yeah.Carlee: And so, I was just like, “Oh yes. I can vibe with him and if I do have to transfer, I will feel comfortable going to him.” Pregnancy went good. At 36 weeks, I started to feel really nauseous, especially at night, and just no appetite. You know, you're growing a baby, so there's no room. That's what I chalked it up to be. I was really achy and really tired, like, super tired. But you know, I am 36 weeks pregnant and that's pretty typical. And so, I just chalked it up to be the end of pregnancy.It turns out that those are all symptoms of cholestasis that I didn't connect until the end. So 36+6, I was laying down relaxing at the end of the night and I asked my husband, I was like, “Is there a mosquito in here?” Because whenever there is a mosquito, I always get eaten alive and he doesn't get bit at all. And so, I am like, “There's got to be a mosquito in here because I am just itchy all over.” And just frustrated. I was like, “Ugh, I hate being itchy.” You know? And so, I go to bed and I am just itching like crazy. This is no mosquito. This is more than any mosquito could ever do. I'm not sleeping at all.I start googling. You know, the worst idea to do in the middle of the night. I start googling everything, itchiness at the end of pregnancy and it comes up with cholestasis of pregnancy. I am just like, “Oh no,” seeing that I would have to be induced potentially or all of these different things. I just started having really negative thoughts and I tried to get some sleep but I cannot. So once it was more of a decent time in the morning, which, I guess there is no decent time for a midwife or a doula, I called my midwife. Oh, and I had a doula as well, I forgot to mention, but I did hire an amazing doula who was super great during my pregnancy. So, I called my midwife and doula and just let them know, “I am itching really bad. What should I do? I read that it could be cholestasis.” My midwife was like, “Yes. It could be cholestasis. You'd better get it checked out. Why don't you go to the hospital where the OB is? I will let him know that you are coming. Let's just get it checked out just to make sure. Let's do it for baby. Let's make sure that we get keep baby safe.” And so, I was like, “Okay, let's do that.” She was confident, “You're probably just going to get the test results and come back home, but maybe text us just in case you do stay and do get induced,” because that morning, I was 37 weeks. That's the day that typically they induce moms with cholestasis.So, I was just a basket full of emotions, but my midwife and doula were so reassuring and just kept saying that, “This is the best thing for your baby,” and that's what I wanted was, I wanted my baby to be safe and be healthy. I knew I could do this for baby. We decided to go to the hospital where the OB was. It was about 30 minutes away and with COVID and everything, I decided to pack up everything just in case we did stay. I wanted my baby to be in a cute outfit when he or she was born. We didn't know the gender again. We said goodbye to my daughter as if we were going to have a baby which was so weird and so hard. I was not prepared for that. Everything just seemed so rushed and so quick, that I really had to start shifting my mentality to not focusing on how the hospital was the last place I wanted to go right now and I do not want to have my baby in a hospital, but you know what? God is in control. He led me and He taught me so much with my first birth, that He can teach me so much right now and He will lead me now. And so, I just tried to give it over to God and just trust. I was so, so nervous though especially knowing that induction with VBAC is just not ideal.Meagan: Less ideal, but not impossible.Carlee: Right. Right.Meagan: Yes.Carlee: Exactly. That's what my doula and my midwife-- they were so encouraging. Like, “You can still do this. You can still have your VBAC. This is not a one-and-done, end-all, be-all. And so, I was just trying to say very positive. So, I got to triage and it was just me allowed. Husbands weren't allowed because of COVID. I got there around 11:00 a.m. I just thought it would be an NST and blood draw. The OB came in and explained to me my options, and what could happen once I got the results, and just very much informed consent. I got my numbers back and they were some of the highest he had seen. He would have let me leave. He would have let me go home and try to get labor going on my own, but I just felt like it was best to stay and to get induced because I wasn't sure what this was, you know? And because it can be scary with losing your baby. I definitely did not want that. And so, I just felt like it would be best to stay.I was there basically all day. They were really busy that day. I was just in triage and the little curtain you can't go around because of COVID, so I'm just staying there trying to stay up. I was doing squats in the little curtained area. I'm trying to do all these positions. It was very weird. But my nurse in triage was so comforting when I told her I was trying for a VBAC. She got so excited and said, “Oh my goodness. The hospital has a 95% VBAC rate.” All this great stuff. I was like, “What? Oh my goodness.” Super exciting.She actually ended up visiting me every night in the hospital after that. After her shift, she would come by and say, “How are you doing? Where are you at? How's the day been?” Because I was there for multiple days. She was really comforting at a time that I was so, so confused and unsure and just scared, you know? That was very nice.I didn't get back to my room until 7-7:30 because they were so busy with cases more severe in mine and so they were like, “Oh she gets the next room. Sorry. She gets the next room,” which I was grateful for, but it was also just like, “I am so sick of being here and my husband couldn't be with me.” Anyway, trying to remain positive and grateful, but I finally got back to my room. My nurse, her name was Beth. I still remember her. She came back to my room. She was an old lady and she looked a little like, I don't know, a little scared. I am like, “Okay, this is not going to go well,” but she ended up being the most confident in my induced VBAC. She was like, “Oh honey, you've got this. You're going to be so great.” I was trying to go natural. She was all for me trying nipple stimulation first. We got a little breast pump set up and she was like, “Do you want a show? You guys just enjoy your time here.” Super sweet. Super nice. So we turned on The Office and watched a couple of shows or whatever and got some contractions going, but nothing serious and nothing to write home about. We decided at that time to start Pitocin. And at that point, I hadn't had an IV yet. I hadn't gotten checked. So the OB came in and he checked me. I was 0 centimeters and 0% effaced and very high up which, I mean--Julie: Oh my gosh. How frustrating. If you're 37 weeks, you kind of expect that, but when you're trying to have a baby now, it's just gotta be hard.Carlee: I was like, “Wait. My baby needs to come.” But yeah. My doula was like, “Carlee, you are 37 weeks. That's exactly what you should be.” I was like, “Oh yeah.” No one was concerned about that. They were like, “Yep, that's fine.”Meagan: That's such a good point. Such a good point right there. That's exactly what you should be. I love that.Carlee: Right.Meagan: Because you wouldn't expect to be 4 centimeters at that point, right?Carlee: Right. I didn't want to be.Meagan: Like, you're really early. Yeah.Carlee: And so, it was a good-- like, “You're exactly where you should be.” And I was like, “You know what? That's right. That's good.” So, I got the IV in, which I hated again, but it was better and started at the lowest low of Pitocin which I made sure, because of what I have learned here, that you start at a 2 and move up 2 every 30 minutes, right? On Pitocin?Julie: Yeah, or longer. You know, 45 minutes to an hour. Yeah.Meagan: I like to say an hour. I like to suggest to my clients, to encourage an hour because it really takes 30 minutes for the uterine receptors to receive it and start acting. And so, it's hard to know what it's actually going to do at 30 minutes because we haven't given it time to actually do it. Does that make sense?Julie: Yeah, it actually starts responding within minutes, but it takes 45 minutes for the full strength to hit the uterus. So you're not contracting to the level you adjusted it to until it has been 45 minutes. So if you're adjusting every 30 minutes, you're contracting based on the dose you got two times ago instead of the last dose. I don't know if that makes a lot of sense.Carlee: Yeah. I think they were doing every hour. I can't remember. I was like, you know, and it hurts. I'm pretty sure they said every hour because they were very VBAC friendly and everything. So I think they were doing that, but I am not sure. But it ended up working out. So that night, on and off throughout the night, and then at the shift change the next morning, the OB checked me and said that I was 2 centimeters and 50% effaced, which, I was bummed because that just seemed like my fate in birth is just going so slow. But everybody else was so excited about that. They were like, “You made so much progress over the night.” I was like, “What? Okay. I guess so.”They were just so happy because, at that point, we could try and get the Cook's catheter in, which, I have always heard about the Foley bulb, but my OB wanted to do the Cook's catheter. I don't know if you want to try and explain that.Meagan: I mean, it's pretty similar. Cook's catheter actually has better results. But I mean, it's similar. It's a catheter that goes into the cervix and is inflated like a balloon on the other side with the saline. It puts pressure on the cervix which is like a manual dilation, then it eventually, once the cervix is open, it just falls out. So people all around the world, you know, it just depends. It's honestly a doctor's preference and sometimes it's what the hospital has. It's either a Foley or a Cook. But essentially they are the same.Julie: Yeah. The Cook's just puts pressure on both ends of the cervix and the Foley bulb just pulls from the outside, or from the inside, towards the out.Meagan: It pushes pressure down. Yes. It pushes down.Julie: From the inside of the cervix to the outwards, yes. It pushes down on the cervix. That's right.Carlee: Gotcha. Okay. So, yes. So he tried to get that in twice and it was not working. I was like, “No, no, no. I have to do this. This is the only way.” You know? I am just having all these negative thoughts, but he was like, “You know what? Try and relax. We're going to take a break.” And then his wife who is actually a certified nurse-midwife, they own a practice together and work in the hospital together and everything. He was like, “I will have my wife come in and try. She's got smaller hands,” or something. And so, she came in two hours later and she got it in the first try which was exciting. So she took over my care from then on. I don't know, but it was great because I loved her too. So we continued with Pitocin, moving around. We would go up to the full amount of Pitocin and then take an hour break, then get back on. Eventually, so the catheter was put in at 9:30 and then the catheter fell out at 9:15 when I was on the toilet. It was the most exciting moment ever because my body was actually working and I just couldn't believe it. I thought they were going to have to deflate the fluid and take it out manually or something.So my body was working and they checked me that night at 7:00 and said I was a 6. So I was just super excited. I was a 6. Contractions honestly, were pretty consistent, but I was able to breathe through them, no big deal. And through the night again, I labored with Pitocin. Lots and lots of Pitocin trying to give birth. But it was nice. That night, the nurse was there. She was amazing and she was talking sports with my husband which, I think, super helped for him. He had just been in this birth world for going on 24+ hours, and so just having the sports talk with her was super exciting and super nice for him. It gave him a nice big mental shift and excitement.The next morning, Ellie came back to check me. I was still a 6, but kind of 7 centimeters and 80% effaced. So again, it was easy to feel discouraged. That was a whole other night of laboring and Pitocin. My doula decided to make her way over because she couldn't leave once she got there. And she had four other births going on at the same time, so I felt really bad, but she was a saint and came in. She and my nurse gave me some new positions to try to help baby labor down and it was a huge help. The positions just helped me a ton. Hands and knees, ball, toilet, side-lying, all of the things. I couldn't walk the halls but was just trying to stay active. Also, trying to remind myself to rest because it had been so long and just to be okay with slow because sometimes that is okay and my baby was, her heart rate was amazing. Sorry, it was a girl again. I blew it again. But it was a surprise for us. So she was amazing and probably what let me keep going this long.At the end of the night, Ellie, the nurse-midwife, was in the office all day and she didn't like having other people check me or do anything. And so, we waited until she got back to do anything else. But around 4:20 that afternoon, I was laboring on the toilet and trying to stay positive knowing that 7 centimeters was where I got stuck with my daughter. I knew that there is usually a wall when most women are trying to VBAC and was trying to get over that. As I'm sitting on the toilet, I feel my baby drop. I had never experienced that before, and so to feel her drop down and get into my pelvis, I broke down. I lost it. I started crying and saying, “I can do this. My body isn't broken. I can get past the 7-centimeter hump.” And just the biggest motivation for me. My doula actually got a picture of me on the toilet and it's one that I will cherish forever. It's amazing just seeing the confidence in me that knowing that I could do this.I got checked again and I was 7 centimeters still, but 90% effaced and at 0 station. I made some big progress. We decided to have my water broken, which I thought a lot about but decided we need to get this going and it will be the next best step. And so, I got my water broken and then contractions amped up a ton. I asked to turn off the Pitocin. I was doing it on my own now. I got in the shower, but I had to get out of the shower because they wanted to keep checking with the monitors. Those portable ones weren't staying on. I just really wanted the birth tub like I had envisioned during transition to be totally in the tub, and relaxing there, and breathing through, but I was not there. I was in a hospital where I did not want to be. I came to realize that I should probably get the epidural to give me the biggest shot at this. It was around 7:30 at night. I got the epidural and it worked pretty good. Yeah, it worked pretty good. That's about it.We were able to rest until about 11:30 and I got checked. So, four hours later, and I was complete and at +2 station. We were all so, so, so excited. I got to labor baby down for about another hour and then I started pushing. And pushing with the epidural was not my dream. I couldn't really feel what I was doing. I felt pretty ineffective, but soon I got to reach down and feel my baby which was super cool. Even at this point I still was like, “I could have a C-section at any point.” Like, they could still wheel me back. I was not positive. Although, I guess when I touched the baby's head, I was pretty close. I don't know if-- I doubt you can have a C-section at that point.I don't know, but it was really exciting. And so, towards the very end, I started feeling really nauseous and as I was pushing, I started to throw up. It was really glorious having my husband hold a throw-up bag as I am pushing. Everyone was coaching me, like, “Come on. You can do it. Push harder.” And I am puking my guts out. I think that happened through four contractions. I definitely-- I threw up pushed my baby up which was so weird, but pretty cool I guess. I guess that's pretty common, being nauseous and throwing up at the end.Julie: Yeah.Meagan: It definitely is because a lot of things are shifting, too. As baby is moving down, our organs and all those things that have been pressed up and jumbled around to make room, they're moving and shifting, and so sometimes it can make us nauseous.Julie: They are starting to let loose.Meagan: Plus, we are holding our breath during pushing and that in itself can make us nauseous, and then we get hot and that can make us nauseous. So it's all just--Julie: A hot mess.Meagan: Yeah.Carlee: That was me. That was me at the end. Yeah. I threw up and she came out, but I got to pull her up on my chest which was the most amazing moment ever. Something that I wished with my first baby I could have done. But it was amazing. So I got to pull her up, do skin-to-skin with her for two hours or whatever, and then, yeah. That was my birth, basically.Julie: That's exciting.Meagan: Aww. Congratulations.Carlee: Thank you.Meagan: I know. It is such an awesome feeling. So, question. After you had your baby, did you feel much better and feel less like you had cholestasis? Did you feel better?Carlee: Yeah. It was interesting. Once I got to the hospital and started the whole labor process, I really didn't feel itchy again which was weird, but I don't know. I guess I just needed to get to the hospital and then my body could relax. I don't know. Yeah. I didn't really have any more itching after getting there and then after having the baby, yeah. My nausea went down. My achiness, you know, all of those things. So yeah, it left right away, which, I know sometimes it can stay on for a couple of days or so, but--CholestasisJulie: Yeah, usually it resolves pretty quickly after the baby is born. It is so interesting. I just want to talk a little bit about cholestasis. It's actually not that complicated of a thing to understand. But it is something that you usually don't really hear about until you have it. Right? So cholestasis is actually a problem with the liver. It affects the liver. It either slows down or stops the normal flow of bile from the gallbladder. So it can cause itching, which is the first symptom of cholestasis, and then it can turn into jaundice-type symptoms like the yellowing of your skin, eyes, and mucous membranes. Essentially, it starts deteriorating your liver. And then, if you have problems with your liver, then it can also cause problems for your baby which is why they recommend inducing cholestasis around 37 weeks if things aren't looking too bad. Sometimes they even recommend it at 36 weeks. Usually, it develops later on pregnancy, but sometimes it can show up in early pregnancy, which would mean you would need to transfer to a maternal-fetal medicine or a high-risk provider pretty quickly in order to manage that.So, pretty simple right? It affects the liver and it affects its ability, it stops the normal flow of bile, which kind of sounds really disgusting, but it is just a normal body function. Yeah. And the cool thing is, I really love this story because we were talking about cholestasis, which, I don't know that we have had somebody with cholestasis on, have we?Carlee: You had one.Julie: Did we?Carlee: I listened to it, yeah.Julie: Oh, so we did have one. But it has been 170 episodes. You guys, I can't even remember. I wish I could remember every single topic that we have talked about. But also, with the cholestasis, and then you had an induction at 36 weeks with a cervix that was not showing any signs of being favorable and a nice, patient birth team that let her go low and slow on the induction, and she had a long labor, which is kind of expected when you are 37 weeks pregnant. But with the patience of her birth team, and the support of her doula, and her ability to make decisions regarding her care, all set her up for a nice healthy VBAC. Now, I'm not saying that every time you have this scenario, sometimes it is not going to go that way, and sometimes a repeat Cesarean will be needed because if your body is not responding to labor, it's just that a whole bunch of things come into play.But I really like hearing stories of an early induction or preterm induction. I guess you were right on the brink of the early term category at 37 weeks. But I love hearing those stories of success because it gives people hope when they do have things that are mesically-- I just combined medically and necessary into one word. Medically necessary for the baby to come out, you don't have to go right to a C-section, although in some circumstances it might be the best choice. But where induction is an option still, you can have that induction and be patient, and be prepared for the long-haul because honestly, a 37-week induction is probably not one of those ones that is going to take two hours, and then you have a baby. It is probably going to take a couple of days. As long as you are set up with the right mindset for that and you have a patient team, then you are going to have a really good chance of having a good birth experience and an even better chance of having a VBAC because patience is the key when we are working with earlier inductions.Meagan: We said earlier that obviously, induction is not the most ideal. It is just not, but it's not impossible. When you have providers like Carlee did, it is so possible. It is extra possible because they have got patience, they understand the physics of birth, and what the cervix does, and what the cervix needs. A lot of the time, it just needs time, like Julie said. Usually, you don't go in, unless you've totally had a baby before, I wouldn't say that it is impossible to have a baby within 24 hours. A lot of the times, you go in in the morning and have a baby by 3:00 p.m., but when you haven't had a baby vaginally before and your cervix hasn't gotten all the way there yet and things are different, it just takes time. It takes a lot of time and the biggest thing, one of the biggest things that we talk about in our VBAC course a lot is finding a good provider that you trust and that trusts you because if your provider doesn't trust you, that could be a problem.Julie: Yeah. You need trust both ways.Meagan: Because that means your opinion, yeah. Your opinion won't matter as much because they don't trust you, right? So you need to trust them. They need to trust you. And all of us need to trust birth. We need to trust birth. We need to trust our bodies, that our bodies can do it. It just needs time. You know, from my birth, I likely would have ended in a C-section if I were in a different place because it was 42 hours and I was stuck. I was a certain centimeter for a really long time and I was exhausted. It was rough. And it's just, yeah. I can't stress a good provider enough. So, so proud of you, love and congratulations again. Thank you so much for sharing your story.Carlee: Thank you guys so much.ClosingWould you like to be a guest on the podcast? Head over to thevbaclink.com/share and submit your story. For all things VBAC, including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan's bios, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Nat chats with  twin mom Lucy Graham about her twin pregnancy after IUI, a diagnosis of cholestasis, C-section delivery at 35 weeks, how the newborn stage went with feedings and sleep, what it's like with a 2 mom family, and what her day-to-day life is like with 7-month-old twin girls.Twins Tale is sponsored by Zoe Strollers. Be sure to check out their awesome twin strollers here.Lucy Graham is originally from the East Coast but has lived in Hawaii for 16 years. She moved for grad school and never looked back. She met her wife in 2016, got married in 2018, and they decided to try to have a baby in 2019. Lucy got pregnant on their second IUI attempt and they were completely shocked to find out a few weeks later it was twins (especially because they had been told there was one egg). Lucy was an elementary special education teacher but now works from home as an editor while her wife travels a lot for work (or did pre-COVID). They now have 7-month-old fraternal twin girls and are still shocked on a daily basis that there are two!BabyBuddha portable breast pumpMAM Perfect Night Pacifiers - 6 months+Owlet Smart SockSkip Hop Activity CenterSUBSCRIBEMake sure to SUBSCRIBE to A Twins Tale for more awesome stories of twins at ages and stages from birth to college, from the creators of Twiniversity.If you liked this podcast, check out the Twiniversity Podcast with Natalie Diaz!MEMBERSHIPSign up today for a Twiniversity Membership! Choose from 2 levels starting at $6.99/month to connect with other parents of twins in a monthly Zoom twin club, build your twin parenting community in our private Facebook group, and expand your twin parent knowledge with our video learner library. Click here for details.FIRST YEAR WITH TWINSAre your twins in their first year? Check out our free First Year with Twins resource to learn tips, advice, and ideas for getting through your first year with twins!BABY SAFETY COURSEOffered on-demand, the Complete Baby Safety Course includes 30 instructional videos on infant, toddler, and child CPR, a variety of first aid techniques you may need with kids, a full explanation about different kinds of car seats and how to install them, and a room-by-room description of how to best childproof your home. Click here for details.CONTACT USVISIT Twiniversity.com for tons of free twin tips!FOLLOW us on Facebook, Instagram, Pinterest, YouTube, and Twitter.SUBSCRIBE to our email newsletter!

In episode 112 of Kiwi Birth Tales I speak with Sophie and she talks us through her pregnancy and birth stories with her 2 boys and angel baby Violet. In this episode we discuss: - Chemical Pregnancy- Cholestasis - Induction- Ventouse - Episiotomy- Miscarriage at 18 Weeks - Loss - Postpartum period after loss- Retained Product- TTC- Difficult PP recovery

Mathusha is at the end of her maternity leave and heading back to work. Meanwhile, Adriana is expecting her third child and talks briefly about cholestasis of pregnancy. What is it and when should you advocate for yourself? --- Send in a voice message: https://anchor.fm/coffeeandbottles/message

Nat chats with Linda Grein, mom to three boys (ages 2, and 9-month-old fraternal twins), about her twin pregnancy (including a cholestasis scare) and delivery, the early days with twins, and how she's managing life with 9-month-old twin boys plus a toddler boy. Twins Tale is sponsored by Zoe Strollers. Be sure to check out their awesome twin strollers here.Linda Grein has worked in traditional public, public charter, and private schools around the US as a teacher, an administrator, and now a math coach for schools. She supports schools (now virtually, due to COVID) on strategic planning, professional development, and building internal capacity so that teachers can be supported to create fun, engaging math learning for kids. Although her work isn't aimed towards parents, with the onset of COVID-19 and the uncertainty about schools Linda is determined to support anyone in creating positive math learning spaces and experiences for kids. Find more about resources, webinars, and her constant vetting of all resources out there at eduquatellc.com.Pregnant with intense itching? It could be CholestasisSlumberPod - Take $60 off the purchase of two SlumberPod2.0s or two SlumberPod2.0 combos (with the fans) with the code TWINS2020. This code can be used on both their US website (slumberpod.com) and Canada website (slumberpod.ca).Precious Little SleepSUBSCRIBEMake sure to SUBSCRIBE to A Twins Tale for more awesome stories of twins at ages and stages from birth to college, from the creators of Twiniversity.If you liked this podcast, check out the Twiniversity Podcast with Natalie Diaz!MEMBERSHIPSign up today for a Twiniversity Membership! Choose from 2 levels starting at $6.99/month to connect with other parents of twins in a monthly Zoom twin club, build your twin parenting community in our private Facebook group, and expand your twin parent knowledge with our video learner library. Click here for details.FIRST YEAR WITH TWINSAre your twins in their first year? Check out our free First Year with Twins resource to learn tips, advice, and ideas for getting through your first year with twins!CONTACT USVISIT Twiniversity.com for tons of free twin tips!FOLLOW us on Facebook, Instagram, Pinterest, YouTube, and Twitter.SUBSCRIBE to our email newsletter!

After naturally conceiving twins, Alina and her husband were told by doctors that one of their twins would pass away shortly after birth.

Donna Benavides, Founder and Chair of the non-profit ICPcare.org joins host Chris Stallman, a certified genetic counselor, and special guest expert Alfred Romeo, RN, PhD to talk about the less known condition of Intrahepatic Cholestasis of Pregnancy (ICP). Chris and Alfred answer commonly asked questions Donna receives through her supportive community of pregnancy women affected by ICP. This episode contains evidence-based information that's current as of the day published and may change as data emerges. To get the very latest information about this topic in pregnancy/breastfeeding, please contact a MotherToBaby specialist at 866-626-6847, via text message at 855-999-3525 or through https://mothertobaby.org. 

In this episode we meet Kristi, a mum of two living with her husband and two boys in Brisbane. In Kristi’s first birth she was recommended an induction due to Obstetric Cholestasis (liver disorder presented in pregnancy which causes itchiness). Despite dilating to 10cm and reaching the pushing phase of labour, Kristi was taken into theatre for an emergency caesarean. She did not know what actually caused her caesarean until years later.After a difficult start to breastfeeding which involved a tongue tie, Kristi was diagnosed one year after her birth with post-traumatic stress disorder (PTSD) and she bravely and honestly shares the forms this took with her and her coping mechanisms to deal with the psychological trauma inflicted by her first birth. Sadly up to 1 in 10 Australian women emerge from their birth with PTSD.Kristi understandably really struggled with the decision on whether or not to book an elective caesarean or go for a VBAC during her second pregnancy. This was compounded by a meeting with an obstetrician who gave her a less than 40% chance of having a successful VBAC as he suspected she may have a narrow pelvis. But ultimately, with the support of her husband, her primary midwife from her public hospital’s Midwifery Group Practice (MGP), and her doula, Kristi went on to naturally birth her 4.75kg (10 lbs.) baby.~ Notes ~Resources Kristi used:Book by Dr. Kristin Neff:https://self-compassion.orgBirth education:https://evidencebasedbirth.comDoula:https://www.idealbirth.com.auBirth Trauma and PTSD support:PANDAhttps://www.panda.org.au/info-support/after-birth/child-birth-traumaCOPEhttps://www.cope.org.au/preparing-for-birth/things-dont-go-plan/post-traumatic-stress-disorder-ptsd-2/The Gidget Foundationhttps://gidgetfoundation.org.au/get-support/,Beyond Bluehttps://www.beyondblue.org.au/get-support/get-immediate-supportPregnancy Loss:https://www.bearsofhope.org.auhttps://rednosegriefandloss.org.auhttps://miscarriagesupport.org.au**VBAC Birth Stories features women's lived experiences. It is not intended to replace medical advice. Should you have any concerns during your pregnancy please always consult your healthcare provider.Please connect with us on Facebook or Instagram: @vbacbirthstories

Boss mama of two Keeley describes her journey into motherhood. In this episode young mum Keeley talks about her pregnancy being very challenging - suffering from preeclampsia & Cholestasis. We hear how she went into labour at 35 weeks and was in labour for a long time but ended up having an emergency c-section. Keeley goes on to chat about her experience having a baby in NICU & her challenges in postpartum. Her journey and experience has lead her into doing birth photography and has even interestered her into becoming a doula. This mama is a true inspiration - she has had a lot of life lessons , especially coming into motherhood and has so much wisdom & powerful advice to give to other mamas. You will get so much from this episode

In today’s episode, we return to our cesarean birth stories that were scheduled for last month’s Cesarean Awareness Month following our 3-week detour to share birth stories taking place during the Covid-19 pandemic. Do be sure to give us a follow over on Instagram or Facebook (both @birthmattersnyc) for some educational content on this topic that we posted last month. The month of May will be the last few episodes of our first season, as we'll be going on hiatus for the summer to prepare lots more great content for the fall. Today, Amanda & Grant share their firstborn’s birth story. Amanda describes how she developed cholestasis during her pregnancy, which is a medical indication for induction. She’ll describe the reasons that the way her labor played out led to baby needing to be born via cesarean. While this was not what Amanda had wanted after she had planned for an unmedicated birth with a midwife and doula, it was still an overall positive birth experience for her due to the compassionate care she received from everyone around her, including her partner, Grant. Get ready for all the feels when you hear both Grant and Amanda express love, admiration, and appreciation for each other throughout this momentous life experience and how this aspect helped everything feel like an overall sweet memory. Amanda will also share a bit about the early challenges she and baby faced as they started breastfeeding.

By your fourth birth, there’s no way you’re trying anything new, right?   Hey there Happy Homebirthers, and welcome to episode 71 of the Happy Homebirth Podcast, where we’ll be speaking with Kerrie, who went from a string of 3 inducted hospital births to an intervention-free homebirth.   Before we jump in, I’ve got news!  Happy Homebirth Academy is set to launch in just a few short weeks!  Tell all of your friends!  And if you’re a birth worker interested in checking out the program, give me a holler at katelyn@myhappyhomebirth.com or DM me on instagram.  I’m hopeful to let some fellow birth workers take a look before launch day… provided I have it ready.   I am so excited about the content of this course.  It’s perfect for your first, fifth or tenth birth, whether you’ve had them all at home or all in hospital, and it gives you the tools have an empowered, mindful, peaceful homebirth.  It’s my third baby.  SO.  To keep updated with the launch, be sure to join the Happy Homebirth Pop Up group on facebook, or check out my free homebirth essentials mini course! It’s a quick little guide to some of the most important aspects of having a peaceful homebirth.  Just go to myhappyhomebirth.com/essentails for your download.   Show Notes:  Kerrie used a traditional obstetrician practice for her first baby. At the end of her pregnancy, she was diagnosed with Cholestasis of pregnancy, which is when the liver stops filtering out bile acids, which can be dangerous for the baby. She was induced at 38 weeks pregnant Looking back, there were several aspects of the labor she was unhappy about.  They did internal fetal monitoring, so her baby had a probe stuck in her head, and Kerrie wasn’t able to move around because of this.  The doctor threatened to wheel her to have a c section, and then said she was going to cut an episiotomy, which she also was very unhappy about. At that point Kerrie roared the baby out! For her next pregnancy, she thought that she had Cholestasis again.  She felt uncomfortable, so she went in at 37 weeks to have an induction. Her second labor took a very long time.  Once her water was broken, her son came 15 minutes later. She had been asking them to break her water for a long time! Her third pregnancy, she had no symptoms of Cholestasis. At 39 weeks, she was given the option to have an elective induction, and she said, “Yes, please!” With her third baby, she elected to get an epidural.  Once she finally got it, she laid back and his head emerged. Her third birth was the first time that she had requests that went against the typical routines of the hospital.  She didn’t want the baby bathed or vaccinated, and she felt that she had to fight and wasn’t being heard When she found out she was pregnant again, she was confident that she was having a homebirth. When she began telling people she was going to have a homebirth, people told her she was crazy. Her midwife connected Kerrie with a neighbor who had also had a homebirth.  This neighbor introduced Kerrie to an entirely new, crunchy tribe, who accepted her family with open arms. With her 4th baby, she was convinced she wasn’t in labor because she was so used to pitocin contractions. Kerrie’s water broke, and she got in the tub. Her neighbor called the midwife, and the midwife told her not to let her get in the tub.  She knew Kerrie’s baby was big, and she knew that getting in the tub would likely let her relax, and she worried she’d have the baby without her. Her labor was only an hour and a half in length. Kerrie’s community gets together with all 40 children for dinners weekly.  This was so special for her postpartum.  Everyone was checking in on her and taking care of her— never expecting to hold the baby, only doting on her.   Episode roundup: Just because you’ve had 2, 3,4 or 10 babies one way doesn’t mean you automatically have to do it the same way next time.  Kerrie went from 3 inductions to an unmedicated, untouched homebirth.  You can change your situation! Wasn’t it beautiful to hear how Kerrie gained such a supportive community?  This is so important postpartum, and it sounds like she was truly cared for and doted upon postpartum.  I loved hearing how she was cared for so well as her baby struggled with breastfeeding.  What a difference our community can make.  I encourage you to reach out to the other mothers around you.  Even having one or two friends or family members who can walk through the postpartum journey with you can make a world of difference. Okay my friends, that’s all I have for you this week.  Go download that free mini-course, and I’ll see you next week!

In the next episode of Bowel Sounds, hosts Dr. Jenn Lee and Dr. Peter Lu talk to Dr. Bill Balistreri about neonatal cholestasis. Dr. Balistreri is a pioneer in the study of pediatric liver disease and a former NASPGHAN President. We talk to him about why babies with jaundice past 2 weeks of age need further testing -- and why this is an important topic for not only pediatric gastroenterologists but also for pediatricians and parents. We review causes of cholestasis in infancy, including biliary atresia. We also discuss his career thus far and advice for younger trainees and faculty.As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.References:Guideline for the Evaluation of Cholestatic Jaundice in Infants: Joint Recommendations from NASPGHAN and ESPGHANProduced by: Peter LuSpecial requests:Thank you to everyone for listening to our podcast. If you enjoyed this content and thought it was useful, we ask you to consider doing any or all of the following three things:Tell one person that you think would like this type of content about the podcast. We want to reach more GI doctors and trainees as well as general pediatricians, pediatric residents and medical students.Leave a review on Apple Podcasts -- this helps more people discover our podcast.You can also support the show by making a donation to the NASPGHAN Foundation via the link below.Support the show (https://www.naspghan.org/content/87/en/foundation/donate)

The low down on the salty itch. From everyone's favourite bud: Dr AB herself!

In this episode I am excited to welcome Nicole Phelps! Nicole is a philanthropist who spends the majority of her volunteering with the Michael Phelps Foundation, which promotes water-safety, healthy living, and the pursuit of dreams. In addition to her efforts with the Foundation, she also supports events and programs with Make-A-Wish and Operation Shower among others. A mother of three boys, Phelps is a “Mommy Advocate” and works to bring awareness to the challenges of motherhood by sharing her personal experiences through content campaigns, social media platforms and speaking engagements. A former marketing professional with YP, Phelps graduated with honors from the University of Southern California’s Annenberg School of Communications and Journalism and also cultivated a successful career in pageantry, being named Miss California USA 2010. She currently resides in Paradise Valley, AZ with her husband, Michael, their three sons (Boomer, Beckett, and Maverick) and two French bulldogs (Juno and Legend). Hear Nicole share her pregnancy and birth stories, and particularly her experience with cholestasis during pregnancy – a liver condition that can cause severe itching and other symptoms, and carries the risk for serious complications including stillbirth. We discuss the evidence on cholestasis, and the vital members of Nicole’s birth team who helped her along the way. Connect with Nicole Phelps on Instagram and Twitter. For more information and news about Evidence Based Birth®, visit www.ebbirth.com. Find us on Facebook, Instagram, and Pinterest. Ready to get involved? Check out our Professional membership (including scholarship options) and our Instructor program. Find an EBB Instructor here, and click here to learn more about the Evidence Based Birth® Childbirth Class.

In today’s episode I chat to Amy Gerard who discusses her three pregnancies and births with the honesty and humour that she’s so well known for on instagram. Amy and Ryan had only been dating for seven months when they unexpectedly fell pregnant with their daughter, Charli. Amy suffered severe nausea, migraines and nosebleeds and later into the pregnancy developed Polyhydramnios; a condition that creates excess amniotic fluid. As a result, Amy gained 30kg and when her waters broke at 37weeks, she lost 15kg in fluid overnight.   After going into the birth centre for a stretch and sweep, Amy returned home to labour but whenever she called the hospital to update them on her progress, they encouraged her to stay at home and come in the following day. She admits she felt really unsupported and was understandably upset. Eventually she heeded the advice of her mum who encouraged her to present to the birthing suite. At this stage she was stressed and anxious and not coping with the growing intensity of her contractions. “I had no idea what to expect…I had no idea what was happening and where I was at. I had fear of the unknown and it had gripped me,” she says.   After requesting an epidural, the anaesthetist had to administer it three times before it worked as Amy’s excess fluid made it very difficult to find the exact spot. Once she was pain-free she happily laboured for a few hours till she reached full dilation and when the epidural started wearing off she began pushing. Second stage took roughly 40minutes and Amy admits that she dug deep to access energy that she never knew she had. Charli fed well from the start and whilst Amy felt like she had been hit by a freight train, she returned home after two nights and settled well into new motherhood. However, she admits that the emotional rollercoaster of the first few weeks took her by surprise; she was teary, anxious and exhausted and perplexed by the fact that her new baby didn’t come with a how-to guide.   Eleven months later Amy and Ryan got married and she fell pregnant soon after with baby Bobby. Bobby’s pregnancy was a very smooth ride and apart from six weeks of antenatal depression during her second trimester, Amy enjoyed the whole experience. However, late in her third trimester she started to get itchy hands and feet, so much so that she would scratch at her palms with a hairbrush and brush her hands against brick walls. She casually mentioned it to her midwife at her 37weeks appointment who sent her straight for a blood test. The results came back the following day and her bile acid levels were incredibly high; she was diagnosed with Cholestasis and induced a few days afterward. “The drip was administered and my waters broke and then I closed my eyes and lay there, listening to my music and focusing on my breathing. Ryan was rubbing the bottom of my leg and as the contractions were building I completely zoned out and thought about the lady in my calm birth classes who taught me about breathing techniques,” she says. Her midwife encouraged her to focus on opening her bottom with each exhalation and before long she felt like she was ready to push. “I was like: Yes, I did it! I pushed him out in 14 minutes! From when the drip went in to holding him in my arms was 90 minutes. I honestly felt great!”

Pregnancy Podcast – Episode 36: ICP/Cholestasis and Self Advocacy with Meg Brunson  For the full show notes, visit: https://growingourfamily.com/s01e36/   Meg Brunson is a mom of 4 and the host of the FamilyPreneur Podcast. She is here to talk all about ICP (also known as Cholestasis) and Self Advocacy during Pregnancy.  Show Notes Facebook Group: “Growing […] The post 36: ICP/Cholestasis and Self Advocacy with Meg Brunson appeared first on Growing Our Family Podcasts.

Isabella shares her journey to birthing Baby Willow as well as her struggle with Cholestasis in pregnancy as well as her process to make the decision to wait on a procedure to be done until her daughter is at an age to have a say in the matter. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Today you get a 2-for-1 -- 2 birth stories from one mama. Melissa has an almost 3-year-old, Segovia, and a 6-week old, Adelina. She shares her first 1st birth story, which was an unusually quick, 6-hour induction with no pain meds and with doula support. Then she shares her rationale for switching care providers from an OB over to working with a hospital midwife for her 2nd baby’s birth, which was an even faster, 4-hour, unmedicated labor.

Natalie had both her children through midwifery care in Melbourne. Her first pregnancy was quite straight forward and she delivered her first son at 36 weeks without pain medication. Reuben had a severe tongue tie and she was unable to get him to latch. Natalie expressed around the clock and bottle-fed her little boy. He wasn’t sleeping well and she wasn’t able to enjoy him as she was constantly pumping, feeding and resettling. It wasn’t until Reuben was one-year old that Natalie realised that she had post natal depression.   To hear more about Natalie’s story and how she developed cholestasis tune into this weeks episode.   Topics include: postnatal depression, midwifery care, tongue tie, cholestasis

A podcast on obstetric cholestasis from a clinical perspective. This podcast is intended for medical and midwifery students and was made as part of an assignment for the UCC Obs and Gynae Masters by an SHO in obstetrics and gynaecology.

In this episode of whining moms Jacki is joined by Chrissy, a mom to a 4 month old boy! They discuss Chrissy's ambition and businesses and the choices her and her husband have made for their family. They also discuss how Chrissy's diagnosis with Cholestasis effected her birth plan and delivery!

Author: Gretchen Hinson, MD Educational Pearls: Clinical manifestations of severe hypothyroidism may include: Pale, cool, diaphoretic skin Myxedema is the non-pitting edema seen in hypothyroidism Hypothermia, heart failure, hypotension and shock Shortness of breath Cholestasis, constipation Encephalopathy and coma   Mortality is 30-50% Specific treatment includes thyroid hormone (T3, T4, or both) and glucocorticoids (for potential adrenal insufficiency)   References: Kwaku MP, Burman KD. Myxedema coma. J Intensive Care Med. 2007 Jul-Aug;22(4):224-31. Review. PubMed PMID: 17712058. Ono Y, Ono S, Yasunaga H, Matsui H, Fushimi K, Tanaka Y. Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan. J Epidemiol. 2017 Mar;27(3):117-122. doi: 10.1016/j.je.2016.04.002. Epub 2017 Jan 5. PubMed PMID: 28142035; PubMed Central PMCID: PMC5350620. Lee CH, Wira CR. Severe angioedema in myxedema coma: a difficult airway in a rare endocrine emergency. Am J Emerg Med. 2009 Oct;27(8):1021.e1-2. doi: 10.1016/j.ajem.2008.12.027. PubMed PMID: 19857436. Summarized by Travis Barlock, MS4 | Edited by Erik Verzemnieks, MD

The Brave Files returns this week with an inspiring story of friendship, surrogacy, and jumping into a familiar unknown. Heather sits down with longtime friend, Karen Kitto, this week to talk about her brave and selfless decision to be a surrogate for friends who were unable to carry their own children.One day about 10 years ago Karen had a random thought that simply wouldn't go away. She thought about being a surrogate for her friends, who were struggling to have their own children. Karen describes the decision as her “buying them admission to the amusement park.” She could carry the baby so that they could have the lifetime adventure of parenthood. After one failed attempt to inseminate, Karen was surprised to learn she was carrying two babies! It was a wonderful shock to her and to the mother of the babies.As with all stories, there were some struggles. Learning to juggle caring for Juggling taking care of her own two children and carrying two babies was a difficult job! She also developed Intrahepatic Cholestasis during the pregnancy which resulted in an early c-section.All in all, Karen says she would make this sacrifice again if presented the opportunity.Details show notes here.

Julie needed to find purpose in her pain and to let others know that infertility can have a happy ending. But she was still “in the infertility closet” and valued her privacy. Then she discovered our podcast while on a road trip. This is her story. -- For more about Sarah’s Laughter, please visit our website at sarahs-laughter.com. Our podcast-only site is podcast.sarahs-laughter.com. You can follow us on social media linked here: Sarah’s Laughter on Facebook & Instagram, and @sarahs_laughter & @jasonforbus on Twitter. Sarah’s Laughter also holds the Baby Steps Fun Run, where we give away a $10,000 grant for expenses related to either adoption or fertility treatment. We also partner with local SART-listed fertility clinics to give away IVFs at the event. Check babystepsfunrun.com for details and schedule. *** Sarah’s Laughter is a 501(c)(3) non-profit public charity. If you’d like to help support what we do, including this podcast, please visit sarahs-laughter.com/give. Thank you. -- Want to share your infertility story on this podcast? Email us at podcast@sarahs-laughter.com

In this interview, Christopher Shade, PhD, discusses the many factors that can block effective detoxification and how clinicians can address these issues. Cholestasis, endotoxins, estrogen, oxidation, and other detoxification disruptions are explained, as well as key nutrients and botanicals that can be used to help push toxins out and prevent re-absorption. Shade goes into detail about the detoxification protocol he has created.   About the Expert Christopher W. Shade, PhD, founder and CEO of Quicksilver Scientific, specializes in the biological, environmental, and analytical chemistry of mercury in all its forms and their interactions with sulfur compounds, particularly glutathione and its enzyme system. He has patented analytical systems for mercury speciation (separation of different forms of mercury), founded the only clinical lab in the world offering mercury speciation in human samples, and has designed cutting edge systems of nutraceuticals for detoxification and antioxidant protection, including advanced phospholipid delivery systems for both water- and fat-soluble compounds. Quicksilver Scientific is recognized globally for innovating on behalf of the pharmaceutical and nutraceutical industries. Dr. Shade is regularly sought out to speak as an educator on the topics of mercury, environmental toxicities, neuroinflammation, immune dysregulation, and the human detoxification system for practitioners and patients in the United States and internationally. About the Sponsor Quicksilver Scientific is a leading manufacturer of advanced nutritional systems with a focus on detoxification. We specialize in superior liposomal delivery systems and heavy metal testing to support optimal health. Our advanced liposomal supplements are highly absorbable, and support the body in the elimination of ubiquitous toxins, enabling you to achieve your genetic potential. At Quicksilver Scientific, we are passionate about health and well-being, and are committed to improving the lives of everyone we touch.

Obstetric cholestasis is a rare complication during pregnancy caused by a reduced flow of bile down the bile ducts in the liver, which causes some bile to leak out into the bloodstream. This build-up of bile acids in the bloodstream can cause a persistent itch in the last trimester of pregnancy, especially in your hands and feet. Like so many things, the symptoms go after you have your baby. Obstetric cholestasis is more common in twin pregnancies, although, we do not know the exact cause. Often when symptoms appear during pregnancy we tend to blame hormones. Oestrogen and progesterone hormones can affect the liver by slowing down the rate of bile passing out along the tiny bile ducts. Learn about some of the risks associated with obstetric cholestasis and some things you can do to relieve itching.

Dr. Michael Trauner discusses his manuscript "Alterations in Lipid Metabolism Mediate Inflammation, Fibrosis, and Proliferation in a Mouse Model of Chronic Cholestatic Liver Injury." To view the print version of this abstract go to http://bit.ly/s4QzUf.

Background/Aims: The expression of transporters involved in bile acid homeostasis is differentially regulated during obstructive cholestasis. Since the drug efflux transporter breast cancer resistance protein (BCRP) is known to transport bile acids, we investigated whether duodenal BCRP expression could be altered during cholestasis. Methods: Using real-time RT-PCR analysis we determined mRNA expression levels in duodenal tissue of 19 cholestatic patients. Expression levels were compared to 14 healthy subjects. BCRP protein staining was determined in biopsies of 6 cholestatic and 6 healthy subjects by immunohistochemistry. Results: We found that in patients with obstructive cholestasis mean duodenal BCRP mRNA levels were significantly reduced to 53% and mean protein staining was reduced to 57%. Conclusions: BCRP, a transporter for bile acids and numerous drugs, appears to be down-regulated in the human duodenum during cholestasis. The clinical impact of these results has to be investigated in further studies. Copyright (c) 2006 S. Karger AG, Basel.

Background/Aims The apical sodium dependent bile acid transporter ASBT (SLC10A2) contributes substantially to the enterohepatic circulation of bile acids by their reabsorption from the intestine. In the rat, its adaptive regulation was observed in the kidneys, cholangiocytes and terminal ileum after bile duct ligation. Whether an adaptive regulation of the human intestinal ASBT exists during obstructive cholestasis is not known. Methods Human ASBT mRNA expression along the intestinal tract was analyzed by real time PCR in biopsies of 14 control subjects undergoing both gastroscopy and colonoscopy. Their duodenal ASBT mRNA expression was compared to 20 patients with obstructive cholestasis. Additionally, in 4 patients with obstructive cholestasis, duodenal ASBT mRNA expression was measured after reconstitution of bile flow. Results Normalized ASBT expression in control subjects was highest (mean arbitrary units± SEM) in the terminal ileum 1010 ± 330. Low ASBT expression was found in the colonic segments (8.3±5, 4.9±0.9, 4.8±1.7 and 1.1±0.2, ascending, transverse, descending, and sigmoid colon, respectively). Duodenal ASBT expression of control subjects was found with 171.8±20.3 at about four fold higher levels when compared to 37.9±6.5 (p

Listen in this week as I chat openly about having a cesarean birth with my third baby after having two vaginal deliveries.In this episode, I chat about:• Cholestasis of Pregnancy• Potential birthing complications• How I came to my decision to have a C-section• How I mentally and emotionally prepared• The power of the playlist• Finding joy and excitement in my birthing process