Podcasts about cytotec

In a perfect world, your body is ready, your baby is fully mature, and you spontaneously go into labor on your due date. In reality, nearly one in four expecting mothers undergo a procedure to induce labor. The key is knowing when an induction may be medically necessary and when it may be better to wait it out. Explore the many reasons a care provider may suggest an induction, from medical considerations to practical concerns. Learn your options, the various methods used to initiate labor, how each approach works, the potential risks and benefits, and why timing matters. This episode examines the evidence on all of your options, including stripping and sweeping membranes, misoprostol (Cytotec), dinoprostone (Cervidil & Prepidil), synthetic oxytocin (Pitocin), using a laminaria or balloon catheter, and breaking your water.      Thank you to our sponsors   The VTech V-Hush Pro Baby Sleep Soother has every feature you could possibly want to transform any room into a sleep sanctuary. Create ideal sleep patterns and environments for your baby so your whole family gets better and longer sleep. The V-Hush Pro has built-in sleep programs and sleep tips from WeeSleep experts, over 200 pre-programmed stories, classical music, lullabies, and natural sounds. You can even record and upload your own voice, songs, or stories using the subscription-free app. The VTech V-Hush Pro Baby Sleep Soother is available at Walmart and Amazon.   The FamilyAlbum app: Keep family in the loop + get 11 free photo prints delivered each month CLICK HERE. FamilyAlbum is a free app that gives parents a private and easy way to share photos and videos of their little ones with family. With FamilyAlbum, you'll get an easy interface to use with the whole family, unlimited photo storage, automatic organization by month with child's age, no third-party ads, and 11 photo prints every month--all for free! Click here to download the app   Try AG1 and get a FREE 1-year supply of immune-supporting Vitamin D AND 5 FREE AG1 travel packs with your first purchase. That's a $48 value for FREE! Just one daily scoop provides whole-body benefits like gut, immune, and stress support. AG1 sources bioavailable ingredients that actually work with your body. Plus, their formula has all non-GMO ingredients and contains no added sugar. With AG1, I know I am filling any nutrient gaps and supporting my gut for healthy digestion. (As a friendly reminder, pregnant or nursing women should seek professional medical advice before taking this or any other dietary supplement.)     Read the full article and resources that accompany this episode.     Join Pregnancy Podcast Premium to access the entire back catalog, listen to all episodes ad-free, get a copy of the Your Birth Plan Book, and more.     Check out the 40 Weeks podcast to learn how your baby grows each week and what is happening in your body. Plus, get a heads up on what to expect at your prenatal appointments and a tip for dads and partners.     For more evidence-based information, visit the Pregnancy Podcast website.

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

Sometimes people want to try to get labor moving with more natural labor induction techniques before they get to the point of being faced with a medical induction. Due dates are given more weight with some providers than with others. In an attempt to avoid Pitocin, Foley Balloons, Cervidil, Cytotec, or any of the other medical induction techniques, some people opt for teas, herbs, and more.  In this episode of Birth, Baby! Podcast, hosts Ciarra Morgan and Samantha Kelly, along with their returning guest midwife Leonora Colon, delve into the intricacies of labor promoters and the importance of understanding due dates in pregnancy. They discuss the significance of due dates, the protocols midwives follow regarding labor timing, and various natural methods to encourage labor. The conversation emphasizes the need for autonomy in the birthing process and the importance of supportive care, whether at home or in a hospital setting. Website: www.HomeBirthHoney.com Instagram: @homebirthhoneyatx Please feel free to reach out to us with any recommendations for show episode ideas. If you'd like to be a guest, email us with some information about yourself and what type of podcast you'd like to record together. Thank you for all of your support and don't forget to follow and review our podcast, Birth, Baby! Instagram: @‌BirthBabyPodcast Email: BirthBabyPodcast@gmail.com Website: BirthBabyPodcast.com Intro and Outro music by Longing for Orpheus. You can find them on Spotify!  (00:00) - Introduction and Disclaimer (01:02) - Understanding Due Dates in Pregnancy (09:02) - Navigating Labor Timing and Midwife Protocols (12:57) - Labor Promoters: What Works and What Doesn't (20:05) - Natural Methods to Encourage Labor (31:54) - Final Thoughts on Labor and Support Options

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

“Whatever happens, I just want it to be peaceful, and I want to be present.”Kerri is a labor and delivery nurse born and raised in Kentucky. The only thing on her first birth plan was not to have a C-section, yet it became her reality. We know many of you can relate.She had a medically necessary induction at 36 weeks due to preeclampsia. Kerri describes her experience with getting magnesium, aka a “flu in a bag”, seeing double and going in for a C-section. Her surgery was straightforward, but Kerri felt very out of it and disconnected. Kerri was very intentional about her plans for a VBAC. Her birth team was on board and supported her requests. Throughout her pregnancy, Kerri's greatest desire was to feel present for the moment of birth no matter the outcome. When labor stalled and baby had a hard time engaging, Kerri felt peaceful about requesting a second C-section. With things happening on her terms, Kerri's birth was the peaceful and healing experience she hoped it would be.Evidence Based BirthⓇ - The Evidence on VBACEvidence Based BirthⓇ - COVID ResourcesNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. We have a CBAC story coming your way today. If you did not know what CBAC means, that is Cesarean Birth After Cesarean. This is a topic that a lot of people avoid. I don't know, tell me, Kerri, who is sharing her story today. Do you feel like CBAC stories are sometimes avoided when you are preparing for a VBAC?Kerri: I think so. I know I avoided that as I prepared for my own attempted VBAC. Meagan: Yeah. Kerri: Yeah. I think that CBAC is something that we try to avoid because we all hope for that VBAC. Meagan: Yeah. We overlook it and it actually breaks my heart. I encourage everyone to listen, especially if they are wanting to VBAC, every VBAC story, but as well as every CBAC story for a lot of reasons. One, understanding maybe what led to another CBAC and two, the healing and the fact that it can be a peaceful experience. It's not the end. There are so many things to CBAC, I think, that are missed. It's the same thing with uterine rupture stories or things like that. I'm not wanting that, so I don't want to listen to that. Now, I don't want to shame anyone if they skip over a CBAC story, but I really encourage everybody to listen to all of these stories because they are empowering. They are uplifting, and they are going to help you grow in ways that you may not even know. Before we get into cute Kerri's episode, I wanted to share a review. This was actually left a little bit ago too, actually. It was in 2022. No, 2021. It says, “Going for my VBAC after two C-section in 2022”. It says, “Thank you so much for this valuable resource. I have been listening to your podcast since early in my second pregnancy. I found out I was expecting again 9 months after my CBAC, and I was immediately and depressed that I would be going through all of that all over again very soon. I am now 14 weeks, and I'm drawing strength every day from the stories you share. Thank you, thank you, thank you. I have hope this time that it will be different.” Now, that's another good note to have. Even if you do have a CBAC, that doesn't mean that's the end. That also may mean you find healing in that, and you want future CBACs, right? You want to schedule that CBAC. I love that note about healing and strength. That's what all of these episodes are doing. Okay, Kerri. I am so happy that you are here. You are in Kentucky.Kerri: Yes. Meagan: Okay, were you in Kentucky for both of your births? Are you from Kentucky?Kerri: I have lived in the same small town my whole life. I live just outside of Lexington. It's a little bit bigger than it used to be, but it's still a small town to me. Meagan: Okay. Kerri: I have lived in Lexington my whole life. I gave birth at the same hospital where I was born. Meagan: Yeah, me too. I would say I'm boring. I'm boring. I haven't been anywhere, but I don't think it's boring, actually. I love Utah. I've been born and raised here. I actually gave birth at the same hospital for my C-sections and with the same provider who gave birth to me. Kerri: Oh, that's so funny. That's wild. Meagan: Kind of crazy, huh. Well, thank you so much for being here today and sharing your beautiful stories. I'd love to turn the time over to you. Kerri: Yeah. I'm so excited to share. I've listened to this podcast quite a bit since my first C-section, so I'm really excited to be on today.Meagan: Well, thank you for being here. Kerri: My first pregnancy was already a surprise pregnancy. Me and my husband had just gotten married, and a month and a half later found out we were pregnant. It was already quite a bit of a surprise being pregnant. You know, pregnancy went well. The first trimester went well. Around 28 weeks, I had gotten COVID. This was November of ‘21. COVID was still fresh. I had gotten COVID, and I made it through that. I thought everything was going well, but from that point on, I just was feeling more and more sick. I had been a nurse for a while, but I was a new nurse to labor and delivery. I was working night shifts, so I just really attributed the way I felt to working nights. I'm just pregnant. I'm working the night shifts. This is probably what's wrong with me. Around 35 weeks, I just started feeling miserable. I had an appointment with a provider who wasn't my provider, but he was a provider I had worked with. At that appointment, my blood pressure was elevated. He said, “Let's just get a preeclampsia panel, and do a 24-hour urine just to be safe and see what's going on.”I did that, and I turned in my 24-hour urine. I went to work that night. That shift was miserable. I don't know how I made it through that shift, but I did. I got off that morning, and the provider called me that morning. He was like, “You have preeclampsia. You cannot work anymore. You're on light duty at home, and you're being induced at 37 weeks.” That was already quite a bit of a shock. I had been around birth just enough as a labor and delivery nurse. I had just already in my head pictured this beautiful birth experience that you see on Instagram, and I'm like, “This is already not happening for me.” He tells me that. I'm home for a few days, and I'm just feeling more miserable as I'm home. After that phone call a few days later, I checked my blood pressure, and it's severe at home. It's over 160/110. Being the nurse I am, they say nurses make the worst patients. I was just like, “I'm going to ignore this for a little bit, and we'll just see if this gets any better.” I check it again later that afternoon, and it's still super high. I called my husband, and we decided to go to the hospital. We get there, and my blood pressure was high, but it was not severe enough to do anything about it. They were like, “Let's just keep you overnight and see what you do.” Over the 24-hour period of being there for observation, my blood pressures just went up and up. I had some more severe, and they were like, “You know, it's time to have a baby.” I was just shy of 36 weeks at this point. They started a magnesium infusion to help with the preeclampsia.Meagan: Blood pressure. Ugh, did it make you feel yucky?Kerri: Oh, yes. Magnesium is awful. I feel for anybody who has to be on that. It was awful. We call it flu in a bag, and it truly is that. Meagan: Flu in a bag. Okay. I've never heard of that, but I can understand that based off of the way I've seen my clients feel. Kerri: Yeah, that's exactly how you feel. Flu in a bag. It just makes you feel yucky. We started that, and we started the induction process. We started with the Foley bulb. We put that in. That was in until the next morning, and it comes out. When it came out, I think I was 3 centimeters, but not very effaced. It was just an artificial 3, a Foley bulb 3. They were like, “You know, your cervix isn't very favorable. Let's do some Cytotec.”We did a few doses of Cytotec. They rechecked me after that. It was still not very favorable. I think this was the evening at that point. They were like, “Let's just take a break, let you have a meal, and we'll try this again.” We do that, and then we start Pitocin. We did that all night. The next morning, my provider checks me. I'm finally a 4. I was ecstatic. I was like, “Oh, I've made some change.” I was really excited. They checked me. I was 4. They break my water, and they're like, “Let's just see what happens.” I had gotten an epidural at that point because I was already pretty miserable from being on magnesium and all of these induction agents. I was like, “I really need some rest.” I was already epiduralized. The nurse who was taking care of me at the time was a really good friend of mine. She was like, “Let's do everything that we can to try to have this baby vaginally.” She did Spinning Babies. We did all of the positions that we could. They checked me again later and I was a 5. I was ecstatic, like, okay. We're doing something there. A few hours later, I'm starting to feel pretty miserable, more miserable than I had felt before. I look over at the computer, and I'm seeing double. I call out to my friend. I'm like, “I don't know if this is normal, but I'm seeing two of everything.” She was like, “No, it's not.” She calls my provider. He said, “Let's draw a magnesium level. Let's see what's going on.” So they did. My magnesium level was high. They decided, “Let's just recheck you. We'll see you if you made change. If not, we'll have to have a section.”They checked me. I was still a 5 at that point. They decided with everything that was going on, it was probably in the best interest of the situation to have a section. I agreed, but I was heartbroken. My whole pregnancy, my only birth plan was don't have a C-section, and at that moment, that was my reality. Everybody who was with me that day, they were my coworkers. They witnessed me have a full-blown panic attack over it, but everybody made it through that with me. They loved on me, then we finally went back to the C-section. I'm pretty out of it from the magnesium at this point and just having labored so long. They started the section. I felt like I could feel more than what I probably should have been able to feel. I let them know, and once they got the baby out, they gave me ketamine just to help with my pain. I was knocked out for 12 hours, so I don't remember my baby's birth at all. Meagan: That's hard. Kerri: Yeah. It was really hard. I feel like the moment I actually realized I had a baby was the next morning. There's a video where I'm like, “Oh my goodness.”Meagan: Yeah. Yeah. Were you feeling any better by then?Kerri: I was still under magnesium, but I was feeling better. Meagan: Good. Kerri: The protocol, at least at the hospital that I work at in, is magnesium 24 hours postpartum just to make sure you still don't– Meagan: Yes, that is how it is here too, then they'll recheck things and if blood pressures are still elevated or anything like that, and if levels are elevated, then they'll remain, and if not, then they'll take you off. Kerri: Yeah, we did that for 24 hours. Once that was off, I finally got to go up to the mother/baby unit. I started to feel more normal at that point, but just that whole experience, I felt like I was just not even a part of. I was just there having the baby, but I didn't feel like I was actually there having a baby. Meagan: Yeah. Yeah. Did that carry onto the postpartum and future as stuff to process for you, or did it feel okay? Kerri: That was very hard for me because I worked with birth every day. I got to see these beautiful moments of people having their baby, and I didn't feel like I had gotten that. I don't remember my baby being born. You know, it's different. I had pictures, but nothing quite as good as remembering that. That was very hard, and it really affected me for a long time. You know, it still does. I would have loved to have been present in that moment. That just wasn't the reality for me. Meagan: Yeah. Have you done things to work through that, or anything to suggest for someone who maybe have experienced that or have been put under anesthesia where they just couldn't remember or be present in their birth?Kerri: For me, my faith is something that is very important to me. Praying and talking with God about it has really been helpful for me. It was still a beautiful moment. I've come to terms with that. Meagan: Good. Good. Okay, so baby number two. Oh, I was going to ask you, with being preterm, did they do a special scar or anything, or were they able to do a regular low transverse?Kerri: Just a regular low transverse incision. Meagan: Awesome. Awesome.Kerri: Yeah. So baby number two, we knew we wanted another one, and honestly, as soon as we were in that hospital room, I remember I told my husband that I never wanted to have a C-section again. When we started thinking about number two, we were going to start working towards having a VBAC. When she was around 20 months, I found out I was pregnant. Prior to the pregnancy, I had done a ton of research on what is the best way to get a VBAC, and what is the best way to prevent preeclampsia which is silly because we know preeclampsia can't necessarily be prevented. Meagan: Yeah, there are things we can do to try to reduce the chances, but there's nothing that we know for sure, concrete that this is what you can do to make sure you don't get it. Kerri: Yeah. My provider did have me start taking low-dose aspirin early on in the pregnancy, and I didn't get it again, but you know, I did all of this research like, what can I do? Looking back now, I think I put too much pressure on myself to try and prevent it. I found out I was pregnant when she was 20 months old, and we were so excited. We were just thrilled. We just couldn't even describe that. I was so excited to start doing what I could in the pregnancy to get my VBAC. That's all I could think about was my VBAC. I remember praying to God. I just prayed that this pregnancy I could have my successful VBAC. Then as the pregnancy got closer to delivery, in my head, I'm like, “I could have another C-section. I need to start thinking about this.” So then I shifted my mindset. I was like, “You know, if I have to have another C-section, it's okay. All we want is a peaceful delivery.” So that's what I kept telling myself every day in my prayers. I was like, “Whatever happens, I just want it to be peaceful, and I want to be present.”Meagan: Yeah, I bet that was a really big deal for you.Kerri: Yes. I just kept saying that every day. That's what we're going to do. Peaceful delivery. Present delivery. I kept telling my coworkers because they were rooting for me. We were going to make this a better experience. My provider the whole pregnancy was great. She was very VBAC-supportive. I did a lot of research prior to the pregnancy about who I wanted to see, and I worked with these providers. It was a hard choice to make. I work with great providers, but I feel very confident in the provider I picked. She took such great care of me, and I'll forever be grateful for her. Towards the end of the pregnancy, me and her had a chat about what are we going to do to get our best attempt at having a VBAC? I ultimately decided that I wanted to be an induced VBAC. Not necessarily that I wanted to be induced, but I needed the peace of mind. I already had a lot of anxiety just because of the last pregnancy, and I just needed an experience where I could at least expect something. This may not end in a successful VBAC, but I really want to try. We scheduled the induced VBAC, and she was like, “This might not work.” We had a lot of conversations about that. She was like, “Induced VBACs aren't always successful,” which I appreciated her saying as a provider. I was like, “This is what I need just for my peace of mind.” We scheduled an induction. Everything was going great. I went in at night. I had gotten a Foley bulb again. My cervix wasn't favorable necessarily. I was 39 weeks on the dot. Maybe if I would have waited a little longer, I would have been more favorable. At that point, I wasn't the most favorable, but I still wanted to go through with it. I had wrapped my head around that that day was going to be her birthday and we were going to go through with it. We started with the Foley bulb, and it stayed in for what felt like forever. They put it in at midnight. It did not come out until 11:00 AM the next day. I was not expecting that because last time, the Foley bulb did not stay in that long. This time, I had made it to 39 weeks, and I was thinking that my cervix would do more, and it just didn't. My provider came in. She was able to get it out. She broke my water, and I was at a 4 at that point. It was ready to come out, but it didn't on its own. I wasn't expecting that. I was expecting a little bit more. Meagan: That can happen. It can be in for up to 12 hours and not fall out. That can happen, but I'm sure after your previous experience, you're like, “Wait. Why isn't this out yet?” Kerri: Yeah. We did that, and I decided she was going to break my water. Me and her and my nurse who was taking care of me was a really good friend. We were like, “Let's just get an epidural because we know that there is a bit of a higher chance for uterine rupture for being an induced VBAC or TOLAC.” Meagan: Were you feeling contractions at this point?Kerri: I was. I was feeling contractions. That was something, I kept telling my husband, that I was really excited about. With the last experience, I was really out of it having been on magnesium and having gotten an epidural so early. I just didn't even feel like I got to experience labor at all. Like I said, I didn't feel like I was a part of that experience. I was really excited this time to be able to experience contractions. While they were very, very painful, I was very grateful to have that experience. I had asked for a few doses of fentanyl. Meagan: Fentanyl?Kerri: Fentanyl, yeah. We used to do [inaudible], but right now, we have fentanyl. I had asked for a few doses of fentanyl, but I really tried to tough it out because I was like, “I really want this experience.” The whole pregnancy, I had been prepping for how I was going to manage labor while I didn't have an epidural. I had a friend who I worked with. She is also a doula, and she is going to school to be a midwife. She had talked me through a few different things that I could do. I had really prepared, and I was really excited to be able to experience some contractions. Meagan: Yeah. Kerri: But we had decided, “Let's get an epidural just to be safe.” We got an epidural, and everything was smooth sailing. We got the epidural. We started some Pitocin. I had asked for peace of mind for me, an IUPC which is the intrauterine contraction monitor because I wanted to know what my uterus was doing. If I was going to be an induced VBAC and I'm going to have a higher risk of rupture, I wanted to know exactly what my uterus was doing, so I asked for one of those to be put in. They put one in. My contractions were adequate. We were moving along. I'm just ecstatic at this point because I'm like, “I have never had adequate contractions. Last time, I made progress, but nothing like this.” I was very, very excited. Throughout the course of the day, me and my friend who was taking care of me decided that we were going to do every Spinning Babies position that we could do. My epidural was just perfect enough. I was able to help move by myself and do all of these positions that I had planned on doing. It was great. I was so excited. They checked me, and I was a 5. I was excited that I had made it a little bit farther than what I had thought I would because last time, I had stayed at a 5 forever. I was at a 5, and I was expecting to just keep making progress. A few hours later, they checked me again, and I was still a 5. My provider is like, “Your pelvis feels very tight, and your baby's head is not applied at all.” So then, I felt crushed in that moment. I had been planning on having this successful VBAC, and it doesn't feel like it's going to happen. Prior to the induction, I had been living in the Miles Circuit and doing everything I could to get her the best engaged she could be. She wasn't doing it. She said, “We'll give it a few more hours.” Meagan: What were your MVUs at this point? Sorry, I just interrupted you. Kerri: I think they were 200. They were adequate. Meagan: Mhmm, cool. Kerri: My contractions had been adequate for a while, and I wasn't on very much Pit. Meagan: Good. Kerri: I was thinking that things were going great. She was like, “We can keep going if you want. I'm going to stay with you. I'm going to do your delivery regardless of the outcome.” We decided we were going to keep going. A few hours later, I get checked again. I'm still 5. Her head's still not applied. My friend who was taking care of me was about to leave because her shift was over. She was like, “We can call it right now, or we can give it another shot.” She said, “You'll never get this experience again, so if you want to keep going, keep going, but if you don't, it's fine.”Kerri: I decided, “I want to keep trying.” I kept trying. Then a few hours later, I was checked again. I was still a 5. Her head was still not engaged, so we decided that we were going to have another C-section. That was heartbreaking. I remember in the moment feeling a little heartbroken, but also feeling at peace about it all in one. Meagan: Yeah, which is important. Kerri: Yeah. We go back for the section. I was nervous about having another section just because my first one was so traumatizing. I wasn't sure how it was going to go. I was really nervous about anesthesia. Is it going to hurt this time? Am I going to be knocked out because I'm feeling too much? The anesthesiologist who took care of me decided, “Let's just give you a spinal.” My epidural had fallen out actually, so she said, “Let's do a spina. Let's make sure you are the most comfortable you can be.” They did that. They started the section. I couldn't feel anything which I'm already thrilled for. I remember just laying there, and I felt so present during the whole thing. My baby came out, and I remember being a part of that moment. There was a clear drape, so I was able to see what was going on. My provider– I feel like we had developed such a good bond. She did everything to make sure that it was a good experience for me and to make sure I was present. Something that was important to me was that my baby would be with me a little bit longer while I was in the OR. I didn't have my baby with me last time, so I really wanted that. I didn't necessarily do skin-to-skin, but I got to hold her. She got to be with me the whole time, and it was perfect. She got to be with me during recovery. That whole birthing experience was just the most beautiful thing.Meagan: Good. So you have been able to walk away feeling positive about a birth experience. Kerri: Yes. That's not something I thought I would get with a C-section. After my first, I had a lot of postpartum anxiety. I had very negative feelings towards C-sections. I didn't enjoy seeing my scar. To me, that was just a reminder of what my body had done to me. I felt betrayed by my body, and for the longest time, I just was ashamed of the fact that I had a C-section. After that experience with my second, I was very proud that I did have a C-section because reality hit me that this isn't the most ideal way to give birth to a baby, but it happens, and thank God they are available, and I have two beautiful babies because of my C-sections, so I'm very, very thankful for them now. Meagan: Yes, good. Good. Kerri: When my husband and I decide to have another one, I'm like, “This will be great because I think that for me, I'll just have another repeat section, and it will be scheduled. It's going to be great, and I'm excited about it.” But it's just something to be able to look back and be able to think of this as such a positive experience as opposed to my first. I wasn't proud of my birth story at all. It was something I carried with me for a long time, and now, I'm thankful that I can have a different perspective about it. Even about my first, my first birth was beautiful in its own way.Meagan: Yeah. It's hard because you don't want to only think about those births as negative or traumatic. You want to pick out the positivity from it, but sometimes it is hard to see all of that, so it's been so great to hear that you– one, it sounds like with your labor, it really was a lot of your choice along the way. You decided this was something you wanted. Your team went with you and then walked with you along the way. In the end, it was able to be something that was a lot more healing. Even though it was still a Cesarean, it was a healing experience for you. You got to have your baby that whole time, and you got to grow through that experience. Like you said, you may choose to have a third C-section, and that's okay. I think that's one of the things I love about this podcast is that it's not if you choose a C-section, you are shamed. That's just not how it is. Everyone needs to choose what is best for them and their individual circumstances. I love that you've been able to go from the furthest end of the extreme to coming back, and then possibly if you have another baby, it sounds like something that you are already looking forward to having an even different experience. I love that you've been able to have that and you can share these stories and you can hold onto these good feelings because it really is important. Kerri: Yes. Even as a labor and delivery nurse, I feel more positive about taking care of women who have C-sections because for the longest time, every time I went into the OR, it brought up feelings from my own first C-section. It was hard to be the best nurse that I could be when I was dealing with my own feelings, so I'm thankful now that I have this perspective of, “This is beautiful in its own way.” Every birth is beautiful. You're bringing your baby into the world. Who cares how it happens? I think we get so wrapped up in God made our bodies to give birth a certain way, and that's just not the reality for some people. I'm thankful we live in a society where C-sections are readily available and we can have them. They can be just as beautiful.Meagan: Yeah. CBACs really can be. My second C-section was very, very healing. I think it was exactly what I needed to have healing from my first birth that I didn't realize I didn't heal from. I was really, really grateful that I had the experience. Again, it wasn't the birth I desired, but it was such a better and healing experience for me. I was really, really grateful for those. Okay, I have two things that I want to talk about. One is preeclampsia. Not even just preeclampsia, but COVID. I was just wondering, as a labor and delivery nurse, have you seen things like preeclampsia or placental issues or anything like that from people who have had COVID during pregnancy? Rebecca Dekker has such an incredible blog, and I'm going to make sure to link it here. I have seen this weird connection with pre-e with a placenta or placental issues that have had COVID. I was just curious if you've seen anything like that. Kerri: You know, I feel like that is something that we've seen more of. I will say I started working as a labor and delivery nurse in 2021, so I can't speak for what nurses saw prior to this, but I do feel like I see a great deal of preeclampsia, especially during that COVID time. Women were having more complications. More women are getting more sick. I don't know if there's a correlation, but I will say that as far as pregnancy goes, it does seem like a lot of pregnancies are becoming more high-risk.Meagan: Because of that? Because of COVID?Kerri: I don't know if it's necessarily COVID or just the way we eat, the way we take care of ourselves, but I feel like during COVID, there were a higher number of combinations whether there's a correlation or not. Meagan: Yeah, that's interesting. I just barely read the most recent update. I need to dive into that more, but I was wondering as a labor and delivery nurse if you had seen that. You mentioned with your first that they had tested you, and your magnesium levels were too high. Are there things that can reduce magnesium levels? Obviously, maybe lowering the magnesium levels that are given, but are there things that can be done in that situation to lower their magnesium levels?Kerri: If your magnesium level is high, we can give you the reversal drug which is calcium gluconate. We can give you that, but we are already inducing, you and it's high, and you're not making very much progress, at that point–Meagan: The provider may not be wanting to do that. Kerri: Yeah, delivery is the best option.Meagan: Yeah, for preeclampsia, which we do know. I was just wondering if there was such a thing that could help. Kerri: Yeah. Ideally, just do what you can to deliver. But you know, that's something that people should talk to their provider about in that moment. Meagan: Yeah. I agree. I agree. Then last but not least, I just wanted to share a little bit more because I think a lot of people do question induction and VBAC. What are the risks? Sometimes, the risks seem astronomical, and sometimes they are not to some people. Everyone takes it differently. I wanted to share some evidence on that. With the risk of induction, it does increase just like you had mentioned. It does increase the risk of uterine rupture when we are induced. It's about a 1.1% if you have Pitocin and about a 2% if you have prostaglandins, and then of course, we know misoprostol. How do you say that?Kerri: Misoprostol, but however you want. Meagan: Yeah. I saw misoprostol, but I've heard people say MYsoprostol. It is about 6%. It definitely increases with certain things that you do. It's about a 1.1%. Uterine rupture in general is just around 1%. It increases it ever so slightly, but it's really important to take the right precautions. A Foley bulb is a fantastic way to start jumpstarting labor, but sometimes it does need to have a little bit of an opening, at least 1 centimeter. Kerri: Where I work, we don't do Cytotec for TOLACs. Meagan: Most people shouldn't.. Kerri: It's a 1 to 1 assignment. Your nurse who is taking care of you wouldn't have another patient. Meagan: Interesting. Kerri: They make sure that all hands are on you and make sure that your uterus is okay. When it came down to me when I was thinking about wanting to TOLAC and hopefully have a VBAC, I looked at the risk. I think it's important. I listened to a podcast. I think it was by Jordan Lee Doulie. She had an OB on her podcast talking about VBAC. He said, “It's important to remember that there is a risk whether you're having a repeat section or you're having a TOLAC.”I really took that to heart. For me, the risk of uterine rupture is small enough that I want to try. I know that I'm going to be in a hospital. I know I'm going to be monitored, and if that's something that's happening, I know I'll be taken care of quickly. I was okay taking the risk. I think that has to be such an individual choice. It does carry risk as well, so that's why I needed to at least give it a shot. I'm somebody that I fully support whoever wants to have a VBAC after two sections, but for me, that's not something I want to do. But as with everything, you have to look at both sides of it and make your decision. Meagan: Yeah. I think that's what we talk about on this podcast. Learn the risks. Learn the facts. Learn what the evidence says, and then follow your heart. What feels right? I appreciate you so much for coming on and sharing your journey. I do love how much you were able to be a part of your birth that second, and then also your postpartum experience is so important. Kerri: Oh yeah. I'm 11 weeks postpartum now, and I just have to say that my mental health this time is so much better, and my recovery post-C-section was so much better. I really have such positive things to say. It was such a good experience. I'm forever grateful for everybody who took care of me. I'm forever grateful for my provider. I just love her dearly and am just so thankful for her. Meagan: Good. I'm so grateful for you. I'm so glad you had that support and that loving team. Thank you again for sharing.Kerri: Yes. Thank you so much for having me on here.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

Läkemedlet misoprostol har sedan länge använts i Sverige och internationellt för att sätta igång förlossningar. Det finns två olika beredningar av läkemedlet som används vid igångsättning, tabletten Cytotec som man löser i vatten och ger att svälja, eller en färdig tablett, Angusta, som sväljs. Nu publiceras resultaten av en svensk studie där man undersökt om de två varianterna är likvärdiga vad gäller säkerhet och effektivitet, en viktig fråga eftersom Angusta kostar 43 gånger mer än Cytotec. Kan vården göra besparingar, utan att göra avkall på patientsäkerhet? Svar ja, säger vår gäst Elin Svensk, specialistläkare i obstetrik och gynekologi, och doktorand vid Institutionen för klinisk forskning och utbildning på Södersjukhuset, Karolinska Institutet och en av studiens huvudförfattare.Hör när Elin Svensk berättar om hur studien gått till, vad man undersökt och hur man kommit fram till att det finns goda skäl för vården att använda Cytotec i vattenlösning vid igångsättning. Avsnittet är i samarbete med MAM Hosted on Acast. See acast.com/privacy for more information.

Show Notes: Cytotec is commonly used in maternity units across the country for cervical ripening and also for postpartum hemorrhage...but should it be?  Today we'll learn all about Cytotec (misoprostol) directly for the drug insert. You will learn about how it relates to things like uterine rupture and other catastrophic outcomes.  The hospital won't give you true informed consent - so now you can have the information you need to make an informed decision. In this episode, you will learn: Information about Cytotec according to the drug insert available publicly on the FDA website Indications for the use of Cytotec The risks of using Cytotec How to decide if you should consent to Cytotec being used in your pregnancy Alternatives to Cytotec for cervical ripening So much more!   Links from this episode: Vote for Dr. Stu https://discourse.nomineesforthepeople.com/t/stuart-fischbein-md/28206?mc_cid=f27e542bea   Born in the USA: How a Broken Maternity System Must Be Fixed To Put Women And Children First by Marsden Wagner, MD https://amzn.to/4fUZfT8   FDA Cytotec Info https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/misoprostol-marketed-cytotec-information   Helpful Links:   3 WAYS TO WORK WITH LORI: --> Sign up HERE for the Your Birth, God's Way Online Christian Childbirth Course or go to go.yourbirthgodsway.com/cec! This is a COMPLETE childbirth education course with a God-led foundation taught by a certified nurse-midwife with over 20 years of experience in all sides of the maternity world! Learn more or sign up HERE! —> Having a home birth and need help getting prepared?  Sign up HERE for the Home Birth Prep Course or go to homebirthprep.com --> Sign up for your PERSONALIZED Pregnancy Coaching Midwife & Me Power Hour HERE or go to go.yourbirthgodsway.com/powerhour These consults can include: birth plan consultation, past birth processing, second opinions, breastfeeding consultation, and so much more!  Think of it as a special, one-hour appointment with a midwife to discuss whatever your concerns may be without any bias of practice policy or insurance policy influencing recommendations.   Get Christian pregnancy and birth merch HERE (https://go.yourbirthgodsway.com/store)   Lori's Recommended Resources HERE (go.yourbirthgodsway.com/resources)   Sign up for email updates Here   Be heard! Take My Quick SURVEY to give input on future episodes you want to hear --> https://bit.ly/yourbirthsurvey   Got questions?  Email lori@yourbirthgodsway.com     Socials: Follow Your Birth, God's Way on Instagram!c @yourbirth_godsway Follow the Your Birth, God's Way Facebook Page! fb.com/lorimorriscnm Join Our Exclusive Online Birth Community -- facebook.com/groups/yourbirthgodsway   Learn more about Lori and the podcast at yourbirthgodsway.com!   FREE Bible Study Course - How To Be Sure Of Your Salvation --> https://the-ruffled-mango-school.teachable.com/p/how-to-be-sure-of-your-salvation     DISCLAIMER:  Remember that though I am a midwife, I am not YOUR midwife.  Nothing in this podcast shall; be construed as medical advice.  Listening to this podcast does not mean that we have entered into a patient-care provider relationship. While I strive to provide the most accurate information I can, content is not guaranteed to be 100% accurate.  You must do your research and consult other reputable sources, including your provider, to make the best decision for your own care.  Talk with your own care provider before putting any information here into practice.  Weigh all risks and benefits for yourself knowing that no outcome can be guaranteed.  I do not know the specific details about your situation and thus I am not responsible for the outcomes of your choices.    Some links may be affiliate links which provide me a small commission when you purchase through them.  This does not cost you anything at all and it allows me to continue providing you with the content you love.

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

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

The use of Cytotec, or misoprostol, in obstetrics has a complex history. Initially created to treat gastric ulcers, Cytotec also plays a critical role in reproductive health. It has been used for medical abortions, cervical ripening, and labor induction. In this episode, we explore Cytotec's journey from its original purpose to its controversial use in childbirth. We'll break down its benefits and potential risks. Learn more about the off-label use of medications in healthcare and how this is a widely accepted practice. Whether you're a birth worker or just curious, this episode offers key insights into Cytotec's role in modern obstetrics.

Send us a textUnlock the secrets to a more empowering childbirth experience! Join me as I sit down with Suzzie Vehrs, a dedicated doula and mother of two, who made a remarkable transition from finance to birth advocacy. Suzzie opens up about her personal journey through pregnancy, loss, and the incredible power of support during childbirth. You'll gain insight into the vital role doulas play in helping mothers make informed decisions and letting their voices be heard in the delivery room. Plus, we dive into the recent legislative changes that have made insurance coverage for doula care more accessible than ever.Navigate the complexities of hospital births as Suzzie shares strategies for ensuring informed decision-making and effective communication with medical staff. We discuss the varied policies of different hospitals, especially concerning interventions such as inductions and the use of drugs like Pitocin and Cytotec. Suzzie emphasizes the importance of having birth preferences that accommodate both an ideal vision and potential complications. Learn how doulas and labor nurses can collaborate to advocate for the mother's choices, fostering a supportive and understanding environment.In our final chapter, we delve into practical tips for hiring the right doula and the nuances of creating a positive birth experience. Suzzie offers guidance on financial considerations, conducting thorough interviews, and the benefits of prenatal planning with techniques like hypnobirthing. We also explore how to maintain a calming environment in a bustling hospital setting. Wrapping up, we highlight the collaborative relationship between nurses and doulas and the incredible resources available on shebirthsbravely.com to further support expectant mothers. This episode is packed with valuable insights to help you feel confident and empowered as you prepare for childbirth.Connect with Suzzie Vehrs: https://shebirthsbravely.com/ Join the Bump & Beyond Online Community for moms & moms-to-be! Coaching offerKelly Hof: Labor Nurse + Birth CoachBasically, I'm your birth bestie! With me as your coach, you will tell fear to take a hike!Support the showConnect with Kelly Hof at kellyhof.comMedical Disclaimer:This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman's medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.

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

In this episode, Trish educates on preparing for an unmedicated birth while being induced.She covers various induction methods, including Cytotec, Cervidil, Foley bulb, and other methods such as membrane stripping, emphasizing the importance of being educated about these options. Trish shares personal stories from her own unmedicated births and discusses the impact of having a positive mindset, preparation, and a flexible birth plan. Also highlighting natural pain relief methods, the crucial role of birth partners and doulas, and the importance of creating a calm and supportive birthing environment. “ You have to be informed. To be empowered. Remember your birth experience is unique and personal to you with the right preparation and mindset. You can have the birth you want, whether or not you're being induced.” - TrishTrish encourages listeners to stay informed and empowered to make the best decisions for themselves and their babies.00:52 Understanding Unmedicated Inductions01:58 Types and Methods of Induction06:07 Preparing for an Unmedicated Birth07:04 The Role of Mental Preparation09:07 Importance of Birth Education and Planning13:00 Natural Pain Relief Methods14:53 Support Systems: Partners, Doulas, and Healthcare Team18:49 Creating a Calm Birth Environment19:52 Personal Birth Stories and Final ThoughtsMore from this episode:Grab the Navigating Induction Choices WorkshopResources: Grab a Free Pregnancy/Postpartum Checklist BundleConnect w/ Trish: On InstagramOn FacebookOn YouTubeOn Pinterest On TikTokFor more pregnancy & birth education, subscribe to The Birth Experience on Spotify, Apple Podcasts, or wherever you listen to podcasts.Next Steps with LNM:If you are ready to invest in your pregnancy & postpartum journey, you are in the right place. I would love to take your hand and support you in your virtual labor room!If you are ready to dive into a birth class and have your best and most powerful birth story, then Calm Labor Confident Birth or The VBAC Lab is your next step.If you have a scheduled cesarean, take our Belly Birth Masterclass and own that experience. If you are a newly pregnant mama or just had the babe, you want to join our private pregnancy and postpartum membership, Calm Mama Society.Remember, my advice is not medical advice. Always discuss what...

“It was just such a redemptive, wonderful experience. I am so grateful to The VBAC Link for seeing me through it, for giving me the information, and just the inspiration to even take this on because if I had never found you, I don't know for sure if I ever would have gone through with it. So, thank you so much for that.”Amanda's episode will warm your heart, give you chills, and bring tears to your eyes. Her birth stories include a rough induction at 36 weeks due to preeclampsia with an 11-day NICU stay and not getting to hold her baby for 32 hours. When she found The VBAC Link, Amanda was given hope that she could have another baby and that her experience could be very different. Equipped with information and drive, she was able to do just that. Amanda's VBAC birth was spiritual and powerful!Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Episode Topics:Review of the WeekAmanda's storiesMonitoring for preeclampsiaCervadil, Magnesium, and CytotecConsenting to a CesareanThrowing up during the C-sectionWaiting 32 hours to hold her babyFinding The VBAC LinkPraying for a babyScared or scarredSigns of wavering provider supportPhysical and mental preparationContractions beginAdvocating during laborThe night nurse“It is done.” Importance of lactation supportMeagan: Hello, everybody. How are you doing? I hope you are doing great. Right now, I can just tell you that my face is already hurting from smiling just from talking to our guest for 5 seconds. We have our friend, Amanda. Hello, Amanda. Amanda: Hello. Meagan: Oh my goodness. She has just been the sweetest thing just pouring on the sugar and sweetening me up. I mean really, she is saying just the nicest things about The VBAC Link and it has just been so fun to hear how The VBAC Link was part of her life. You guys, I love this so much. Thank you for supporting this podcast. Thank you for supporting us on Instagram and Facebook and all of the places. I truly from the bottom of my heart love you. I know I haven't always met you but I love you and I love this community and I love what we are doing here. I am so grateful for the opportunity. I just wanted to say that it really wouldn't happen without all of you so really from the bottom of my heart, thank you. Review of the WeekMeagan: We do have a Review of the Week so I want to jump into that and then we are going to get into Amanda's stories and maybe even some other things. We will see what this episode transpires to. Okay, so this is from Liz Judd and it doesn't say where it was from, but it says, “Empowering”. It says, “I found this podcast around week 30 of my second pregnancy by searching for ‘VBAC'. I had a traumatic C-section in 2019 and I knew I did not want to go through that again. It was helpful for me to learn the evidence on VBAC, how to advocate for myself, and healing to listen to other's stories. I just had my second child by VBAC and I thank you for the role you played in that.” Seriously, it warms my heart and you just said the same thing. You carried me through my whole pregnancy, and then this was back when Julie and I took a big 10-month break and you were like, “Oh no, they're gone!” But here we are. We are back and I hope that we are carrying someone else or many other people through their pregnancy journeys as well. Amanda: I'm sure that you are and that review could not have related more to my story so I can't wait to get started for you. Amanda's storiesMeagan: Okay, well without further ado, let's do it. Let's get started.Amanda: Here we go. My husband I met in 2004 which yes, was 20 years ago. We got married in 2009 and we were just living our best lives. We were traveling, doing all of the things. I had lost 129 pounds and I said, “I want to run a marathon and have a baby.” Meagan: Dang, yeah. Amanda: I was even a group exercise instructor at the time. Life was good. I ran the Marine Corps Marathon in 2015 in October and in 2015 December, I got pregnant. What was really special about that was we got engaged on Christmas Eve so on the 10th anniversary of our engagement, I got to share the news with my husband that we were expecting. Meagan: Yay! That's so awesome. Amanda: It was really special but other than that, I really had no knowledge at all about pregnancy and birth. I just knew that I wanted an unmedicated birth. Where I came up with that, I'm not sure, but I just was going to trust my doctor. That's where my brain was at. I went to my normal OB who I had always gone to and it was a very small practice. There were three doctors and a nurse practitioner and up until this point, I had always seen the nurse practitioner. She confirmed my pregnancy and she advised that I limit my exercise from what I was currently doing and to only maybe just walk and do some light cycling. Meagan: Oh my gosh. My OB said the same thing. I was wanting to run a half marathon and he was like, “Oh no, you're having too much round ligament pain. Just go for a walk.” I was like, “What? Okay,” so I stopped working out. Amanda: Right. That's exactly what happened to me. Now I know that was the first red flag of this practice, but I didn't know at the time. I was just like, Okay. Listen to what the doctor says. So I just kept going to my appointments and I generally felt okay but at my appointment check-ins, my blood pressure started to be high. They would put me into the room and I would lay down on my left side and they would have me do the whole appointment that way and then they would check my blood pressure at the end and it would be okay so they would have me come back in a couple of days for a re-check and it would be okay. We just continued on that way until I circled through all of the doctors and back to the nurse practitioner. She was really the only one who seemed a little more concerned than everybody else about what was going on. Monitoring for preeclampsiaAmanda: I got back to her and she sent me to the hospital for a blood pressure monitor. It wasn't super high so they sent me home, but they told me to do a 24-hour urine collection. I did that and my protein in that came back at 299 and she said, “Well, 300 is preeclampsia so we are just going to keep monitoring it.” Meagan: Mhmm, okay. Amanda: Okay. That's exactly what I said. Meanwhile, I'm not exercising. I'm just taking my prenatal and going to these appointments. I didn't have any preeclampsia symptoms either. I had no headaches, no spots, no swelling. I just felt yucky. I just chalked it up to pregnancy. I thought, Okay, I'm pregnant. This is what I should feel like. Meanwhile, people around me are pregnant and they are like, “I feel fabulous. I love this.” I was like, I don't love this. This is not great. I'm excited to have a baby but I don't love it. I also got carpal tunnel. Meagan: That is a thing by the way during pregnancy that people don't talk about. Amanda: They don't and I didn't know about it. My doctors were just like, “It'll go away when the baby is born. It will go away when the baby is born.” I'm like, “But I'm really in pain. My poor husband has to cut my food. I can't function here.” Finally, one of the doctors said, “Well, if it hurts that badly then you can go to a hand and wrist doctor.” Okay, so I did and I ended up getting a cortisone shot because it was unmanageable. I had the braces. I was doing night braces and day braces so that did help a lot. A high blood pressure and getting admitted to the hospitalAmanda: In the meantime though, we moved from an apartment to a house. I was the matron of honor in a wedding and then we moved into our house on July 17th. I had a surprise baby shower on August 6th and August 8th which was my 36th week, I had a non-stress test at the hospital. I went into the hospital for the non-stress test. They took my blood pressure. The nurse didn't say anything. She was like, “I'm just going to take it when it's over,” which is something I had heard the entire time. I do the non-stress test. She takes my blood pressure again. She says, “You know, the doctor wants to talk to you.” I was like, “Okay. That's fine.” I go into this little room and the doctor starts saying things like, “Not going home” and “Going into triage” and “Keep you pregnant as long as possible”, so I was like, What? I just couldn't even process those things. Meagan: And there wasn't any extra talk of, this is why. Amanda: No. Meagan: Yeah, okay. Amanda: No. I called my husband. I was like, “Listen, you might want to come be with me because I'm not sure what's going on.” So I go over to triage which was right around the corner and I'm waiting in that waiting room for over an hour. I'm still not thinking there is any type of emergency. They take me into triage and they take my blood pressure which was 214/111. Meagan: Okay. Amanda: Yeah. Meagan: Okay, well that's high. Amanda: Yeah, so then everyone starts going a little bit crazy. They start giving me medicine. They have me only lay down. I'm not allowed to get out of the bed and they start talking. I start hearing words like, “Possible seizure” and I'm like, “What is happening here?” A nurse finally comes over and says, “We are going to admit you. We just don't know yet if it's to labor and delivery or high-risk OB.” I looked at my husband. I was like, “Are we having a baby right now? Are we having a baby?” Then at that point though, that's when all of the things started happening to me and I was not a part of any of these decisions. Cervadil, Magnesium, and CytotecAmanda: I realize that that was a very high blood pressure and I didn't really check it after that, but they do take me up to labor and delivery where the doctor starts with Cervadil. This is on a Monday night. She inserts the Cervadil but I had zero dilation. They also put me on magnesium and when they did the magnesium, they also wanted to give me a catheter because they didn't want me to move. I said, “I don't really want that.” At this point, I still felt fine and nobody was really explaining to me–Meagan: The severity of things and what was really happening, yeah. Amanda: Right, right, right. So then they were giving me the saline. It was just so much fluid so I had to use the bathroom a lot. They were just letting me use the bedpan and teh nurses were so irritated by me. They would just stand there and watch me. I just felt horrible. It just was a very uncomfortable experience. Then there was the magnesium which–Meagan: Bleh. Thumbs down. Amanda: Yes. It was awful. I just felt terrible. They also gave me a shot for lung development because I was only 36 weeks. Yeah. My water broke on its own but that is the only part of labor that I experienced at all with him. After my water broke, they gave me a dose of Cytotec, and literally nothing happened. Not one thing. My blood pressure was still unstable. The magnesium made me feel awful and then I felt decreased movements. I just kept telling the nurses, “I can't feel the baby moving. I can't feel the baby moving.” I was scared. At one point, we knew nothing was happening. My husband and I actually called the doctor and said, “Should we have a C-section? Is this what is going to be happening?” They said, “No. Let's just see how this plays out.”Looking back, I'm shocked that that was the answer they gave me because of everything else that was going on. They just kept doing cervical checks and they were very uncomfortable because I had zero dilation and I didn't know I could say no. In fact, one doctor came in. This was actually the doctor who ended up delivering him. She said, “Do you want an epidural?” I said, “No. I don't even have any pain.” She said, “Well then, you need to let me check you.” Meagan: Wait, because you didn't want an epidural then you had to let her– what? Amanda: Right. I think she was saying this because I was acting like it was uncomfortable. I mean, it was uncomfortable. I wasn't acting. Then they gave me another dose of Cytotec. Nothing is happening. Now this is late Tuesday night. My blood pressure is all over the place. They keep giving me different doses of medication. I was on fire from the magnesium. I just kept saying, “This room is so hot.” They said, “But it's the coldest room in the wing.” “I don't care. I'm burning up.” Meagan: You're like, “My skin feels like it's on fire.” Amanda: So they gave me a fan. That was their accommodation for that. Consenting to a CesareanAmanda: It was around 12:45 so now this is Wednesday morning at 12:45 AM. The doctor comes in and she is just sitting on the end of my bed. I was in and out of awareness. I remember having her be there, but the magnesium is terrible. They just kept taking my blood pressure and she just kept giving me medication. All of a sudden, she stands up and she says, “We need to do a C-section right now.” I still don't know to this day if it was a decel. I don't know if it was his heart. I don't know if it was my blood pressure. I don't know what happened that made her stand up, but I just remember watching that happen and the look on her face. They were laying me down. They were giving my husband scrubs. I'm signing all kinds of consent forms laying down and then they gave me this awful drink for nausea and wheeled me into the OR. Because I had the magnesium, they were lifting me. I wasn't allowed to do anything by myself and I forgot to mention that since I wasn't exercising or doing anything, I gained 90 pounds during this pregnancy which was terrible but I didn't know. I wasn't small and they were moving me around. I get a spinal. As soon as I got the spinal, I said, “Oh my goodness. I'm going to be sick.” I just felt so nauseous and I remember the anesthesiologist behind me saying, “It's okay. We're ready,” and other people saying, “Lay her down. Lay her down.” They immediately lay me down and then I vomit into the bucket. Meagan: Oh yeah, that's the most miserable feeling. Amanda: It was terrible. He was ready. He did have a bucket. He wasn't lying, but then they squirted something on my stomach and I just remember saying, “I can feel that. I can feel that.” The doctor says, “Yeah, but is it cold?” I said, “No.” She says, “Starting incision.” She just is going. Throwing up during the C-sectionAmanda: Literally every time they pushed on my stomach, I was throwing up. Every single push and shove they did, it was awful. It was awful. But at 1:38 AM, our first son was born and there was one squeaky little cry and then he stopped and the NICU team got to work on him. They were about to take him up to the NICU and God bless my husband. He stops in front of the door and says, “Can she at least give him a kiss first?” They brought him over really quickly. I got a kiss and then they took him away. All was quiet. I was still nauseous and I just remember the anesthesiologist saying, “They're just putting you back together. Why don't you try to take a nap?” I was like, “Um–”Meagan: Okay. Amanda: Right. Needless to say, the bedside manner all the way through was not great. Meagan: Not great, no.Amanda: But once I got into recovery, I was just holding onto the fact that they said I could see my baby in 24 hours. I was like, Okay. I just have to make it 24 hours and they will take me to see him. I set an alarm on my phone. I am pumping. They gave me the pump. I am pumping. Any colostrum I am getting, I am sending up to the NICU. My blood pressure is still not settling down. Waiting 32 hours to hold her babyAmanda: 24 hours goes by. I call the nurse. I'm like, “It's 24 hours. Take me up to see my baby. Please take me up to see my baby.” She's like, “Well first, we have to take your blood pressure.” It was not good. She was like, “Wait 2 more hours and then we will check.” I was like, “I just waited 24 hours and now I have to wait 2 more.” They take my blood pressure again and it was fine. I was like, “Yes. I'm going to go see my baby.” They were like, “Well actually, you have to walk and go sit in this chair first and then we can take you up. We have to take your blood pressure from this chair.” I sit in the chair. My blood pressure is not good. “Oh, you have to get back in bed. We can't take you up.” At that point, I just lost it. I was like, “I can't.” I told my husband, I was like, “You have to tell people to stop texting and stop calling. I cannot do this. I just don't understand what's going on here.” I did not know it at the time, but after they got me back in bed, my husband went back into the hallway. He told the nurses. He was like, “You have to take her up there. You have to take her up. She has to see that baby.” Sorry. Finally, the nurse came in and she checked my blood pressure and it wasn't great but she thankfully had I guess fewer patients so she came up to the NICU with me. She did take me up there and after 32 hours, I finally got to meet him and hold him but as soon as we were together, both of our health's dramatically improved. My husband knew that that's what we needed. I'm so grateful that he did that. Meagan: Absolutely. Amanda: I ended up staying admitted for 5 days because they just couldn't get my blood pressure situated and then our son Jeffery David came home after 11 days. Physically, my healing was okay because I had 11 days of sitting. Meagan: Hanging out in the hospital not doing much. Amanda: Yeah, and you know, God bless my family and friends who drove me to the hospital every day to go see him. Some of them sat with me for hours and hours and hours just because I was by myself but my mental healing was not great. Because of everything that happened, I had just closed the chapter on kids. We were apparently one and done. I told my husband, “I am not doing that again.” I mean, I was on blood pressure medicine for 2 years after that. Meagan: Wow. Amanda: Yeah. It was bad. I just said that I always wanted more kids, but I'm not going to do that again. That was terrible. Finding The VBAC LinkAmanda: So my son was about 2 and I was listening to a different podcast. They were interviewing these two doulas who had VBACs and I was like, Who are these women? Then obviously, it was you guys. Meagan: That's awesome. Amanda: I went over and I found The VBAC Link. I was like, Oh my gosh. I didn't even know a VBAC existed up until this point. I was listening to your podcast and I listened to all of the episodes and then I finally said to my husband, “Listen, I found this information. It's really inspiring and really informative and if we ever had another baby, this is what I want to do.” He is the most supportive person that exists. He is my biggest fan and biggest cheerleader. He was like, “Okay. That's fine.” With a list of questions from your website, I went and found a new OB who I interviewed and I decided that they were supportive because aside from answering all of those things positively, she could also tell me the nearest provider who delivered VBAC twins and the nearest provider who did VBAC breech births. Meagan: Wow, that's awesome. Amanda: She said, “It's not here, but these are the two places that you could go.” I was like, Okay, I feel like this practice will work. It was also much, much bigger. They had two midwives on staff which I was very interested in because I'm definitely more of a midwifery mindset. In the meantime, I also went to pelvic floor therapy and while she fixed a lot of internal things, she also did a scar release which was very intense but very, very needed. I didn't know that until I had it and then I was like, Oh my gosh. I didn't realize how uncomfortable I was just living my life all of the time. It was amazing. Meagan: How game-changing it really is. Yeah. Not even just for birth, but for life like you said. Amanda: Yes. I couldn't even sit criss-cross applesauce just because I had so much tension in my hips and everything. It fixed so much. Praying for a babyAmanda: Then my son is approaching 4 years old and then one night we were saying our prayers just he and I at night and he says, “I pray for a baby in mommy's belly.” Meagan: Aww. Amanda: I was like, “What?” Meagan: “What did you just say?”Amanda: Yeah. There was no one pregnant around us at the time. I didn't even know at that time that he knew that babies in bellies were a thing. That continued for weeks. I never once reminded him. Every single night, he would pray for a baby in Mama's belly. I talked to my husband. I was like, “We need to address this one way or another. We either need to tell him that that is not happening or we need to have a serious discussion.” So since I'm here, you know what we decided on. Meagan: Spoiler alert. Amanda: We were blessed with a second pregnancy. Now, the day I took that pregnancy test, I went on The VBAC Link website. I looked up your doulas and I found doulas in my area. I just kept scrolling back to this one profile that just kept speaking to me. Her name was Mallory. I sent an email to her which was “Seeking doula, have questions”. She wrote back to me and that is actually who I ended up having as my doula. She was literally with me from day one. But I started this pregnancy at advanced maternal age because I was 35 at the time. I was plus-sized so while I wasn't 90 pounds heavier, I had lost some weight, but I still had a higher BMI. I also consistently worked out 4-5 times a week and I was loaded with information. I had a new OB and I instantly became their worst nightmare. I know it because–Meagan: Because you had all of the information. Let me just tell you. Providers, I think it catches them off guard when people come in and have information and they are like, “Oh, wow. This lady knows what she is talking about.” That's how it should be. We should know what we are talking about. Amanda: I agree. I always say that I wish there was a second-time mom the first time because I just went in armed with so much information that I never would have gotten if I didn't have such an awful experience the first time. I started taking a baby aspirin every day just because of the blood pressure issues before. Scared or scarredAmanda: This is a much larger practice. Like I said, they had two midwives and as I rotated through those doctors, I realized that some were supportive, some were tolerant, and some were scared. Meagan: Oh yeah. I like that you say that. Scared. Because I think that's the case with a lot of the “unsupportive providers”. I think they are scared or scarred. Amanda: That's a good point. Yeah. That's a good point. Meagan: They just haven't had a great experience. Amanda: Right. So along with all of this medical information, I also am very strong in my faith and I was having a hard time. I was having an internal struggle because I had all of this information and I wanted this so badly but I was struggling with the fact of what if this wasn't God's plan? I was fighting for all of this stuff and what if it wasn't His plan? I shared that with my doula, Mallory, and she actually said to pray then if this is not Your wish, then take the desire away. Meagan: That just gave me the chills. Amanda: Yeah. I wanted to share that because it changed me so much. I prayed it every single day of my pregnancy and the desire never went away. I felt like it was okay. Because I was able to pray that and the desire was never going okay, I just felt so strongly and continued going along in this happy, healthy fast pregnancy. There were no physical issues. I had no carpal tunnel. I gained a total of 16 pounds. Total. I mean, I worked out up until 39 weeks. At my 39-weeks, I was doing body pump. I lifted the weights over my head. The instructor was like, “How long are you going to do this for?” I was like, “Actually, I'm all done today.” Meagan: Today is the last day. Amanda: If I knew though that I was going to go to 41 weeks, I probably would have kept going but I just wanted to some time to be done with the gym and just get in the right mental space. Signs of wavering provider supportAmanda: At 30 weeks though is when the support started to waver a little bit. There were more questions about heart decels and reminding me of the continuous monitoring. At 32 weeks, I was having a scan to make sure baby was head down and I had been going to the chiropractor this whole time. This baby liked to hang out transverse. Before my 32-week appointment, the night before, I went to the chiropractor and I was like, “Listen. I know you have been doing Webster the whole time. I have an appointment tomorrow. They are checking to see if he's head down. What can you do?” He's like, “I got you.” So I don't know what he did, but I was driving home from the chiropractor and it felt like I was on a rollercoaster. You know how your belly does that flip? It was so intense at one point that I actually pulled over and chilled for a minute. It was just so much movement happening. The next morning, I went to my 32-week appointment and he was head down. Meagan: Awesome. Amanda: That was pretty cool. Then at 36 weeks, they started to pull the big baby card. Meagan: Oh yeah. Amanda: They gave me an ultrasound and they said that the baby was measuring 11 pounds. Meagan: Whoa. Amanda: I said, “That is impossible.” First of all, I gained 16. There's no way 11 of that is him. Then they were like, “Well, you do have a high BMI.” I was like, “That does not mean that he is going to be a big baby.” I had the article that I brought with me about all of the evidence and I declined a re-scan. That blew the receptionist's mind. I said, “No. I'm not.” She said, “Well, the doctor said you have to.” I said, “I don't have to though so I'll make my next appointment, but it's not going to be for an ultrasound.” That night, I actually got a phone call from a doctor who was like, “Why did you decline the scan?” I said, “My baby is not 11 pounds. He's not.” We had a big conversation and we agreed on a different type of scan. Now, I can't actually remember. I apologize. I can't remember what kind it was. They took different measurements but at that one, he measured 6 pounds. Meagan: What? That's a dramatic difference. Amanda: I know. Where I thought, that's where I thought he was going to be in my head so then I was given the green light to proceed with the way I wanted to. This whole time, I just had such amazing support from my husband but also from my doula. She would check in before every appointment. She just was amazing. I would be in the parking lot and the text would appear, “How are you feeling about this?” Then when I would come out, she would check in with me. In fact, even before recording this podcast, I got a text from her, “How are you feeling about this?” I was like, She is a gem. But I got the green light. Meagan: We should have had her on. Amanda: I know. I did think about that. I feel so bad. Meagan: That's okay. That's okay. Amanda: She's got a new newborn of her own. I know, it's wonderful. At 36 weeks, I also started to get the on-call schedule of all the doctors. I would say, “Who is working this week?” I would keep it in my phone so I knew who would be working because there was one doctor who at an appointment told me directly that she is terrified of VBACs. I knew that I should avoid her at all costs because I just knew that if I had her, she would find some reason to deem it C-section worthy. Physical and mental preparationAmanda: Throughout this pregnancy, I'm doing chiropractic care. I'm drinking raspberry leaf tea. I'm eating the dates when I was supposed to eat the dates. I also went back to pelvic floor therapy and told them that I want to have a VBAC. Help me prepare for that. That was wonderful. I became so passionate about this whole thing. Everybody knew. My poor coworkers had to listen but if there was anybody around me who was getting a C-section, I had to tell myself, “They didn't ask you. They didn't ask you. They don't want a VBAC.” Meagan: I know. Amanda: I also got acupuncture because I was just trying all of the things. Also, in The VBAC Link Facebook group. I found someone was Catholic affirmations that they had made. She shared that file with me so I had them all printed out. I was ready to go and then my due date comes and my due date goes. Meagan: Hello, goodbye. Amanda: Yes. I had never been pregnant past 36 weeks before so I was like, Well, this is pretty awesome, but I felt incredible. I still was coming to work. I came to work on my due date and my principal was like, “I did not expect you to be here today.” I thought, Don't underestimate me just like those doctors. I'm here. Contractions beginSo on a Monday, I was 40+3 and I had an appointment. I saw a midwife at the practice who was actually a VBAC mama herself. She and I just had this vibe and I was like, Yes. I love her. I knew at that appointment at 40+3 that I was going to ask for a membrane sweep. So I did and she tried but I wasn't dilated at all. She was really giving it her best shot, but she couldn't do it. I felt fine. I was fine with it, but I was also a little disheartened because I knew that pressure was going to start coming from the providers. This is where my BMI came in handy because I could qualify for an early induction because of that because like I said, I had the work schedule and that doctor who was terrified of VBACs was working on Friday. Meagan: So just a couple of days later. Amanda: Yes. Yeah. This was Monday at this point, so I scheduled an induction for Wednesday. I was like, Okay. Let me give myself a couple of days to see what I can do, but I also knew I didn't really want to go too far past 41 weeks because I know at 42, the risks go up and I knew time was of the essence. After that appointment, I go back to school and I'm standing on the playground with my partner. There are all kindergarteners running around and running around. I felt this intense squeeze in my belly. I looked at my partner who has had three babies and I was like, “Oh my god, what does a contraction feel like?” I was like, “I think I just had my first contraction.” We were just cheering out there and they continued every 10-12 minutes all the way through Tuesday. I come to work on Tuesday. I was still having contractions but they weren't increasing in intensity so it was okay. Meagan: Yeah, just happening. Amanda: Yeah, but Tuesday, I did decide to leave work early. I just checked in with my principal and I said, “I think I'm going to go home. I think being in a better headspace knowing I'm home and relaxed might help.” As I was leaving, one of my coworkers who had a C-section several years ago came up to me and she said, “There are a lot of women who would love to be in your shoes so good luck.” I thought that was really special. Meagan: Mhmm. Amanda: I appreciated that. I knew. I was like, Yes, I'm doing this for me and for a lot of people. So anyway, sorry. I was in constant contact with my doula. I go home. My contractions are increasing to 7-10 minutes apart. They are more intense at night. Now they are 5-10 minutes apart but I still decided to go to the hospital on Wednesday morning for the induction because I know my body. With my first baby needing the NICU, I knew that as much as I would dream of a home birth, I know that I was afraid in case intervention was needed and I knew that my body would just relax when I knew I was in the place where the interventions could be if I needed them. Advocating during laborAmanda: I send my son to preschool and I go into the hospital with my birth plan and all of the things. I tell the doctor I want Foley but no Pitocin. He was like, “Uh,” and then he watched me have a contraction and then he said, “Are you having contractions?” I said, “I am.” He said, “Okay, we can do it then.”I got the Foley and he also when I was talking with him about my birth plan said, “Listen. We all read it and we want this for you.” I just thought that was a cool thing for him to say. Meagan: Validating. Amanda: Yes. So I'm in New Jersey and here, VBAC after two C-sections is not a thing. I knew that this was really my chance and I also knew that really, two was enough for me. I knew I wanted two children to make our family complete and that was it. One of the things for a VBAC here in the hospital and with the practice is continuous monitoring. Trust me, I tried to not have them do that. Meagan: It's a real fight if you decide to try to fight it and that's really common everywhere. Continuous fetal monitoring is usually pushed really hard and it's one of those things where it's like, is it worth fighting for to you? You have to weigh it out because you really do have to put up a fight. Amanda: I tried, but like you said, I wanted the VBAC more so I was like, Okay, fine. We can do this. They did thankfully have a portable monitor because I really wanted to labor in the shower. They had a portable monitor. It could go in there. I was like, “Good. We're golden.” But then my baby did not want to be on the monitor so he kept falling off but there was no decel. There was never a concern. Meagan: Just loss of heart rate because baby moved away. Amanda: Because the monitors fell off. Yeah, so at one point, one of the midwives– not the VBAC midwife, the other midwife– comes in and says, “We're just going to put an internal monitor in.” I remember my doula looked at me and she said, “Do you know how they do that?” I said, “No,” so then she explained that to me and I declined. Meagan: Yeah because they do have to break your water to do that. Amanda: Oh, I'm sorry. My water did break. Meagan: Oh, your water did break. Amanda: I apologize. I missed that. Gosh darn it. Meagan: I might have missed that. Amanda: No, I missed it. I missed it. But I didn't want the internal monitor. I just didn't feel like that was right for me. I was like, “I'll just keep struggling with this. He is safe and happy and comfortable. I'll be fine.” The night nurseAmanda: Everything was going fine. My body was doing it. I didn't need Pitocin and I was loving labor. Everything that I had practiced and done and just my head space was good and I had listened to some fear-release meditation prior to this and it was just wonderful. I was living in labor land. It was wonderful. Then shift change happened and the night nurse came. The night nurse was very, very intense. My day nurse would let that monitor ride a little bit without being on. This night nurse was not having it. Continuous monitoring meant continuous monitoring and she felt that she needed to do that 3 inches from my face with her hands just pressing and touching me and I really was feeling very overwhelmed by her. Meagan: Yeah. Amanda: I was trying to ignore her and they brought in the bar and I was laboring on the bar. It was wonderful but I still remember that I could smell her breath through her mask. It was too much. She was too much. I said, “Please can I labor in the shower and then we can get together?” She was like, “Okay, as long as baby stays on the monitor." I was like, Please baby, stay on the monitor. So I get in the shower and I was like, Okay. We're fine. Life is good. This is wonderful. I feel great. I'm rocking. It's great. Then I hear the bathroom open and I turn around and she is standing there in a full raincoat. She's got a head cover. Meagan: A raincoat? Amanda: She's got a plastic gown on, plastic shoes, and she comes in the shower with me and is trying to adjust this monitor. Meagan: Oh dear. Amanda: I lost my mind. I don't remember what I said but all I remember is screaming at her and her leaving but telling me I had to come out of the shower. So she leaves and I walk out and my husband and my doula are just snickering because I just kicked her out. But I was like, “Why is she in the shower with me?” I get dried. I get redressed. I'm back in the bed and she's back. Then my blood pressure starts spiking and I start hearing, “High blood pressure, high blood pressure.” I'm like, Oh my god, it's happening. Meagan: It's her. It's her. Amanda: Right, but I got scared because of what happened before. Meagan: Of course. Amanda: I was like, “I can't have this.” I remember Mallory looked at me and she said, “Do you want an epidural?” I didn't initially want one because I wanted to feel this. I wanted to feel all of this. She said, “It would just be a tool to reach your ultimate goal.” Now, I knew two things at that time. It was one, an epidural would help keep me still which was going to help keep this monitor one and two, it's known for bringing blood pressure down. So I agreed. I was kind of sad about it, but I knew ultimately that I was going for the VBAC. That's what I wanted so I had to keep that in my sights. In my head, I didn't say this out loud, but I said, “Okay. If I am a 6 or less, I will get an epidural.” I had a doctor come in and check and I was a 6. I get the epidural and obviously, it doesn't work so I get a second epidural. Meagan: Oh my gosh. Amanda: It was lovely, but that one did work. That brought my blood pressure back to normal and I was still, but then man. Between my husband was helping my doula and she had the peanut ball and she was still moving me. She was holding that monitor on. She was watching that monitor for me. It was just amazing but the problem was that the epidural stopped my contractions. Meagan: That is a downfall that can happen.Amanda: Yeah, so then I did consent to Pitocin at that point because everything stopped. “It is done.” Amanda: I had the epidural. I had the Pitocin. Things were progressing. I was dilating. We were moving me as much as you can with the epidural and then around 4:00 PM, my epidural wore off and I felt it wear off. I was like, Oh my gosh. At 4:45, the midwife came in and she checked me. She said, “Oh, you are 9 centimeters. This is wonderful. I'll be back in a few hours.” I'm thinking, A few hours, I don't feel like I have a few hours here. I felt my body start pushing all by itself. I was like, Oh my gosh. This is amazing, but I was like, “You have to get her back here. I know she said I was just 9, but you have to get her back here.” She came back and she said, “Oh, you're 10 already. Let's do a practice push.” I was like, “Wait. I need the mirror. Where's the mirror? I want to get the mirror.” There was a full-length mirror that they brought in and I thought there was going to be a little hand mirror situation so I was really happy with the full-length mirror that came in. She said, “Let's do a practice push,” and she was like, “Oh, you are an excellent pusher. You've got this.” I'm watching in the mirror and I hear from the hallway, “Don't let her push until I get in here!” And it was the doctor that I originally interviewed. She came in. She said, “I want to see this through.”Now, meanwhile, I had not seen her throughout my entire pregnancy as one of my providers but I thought that was so cool that she remembered that and came in for this. It was the midwife, not the VBAC midwife but another midwife and her were there with me and as I started to push him and his head came out, the midwife said, “Oh, do you want to feel his head?” Before I could even answer yes, the doctor said, “Oh, she does,” and takes my hand and I feel him. I'm pushing. I'm watching. My doula is taking pictures and all of a sudden, the midwife is blocking the mirror. I'm like, looking at her and I'm like, “I can't see.” I'm hearing her say, “Amanda, Amanda, Amanda.” Finally, I look over and she's blocking the mirror because she is holding my baby in front of me. Meagan: Oh my gosh! No way. Amanda: I was like, “Oh my gosh!” Then I'm looking at him and then there is a bright light behind him and I feel this moment of peace and I feel in my heart and I hear, “It is done.” I just know that God was there with me the entire time and I'm so grateful for that. My husband got to cut the cord and I got to hold him immediately– well, we didn't cut the cord until it stopped pulsing. he was so cute. He was like, “She told me to wait until it's white. Is it white? Is it white? Is it white?” It was just wonderful and he cut the cord. I got immediate skin to skin and I got to do his first latch right then and there which was so different. It was so different than my son. It was just such a redemptive, wonderful experience. I just am so grateful to The VBAC Link for seeing me through it and for giving me the information and just the inspiration to even take this on because if I had never found you, I don't know for sure if I ever would have gone through with it. So, thank you so much for that. Meagan: Oh my gosh. You are so welcome and thank you for sharing this beautiful story. I'm looking at your photo right now and oh my heck. I don't know who took it–Amanda: My doula, she took it. Meagan: Mallory?Amanda: Mallory. Meagan: Mallory killed it with this photo. I mean, seriously it is beautiful. Amanda: Thank you. Thank you. Meagan: I highly suggest if you are listening right now, head over to Instagram or Facebook and check out this absolutely empowering photo. The emotion, oh. Congratulations. I'm so stinking happy for you. Amanda: Thank you. Thank you. Thank you. It was quite a journey. Importance of lactation supportAmanda: I just wanted to add one more thing if I could. Meagan: Yes. Amanda: I got to nurse Jeffrey David eventually, my first baby once he left the NICU but it was a rough time and then with Charlie, my second, I got to latch him right away and I am still nursing him now. He'll be 3 in June. I just want to say just like you get doula support for your birth, get yourself some lactation support if breastfeeding is the way you want to feed your baby. Meagan: 100%. 100%. Amanda: Yeah, so I used my friend, Lauren. She is from Cozy Latch Counseling and she has seen me through this entire process. I went back to work. I was able to pump and provide milk and now like I said, he's almost 3 and I'm still able to do that. If I hadn't had that lactation support from the very beginning, I don't know if that journey would have been as successful as it was. Meagan: Yeah. I mean, I full-on believe having lactation support even before the baby is here to talk about it. Talk about your plan. Discuss what you are wanting, your desires, your needs, and then getting that help right away even if it's your second, third, fourth, or fifth baby. Everyone is so different and I love that you brought that up because definitely, we are passionate about that for sure as you know or if you have been listening. We love The Lactation Network. We absolutely 100% would agree with you on that. Oh my gosh, well my face is just so happy. Can you just see my face right now? Amanda: I can. Meagan: I'm just smiling so big. My cheeks are throbbing a little bit, but that's a good thing. I'm just so grateful for you. This is such an amazing episode and congratulations again.  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

Podcast Fam, on March 27, 2024 our episode was called "Balloon for PROM: Yea or Nay". Although mechanical cervical balloons for induction were the focus, we also discussed which medication is better (based on published data) for labor induction after PROM. Well, in this episode, we pick up from march with ANOTHER NEW STUDY released today (June 25, 2024) in AJOG MFM. This RCT builds on the evidence that going straight to Pitocin (despite an unfavorable cervix) is the way to go after PROM. Although there are study design limitations, this is reassuring- and validating- information. Listen in for the "I TOLD YOU SO DANCE", and for details.

Breaking down the most common birth interventions- Foley Bulb, C-sections, Cervidil, Breaking your waters, Epidural, Pitocin and MORE!We're talking about EACH ONE's purpose, pros and cons, and how each is administered. Get out your birth plan or note pad, because you'll want to take notes!Today's episode Amy from the Somatic Mother walks us through labor and delivery 101.Today's episode is going to cover these interventions:- Cervical checks pros and cons- IV's and monitoring pros and cons- Cervidil  pros and cons- Cytotec pros and cons- Foley Bulb pros and cons- Pitocin pros and cons- Artificial Rupture of membranes / breaking your water pros and cons- Assisted Delivery pros and cons- Episiotomy pros and cons- Epidural pros and cons- Cesarean Section pros and cons-------------------------------------------------------------------------------------------------------------IMPORTANT LINKS:- Sign up for the Learning To Mom Newsletter HERE:https://mailchi.mp/2dca1ad2573f/learning-to-mom-newsletter-opt-in- Shop HERE for the BEST Montessori toys and furniture at mylittlesongbird.com                  Connect with them on Instagram Here                   Use LEARNINGTOMOM15 at checkout for 15 percent off!!! - Shop HERE for the Flipping Holder at flippingholder.com                  Connect with them on Instagram Here                   Use LEARNINGTOMOM at checkout for 20% off and free shipping!!- Connect with ME on Instagram HERE or at @learningtomom.podcastHow to connect with Amy:- Her website Linked HERE-------------------------------------------------------------------------------------------------------------what interventions are safe in labor, should they break my waters, what to include on my birth plan, how to be informed about pregnancy and birth, Pregnancy symptoms, First trimester tips, Prenatal vitamins, Pregnancy diet, Safe exercises during pregnancy, Maternity clothes, ultrasound information, Pregnancy apps, Birth plans, Baby registry essentials, Morning sickness remedies, Prenatal yoga, Gestational diabetes, Baby development stages, Pregnancy books, Labor signs, Breastfeeding tips, Postpartum care, Childbirth classes, Maternity leave rights, Pregnancy health insurance, Fetal movement, Pregnancy support groups, Safe skincare during pregnancy, Pregnancy podcasts, Nursery decorating ideas, OBGYN recommendations, is pitocin safe in labor, are cervical checks safe in labor, all the medical interventions of a hospital birth

“Birth is birth and we just want our babies here safe, but I also think that we all deserve to be empowered to have the birth that feels right.”One night, a few months after her second C-section, Arianna had a dream that she was giving birth vaginally to a sweet baby boy and pulled him right up to her chest. The next morning, she took a pregnancy test and it was surprisingly positive. Coming from a small town in Wyoming, she already knew from her second pregnancy that VBAC was not allowed locally. But at that moment, Arianna knew she was going to do whatever it took to have her VBA2C. Arianna traveled 2.5 hours each way for routine midwife and OB appointments in Montana to have VBAC-supportive providers. She faced many roadblocks including a short pregnancy interval, gestational diabetes, preterm premature rupture of membranes (PPROM), a medical induction, other interventions she wasn't planning for, and slow progress. But her team was patient and encouraging, Arianna felt divinely watched over, and her VBA2C dream literally came true!  The VBAC Link Blog: What to do When Your Water BreaksThe VBAC Link Blog: VBAC With Gestational DiabetesThe VBAC Link Facebook CommunityNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 01:44 Review of the Week03:52 Arianna's first birth story07:04 Requesting a C-section08:34 Arianna's second birth11:36 VBAC preparation15:37 Signs of preterm labor20:34 Going to the hospital24:04 First cervical check27:10 Slow effacement 31:05 Catching her baby33:59 Importance of support36:35 Dual care tips44:56 Traveling tipsMeagan: Hello, Women of Strength. We are on episode two of the week and I am just so excited that we are doing this. It is so fun to bring double doses of VBAC, CBAC, and educational stories to inspire and encourage you during your journey. Today, we have our friend, Arianna, and she is from Wyoming. Is that correct?Arianna: Yep. Meagan: Yes, Wyoming. Where in Wyoming?Arianna: Buffalo. It sits under the Big Horn mountains.Meagan: Awesome. You guys, she actually traveled quite a distance to find her provider and that is something I think we get often in our community where it's like, “I don't know how far is appropriate to travel.” I think the answer literally depends on what's appropriate for your family and your living situation and your needs and everything like that. But Arianna– I just started butchering your name. Did you travel 2.5 hours?Arianna: About 2.5 up to Montana. Meagan: Okay, so we are definitely going to want to talk about that because I know this is going to be something that people are going to be interested in. Also, you had gestational diabetes. Arianna: Yes. Meagan: Yes. So okay, you guys, any story right? But if you are looking for knowing how to travel or gestational diabetes or anything like that, this is definitely the episode to listen to. 01:44 Review of the WeekMeagan: But of course, we have a Review of the Week and this is a fresh review, well fresher review. It's in 2023 so just last year which is crazy still to me to say that this is last year, but it was in 2023 by sayerbaercooks. The review title is “Educating and Empowering.” It says, “Just had my VBAC. My pregnancy and birth changed all for the better thanks to this podcast and the women who shared their stories. This tool gave me the information I needed to advocate for me and my baby. I learned about the medical system and about myself and I had a fantastic birth which was the icing on the cake. I cannot thank you all enough.”I love that so much. I love that this podcast is doing exactly what we created it to do. So Women of Strength, one, if you have shared your story on our podcast, thank you. Thank you so much for creating such an amazing space for all of the Women of Strength listening. And if you are interested in sharing your story, definitely email us. Reach out or you can go online at thevbaclink.com/share and submit your podcast story. We're sharing both on social media and we're sharing on the podcast. We are hoping to get to some more of our submissions. 03:52 Arianna's first birth storyMeagan: Okay, darling. I am excited to hear your story. I feel like as I was reading your blurb about your story, I feel like there is so much that you did, truly, that you did between hiring a doula, driving 2.5 hours, going to a chiropractor, reading all of the books, listening to the podcast, eating really well, finding the true support that you deserved– you did a lot and that is hard to do. Sometimes we do all of that and our birth still doesn't end up the way that we wanted, but sometimes I feel like when we look back, we at least know that we did all that we could, but I'm so excited for you to share your VBAC after two C-section story with us right now. Arianna: Thank you so much for having me. I am so excited. I'll just start with my first. I feel like that's where we go. I was a single mom with my first pregnancy and I was young. I was only 22, or almost 22, and I think really the only thing I did was the 2-hour hospital birth class. I think I just had this expectation of, “Well, women push out babies and that's just what I'll do.” I didn't feel prepared. I felt very alone. I was induced at 41 weeks and 6 days because my body was just not having it. I did everything I could think of and acupuncture and he just didn't want to come out. I had a pretty easy induction. We started with Cytotec and Pitocin. After I got my first dose of Cytotec, my water broke two hours later. I was 2 centimeters. Meagan: Darn it. Arianna: That was rough and the contractions were just insane. Pitocin contractions are the devil's work, I think. There were super painful. I had my mom with me, but I just didn't feel like I was in a supportive environment looking back especially. I got the epidural right away because I was like, “Oh my gosh, it's not supposed to be this painful.” Meagan: Yeah. Well, Cytotec, Pitocin, water breaking– all of those things packed together, that's tough. Arianna: It was intense. I labored in bed all day. All day long. I progressed really well. I got to 10 centimeters. I started pushing and I was like, “La, la, la. I'm going to have a baby. This is great. I've got my drugs. I can't really feel anything.” But I think within the first hour of pushing, I was like, “Well, I'm doing something wrong because nothing is happening.” The doctor kept saying, “He's so high up. He's not coming down.” So I think what broke me though is the older nurse. I will never forget her face, but she just made a snide comment of, “Girls these days just don't know how to have babies.” Meagan: Oh.07:04 Requesting a C-sectionArianna: I was like, “Oh, okay.” I pushed for three total hours and then I started to just really feel like something was wrong. I asked for a C-section. Meagan: Okay, yeah. Arianna: Looking back, I'm like, “There are so many things that could have gone differently.” We ended up with a C-section and he was OP, so he was face up and he was slanted. Meagan: I was just going to ask that. Arianna: Mhmm. He was a little slanted and OP. You know, later I found out he was kind of having some developmental things and he was struggling with the right side of his body so I ended up finding out that he had actually gone without oxygen and had a blood clot and had a stroke during delivery. I'm grateful for that C-section and trusting my body that things didn't feel right, but it came with a lot of trauma over all of it. Arianna: Around that time, my son was about 2, I met my now husband and we went down the road of diagnosis and specialists finding out he has mild cerebral palsy. Meagan: I was just going to ask if he has cerebral palsy. Arianna: He is a rockstar, truly. He has saved my life in so many ways. I am so proud of him. He works so hard with PT and OT and all of the things. 08:34 Arianna's second birthSo moving on, I got married to the most amazing man ever. He loved every part of me. I struggled pretty intensely throughout my teenage years with mental health stuff, suicidal ideation, depression, and all of those things. At the time, I was pretty heavily involved in suicide prevention. That is always a huge part of my life. We got married and we got pregnant right away. I had a miscarriage pretty early on and then we got pregnant again. I had heard of this little fairytale thing called a VBAC. I was like, “Ooh, yeah that's cool.” I brought it up to my doctor at our little small hospital. Immediately, he was like, “It's not really safe, but if that's what you want to do, we don't do them in the state of Wyoming.” So I was like, “Okay. Well, we'll just have a C-section,” because I really didn't know and I was still dealing with the trauma of my first birth. Five years had gone by and I wasn't aware I was so traumatized until I was having another baby. Meagan: That's often the case. We don't really recognize it until we are in that new situation and all of the flooding memories come in and we're like, “Oh crap. Wow, I have trauma.” Arianna: Yeah. My doctor was amazing. He really validated where my anxiety and my fears were coming from. I didn't want a C-section, but in my mind, we are told, “If you've had one, everyone says you have to have another. It's the safest option,” so I trusted that.At 38 weeks, my water broke. Meagan: Okay. Arianna: I was like, “Oh, my body could do it.” I still had my C-section, but that for me, was redemptive because I was like, “See? My body could do it,” and that was okay. That was an adventure. When my daughter was 6 weeks old, I got mastitis and was septic and in the hospital for a week and a half.Meagan: Yikes. Arianna: That was insane and I was on heavy-duty antibiotics for three or four months but I was also on the pill so those two things counteract each other if people don't know that, so when she was 7 months, we found out we were pregnant in a wild way. I had a dream one night that I had a baby boy vaginally and I caught him and brought him to my chest. The next morning, I took a pregnancy test. I told my husband, “I will not have another C-section. I will not.” That just started this, “I'm going to have a VBAC and I don't even know if this is real or if people after multiple C-sections do this,” because living in such a small area, I didn't know anyone who had ever had a VBAC. 11:36 VBAC preparationSo I was like, “Okay. We are doing it.” I got all of the books. I joined all of the Facebook groups. I started listening to The VBAC Link and I hired a doula. I was probably only 8 weeks pregnant when I hired a doula. I found the midwife clinic that was within the hospital in Montana 2.5 hours away. I knew I needed a doula there. I had a pretty good pregnancy. It was scary bringing it up to my provider here. I did see him a couple of times throughout my pregnancy just in case something happened. Meagan: Yeah, that's called dual care and I think that's actually a really great option when you are traveling or sometimes if you are going out of the hospital and you just want to be established in the hospital as a backup plan, doing that dual care is actually really good. Arianna: That was the hardest fight of the whole pregnancy because I was so set on getting my VBAC and it wasn't safe. There were just all of these things and eventually, he got on board, I think, because he knew how serious I was. I had such an amazing experience driving 2.5 hours away. Looking at it now, it wasn't a big deal at all because I was so set. It didn't matter. I would have gone anywhere because I was so set. “This is what I am doing.” The midwife clinic was within the hospital so they worked alongside OBs and everything. Sorry, I'm getting emotional. Meagan: That's okay. Arianna: The midwife clinic was amazing. They never once, every time I would go to an appointment, I'm like, “Okay. This is the time they are going to tell me that I can't. I can't have a TOLAC. I can't even try.” That's all I wanted. I wanted the chance to try. They were always so encouraging and amazing like, “No, you can do this.”It was a clinic so there were several different midwives that you saw on rotation. There were a couple of times I would catch one that was like, “You've had two C-sections. We don't really do this,” then there would be somewhere it was like, “Yeah. You're going to do great. This is going to be awesome.” I just tried to hold onto that. Really, the whole experience was just a testament to how loving God is in my life. I really had to find peace towards the middle end of my pregnancy and I just had to give it to God because I was starting to really become anxious. Arianna: Then I failed my glucose test and I was just like, “Well, here we go. I'm going to have a C-section now.” Then I really started to dive deep. The thing that got me through the 2.5-hour” drives there and back was The VBAC Link because I didn't have an army of women who got it in any way really. I needed that. It gave me a sense of community and this distant village of women I'm never going to meet. They're there. They're out there and it's definitely possible. So listening to stories of women who had similar experiences got me through. I had gestational diabetes. It was diet-controlled. I'm a little thicker than I would want to have been through a pregnancy, so the gestational diabetes in a way was kind of a blessing in disguise because it really held me accountable to exercise and eating healthy. It kind of helped in a way. I'm really grateful I didn't have to be on medication. Meagan: Yeah. 15:37 Signs of preterm laborArianna: So at about 30 weeks, I started losing parts of my mucus plug. I was like, “I don't think this is normal.Meagan: A little early, yeah. Arianna: But it grows back, so I was like, “I'll be fine.” At about 34 weeks, I went and had a big appointment with my MFM and my midwife. I got to tour the hospital and for a small-town girl, I was like, “Wow. This is insane. This is where you have a baby.” The NICU was right there. There were operating rooms right there on the floor in case of anything. We got to see delivery rooms. The lady who gave us our tour thought that I was genuinely insane because I had two C-sections. She was like, “Oh.” Meagan: I don't understand. When I went to go get my records, they looked at me like, “What? What are you thinking? You are scary,” like I was some plague or something. What? Arianna: Yeah, and I think the biggest thing I faced was, “Why? You had two C-sections. You recovered just fine. Why does it even matter?” Meagan: I know. Mhmm. Arianna: I could never really give them an answer because it wasn't– I think a lot of people made it sound like I had to prove myself and my ability as a woman and as a mother to have a vaginal birth. I think that's very valid for a lot of women because there's trauma in this “I'm not good enough” feeling still surrounded by C-sections which is not true. Birth is birth and we just want our babies here safe, but I also think that we all deserve to be empowered to have the birth that feels right. Meagan: Absolutely. Arianna: And that feels like we are worthy of that, that we could do it or just an opportunity to try. She was the first person that it didn't bother me. I'm like, “I'm 34 weeks. I am doing all the things and I'm going to have this perfect, totally chill VBAC experience and it's going to be amazing.” Well, the next week, I really started to have inconsistent contractions. I was really losing my mucus plug. I woke up at 35+4 and definitely had some bloody show. I just felt kind of leaky. Every time someone was like, “What do you mean leaky?” I'm like, “I just feel leaky. I don't know.” Meagan: You're like, “Something's going on down there.” Arianna: Something is going on, but it's too early, so I was like, “I'm just going to act like everything's fine.” My daughter had a doctor's appointment at the clinic that day, a wellness checkup. The doctor was like, “Are you doing okay?” I'm like, “Yep.” In my mind, I'm like, “If I say anything, they're going to check me and for all I know, I could be dilating. My water probably broke.” I was pretty sure my water broke. Meagan: Were you still inconsistent with your contractions at this point?Arianna: Yeah, mhmm so it was like, “No, I'm good.” I don't want to get stuck here. I don't want to have a C-section.20:34 Going to the hospitalArianna: So we finished up her appointment. I called my husband. I called the midwives and the midwife nurse I spoke to just told me, “If you want a chance for your VBAC and there is any chance you are in labor, pack up your stuff.” We are 2.5 hours away and those potty breaks at that fully pregnant, I'm going to have to stop and use the bathroom. It was going to take us a minute to get there. We got the kids situated and it was a beautiful day. It was so beautiful. My contractions were super chill and super inconsistent. We drove. We danced and laughed. I cried. I was nervous. I was excited. We got there and I really wanted KFC because I had just eaten super healthy my whole pregnancy and what were they going to do? So we got some food. We got to the hospital at about 2:30 in the afternoon and it was nice because the midwives had their own nursing staff. It felt so different than my first birth, tenfold and then even my C-section with my second. We got there and the whole time, I was mostly angry because we just drove 2.5 hours and there's no way I'm in labor. There's no way. We just wasted all of this time to come up here. The first thing they did was check to see if my water had broken. They did that swab. They sent it off and we just sat in the room for an hour. I was texting my doula and I was like, “Oh my gosh. They're going to make me have a C-section.” She's like, “No, just calm down.” She was so amazing. Yeah, they came back and they were standing there. We had the OG midwife and then we had a new midwife to that clinic so she was kind of just taking charge of things, but the nurse came in and she started writing on the board. Then I let out some potty words and I was like, “Oh my gosh.” Meagan: What the heck? Arianna: No. Quit writing on the board. I asked, “Is it negative?” She was like, “Yeah, your water broke.” I was like, “Okay, so I have to have a C-section. You're going to put me on a clock.” I just started downward spiraling. The stress. I was like, “It's too early. I'm only 35.5 weeks. It's too early.” That was the scariest moment because I felt so out of control. I really just had to start praying and listening to some music. So I was too scared to get a cervical check because I remembered not dilating with my first then even with my second, my water broke and I was 2 centimeters before I had my second via C-section.Meagan: Right. And you're not contracting a ton right now. Arianna: Not even. I mean, maybe one every 30 minutes and it was like mild, period cramps. I'd get an intense one every once in a while, but it wasn't consistent so I was really worried that I wasn't dilating. My water broke too early and I was like, “Even if they let me try, it's just going to be this cascade of interventions and everything is just going to go out the window. I've worked too hard.” It was awful. My mindset was not great. 24:04 First cervical checkArianna: I did end up letting her check me. I was 1 centimeter and I was only 20% effaced so there was a whole lot of nothing going on. After a few hours, they had to talk to my MFM because I was early. I had gestational diabetes. They had to talk to the on-call OB. We had to have this checklist of people and what we were going to do. She came back in and she was like, “Okay. I'm going to check you and if we're still good, we're going to do a Cook catheter,” which is the double Foley, “and we're going to do Pitocin.” Immediately, my husband stood up and was like, “She doesn't want Pitocin. Pitocin is not good. That is her last resort.” I felt really supported. I thought, “Oh my gosh. He's listened to me this whole pregnancy. These are things we don't want.” I talked with my doula. I talked with my husband and this was kind of my only shot if I wanted to try, we needed to get things going. But they were very good about never putting me on that clock. Meagan: Good. Arianna: Which was great. Yeah, so at about 7:00 at night, we had been there a few hours. I was 1 centimeter, but I was 50% effaced. She was like, “See? You are doing it.” We did the Cook catheter and they let me wait a couple of hours before starting Pitocin and they started very, very low. Meagan: Good. Arianna: Which was awesome. My doula came and we just walked. As soon as I got that Cook catheter, I was like, “All right. Come on, hubby. We are walking these halls because I'm not sitting down. I cannot.” I couldn't let my mind get the best of me. We walked for 5 hours. We were just moving. Meagan: Wow. Arianna: We didn't sit down. There were a couple of times with that Cook catheter where I was like, “Dear Lord, help me. This is the most uncomfortable thing ever.” We were on the opposite side of where my room was on the hall and my water gushed. I mean, it was the movies. I was like, “Uh, what do we do?” It's 12:30 in the morning and this cute little housekeeper came and she helped me get a little cleaned up. I waddled back up to our room. At that point, my contractions were coming. They were coming. They had upped the Pitocin a little bit and I still did not want to get checked or anything. I still had the Cook catheter, but I would say at about 1:30 in the morning, I was on my dilation station backward on the toilet and that thing just popped out. I was like, “Oh my gosh. It's happening.”That was a moment where I was like, “Okay. I'm going to get to have my baby.” I waited about another hour before I would let her check me because I was scared. I was scared for the discouragement of, “Oh, well you're only 4 centimeters or something.” She checked me at about 2:30 and I was 8.5 centimeters. Meagan: What?27:10 Slow effacement Arianna: I was only 50% effaced. So I had not effaced in that whole time. Meagan: Dilated but still thick. Arianna: Oh my lord. We don't talk about that I feel like. We hear, “8.5 centimeters” and I was like, “I don't need an epidural. I'm going to push this baby out in an hour. This is going to be great.” Yeah, no. I stalled. Nothing happened. They kept upping my Pitocin and I let her check me again at about 5:00 and at that point, I was having major back labor which then me and my doula were like, “Oh no. He's OP. He's definitely face up.” Meagan: We've got to work on this. Arianna: I was trying to walk and move in the bathtub and I was just miserable. I probably let those contractions that were on top of each other, no breaks, for another hour and a half and by 6:30 in the morning, I yelled, “Pineapple!” That was my safety word. My husband was like, “Don't tap out. You're doing great.” I instantly was like, “I'm not tapping out. Why would you say that?” He was like, “No, no. I just meant you are doing so good.” Because I had gone all that time without asking for drugs, my night nurse thought I did not want the epidural at all. She was very encouraging and amazing. She was like, “No, you're doing great.” My doula was pulling out the peppermint essential oils and all of the things and all of the counterpressure. I mean, I just was like, “If I don't get the epidural, I'm not going to make it. I won't be able to keep going. I'm exhausted. I'm in so much pain.” So lord bless that anesthesiologist because he was there within 15 minutes and I was struggling. I was like, “I can't breathe. I can't do this.” The whole energy of that room was so healing. It was so positive because no one was yelling. It was so stress-free. I got the epidural at about 7:30 in the morning and I slowly, very slowly kept going. Very slowly. I think at about 9:00 or 10:00, I was only about 9 centimeters and 70% effaced. That was a moment where I was like, “I'm going to end up having a C-section.” Meagan: That moment of doubt. Arianna: That doubt just came in and my doula and my husband were like, “No, you're not.” Once I got my epidural, my doula and my nurses were changing me every 30 minutes. I had the peanut ball. We were flipping positions. We were doing all of the things and my nurse came in at about 11:00. I called her and I was like, “I need you to check me because I need to get up and go number two.” It's not the baby, I swear. I have to go to the bathroom. She kind of giggled and she checked me. I was like, “Don't tell me.” It was those magical words that I had waited for my whole pregnancy, “You're complete and it's time.” Because I was early, we had to have this whole team of people. We had NICU staff and several nurses. We did a couple of practice pushes and his head was down there and ready. I ended up having to push for probably 45 minutes and my midwife had to just do a little snip because we really started to have some decels. I started to get a little panicked. My husband was just there and I just had to close my eyes and start praying, “God, you know my heart. I can do this.” 31:05 Catching her babyArianna: One more push and he was out. I helped bring him to my chest. He did come out with the cord wrapped around his neck so then I knew why he was starting to have some decels. I got to hold onto him for a little bit and then he had to go to the NICU because he was having some breathing issues. I just remember my husband saying, “You did it.” I think any woman listening to it who has had the VBAC, that moment, there's no moment like it really. It's not like, “Oh, I just had a baby vaginally,” it's “I just did something that so many people told me I couldn't do or that my body wasn't capable of” or whatever. It was so healing and so amazing. He was only in the NICU for a few days which was a huge blessing.Meagan: That's awesome. Arianna: I feel like just stuttered through all of that. I don't even remember half of the stuff I said or that I wanted to say, but I think overall, the experience was just a testament to how strong our bodies and our minds can be. I know that in the moments, I really believe I stalled because I got in my head. I was just like, “Okay, I can't do this. This is hard. I'm not progressing. My body's not working right.” I just really believe in the power of the mind. I think personally, my only goal in medication was to make it to 6 centimeters. I was like, “I just want to get to 6 centimeters without the epidural” and I made it past that. Meagan: Yes, you did. Arianna: I was very happy to get the epidural because I knew that I needed that break physically and mentally. Yeah, that's a rundown I guess. It was beautiful. I'm blessed that I have all of my babies here and that they were here safely. My second C-section was redemptive. It was healing. I had a doctor who listened to me and made me feel safe and cared for. In my VBAC experience, I had to fight for a support system that was almost 3 hours away, but what was so beautiful was what came after just this, “Wow,” or having people I don't know super well messaging me and be like, “Hey, what did you do? How did you go about this?” I'm like, “You know what? This is why it mattered?”33:59 Importance of supportArianna: It doesn't matter how your baby gets earthside, in my opinion. Meagan: It doesn't. It doesn't. Arianna: C-section is okay. It's totally fine. It's okay if you want repeat C-sections because that works for you but I think it also needs to be okay for women to want the opportunity to try for a vaginal birth as long as it's safe and healthy and everything, but I think for me, the biggest thing was feeling supported. It came in so many different ways but it's how I made it through for sure. Meagan: Yeah. Support is one of the biggest tools in our toolbag when it comes to achieving the birth we desire. Like you were saying, it doesn't mean we have to have a VBAC. It doesn't mean you have to have a C-section. It doesn't mean you can't be induced. We have to dial into what we desire and then find the support that surrounds that type of birth. I think that if I'm going to be super honest, that's where I get really angry in this community because I see time and time and time again people not being supported, people not being given the opportunity to even try to have it. You know what I mean? We just cut people off in this world and it's just so frustrating to me. Providers, why can we not step up to the plate and offer people support? Why do we have areas that are absolutely not supportive? If they are capable of giving birth to a baby, they are capable of helping someone give birth to a baby in any way, right? It's just so frustrating and it's for sure the biggest tool that we can have. That sometimes looks like driving almost 3 hours away or that sometimes looks like hiring a doula further away or whatever. It's important. It's so important and Women of Strength, I want you to know you are worth it. You are worth getting the support. You are worth finding the support and36:35 Dual care tipsMeagan: Let's talk a little bit about traveling. You talked a little bit about how you did a little dual care. I think it's a really great option to have if you are traveling, but there was something that you mentioned and I wanted to talk about this as well. It can actually sometimes be a little difficult because you've got one side that's not supportive and one side that is supportive. Sometimes, they are saying different things. It's pulling you in all of these directions, making you question, and that can be really, really, really difficult. I had a client years ago who did dual care at the same hospital for a little bit and then transferred out of the hospital. The midwives and OBs were like, “No, your placenta is going to die. Your uterus is going to rupture.” They were saying all of these really, really big and scary things. She would call me and she was like, “What do you think about this? Maybe I'm making a bad choice,” even though in the end she was like, “I knew better, but they got to me.” That can be something that can be hard to battle within your own mind and doubt that intuition. Know that if you are doing dual care, that can come up. Did you notice that? Arianna: Yeah, hearing you speak, I'm like, “Oh my gosh, that was how I was with my doula.” I would go here and see my provider. I think honestly, it's not that they wouldn't support VBACs, I just think the information they have is dated and realistically, it's not safe because “we don't have 24-hour anesthesia.” If something happened, they wouldn't be able to provide the care needed. But also, there were so many times where I felt like the information I was being told or the data was not anything I had found and then I talked with my MFM who was 100% on board and he was like, “Yeah. You're going to do great.” Then I was like, “Wait, what?” A big thing especially was, I don't think I would ever do that again if I had another. Meagan: Dual care. Arianna: Yeah, I wouldn't. It implants so much doubt. It's not that they weren't supportive, it's just that they weren't the support I needed. I think a big thing was I needed to feel supported because a VBAC is this hypothetical creature that lives somewhere far-off that no one has heard of, so that was the hard part was living in this tiny area where it was not safe, super dangerous, no one does it, especially after two C-sections. Meagan: Right, yeah. I mean, my dual care experience lasted very short-lived because I did end up transferring officially to my midwife, but I went in every time knowing that they were going to have an opinion, but I knew where my heart stood. It was nice to have those options if transfer needed to happen and things like that, but I knew what they were going to say, I was going to hear it but let it bounce off. It was really hard to have to go in there every time and be like, “Okay. You're going to get doubt and that's okay. People are going to doubt you and that's okay. You're not doubting yourself. Know it.” Arianna: Yeah. It was a mental workout every time. I knew they cared about me and my well-being of myself and my baby 100%, but I knew that in their minds, what I wanted to do was not a good idea and it wasn't safe. I think my biggest encouragement to people who maybe do dual care is the best option is not to go to their appointments alone. That's huge. I think I survived it because I had such a huge support system. I had friends who were like, “Nope. Do you want me to come with you? Don't get discouraged. You can do this.” Really, I had to get to a place in my pregnancy where I think with VBACs, we get really stuck with research and all of the information and the podcast and the forums on Facebook and all of these things, where it's like, “If you want to have a VBAC, it has to look like this.” Everything I thought was going to happen went out the window. I got gestational diabetes. I had preterm labor. I had to get induced. My baby ended up in the NICU. All of the beautiful aspects that everyone talks about around VBAC were not realistic because every birth is different for everyone.I think a big thing for the VBAC community that I didn't feel supported in is, “What if I have to get induced? What if I fail my glucose test? What if I have these barriers or preterm labor? What if I have all of these roadblocks?” Meagan: Well, you actually had a shorter interval too, but no one ever really said anything. There are so many things that something could come up. Arianna: Yeah, my babies were only 15 months apart. Meagan: There are all of these things and I'm like, “There are so many roadblocks that could have come up along the way.” Arianna: Oh yeah, when I unpack my VBAC suitcase and I look at things, I'm like, “Wow, this is heavy,” because I had also just had this near-death experience with my second child with this mastitis. It was just a God thing. I mean, it was for me. I mean, it was 100%. I know that God knew my heart in the whole experience and He was so faithful to all of it. For me, I like to think that I give things to God but then I slowly take them back and this was the one experience in my life where it was like, “God has to have this 100%” because I look at all of the little roadblocks and they weren't roadblocks at all. They were just little bumps and we made it through. Meagan: I love that so much. I am so proud of you. I'm proud of you for getting the education, doing the research, and joining the community so like you said in the beginning, you had that community of women all over the world that were in very similar spaces and that you could connect with. That's something I love so much about our VBAC community on Facebook is you get on there and you're like, “Whoa. I'm not alone. I feel alone right here, but I'm not alone.” You can turn to that space. You can turn to these podcasts and you really truly become friends with some of these people, right? I'm just so proud of you and so glad that you had your VBAC. I'm so thankful that you were on the show. I wanted to let everyone know that we do have blogs on gestational diabetes. We have blogs on laboring at home, what to know and when it's not safe, and things like that for people who may be traveling a little distance who are not in preterm labor. We have tons of blogs. I don't know if you've ever had this, but it's called Real Food for Gestational Diabetes by Lily. Arianna: Yeah. Meagan: You know it? Arianna: I read it. Meagan: That is such an amazing book and we've had Lily on the podcast. I just think that one is a really great go-to. She also has Real Food for Pregnancy so that's a really good one. But yeah, just getting all of the education you can. 44:56 Traveling tipsArianna: I want to touch really quickly on what it was like traveling in preparation for birth. Obviously, mine didn't go to plan, but I think the biggest thing that I see people asking is, “Well, when do I leave? How do I know?” My plan was for my midwife to have vouchers for the hotel that was right next to the hospital so there were options available or trying to find a family or friend that you could stay with. My plan was actually to go up there and stay at 38 weeks until baby came. I was intending to labor as much as I could at the hotel or whatever. Obviously, things worked out great, but having a plan like that in place between 37 and 38 weeks is really comforting because like my midwife told me, she was like, “If you want that chance for a VBAC, pack your bags and get up here.” That's my biggest piece of advice. If you are traveling, try to have a plan set up towards the end. Where can you stay? Do you have a support system up there? That was huge. Meagan: Yeah. I agree so much. Yeah. Having that and having the plan in between like, okay. if labor shifts really fast, know the hospitals in between or know where you can go in between. Be prepared. Have the things in your bag. Have a little bit of a plan. Get the support at home and when you're there. All of those things are going to add up and create a better experience for you. It is possible to travel. It's worth it in my opinion. I only had to travel a really short distance, but I've had clients that travel literally from Russia to Utah to have these VBACs. I think she would vouch every single day that it was worth it. You just have to figure out what's best for you and your family. Find the resources, get the support, and rock your birth. 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

I don't know who needs to hear this, but…You do NOT have to be induced at 39 weeks to have a vaginal birth. You CAN have an induced VBAC. Your cervix DOESN'T have to dilate by 40 weeks.Home birth is just as SAFE as hospital birth, even for VBAC.Your pelvis is PERFECT. You are capable of doing MORE than you even know.Tune in to today's hot episode to hear Meagan and Julie dive deeper into these topics and many, many more!Additional LinksThe ARRIVE Trial and What it Means for VBACHome Birth and VBACBrittany Sharpe McCollum - Pelvic BiodynamicsNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello everybody. We are already a month into 2024 and we are ending the month off with a nice, spicy episode. I think it will be a little spicy. Julie is with me today. Hey, Julie. Julie: The bringer of the spice. Meagan: The bringer of the spice. You know, ever since you stopped doing doula work as well, you have picked it up a notch in your spice. Julie: Because I'm tired of watching people get railroaded by the system. Meagan: I know. Julie: I have picked it up a little bit, yeah. Meagan: I know. Julie: You have to deal with the backlash by yourself if there is some backlash. Meagan: Seriously. No, this episode is going to be a good one. Women of Strength, I think that this episode is going to be very empowering. Yes, it is going to be spicy. We are going to have passion because if you haven't noticed over all of the years of Julie and I recording, we have passion. When it comes to like Julie was saying, people not being railroaded by the system or not taken advantage of and really knowing what information is true and not, we are pretty passionate about it. So today, we have an episode for you that is going to be amazing. It's titled, “I Don't Know Who Needs to Hear This, But…” We are going to be telling you all of the amazing things. Review of the WeekWe have a Review of the Week so we are going to get to that and then we are going to kick it up a notch. Julie: Perfect. All right, yeah. I'm really excited about this episode inspired by all of you really, all of us, and everybody in the birth community around the whole entire world. Anyways, this review is from Apple Podcasts and it's titled “Highly Recommend.” It says, “Thank you, Meagan and Julie, for creating this podcast. It holds space for mothers with so many different birth stories and as we know, representation matters. After an unexpected emergency Cesarean with my first daughter, I found myself seeking stories similar to my own. I literally binged your show. It  helped me process my own trauma and was incredibly healing. I have since become a labor and delivery nurse and I find myself recommending this podcast to my patients regularly.” What? That's awesome. “I'm happy to say that this podcast gave me the courage and confidence to TOLAC and I had the most empowering and beautiful VBAC in November. Thank you a million.” That is incredible. I love it. Meagan: That is incredible. I love hearing when labor and delivery nurses or providers will hear the podcast and recommend it to their patients and their friends and their family. That makes me so happy. If you are like our reviewer and you would recommend the podcast, if you wouldn't mind doing us a solid, pause right now but come back because it's going to be great. Pause right now and leave us a review. Go to wherever you are– Apple Podcasts, Spotify, or if you are just listening on our website which you can at thevbaclink.com. You can even just Google “The VBAC Link” and leave us a review and recommend us there because your recommendations and your reviews are what help other Women of Strength find this and find these amazing stories and find the information like what we're giving today. Meagan & JulieMeagan: Okay, Julie, I am so excited. I am so excited. This idea is amazing. We were talking about this before. This is kind of like a viral reel. This reel went viral. “I don't know who needs to hear this…”, but Julie said this. Boom. That is what we are going to do. This is amazing. This episode is going to be so fun. We have actually scrolled The VBAC Link Community which by the way, if you are not in The VBAC Link Community on Facebook, we have a private Facebook group that is very safe and very welcoming to all Women of Strength no matter what type of birth they are wanting, vaginal or Cesarean. You can find us at The VBAC Link Community on Facebook. Answer the questions. You do have to answer the questions to get in because we are very, very strict with that and then we'll get you in. If for some reason, you have a weird decline because sometimes Facebook is declining them on their own, I do not know why, just message us at thevbaclink.com or on Instagram or wherever and just let us know, “Hey, I'm trying to get in,” because we have definitely been having issues. Julie: Weird. Meagan: I know, right? People are writing us like, “We've been trying four times and it's just declining.” But okay, you guys. Julie, do you want to kick it off? “I Don't Know Who Needs to Hear This, But…”Julie: Yeah, let's kick it off. Okay, so I don't know who needs to hear this, but you do not have to be induced at 39 weeks to have a vaginal birth. Meagan: Correct. You do not. Julie: It makes me so mad. It lights my fire. I have a friend who lives in Maryland. He is a major researcher. He researches everything and every topic– politics, home school versus public school, anything. He can give you a one-hour speech on demand because he is on a top-notch level. His head is in the papers. He is just there. But for some reason, we as a culture don't like to do that amount of research when it comes to having our babies. Right? Why is that? Anyway, so when his wife had their first pregnancy, it was right after the ARRIVE trial came out, and of course, she got induced at 39 weeks. They've had two other kids since then. They got induced at 39 weeks every time. Lucky for them, it was super great. They had pretty uncomplicated, straightforward deliveries and everything was fine, but I wanted to scream at him and say, “Friend! You research the heck out of everything. Why are you guys not looking into this for your own babies and your own children and your family, the most important thing in your life?” It's always been interesting to me for that. So we know by now that everybody is hungry to induce at 39 weeks. We also know by now– I mean, we knew early on, but the rest of the world is catching up now showing that the results of the ARRIVE trial are incredibly flawed. If you don't know what the ARRIVE trial is, just Google “The ARRIVE Trial, VBAC” and our article on the ARRIVE trial will pop up, but basically it says that induction at 39 weeks lowers Cesarean rates and other complications for mother and baby but there are so many things wrong with that study. There are so many things wrong with that study. I'm not going to get into it because we have a short amount of time, but go look into it. We know now that there have been several research articles from major universities doing research on giant, enormous population groups showing that it actually increases complications and risks associated with induction and it increases the risks of having a Cesarean for mothers. So, guess what though? I hate how fast the ARRIVE trial took on. Everybody is like, “Woohoo! Induction at 39 weeks, let's do this,” but guess what? Now that we are showing that it is actually harmful to families, everybody is looking away. It's going to take 10-20 years for this trend to stop. Meagan: But yet it took overnight for it to start. That's what is frustrating to me. Julie: Because it is more convenient. It is more money. It is easier to manage. Meagan: I have so many feelings. You guys, we have a blog on the ARRIVE trial. We actually have an updated episode on the updates of the ARRIVE trial as well so if you are wanting to learn more about the ARRIVE trial or if you are being told that you need to be induced at 39 weeks in order to have a baby, go check out Episode 247 because we are going to talk more about that topic. Julie: Yeah, absolutely. There's lots to go into it, but I just want you to know. We want you to know that it's okay to go past 39, 40, and 41 weeks and wait for your body to go into spontaneous labor. That is really your best chance of having a vaginal birth. Now, there are reasons and times when a medical need for an induction arises that are true and are actually real. Having an induction doesn't mean you are going to have a C-section, so if you need to go that route for whatever reason that is medically safe for you and your baby, it is safe to do that. “I Don't Know Who Needs to Hear This, But…”Meagan: So on that topic, I don't know who needs to hear this, but induction is okay for a VBAC and it is possible to have a VBAC with an induction. So yes, it's more ideal to have spontaneous labor and for things to happen on their own and not to be intervened. But, if medically, there is a reason for an induction, it is okay. You do not have to just have a C-section because there is a medical reason to have a baby. You can be induced. “I Don't Know Who Needs to Hear This, But…”And then sort of on the same topic, but I don't know who needs to hear this, but your cervix doesn't have to dilate by 40 weeks. It doesn't have to. It can dilate after. It doesn't mean it's not going to. If you are not dilated or effaced by 40 weeks, it doesn't mean it won't, right? Julie: Yep. I hate when people say, “I just left my 37-week check-up and I'm not dilated at all. My provider thinks I needed to schedule a C-section.” I'm like, “Your cervix is doing exactly what it needs to do before it's time to let the baby out which is stay closed, stay tight, and keep that baby in.” Meagan: Yeah. Yeah. I don't love that because if a provider is checking at 37 weeks and someone's not dilated, they're placing doubt that they are not dilated and placing thoughts of, “Oh, you're not dilated yet. Oh, you're 37 weeks.” If they're already having that tune, that, to me, is a red flag because if you are 40 weeks and you are still not dilated yet, what do you think they are going to say then?Julie: It's just a sign of control. They want to be able to predict and control and yeah. It might not be the best provider to support you. “I Don't Know Who Needs to Hear This, But…”Julie: Okay, I got one. I don't know who needs to hear this, but home birth is just as safe as hospital birth even for VBAC. I think that a lot of people don't know this aside from there have been several major studies in the last 10 years or so showing this, but I feel like what most people don't realize is that home birth midwives, aside from the random rogue ones– you know, here and there you are going to hear a story– but most home birth midwives are incredibly educated and trained at similar levels as hospital midwives are. Now, depending on whether they are certified or licensed, there are different regulations in every state, but midwives at home can carry Pitocin, methergine, and Cytotec. They can carry antibiotics if you are—Meagan: GBS positive. Julie: They can give you IVs. They can draw your blood. They can do all of the routine prenatal tests that you can do in the hospital. They have emergency transfer protocols in place. Every state is a little bit different, but in Utah, it is amazing. The seamless transition from home to hospital and transfer of care records and everything like that, a lot of people just don't know that home birth midwives– like I said, it depends on the state and the regulations whether they are certified or licensed and that type of thing– have access to all of the things except the operation room that you have in a hospital. Meagan: And…Julie: Go ahead. You do the and. Meagan: And if there is an emergency like she was saying, there is a transfer protocol in place. Usually, it doesn't get to anything crazy because we are transferring based on XYZ before there is any true emergency. Julie: Yep. And you know what? Paige is going to be going nuts here because she is going to have to drop so many links into the show notes, but like I said, there have been so many studies that show birth outcomes are similar and some of them are better at home than in the hospital, right? Like a decrease in hemorrhage at home and yes, we can sit here and say that home birth is safe. Meagan: Home birth is safe and a reasonable option for a VBAC. “I Don't Know Who Needs to Hear This, But…”Meagan: I don't know who needs to hear this, but your pelvis is perfect. Julie: Your pelvis is perfect. Meagan: Your pelvis is perfect. Your pelvis is not too small, you guys. Yes, there are rare occasions where we have a pelvis that is going to be less ideal to get a baby out or harder where maybe they have gotten in an accident and they've had a pelvic fracture. We've talked about being malnourished as a child or things like that, but it's really rare for your pelvis to actually not be able to get a baby out of it. It was designed to do that. It can do that. We all have different sizes and shapes and little ingredients to our pelvis–Julie: Pelvic ingredients. Meagan: It can do it, you guys. Sometimes it's changing a position because sometimes our babies need to come out posterior. I learned this in a pelvic dynamics class from Brittany Sharpe. She is freaking amazing and we will drop her Instagram in here as well. But you guys, our pelvises mold. They shape. They move. They form. Babies' heads mold, but they are all different shapes, and sometimes, our babies have to come into our pelvis in a posterior position to get out vaginally, or sometimes they have to come in looking transverse because of the way they are shaped, but it's really rare that your pelvis is too small. So if your provider in your C-section said, “Yeah, well while I was in there, I looked and it's way too small. You definitely should have a C-section here in the future,” just move on from that doctor. Your pelvis is perfect.“I Don't Know Who Needs to Hear This, But…”Julie: Move on. All right. I don't know who needs to hear this, but big babies are not a medical reason for induction and it does not mean that your baby can't be born vaginally. Meagan: And it's not a reason for a scheduled C-section. Julie: Yep. Meagan: That goes with any previous C-section because I've seen so many people say, “I've had a C-section because my baby measured large.” First baby. Julie: Even ACOG says that it's not a good reason. Meagan: I know. It drives me batty. Why? Why are we doubting our bodies' abilities? Women of Strength, if you are one and you said, “Okay,” and that's why you had a C-section, don't shame yourself, but know that your body creates a perfect-sized baby. Julie: Yeah. Don't shame yourself because the system railroaded you. Blame the system. That's who you blame. Meagan: And don't lose belief in your body's ability to get your baby out. If your baby is on the larger side, be like, “Well, dang. I'm going to have a good sleeper and likely a good eater.” Be happy about that and not shame yourself and be like, “Oh, I made a big baby,” because also, what I have seen in next babies, I've seen Women of Strength stop eating and restrict themselves of the nutrients that they need because they are so terrified. Julie: Scared that their baby will be too big. Meagan: Yes, they are so terrified of having too big of a baby that they are actually not giving themselves the nutrients. We know, especially with all of the Needed prenatal information that I've learned, that we are already malnourished as a society today not even just with taking supplements but in our daily food, our soil has changed. Our food has changed. Our nutrients have changed. We don't want to be withholding those nutrients and food because we are so scared of having too big of a baby. Do not let a provider– this is my “I don't know who needs to hear this”, but do not let a provider do that to you. Julie: Yeah, we all have stories that we can pull out of anything about these big babies. I was just at a birth last week. It was a scheduled induction at 37.5 weeks because of baby's size. They thought the baby was going to be almost 10 pounds at 37 weeks. Baby came out at 8 pounds, 3 ounces. Now, that is a little large for a 37-weeker, but my goodness, it wasn't a 10-pound baby. Okay? This is one of the harder things about being a birth photographer sometimes is that you are not involved in their decisions prenatally so I don't always have the opportunity to help them learn things. Some people just don't want to learn and that's totally fine, but I have another friend who just left an induction. It was a VBAC induction actually and it ended in a VBAC. It was great, but they suspected IUGR which is a small baby. Meagan: Intrauterine growth restriction by the way for whoever does not know that. Julie: Yes. They expected the baby to be super small and I forget. I think it was in the 39th week. They expected the baby to be smaller than 6 pounds. Baby was born at 7.5 pounds, just fine. Meagan: Perfect. Julie: These things are not accurate and if you are healthy, then I think it's important to know that your body can do this. Now, okay. Okay. I do want to add a little nuance there that all of these things that we are going to be talking about today there are situations where induction is necessary. With uncontrolled gestational diabetes, for example, your baby might be bigger. But what I've found most often with gestational diabetes is that we put these women on really restrictive diets and we tell them to be careful about what they eat and to exercise and all of these things. I find that my gestational diabetes clients usually end up having babies that are a little bit smaller than average because of all the restrictions we put on them like you were just talking about. So I just want to add a little nuance there that there are going to be some exceptions to what we are talking about. What we have a problem with here at The VBAC Link is when people take those 1 in 100 or 1 in 1000 situations where extra help is needed and blanket-apply it to 100% of the people. That's what we're trying to combat here. Meagan: Yeah. Absolutely. Julie: All right, Meagan. What you've got? “I Don't Know Who Needs to Hear This, But…”Meagan: I don't know who needs to hear this, but it's always okay to say no. Julie: Yes! Meagan: Always. If you are having someone and it doesn't even need to be a provider, anybody who is telling you what you are going to do and you are not feeling good about that decision, say no. That is okay. I was in another VBAC group during my own VBAC after two C-sections. I was in multiple VBAC groups. I was in a group and there was someone that wrote into their comment. They said, “My provider told me that I could not be induced. I could not do this. I could not do that,” and these things. Did it just irk you? I know you saw it, Julie. Did that just irk you, that comment? Julie: Yeah. It irks me because why do we as doulas, birth photographers, and patients have to be the ones to show our providers what the evidence says? Why do we? Shouldn't they be the ones practicing that evidence-based care? Shouldn't they? Oh, here's my radical acceptance coming in, speaking of radical acceptance. I need to work on radical acceptance of the system, I think. But why? I don't want to accept it. I want to change it. So there's part 3 coming out soon. How to change it. Meagan: Part 3 of radical acceptance. How to find radical acceptance through the system. This is the thing. We talked about this, I think, even before we pushed play but a provider or someone who wants to control you in this situation that you are going to be in– your birth. This is someone who wants to control your birth and is telling you what you are or are not going to do or what they are going to do to you.I'm hearing providers saying, “I'm going to strip your membranes at your next visit.” No. No. That is not how it works. Julie: Or they walk into the room while you are laboring, “Okay, we are going to break your water now.” What?Meagan: It is okay to say no. It is okay and I know that it is hard. I know. I have been there. I have been there just in life in general where I'm in a situation and I'm like, “Oh, I just don't want to cause contention and is it really that big of a deal? Maybe I should just say yes.” No. If your gut– and you'll know. If someone is coming in like Julie said and is saying, “We're going to break your water now,” and you're like, “Ugh,” immediately, that is your intuition saying no. Julie: No. Meagan: It is okay to say no. It is okay for you to say, “I do not want a cervical exam right now. I had one two hours ago. Not much has changed. I'm good, thanks.” It's okay. Women of Strength, please, please, please. This is how we change the system. We have to be strong and we have to stand up for ourselves. We do and it's stupid that we have to bring the evidence to the table, but we have to say no. We have to stop letting the system or the world, the world, railroad us especially when it's to our own body. We would never go down the street to the gas station and walk in and tell someone in that store what we're doing to them. Never. Would you? I would never. Maybe some would. Julie: I need you to drop those prices of the gas for me. Meagan: Yeah, right now because I'm about to pump my gas. I need you to drop it down 50 cents cheaper. You guys, no. We should not, just because we are in birth and just because we are in labor and just because we have a provider that went to a heck of a lot more school than us, right? I'll give them that. They went to a heck of a lot of school. I've never gone to medical school. It is not okay for them to tell us what you are or are not going to do. Okay, that's my rant. Julie: Oh, I've got one that I just came up with. Meagan: Okay. “I Don't Know Who Needs to Hear This, But…”Julie: I don't know who needs to hear this, but you can gain information from Google– accurate and good legitimate information from Google that is similar to information that other people are getting through school. Oh ho, ho, ho. Meagan: Oh ho, ho, ho. Julie: Yeah, take that. This is going to be a little spicy one here. I hate it. I hate it– okay you've seen this sign. I know everyone has seen them before or little bugs that are like, “Don't confuse your Google search with my medical degree,” then be like, “Why the heck not?” If it's so easy to pull something up on a Google search, then why should I trust your medical degree then? Okay, that's a little extreme, but what I'm trying to say here is that we have access to the largest collective database of information to ever exist in the history of the world, right? We can literally sit on our computer and order dinner, put in a grocery order, and have it delivered to our house in an hour. We can find information on anything we want to know from legit, credible sources. Right? I could find out how to build an electric outlet into my fireplace above. That's my project right now. I need an outlet on my fireplace.Meagan: YouTube University. Julie: Exactly. Now, is there a lot of misinformation out there? Sure. But listen, if you know how to find credible sources like Google Scholar, Google Scholar legit has studies and sources and references that university databases pull from. There is accurate information and studies available at our fingertips, so why? The same studies that people are accessing at their universities towards their medical degrees are at our fingertips so I hate when people say, “Don't confuse your Google search with my medical degree.” Yes, are medical degrees valuable? Incredibly, especially when you can collectively put pieces of information and everything like that together. I feel like there is lots of worth there as well, but when we are talking about individuals, you know your body better than any provider with any level of medical degree is going to know your body. You know it better. Your intuition will guide you better than any provider with any medical degree. I know I'm going to get a lot of cringes right now by talking about this, but your Google search is worth a lot when it's pulled from a credible source so I hate when people say. That's one thing I can't. I usually scroll past the trolls and comments on Facebook now. I just don't let it be worth my time. I have radically accepted that there are trolls and it's fine and I'm going to live my life, but when I see someone using those words, “Don't confuse your Google search with my medical degree,” that is when I'm going to get on there and say, “Why? Why discount these billions and billions and billions of research articles and things like that that we have access to?” Meagan: I think that's one of the big passions between why Julie and I created The VBAC Link Parent Course and Doula Course because we wanted you to be able to find that information in one spot. It is confusing and it is overwhelming. Those providers, yeah. There are some BS things out there on the internet. It's really hard to decipher. Julie: Like the ARRIVE trial, right? Meagan: Yes. I think we have three pages of studies and citations and all of these things in our VBAC manual and in our VBAC course so you can take that and take it to your provider and say, “This is what I have found. This is the evidence. Can we have a discussion about this?” Women of Strength, it is okay to have a conversation with your provider. You can ask questions. A lot of the time, you walk in and they are like, “Hey, do you have any questions?” You're like, “Maybe. Should I have any questions?” You should be encouraging these conversations with your provider. It's going to help you get to know them. It's going to help you guys have a better understanding of each other and you're going to be able to learn about these studies. Julie: I want to cut in here for just a minute before you change gears. I know that when we were putting our course together, this was something that was super important to me and Meagan. You don't have to take our word for it. I remember uploading lots of studies, the pdf versions of studies and bulletins, and things like that into the course because we wanted you to be able to go and dig deeper on the parts that you wanted to dig deeper from right from these credible sources. I love when I can find a Cochrane review because a Cochrane review is a review of several studies studying the same thing so you can just gather so much more information. We have a Cochrane review in there. We have links to everything. That's why we are so careful to be so meticulous and cite our sources and where we found this information so that you can go on your own journey to the other parts that resonate with you a little bit more. Meagan: Absolutely. Okay, well we are wrapping up. Is there anything else, Julie, that you are like, “I've got to let these guys know”?“I Don't Know Who Needs to Hear This, But…”Julie: Yeah, I think one more thing without having to really expound on it too much. I don't know who needs to hear this, but sometimes trusting and believing your body doesn't work. I don't know how to say that the right way. Maybe I'm going to expound on it. I loved this affirmation so much because I used it on my home birth and my first VBAC. It was like, “I trust my body to birth my body,” and things like that. I had a lot of trust, but I feel like reframing it to, “I trust my body to know what to do,” is better because what happens when some emergency comes up and your body doesn't push it out? What happens when you have a traumatic pelvic floor injury and your pelvis really doesn't know how to push out a baby? I mean, what happens if your baby's heart starts tanking and baby has to come out right now? That's not your body failing you. I feel like sometimes that's what sets people up for failure. They believe so much in their body, but sometimes emergencies happen. There is some nuance there, so yes. Trust your body, but trust it to guide you on the right journey. Sometimes it sets us up for trauma afterward. You'll be like, “Oh my gosh, my body is broken. How come trusting my body didn't work?” I feel like trusting your body is a big part of it, but trusting your body to guide you on the right journey for a nice, healthy delivery is more important than trusting your body to be able to push a baby out. I don't know. What do you say to that, Meagan? Meagan: Yeah. I love that. That, I think, is where a lot of postpartum issues come because we were like, “But, I knew that I could do this.” It's not that you couldn't, it's just that something else happened. Right? Julie: The circumstance. Meagan: Yep. The circumstances changed and that's hard. That's hard, yeah. I love that. I love that you said that. “I Don't Know Who Needs to Hear This, But…”Finally, last but not least, I don't know who needs to hear this, but you are amazing. You are a Woman of Strength. You are capable of doing more than you even know. Than you even know. I truly believe that. I think through life and experiences, especially when things are hard, it feels like you can be at a loss, like you are alone, and like you couldn't possibly do these things, right? But Women of Strength, VBAC is possible. VBAC after multiple Cesareans– possible. VBAC with twins, VBAC with big baby, VBAC with diagnosed small pelvis, VBAC with medical induction needed, VBAC is possible. If you don't want to have a VBAC, that's my final, final. If you don't want one, that's okay. Julie: Yeah. Meagan: That is okay. Vaginal birth is not always desired and that's okay. But you need to learn. You need to find the information and that is what these stories are here for. That is what Julie and I are here for and other birth professionals here that we have on this podcast. That is what the course is for. That is what the community is for, for you to learn, for you to grow, and for you to know that when you are told some of these things, they are necessarily true. Okay. Julie: I love that, yes. 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

Meagan finishes out this year of podcasting by answering some of your most common questions! Topics range from the time between births, gentle induction methods, gestational diabetes, “just-in-case” epidurals, home birth, tips for having a successful VBAC, and how to cope if you don't get your VBAC. “Women of Strength, I just want to thank you so much for all of your continued support. We love your support and we are so grateful that you are here.I love you. I feel so passionate about helping you as an individual find the best path for you.I want to help you walk through this journey and feel loved, supported, and educated.” Additional LinksReal Food for Gestational Diabetes by Lily NicholsHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello. Welcome to The VBAC Link. If you have been with us all year, I just want to say thank you and if you are new to joining The VBAC Link, I'd like to say welcome. Welcome to the show. This is the last episode of 2023 and it's kind of hard to believe honestly. I went through all of our episodes and we have seriously so many incredible episodes. I am so honored for those who have come and shared their expertise and given us their time. I am so excited today to share this last episode of the year with the most common 2023 questions. We have some pretty common questions, but we have so many others as well. So of course, we have a Review of the Week. I want to dive into that really quickly before I get into those questions. Review of the WeekThis is from cristab. It says, “I am a birth and postpartum doula who is always on the search for a birthy podcast to listen to in my car. I was so excited when I found The VBAC Link so I could listen to these amazing stories from women all over the world who have reached their goals through becoming educated thanks to Meagan and Julie. I've recently certified with The VBAC Link and as well, I'm so impressed with the thorough delivery in which their knowledge was shared in their training. I'm super excited to move into this next chapter of my career and I'm thrilled to do so with the amazing community and support.” Thank you so much and thank you for joining our family. Doulas, birth workers, birth photographers, if you love birth and you are wanting to learn more about VBAC and how you can support people out there who are wanting to VBAC, who are wanting to avoid Cesareans, and who are just needing support from the community, we have our VBAC Birth Worker, VBAC Doula birth course where we are going to teach you all of the things about VBAC as well as help you know what us as VBAC moms are up against. And parents, if you want to dive in and get more educated for your future birth, I highly suggest checking out our course. You can check it out at thevbaclink.com.2023 VBAC QuestionsMeagan: Okay, you guys. We have so many questions that we get all of the time. If you haven't also joined us on Instagram, we do Q&A's almost weekly. We love answering your questions even if it's a question that we've had before. We're going to get to it and we're going to answer it. Here are some of the most common questions that we get. Number one on the list is how long after my C-section do I have to wait until I get pregnant? This honestly is a question that I think is personal. Now, there are suggestions out there by providers who are saying anywhere between 18-24 months is what we commonly hear, but we even have some providers who are like, “Yeah, cool. In 15 months, you can go on and have your baby.” There can be an increased risk of uterine rupture with a really small gap or duration. So if you have had a C-section and then three months later, you get pregnant, you may have a provider who is a little bit more skeptical or even six months later, you may have a provider who is a little more skeptical and talking about the risk of uterine rupture, but that still doesn't mean that it's not possible or impossible or that you are for sure going to rupture. I think a common rule of thumb is that 18-24 months, but again, it comes down to a very personal decision. If you want closer babies or it happens or whatever, I think that's more of a personal choice, and then just finding the support out there to support you in your desires. I did a one-on-one consult with a mom back here in the fall and she had a six-month duration. She went from provider to provider to provider and they all said, “No. Absolutely not.” We got her in contact with another provider and they said, “Yeah. No problem. There is no reason.” I was so excited to get a text message from her after saying that she did it. She had her vaginal birth and she was so happy. That was a duration of six months. Okay, another question that is really common is, “Trying to go for a VBAC and really want to go into spontaneous labor, but her provider is saying they can't go past 41 weeks.” They cannot go past 41 weeks. Now, I'm just going to say that I don't like the answer to that. The follow-up question to that question was, “Should I switch my provider?” You know, we're not here to tell you that for sure you need to switch a provider or anything like that, but if you have a provider that is putting stipulations on you like you cannot have a baby past this day and if you get to that day, you have to have a C-section, you may want to look into some other providers because that's just not evidence-based.Going past 41 weeks in general is something that has become more and more controversial, especially after the ARRIVE trial. We have episodes on the ARRIVE trial. We have blogs on the ARRIVE trial, so make sure to check those out as well. It's kind of weird. They did an induction at 39 weeks for first-time moms to see if it would reduce complications like hypertension, preeclampsia, and even Cesareans. It's kind of been since 2019, I feel like, more of a hot topic, but it's actually pretty common for babies to go overdue. I am putting big quotes on this. “Overdue”, past 40 weeks. Know that if you have made it to 40 or 41 weeks, it's very common and you're okay. There are common things that a provider may do at 41 weeks. They may suggest a non-stress test just checking in on baby and making sure everything is going well, but it's still okay. In fact, ACOG suggests, I think it's 42 weeks, really. So, you know. At 41 weeks, you could still be pregnant or a week or you could have a baby in three days or even three hours. They have not really found any increased risk of uterine rupture or other complications necessarily like that after 40 weeks, however, there are things that can come into play where VBAC after 40 weeks may be lower or require interventions because there may be things like hypertension and things like that that come into play. But even if your provider is saying that you can't go past 41 weeks and you have to schedule C-section, that right there is a red flag and something that would be concerning to me because induction is, which is also another question– can I be induced and have a VBAC or can a VBAC be induced? VBAC can be induced. It's very reasonable. There are ways to do it. Some tips that I would suggest are doing as low and slow as possible. Now, we got a message back on one of the days that we did a Q&A from a mom saying that she did not believe that it was possible to do low and slow. I do disagree. I think that it is possible to do low and slow inductions. I've seen it. It happens all the time. You do have to sometimes fight for it and be educated so you can have that conversation and understand what that means. So let's talk about low and slow meaning that if we are starting Pitocin, we are not upping it to 4 mL every 30 minutes. A lot of providers out there will suggest that. 4 milliliters every 30 minutes. Boom, boom, boom, boom. It's a little overwhelming, first of all. Sometimes it takes our body a little bit longer to respond fully. Now, Pitocin, once it starts going in, it's in the body, but it may not fully be responding so if we up it every 30 minutes and then we take 45 minutes to respond, then it may be too much, right? And 4 milliliters versus 2. So maybe you say, “Okay, let's cut that in half. Instead of 4, we do 2 or even 1.” Sometimes there is a lot of pushback on that 1 because they are like, “Oh, it's pointless. It will take forever,” but it's still okay. It's still okay so decide what milliliter is best for you and go for that. Fight for that. Low and slow there. Then another thing is avoiding breaking water or too many interventions all at once meaning we are going to place a Foley, start Pitocin, and break your water all at the same time. That is unnecessary. We really, really, really do not need to do that. That is just going to overwhelm everybody a lot of the time including the baby. But breaking waters. Breaking water in that earlier stage. Maybe we have– in fact, we are sharing a story. It's coming up in 2024. I just recorded it not long ago where the mom was 2 centimeters and they broke her water. She wasn't really contracting. They broke her water, started Pit, all of the things, and not a lot of progression. If we break our water early on, it's not a guarantee that our body is going to go into labor, but a lot of the time, there is a selling factor of this breaking the water where it's, “Oh, it's the natural way.” Okay, all right. Breaking our water is natural. However, artificially breaking our water does not mean that that's natural. That means that we are intervening and doing something that our body did not do at that point. So if we do that and we do that early on and our baby is high or our baby is in a weird position and then we have these floodgates open and the baby comes down, and the baby is in a wonky position, now we've got a poor fetal position, not a lot of progression because that often happens, a harder labor, a longer labor, maybe we're introducing more interventions, so it kind of becomes a cascade. Maybe when I say slow, take it slow. Let's not intervene with every single thing that there is possible in the labor and delivery unit. Maybe we just do a Foley or maybe we do Foley with a low dose Pit of 2 and we don't up it from there. That's it. That's where we start. We wait for the Foley to come out and then we assess after that. Low and slow inductions and yes. You can be induced and no, you do not have to be induced at 41 or 40 weeks. So okay, one of the other questions– well, there are a ton, but one of the other questions I'm going to go to is about hypertension. “Can I still VBAC with hypertension?” So, yes. Absolutely, you can VBAC with hypertension. Sometimes, providers will come back and say that it can increase our blood pressure and things like that. It's kind of weird. I don't know if there actually is a study that shows this, but a lot of doula clients who have hypertension go to be induced, once they start labor, their blood pressure seems to kind of chill out. It's kind of interesting. I do not know why, but yes, you can still have a VBAC if you have hypertension. So another question is, “If you get induced, does your risk of uterine rupture truly skyrocket to an insane amount?” We've heard people give us such crazy numbers like, “I have an 80% chance of rupturing.” I don't know where providers are getting that, but no. Or, “I have a 60% chance or I have a 25% chance.” Now, if someone is telling you that you have these chances, I would like to challenge you to challenge them. Now, I never want to say to be combative and blah, blah, blah. That's not what I'm saying, but I'm saying don't be scared to ask, “Where do you get that information? Is there a link? Can you provide me with printed information on this topic or on this stat? I would like to see that. I would like to go over this so I can make the best, educated decision for myself.” If they are like, “Oh, well I don't know. I don't know if I can find that,” well, yeah. It's because there's not one. If there is one and you do receive that, will you please email me at info@thevbaclink.com? I would love to see that. I've never seen a study that says that someone has an 80% chance of rupture because they have had a previous Cesarean. So statistically, uterine rupture really happens in about 0.4 to approximately 1%, maybe 1.2% depending on some providers and some studies. But overall, that's pretty dang low. That's really, really, really low. So if someone is telling you that you have a 60, 25, or 80% chance, that's just not true.Then another common question is about ways to avoid uterine rupture. Now, we don't always know why uterine rupture happens. It's hard to say exactly what caused that uterine rupture. I don't know if you knew this and it's very, very small, but uterine rupture can even happen in people who have not had a previous Cesarean. So that's a thing too, but things that we can do are try to avoid those inductions that are absolutely unnecessary and if you do get induced, talk about those best methods like what we were talking about. We have a blog about that as well and we talk about that in our course. Really learn about those methods and avoid aggressive augmentation. Avoid Cytotec completely. That's a big no. You know, and do everything you can to make sure that your baby is in a better position so maybe Spinning Babies, the Miles Circuit, hands and knees, do pelvic floor therapy so we can help our pelvic floor be in a position where we can push a baby out that way and things like that. Educate yourself. Listen to these stories. Attend our Q&A's. All of these things can educate you so you can help reduce these things that may increase chances of uterine rupture like Cytotec or aggressive inductions. Okay, another common question is, “If I have gestational diabetes, can I have a VBAC?” Yes, yes, yes, and yes. Yes, if you have gestational diabetes, you can still go and have a VBAC. Sometimes, a provider may suggest an induction at 39 and I've even been hearing 38 weeks with gestational diabetes especially if it's not managed well. One tip that I would highly suggest is really understanding gestational diabetes. Knowing that food and exercise and things like that can impact gestational diabetes and learning how to manage those if you can. Talking with your provider, understanding what they're going to be looking for, what they're going to be doing because that's also going to help you stay more relaxed when you understand the process from them instead of just being caught off guard. I highly suggest checking out the book Real Food for Gestational Diabetes by Lily Nichols. We'll make sure to put the link in the show notes as well, but that's a really, really, really wonderful book to check out and it's going to help you understand a little bit more about how to manage those sugars and just more about gestational diabetes. But also know that you do not have to be induced if you have gestational diabetes. You just don't, but it's going to be really common to have that be offered. Okay, so a couple of other questions that we get are, “I had failure to progress. Big air quotes, ‘failure to progress' and my doctor is telling me that because my body didn't do it the first time, it won't ever do it again.” I'm sorry, but your provider is a big, fat liar. Such a big, fat liar. Just because you didn't progress with one labor doesn't mean you won't with another one. Honestly, it's more likely that you didn't progress because of an environment, because of a rushed labor, because of a rupture of membranes artificially and baby was coming down so we got a wonky position, lack of ability to move during labor, and things like that. Progressing and trying to push labor on and it's not progressing because labor wasn't ready to begin– these are things that truly are going to be more of the reason for a failure to progress other than the reason that your body doesn't know how to get to 10 centimeters. Truly, it does. Know that if your provider is putting doubt in your mind, that you can't have a baby because your body didn't do it before, you may not be with the right provider or you may have to fight hard. And again, it all comes down to, I think, finding that education and support. Another common question is, “Can I VBAC with twins? Is it safe?” Yes, you can VBAC with twins. Yes, it is safe. Sometimes, providers will have some stipulations as far as Baby A needs to be head down and Baby B is okay to be breech, or sometimes it's like they both have to be head down. They might have some restrictions on that and a lot of the time, they will have you actually give birth in the OR. They'll have you push and give birth in the OR, but yes. Research shows that a vaginal birth for twins is generally safer than a Cesarean, truly, even though some providers still discourage it. A podcast to check out is Dr. Stu and Midwife Blyss. They have an amazing, I think it's Birthing Instincts, podcast and they talk about twins and delivery and things like that as well. Okay, so a common question is, “How can I prep? How can I prep for a VBAC?” I'm going to give you a couple of tips right here. I already have said it a couple of times, but your provider. Your provider is really, really, really, really important. You need to find a good provider, a provider that's going to support you, a provider that wants this birth for you just as much, right? A provider that is not going to disregard you and pull out bait-and-switches in the end with non-evidence-based information to scare you and then make you feel like no one's going to want to take you because you are already so late in pregnancy. Ask these questions before you settle in with a provider. Ask questions like, “How do you feel about VBAC?” not, “Do you support VBAC?” How do you feel about VBAC? Open-ended questions allow a provider to give you a lot of information without you even saying a word. If they stumble and say, “Oh, yeah, yeah, you know. I feel good. It's fine. It's fine. It's fine.” Okay, know. If it's like, “I actually feel like it's a better option and this is something I would suggest and this is why. There are going to be pros and cons to it on both sides. There are going to be cons to having a VBAC for these. Here are the risks. There are going to be cons of having a C-section. Here are the risks.” Yes, there are risks to having a C-section. Also, if your provider ever tells you that there are no risks to having a C-section, that's bullshit. I'm sorry. I'm saying. It's the end of 2023. That is B.S. That is not true. So, talking to your provider with open-ended questions. How do you feel about VBAC? Another question, “How do you support your VBAC moms? What does that care look like?” If they're like, “Yeah, totally. It's just going to be like normal. We might check you if you go over 41 weeks. We might want to do an NST or we might want to do this,” or something like that and it's lining up with evidence-based. Okay, that's to be expected. If it's like, “Yeah, no totally. We love VBAC, but you have to have the baby by 41 weeks. It has to be spontaneous. You can't induce. You have to get a just-in-case epidural.” Those are all, again, the B.S. answers that are going to tell you that you're probably not in the right place. Have open-ended questions for these providers. Number two– get the education. Educate yourself so that if you do have a provider coming in and telling you things that you are unsure of, you will have that resource to go back to and be like, “Oh, I actually do remember that and that's not true,” or, “Yep, that's right in line with evidence-based care.” It can also help you have a better discussion with your provider because you want that. They come in and they ask you. They say, “Do you have any questions?” They don't really have a lot of time, honestly. These poor providers are overworked. They don't have a lot of time, but too, it will help your time be better when you do go to those prenatals. I remember going and they were ten minutes long and it took a lot of energy to get there. I'm just like, “Why? What is the point of these visits?” Make a point to these visits. Ask these questions. Learn the education so you can have those educated discussions and get a better feel for your provider. They can get a better feel for you. They can learn that they can trust you also because you are educated. They are not going to second-guess you if you are saying no to something that they are offering to you in labor because they know that you are educated. Take a class. Listen to these podcasts. Read the blogs. Get into the Facebook communities. Learn about what people are saying. Read the links that are being shared. Education is important. Another way to prep truly is finding the support even outside of your provider. I feel like if you can have the support and the sounding board, it helps so much. With my VBAC after two C-section baby, I had it, but in places– I loved it in the places that I had it, but it lacked in the places that I wanted it, from my family and friends. That was really hard. I think that's also another tip for where education comes in because you can help educate your family and friends along the way when they are like, “No. You can't VBAC. No way.” Truly, finding that support is important, and also, prepping in a way that if you don't have that support, let those people know that you love them with all of your heart, but unfortunately, you are not going to be sharing your desires and things. Nutritionally and physically, be healthy. Eat good food. Get good supplements like Needed. Drink your water. Stay hydrated. Make sure you are trying to get at least 30 minutes of walking a day and staying active. Of course, if you have certain situations, you want to always make sure with your provider that it's all in line with your birthing plan and your personal situation, but taking care of yourself is truly important. As we have learned with Needed and things like that, we know we are not getting the nutrients. We know we're not getting the hydration that we truly need every single day. If we can try and get that, it can help our pregnancy be better. It can help your birth be better. It can help in all areas and also mentally. I think if we are fueling our bodies with the right things, then we are truly going to be in a better spot. Okay, so another question that I have seen here and there and even more in the CBAC community is, “How do you deal or how do you cope with not getting a VBAC?” Now, this can be hard and this can be sensitive. Sometimes we have things in our head or we are told certain things and then it's in our op report and we were led to believe something that actually didn't happen or we were led to believe something that actually wasn't documented. I think that's a really good way to process. Really undersatnding that it's okay to be mad or sad. It's okay to feel those feelings, welcoming them in, and then working through the process step by step. I definitely think that knowing that sometimes we don't know the answer and accepting that, we talked about that this year with our radical acceptance episodes. Sometimes not knowing the answer can hang us up and really, really impact us and bring us down, but knowing that sometimes we may not know the answer. We may not know the why. We may not know what happened and trying to accept that and let that go is really, really difficult. But trying to practice that radical acceptance is really powerful. Yeah. There are so many questions along the way that we have been asked, but these are kind of some of the most common. Another one, I think probably the last one that I will share today is about an epidural. “Do I have to have an epidural if I have a VBAC?” No, you don't. No, no, no you don't. You do not have to have a “just-in-case” epidural if you are wanting to go for a VBAC. You just don't. It takes time to dose an epidural, so I think if you look at it and you think about it you're like, “It kind of makes sense. Okay. They place the epidural. It's already placed. That can take some time.” But then they have to dose it and then wait, what? Maybe it doesn't make sense, right? Okay, so I'm just going to walk you through it. It sounds like it makes sense until you walk through it. So then they have to dose the epidural which then takes anywhere between 20-30 minutes to really work and get to a point where they can perform a C-section. So a “just-in-case” epidural, although yes, it takes the time of placing it, it doesn't take the time of dosing. The “just–in-case” epidural is typically placed just in case there is an emergency. If there is a true emergency, they're not going to have the time to dose the epidural and get it to a point that it is ready for you. They're going to probably do general anesthesia at that point. The “just-in-case” epidural, I think, is just bull. I don't like it. I don't like when a provider puts a restriction on someone like that. Like, “You want to go unmedicated? Well, okay. Sorry, you can't. You can VBAC, but you can't go unmedicated or you have to have a ‘just-in-case' epidural.” Do you have to have an epidural?Another common question is, “Can I have a VBAC if I have an epidural?” Yes. Absolutely. Going unmedicated is not for everyone or if you want to go unmedicated and then you have a really long labor or something is happening and you decided to change your mind, that is okay. Women of Strength, plans change in labor. It changes all of the time. I see it time and time again through clients and through things. It doesn't always mean the plan is to change from an epidural to no epidural. Maybe it's from this to that. Maybe it's, “I didn't want IV fluids and now I need IV fluids because I can't keep anything down.” It changes. Plans change, but yes, you can have an epidural with a VBAC and still have a VBAC.Know that if you are wanting to VBAC, but you are not wanting to go unmedicated, you can still do that. If you are wanting to VBAC and you want to go unmedicated and your provider is telling you that you have to have an epidural or you have to have a “just-in-case” epidural, that is also false. Find what works best for you and it all circles back to education and finding the support in the provider and in the system. Okay, I lied. One more. Home birth. “Is home birth safe?” Yes. You can have a home birth. We have HBACs, home births after Cesareans, all of the time. We have them on the stories. We have them on the blogs. We have them on our Instagram. We see them in the community. Home birth is a reasonable option for VBAC. Now, the providers and ACOG are probably not going to suggest it. We go off of ACOG a lot, but know that these providers are probably not going to suggest and out-of-hopsital birth, but can you? Yes. Can you do it safely? Yes. Are there signs of uterine rupture typically before uterine rupture happens? Yes. Usually, do you have time to get to another location? Yes. So know that if you are desiring a home birth after Cesarean or even a home birth after multiple Cesareans like me, a VBAC after two C-sections, that is possible. It is totally, totally possible. Women of Strength, I just want to thank you so much for all of your continued support. We see it on Instagram. We see it on Facebook. We see it in our group. We get it in reviews here. We love your support and we are so grateful that you are here. We truly are here for you because we love you. I know I've said this before. It's weird for me to say I love you because I've never met you, but I do. I love you. I feel so passionate about helping you as an individual find the best path for you whether that is VBAC, whether that is CBAC, whether that is unmedicated, medicated, in-hospital, out-of-hospital, inductions, or spontaneous. I don't even care what type of birth you have. I want to help you walk through this journey and feel loved, supported, and educated. So again, if you are just with us, welcome. I'm so excited for 2024. We've got so many amazing things coming. If you have any questions about anything we offer on our podcast, our course, our blog or anything like that, always know you can email us at info@thevbaclink.com. If you've been with us and you've had your VBAC or you are still working for your VBAC or you are a birth worker or whatever it may be and you are with us and you have been with us forever, thank you from the very, very, very bottom of my heart. I truly love you and I'm so grateful that you are here. We will see you in 2024. 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

Anneke is a Pelvic Floor Physical Therapist from Oregon who is a long-time VBAC Link Podcast listener. During her first pregnancy, she would listen to 5+ hours of episodes commuting back and forth from work! Anneke was more than committed to having a vaginal birth with each of her pregnancies, but what she has learned from her births about advocacy, trust, and defining success are beautiful lessons that have changed her forever.At The VBAC Link, we are here to help you achieve your goals of a vaginal birth. But even more importantly, we are here to advocate for empowered decision-making in the birth space. Anneke is an inspiring example of being educated, strong, and finding healing within circumstances that were out of her control.“Since my first birth, I've asked, ‘Why? Why not me? Why does this keep happening and why can't I just be like so many others on the podcast and so many others across the country? Why can't I just will it into being?' From these questions, I'm starting to believe that my story actually might begin at the end. I've realized that maybe my story isn't about the mechanism of birth at all, but what it birthed in me which was the ability to see my own strength.”Additional LinksThe Lactation Network WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello. Wherever you are listening from, welcome to The VBAC Link. We have three beautiful stories for you today. They are all unique. They all have certain things along the way that add some unique factors. We have our friend Anneke. I keep questioning that, but it's Anneke and she has had three Cesareans. Her Cesareans really all have been a little bit different and for different reasons. We've got IVF. We've got low fluid and we have breech presentation. I'm excited to share your stories or have you share your stories today, but as always, we love starting our podcast out with a review. Review of the WeekToday's reviewer is from a girl named Megan. It says, “Great resource.” It says, “Such a great resource for VBAC mamas to come and listen to women's stories and get great evidence-based practice information. I do wish these ladies would do a little less interrupting of the storytellers.” Well, I'm so sorry, Megan. We definitely do jump in so hopefully, Anneke, you don't feel too interrupted. But we do like to be a part of your story as well because we want you to share your story, but we are listening and we are listening for the first time. We are reacting as if someone else would react the first time they are listening, right? So yeah. Thank you, Megan, for your review. We do love your reviews as always. Seriously, anywhere you listen– Apple Podcasts or Google. You can email us. Write us on Instagram. Let us know what your review is because we would love to read it on the next podcast. Anneke's StoriesMeagan: Okay, Ms. Anneke. Welcome to the show. Anneke: Thank you. Meagan: Thank you for being here and sharing these stories. I just want to turn the time over to you and have you share away and educate these listeners. Anneke: Awesome, well I am a long-time listener of your podcast actually. I think I found your podcast before I gave birth to my first child. Meagan: Oh really? Anneke: Yeah. I was doing 5-hour drives. I am a pelvic floor physical therapist. Meagan: Oh yes. I wanted to talk about that too by the way at the end. Don't let me forget. Anneke: Well, I was contracted to work where I am actually working now. It was a 5.5-hour drive. I would go down once a month and treat patients so I would listen to 5.5 hours of your podcast. Meagan: You would get through quite a few episodes. Anneke: Yeah. Lots of episodes. I always had this dream that I would be able to come on The VBAC Link with this triumphant VBAC– well, with this triumphant story. I never expected to have a Cesarean. I don't think anybody ever does. But after I had my first, I was like, “Okay. My goal is to someday be on The VBAC Link with this triumphant story.” I'm not here today with the triumphant vaginal birth that I was hoping for, but I really think that my births tell three stories. The first one is about advocacy and then the second one is about trust and then the third one is about defining success. Meagan: Oh, that just gave me the chills. That really did. So let's talk about this. Anneke: So my first pregnancy started after about three and a half years of infertility. We went all the way through to IVF. I'd been having some mental health struggles getting through all of the infertility pieces so I'd been doing counseling and that was amazingly helpful. We get into the pregnancy. Everything is going beautifully and at about 18 weeks, I had some really bad swelling. I told my provider and he was like, “Well, sorry. Sometimes people just get swelling.” I just went with that. A friend of mine who is a pelvic floor PT– I was seeing her because I was doing all of the things. I had prenatal yoga and I was seeing a pelvic floor therapist because I had some pelvic pain and pelvic tension in the past. She took my blood pressure one day and it had always been normal in the OB's office. She was like, “Wow, you're a little elevated.” That was in August at about 20 weeks probably. Baby looked fine and he was growing just fine. I'm just continuing to get more and more swelling. They were like, “Well, shucks.” I probably went into OB triage three times because I had systolic pressures above 150. Meagan: Oh!Anneke: Yeah. The third time I went in, they said, “Stop taking your blood pressure. Stop coming in. You're fine.” Meagan: Did you have protein at all? Anneke: No, so everything was always really clear. I was peeing in a cup every time I went into the OB's office. They would take my blood pressure and they'd say, “You're fine.” I went in sometime in October to get my flu shot and they said, “Oh, your diastolic (bottom number), is a little high.” I had an OB visit two days later and they said, “Just let him know.” He put me on metoprolol, a beta-blocker blood pressure medication, and had me start tracking my blood pressure which was kind of validating because I had been trying to tell them for weeks that my blood pressure was high. So I'm tracking it and the metoprolo was working okay. My blood pressure was elevated, but it wasn't scary. I went to my 32-week visit and I actually did have a little bit of protein in my urine at that visit. So we were living in Salem which is the capital of Oregon so it's a big city. The big research hospital is only an hour away. It's really close. They went and sent me for bloodwork after I had some protein in my urine. They called me later that day and said, “Hey, your numbers are borderline so we want you to come in and get these injections.”Nobody had talked to me about preeclampsia. Nobody had talked to me about, “Hey, we're concerned about this.” They were just like, “Hey, you're probably looking at an induction at 37 weeks.” They said, “You're borderline. We need you to come in for these shots.” I was heading down to Lakeview where I live now to do some contract work. I said, “Well, I'm going out of town this weekend. Can it wait until next week?” I could come tomorrow. The shots are supposed to be 24 hours apart. They said, “Oh yeah, yeah. It's fine.” Now, looking back, in a movie, that's where they would say, “Dun, dun, dun.” They sent me 5.5 hours away to rural Oregon where the only hospital there is a critical access hospital that does not have a NICU. It does not have on-call anesthesia. It has nothing. Although now, having been here, it has a lot more than what we think. So anyway, I go down. I work that day. I woke up the next morning and had all of the preeclampsia symptoms. I bet I had gained 20 pounds overnight. Meagan: Oh man. Anneke: My blood pressure was 180/25. I came down and my mom and my husband were staring at me because I was so swollen. Meagan: You didn't look good. Anneke: Yeah, and because of the attitude I got from triage– my husband had me call triage up in Salem and they said, “You need to go in right away.” But they had sent me home so many times before, so I was like, “Well, I have a hair appointment so I'm going to go to my hair appointment.” My hair looked awesome and I walked into the local ER here. This is where I grew up, so I knew everybody working and they didn't recognize me because I was so swollen. I had gone from borderline preeclamptic on Wednesday to by Saturday morning, severely preeclamptic. I ended up being life-flighted out to Salem. Meagan: Oh my gosh. Anneke: The ER doc that was here said, “If you were one week farther along, I would deliver you.” I was only 33 weeks at that point. They got me up to Salem and they were able to stabilize me. They said, “Okay. We're just going to go week by week. We're going to try to hold you off until 34 and 35 and get you as close as we can.” So Saturday went by. Everything was looking better. Sunday, our game plan was to wait, and then by Sunday evening, I had stopped peeing. I was drinking tons of fluid. That was actually the first time– I mean, I'm a medical provider and that was the first time that I was like, “Okay. Something is wrong.”Meagan: Yeah. My body is not happy right now. Anneke: Yeah. The nurse was like, “Okay, come on. Let's just go pee.” I was like, “Dude. There's nothing in there.” Lo and behold, I had kicked over to near eclampsia. They worked for a couple of hours to try to get my blood pressure down and stabilize me. It wouldn't stabilize. The OB who was at the hospital in Salem came in and said, “I think we are going to induce you tonight and you're going to have 36 hours to deliver or we're going to take you to C-section.” That was really scary for me. I had a doula. I had a doula team that I loved, but my whole birth plan was movement. I really wanted to go medication-free, but they said, “Look, no. We're going to induce you. Cytotec, Pitocin, and you're going to be in bed.” I got really scared and talked to my doula and my husband, and then the OB came back in probably an hour later and said, “Nope. Actually, we're just going to take you to C-section,” then basically turned around and walked off. The poor nurse. I remember just bursting into tears because even though I was scared of not moving, I really didn't want a C-section. That actually– my son was born the next morning at 3:00 AM and they whisked him straight to the NICU then because of all of the magnesium they had me on, I didn't hold him. That was Monday morning. I probably didn't hold him until Tuesday afternoon. I got to see him briefly, but one of the things that stands out to me the most is being in the PACU, the recovery from surgery, and the doc staying with me for about 2.5 hours. Looking back, docs don't stay with you. Meagan: No. Anneke: They are very worried about you if they are by your bedside for 2.5 hours. We were really lucky. We had a very short NICU stay. We had a wonderful NICU team. My recovery was rough, but as soon as I gave birth, the preeclampsia started to fade. I lost all of that water and I felt a lot better. But I walked out of the hospital 10 days later with my baby, looked at my husband and said, “Next time, I am doing a vaginal birth.” He was like, “Pump the brakes for a minute.” Meagan: He's like, “Maybe let's just not even talk about that.” Anneke: Yeah. But I was so committed. I had really severe postpartum anxiety that I probably should have been treated for because if anyone comes out of the NICU, you come out of this gruesome schedule of waking your baby up and pumping and feeding. So for about 6 weeks, I just didn't sleep and had really severe postpartum anxiety. I should have been treated probably, but you're not really in a headspace to think about that. But I remember, thank God for my mom and my husband, screaming at my mom about washing the bottles incorrectly. Thank goodness my mom loves me because she was like, “Okay,” and just supported me. Meagan: Yeah, but those are actually signs of postpartum anxiety where you need things to have to be just so or you're really nervous about a binky falling on the ground. Yeah. It seems super irrational to other people, but it is so real to the person going through it. Anneke: Right. Right. I think it just speaks to the lack of postpartum care that we have. They discharged me. I mean, I found out about 5 years later that I almost died that night. The Cesarean was life-saving. That was absolutely what I needed. They discharged me 5 days later with just, “All right. We'll see you in 6 weeks,” and then at 6 weeks, they're like, “Well, back in the saddle, Sally.” There's no coverage there. No coverage of care for me. Meagan: I know. It's where we're going wrong. Anneke: Right. Meagan: They're going wrong in the postpartum area in a lot of ways. Anneke: Yeah. I had trauma and nervousness. It was probably 6 or 7 months before I finally came out of that postpartum anxiety, probably a year before I felt like myself. After about a year, I mean, I think just like everybody, you're like, “Okay. I could do this again.” You know? I started to get in shape. I started to exercise again, and then I had this weird episode of bleeding. I thought, “Oh, it's just my period coming back and being stupid. It actually ended up being a miscarriage. I had never gotten pregnant before. I had never gotten pregnant on my own before so it was kind of this weird happy/sad experience. Fortunately, we were able to naturally conceive my second child, my first daughter, about two months later. Meagan: That's awesome. Anneke: Yeah, it was amazing. I was so grateful. I found immediately that I had this focus on wanting this vaginal birth. I felt very fortunate because the other podcast I listened to all throughout my pregnancy was one by Parijat Deshpande. She had a podcast– I guess she doesn't record for it anymore– called Delivering Miracles. It was all about high-risk pregnancy and doing all you can to reduce your risks of having a high-risk pregnancy and also recovering. I think I emailed her office person every week for a year because I really wanted to work with her. I finally was able to get in with her right around the time we found out we were pregnant. She does a lot of trauma relief work. It's a lot less of talking out your issues and more using movements and visualizations to help bring down your sympathetic fight and flight nervous system. I worked with her throughout my entire pregnancy. I felt like a rockstar. There was no swelling. I guess in the meantime, the other part of the story is that we had moved down to Lakeview– the really rural, critical-access hospital place. We moved down here in between my first and second child. There are no VBACs here so the closest place is about 3.5 hours away for a supportive VBAC provider. Meagan: That's a long drive. Anneke: It's a long drive. We actually made the decision that we were going to go back to Salem to do a VBAC. I love my provider down here. I actually went with the guy who admitted me to the ER the day I had preeclampsia. He was a totally different personality than I thought was going to be a good fit for me. When he admitted me that day in the ER, he explained exactly what was happening to me. He explained why he wanted me to do the things he wanted me to do. I thought being flown– and he explained, “Look. You could have a seizure. You could have a stroke. This is my very strong recommendation. This is not a prison, but this is a strong recommendation.” I just really liked that approach. I felt like I had a lot of trust there. He had saved my life. I mean, it sounds dramatic, but he had saved my life once. I went with him again and he was very supportive of figuring out how to make the VBAC work and when to go and how to transition, but he also had a backup plan for a Cesarean just in case. At about 28 weeks, they always do a little ultrasound at the visits, and she was breech but everything else looked fine. He was like, “Oh, you have plenty of time.” The weeks go on and she continues to be breech. He's in the back of his head thinking, “Okay, we need to probably start looking at the calendar and thinking about dates.” I'm just in denial at this point. I'm like, “It's going to happen.” Like all of the stories on The VBAC Link, you will it. You positively think. You do the stretches and the walking and the whatever and they're going to turn. Baby is going to turn. We get to 34 weeks and he said, “You know, let's just check you on ultrasound. I just want to make sure,” because my placenta had been anterior. He was like, “I just want to make sure that your placenta is off your scar in case we have to do a Cesarean.” We were excited because of course, it's a really small town. Lakeview is where I live and it is a town of about 2,000 people and a county of about 7,000. You literally know everybody. We're about 100 miles from the closest next hospital. We're very rural. We know the ultrasound tech of course and she was like, “Oh, we're going to do 3D,” so we walked in being very excited. She did the biophysical profile and I had a fluid level that day of– my AFI was a 4.1. Meagan: Oh. What week is this? Anneke: 34. Meagan: 34. That's low. Anneke: That's low. She was like, “You're not leaving today.” I was like, “What?” So thank God, I was working with Parjat Deshpande. We immediately kick into all of the things to help keep my anxiety low and help keep it all out of my body. We were tracking so now I was doing biophysical profiles. I think they started every other day and my fluid numbers started to come back up. Our docs here consult with maternal-fetal medicine out of a town about 3.5 hours away. They said, “Okay, as long as you are trending upward, you are fine.” But at that point, we kind of knew that a VBAC was off the table because with that low of fluid, baby is really unlikely to turn. At that point, I was like, “Okay. Let's just keep her healthy. Whatever we need, whatever we've got to do.” So we are chugging along and at about 35 weeks and a couple of days, my fluid level got all the way down to 2.1. It had come up and then it started to come way back down. The earliest that our hospital can deliver babies is 36 weeks. Meagan: You were a week out. Anneke: I'm a week out, yep. Oh my gosh. There's all of this lore about low amniotic fluid, so I was probably drinking close to 2 gallons of water a day. There is no direct correlation. There is a correlation with hydration and low fluid, but not pathologically low fluid. But there is all of this lore, so I was drinking close to 2 gallons of water a day and also drinking these buttermilk and blueberry smoothies. It was an Indian culture thing to have buttermilk to help with fluids. They are actually weirdly good but I was drinking one of those every day. Meagan: Interesting. I've never even heard of that. Anneke: Yeah. I mean, all of the Google things. We were just doing all of the Google things. We made it to– when I was 36 weeks, both my OB and I breathed a sigh of relief. We're like, “Okay, we made it. Okay, so here we go now. We're going to keep tracking her to 37 and get her to early term or late preterm.” The MFM was like, “Nope, just go for it.” We ended up delivering her at 36+1 via Cesarean. What was so wonderful about that birth is because of my work with Parijat and really trusting in a medical team that was around me, I felt like that birth was not traumatic. It was scary and we were worried, but she came out of me and just started screaming right away. I was able to breastfeed. She came right to me in the OR and we breastfed in the OR. I mean, the one nice thing about having a Cesarean is that the spinal takes a long time to wear off and you have a catheter. I think I did skin-to-skin for 6 hours. My husband did not hold her for 6 hours. That was one of the things that really left me with some trauma from my son. So I just remembered these goldeny, autumn afternoons and she was just on my chest and I just could not have been happier. Even though it wasn't the VBAC and it was preterm, it was still like I just had this incredible team around me that ultimately gave me the experience I wanted even though it wasn't the method. Meagan: Right. That is something that I feel is so important to touch on because sometimes we hear Cesarean stories and we hear trauma. Scary, traumatic. Anneke: Right. Meagan: I don't want to say that Cesareans can't be scary or traumatic or that they're not, but they don't always have to be. They actually can be very healing. Anneke: Right. Meagan: And redemptive. You might think, “Oh, you didn't get a redemption birth because you didn't have a VBAC,” but there are a lot of really amazing beautiful wins that were very redemptive in her birth, right? Anneke: Right. Meagan: That skin-to-skin and being involved and having that team be supportive of the whole team and motivating you, “Okay, we're going to get to 36 weeks.” All of these things are really awesome stuff. Anneke: Yeah. It was incredible. You know, we've had two births now that were– the first one was very scary. The second one was very scary and we almost stopped having kids. I had this dream of having four children. My husband is like, “Well, I wanted two. You wanted four so we compromised on four kids.” That's what he says now, but at the time, he was like, “No. I can't go through this again.” I was actually kind of along, especially for the first year, on the same path. I felt so grateful to have a positive experience. Everybody was healthy. Our family was wonderful. About a year out from her birth, maybe 7 or 8 months out from her birth, I really started feeling like I wanted to pursue our dream of having four kids. My husband really struggled with that so he and I both went to counseling. We went separately to counseling because we both had a lot of trauma actually left over from the first birth, my son's birth. Both of us– he did some EMDR work which was really powerful and I just did some talk therapy which was really good. Ultimately, we decided that we wanted to have a third baby and then eventually go on for a fourth. It took us a little bit longer to get pregnant. At that time, I found out that in my first birth, they were tracking my labs and one of the things they track is sodium. That fluid imbalance, sodium is a very important lab value that we need. I was digging through pages and pages and pages of notes trying to figure out, “Why did they never even give me a chance?” Because even though my daughter's birth was very redemptive, I still had this fire in me for wanting to know what a contraction felt like. In the meantime, I've developed this pelvic floor and OB program at our little local hospital here and I'm a childbirth educator and I'm just touting the virtues of vaginal birth and feeling like we have totally overmedicalized birth. So I'm digging through all of my notes and I find that my sodium had been trending over the 12 hours before even I realized that I wasn't peeding. My sodium had been trending down. By the time they made the call to go to C-section, I was three data points away from being a 50/50 survivor. My sodium had gotten so low. I didn't have 36 hours to try to labor. Meagan: Well, and when sodium gets really, really, really low, can't you actually have a stroke? Anneke: Yeah. Yeah. Meagan: And a major stroke. Anneke: Yeah. Like 50/50 coin flip on survival. It actually gave me a lot of closure to see that. I wish they had explained it to me like that at the moment, but it was like, “Okay, that was the right call.” Meagan: Validation.Anneke: Right. I hate it when you're given platitudes about, “Well, healthy mom and healthy baby.” It's like, “Well, obviously.” I wouldn't wish for something different, but there's also an experience that I'm looking for. So rolling into our third pregnancy, shoot. Being pregnant with two kids is no joke. I kind of had a harder pregnancy. We were able to conceive naturally again. Meagan: Yay!Anneke: Yeah. This time, we started with maternal-fetal medicine. They were tracking us from 16 weeks on. I had monthly visits with them all the way up to 36 weeks. Again, everything is going swimmingly. She looked lovely. My fluid is great. My blood pressure is low. We get to 28 weeks and she's breech. Along with being a pelvic floor PT and a mom of two at the time, I am a varsity volleyball coach and my husband is a wildman firefighter. If you haven't been out west for the last couple of years, it's been insane or I guess living under a rock because it's made national news. So this is during the summer rolling into volleyball season. I've got a breech baby. I've got this whole plan for a VBAC. I'm going to go into labor. We're going to drive 3.5 hours. I'm going to labor in the car with my husband driving like a grandma. We're going to do this. I was back to every day listening to a VBAC Link podcast and just willing it into being. I hit about 33 weeks and I'm doing uterine ligament mobilizations on myself. I bought a Spinning Babies class and was doing close to 2 hours of exercises a day to do inversions and side-lying and all of the rebozo sifting. At about 33 weeks, a friend of mine told me about this postural restoration physical therapist over in Grants Pass which is about 4 hours away from here and I went. I got an appointment with her and drove 4 hours one way to go see her. I got in with an acupuncturist. We did all of the things. Meagan: Literally, yeah. Anneke: Literally all of the things. A little after Labor Day, my husband was home. So firefighters work for 2-3 weeks on and then they get 2-3 days off. Usually, in busy fire burn season, they will turn and burn and go back out. He came home after Labor Day and I was a wreck because I was so stressed out with trying to get her turned. It was the middle of volleyball season. It was a busy fire season. They were supposed to leave the next day to go on another 2-week assignment and I just burst into tears. He was like, “Do you need me to stay?” I'm not very good at asking for help, but I knew that if I didn't leave everything out on the table, I would always wonder if she didn't turn, I would always wonder, “What if?” We made the decision that he was going to stay back from what would have probably been his last fire assignment before she was born anyway and we did, like I said, 2-2.5 hours of exercises daily to try to get her to turn. I drove back and forth to Grants Pass several more times and then finally, I was really nervous about doing a version, but that was something that my OB in Medford had suggested as a possible thought and my OB here was like, “Look, we can't offer you a VBAC here. I don't feel comfortable doing a version here because we just don't have the resources.” So at my 36-week appointment, I said, “Look. I don't know how comfortable I feel with a version. Is that going to be too much?” This is what I love about my OB. He leaned forward and said, “I have never known anyone as committed to wanting a VBAC as you. I think you need to do everything.” We drove over to Medford. We took all of our bags just in case it threw me into labor or something. Meagan: Right, or you had to stay. Anneke: Right. We went over and saw my OB there. He was like, “Okay. You're going to go to the hospital.” He explains the whole procedure. They couldn't give me the uterine relaxing medication because I had a little cardiac event in the pregnancy earlier that was just a one-off but he didn't feel comfortable giving that to me. For anyone who has been through a version, those are really uncomfortable. I mean, it wasn't the worst pain I've ever felt, but it's like being squished, very heavily squished by a full-grown man. You could see it in his face. He gets a hold of my daughter and he turns her 90 degrees and then she slips back. You can see that he's like, “Oh yeah. We've totally got this.” He hooks his hands on again and turns her 90 degrees and she slips back. So he's like, “Okay. Third time's the charm. Third time's the last time. We're not going to do it anymore, but we're going to get her.” He gets a good grip on her and he gets her to 90 degrees and gets her a little bit farther. I felt her jerk and her heart rate dropped to 60. We all just held up our hands and we're like, “Nope. Nope.” I didn't know this guy very well. He came very highly recommended. He was very friendly, but I'd only seen him a couple of times. He was just like, “Okay, well you can drive back to Lakeview and go schedule a C-section. We'll see you later. I have more patients to see.” I really liked him, but I'm starting to get a little sniffly and teary. He was just like, “I'm really sorry,” and left. I think I cried the entire way home and then I cried the whole next day. I told my husband, “I'm not calling my local OB. I'm not calling him.” He was like, “Yeah, but the baby's got to come out at some point.” I did finally see my OB the next week which would have been close to 38 weeks. I mean, the poor guy. I know he felt so bad, so he was like, “Okay, what can we do?” I really wanted to go into labor. I mean, this OB puts up with a lot of my shenanigans, but that was a hard no. He was like, “Absolutely not. You're not going into labor. We're not going to introduce bacteria when we don't need to.”I'd read a lot about a gentle Cesarean where mom gets to pick baby up or baby gets to go straight to her chest. Meagan: Mother-assisted Cesarean. We're seeing it happen. Anneke: I know. I'm very committed to the next one to maybe making this happen. I've got to work on this guy for a little bit, but that was a hard no on this one. One week was not enough time to prepare him, but what we were able to do is I had good friends who were OB nurses. We were able to schedule it on a day that they could be there. Our normal procedure for Cesareans here is that baby is born and then they do the cord clamping and then baby goes to the warmer, but my OB for delayed cord clamping instead of just laying her on my legs, held her out with full arms extended, probably burning to let me see her. She was a big kid. She was almost 9 pounds. That's actually the picture that I sent to go along with it. Then he took her over to the warmer and my friend, the nurse, was right behind him and swooped her up and brought her right to me. It was as close to that immediate skin-to-skin as we could have gotten. My struggle in the week between the version and her birth was that I just felt so broken. I really felt like my body had failed me and that for whatever reason, I wasn't destined to ever feel a contraction or to even try to give birth vaginally. I worked with my therapist over that week and actually did some EMDR myself because I just really felt like what I had done was valuable. I did everything I could to give her a vaginal birth and I under no circumstances wanted that feeling of brokenness to be passed to her even via osmosis. I worked really, really hard to have that open, brave feeling the day of her birth. When she got put on my chest, I didn't want any of my insecurities to get passed on to her. It was difficult after her birth too. I really struggled with feeling like I was worthy and like I had done enough. The other thing too is that I felt like I was going to have difficulty teaching childbirth education. Who am I to teach in this space? Meagan: I get that. When I became a doula, people would say, “Oh, so how was your vaginal birth? Did you go unmedicated?” I'm like, “I had two C-sections.” They're like, “Well, how do you feel qualified to support me through a vaginal birth then?” It's like, “I totally do.” Yeah. It was really something hard to overcome not having ever had a vaginal birth. Anneke: Right. Right. I had one patient. She sticks out to me. She said, “Well, okay. What do contractions feel like?” I had to be like, “Well, people describe them as–”. I wasn't able to tell her and that tore me apart. Since she was born, I've taught two series of childbirth education. I've had a bunch of pregnant patients and I've helped patients labor and helped teach them positioning and counterpressure. I realize looking back, I'm a pelvic floor PT and I threw my entire base of knowledge into my drive and journey to achieving a vaginal birth three times. When that failed, I literally went with blind faith. Anything that the internet or anyone suggested to me, I tried. I prayed and I meditated and I positive-affirmed myself every day and it still didn't happen. So in the end, I've never had that chance to be able to actively tell her or from experience tell my patients what a contraction felt like. Since my first birth, I've really asked, “Why? Why not me? Why does this keep happening and why can't I just be like so many others on the podcast and so many others across the country? Why can't I just will it into being?” So from these questions, I'm starting to believe that my story actually might begin at the end. After my belly has been cut into for the final time after the scar tissue knits back down and I can cough without pain, I've realized that maybe my story isn't about the mechanism of birth at all but what it birthed in me which was the ability to see my own strength and give that to my people who are in a world where victimhood and fragility eat away at our resilience and our grit. I thought that not being able to labor to not meet my children has broken me but I can't be broken. I can't be a broken mother to them. I want my kids to be strong, confident, and powerful. I can't teach them that if I can't model that. So I didn't get a vaginal delivery. I didn't get to experience labor pain and comfort measures and to have my partner doing counterpressure and using a comb and work together to bring my babies through my pelvis. I didn't get to look adoringly at my husband as I pulled my baby onto my chest myself, but what I did was I made the choice to put my child's needs before my own desires and I sacrificed my body in order to protect theirs. My labor was really giving my control and placing trust in my medical team and God to bring my babies into the world. I'm not broken by my births. I really feel like I'd been remade into what a mother is supposed to be. Meagan: Absolutely. I'm just crying over here. That was beautiful. That was absolutely beautiful. You know, I've talked about this before, but the way we give birth doesn't define us. It doesn't say that we are a successful mom for giving birth vaginally or by a Cesarean. It doesn't mean that our children are going to be weak or struggle because they didn't come out vaginally. Anneke: Right. Meagan: Wow. I just love everything. I'm seriously crying here. That was just beautiful. You are beautiful. Anneke: Thank you. Meagan: Every single one of these births is beautiful. You don't have to give birth vaginally to have a beautiful experience and to be a powerful mom. Like you said, “I'm not coming here today to share the vaginal birth that I wanted so badly and that I longed for,” but look at what you have done. Look at how you've grown. Look at how strong you are. I believe that our children– right now, they are little. They probably don't really understand the magnitude of what a Cesarean birth or a vaginal birth even looks like and what that means, but I promise you that no matter what, these babies are going to be grateful for you. Women of Strength, as you are listening, know that the way you give birth does not define you. You are incredible. Anneke: It actually hit me during the last childbirth education series that we taught. We go around and we talk about all of the interventions for birth– epidural, IV meds, Cesarean, or vaginal. So often, we have people who say, “Well, whatever baby needs.” It actually struck me during this last class. I said, “Look, of course, it's whatever baby needs. What you need is to cope. You need to know your strength and what will keep you strong because that is what takes you through this without trauma and takes you through feeling stronger and successful no matter the mechanism, no matter the medications, or the delivery method. It's about how you approach your birth and how you are going to continue to be strong whether you are pushing them or whether you are being brave and being cut open. No matter what it is.” Meagan: No matter what, yeah. Well, thanks for that. That was amazing. Anneke: You're so welcome. Meagan: Sorry for the sniffles, guys. That was beautiful. Congratulations. Anneke: Thank you. Meagan: Huge congratulations to all of your growth. Even through your journey with pelvic floor, you are going to help so many people. And with pelvic floor, tell us a little bit more about what you've learned even both ways with vaginal and Cesarean and how the pelvic floor actually is connected to both, and how even Cesarean mamas need guidance through pelvic floor. Anneke: Yeah, absolutely. I actually see a lot of the same issues post-vaginal and post-Cesarean birth. With vaginal birth, usually what happens is you're pushing a watermelon through a quarter-sized hole so those muscles and your joints are designed to stretch. There are lots of movements and things that can help. It would be like overstretching your hamstring. It just reactively spasms and tightens back down. That's even in the absence of tearing and things like that. Pelvic floor tension is really, really common after a vaginal birth but also after a Cesarean birth. Now you've lost stability from your abdomen. You can't even sneeze for 8 weeks without feeling like you're going to burst open. My nose actually wasn't better for a year after my first son because it was just so fast. Oftentimes, I actually see a reactive spasm of the pelvic floor in women with Cesarean deliveries as well because your pelvic floor is overcompensating through your lack of abdomen support. I actually treat those women a lot of the same and then of course, we do a lot more of scar tissue work with Cesarean. It's a lot more like abdominal training early on in women with vaginal delivery, but yeah. I mean, it's almost identical. The initial recommendations are a little bit different, but by 6 weeks, I'm treating women the same. What I actually love, I wanted to mention this about rural hospitals. People get scared to deliver in rural hospitals, but what's beautiful about our situation is that your OB will also likely be the one to come deliver and will also see you for the 3-day weight and color check, the 2-week visit, the 4-week visit, and the 8-week visit. They'll see you at the 6-week visit for you too. We have so much better follow-up for mom and baby here than I got in a big, fancy hospital in the city. I think I see people way sooner than I would see them in the city. I'm seeing people easily 4 and 6 weeks out where in the city, it might be 6 or 8 months. Meagan: Right. There are so many of us that it's 6 weeks out. That's when we are going in for our first visit and they're like, “Oh, what birth control do you want?” That's what we're asking. We've gone weeks and weeks and weeks with the pelvic pressure and that bulge or the leaking or that disconnect when we could have been doing something. Maybe 2 weeks out, we're not doing the exact same things, but there are things that we can do even through breath with our scar or mobilization for a Cesarean and all of these things that we can do. If you are like the many of us who don't get seen as you have which is the way it should be in my opinion, I think that we should be seeing people 3 days out or 2 weeks out and all of these things because that's when so many things are not caught. Know that it's okay. You can still turn to a pelvic floor specialist and therapist even while you're waiting. Anneke: Yeah. I've started a program at our hospital where I actually try to catch C-section moms in-house. I'll give them laying on your stomach and early abdominal work and how to get out of bed. Nobody teaches you how to get out of bed after a Cesarean. You can really screw up your scar tissue by straining on it too much or just be in a lot of pain for a really long time. The other really great thing about PT and insurance companies now is that you actually don't often have to wait for your doctor to refer you. If you are 2 weeks out and you are still leaking or you have a lot of peeing, you don't have to wait to see your doc. You can actually just call a pelvic floor PT and a lot of insurances will let you self-refer. It's pretty awesome. Meagan: Right. It is awesome. I just think, like you were saying, we just don't talk about pelvic floor after a Cesarean very much because we just don't think about it. We haven't pushed a baby out of our vagina so probably are okay, but the disconnect with our abs– Cesarean birth really is quite intense internally. So yeah. Don't hesitate. Go out. Can you tell everyone where to follow you?Anneke: Yeah, so where I talk most about pelvic floor and PT stuff is actually called @teamgriffith2011 on Instagram. If you are interested in finding a pelvic floor PT near you, if you go to the section on Pelvic Health, just Google that on the internet and there is actually a PT locator. That is how you will be able to find someone close to you. Meagan: Fantastic. Do you suggest people do it even before birth? I know you did with yours, but as a pelvic floor PT, do you suggest people go before?Anneke: Especially if you don't have a program in your hospital where PT tries to snag you before you leave, I would think it would be helpful. I do what I call a labor and delivery biomechanics visit. I'll have people come in. We'll talk about positioning and counterpressure and then I almost always give them vaginal delivery and Cesarean early-stage exercises. That would be something that a PT would be able to tell you what are the very first things you should start doing, when to start doing kegels, or how to get back. A lot of times, it's just teaching you how to diaphragmatically breathe because that will teach you how to coordinate your pelvic floor to the yoga breath. Meagan: Awesome. Well, thank you so much for giving me a good cry today. Anneke: You're so welcome. Meagan: And educating us on pelvic floor. Seriously, it was beautiful, and congratulations to all three of your babies. Anneke: Thank you so much. Meagan: Yep.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Today on the podcast, Sarah joins us from Minnesota. Sarah got COVID-19 very early on in her first pregnancy during the height of the pandemic. The protocol at her practice was to recommend a precautionary 39-week induction. Sarah trusted her doctor and consented to the induction along with other interventions that were suggested. Her birth ended in a Cesarean under general anesthesia. During recovery, Sarah's knees would buckle to the point where she needed assistance walking and fell until the problem slowly resolved. When she achieved her VBAC, Sarah was able to immediately walk unassisted. She wasn't groggy from just having had anesthesia. Her throat didn't hurt. She got the immediate skin-to-skin she missed the first time.Sarah is such an amazing example of how powerful a VBAC birth can be, especially with the right prep and the right team. We just love how hands-off and supportive her doctor was. Sarah went into her birth mentally and physically strong. She labored hard, stayed calm, and pushed her baby boy out in 20 minutes!Additional LinksNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode DetailsMeagan: Welcome to The VBAC Link. We have a story for you today coming from Minnesota. We have our friend, Sarah. And Sarah, tell me. Did you have your babies both in Minnesota or have you moved since then? Sarah: Yes, both in Minnesota. Meagan: Both in Minnesota. All right, so Minnesota parents, listen up. This is a wonderful episode in your area. Review of the WeekAs always, we have a Review of the week but first I want to talk a little bit about COVID-19. Sarah and I were just talking about how we have seen so many COVID-19 stories coming through. They had their C-section through COVID-19 or even had their VBAC during COVID-19 and then now they have gone on to VBAC. There is definitely a trend of situations that we are seeing so I'm just so curious today. Go comment on today's episode and let us know if you have any relation, but a lot of providers are wanting to induce if you have the virus, COVID-19. Sarah, that was kind of the case with you, right? They wanted to induce because you had COVID-19. Sarah: Yes. That was kind of the standard of care at that point. Meagan: Yes, which is kind of interesting to think about the new standard of care. I really am curious to see one day what the Cesarean rates did during COVID-19. You know, there is some evidence here and there on it, but I'm really curious to see what the Cesarean rate did because we do have a lot of people saying that they were induced because they had COVID and then they ended in a Cesarean. So we're going to talk a little bit. She's going to share her birth and her induction story that then led to her VBAC. But of course, we have that review. It is by Raving Abbeh and the title is “Confidence.” It says, “I found this podcast at 34 weeks pregnant and it helped me gain the confidence to fight for my chance and get a VBAC. I hope to submit a success story in a few weeks.” And guess what? This was also during 2020, so Raving Abbeh, if you haven't submitted your story, we would love you to and as always, you guys, we're always accepting stories. We definitely record in chunks, so know that if it takes time, that doesn't mean you haven't been chosen or you will never be chosen, but if you want to submit your story, go to thevbaclink.com/share. Sarah's StoriesMeagan: Okay, Sarah. Welcome to the show. Sarah: I'm so excited. Meagan: I'm so excited. I'm so, so excited. Well, tell us more about this 39-week induction and why they were saying it was the new norm. It was the protocol, right? Sarah: Yes. So at this time, I was working full-time in the hospital where I gave birth as a radiographer– an X-ray tech. I was kind of in the world a little bit. It was definitely not a fun time to work in the hospital. I actually tested positive when I was 8 weeks pregnant, so very newly pregnant. I was seeing family med for my provider and what they were doing at that time, they said, “Okay. This is what's going to be different. You're going to meet with a high-risk OB who specialized in COVID.” I would have growth ultrasounds every 4 weeks and then also, they were recommending this induction at 39 weeks. When I asked about that, what she said was that they had seen issues with the placenta. That was the reason that they had. I actually looked back on it now and I think in the study, they really only had 16 pregnant people so that was what they were basing this all off on. Meagan: Which is really nothing to start making a protocol so wide-ranged. Sarah: Right. Right. And actually, right now, my sister-in-law had COVID and she's pregnant. She had COVID at the same time I did at 8 weeks, but now it's 2023 and her doctor is not doing the growth ultrasounds. They're not recommending induction. There actually is nothing different with her current, right-now pregnancy which I find interesting. Meagan: Interesting, right? Right? Sarah: But again, it can range. Meagan: In 2020, it's interesting because they were like, “Oh, we're going to have you with this provider who specializes in COVID pregnancies,” but how does someone specialize that fast? Sarah: Right. The person that was the specialized person was the highest-up person in the department of OB. Meagan: Okay, so definitely a specialized OB. Okay. Sarah: Right. I actually only ended up meeting up with her one time because if there was anything abnormal, that's when I would go to her but my pregnancy was completely normal. I had no issues related to COVID or related to anything else which was obviously a blessing, but kind of also a bummer because now, I'm going to have this completely unnecessary induction at 39 weeks.Meagan: Yeah. Sarah: She did mention at the time that if I wanted to go past 39 weeks, I could definitely make that choice but she would do NSTs. Now after learning so much and being where I am now, I would have been like, “Okay. Let's go longer and do NSTs,” but at the time as a first-time parent, I was like, “That sounds kind of weird. Let's just do what you think.” Meagan: It sounds intense with all of these extra visits. It's a lot. It sounds like a lot. Sarah: Yeah. Otherwise, about that pregnancy, being a first-time parent and having this medical background, it's no surprise probably that my attitudes towards the doctors were that I completely trusted their knowledge with the COVID stuff because it was so new. Meagan: Oh yeah, and scary. Sarah: Yeah, definitely, but I was completely unaware that there was such a wide range of ways to treat pregnancies and so many different attitudes on how to birth babies. I was just clueless to the whole thing about the cascade of interventions and why do inductions have an increased risk of C-section? I was completely clueless to it. I am just used to with a doctor, you have a certain condition and there are ways to treat it. It was very narrow. But with birth, there are midwives. There are doulas. There are so many different ways to treat someone's birth and pregnancy that was just over my head. When people would ask me, “Oh, why are you having an induction?” and tell me that maybe I shouldn't do that, I was like, “Oh, well why wouldn't I when they say that is the best thing to do for this COVID situation?” For me, it was like, “Well, they know better than me.” Meagan: Right, yeah. Sarah: I think you say all the time that you don't know what you don't know. Meagan: You don't know what you don't know and you can't judge yourself for not knowing what you don't know. Sarah: Yes. I definitely had to work through forgiving myself for sure. Meagan: Yeah. You have to take the information. I think I talked about this too. My husband had said this. We took the information we were given and made the best choice that we felt we had with the information provided. Sarah:  Yes. Meagan: Right? And that's what you did. Sarah: Right. Honestly, it's funny now. Even just preparing for birth in general, take away the COVID part, it's kind of funny how I did basically nothing to prepare for birth. I just focused on my registry and other things like that after the baby got there. It was kind of because I had this, “Oh if I go with the flow, I'll have the best outcome. I don't want to put too many expectations on myself. I don't want to pressure myself. I'm just going to go with the flow. I don't know how my body is going to handle it,” which does have a place. There is a goodness to that, but I think I was a little too extreme where I was like, “My mom had C-sections. I know if that happens, it happens.” It was just very, “Whatever happens, happens.” Now, I look back and I'm like, “Well, now all I did was have no tools in my toolbox to deal with pain, labor, or resources to help make those hard decisions that I was going to have to make.” I had nothing in the background to help me with that. Meagan: No tools in your toolbox. Sarah: Exactly. That's why it was very different for my second birth but at that time, I was like, “Okay, whatever happens, happens. I don't know what's going to happen to me or how my body is going to take it, so we'll just see what happens.” I was scheduled at 39 weeks on a Monday and actually, that Friday before, they called me and said, “Hey, do you want to come in early? We have a lot of people scheduled on Monday.” I was like, “Oh, I'm excited to meet my baby. I'll go in even earlier,” which is like, oh. Okay. That weekend, we were actually moving into our new house an hour away. Meagan: Oh my gosh. Sarah: We actually spent one night at our new house and the next day we drove back to Rochester to have our baby but we were so excited. Meagan: Yeah. Absolutely. Sarah: I wasn't even thinking about anything else. We were scheduled for a 7:00 PM Saturday appointment then. When I got there, I was completely 0% dilated. Closed. 0, 0, 0, -3 station. Furthest from ready. Meagan: Not ready to have a baby, yeah. Sarah: No. So they started me with Cytotec overnight and in the morning, they placed the Cook catheter then they started Pitocin right after. I faintly remember watching Beauty and the Beast bouncing on a ball, but that was the extent of any movement in my labor. Like I said, I didn't prepare for anything. I just was like, “Oh, bounce on a ball. Everyone says that's good.” I didn't do much. But what did start happening was the baby was having decels, not liking the Pitocin, so I had to get moved from side to side. I was lying on the bed– not the best position to have the baby not be so high up. Meagan: Right. Sarah: But then by 10:00 AM, they took out the Cook catheter. I was 4 centimeters dilated. Things were moving along. But then at 11:00, they had to turn down the Pitocin because again, the baby was still not tolerating it very well. Then I felt a big pop in my belly and I was like, “Oh, is this what it feels like when your water breaks?” I was excited. I'm like, “Oh, that sounded like a balloon popping.” So they came in and they were like, “No, we don't see anything. Your water didn't break.” I was like, “Oh, okay sure.” Meagan: I felt something. Sarah: So then a half hour later, they came back in because they had to actually turn off the Pitocin because the baby still wasn't happy. They checked me and they're like, “Oh, there's all your water,” and it gushed out on them. So I was like, “Okay, well at least I know that I can trust my intuition even though you didn't quite believe me.” Meagan: Yes. Sarah: But I'm not crazy. It did break. The contractions were getting really intense at this point. I tried laughing gas. It didn't really work. At that point, I decided, “Okay. I'm ready for an epidural. I feel like I've gotten as far as I can with what I prepared,” which was nothing. I actually found out this after the fact, but at this point, they actually gave me medicine to stop my contractions. Meagan: Like terbutaline or something?Sarah: Yes, exactly. They gave me that at this point. I actually have no recollection of this, but I was able to look at my records after the fact and I was like, “Oh, I never knew they even gave me that.” Apparently, they gave me that to stop things or slow them down or whatever. I was about 5 centimeters dilated at this point and they placed the epidural. Everything went smoothly with that and then an hour later, they were like, “Oh, we're going to start the Pitocin again.” I was like, “Okay.” I was 5 centimeters at that point and then 40 minutes later, they checked me and I was 9 centimeters. Meagan: Whoa, so your body went into total relaxation mode and dilated. Sarah: Yes. Yes. I was like, “Cool. That was fast.” They had just sent away the doctor. They had to call her back. Shortly after that, I was at 10 centimeters, ready to go. This is when they had me start pushing. One important part that I know now is that I don't remember ever feeling pressure or the urge to push or anything like that. They were just like, “Okay. It's time to push.” I'm like, “Okay.”I did end up pushing for about 3 hours. They did let me try a few different positions. They tried to turn down my epidural to help too, but she never really progressed past that zero station. So nothing was happening. I was mostly on my back for all of it.I remember them saying that they would let me push for the most at 4 hours, but at the 3-hour mark, I was exhausted. I felt like we had made no progress. I was just like, “Nothing's going to change in another hour at this point for me. I don't know what I'm doing. You try to tell me how to push. I still don't know.” Meagan: Yeah. You're just like, “I'm tired.” Sarah: Exactly. The contractions were beginning to be really painful. Again, I didn't really have a way to cope with them. The pushing wasn't working so I consented to the C-section. I just remember feeling so defeated and just crying, being wheeled into the OR. My doctor stayed right by my head and talked to me until my husband was supposed to come in because I kept saying, “Hey, I feel these contractions. They are strong.” They were trying to give me all of the medicine to numb me enough. They were doing the prick test to make sure that I couldn't feel it and I just remember it was really hard because my nose was plugged up from crying. I felt like I couldn't breathe anyway. I wasn't sure about the pokes. I was like, “They are sharp to me. I feel them. They don't feel like pressure. They feel sharp.” They were like, “Okay. Well, we're going to have to put you under.” They put the mask on me. I breathed in and went to sleep. Meagan: And you were gone. Sarah: Yep. Then I was gone. Meagan: Your husband probably never came in then? Sarah: So he did get to go into the OR. She was born. They let him go in so he was all gowned up. He was in the OR. He kind of tells it like, “Yeah, it was so weird. I looked over and there you were on the table.” He wasn't so close to me. Meagan: Sleeping. Sarah: But yeah. I was sleeping. He did get to do skin-to-skin. They let him do that in the OR which was really nice. They got a bunch of pictures of her getting weighed and him cutting the cord in there so it was nice to have some of those pictures that I can look back on. Meagan: Right. Sarah: That's something. Meagan: Right, yeah. It helps you relate, too, when you're not awake. Sarah: Exactly. It was definitely a weird experience. But when I did come to, apparently, I had been awake longer but you know how that works. When you're waking up from anesthesia, it's kind of weird. But apparently, when I woke up, they told me that I was just like, “Where's the baby? Where's the baby? Where's the baby?” They rushed me back. I don't remember any of that, but what I do remember is when I woke up, my throat was so sore and hurt so bad. But she was on me and she latched immediately and started feeding so that was really special. Meagan: Yes. Sarah: Just how she was able to eat right away and I didn't have any problems with that which was really nice. I know that can happen sometimes. That's basically that birth. Meagan: An unexpected ending and a less-ideal situation, but then to come out and have things work out really nicely was probably really healing and comforting. Sarah: Yes. Right away, I was definitely happy. She was healthy. I was okay. She was eating. But I remember just recovering from a C-section, you're in a fog. I remember my legs being in those machines to keep the blood flowing, having a catheter, having my sore throat, and whispering to talk. That kind of thing was definitely not a fun recovery in that aspect right immediately after. Meagan: Yeah. Sarah: I actually had a really weird thing. I had problems with my knees. Meagan: Oh. Sarah: I have never heard anyone else talk about this. Meagan: Interesting, like wobbly and strong? Sarah: So what happened was once they took out the catheter and then they give you the, “Okay, it's time to try to go to the bathroom for the first time.” When I tried to stand up, my knees would just buckle. The first day, I had to have two people assist me to the bathroom. The second day, it was also a two-assist. Slowly, they started to not always buckle. I was in the hospital, I think, for four days. Four or five days. Eventually, they wouldn't buckle but when I got home, they would buckle when I went upstairs. I did fall twice but slowly, they did get better. It was fine. It was just if I unexpectedly took a step. My cat scared me and I stepped and then I would fall because my knee wasn't expecting it. Meagan: I just looked it up because I am legitimately curious. It says, “Acute lower limb compartment syndrome after a Cesarean.” Sarah: Oh. Hmm. Meagan: Interesting. So it can happen. Sarah: Interesting. I was just kind of assuming it was a mix of me being numbed from the waist down for hours and then my legs being up in the air for hours and then being in the C-section, and then also laying down. Do you know what I mean? Something with that, but no doctor or anything ever said anything to me about it. They were just like, “Oh, okay. That's weird.” Meagan: Yeah. Really, really interesting. It says that it's rare. Sarah: Oh. Meagan: It's pretty rare, so you get to be in one of those rare groups. Thank you for sharing. Sarah: Yeah, so otherwise, I hadn't really fully processed the birth but every time I would tell my birth story, I would choke up or cry and that's when I realized, “Oh, maybe I didn't really like that very much” because at first, you're just happy the baby is okay and you're okay. I actually remember right afterward, I was like, “Oh, okay for any other baby, I'll just schedule a C-section. This time it will be planned and I'm going to be awake for it.” I honestly wasn't even thinking about VBAC right away. I was just like, “Oh, the future will be easier. It will be fine.” But when my daughter was around 6 months old, I started to listen to The Birth Hour and I found myself searching C-section stories, looking for things like mine which led me to hearing VBAC stories, searching those out, and then finally finding The VBAC Link. That was the big game changer. I am so appreciative of you guys having this podcast and keeping it going on and all that. Meagan: Absolutely. Sarah: Such an inspiration. I learned so much even from both podcasts about interventions, doulas, birth teams, and most importantly, trusting in a woman's body. It kind of leads me to this big thing. It's like, why do we have to go through some sort of trauma to become an advocate for women and educate ourselves? Meagan: Right? Sarah: I feel like that's such a theme. Meagan: It's so true though. It's so true. Why do we have to go through a really crappy experience? It doesn't always have to be crappy. I'm not saying C-sections are crappy, but a big experience to have passion and to feel that motivation behind that.Sarah: Exactly. Yep. Sometimes, it's so hard because it's like when you talk to someone who hasn't been affected by this kind of situation where it doesn't go their way in the hospital, it sounds like a conspiracy theory. “You can't trust the doctors.” That's not what we're saying. It's so much more than that. Meagan: It is. It really is. It's not even just in birth. Truly, right? My husband does not do what he does, I think, mainly just because he didn't want to do it one day. It was like, “Hey, this really unfortunate situation happened to someone I love and I want to be available in a different manner to help them or help anybody else.” So he took on his profession. It's like IBCLCs– I'm sure a lot of them have had unfortunate or poor nursing experiences and are like, “We want to help other people have better experiences.”Sarah: Yes, because it's the information that, “Oh, wow.” It makes complete sense that, “Oh, things might go a little bit better if you let your body naturally do it.” Oh, well yeah. That makes sense. It makes sense that, “Oh, if I have someone who's trained in positioning, maybe if I move my body in this way, then I can get my baby in a better position to come out better. Oh, that makes sense. Why didn't I know that? Why didn't my doctor say, ‘Hey, there are some positions that can help.'” It's confusing to me. It's like, well that makes sense. Meagan: Yeah. Sarah: Yeah. So obviously, I just dove right into all of the VBAC stuff and learning all about that and listening to different stories. I was super excited for my next pregnancy because I had made the decision, “Yes. I'm going to go for a VBAC and I'm super excited about it.” I was ready to do all of the things to make it more successful. We got pregnant when my daughter was around 15 months old. We wanted a two-year age gap and they're both two years apart in April so that worked out for us. Meagan: Perfectly, yeah. Sarah: So the things I did to make it more successful– they are all things that people on this podcast talk about. For physical things, it was workouts that focused on birth prep. I didn't do anything crazy like walking for miles and miles every day. I just did the minimal which was doing some exercises every day for hips opening, cat/cow, and all of that stuff. I did the Miles Circuit later on in pregnancy every day. I ate my dates every day. I drank my tea.Then I think the biggest thing, too, is mentally preparing. For mentally preparing, I got my doula. I really love that the doula does the meetings before the birth. I didn't even know that when I had heard people talk about doulas but meeting before and talking about what birth plan I wanted, what things– Meagan: Your desires. Sarah: Exactly and what things could happen. I'm like, “This would be so helpful for a first-time parent to know all of this stuff.” I wish I had gotten her with my first. Also, just talking about coping mechanisms, what are some positions that we are going to do, talk about scenarios. It was great. Then I also, for mentally preparing, I looked up a bunch of different coping mechanisms. I actually did Hypnobabies. I wasn't consistent with the meditation, but it was very helpful to practice the breathing and visualization. Meagan: I did too. I did it as well. Sarah: I was really bad at the meditations so that didn't stick with me, but it was really, really great to practice the breathing and all of that. And honestly, just listening to birth stories is mentally preparing because I would really only focus on positive stories toward the end of my pregnancy. I was like, “Okay, now we are in the home stretch. We are just going to stick to all of the positive ones.” The big thing, too, was finding my provider. I joined The VBAC Cesarean Support Group on Facebook way earlier and everyone had all of the recommendations of who to go to. My provider is actually family med, but he is more like a midwife. Actually, my doula said that he's actually more crunchy than a midwife as a family med. For all of the births that she attended, she said, “He is more hands-off than a midwife.” I'm like, “Wow.” Meagan: Wow, that's cool. Sarah: And what's great is that he attends all of his births so there is no rotating call schedule. Meagan: Which is huge. Sarah: There's no, “Who's going to be there?” He's very trusting of women's bodies. I did my due diligence and I asked him, “How often have you personally seen a uterine rupture? How often do you use the vacuum? How often have you done episiotomies?” You know, so just asking him all of the things. He had really great responses and I felt really solid with him. Meagan: Which is really important, right? To have those conversations also. We know that when they come in and they say, “Hey, do you have any questions?” It's really okay to ask questions. Sarah: Yes. That's the big thing. So because he's not an OB, I had to go do a consult with the OB that he works with in the hospital. The OB who works in the hospital definitely wasn't making me fearful, but there's a certain form you have to fill out that says, “Hey, obviously if you're successful with your TOLAC, that's going to be the safest option for you. But if you're not successful, that's the least safe.” It's easy to plant doubt, but after I saw him again, I asked my provider, “How often do you see it?” It was such a small amount and since he's one of the VBAC go-tos, I felt very confident with him. It was really nice to have that fear taken away in that way. Meagan: Yeah. Yeah. Sarah: And then this is kind of interesting. Just for fun, I did message my old provider at my previous hospital just to see what she would say about my chances for VBAC. I actually messaged her before I was pregnant. I said, “Hey, I am kind of processing and struggling from my C-section. What do you think about my chance for VBAC?” It was just on a message. What she said was, “You did everything you could at that time to have her vaginally, but she just didn't fit your pelvis for whatever reason. We think of fitting as a lock and key situation. Both pieces have to work together to open, so there's no way to know if a future baby would ever fit your pelvis better than she did.” Then she kind of went on. I thought, “Nope.” I'm like, “Nope. I'm not taking that in.” Meagan: Yes. Sarah: It was interesting. Meagan: Thank you so much, but no thanks. Sarah: Exactly.Sarah: Exactly. I'm like, “I don't think she didn't fit my pelvis. That's not a thing.” Meagan: But you know, it's an easy thing for people to say or diagnose. It's like, “Oh, well your baby was perfect. You were perfect, but the two together didn't really match that time.” Sarah: Right. Meagan: That doesn't necessarily mean that's true. We just don't know. Sarah: Again, we can't go back in time and have me try something different. Meagan: Yes, yes. Sarah: But I think it's interesting that she said that. Meagan: It is. Sarah: Again, I talked to my doctor. He's like, “Oh yeah. Great. Let's do it.” Meagan: Yeah. Sarah: He said, “You've got this.” So you know. Otherwise, I'm preparing. This is the funny thing too, again. At first, I didn't have any intention of trying to go unmedicated. At first. I was like, “I definitely want to VBAC,” but I wasn't trying to do that. I was just focused on the VBAC part. But once you hear enough birth stories, you know that if I do all of this preparation and I go as long as I can without this intervention, I'm going to have the best possible chance of a healthy vaginal birth. If it still ends in a C-section, it's because that was what had to happen not because I didn't know any better. Meagan: Right. Sarah: So that's when I was like, “Yes, okay. It makes sense for me to try. I should just try to go unmedicated. I should just do it. Whatever happens, happens.” I still am keeping my go-with-the-flow but with a lot of preparation. It was kind of funny because when I would tell people that, “I'm trying to go unmedicated,” people will say the craziest things to you. Meagan: Right? “I could never.” Sarah: Yes, or “I know someone who did and it was the worst thing they ever chose to do. They said, ‘Never do that.'” It's like, I know and I've heard many, many stories of people doing it and are very happy with the outcome. So definitely right before, I was 37 weeks. I was like, “I'm going to read Ina May's Guide to Childbirth.” Everybody talks about it, but I just wanted to hone in and focus on those unmedicated birth stories and just say, “How did you guys do this? How was it successful?” That was really helpful. I really liked that book. That was really good. Meagan: Yeah. I really like it too. Sarah: Yeah. Otherwise in this pregnancy though, I physically felt really good. I got Braxton Hicks contractions which I didn't have in my first pregnancy. That was definitely new. Meagan: Yes. Probably exciting. Sarah: It was exciting. I was like, “Okay, yeah. Every birth is different.” That was one of the Hypnobabies thing that stuck with me. Each baby is different. Your birth is going to be different. Don't let that fear creep in on you. But at 33 weeks, I found out the baby was breech so that was scary. Meagan: Yeah. It throws you for a loop, right? Sarah: Yes. When I found out that he was breech, I immediately messaged my doula. She gave me Spinning Babies exercises to do every day. I was making sure I was sitting forward and all of that stuff. Then I went to see a chiropractor first and then she also gave me this massage therapist who was trained in breech balancing massage. I went to both of those and the baby was flipped at my next appointment at 35 weeks. Meagan: Yay. Sarah: So I was very happy. The coolest thing with the massage therapist—in our state, I'm pretty sure she is maybe the only one who does this breech balancing massage. She told me because I actually went to do a follow-up appointment. Even though he was already head down, I was like, “Let's just go again to make sure.” She said that she was treating six other breech moms at that time and they had all flipped when I came back from my second appointment. Meagan: Oh my gosh. Sarah: Yeah. I'm always in the groups. I'm like, “If anyone is breech, try this specific breech balancing massage. Yeah.” It's really interesting just listening to her talk about it because she is so knowledgeable about, “Hey, your baby is breech for a reason. You have these muscles that get tightened. Your pelvis is this bowl and if things are in the wrong position, the baby wants to be head down. If I can release all of these muscles and make more space in there, even if the massage might not on its own make your baby flip, but giving your baby that space, then your ECV is more successful if you do that. Meagan: Right. Sarah: I was very happy because I had done all of this work and hyped myself up. I wouldn't want to have to schedule a C-section for this reason after all of that but if it happened, it happened. Meagan: Yeah. Sarah: So everything was going good then until my 39-week appointment. I had a high blood pressure reading so I was like, “Oh great.” But my doctor was not worried. He had me do an NST, labs, and monitor at home. I came back in a few days and everything was good. That was nice. Actually, the day that I went back for my follow-up for my high blood pressure was the day that I got my birth records. They had my birth records there for me. I had gone this whole time. I was almost 40 weeks and I was like, “I still really want to see.” Meagan: You had requested them? Sarah: Yeah, and it just took a really long time to get them. When I had that appointment, I was able to get my birth records earlier than I thought. I didn't think I was even going to get them by the time I had the baby. I was able to read through them and kind of work through it. My doula was like, “Oh, do you want to call and talk about it?” I was like, “Yes.” It was kind of like a fear release for me because that night I went into labor. Meagan: Yeah. Did you find anything in there that you didn't know before? Sarah: I mean, that one thing was that terbutaline. I didn't know that. And then I was just curious about some of the dilation. Also, I saw on my records too that the surgeon who did my C-section put, “This patient is a candidate for a TOLAC.” Meagan: Oh yeah. Sarah: It was nice just to have that and to see that the surgeon who did my C-section would put that on my note like, “Yeah. They are a candidate.”Meagan: Yeah, it's helpful. Sarah: Just working through it too was nice to see it in a timeline. So that night was the night I went into labor. At 2:00 AM, I woke up with my contractions. Right away, they were 3-7 minutes apart. I had the same situation three weeks before where I woke up and had contractions that were 3-7 minutes apart, but they fizzled out and didn't come back. I only had that situation one time earlier. So I was like, “Oh, this could be another practice. This could be the real thing.” But they were stronger than the last time. That's the biggest thing too. Even though they were so close together, I was handling them so well that I was like, “I think I'll just wait this out,” which is interesting because if you're a first-time mom, you're like, “Hey, this is 4-1-1. I'm having them.” Meagan: You have to go! Sarah: And they're long. A lot of them were long like at least a minute, but they just weren't strong so I was like, “Okay, well I'll wait.” Then my husband woke up at 4:00 AM. I was like, “Hey, I'm having these contractions.” His response was, “I'd better hurry up and go work. I've got some work to get done.” He's like, “Oh no. I gotta go.” So then he went away to go work on stuff. Then by 6:00 AM, I was like, “Okay.” I had a couple really strong ones so I was like, “Oh.” Then I was also getting back labor so I was like, “All right. Time to text the doula.” I was like, “Hey, this is what's going on.” She was like, “Well, your back pain might be because of the baby's position, so try to do the Miles Circuit. Eat a good breakfast. Hydrate. I'm preparing you for possibly a long day.” I said, “Okay, sounds good.” I had my bagel with cream cheese. I got my Body Armor drinks out, but when I tried to do the Miles Circuit, it was so intense. I could not. The minute I laid down and I had a contraction in the Miles Circuit position, the laying down one, it was like, “Whoa, no.” Meagan: Not gonna happen. Sarah: I'm like, “I think this is time for me to start going into some prep mode here.” So I dimmed the lights in my room. I had my ball but I actually didn't like bouncing on it so I never bounced on it. Meagan: Was it uncomfortable? Sarah: Yeah. For me, that seated position was uncomfortable. For me, I was in a forward-leaning position. I'd lean against the wall and sway or I'd have my husband come. I'd hug him and sway. I'm like, “This is working out okay.” The back labor was a different aspect that was like, “There's got to be something I can do for this back labor.” I messaged her and she's like, “Okay, well obviously have him try to do hip squeezes,” but he wasn't really getting the job done with the hip squeezes. She recommended the shower to also help us see if it's going to calm down or if it will keep going. I got in the shower and it was magic. The heat on the back was perfect. My favorite thing ever, but the hot water ran out after 15 minutes and I was so sad. Meagan: Oh shoot. Sarah: So the hot water ran out and I was like, “Oh man.” I got out of the shower and I was like, “Now we might just have to go to the hospital right now because I need hot water. I want to get in that tub.” That was my dream was getting in the tub. Meagan: Right. Sarah: So my doula checked in with me at this point and asked about the shower. I was like, “Yeah.” I think I was kind of in denial because I was like, “Oh, it's medium intense,” but they were still happening. She was like, “Okay, well maybe you should start heading in as long as they are staying 3-4 minutes consistently for an hour. Go ahead and start heading in.” At this point, she also tells me that she is actually in another birth. Then she joined me with the backup doula so she was at another birth. I was like, “Oh bummer.” But my backup doula ended up being amazing as well. But you know, when you're preparing with someone— Meagan: Can I just say right there that is a real thing? It's usually if you have to have a backup doula, it usually works out so well. Right? Sarah: Yeah, it was so good. Meagan: But like you were saying as I was cutting you off, as you were preparing with someone else, it's hard. Sarah: Yeah, it's kind of a bummer because you know this person so well and you had worked with them, but it worked out perfectly fine too. I really like my backup doula. She's great as well. She told me, again because I was like, “Hey, what can I do for now? We're going to head in probably soon but what else can I do for this back pain?” She was like, “Do you have a heating pack?” I'm like, “Ooh, yes.” I was putting a hot pack on my back which again, wasn't hot enough for me. Meagan: You needed a hot tub. Sarah: It did something. At this point, my daughter had actually woken up because we were still at home. It was about 8:00 and she was so sweet. Every time I'd have a contraction, I'd go into my room. I'd have my calming music on and my swaying but then I would leave and I'd come back out with her. She was just so sad. She wasn't crying, but she had these big tears welling up in her eyes. I would hold her and she would pat my back. She was like, “It's okay.” It's like she knew that something was going on. I was like, “I'm okay. It's okay.” She was just kind of like, “What is going on?” I wasn't making loud, loud noises but I would be doing horse lips through them or moaning. Meagan: Coping. Sarah: Yeah, nothing too crazy, but for her, she could tell that something was going on. Luckily, my mother-in-law and sister-in-law came over shortly after that around 8:30ish. My sister-in-law took my daughter and was like, “Let's go play,” so she was good. She was good. My mother-in-law saved me because she said, “Oh, I will boil hot water.” So she got a big pot and boiled hot water. She put cloths in them and put those on my back. That was amazing. Meagan: I bet that felt really good. Sarah: Right. So at this point, my husband probably should have been getting the cars ready for us to go to the hospital, but instead, he was cleaning the house frantically. Meagan: That was probably his way of coping. “Oh my gosh, this is happening. I'm going to go work and then I'm going to go clean the house.” Sarah: Yes. Yes, so we're like, “Okay, it's time. We've got to get going.” I'm like, “Yeah. I've got to get going.” So finally, we get in the car. My back is soaking wet from these hot towels but they are saving me. Luckily, the drive was only 10 minutes. I had my hot towel in there. It wasn't the most comfortable, but we got there. They checked us in and they moved us to triage. At this point, again, the sitting position was not my position for labor. It was, “Nope, not happening.” I was always kneeling, facing the back of the bed. The back of the bed was up. I held onto it. Then when I was in triage, though, I didn't have my coping mechanisms. I didn't have my hot towels. My next plan that I had was the comb technique. I had packed a couple of combs. I was telling my husband, “All right. Your hip squeezes—” he was trying to find the combs and of course, he couldn't find the combs that I brought. But he did remember that he brought his own comb. Meagan: Hey! Sarah: So I was able to take his comb which I can say RIP to his comb. I used it. There were little comb tings, whatever they are called, the teeth of the comb were everywhere at the end of my birth but it definitely worked. So then every time I would have a contraction, I was pushing on the comb and breathing as they were checking me into triage. But they were able to kind of get the band on me. They gave me an ultrasound to make sure the baby was head down while I was in triage. Then they checked me. The nurse checked me and when she was down there, she was like, “Oh, it's really hard to tell how dilated you are because you have a bulging bag of waters and I really can't tell what you're doing.” She was like, “I think you're almost complete.” I'm like, “Okay.” Meagan: Whoa. Sarah: I'm like, “Okay.” This whole time, she'd been trying to call someone on her radio, but they were really busy. At that point, she was like, “Okay, let's get this room.” She was like, “I'll just wheel you on this bed unless you want to walk.” I'm like, “Actually, I want to walk.” I was actually thinking, “You know what? I think I want the bed that is in the room. The triage beds aren't probably as comfortable.” That's where my mind was so I was like, “Let me just walk.” Meagan: No. Sarah: So they get me in the room and again, my doula is on her way but she's not there yet. It's about, I think, 10:00. My doctor comes in. They put the little IV on my arm in case I need any medicine. All I'm doing right now- Meagan: Hep lock. Sarah: Yes, exactly. All I'm saying is that I just wanted to get in the tub. This is me the whole time in triage. Meagan: I just want the water. Sarah: I want to get in the tub. I want to get in the tub. The comb is helping, but I want to get in the tub. So he comes in. I'm like, “Hey, can I get in the tub?” He's like, “Well, you can but I should probably check you first if you want me to. If you're really close like the nurse thinks, then you'll have to push soon possibly.” I'm like, “Yes. Check me because then, if I'm not, I can get in the tub.” That was in the back of my mind. He checked me. He's down there for a while and I'm finally like, “Okay, you've got to get out.” He's like, “I understand why they are having a hard time. Yes. You have a big, bulging bag of waters. I can tell why she had a hard time and I think you're maybe 7 or 8 centimeters but I can't tell. As soon as the water breaks, you're going to be fast.” I was like, “Sounds like I can get in the tub.” He was like, “Yes, you can.” Meagan: You're like, “Perfect.” Sarah: Perfect. This is when my doula came around this time. She helped get the tub in motion because they were like, “Well, it's going to take a while. We've got to get you on these mobile monitors.” She went in and she got the water going and I was able to get in the tub. The only problem is that once I got in the tub, I was like, “Oh, I think I have to poop,” which is the magic— Meagan: Means you're going to have a baby! Sarah: She was like, “Well if you want, you can sit on the toilet and see if you actually do poop.” I was like, “Sounds like a plan.” I sat on the toilet facing the back of the toilet. I had my hands on my comb. My comb was with me everywhere. That's when I had the scary, scary transition contraction. I was so happy I had her there because she was saying all of the right things and at this point, I can't remember any of them except for her saying to me, “This is the hardest part, but it's also the shortest. You are in transition.” When I heard her, I was like, “Okay, that makes sense.” I was a little shaky. You just feel so out of control. I was like, “Whoa. I don't know about this. I'm not sure about this.” Meagan: You start questioning. It's weird. Sarah: It is really, yeah. But she was saying all of the things I needed to hear, so I was good. So then I was like, “Okay, no poop is coming. Let's get back in the tub.” So I got back in the tub, and then I had probably one contraction and then a lab person came to the door and was like, “I've got to take your blood.” We're like, “Uh, okay. Let's just wait until she's in between contractions.” I'm like, “That's a good idea.” So she comes in. She turns on the light. I'm like, “This is throwing off my vibe.” She sits down next to me and she scans my band and then they were like, “Okay, let's wait for the next one.” The next contraction came and it was the, “My body is pushing! I'm pushing. Help!” I had that fetal ejection reflex, but my water was still intact so it was more of the water ejection reflex. Meagan: It was pushing that, yeah. Exactly. Sarah: My body did the thing where it pushed on its own. I've always heard about this when I've listened to the podcasts that this happens. I was always like, “Oh, I want that. That sounds nice. Do it for me,” but I did not like it. Nope. Especially because I was in the tub, maybe that's why, but I just felt so out of control. I was like, “Whoa. I'm not controlling this pushing,” but I was also very excited because I knew that meant it was time. The lab person promptly left the bathroom and they never got my blood. I don't know why they needed it, but they never got it. Meagan: I know. It's so weird, “We need your blood right now.” It's like, “Really? Why?” Sarah: Yeah. Especially when, “Oh, I'm in transition about to have a baby.” I think you're okay. Meagan: Seriously. Sarah: I had that. So that happened and then my doula was like, “Well, do you think you want to get in the bed?” I'm like, “Yes. If a baby is coming, I need to be on the bed.” So again, my favorite position—even my tub position was my hands and knees. I was draping my hand on the back of the bed kind of in that—I wasn't really hands and knees because I started that way and then I ended up hugging a pillow and kind of squatting back. Meagan: Yeah, okay. Sarah: Yeah. I started pushing. Again, my waters hadn't broken yet which was obviously, this is a big thing with my provider. He is hands-off. Any other provider would have said, “Do you want me to break your water?” Meagan: Absolutely. Sarah: That would have been a thing. It was kind of interesting that “Nope. I'm just doing it all on my own what my body wants to do.” I was pushing for about 10 minutes and then my waters exploded. They all knew it was coming, so no one got drenched, but it was so loud. Meagan: Everyone was probably a little sensitive in that area. They were probably like, “I'll walk over here.” Sarah: Yes. They expected it. My doctor was like, “I might get drenched, but I'm ready for it.” But he didn't. Meagan: That's okay. Sarah: It was so loud. I was shocked. It was like a gunshot. It felt like it was just like BAM when I pushed it out. So that was great. Then about 5 minutes after that, he was born. I pushed the waters out and then pushed him out. His head was right there and they were like, “Oh, you can reach down and feel the head.” I'm like, “I can't.” I had to reach down. I'm like, “My arms are too short.” So then I pushed him out. It was about two pushes I think.Yes, as soon as that water was done, yeah. He was two pushes after that. It was about 20 minutes of pushing total. Meagan: Whoa. That's like nothing. Sarah: Yeah, then I got to flip around. They put him on me and they didn't cut the cord until it was done pulsing. They did delayed cord clamping. They did the golden hour. He was just on my chest the whole time. I birthed my placenta which was fine. I did have a small tear which was just something I was scared about with an unmedicated birth. I'm like, “Oh, that will be not pleasant. I hope I don't but again, no idea. I probably will. Most people do.” It was a very small, I guess, second-degree tear but he numbed it. It just felt like a bunch of little bee stings. He numbed it and stitched it. It was fine. Baby was on my chest for that whole hour. What was crazy to me—I also consented to having the Pitocin drip afterward to get the— Meagan: The uterus to contract down, mhmm. Sarah: Yes, yes. I had that. Once that was done, I was able to just stand up and go to the bathroom. Meagan: Amazing, right? Sarah: I could just get up to go to the bathroom. I felt good. I felt fine. This was about 10:50 in the morning, so yeah. I was at the hospital for an hour and a half before he was born. Later that night around 5:00, we had family come over to see the baby that night. I felt as great as could be with still normal postpartum stuff. Meagan: Right. You did just push a baby out. But you weren't knocked out and coming too and all of those other things. Sarah: Yes. So yeah. That's about it for that.Meagan: Aw, yes. Well, congratulations. I'm sure that was a very different experience. I mean, I'm sure both babies were, right? We all cherish our babies' births but to be more present in your baby's birth, I'm sure definitely left an impact. Sarah: Yeah. Even my husband told me that for this time, he actually teared up and felt like it was just such a more of an emotional experience even for him which is completely understandable. It was actually really scary for him with the C-section he told me. They tell you, “Hey, we're going to go put your wife out. We're going to come back and get you and then you're going to come and be part of it.” He's sitting there waiting, waiting, waiting. They just kind of say, “Hey, you can't go in anymore. We knocked her out. You have to wait here. It's going to be a while.” Then he's just like, “Oh, is she going to be okay?” It was a little scary for him too, that first one. This was a lot, obviously, more emotional and just a really cool experience for both of us. Meagan: Yeah. I'm sure it was very healing for both of you like you said. That couldn't have been easy for him walking in and seeing you in that manner. I mean, the fact that he even brought it up. “It was weird when I walked in and you were laying there but then I'm over here doing skin-to-skin with this baby.” Sarah: Yep. Meagan: I'm sure it was so healing for both of you. Huge congrats. Sarah: Yeah, thank you. Oh, and one thing to mention with the doctor is that because I gave him all of my birth plan too, at no point in this hospital situation was I ever offered anything. They knew what my preferences were. They never said anything about any interventions at all. They never said, “Do you want us to break this water?” Everyone was on board. It was great. Meagan: Yeah. You really didn't feel like you had to fight along the way. Sarah: Yeah. It was all supportive which is what I wanted. Meagan: Yeah, and what you deserved. Sarah: Yeah. It was really great to have that. Honestly, the thing I also really liked about pushing in that position where you are facing the back of the bed was that I didn't see all of the people staring at me. It was nice because—and not that it would have mattered—but I'm kind of socially anxious in that situation so it was nice to just be focused on my husband's hand holding me. I've got my comb. I'm breathing. I'm totally in it. I'm not looking around. With the C-section, that labor was like everyone was staring at you. You're pushing and trying and nothing is happening. It was so nice to just be here in my world. I never even saw anyone. Meagan: Yeah. Sometimes you see people's faces and they are not wanting to communicate with their mouths so they communicate with their faces. So when you are just staring at all of these people surrounding you, you find yourself, “What are they saying?” Sarah: Yeah, exactly. Meagan: You start questioning it. It pulls you out of that space. It sounds like you were really able to stay in that space because maybe you didn't see any of that. Sarah: Yes, exactly. When I was pushing, it was really hard. I'm not saying it was easy. “Oh, unmedicated in 20 minutes.” No. It was hard work. There were times when some doubts would creep in and I was like, “What if he's in the canal too long? Will he be okay?” It would be easy for those doubts to creep in, but my doctor and my doula were all saying the things that I needed to hear. “You're doing it. Your body knows what to do. Keep pushing this way. Push like you're going to poop.” They were saying all of the things to keep me focused. It would be so easy if you're not ready to give birth to a baby, that feeling would be very scary. You would feel very out of control. I could see how easy it would be for that to be very, very scary. Having the people there that knew what to say to me was very helpful. Meagan: Yeah. Absolutely. The team is really that powerful though. It really, really is. Sarah: Mhmm. Meagan: So get a team. If you're looking for a doula, we've got doulas on our website that are VBAC-trained and certified. Get a good provider who is supportive and loving and willing to just like Dr. Ryan, just yeah. “Let's do this. Let's do it.” Super supportive from the get-go. “Yeah, we have to have this consult, but I'm not not supporting you by sending you to this consult.” Sarah: Exactly. Yep. He's like, “This person knows that I do a lot of VBACs. They've been through this before.” Meagan: Yes. Yes. Sarah: Yeah. Meagan: Well, huge, huge congrats.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

Segunda-feira, 17 de julho de 2023. Eu sou Leo Lopes e este é o Castnews, o podcast semanal de notícias para podcasters. Aqui você ouve, toda segunda-feira pela manhã, um resumo das principais notícias sobre o mercado de podcast no Brasil e no mundo. Os 20 anos da criação do podcast, o anúncio de uma versão grátis do Podpage, o primeiro estúdio móvel de podcasts do Brasil e a biografia em áudio do empresário cearense Edson Queiroz estão entre as principais notícias que você vai ouvir nesta 24ª edição do Castnews! NOTÍCIAS: 1 – Dia 09 de julho de 2023 foi um dia importante para o podcast mundial: nesse mesmo dia, há 20 anos, o jornalista Christopher Lydon e o programador Dave Winer gravaram o primeiro podcast, utilizando um gravador e um laptop na Universidade de Harvard. Mas o termo “podcasting” só seria utilizado quase um ano depois, em fevereiro de 2004, pelo jornalista Ben Hammersley em um artigo chamado “Audible Revolution” no periódico inglês The Guardian. Em celebração aos 20 anos do podcast, o editor do Podnews James Cridland conversou com o pioneiro Christopher Lydon, que fez uma reflexão sobre suas expectativas iniciais e como o podcasting se tornou um fenômeno global. A matéria com os principais pontos desse papo você confere no nosso portal em castnews.com.br . Aqui no Brasil, há alguns anos nós escolhemos o dia 21 de outubro como o Dia do Podcast, já que foi em 21 de outubro de 2004 que o primeiro podcast brasileiro, o Digital Minds do Danilo Medeiros, foi publicado. Logo logo a gente vai celebrar os 19 anos de podcast no Brasil, e ano que vem com certeza teremos muita coisa acontecendo na celebração dos 20 anos do podcast nacional. Ler a notícia completa 02 – A empresa de pesquisa Coleman Insights lançou o Pod Predictor, um serviço que permite testar um podcast antes do seu lançamento. Os criadores de conteúdo enviam pro Pod Predictor o título e a descrição do programa, que são avaliados por mil ouvintes de podcasts nos Estados Unidos e no Canadá. Depois disso, os ouvintes deixam seus feedback sobre o conteúdo e se o material gerou interesse suficiente pra baixarem o episódio. O serviço também fornece dados detalhados sobre faixa etária, gênero, etnia, geolocalização e interesse por categoria. O objetivo é ajudar os podcasters a lapidar sua mensagem antes do lançamento, evitando frustrações e perdas financeiras. O Pod Predictor é um serviço pago que já está disponível para teste. Ler a notícia completa 03 – E olha só que notícia bacana: um casal do Mato Grosso do Sul vai inaugurar esta semana o primeiro estúdio móvel de podcast do país. O jornalista Otávio Neto e a analista de marketing Adriana Maldonado, a “Bugra”, transformaram uma van em um estúdio completo com três espaços de gravação. Com isso, eles esperam levar o estúdio a locais inusitados, incluindo assentamentos, aldeias indígenas e fazendas, e captar informações e histórias variadas através do podcast. O lançamento do estúdio móvel vai acontecer em Campo Grande, com a primeira viagem para Corumbá, capital da cultura sul-mato-grossense. O casal também planeja ministrar mini cursos e palestras em escolas para incentivar novos jornalistas e podcasters. Aqui uma notícia que recentemente a gente publicou sobre um estúdio móvel de podcasts que estava em atividade na Europa, e rapidamente empreendedores brasileiros já adaptaram essa ideia pra nossa realidade também. Ta aí um exemplo de que se você tem uma ideia ou um projeto, deve colocar logo em prática, porque senão alguém vai fazer antes de você. Ler a notícia completa AINDA EM NOTÍCIAS DA SEMANA: 04 – Foi lançado na última semana o Blubrry Podcasting Stats PWA, um novo aplicativo da Blubrry que permite que os podcasters acompanhem as estatísticas de seus programas de qualquer lugar, tanto do desktop quanto dos seus smartphones. O aplicativo fornece acesso contínuo a dados importantes como reproduções, retenção, geolocalização e comparação de episódios. Ele também possui integração de pesquisas com a audiência em tempo real. O app tem certificação IAB, oferece uma compreensão mais profunda do público, e ajuda os podcasters a tomar as melhores decisões baseadas em dados da sua audiência. Ler a notícia completa 05 – E de acordo com dados recentes do Listen Notes, o lançamento de novos podcasts continuou em queda em junho, seguindo a tendência que a gente já tá falando aqui desde maio. A produção de novos podcasts teve uma queda ainda maior em relação ao mês anterior, o que resultou no menor índice de lançamentos dos últimos 12 meses. Essa tendência de menor produção parece se manter em 2023, refletindo o cenário pós-pandemia mundial. Vale lembrar que o Listen Notes é uma plataforma de busca de podcasts que oferece estatísticas com base em seu próprio banco de dados, que abrange milhões de podcasts e episódios em todo o mundo. Ler a notícia completa 06 – No final de junho, o Podcast Addict, um aplicativo de podcasts para Android com mais de 10 milhões de downloads, anunciou que não vai mais ser possível fazer o compartilhamento automático de conteúdo no Twitter. Isso ocorreu devido ao Twitter ter começado a cobrar pelo uso de sua API. Os usuários ainda podem compartilhar podcasts manualmente em qualquer rede social. Alguns podcasters expressaram descontentamento com essa atualização, enquanto outros ficaram surpresos porque nem conheciam o recurso de compartilhamento automático. A empresa revelou que cerca de 15 mil tweets eram enviados diariamente por meio desse recurso que agora foi descontinuado. Alguns usuários atribuíram o fim do recurso ao Elon Musk, atual proprietário do Twitter – e com razão, porque a atualização da API do Twitter prejudicou a integração com muitos serviços. Entre eles, o Podcast Addict. Ler a notícia completa E MAIS: 07 – A plataforma de criação de websites para podcasts Podpage anunciou que a partir de agosto vai lançar um plano gratuito. Essa opção vai permitir que os podcasters interessados criem um site para seu podcast sem custos. A principal diferença em relação aos planos pagos é que não vai ser possível ter um domínio personalizado, o site vai obrigatoriamente ter a URL www.podpage.com e um selo escrito “Feito com Podpage” na parte inferior da página.  Atualmente, a Podpage oferece três planos de assinatura: Basic, Pro e Elite, todos com domínio próprio, design específico para podcasters, importação automática de episódios para o site, designs otimizados para dispositivos móveis e otimização básica de SEO. Ler a notícia completa 08 – E por falar em SEO, é claro que nessa última semana também teve muitas dicas de produção de podcast lá no portal do Castnews. A plataforma de hospedagem RedCircle reuniu algumas orientações sobre como otimizar a audiência do seu podcast fazendo bom uso do SEO, e é claro que a gente traduziu o conteúdo na íntegra. Além disso, lá no site também foi falado sobre três ferramentas gratuitas com inteligência artificial para ajudar os podcasters a criar capas para seus programas.  Não deixe de conferir essas e outras dicas de produção, que podem ser muito úteis na criação de um bom podcast independente. Ler a notícia completa Ler a segunda notícia completa HOJE NO GIRO SOBRE PESSOAS QUE FAZEM A MÍDIA: 09 – A roteirista, escritora e podcaster Mabê Bonafé anunciou recentemente que o podcast “Caso Bizarro” foi adquirido pela Wondery, estúdio de podcast da Amazon. O podcast mistura true crime com comédia, e é um derivado do podcast Modus Operandi. Com a aquisição, o Caso Bizarro terá dois episódios semanais, com um deles sendo exclusivo na Amazon Music. Além disso, uma vez por mês, o Chico Felitti e o Filipe Bortolotto vão participar do podcast. Os fãs do programa estão animados, e não é para menos. Ler a notícia completa 10 – E você já pensou em transformar algum hobby na sua principal fonte de renda? Claro né, se você é podcaster você já pensou nisso… Porque foi isso que fez o Mike Muncer, apresentador, produtor e editor do podcast “Evolution of Horror”. O projeto começou em 2017 e, em 2019, o Muncer criou uma página pro podcast no Patreon. Atualmente, o Evolution tem 12 mil assinantes no Patreon, e é o que coloca comida na mesa do Mike Muncer atualmente. Ele aconselha os podcasters em ascensão a não terem medo de arriscar, planejar o tempo de forma eficaz e evitar promessas excessivas aos apoiadores. Ler a notícia completa SOBRE LANÇAMENTOS: 11 – Na semana passada aconteceu o lançamento oficial do podcast “Edson Queiroz, Uma Biografia”, a versão em áudio do livro com o mesmo nome. A biografia escrita pelo jornalista Lira Neto narra em detalhes a vida de Edson Queiroz, o empresário cearense criador do Grupo Edson Queiroz, da TV Verdes Mares e da Universidade de Fortaleza, entre muitos outros empreendimentos.  São 23 episódios cheios de informação sobre um homem que deixou um legado significativo no setor empresarial e educacional, além de ter sido uma figura importante no desenvolvimento cultural e industrial do Ceará. O podcast foi narrado por mim e produzido pela Rádiofobia Podcast e Multimídia, e já está disponível em todas as principais plataformas de podcast. Ler a notícia completa 12 – O Spotify lançou a nova temporada do podcast Upbeat, focado em temas relacionados à publicidade no áudio digital. Composta por 11 episódios, a nova temporada já está disponível na íntegra lá no Spotify. Diferente da temporada anterior, onde líderes de marketing de grandes marcas foram entrevistados, esta segunda temporada está com mais papos descontraídos com alguns dos maiores nomes da publicidade atual no Brasil. Então se você é da área de publicidade, propaganda ou marketing, dá uma conferida, pega pra você alguns insights, e aproveita pra entender melhor como usar o áudio digital a favor das suas campanhas. Ler a notícia completa RECOMENDAÇÃO NACIONAL: 13 – E na recomendação nacional da semana, a gente tem mais um podcast incrível que tá inscrito na #OPodcastÉDelas2023 . O podcast “Descriarte”, apresentado por Ariel Machado, propõe uma maneira de sentir as artes de forma não-visual, através da audiodescrição. Mas o Descriarte vai muito além de só “descrever imagens”. O programa mergulha no contexto histórico das obras, examina a vida dos artistas e promove debates sobre a sociedade em que a gente vive, com uma abordagem detalhada e muito informativa. Então se você tá em busca de um podcast que combine arte, contexto histórico, debates sociais e acessibilidade, o Descriarte é uma escolha fantástica. Não deixe de conferir o episódio “Olhar de Zanele Muholi”, que foi o episódio inscrito na campanha, e aproveite essa experiência única de imersão por áudio dentro das artes visuais. Ouvir EVENTO 14 – E nesta quarta-feira, dia 19 de julho, tem o Cabíria Festival acontecendo em São Paulo. No evento, vai acontecer a gravação ao vivo de um episódio da Rádio Novelo, seguido por uma sessão de perguntas e respostas, tudo na ESPM, a Escola Superior de Propaganda e Marketing em São Paulo. Os convidados vão ter a oportunidade de assistir à gravação do programa “Faça Você Mesmo” sobre a descoberta do Cytotec pelas mulheres brasileiras, seguido pela gravação do episódio “Estranhas no Ninho”, que conta a história de duas mulheres no mundo do crime. As inscrições pro evento ainda estão acontecendo, mas corre porque isso pode mudar a qualquer momento, já que o evento está sujeito a lotação. Ler a notícia completa E eu quero lembrar você que você também sempre pode divulgar trabalhos e oportunidades dentro da indústria do podcast, aqui no Castnews. Sejam vagas remuneradas ou vagas de participação em projetos, manda pra gente no e-mail contato@castnews.com.br que elas vão ser publicadas toda semana na nossa newsletter. Além disso, você também pode mandar uma pequena apresentação do seu podcast, e se ele for o escolhido, vai aparecer aqui na nossa recomendação nacional da semana. E essas foram as notícias desta vigésima terceira edição do Castnews! Você pode ler a íntegra de todas as notícias e assinar a newsletter semanal em castnews.com.br. Ajude o Castnews a crescer espalhando o link deste episódio em suas redes sociais e assinando o feed do podcast para receber em primeira mão os episódios assim que forem publicados. Você pode colaborar com o Castnews mandando seu feedback e sugestões de pauta para o email podcast@castnews.com.br. Siga também o @castnewsbr no Instagram, no Twitter e no Threads e entre no canal público do Castnews no Telegram para receber notícias diariamente. O Castnews é uma iniciativa conjunta do Bicho de Goiaba Podcasts e da Rádiofobia Podcast e Multimídia. Participaram da produção deste episódio Andressa Isfer, Bruna Yamasaki, Eduardo Sierra, Lana Távora, Leo Lopes, Renato Bontempo e Thiago Miro. Obrigado pelo seu download e pela sua audiência, e até semana que vem!

Welcome to this episode where we tackle a lot of misconceptions and dive deep into the role of Pitocin in labor and birth.1. Understanding Pitocin Explanation of what Pitocin is and how it functions similarly to the naturally occurring hormone, Oxytocin.Contextualizes the necessity of Pitocin in certain medical situations like induction due to medical complications.2. Natural Oxytocin Vs. Synthetic Pitocin Explanation of the differences in how natural oxytocin and synthetic Pitocin work in the body.3. Alternatives to Pitocin for Induction Discussion of alternative methods for labor induction including amniotomy, prostaglandins like Cytotec, Cervidil, and mechanical dilation methods.How each method has limitations that might necessitate the use of Pitocin.4. Misconceptions about Pitocin Clarifies that Pitocin is approved and intended for use in medical inductions, contrary to some misunderstandings.Discusses the safety of Pitocin in elective inductions and its proper use.5. Overuse of Pitocin Addresses the overuse of Pitocin in spontaneous labors and situations without a medical need.6. Post-Birth Use of Pitocin Explains why Pitocin is often used after birth to control bleeding.Discusses the different dosages and applications of Pitocin during and after labor.7. Risk Factors for Postpartum HemorrhageOutlines the factors that increase the risk of hemorrhage after birth, including prior induction or augmentation of labor.8. Risks of Pitocin Learn about the potential risks of Pitocin, including increased pain, overstimulation of the uterus, potential for emergency C-sections, and the limitation of movement and diet during labor due to continuous monitoring.9. The Natural Birth Process We talk about the nature of birth and the effectiveness of natural contractions. 10. The Role of Interventions in Childbirth: Discussing the overuse and misuse of interventions, I stress the importance of understanding when they are necessary and when. 11. Informed Decision Making: I encourage you to consider your health and your baby's health when making choices in labor and birth. Learn MoreSign up for the FREE 3-Day Labor Masterclass Check Out The Empowered Birth Academy Have your BEST birth!CLICK HERE to learn more about our online birth, breastfeeding, and baby care courses that will help you feel prepared and empowered on your journey to and through motherhood.And be sure to follow @alifeinlabor on instagram to join our little community of mamas who are navigating this stage of life right along side you. https://alifeinlabor.comSupport the show*From time to time, the host or guests may discuss topics related to health, fitness, nutrition, or medicine. This information is not advice and should not be treated as medical advice. All content is for informational purposes only*Support the show

Today we are joined by a truly amazing woman of strength, Morgan. She recently retired after 25 years of active duty service in the Coast Guard and is a mama to two boys and one girl, each with their own very unique birth stories. Morgan's first baby was born vaginally. Her second was a lifesaving crash Cesarean. Her third was a surprise HBAC born en caul! The high of this empowering birth carried her through a difficult postbirth hospital experience in which she almost lost her uterus. Meagan and Morgan share facts and insight regarding the amniotic fluid index. Morgan also gives tips on how to have necessary conversations with your provider to advocate for the birth experience you deserve.Additional LinksBridget's Website (Morgan's Doula)How to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Facebook CommunityFull Transcript under Episode DetailsMeagan: Hello, hello. Happy Wednesday, women of strength. We are bringing another story to you. You are listening to The VBAC Link and we have our friend, Morgan, here today sharing her stories. I'm really excited because just before we started recording, we talked about how Morgan said that she is a numbers girl. She's like, “I love numbers.” It's something that I love too but never have ever retained as well as Julie did. I'd be like, “Okay, I'm trying to remember. Is it this or that?” and she'd be like, “It's this.” I remember names and stuff like that and she remembers numbers. That has been something that I have really missed without Julie being here so I'm excited to talk about numbers with you today, Morgan. We're going to talk specifically maybe about amniotic fluid and percentages and things like that. But yeah. I'm excited to get into some numbers. If you're looking for some numbers on the chances of VBAC, we're going to talk about amniotic fluid. What really is a scary number and when do we really need to induce a labor? Stay tuned. Review of the WeekOf course, we have a Review of the Week so before I turn the time over to Morgan, we will read Britjl14. That is their review today. The subject is “Tears of Joy.” It says, “I literally got teary-eyed when I saw that your podcast was coming back. You gave me the courage to have my VBAC after two Cesarean baby, 9 pounds, 15 ounces, in late August. Such an uplifting and informative podcast. I tell everyone who mentions wanting a VBAC to look this up. So excited for more to come.” I love that. You guys, when we decided to bring the podcast back, it was so exciting for us too. So, so exciting. It was so fun to get all of the emails and the messages on Instagram saying, “Ahh! We've been waiting!” because we took a 10-month break. A 10-month break. That's what we needed to do for our personal lives but we are so happy. I am so happy to be back. I definitely miss Julie every time that I'm recording, but I'm really so happy to be back and so honored to be a part of all of these beautiful stories because really, I wish I had this when I was preparing for my VBAC. I really do. I go back. This probably sounds silly because I'm recording the stories and I'm hearing the stories but then every week, I go in and I listen to the stories because I am learning things after recording and hearing them the first time, a second time. I'm learning things about births and certain procedures so it's always a learning experience even for me who “specializes in VBAC” so it's really, really fun. So yeah. Thank you so much for your review. Remember, if you have not had a chance to leave us a review, we love them. We always, always read them and add them to our queue to read them on a podcast. Morgan's StoriesMeagan: Okay, Morgan. Hello. Morgan: Hi, hi. Thanks for having me. Meagan: Hi. Thanks for being here. Thanks so much for being here all the way from Alaska. Morgan: Yes, yes. Juneau. Meagan: Awesome. So awesome. Well, I'd love to turn the time over to you to share your story. I guess it was actually your second birth story technically?Morgan: My third. My third, yeah. My second was a C-section.Meagan: Yeah, sorry. That's what I am talking about, your C-section. Your second birth story, I also want to talk about because it was a very valid Cesarean. Morgan: It was. Yeah. Meagan: I want to talk about that too because we can come across as so negative with Cesarean because it's a VBAC podcast and we're sharing a Cesarean story that led to a VBAC but a lot of the times, the Cesareans were negative or unneeded or undesired or unplanned, so sometimes it can come across that we are talking badly about Cesareans but I want to point out today with Morgan's story especially that it was very, very needed. We are so grateful for Cesareans too. Even though we are a pro-VBAC podcast, we are not anti-doc and anti-Cesarean. That is for sure. I will let you share your story but I just want to talk about that because sometimes I think it can be like, “Wow. This podcast hates Cesareans,” and that's not the case. That's not the case at all. Morgan: Yeah, so I have three kids now and my first was a vaginal birth. It was mostly pretty well sought out and went through as expected. I was 41+5 and everything went pretty well. I did have some retained placenta at the end so I had to go back in for a D&C at six weeks postpartum because we hadn't caught that before. My second pregnancy was a really good pregnancy. I was healthy. I was working. Everything was going as expected except my son, Cooper, was transverse. He would not budge. I tried so many things to have him budge. I was doing Spinning Babies. I went to the chiropractor. I could not find an acupuncturist where I was that I trusted and was ready to go to, but we tried so many things to get him to turn and it wouldn't work. Toward the end, my doctor and I discussed doing a version. To me, we had discussed the risks of it were having a C-section at the end, but that's what we were going in and trying to avoid anyways so the risks weren't bothering me at that point so we did end up trying a version. It worked. It was very exciting, but then he turned back. I was like, “Oh no!” It was devastating. It was so devastating. Meagan: Oh, that would be hard. Morgan: That was one version and he turned back. So the doctor had said, “Man.” She was right with me on my birth plan too. She was there. She was ready to go. She said, “Well, let's try another one.” I was like, “Okay. Let's do it.” I went through it. I got through the first one. It was uncomfortable but we did it. So the second one, we tried another one, and sure enough, he turned. We were like, “Yes! We've just got to keep him there.” I was standing up all day. I wasn't going to move. He was going to stay in. He turned back. I felt him turn back. I was like, “Ugh.” A second successful version that then turned back. After that, we were coming up on our due date and I was just so adamant about wanting a vaginal birth at that point that I said, “You know what? Why don't we try a third version and we'll just induce right after that? Maybe I won't get my unmedicated birth but I'll still have a vaginal delivery,” which for me was important because I wanted to be able to breastfeed without any concerns. So we tried. We tried a third version. It was on my due date. We were in the hospital. We were ready to induce afterward. My doula was on call. We were going to call her in after I started laboring. In the middle of the version, we lost his heartbeat. She had me connected with an ultrasound the whole time. She's doing the version and there's a nurse that's doing the ultrasound and all of a sudden, we had no heartbeat. She said, “Maybe it's just where we are. Let's move a little bit and see.” I turned and I moved. We tried to find the heartbeat again and we couldn't find it. She said, “Just give me a second.” She walked out of the room. I was all the way in the back of the labor and delivery unit at that point. She walked out of the room so calmly. She went into the hallway and yelled, “We need help in here!!!”Meagan: Whoa. Morgan: I was like, “Whoa.” I was not expecting that. What went from calm right in front of me went to a massive emergency in a hallway. All of the nurses descended and the bed got moving. We went into the operating room and it took 20 minutes because I didn't have an IV or anything connected to me at the time. So 20 minutes later–Meagan: So you were under general anesthesia? They didn't put you under general?Morgan: They did not. No, I saw it. I saw the whole thing. I mean, they had the cover up but there are so many reflective units and metal everywhere that I could actually see what was happening which was fine. I don't mind that. But yeah. They pulled him out 20 minutes later. He was not breathing. No breathing, no heartbeat, or anything. They had to do CPR. Meagan: Scary. Morgan: They got him back. The nurses got him back which is just amazing. He was rushed to a NICU at another hospital, the highest level NICU. I think it's a 4. Meagan: Yeah, mhmm. Morgan: Yeah, so he went to a children's hospital where there was a massive NICU. He's good. Friday is his birthday and he'll be 8. He's just an amazing little kid.Meagan: So amazing. Morgan: So I'm very, very grateful for that C-section. Meagan: How was that for you? How was recovery for you? Morgan: Recovery was fine. There were no unexpected occurrences. We knew it was going to take a little longer. I knew not to work. The thing that was hard was, well first, breastfeeding because I had so much IV fluid in me. Meagan: I was going to ask. Morgan: Yeah. I got really nervous because I was pumping. He was at a different hospital. After two or three days, I saw my levels go down drastically and I was like, “What is this?” What happened was that the IV fluids had left my system so it was just my natural breastfeeding amount. I was not expecting that drastic change. But once we figured out what that was, that was good. The second thing that was hard was his being in a NICU. Once I was discharged from the hospital, my husband was driving back and forth from the home to the hospital. Luckily we were close enough, but I could only sit. I couldn't lay in that NICU. I couldn't lie so there was a little bit of pain there. Once we were ready to get him breastfeeding, we didn't have a room for us. He was still in the NICU so I was sleeping outside in the guest area, like the waiting room along with other families that were going through things like their kids in cancer and stuff and there was nowhere for the parents to stay so we were all making tents in the waiting room. So that was a little hard for that recovery. Meagan: That is hard. That is really hard. Morgan: Yeah. That part was stressful but once we were all home, it was good. It was good. Meagan: How long was he in the NICU?Morgan: He was there for 11 days. They were worried about brain damage so it was a hypothermic treatment that they put him on. Meagan: Did they put him in a cooler?Morgan: Yep, mhmm. Meagan: Yeah. Well, so grateful that all is well. There must have been something. It's so hard because my baby kept going breech. My midwife would flip him and then boom, back breech. Flip him, and then boom. Back breech. It was the same thing. I'd feel him and I'm like, “What the heck?” She finally was like, “We have to trust him. There's a reason. We don't know why. We don't understand it, but we have to trust him.” It's so hard. It's so hard. Morgan: Yep, yep. Meagan: Because I was like, “If I have to have a third Cesarean because he's breech, I will be so mad.” But yeah. That's so hard. Morgan: Right. That's so true. I think Cooper was telling us, “I'm not supposed to be here if I go this way. Things are going to go bad,” and sure enough, they did. He tried twice but then yeah. Meagan: The third time was too stressful for him. Morgan: It was too stressful. I think possibly that maybe that umbilical cord got bent in a way that no airflow could go through or something. We don't know. But yeah, thank goodness for that C-section because it brought him back to us. Meagan: Absolutely. Yeah. So then baby number three? Morgan: Yep, baby number three. That was five years later. We've had a lot of difficulties with some miscarriages. I didn't mention before that I'm Active Duty Coast Guard. I also am on the ships all of the time so you have to plan pregnancies around shipboard life. Meagan: Oh my gosh. Morgan: Yeah. There are big time periods between my kids. But baby number three was five years later. I wanted a VBAC from the start. I wanted an unmedicated VBAC. I knew I could do it. After my first pregnancy where I was so close to being unmedicated and my second pregnancy being a C-section, I knew that VBACs were available. I knew that I could do it. I was so adamant about going down that route. With the Coast Guard, you don't really get to choose. With any military, you don't really get to choose your provider. Most of the time, we are in a military treatment facility. I was very, very grateful to not be there. I had some negative experiences in both the local MTFs. This was in Washington, D.C. so getting to be with a civilian provider was just amazing to me. I was very happy. We were with the INOVA hospital system at that time. The provider I went to for the first appointment was at 10 weeks. We had a great heartbeat. Everything was going well. I was like, “I'm going to have a VBAC with this child.” He said, “Okay. I am good to go on that.” It was exactly what we were expecting. I would never have expected him to say otherwise at that point. I'm like, “Vaginal birth is clearly the way to go without any sort of condition saying otherwise.”The pregnancy progressed. I guess I should mention that I was 40 at this time. With my second child, Cooper, I was 35 or 36 when I had him so I was in that high-risk stage just for age at that point. So of course, I'm there now at 40 and everything was fine. The pregnancy progressed. Everything was going well. At some point midway through, we were looking at what position the baby was in and she was breech. I was not happy about that and he was like, “It's okay. It's okay.” Knowing what happened with Cooper, I was not so thrilled. Meagan: You're like, “I have some trauma on that.” Morgan: I did, yes. At this point, I didn't go for a chiropractor but I did learn that there was a wonderful acupuncturist in the area that had wonderful success with turning babies so I went to him. It was a 3-hour session and I actually felt her move in the session. It was just amazing. I couldn't believe it. It was so cool. I'm like, “I feel her moving.” So she did. She turned a whole 180 at that point. He left us with homework. He called it, “Hot hot sticks” where you burn this incense over your pinky toe. Meagan: Bladder 6, yeah. Morgan: My husband would do it and the acupuncturist said, “You don't take it away when she says, ‘Hot', you take it away when she's like, ‘Hot, hot, hot, hot!'” so that's why she called it hot hot sticks. Meagan: Hey, I have actually seen that work though. The baby flips with those things. It's called Bladder 6. It's really cool. Morgan: We did that. He's like, “You have to do this every day.” We continued to do it. It was great. I mean, I speak wonders about his service in the D.C. area. So that worked. We go back to the doctor and around 30 weeks, he started saying, “Okay, we need to schedule your C-section.” I was like, “Why? No. We don't need to schedule a C-section.” He goes, “Well, you had one so we just need to schedule it.” I said, “I'm doing a VBAC. We talked about this.” Meagan: Yeah, remember at 10 weeks?Morgan: Right, right. He said, “Well, just in case.” I was like, “Why can't we just induce? There are many steps between vaginal delivery and a C-section.” Meagan: Yes. Morgan: And scheduling a C-section I should say, right? So he taught me then, “We don't induce with VBACs. There's no Pitocin.” Later on in the story, I found out that that's not exactly accurate. Some doctors will do it but he wouldn't. That appointment was leading us down the road of research and starting for me to learn more about how to advocate and how ACOG and obstetricians and gynecologists work in their network and what their risk levels are and how important being able to talk to them in their language was. Meagan: Yeah.Morgan: He said, “We're going to schedule a C-section for 37 weeks.” Meagan: Whoa. 37 weeks?Morgan: I was floored. Yes. I was like, “This isn't even a full-term baby. No. No, no, no.” He goes, “Well, this is when they do it. It's just easier. If you want a VBAC, as long as you go into labor before the C-section then we're good.”Meagan: 37 weeks?! How rare is it that people go into labor? I mean, it happens. We know this but it's not very common that the body just spontaneously goes into labor before 37 weeks and then we have a baby going into labor at 37 weeks and we're concerned because before 37 weeks, we're not full-term. Interesting.Morgan: Exactly. I was like, “No. No, no, no.” I was so upset after that appointment. I was like, “First off, my body would never go into labor before that.” I mean, sure. I'm speaking in exacts. Meagan: Didn't you say that your first one was 41+5?Morgan: Right, 41+5 for my first. With my second, I had no contractions. I mean, he was transverse, but I had no contractions before 40 weeks so I was like, “There's no way my kids are coming early. That's just proven to be wrong for my body so far.”Meagan: Oh my gosh. Morgan: I left that appointment and I was really frustrated with it. I started doing work. I started doing research on where are the risks, what are the risks, and getting myself familiar with it. I started being in that defensive zone where I was having to prove myself. I found your website. I found your blog. I started listening to every single episode. I mean, it just gave me so much knowledge on where to look and what to look out for and the bait-and-switch that you were calling it. I was like, “This is me! This is what's happening.” So I did. I researched and defenses were up at that point which is unfortunate because you don't want to be in a defensive situation. Meagan: It is unfortunate, exactly. It's so hard because again, we've talked about this on the podcast. We don't want to have to walk in with our arms up and be ready to punch. It's not what we should be doing. We just want it to be a nice, cohesive relationship where the provider is listening and we are listening to the provider because it's also important for us to listen to the provider. They did go to medical school for a reason but at the same time, we also have to know that sometimes what those providers are saying is maybe skewed based on their own experience or maybe whatever. I don't know. We've had providers tell people that they have a 30% chance of rupturing after one Cesarean. We have to still be aware that there is more information but we should never feel like we always have to have our wall up and our fists ready. It shouldn't be like that and it's unfortunate that sometimes it is. Morgan: Right, right. So after that appointment, I had already known I wanted a doula, but I was adamant about getting a doula with this one as well. I found one and she was amazing. She had been a doula for a VBAC before so she had also pointed me toward research and was ready to help me. She really was. She was awesome through this whole event and the whole birth. Time continued to progress. I remember going and taking my older kids to Chuck E. Cheese one day. They were off doing their thing with all of the arcade games and I'm on my phone. I'm listening to a podcast. I'm scrolling through ACOG research and I'm like, “I don't want just the bulletin. I want the research behind it.” I'm doing all of this on my phone trying to find it all and I found it. I found what I was looking for. It was not just the risk of a VBAC and the risk of a second C-section. It was, “What happens when a person has already had a vaginal birth?” It's a conditional probability, right? I'm a numbers person. I had already had a vaginal birth. Then it looks up, “What are those risks for a person to have a VBAC and a person to have a C-section?” When a person had already had a vaginal birth, the risks for a uterine rupture and the risk for mortality were actually so far below what the normal risk levels were. They were actually below your first birth. So if you're a first-time mom and you're having a first-time vaginal birth and you still have the mortality risk and you still have the uterine risk, my risk was lower than that because I already had a successful vaginal birth. Those were the risk levels he was working on. I was using his research and I was like, “No, no, no. You can't tell me my risk levels are extraordinarily high when your own research that you are following tells me that I'm actually safer. I'm in a less risky stance now than when I had my first child.” I was even more adamant at that point to go towards a VBAC. I told him, “I will not have a C-section at 37 weeks.” I think it was your podcast that helped me advocate for myself in terms of standing up to a doctor. I have advocated in many other situations like law enforcement, school, or whatever but doctors were a whole new ballgame for me. To be able to say, “This is my right and this is my voice and I get to make this decision,” was a little intimidating before. Meagan: Oh absolutely. Morgan: I learned how to do it. So over the course of 3 or 4 weekly appointments at that point, I had rescheduled and rescheduled and rescheduled until finally, I got him to 41 weeks for a C-section. That was with the threat of going to another provider who I did go see on my own who was willing to induce with a mild amount of Pitocin, was willing to wait until 41+4 for a C-section, and was just on board with the concept. I had gone to see them and the unfortunate part was that they were not in the network so while I could pay a little bit of that bill, I couldn't pay the what-if part of it. Like what if things go bad and I have to be in the hospital? All of that wouldn't have been covered. Meagan: Which is so hard. Morgan: That would have been tens of thousands. Meagan: That's so hard when we are restricted by insurance. Morgan: Yes and I was. Tricare is very restrictive. You don't get to go choose another doctor just because you don't like this one on Tricare Prime. You are stuck and I was. I went back to him and said, “I don't want to be here right now but I can't be anywhere else. I can walk into an emergency room and have a birth that way.” I was totally fine with doing that so I told him, “This is where I am. I am not happy with your care for me right now. I don't think that you're listening to me. I've seen another provider that tells me that this is possible and I also know that there is a wonderfully VBAC-friendly hospital in Washington D.C. I will easily drive past yours to go to that emergency room if I need to,” because that's where I was bound within our insurance needs. He listened. He listened then and he said, “Okay.” So that's where 41 weeks came. He did, though, say, “I'm not going to give you Pitocin.” I did learn that was his decision. He felt that–Meagan: You have to respect that is his opinion. Yeah. Morgan: Right. He gets to determine what is safe in his mind and he thought a C-section was safe. He did not think that Pitocin was safe. I was like, “Fine. That's fine.” So we waited. We waited until 41 weeks for a C-section. Through that time period, I continued with the monitoring appointments that they want high-risk women to do. So two times weekly, I was going to the hospital. Not his appointment area, but the hospital where they had a clinic. Meagan: The non-stress tests and stuff?Morgan: Yes. All the non-stress tests. It was the non-stress tests where you have 20 minutes of checking the heartbeat and then always an ultrasound as well where they were checking the amniotic fluid levels. After all of these things got done, it took about an hour and I would meet with the doctor who would go over the information with me. That was one-on-one time. I think there were three or four doctors there doing all of the work. I ended up getting to see this one doctor pretty regularly. She was great at answering my questions so I asked her all of the time, “Where are your numbers for amniotic fluid? You are telling me I have an amniotic fluid level. In my world of work with the Coast Guard, then that means there is a risk level if it goes too high or too low so I want to know where your levels are. If you're giving me a number on amniotic fluid, what's the high level and what's the low level?”They told me. They said that the low level was 5.5. I have no idea what the measures of unit are but I know 5.5. I kept going and kept going. Everything was always perfect. On Friday around 40 weeks, she was starting to get worried about a VBAC. This is again a different doctor. At that point, I had already gotten my membranes stripped once. I was dilated to 1 and I was still up a little higher. So there was no movement. There were no contractions, nothing but everything was still fine. All of the levels were still fine. On that Friday, my amniotic fluid was a 9 so it had dropped, I think, by 2. It was 11 that week and by Friday it was a 9. I had been busy but it was still above the 5.5. Everything was fine. She said, “We should admit you.” I said, “What are you going to do if you admit me?” They couldn't answer me.Meagan: Because they're not willing to give you Pitocin so they're not willing to induce your labor. So what is admitting going to do I guess other than signing up for the Cesarean at that point?Morgan: Right, right. So I was like, “Are you just going to let me sit in a room for days on end until I go into labor naturally?” Meagan: Yeah. Morgan: Is there a time limit for that? She couldn't answer those questions. So I said, “You know, I'm okay. I'm going to go home.” So we went. We agreed that I would come back on Monday. I would do a lot of drinking water and Gatorade and I would come back in on Monday and see if that changed my amniotic fluid level. So I did. I came back in first thing on Monday and again, everything was fine in terms of how they had prescribed the numbers to me ahead of time. So fetal kick counts, fine. Baby's heartbeat, fine. The non-stress test and everything there was fine. The amniotic fluid level was at a 7. It had gone back down a little bit further but it was still above the 5.5. At this point, she called in the on-call doctor for my provider's group which was another female and we said, “Let's just do another check right here to see if I'm dilated any further.” I was okay with that. So she did. I hadn't dilated any further but the baby had dropped some at that point. I was happy with that because the baby needs to drop first before you start dilating. That helps it. Meagan: Yep. Morgan: But they didn't see that as anything. They were only looking at dilation. I said, “I'm good. I don't feel like I need to be here. Everything is fine.” They said, “Well, you haven't started dilating further.” I'm like, “Well, it's not like you dilate 10 centimeters over the course of 10 weeks. That's not how it works.”Meagan: Nope. Nope. Dilating needs some contractions a lot of the time too. Morgan: Right, right. We're having this weird conversation where they're telling me that I'm in trouble and I'm just not seeing it. There's no urgency in their voice. There's no actual concern in any of the testing that was happening and again, I'm asking again, “Well, what are you going to do if you admit me today?” They again can't tell me an answer. So I said, “I'm going to go make a call.”I called my doula and we had a long conversation. At that point, we really thought, “If I had to go back again on Tuesday or Wednesday, it was just going to get worse with them urging me and urging me and how much stress did I want to add on for them to do that?” We were getting close to that 41-week C-section date at that point. So even doing all of the things, right? All of the induction things that you do. You're pumping and you're doing the red raspberry leaf tea–Meagan: Walking, yes. Morgan: All of the walking, everything. Nothing had changed, right? I went back to the doctor and I said, “I'm not going to be admitted today. I am going to go home.”We went home and we went to our last resort of induction which was taking the Cytotec, that weird horrible tasting stuff. Meagan: Castor oil?Morgan: Castor oil. Taking castor oil. Cytotec is that horrible drug that induces miscarriage. It was castor oil. So I did two tablespoons of castor oil in a milkshake. It was Ben and Jerry's peanut butter. I wanted a really strong, intense taste to get rid of the castor oil taste. I told my doctor ahead of time that I was probably going to do that. I wasn't trying to hide it. Meagan: Yeah, you weren't sneaking around. Morgan: I did it. That was what I had for dinner that night at 6:30 and at 10:30, I had to go to the bathroom. At 11:30, contractions started. We were home and the kids– both boys were in bed at that point. We were just in labor. I went to the bathroom a few times. At some point, I said, “I really want to be in the bath,” so I went to the bath. I had a nice warm bath and I stayed in the bathtub probably for 45 minutes or so. Then I said, “I need to go to the bathroom again,” and that was when it probably felt like starting to push at that point but we weren't sure if it was still the remnants of castor oil or if it was literally pushing. Our doula had said, “You'll probably feel the castor oil effects for that first hour of labor.” We were still in that first hour so I was like, “Okay. Okay.” But Dave, bless him. He saw a change in me that I didn't see. He saw me get into a more determined working mode in my face. He called my doula and he called my sister. He got everybody in motion. My sister was going to come to watch the boys so that we could get to the hospital when the contractions were around five minutes. My first vaginal birth was 14 hours so that's what I was expecting. I thought it would be somewhere around 12 hours or so for this one. By the time my doula got there 30 minutes later, I was crawling on the floor. She said, “Let's just see how you're doing.” I must have looked like the devil because I said, “We're going to the hospital,” while I'm crawling. Then I had a contraction while she was right there and she was like, “Whoa. You're pushing, Morgan.”Meagan: Whoa.Morgan: “We need to go to the hospital. You're right.” I was like, “Okay, okay. Let's go.” That was one contraction. In between that next contraction, we got dressed. That contraction happened and then the next one. These are about two to three minutes apart at this point. Meagan: Really close, yeah. Morgan: I'm crawling to the end of my bedroom. I had another contraction at the top of the stairs. After that one was done, I walked down my flight of stairs and I got to the front door. I had another contraction and by then, my doula Bridget said, “You're not going to make it to the hospital. We have to have this baby here.” “Okay.”Meagan: Oh my gosh. Morgan: Yeah. Dave calls 9-1-1. Fairfax County has an amazing fire system set up so we were expecting them within seconds. They did. They probably got there five minutes later from our call. Meagan: Wow. that's fantastic. Morgan: They're really fast but I had already had the baby by then. Meagan: Oh no way!Morgan: Yeah. He was out looking for them to show up and I had the baby one contraction later. Meagan: Oh my gosh. Morgan: Kori comes out. Meagan: So he missed the birth. Morgan: He did. He was outside getting the ambulance and firetruck to come. So Bridget was in there and she's like, “Morgan, you're baby's coming. Catch your baby.” I was like, “Oh.” So I reached down and I was on my hands and knees. I reached down and caught her. She was still fully inside the amniotic sac. Meagan: She was born en caul?Morgan: Yeah.Meagan: Oh, so cool!Morgan: Yeah. There was no water rupturing or anything so she was fully inside her sac. Bridget had said, that's the doula. She said, “She's inside your amniotic sac. You need to open that up.” So I remember opening it up and having the water come out around her and fall to the floor. We had gotten some towels down. Then she screams and I just bring her up onto my chest and hold her. She's bright and pink and everything is fine. I felt wonderful. Meagan: I bet. Morgan: It was such a great experience. There was no scariness to it. I wasn't worried about being at home. I felt really in control of the entire process. I knew what was happening. I knew my body was working the way it was supposed to work so I wasn't worried about the pain. There was a lot of pain but it wasn't like pain. It wasn't like someone was pinching me. It was intentional work. It really honed me in on what was happening and it was just amazing. I loved every minute of it. I'm holding her on my chest and two minutes later, nine big firemen come running over. I'm naked. I'm naked. I'm breastfeeding because I had taken off my bra at that point. I'm breastfeeding. I'm just sitting there against the coat closet. Meagan: And your husband was probably like, “Uhhh.” Morgan: Dave is right there. He's right next to me at that point. It has to be nine or so. It was definitely a full firetruck and an ambulance and it was all men. They all walk in and I was mortified. I was like, “Oh my god.” Everything about my toned, intact, powerful, and in-control birth just went out the window. They got me a blanket so I covered up and they were ready to cut the cord. I said, “Let's just hold. Let's just hold off for a minute,” and they did. They let me hold off on cutting the cord. Meagan: Beautiful. Morgan: We let all of the blood drain out. I breastfed. I made sure we got that in and then eventually again, Bridget was so good because she kept a really good awareness of everything that was happening in the situation. She said, “You know, you haven't delivered the placenta yet so we need to go to the hospital.” I was like, “Oh, right.” In the big transition, I had lost my big, powerful, intact mode of doing what I knew I needed to do and I switched to covering up my body and all of that. I wasn't in the zone.Meagan: Yeah, which is kind of telling if you think about it. When you're vulnerable like that, you're like, “I forget that I have this other part of birth that I need to take care of,” because you're just so protective of yourself. Morgan: Right. Right, yep. So we walked out to the ambulance and I did. I walked out to the ambulance holding her and we got there. We had a 20-minute ride. At some point in that ride, I thought I needed to get the placenta out but I couldn't. I was by myself. I didn't know these people. I felt too vulnerable to be able to do it there. Meagan: You didn't feel safe, yeah. Morgan: We get to the hospital and the ER decides that they don't need me. I'm not an emergency at this point so they take me up to labor and delivery. The doctor that I had seen earlier, the day before because it was a 24-hour shift, she's the one that was still on call. She said, “Okay, well we have to get the placenta out.” She was doing this in a very rushed, not pleasant way. She was upset with me because I didn't listen to her earlier and now I'm coming in on an ambulance. I could tell that she was mad. She said, “We can do this here or we can do it in surgery.” I said, “Well, let's do it here. I don't need to go into surgery if I don't need to. You can give me an IV, put a little Pitocin in me and let's go. I know that's how you do that to get the placenta out.” At this point, there's no issue with uterine rupture because the baby is already out so Pitocin should be fine. But that is not what happened. I said, “Yeah, we'll do it here.” The next thing you know, she sticks her entire hand all the way into my uterus. I am in so much pain and she rips out the placenta and with it, she ripped open my uterus. Meagan: *Gasps*Morgan: I screamed. It hurt so much. I handed Kori, who is my little girl, over to Dave at that point. Bridget was just floored. She tells me this afterward because I passed out. Meagan: I'm sure you were in shock. Morgan: I must have been. She went over and went out of the room and yelled to get help even though the doctor was in there. There was another doctor that was nearby. It was the anesthesiologist who came in. She said, “No, no, no. We're not doing this here. We're going into surgery.” My doula took a picture of my blood pressure or my heart, whatever it is. The blood pressure monitor at the time. I was at 50/20. Meagan: I'm sure your heart rate was through the roof. Morgan: Yeah. It must have been. Meagan: You were in shock. Morgan: It was bad. They took me back to surgery and I did come back when I was in surgery. I remember feeling pain like they were moving my legs all around. I was telling them, “You're hurting me. You're hurting me. Get me under. You're hurting me.” I had five D&Cs at this point in my life so I knew what they were supposed to feel like which is easy. They're not supposed to hurt at all. I was supposed to be under and I wasn't. I was telling them, “You're hurting me.” I remember that it was either the anesthesiologist or the nurse. I couldn't see who was next to me, but they were saying, “She's not under. Stop. She's not under.” So finally, I did get under and I had to have a big blood transfusion because of all of the blood loss that I had. Meagan: Blood loss because of your uterus, yeah. Morgan: They stitched me up–Meagan: Stitched your uterus?Morgan: Yep. Whatever they had to do. I don't even know what they did but I still have my uterus. It's still in there. Meagan: Which is great. Morgan: Yes. Yeah. They fixed whatever they needed to fix. That same doctor fixed whatever they needed to fix. I went to recovery. I woke up maybe four or five hours later and it was my doctor that was on call by then. He had said, “You're lucky you still have your uterus.” I was like, “Well, I shouldn't have been in that situation to begin with.” I definitely shouldn't have had a hand go into me the way that it did. 18 hours later, I walked out of that hospital. I went home. I was discharged. I felt fine. The blood transfusion worked wonders. Meagan: Yeah. I'm sure it made you feel better. Morgan: Yeah, and now two years later, I'm allowed to donate blood too so I do regularly because of that. I did before but now I totally recognize that need and do it. But I look back at my birth story and I think about the home birth. I don't really think about what happened at the hospital too much but I do think about how amazing that home birth was and how wonderful it was to have the people near me that were fully a team. Everyone that was there was there for me and it was an amazing team. It was just an amazing birth. I loved it. I knew I could do that. I knew I could do an unmedicated, vaginal birth and I did. Man, it was awesome. Meagan: An unmediated, vaginal birth en caul too!Morgan: Yeah, yeah. Meagan: Oh man. That is so amazing. What you said, you hold onto the home birth. You hold onto that experience. I think sometimes we have to hold onto those experiences. I had kind of a really wonky experience. I don't know if I've talked much about it. I need to do an episode and talk about my postpartum but after I had my son, my VBAC, my body went into some weird shock too and I kept passing out actually. We don't really know to this day. I didn't bleed externally or internally. We don't really know what happened and it's been really frustrating to me to know that and it's there. It's in my mind just like this hospital experience. Obviously, this insane uterine/placenta issue that shouldn't have happened like you said is in your mind but then you're holding on to this over there and that's what I do. I hold onto my VBAC because I do still wonder what happened or whatever. You're like, “Yeah, it shouldn't have happened in the first place, but I'm holding onto this HBAC technically.” It was an unplanned HBAC. That is sometimes where we have to go. We just have to hold onto the good. We have to hold onto the good because there is so much good that outweighs potentially the bad. Morgan: Right, right. Meagan: Yeah. Yeah. Congratulations. Congratulations. Morgan: Thank you. Meagan: I'm sorry that your husband missed it. Morgan: I know. He did. He walked in right afterward and then my sister came right after the firemen to watch the kids. I mean, it all worked out. It was great. Even the boys got to see her before we went to the hospital. My older son, Zach, was just wonderful. He came over and just connected with her right away. Cooper who was five at the time was like, “Oh, firetrucks!” Meagan: Firetrucks! That's cool!Morgan: He's like, “Awesome! Firetrucks. Can I go back to bed?” I was like, “Yep.” It was neat. It was perfect. It was the perfect home birth even as unexpected as it was. It was wonderful. Meagan: Yeah. Yeah. Oh, well congratulations. Congratulations. Morgan: Thank you. Meagan: Yeah. Let's talk a little bit about AFI which is the amniotic fluid because you were getting into this space of, “Oh, they're getting concerned. Oh, let's admit you. You're at a 9.” I think you were at a 7 maybe when they were like, “Oh, let's admit you.” Morgan: They started at 9 on the first day. It was like, “You're at 9. Let's admit you.” Meagan: Yeah. Yeah, okay. Morgan: I said, “No.” Meagan: I'm glad my memory is not too far off. Morgan: You've got it. Meagan: But yes. Let's talk about that because something that can happen and it doesn't always happen but it can happen when we're doing non-stress tests or things like this very commonly in the end is that they're paying attention to this AFI. Sometimes that is one of the factors that pushes people to being induced. Not push reluctantly, but it's the ticket for induction for a lot of providers so let's talk about it. You love numbers and you talk about 5.5. A lot of providers will even say 5-25. 25 is high so after 25, we're looking at high fluid which is also another concern for providers if we have too much fluid. But after 24 weeks of pregnancy, it's most common for them to measure an AFI. They usually don't pay attention to it before 24 weeks but they sometimes do after. It is normal for it to be anywhere from 5-25. The question is, okay. Say you're at 6. Say you're at 7. What do we do? Do we have to induce? No, we don't. You are proof of that. We do not have to induce. What can we do to help with amniotic fluid? Are there other ways?You mentioned drinking Gatorade and water. Definitely increasing your fluid can make a huge difference. We've had a client go in and she was actually at 6, just above 5. She was like, “I just want to go home tonight. I'll come back tomorrow. Obviously, I'll come back in if baby's not very active or anything like that.” She went home and she drank magnesium, like Mag-calm, and a lot of fluids. She went back in and it had gone up. It was just above 7 so not a ton, but it had gone up. They were like, “Oh, okay.” She was like, “I feel good about this.” She kept doing that. She kept going in for non-stress tests and fluid checks. Fortunately, it continued to stay just fine. Then sometimes it doesn't and we don't know exactly why, but hydration is super helpful for upping amniotic fluid levels. Salt can help us retain that a little bit. But yeah. And then getting actual IV fluids. Did they ever offer for you to get IV fluids or anything like that?Morgan: No. Wouldn't that have been helpful? Huh. Yeah, they didn't. I didn't even think about it. You're right. That would have been really helpful. Meagan: Yeah, so sometimes when we're ingesting through our mouth, we don't retain the fluid as much but sometimes via IV, we can and it can be really helpful if we're dehydrated. I've been dehydrated before and I'm drinking, I'm drinking, and I'm drinking but it's not seeming to help then I've gotten into Instacare and gotten an IV and it was boom. Night and day, it felt so much better. That can really improve by getting an IV fluid. So you can be like, “Hey, I want to get an IV fluid. I want to get some fluids.” Sometimes, low amniotic fluid can be caused by underlying conditions like high blood pressure or maybe if they're a diabetic patient. I actually don't know exactly if gestational diabetes can affect it but I would assume probably. Treating these and checking in with blood sugars and making sure our blood pressure is good can also help our fluid levels and our hydration just by checking in and making sure there aren't any preexisting things. Then if we have moms that are dropping dramatically by 5 points or whatever, that could be something where we just do bed rest. We just chill. Just don't do anything to exert our body. And then of course except for eating and going to the bathroom, showering, and taking care of ourselves, we aren't out and about going to Chuck E. Cheese but that doesn't mean going to Chuck E. Cheese lowers your amniotic fluid, I'm just saying we are literally doing nothing. That can sometimes help increase amniotic fluid as well and of course, stay hydrated. Then diet. Diet. Getting more lean protein and whole grains and really fresh fruits and vegetables can also– there's not a ton of really heavy evidence within this but there is some evidence that shows it can impact your amniotic fluids which is kind of crazy. You're like, “Oh, food.” But hydration and stuff come through food and it gives back to our body. So anyway, there are others out there and everything but those are some tips on how to raise amniotic fluid and help. Like you said, you felt very comfortable, very comfortable where you were at. Morgan: I did. Meagan: Yes. That's still another leading factor. We always have to check in with our gut. Always, always, always. Morgan says, “Okay. I'm feeling good about this. I've done the research. I know the numbers. I'm a numbers gal. I feel good. I feel good about this.” Look what happens, right? But it is hard. I would love to know any opinion that you have or anything that you would like to share because it is really hard. You spoke about it earlier. Having that conversation and where your research started and learning how to advocate for yourself which you did very much so. I mean, it would have been very easy for you to schedule a Cesarean at 37 weeks or it would have been really easy for you to schedule a Cesarean at 39 or 40. But any tips that you have for our listeners to really, truly advocate for themselves? Again, we talked about how we don't want to go in with our punching gloves. We don't want to be punching and be combative back and forth but we want to have that really healthy relationship saying, “This is what your practice of obstetricians and gynecologists says. Let's talk about this. Let's have this conversation.”Morgan: Yeah. It was a hard conversation. I would say it was not one that ended in one appointment. That actually made it hard too because you've got a 30-minute appointment and you have to stop this conversation and start it a week or two weeks later. But every time, I really thought ahead of time. It was not a spur-of-the-moment discussion point for me. It was one that was planned. I wrote down exactly what I wanted to discuss beforehand so that we could really have that conversation and we could get through it in the amount of time that he had available. I do want to still be respectful and respect his schedule. I want to respect the other women that are there that need care as well. I also wanted to hear from him on why he wouldn't do Pitocin, why he was worried about wanting to be so far in front of 40 weeks, or not wanting to go past 41 weeks. I got the answers to those things. Some of them I agreed with and some of them I didn't, but really these decisions on pushing the C-section date back to 41 weeks, he ended up being okay with after all of the discussion and me saying, “Look, I don't care about scheduling. I don't care if it's first thing in the morning. You're assuming that I want to get in on the schedule at 8:00 AM but I don't. I don't care about that. If it has to be 3:00 in the afternoon, whatever. I want it to be at 41 weeks. That's more important to me than an 8:00 AM scheduling of stuff.” I did go to the other doctor and get a second opinion but I had to pay that $300 for that appointment. Meagan: To do that, yeah. Morgan: Right, right. Meagan: I love that you mention how it's so easy on both parties, on the birthing parents' side and the provider's side to just assume, “You don't want to fast all day because when you have a scheduled Cesarean, you have to fast so you want an 8:00 AM Cesarean, don't you?” But it's so important to say what you mean and where you're at so there is no assuming. They know. They know where you're at. Morgan: Right. Right. Meagan: I mean the same thing with providers. I encourage them to not just assume that the patient wants something but also talk about where they're at. Like you said, you could have that conversation and be like, “I can see that. I can see that 100%. This is where I'm at,” and then you guys can have that meeting ground. It's so important. It's really hard, you guys. It's really, really hard when you are in that space because we don't want to go against a medical provider. We don't want to fight. We don't want to say, “You're wrong.” That's just not the position we ever want to be in but if there's something that's deeply in your gut and you're like, “No. This is not what I've found out,” or “No. This is not what I'm okay with,” then have that conversation. I encourage you to have that conversation because that is going to better your relationship with your provider. Morgan: Yeah, absolutely. Meagan: Well, thank you so much. Morgan: Thank you. Meagan: Thank you so much for being here with us and sharing your beautiful story. I'm sorry that happened at the hospital but I'm so glad that you were able to leave pretty quickly and get back to your family at home. Morgan: Yeah, me too. I did not like that. But when I look at everything that happened, it was a wonderful story. I got my baby girl. Our family is complete and I'm just in awe of what a woman's body can do. Meagan: Yeah. Absolutely. We are true women of strength. Morgan: Absolutely. Meagan: No matter how we birth, we are women of strength. I full-on believe that. Thank you so much and have a wonderful day. Morgan: Thank you. You too. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Natalie shares her journey of the loss of her baby at 12 weeks pregnant, giving birth at home, and coping with the grief and fear of what her future would hold. She does share that she went on to get pregnant again and welcomed her living daughter! WORK WITH ARDEN + HER TEAM: Book a 1:1 call ⁠⁠HERE⁠⁠ View virtual support groups⁠⁠ HERE⁠⁠ For email support with Arden, click ⁠⁠HERE⁠⁠ Support Arden's work by "Buying Her A Coffee" - ⁠⁠https://www.buymeacoffee.com/VPqVJzwhxj⁠ --- Send in a voice message: https://podcasters.spotify.com/pod/show/arden-cartrette/message Support this podcast: https://podcasters.spotify.com/pod/show/arden-cartrette/support

Brittany's first C-section came after a long and exhausting pushing phase with no progress. Her second C-section came after providers gave her a 50/50 chance of VBAC success due to the VBAC calculator. Brittany chose a repeat Cesarean for the comfort of a controlled environment following multiple traumatic pregnancy losses beforehand. She did not expect another horrible recovery with an elective Cesarean, but it was even worse than the first. Brittany immediately began devouring all information about VBAC after two Cesareans even before her third pregnancy. When she became pregnant, she found an extremely supportive provider 2.5 hours away which proved to be the best decision she could have made. Her VBA2C was everything she hoped it would be– raw, difficult, beautiful, redemptive, and empowering. Right after that birth, she wanted to do it all again! Additional LinksBrittany's InstagramHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Facebook CommunityFull Transcript under Episode Details Meagan: You are listening to The VBAC Link Podcast and this is your host, Meagan. I am always honored to be on this podcast with you. I love the listeners. I love the storytellers. I love the reviewers. We just love everything about this community and I am excited to bring a VBA2C– I'm not even going to be bringing it actually. Our friend Brittany is going to be bringing it. We are having a VBAC after two Cesareans story. Our most requested podcast topic is VBAC after multiple Cesareans, specifically two. We know how hard it is to find providers to support a VBAC after multiple Cesareans even though ACOG themselves says that VBAC after two Cesareans is totally acceptable and reasonable to go for. It's really hard and it's frustrating. I know as a VBA2C mom myself that it's so frustrating. It's so frustrating, right Brittany, to feel total defeat over and over again, being told that you cannot, you should not, and being filled with horror stories. I mean, all of the things. It's so frustrating and this is why we are here. We are sharing these stories. We are letting you know that you can. It is possible. It might not be easy along the way and you're going to hear today in Brittany's story that it's not easy but it is possible. So we have our friend Brittany like I mentioned. She is from southern Minnesota. She has been through quite the journey which she is going to share with you. If you want to know what some takeaways will be from this episode, one thing is finding that supportive provider just like we were talking about. It's so important. It's so key but we know that it can be challenging being rejected multiple times and being told no, and then not finding a supportive provider until the very end of pregnancy. You guys, this is something that I want you to know. If you are not feeling like you are being supported, if you are feeling or seeing the red flags, if something in your gut does not feel right, you are not stuck. You do not have to stay with any provider because they saw you for 34 weeks, 28 weeks, 40 weeks, 41 weeks, or even 42 weeks. You are not stuck. You can change. It's not always easy and we understand that, but you always have options to change. You can fire a provider at the very moment. We don't necessarily encourage you to fire your providers. I don't want to make it sound like, “Fire your provider!” but you can. If it's not feeling right, if it's not a good mix, you can say, “I would like to request a new provider at this time,” or you can start finding it through so many amazing resources like right here at The VBAC Link. Women of strength, if you are looking for a provider, write us. Go join our VBAC Link Community. We have a whole list of providers on there that have been known as supportive. I can't tell you. I'm just here in Utah. I've not met all of these providers. I've not talked to them. I've not interviewed them. These are providers that are being suggested by our other women of strength who have truly gone through this experience and believe them to be VBAC supportive. Their names are being compiled on this list for you all over the world not just here in the U.S. as guidance for you to help you find a supportive provider. So go to The VBAC Link Community on Facebook, answer the questions, and go check it out. And if you are listening today to this episode, please PM us on Instagram, Facebook, or info@thevbaclink.com. Tell us who your supportive providers are. If they are not on the list, we want to get them on. If you are a supportive provider listening, we want you on this list. It is so important and we as VBAC moms ourselves, and Brittany, I am sure you will attest to this. It is so important to have that provider on your side. It is so important. Review of the WeekOkay, I will jump off my soapbox and we will get to our Review of the Week so cute Brittany can share her stories. This is actually on our How to VBAC: The Ultimate Prep Course for Parents. Parents, if you didn't know, we actually have a VBAC prep course for you. It's filled with information on the history of Cesarean, the history of VBAC, the pros and cons, how to VBAC, and how to find these supportive providers. We will provide you with a lot of printables and things to take along with you on your journey to make sure that you've got the perfect team and that you feel confident in the birthing choice that you are choosing. This says, “This course was so helpful, especially with helping to educate my husband on the safety of VBACs. As he had previously been nervous about my choice, we watched all of the videos already and will also be reviewing the workbook again before birth. Highly recommended.” Thank you, Heather, for sharing that review. Yes, just like she said, this course is amazing. We have reading material and then we have a workbook that you can follow along. You can either download it or purchase a workbook to go along with it. We encourage your birthing partners to take this course with you because it is important for them to know this information. So check it out at thevbaclink.com if you haven't already and we will see you on the other side. Brittany's StoriesMeagan: Okay, Brittany. Brittany: Yes. Meagan: Thank you so much for taking the time today to share these stories. Like I said, we get emails and messages on Instagram and Facebook in our inbox saying, “Please share more VBAC after multiple Cesarean stories,” because there are times when we go in and we have an unplanned Cesarean and then sometimes we get coerced or we feel that it's best to choose another one, but then we start learning more and we want a different experience. We know how hard that is. I welcome you and let's turn the time over to you. Brittany: Absolutely. I am honored to be here. I am very excited to share my story. I know am a mama to three babies. I'm going to share a little bit about my C-sections before I move on to my vaginal birth. I found out I was pregnant with my first son in 2016. I'm sorry. I had him in 2016. I was actually newly sober. I'm a person in recovery so I was very new to a lot of things in life. I was going to be a single mom and I also was sober so a lot of big changes were going on at that time. I was very uneducated about birth, being a new mom, and everything at that time. I was going through so much at the time obviously and then I was nine days overdue which we know truly isn't overdue but that's what they say. At that point, I just wanted to have him. I was not educated about interventions or anything like that so I just went with the punches. Whatever the providers and team wanted, that's what I did. I also knew as much as possible, I didn't want as many pain meds as possible just because of my recovery from substances and I really liked narcotics so I knew that I didn't want to go down that slippery slope. I allowed them to induce me with two doses of Cytotec. It started working but then they wanted to break my water and I allowed them because I truly didn't know better or have any information on that. I got an epidural super early even though I think I panicked more than anything. I didn't want to have pain so I just got it not knowing that I was going to have a long labor and being stuck in bed wasn't going to do me any favors. After laying in bed basically for 24 hours, I pushed for two hours. He was not descending. At that point, I was truly done. I was exhausted. I had been up for two days being induced, so we decided on a C-section. He was sunny-side up so that's what made it more difficult for him to come down which made sense. So he was here. Recovery was rough. I'll talk about that a little bit more later. Fast forward to some time in 2017, I went into the ER. They couldn't really figure out what was going on with me. I really wasn't feeling well. Long story short, I actually had an ectopic pregnancy. I was on the IUD at the time so I had no idea that I was even pregnant. It was very traumatic. I went from not knowing I was pregnant then they had to take the baby out. I actually lost one of my tubes at the same time. I had to have lifesaving emergency surgery. I was in the hospital for five days and they couldn't do it laparoscopically. They did have to cut me all the way open and take everything out. So that was very traumatic and a very big loss. Then I met the man that I eventually married in 2018. We experienced an early miscarriage in 2018 as well so another loss. In 2019, we found in late 2018 going into 2019 that we were pregnant with our rainbow baby. At that point, I was very unsure of what I wanted for my birth. I knew how terrible my C-section experience was but I was also terrified of laboring for that long and then ending up with another C-section again. I trusted my doctors. I was listening to them. Of course, they did the VBAC calculator and at that time, they told me I had a 50/50 chance. Being that he never descended, they said, “It's up to you what you want to do” and I had lost two babies. I just wanted a baby here safe so I was like, “You know what? 50/50. Let's just go with the C-section.” I was hoping that not having that long labor beforehand would really help with my recovery. I just wanted my baby here safely too. With it being my rainbow baby, I just wanted my baby here. Meagan: Absolutely. Brittany: Yeah. My C-section, the surgery itself went fine with my second son but it was an even worse recovery. I had a severe reaction from the adhesive tape that was on my belly. I broke out completely all over my whole body.  Meagan: Oh man. Brittany: I had shoulder pain and I have high blood pressure so it was very scary to have shoulder pain. It was very scary because I instantly thought of heart problems. It was just shoulder pain from the C-section.Meagan: It's usually air actually crazy enough. Air gets trapped. I had that too. I was like, “What is happening? Is this my milk?” They were like, “No, it's air.” Getting up and walking can really help but it can sometimes get trapped up in that shoulder or even the rib area. Brittany: Yeah, so strange. I was so sick and throwing up for 36 hours. Meagan: Oh, and with a new incision. Brittany: And then I was dehydrated and blacking out from that. It was just an absolute, awful mess. Basically immediately after he was born, I began researching vaginal birth after two C-sections because I knew I never wanted to do that again and I knew we were not done having babies. I binged every single episode that you guys have. I couldn't listen to them fast enough because I knew I wanted all of the information before we had another baby. Even before we were trying, I was doing all of this. I read many books and watched YouTube videos. I was practicing meditation and mindfulness because the mindset is such a big part. I learned about HypnoBirthing and I was also so much healthier. I gained way less weight. I was eating healthier. I was being active and trying to be as mobile as possible to let the baby descend when that time came. Like I mentioned, I do have chronic hypertension so I really wanted to keep that in check because I knew that would be a big red flag for everyone. So then eventually, we did get pregnant with our third baby. I was still doing all of my research and things like that. At that time, I actually did hire a doula as well. I wanted to do everything I possibly could. She was very supportive of a VBAC after two C-sections. So then we started the hunt of trying to advocate for myself. I really worked on relaxing myself just to get in that positive mindset. Initially, where I gave birth to my birth son, they now do some VBACs but they will absolutely not look at people who have more than one C-section and then it's case by case for just a single. They were like, “No, you either have to go to a C-section or go to the high-risk unit.” I said, “Okay, then send me to the high-risk unit. That's what I want.”At 32 weeks, they saw me at the high-risk and complex unit. This was basically to see. They would assess me and see if they believed that I had a fighting chance. My blood pressure at the time was in a great range and I was actually off medication because I was so healthy doing what I needed to do. Meagan: That's awesome. Brittany: Yeah, it was great. I advocated for myself with them saying, “I hired a doula. I have a supportive husband. I have done all of this research. I know what research truly says,” and of course, they pull out the calculator. Meagan: Oh boy. Brittany: It kind of depended. Sometimes it put me at 20%. Sometimes it put me at 40% depending on who did it because of the blood pressure and because of the two repeat C-sections with no vaginal birth before that. They said they would work with me. That was their wording yet they said that they wanted me to have a C-section no later than 38 weeks. Meagan: No later than 38 weeks? Brittany: Yep, yep. Knowing that my first son came at 38.5 weeks, I knew that was probably not likely. I was also in the mindset that if I went to 42 weeks, I was okay with it because I knew that as long as they continued to monitor things, then it was okay. I knew that if I didn't go into spontaneous labor myself, so say that my blood pressure spiked or anything like that, they would not do anything to help induce me. No low Pitocin, nothing like that, no breaking of water, nothing. I would have to do it all on my own. I knew that was a huge barrier too. Meagan: Yeah. They're putting restrictions on you already. Listeners, if you are getting, “Yeah, okay,” but then you are getting restriction, restriction, restriction, then it's probably not the right space. Brittany: Yeah, exactly. Those were my first thoughts. If I'm already knowing that these restrictions are being put up, I'm going to hold in more tension even when I come here and just wait for some kind of failure in the process for them to say, “Okay, we need a C-section.” So I truly wasn't even getting a chance to try. I literally left the office bawling with my husband. And of course, my husband is not as educated as I am because he's not going to be giving birth. He's very supportive and educated just not to our level but they fearmongered him. They made us, not me because I knew the statistic and things, but he was more worried like, “Are you sure this is safe?” and things like that. I was feeling so discouraged. I was 32 weeks pregnant and I was like, “What am I going to do because I know this isn't going to work?”I actually have a very good friend who had her first baby by a C-section and then she had two VBACs after that. She was one of my biggest supporters. She rooted for me so hard. Meagan: She was your motivator and in your space. Brittany: She had to be induced at 37 weeks with her babies due to being high risk with medical complications and she still did it. She just really gave me hope. We began researching together. She literally lives in a different state and she was researching with me. Meagan: That's amazing. Brittany: It is so amazing. That's what's great about this community. We found a provider that actually is 2.5 hours away from where I live. I knew it was crazy, but I was like, “You know what? What does it hurt for me to even go and see this guy once?”Meagan: Listen, it's not crazy. It's not. I know it sounds crazy and the world we live in makes it feel crazy to go so far. It's not crazy. It's not crazy. It's just you advocating for yourself and finding what you need for yourself. Brittany: I came on Facebook groups with you guys and other VBAC groups specific to our area. I just read testimony after testimony about how amazing and old-school he is. I called and even at this point, I was okay if insurance didn't cover things. I just wanted this. He's a different breed. He's a lone wolf, one of those very rare people that we find. I made an appointment. I believe it was for about 34 weeks so it was still a couple of weeks away. When the appointment came, I actually had influenza so I had to cancel it. I was like, “Oh my gosh. Everything that could work against me is working against me.” I said, “Nope. At his next appointment, I'll go.” I went and he had my medical records but he barely looked at me and he was like, “Yep. We're going to do this.” He was so positive. Meagan: Wow. Wow. Brittany: Not that we were going to try, but that we were going to do this. That was great. I continued to go to appointments weekly until post baby's due date. But also he was not naive. He told me the risks of both very realistically but not in a scary way. Just like, “This is what it can look like.”Meagan: These are the facts, yeah. Brittany: The clinic has just a small-town, homey feel. It's truly about the patient. It's not like we are just another number. Truly at the end of the day, he gave me the empowerment that not only was I going to do this but he was going to allow me to try. That's all I wanted was to be able to try this and to have hope in myself. At 38 weeks, we discovered that my blood pressure had skyrocketed. The next day, it continued to be so they monitored me for a little while. I'm also 2.5 hours away so they kept me for a little longer. The next day, it continued to be. Being that I was in a safe zone, the doctor said, “Would you be okay if we did a slow induction?” At that point, I trusted him even though I truly barely knew him. He gave such good vibes. My husband loved him. I said, “Absolutely.” I was completely closed so it did not seem like any baby was coming anytime soon from looking at it. At 7:00 PM that night, they inserted the Foley bulb to help me dilate. At 8:00 PM, my body actually took over and I had some major contractions. My job for the night was to rest, let the bulb do its work and just mentally get in the mindset that we were going to be in labor the next day. In the middle of the night, my COVID swab came back positive even though I had no symptoms. Meagan: Oh no and you had just gotten over influenza. Brittany: Yes. That was very interesting. My doula, this was the one weekend that she was unavailable of course, so she had her sub-doula available but she couldn't come in because of COVID. She was only available by phone which was a bummer but we made it through. 12 hours in the next morning at 7:00 AM, the Foley bulb was removed and I was 4 centimeters. That was great because with my first son, I had already gotten the epidural and I was panicking at that time. I was already in a great mindset. I was managing the discomfort so great. He started the Pitocin super slow and low. That's what he's known for, starting it super low and slow at the smallest amount possible. The baby's heart rate had some decels so they turned the PItocin off for a while, no panicking. They were just going to go with the flow. At 10:00 AM, they broke my water. We just hung out. I was feeling good. My contractions picked up on their own without that Pitocin ever being restarted. My body began doing it with that very little bit of intervention. At about 1:30, I began struggling pretty badly with pain and pressure. I stated, “I want an epidural.” Everyone knew that I didn't want that so I said that I would wait another 15 minutes and give it a minute. I still wanted it 15 minutes later and I knew in my mind that I was holding so much tension in. I just couldn't let it go so I was like, “You know what? At this point, let's do the epidural.” We did it. As soon as the anesthesiologist came in, I knew that I made the right choice. I was already feeling that relief that I was going to feel from just letting my body relax. I knew how important the mindset was that I just needed to let my body do it. Baby's heart again had a few decels but the team worked great to reposition me after the epidural was in. I could still feel the pressure of the contractions. I could tell we were progressing but at 2:45, I progressed far enough to be able to push. I progressed very quickly from being completely closed to being here very quickly within less than 24 hours. The team was so supportive. I could feel the baby moving down still, that pressure. I was ecstatic. Once we started the pushing phase, I was very nervous because that's how far I got with Benny, my oldest. I had pushed with two hours with him and he had never moved down. I was very scared that that was going to happen. With the first push, I knew it was different. I could feel him moving. I could feel the baby moving down. We were gender-neutral beforehand and at 3:44, our sweet baby girl was delivered vaginally. Meagan: Aww. Brittany: Yes. It was quite amazing to feel baby on my chest. It's still shocking now feeling the baby on my chest and having my husband look. He was crying and was like, “It's a girl.” After having two boys, it was the icing on the cake. It was absolutely amazing. Meagan: Yeah, and a different postpartum experience?Brittany: Absolutely. My provider had known how traumatic my C-sections were and then of course with my ectopic, completely being cut open with that too, it was totally different. It was stunning. Even with the epidural, I barely had the epidural so it's not like it was running for a long time. I was never able to eat right away after birth. I pretty much ate almost all labor until the epidural and then to be able to eat as soon as I wanted to right after without throwing up, that alone was huge. I could walk practically right after. No crazy abdominal pain because of the C-section. I could help the baby right away whereas I was stuck in bed for so long after the C-section. The doctor looked at me and he was like, “How is this?” I'm like, “Indescribable.” Meagan: Do you even need to ask? Brittany: It's insane how different C-section versus pure vaginal delivery was. I was ready to do it again. My husband was like, “Okay, we're done having babies because we got our girl.” I was like, “I'm ready to do it again.” Meagan: Yes. Oh, I was the same way. I was like, “No, I want to do this again. This was amazing. I got the birth that I wanted.” There is something special. I want to also point out that sometimes vaginal births can be traumatic too but there is something about that baby being placed on your chest after you've gone through some less ideal or traumatic experiences. Yeah. It's hard because you compare it and you're like, “This is a breeze.” It's still hard. Recovery is still hard but it's just magical. Oh, I love it. I love that you at the end of pregnancy were like, “No. We're going to do something differently.” It ended up being an induction so it was like, “Hey, come. Drive and come and it's planned.” But I would love to know or I'd love for you to share if you can any of your plans for listeners assuming that it was going spontaneously. I think a lot of people get nervous. It's a daunting feeling. They get nervous about, “When do I go? What do I do? It's a long drive.” Do you have any tips or suggestions of what your plan was to travel that distance assuming spontaneous labor went into play?Brittany: Absolutely. We talked about that. That was one of my husband's biggest worries because obviously, he would be driving me. We knew first of all that obviously every labor can be different but that my son's took forever. He was also induced. We were hoping for that but then also, we knew and had great backup for the other kids for daycare at a moment's notice. We had great people to be able to drop them off at. We had talked to the provider too. Basically, if my labor got at all semi-regular if it had happened at home, if my water broke, I was going to head right in because we knew we would be having a baby. We also knew with having two C-sections that we wanted to be near medical attention just in case. We knew that even if my contractions started coming semi-regularly that we would likely head in. I was ready to labor hard in the car if that's what it had to be. Also, say all of a sudden, I got pushy and that's how fast it was progressing, we were okay going to our hospital closer just because then, I'm in the thick of it. We don't want anything to happen to anybody but we knew that it could possibly be a barrier having to drive all the way 2.5 hours to this hospital. Meagan: Yeah. That is a really good point. Preparing to labor hard in the car is no joke for sure. Obviously, that's not what happened but preparing yourself mentally is so beneficial because if that does happen, it can take out some trauma because it could be traumatic in the car if you're not prepared for that and labor is progressing, and then of course, having that plan of, “Okay, if things shift and I'm pushing that baby out, we'll go to this nearest hospital.” Also, I would suggest, you were saying, “Oh, if things were getting active then we would go,” but you could also, when you get there, you don't have to go straight in but just be in the vicinity. Grab a hotel or go to a park and walk around. Just be close by. Preparing for that financially as well if you're getting a hotel or something like that is something that's important because you don't want to have anything crazy happen but also educate yourself on the signs of something going wrong so if you know that it's happening in the car and you still have 45 minutes, you can just go to the nearest hospital at the next exit or whatever. Brittany: Yeah, absolutely. Meagan: Great tips. I seriously love that. Prepare to labor hard in that car because it can happen. Congratulations to you and I am so proud of you on all of your journeys. It's hard because we've had these Cesareans, undesired, sometimes traumatic, or desired with unidentified outcomes where you wouldn't think that it would have been like that. These are the stories that make us who we are today. It's these stories that are changing others' lives and empowering them. Whatever your takeaway is from today, maybe it is recognizing a supportive versus non-supportive provider. Maybe it is figuring out what you need to do for yourself. Maybe it's traveling or whatever it may be. Maybe it's scheduling that repeat Cesarean. Whatever it may be, know that it is your birth. It's your birth. This is your body. This is your baby. This is your future and whatever decision you make that is best for you, we here at The VBAC Link support but do have all of these resources for you to turn to and learn so you can know what your options really are. Brittany: Yes. Information is key. That's one of the biggest things I took away. I am all for people making whatever decision they want in regard to anything including birth, but I just want people to have the information, the correct information, to be able to make those informed decisions. Meagan: Absolutely. Absolutely. One other quick thing I wanted to talk about is how you went in for a VBAC after two Cesareans with no progress. There wasn't any progress being made meaning that your body was not showing signs at that moment of labor beginning or progressing. They started with a Foley bulb or a Cook catheter depending on where you are or what your hospital uses. That can be something that a lot of providers will refuse to use if you're not dilated to a 1. Now, I want to preface. You'll have to tell us actually. It can be very uncomfortable getting a Foley in with no dilation because they're putting a tiny little tube in something that is closed. Brittany: Yes. Yes. Meagan: That is definitely a little bit of a disclaimer there. It can be very uncomfortable but just like Brittany and I want to say it was Shannon? I could be totally wrong. It was a VBAC after three Cesarean birth. She ended up doing a little bit of Pit to try and get her cervix to do something and then got a Foley in. It barely opened if I remember right. It just shows that it is possible. It is possible. They may say that it's not possible. I will say that it's not common for them to do it but it is possible. You can request it. Yes, prepare yourself mentally because I don't know Brittany if you want to describe it at all but it's possible. It's possible to do that. So if you're in a situation and they're like, “You are in no state to be induced,” but you're really not feeling like you want to do a scheduled C-section, try it. Brittany: Yes, totally. It was very uncomfortable. It was truly painful. I had been induced with my first son so I knew what labor was like, but I was like, “Oh, this is pretty rough.” But hands down, I would do it again. After that initial insertion which took a little bit because I was completely closed– Meagan: And probably posterior a little bit so they had to send the tube up and forward. Brittany: It was rough. I was worried that it wasn't going very well, but it just takes time because I was fully closed. I had pretty good contractions just from that for an hour. My body totally took over which was good. I mean, but then it was such good progress. I slept all night. By morning, I was 4 centimeters. I mean, can you honestly ask for more than that? Meagan: That's amazing. Brittany: That was the perfect start to an induction. Meagan: Yeah, absolutely. Absolutely. That's one of the things that the Foley can do is it can get your body to 4 centimeters, sometimes even to 5 centimeters. It's also important to note that sometimes when it falls out, the cervix relaxes. Do you like my sound effects? It's hard because we can see each other. She can get my emotion. It can relax and go backward. It doesn't really go backward, it just relaxes. So sometimes keep in mind that if a Foley comes out at 4 centimeters, you might be closer to 3.5 or 3 but it stretches to a 4 because it just stretched to a 4. If you get checked again and they're like, “Oh, you went backward. You're a 3.” No. Don't let that get in your head. And then they started low-dose Pit and things. That's something I wanted to point out. It's not something that is super common and oftentimes, providers say no but it is possible. Brittany: It was absolutely incredible. I mean, really the biggest thing is to educate yourself. I went to the chiropractor. I did all of the things. I was in so much pain at 37 weeks pregnant, 36 pregnant. I'm a firm advocate of the chiropractor anyway. I love it for everything. Helping my kids poop as weird as that is–Meagan: Oh no, I know. I've done that too and it's amazing. It works. Brittany: Yes. So I had been going very regularly anyway because I knew how much that can help get baby in place and help with pain, help with hips. I was in so much pain and I'm like, “Oh no. This is not good. I can't be in this much pain going into birth.” My chiropractor actually got COVID of course right around that time so I was like, “I can't even see her. Who knows if I'll get to see her again before I have his baby?” I was lucky enough to find a very nearby chiropractor the day before I went in to be induced. I swear that helped a lot too. Just incredible. It turned out beautifully. Meagan: Absolutely. Yeah and if sometimes you're having prodromal labor or if labor it just carrying on, carrying on, and carrying on, going and getting an adjustment can be a game changer. Yes. Awesome. Well, thank you so much for being here with us today and sharing these beautiful stories. Brittany: 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

Cervical ripening.  Cytotec.  Cervadil.  Foley bulb.  Pitocin.  Epidural.  More Pitocin.  Decelerations.  Fetal distress.  C-section.  Sound scary?  Well, there are some very real, tangible trends in modern American maternity care that anyone who's being honest will acknowledge.  One is known to many as the "Cascade of Interventions" and that list of things at the beginning includes a lot of the possible elements of this cascade.  Think of it as the snowball effect.  Once it starts, it's hard to stop.  Today I wanna talk to you about it in a little bit different format than usual to help you understand why you want to avoid it if at all possible.  Spoiler alert -- avoiding an unnecessary induction is the biggest thing you can do to stay off of this roller coaster.   Helpful Links:   Book Your PERSONALIZED Pregnancy Coaching Midwife & Me Power Hour  Here   Be heard! Take My Quick SURVEY --> https://bit.ly/yourbirthsurvey   Got questions? Email lori@yourbirthgodsway.com   Join Our Exclusive Online Birth Community -- facebook.com/groups/yourbirthgodsway     DISCLAIMER:  Remember that though I am a midwife, I am not YOUR midwife.  Nothing in this podcast shall; be construed as medical advice.  Listening to this podcast does not mean that we have entered into a patient-care provider relationship. While I strive to provide the most accurate information I can, content is not guaranteed to be 100% accurate.  You must do your research and consult other reputable sources, including your provider, to make the best decision for your own care.  Talk with your own care provider before putting any information here into practice.  Weigh all risks and benefits for yourself knowing that no outcome can be guaranteed.  I do not know the specific details about your situation and thus I am not responsible for the outcomes of your choices.    Some links may be affiliate links which provide me a small commission when you purchase through them.  This does not cost you anything at all and it allows me to continue providing you with the content you love.

Rachel is a pediatric dentist who owns her own practice in Pensacola, Florida. She fought for an empowering second birth experience even with an initial diagnosis of complete placenta previa. When her placenta thankfully moved, Rachel was cleared to go for her VBAC and she was all in!Rachel drove six hours to be able to birth with the provider she knew would best support her VBAC. With her doula and supportive family by her side, Rachel achieved the beautiful birth she envisioned. Additional LinksHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Facebook CommunityFull Transcript under Episode DetailsMeagan: Women of strength, you are listening to The VBAC Link and I cannot wait for today's story. Reading this story, there are so many twists. Not even twists I should say, but factors to this story. We have our friend Rachel telling it from Florida so welcome, Rachel. Rachel: Thank you so much. I'm so, so honored to be on this podcast. I can't believe I'm actually getting to share this amazing journey with you guys so thank you for having me. Meagan: We are honored that you are here with us. Yeah. I feel like there are quite a few things within your story. Things like baby's position, placenta previa which we are going to talk a lot about at the end, even dental stuff, close duration, so there are a lot of things where I feel like people can relate to this story. Review of the WeekI will read a review and then we will get right into your beautiful story. Today's reviewer is haley222222. It says, “I can't recommend enough. I found this podcast shortly after my C-section in 2019 with my first and it has helped me so much. My doctor had told me that I was only going to be able to have four children because I was going to have C-sections from here on out. This podcast opened my eyes to the possibilities I didn't have a clue about and I had options.” Oh, I just scrolled, and okay. Here we go. It says, “I was able to find providers that I trusted and who actually believed in me. I prepared for my VBAC and unfortunately, my first VBAC was a stillborn at 26 weeks, second baby boy in October of 2022.” So sorry to hear that, Haley. It says, “Although it was heartbreaking, it was truly an amazing experience and I can't wait to have another vaginal birth hopefully with a better outcome and a baby we can bring home. I am pregnant with my third now and I'm relistening to all of the episodes. I am so excited to do this. I am in the process of hiring a doula and we will be taking a birth course this time around. Thank you so much for creating this podcast and I'm so grateful for all that I have learned.” Well, Haley, thank you so much. Again, my condolences to you on your second and congrats on your third, and thank you so much for sharing your review. Rachel's StoriesMeagan: Okay, we have our friend Rachel. Like I said earlier, she is from Florida. So you are a dentist and you have your own clinic, is this right?Rachel: Yes. I am a pediatric dentist. I only work on children. We have a private practice in Pensacola, Florida which is the panhandle of Florida. It's lower Alabama, kind of LA but it's on that end of the spectrum, not south Florida. Meagan: Awesome. That is so exciting. So, so exciting. Rachel: Thank you. Meagan: Well, thank you so much for being with us. I would love to turn the time over to you to share this story and then at the end, we'll get into that placenta previa and some dental stuff. Rachel: I know, who would have thought that dentistry could be related to C-sections? Meagan: Who would have thought? Really, though. Rachel: I know. It's all related. Meagan: We never talk about it so I'm excited too. Rachel: Well, I guess I'll just get excited about my children journey. Again, I'm just so thankful that I get to talk on this podcast. I listen to you guys every single day when I was preparing for a VBAC and Meagan, what you're doing is changing so many people's lives. Like we talked about, I'm sure recording a podcast can get a little crazy like with any job that we do, but you really are making such a difference in so many people's lives so I really thank you for that. Meagan: Oh, thank you. Thank you. Rachel: Yes. So okay, my children journey I guess what you could say started in Gainesville. My husband and I were living in Gainesville. He was finishing up an orthodontic residency at that time and I was working as a pediatric dentist. I had just finished residency and I was working at a private practice. We became pregnant with our first baby. They said I had a subchorionic hematoma around 7 weeks and said, “Don't worry.” It's a pretty common thing I think. Meagan: It is. Rachel: I came back for a follow-up ultrasound anyway around 10 weeks or so and no heartbeat. We had a miscarriage. They gave me two options, either the misoprostol pill to pass the baby or the D&C.Meagan: Cytotec. Rachel: Yeah, or the D&C. After talking to a lot of people, I just decided to have the D&C. It seemed less emotionally scarring. Anyway, so we did that. Right around that time, the day before surgery, the whole COVID thing in 2020 started and they said that for some reason, dentists were considered non-essential so everything was shut down for the whole month of April. Meagan: What?!Rachel: I had never not worked my whole life. This was the most time I had ever had off ever so it was crazy. I was not working. I had scheduled the D&C. That morning, I had a 99-degree fever or something. My OB in Gainesville was amazing. The whole hospital staff was like, “Oh my gosh. She might have COVID. We can't do the surgery.” Yeah, so crazy. My OB had to vouch for me to say that I didn't have COVID and that we could still do the D&C anyway. I'm pretty sure I was the last elective surgery to have done and then after the date, literally I think it was March 20th, and the day after, they stopped doing elective surgeries and stuff. I was super thankful for that. It's Dr. Erin in Gainesville and she was just awesome. We had a miscarriage. It was a super tough time for me and my husband. I just remember praying and asking God to comfort us because we are Christians and I just really believe that God is close to the brokenhearted. The Bible says, “He's near to the brokenhearted.” It's still hard though because he's not here to comfort you physically. I just remember I was praying and there was this dove that came to our house and lived in our backyard. It was so crazy. For several weeks, he just made a nest on the ground.Meagan: That just gave me the chills. Rachel: It is. I'm telling you, I prayed so hard. He can comfort you but he's not going to give you a hug or something. I don't know. Do you know what I mean? So literally this dove came and lived in our yard. That dove was there. I'm not even kidding you. The day that I found out I was pregnant, the dove just left. We were like, “Where did that dove go? He was living in our yard and now he's not there.” That was the day I found out we were pregnant with our second baby, or our first baby. Meagan: Uh-uh. Wow. Rachel: It was so insane. Meagan: Oh my gosh. Rachel: Yes. That was the first crazy thing. I had wanted a puppy after the miscarriage and we had a really small courtyard so my husband was like, “Well, if we get a puppy, I'm getting a monkey.” I'm like, “No.” I was like, “Well if you really do want a monkey, I can look into finding us a monkey if you'll let me have a puppy.” He's like, “Okay, deal.” Well, he knows not to put anything past me after that because I found a monkey and we literally have a little squirrel monkey. His name is Rocko and we have a Maltipoo whose name is Remi. So the week after we got our monkey, that's when we found out we were pregnant again. I was like, “Now we have a monkey and this puppy and now we're going to have a baby.” That's how life goes. If you know me, that's just how my life goes. It's just like, the more fun, the better. Anyway, so I was pregnant with the second one. I also had a subchorionic hematoma in the beginning and Dr. Erin was like, “Okay, I know I told you not to worry about it last time but seriously it's usually not a big deal.” But you know, you're still worried because you have the same thinking. Meagan: Yeah, trigger back a little bit. Rachel: Exactly. So I was just a little worried about that, but I kept pressing forward. So then fast forward later, everything is healthy. Six months into the pregnancy, I found out that we got a great opportunity to move back to Pensacola which is where I'm from. It's about six hours away from Gainesville. It's near my home town. My parents live here. A pediatric dentist, Dr. Stu Bonnin was selling his dental practice in Pensacola so we decided to merge together and transition. I went there. I was probably about seven months pregnant when we moved to Pensacola. I was starting up. I'm seven months pregnant. I'm starting brand new seeing all of these patients I'm just getting to know. My husband started an orthodontic practice next door which is a dream come true. We have always wanted to do this. The doors opened up to where it could happen. Timing sometimes seems crazy but it just happened that way. I mean, I remember we moved here on December 24, 2020, so Christmas Eve. U-hauls are a lot cheaper then by the way. Our family had COVID so we weren't going to go see them anyway. I remember waking up on Christmas Eve or Christmas Day morning and I was sleeping on an air mattress. We had just bought our house and moved everything in. I'm like, “Wow. What a whirlwind. This is crazy.” So we moved halfway through. I'm a new business owner. So then I started seeing patients at about eight months pregnant. I'm trying to establish rapport with my new patients. I just decided it was in their best interest to work up until my due date. I worked up until my due date. At this point, I had no knowledge of birthing a baby at all which is my fault. I should have researched everything but there was just a lot going on. Meagan: Yeah. Don't put too much pressure on yourself there. Rachel: Knowing what I know now–Meagan: You had a lot of juggling pieces. Rachel: I know. Plus I was like, “I don't want to know how the baby gets here. I just want to know what to do after it gets here,” so I did a lot of Taking Cara Babies, reading how to get them to sleep through the night. I really wanted to breastfeed so I was focused on what to do when the baby gets here. Meagan: Which also is something that a lot of the time we forget to do. Rachel: I know. I know. It's all hard. So I worked up until my due date. I was expecting to be two weeks late for some reason because I was two weeks late as a baby. My husband was two weeks late and we were both first babies. I'm like, “It's going to be fine. I'll probably just be a little late.” A week passed and I had found an OB here. They did the BPP thing, the biophysical profile. Everything had been healthy. Nothing was out of the ordinary. She started talking about inducing me because I had borderline low amniotic fluid. That's the reason they gave me. So I guess amniotic fluid level from my understanding can be anywhere from 5 centimeters to 25 centimeters and mine was a 7. So she's like, “It's borderline low. The baby's not in distress but the older your placenta gets, the more likely that you'll have a stillbirth or you can have babies born with cerebral palsy and complications.”Meagan: Big words, very big words. Rachel: Yeah. I'm like, “Oh my gosh, well I don't want that.” I trust the doctor. I'm a doctor. I feel like I look out for people's best interests. I mean, I know I just deal with baby teeth but I truly want the best for my patients so I know she was probably recommending the same thing. All of that is not untrue, but anyways. Knowing what I know now, I'm just like, “What in the world?” She recommended that I be induced because of the borderline low amniotic fluid and that the longer time passes by, the increased chance of stillbirth. Because I had done zero birth education, I had nothing to really guide my decision-making process and my husband wasn't there because it was all COVID stuff. He couldn't come to any of the appointments so I was making these decisions on my own. I was just like, “Okay. We'll get induced. That's fine.” I only had a month off for maternity leave anyways, so I'm like, “Okay. It'll probably work out that the baby's born more on time.” Meagan: That you'll have some time. Rachel: Yeah, exactly. The day before, I just had this really bad feeling. I called the doctor's office and I was like, “Hey, is there any way we can postpone the induction?” I was really nervous. They were like, “No. This is the only time. We don't recommend that. This is the best thing.” I'm like, “Okay.” I got to the hospital. I started on, is it Cervadil?Meagan: Yeah, Cervadil. Rachel: The insertion pill thing. Meagan: So the pill is Cytotec and then there's the tampon-looking thing and that's Cervadil. Rachel: Okay. I think that might have been what that was. So yeah. I did that. I got to 2 centimeters dilated and they started the Pitocin. So then after the Pitocin, it was a gentle induction. The doctor I went to I guess is known for gentle inductions so that was good. I got to 2 centimeters dilated. Our daughter's name is Heidi. Her heart rate started dropping even this early on. I was only 2 centimeters dilated. Every time they turned the Pitocin up, it would drop. I was just like, “Just take me off of everything. Let's just wait.” The OB came in and she's like, “We've already had nonreassuring fetal heart rates.” I hope I'm using the correct words but I think that's what it is. Meagan: Correct. Rachel: It's just not looking good so we would recommend some kind of intervention at this point. I was like, “What about an epidural?” She was like, “Maybe you could use an epidural. It would help you relax and just speed things along.” So I got an epidural and then Heidi's heart rate dropped again. This just kept happening and I will never forget. There was a younger nurse. The doctor wasn't there. It was 2:00 AM and she came walking in the room. She said, “Hey, so the doctor just told us that we need to prep you for a C-section.” I'm just like, “What? A C-section? Excuse me? No one told me this was a possibility.” I had never even researched what that was. I never even knew that was a possibility. Meagan: A lot of us don't. Rachel: I mean, I'm stupid for not realizing that is a possibility, but at the same time, you're not planning on it. It's just an unplanned surgery. Meagan: Yeah. We go in thinking we're just going to have this baby which we do have a baby but we just don't envision it that way. Rachel: I know. I just truly wanted what was best for my baby. Meagan: Absolutely. Rachel: If it meant a C-section to save her life, then obviously that's what I would do but I was realizing this cascade of interventions was leading from one thing to another thing to another thing and I just was so upset. The OB got there and finally, my husband was like, “Whoa. Okay. What is going on here?” He talked to her and he was like, “Let's just take her off of everything and see how her heart rate is.” We literally asked her. We were like, “Listen, if you think our baby is going to lose oxygen or something dangerous where it's going to save her life to do a C-section, we will do a C-section, but if she is okay and we can work through–” the nurses were changing my position and the heart rate would get better. Sometimes I think the cord can just get compressed or things like that. She literally looked at us. I was really upset. I don't even know what I said. I was just really upset. But she looked at us and she was like, “Okay, yeah. The heart rate looks great. You're doing great. I'm okay with that. Let's just give it a little bit longer.” It was probably another 12 hours that we had done that. Long story short, the same thing happened again and after she gave me time, and at that point, I think I had progressed to 6 centimeters. I was like, “Okay, we're going to have this baby. This is looking good.” Even the nurse said that it was looking good. I think the final thing that happened is that I started running a fever and then when I ran a fever, the heart rate shot up and it was super high. Yeah, she was tachycardic. I'm like, “Yeah, she is not looking good.” At this point, it's been 72 hours. I mean, I have so many fluids. I've been on an IV. So we were like, “Okay, we really need to do this.” I was kind of expecting it at that point even though I was super upset and super sad. I was just kind of waving my little white flag. We did what we could and they prepped me for a C-section. It was the craziest thing I've ever experienced because everything went really well with the C-section. The OB was great with the C-section. All of the team was really fast. I kept saying, “I can still feel some pressure. Give me some more medicine. More, more, more.” I was so numb that my intercostal muscles were numb all the way up into my chest so it was kind of hard to breathe. I knew it was just because my muscles were numb so I was okay with it. It was so crazy because I was so happy. I heard my daughter cry so I knew she was healthy. I knew she was there. It was the best moment ever but at the same time, you're sad. Everybody that has talked on this podcast, you know the feeling of where you're so happy. Your baby is here. You're healthy. There could be way worse other things, but at the same time, it's just that this was not what I was expecting. It's crazy. Anyway, she had to go to the NICU because there was fluid in her lungs so she had to have help with oxygen and then she had to get IV antibiotics because there was suspected chorioamnionitis. Meagan: Because of the fever? Rachel: Yeah, because of the fever. So it wasn't proven, but they go ahead and put the baby on antibiotics before the results get back from pathology because it takes a while so they want to go ahead and get them on antibiotics just in case. It came back and it wasn't chorio so she had unnecessary antibiotics. But I get it. You have to have certain protocols in place. So she had to have that. She was in the NICU for just a couple of days. It wasn't bad. I was able to breastfeed. It was a struggle. You have to really make sure you're on a strict schedule when your baby is in the NICU. You have to go feed them and pump especially when your milk is coming in. So that was hard but we were able to do the breastfeeding which is good. Oh, Heidi had a lot of donor milk in the NICU because it was good that they gave her donor milk. I always joke around. I'm like, “She's going to have the best immune system because of all of the donor milk that she got.” Side note, whoever donates breastmilk, you guys are amazing. I just cannot believe that is a thing, so thank you to whoever donated breastmilk.Fast forward to the follow-up, everything is looking good after the C-section. Heidi is doing great. I'm so happy. I wanted to share this. I don't know if a lot of people have ever experienced this but I talked to my provider. I mean, I really liked her other than she suggested the induction. I just really wasn't that on board but she was like, “Yeah. In the future, you will definitely be a candidate for a VBAC.” But then I got this letter in the mail. I'm just going to read it. It says, “Dear Rachel, The patient/physician relationship is important in providing quality care. I feel your unacceptable behavior toward me and the hospital staff as well as your unwillingness to follow my recommendations for your safety and the safety of your baby has jeopardized our relationship. Therefore, this letter serves to notify you that I will not continue to be your provider.”Meagan: What?Rachel: I was so, so sad because I thought I followed her recommendation. She thinks I put my baby at jeopardy. If she thought my baby was at jeopardy, she should have told me that I should have had the C-section earlier. I just was so sad. I, as a physician, I'm not a physician but I'm a dentist and all of my patients, I try to give them both sides to everything. Not everybody is as informed as I am about teeth. Duh, we all don't know. That's why you go to a doctor for advice. Meagan: That's why you go to a specialist. Rachel: I try to give everybody two sides. I try to inform them and then they make the decision. I don't ever want to force someone into doing something that they don't want to do but also if someone doesn't take my recommendation, I'm not going to say, “Okay, you're dismissed from my practice.” I get that some people just don't feel comfortable treating certain people which is fine. I'm not bitter about that but I was super floored that she would dismiss me as a patient because I didn't take her recommendation to get a C-section in the first place. Meagan: You did and then you had a conversation and she said, “Yeah, I'm totally fine with it. Let's keep going.”Rachel: I had a doula with me, Ashley Andrews, she is amazing. She is my prayer warrior doula. She even said, “I don't think you're out of line, Rachel. I'm really confused.” Meagan: I'm sorry. Rachel: Anyways, not to harp on that but it was really sad. It was really for the best because I started looking at other providers anyway because I knew I wanted another baby. Okay, so here's the good part of the story. Dun, dun, dun. Nine months later, we found out we were having another baby. This time, it was a boy so I found a different provider in Pensacola that was okay with VBAC. It's really hard surprisingly to find someone that is super on board. It really is up to you to do the research and all of that. We have doctors. People think doctors are there to give you a magic pill and everything is solved. Doctors can't do anything if you don't make an effort on your end too. I feel like that's why there is so much diabetes and all of these things because you have to do some kind of work on your end too to educate yourself and realize that you can't just go to a doctor and expect them to fix all of your problems. I realized that and I'm like, “Okay, that's in every situation. I have to become educated myself.” I found you guys. I listened to your VBAC podcast literally every single day at lunch and I would cry on my lunch break. I'm such a loser. Meagan: You are not. These stories are amazing. Rachel: I would listen to these stories and I would just cry. I'm like, “Wow. This is so awesome.” My husband, I love him. He's so sweet. He's like, “You guys should make a podcast for husbands on how to deal with their wives when they have decided that they are going to have a VBAC,” because he's like, “All right, I've already accepted all of this stuff. It's fine.” Anyways, at 20 weeks I was diagnosed with complete placenta previa, not just partial. The placenta is completely covering your cervix. My OB here in Pensacola, the new one, was like, “It's highly unlikely that this is going to move. It's complete. It's very rare.” He started talking about placenta accreta and how sometimes it can even grow into the C-section scar and grow out into your bladder and stuff. I'm like, “Whoa.” I was so sad. I'm like, “Y'all, okay. I guess I'll just have another C-section. This is fine.” But then I was like, “Okay. God, you said in the Bible.” Matthew 17:20 says, “If you have faith the size of a mustard seed, you will say to this mountain, ‘Move from here to there' and it will move and nothing will be impossible.” I'm like, “God if you can move mountains, I know that you can move this placenta. I know that nothing is impossible for you.” I just started praying. In the meantime, my sister who lives in Jacksonville had this great practice that helped her with her delivery. Full Circle Women's Care, I highly recommend. I also talked to a friend, Saundra Fetner, who had a VBAC with them. I talked to her about it and she was like, “Yes. You need to go there.” I had a Zoom conference or a telemedicine conference with Dr. Adams. She is the owner there, the OB there. She was like, “Okay, yeah. We even have some missionaries that will be in Africa and then fly here and deliver their baby here and go back.” She was like, “If you want to deliver here, that would be fine with me. You just see your provider in Pensacola and then when it gets time, you just make arrangements to stay in Jacksonville until you have the baby.” Meagan: Dual care. Rachel: Yeah, exactly. I was like, “If something crazy happens in Pensacola, then I have the provider here.” I talked to my provider here and he was completely okay with it. He was like, “Well, with the placenta previa, you might want to try to rent a private jet so you can get there really quick.” I'm like, “Okay, that's not going to happen but whatever.” He was okay with it. I didn't care. Dr. Adams by the way, just has such passion for what she does. If you don't have passion for what you do and you don't enjoy it, why are you doing it? She actually had a C-section with her first baby and she's an OB. So she's like, “I understand how medicine is there if you need it, but sometimes you need to let your body do what it was created to do.” I was like, “Oh my gosh, yes girl. Preach, preach. I'm going to come see you. I don't care that I have to drive six hours. I'm going to come here.” I scheduled a follow-up. Granted, it had only been two weeks since I had been diagnosed with placenta previa. Coming to the follow-up, I had another ultrasound and all of that at Full Circle Women's Care. My first appointment, my sister went with me and we were like, “Let's just not say anything. Let's not say that I had placenta previa. Let's just see what they say.” The ultrasound tech looked at everything and she was like, “Yeah, everything looks great. Your baby's healthy. We just might need to get one more little position of the head when you come back.” I'm like, “What?” So then I'm like, “Okay, well you don't see placenta previa or anything going on?” She's like, “No. The placenta is way over here. This is the placenta here. This is your cervix here. There's no placenta previa.” I'm like, “Oh my gosh.” My mom had been praying. My dad, my mother-in-law, Angie. I'm like, “Y'all, you will not guess what just happened.” I sound so crazy but I'm like, “God moved my placenta.” I even had Ashley, my doula, had her Sunday School group. She was like, “Girl, we've been praying for you.” I know that's not the story with everybody, but it's just so crazy. I really do believe that and I'm just so thankful. I had my appointment with Carol, one of the midwives and she's like, “Yeah, everything looks great. You're due around September. We're going to do everything we can to help you have a successful VBAC.” I'm like, “Okay, Carol. You promise I don't have placenta previa?” She's like, “What are you talking about sweetie? Your placenta is far away from the cervix.” I couldn't believe that it was the case. I had this regained energy and excitement. We were back on track. Let's do it. Then a couple of weeks later, I met with Dr. Adams and it's a group so you meet with different people because you don't know who's going to deliver you. Everyone I saw, I'm like, “If you deliver me, I don't care. Everyone is great. Fantastic.” I met with Dr. Adams and she's like, “You know, there's this thing that you can read.” It is a recommendation for TOLAC or how to have a successful VBAC and how to ripen your cervix. She had all of the guidelines there. She was like, “Have you been following the guidelines? Have you been doing your daily squats to open up your pelvis and doing the specific Spinning Babies exercises to get the baby in the right position?” I'm like, “Yeah, I've been doing my squats.” She's like, “Let me see you do 20 squats right now.” This is at my OB appointment. I'm like, “Okay.” She's holding my hands and doing squats with me at the appointment talking to me about what I need to do. Meagan: Oh my gosh, I love that. Rachel: I'm just like, “This is awesome.” Anyway, she really practices what she preaches. She's like, “All right, then let me see you do some squats.” So I did that. Also, going back so for Valentine's Day of last year, instead of giving me chocolates and stuff, my husband printed off the recommendations that they gave me. I'm like, “You don't care about this as much as I do. I wish you could just know what I'm going through.” He's like, “Okay, Rachel.” He printed off the guidelines of how to have a successful VBAC and he highlighted all of the things. This is on the OB's website, How to Have Your Cervix Ripened Before Birth. These were the things you needed to do. At 20 weeks, drink red raspberry leaf tea. At 36 weeks, do acupressure, acupuncture, and chiropractic care. At 37 weeks, start taking evening primrose oil. At 38 weeks, start using clary sage oil and do birth stimulation, sex, and all of that stuff. At 39 weeks, you can do membrane stripping. He's just so funny because he even bought all of these things. He's like, “Are you drinking red raspberry leaf tea? Is it 36 weeks yet because that's when you need to start going to a chiropractor.” That was awesome. I was just doing everything. I wasn't perfect. I tried to eat healthier and all of that stuff. You do what you can but I work full time. At the end of the day, we're not perfect but I tried to do all of those things. I did that. I found a doula in Jacksonville and she helped me through Hypnobabies. It is super interesting because your mind really can help you control pain. It's so crazy. It really can. I even want to look into this for my patients. I think it would be so cool if you could learn to hypnotize. Dentistry is scary, especially for kids so I'm always looking for new things to try. Okay, so we go to Jacksonville. I was due September 29th. I took a week off early from work. We closed the dental clinic down. I had a dentist that's working for me too, Dr. Bonnin and he's awesome. Thank you for working for me on maternity leave. I closed for a week. We just went to Jacksonville. We had a little mini vacay. We took Heidi. I feel like it was so much just to spend time with me and Edwin with my daughter for a straight week in a really long time and focus just on our family. We have had a lot going on up until then so it was a nice little breather away. Meagan: That's such a beautiful way to spend the end of pregnancy. Rachel: I know. Meagan: Sometimes in the end of pregnancy, we're so stressed. We're getting a lot of pressure from the outside world or from whoever. Why haven't you had your baby yet or why haven't you been induced? So it's nice to just be with your family and create this space going into it. Rachel: Yeah, it really was. It was such a blessing that we were able to do that. I didn't have to worry about, “Okay, let me do the last-minute touches on the nursery.” It was just relaxing. So I'm like, “Okay, for sure this baby is going to come soon.” I'm super relaxed. I saw a shooting star. I'm like, “All right. It's going to happen.” It didn't. A week passed so I'm already a week later and then I think I was 41 and a few days. I had the BPP again and they start doing the monitor thing. They just do the heart rate monitor. Meagan: Oh, a non-stress test? Rachel: A non-stress test just to make sure everything is good. They kept saying, “Everything is good but we are going to keep seeing you back.” They weren't letting me go very long. Meagan: It's very standard doing NSTs at 41 weeks, very standard. Rachel: Yeah, okay. They were just doing all of the things to make sure everything was good. But Dr. Adams was like, “I know you want to go into spontaneous labor on your own. If you're not by 42 weeks,” and she was one to wait up until 42 weeks to do an induction. She's like, “We'll do a super gentle induction. We'll start with breast stimulation. We won't even go to Pitocin or anything.” I didn't even want to hear the word induction so I'm like, “Okay.” But she was great because she allowed me all the way up until two weeks to schedule the induction whereas for some people, it just depends on the hospital scheduling and that's where modern medicine is sad because you have to do the schedule and your body's not on a schedule. Your due date is just a guess date. I mean, Jane, the doula in Jacksonville is like, “So what's your guess date?” because it is. We try to do what we can but at the end of the day, sometimes you just have to let nature take its course. Anyway, so I talked to Dr. Adams and everything was good. I was trying to go into labor on my own. My best friend from dental school, Jackie, actually had premature contractions at 32 weeks so her doctor was telling her all of the things she needs to do to not go into labor and I was trying to do all of the things that they told her the opposite. I'm like, “Okay, what did your doctor say? Okay, I need to do that.” It just goes to show you that getting babies on this earth is just hard no matter what way you look at it but if you're educated, it's a lot easier. Hurricane Ian was brewing up and we had to move from our hotel because our hotel was on the beach and they were like, “We are going to have to evacuate the hotel because a hurricane is coming.” I'm like, “Oh, this baby is for sure coming. It's a hurricane.” It didn't. The hurricane came and went. I even drank midwives' brew and all of that stuff. I was 41 and 5 days or something like that. Our daughter, Heidi, got really sick. She contracted something while we were there. She was throwing up. She couldn't keep anything down. My husband was getting a little bit antsy. My husband was like, “I have a lot of stuff I need to work on at home. Why don't you just stay here with your sister? I'll take Heidi home and I'll come back when you go into labor.” I was like, “Okay, sounds good.” He took Heidi home. She actually couldn't keep anything down when he got home. Home was in Pensacola so it was six hours away from Jacksonville. He drove home and she actually had to be admitted to the ER because she had to get an IV and all of that stuff. I'm just like, “Oh my gosh. My daughter is in the hospital.” I feel guilty because I've been focusing on myself and making sure I don't have a C-section meanwhile my daughter is at home in the ER. I was thinking about, “I'm just going to go home. I'll just be induced again.” You just want what's best for your babies. That's why we're here. That's why we try to avoid C-sections when we can but have them when it's going to save our babies' lives. We just want what's best for our babies so I just felt so guilty that I wasn't there with her. But anyway, she was fine. I finally went to Dr. Adams again. It was the first time I had a check. She said, “Okay, you're 2-3 centimeters dilated.” I'm like, “Why am I not in labor right now?” I was 2 centimeters dilated at the hospital a couple of hours in. So anyways, she's like, “You are super favorable. You are 2 centimeters dilated. You're at whatever plus station where your baby is really low.” She's like, “I'm surprised you're not in labor right now. All you're waiting on is for this baby to say, ‘Okay, it's time for me to come into the world.'” I mean, we just don't know. That's why medicine still has some mysteries to it. You just don't know what puts someone into labor. Anyways, she did a membrane strip which was great. Membrane stripping, is that what it's called? Membrane sweep. Meagan: Yeah, a stripping or a sweep. Rachel: She's like, “Okay.” We had the induction scheduled for that Thursday and it was a Monday. She's like, “Rachel, you're going to have this baby. You're not going to have to be induced. We have it scheduled just in case but you are going to go into labor on your own.” I'm like, “I really hope you're right.” I went home. My sister and I went to a coffee shop and we just relaxed for a little bit and then we went home. We were going to see a movie. My brother lives in Jacksonville too. Me, my sister and my brother were going to see a movie together. He happened to be off work. It was crazy. We're getting ready and then I start having some Braxton Hicks stuff but some contractions. Anyways, it really progressed and it started getting uncomfortable. I didn't know. I thought, “Okay.” We contacted our doula. We met her at the hospital. She was like, “Do y'all really think y'all should go to the hospital?” I was having trouble breathing through everything. I was like, “I don't know. It might just be Braxton Hicks.” We got to the hospital. I couldn't breathe through it very well so then Jane, our doula, was like, “Okay. Let's just go to the hospital and get checked.” I'm getting scared. “No, they're going to trap me. They're going to make me stay and I'm going to have to get a C-section again.” She's like, “Rachel, no. That's not true.” I've got my birth posse with me. We go in. They checked me and I was only at a 4. I'm like, “What the heck? I'm such a woosie. I'm only at a 4?” I'm like, “Let's just go back home.” Carol was there, the midwife that I really had a good connection with and she's like, “Rachel, I really don't recommend you going home. I really think that things are progressing quickly. You should stay here and just relax.” Then I talked to my husband too. Meagan: Make your drive. Rachel: As soon as I got admitted to the hospital, Heidi actually got dismissed so he's like, “We've got two babies heading out.” I'm like, “You're such a nerd.” He's like, “Rachel, stay at the hospital. You're being crazy. Just relax. Do your Hypnobabies thing and I'll be there.” I did that and it was crazy. As soon as I zoned everybody out and put my little headphones on– Meagan: And acclimated to the space.Rachel: Yeah, exactly. I had time to get acclimated. I was like, “Okay. This is going to be okay. This baby is coming.” I just relaxed and then things started getting a little cray cray during transition. Yeah. Now I know what people talk about with that. Also, I didn't have an epidural because I'm like, “No. They slow things down. I do not want to get an epidural.” Yeah. So that was great and then the transition thing. Okay, things started getting really serious. My sister was there with me because my husband couldn't be there. I had my sister and a doula. I was like, “Sarah, why did you talk me into this? This is so stupid. I can't believe I'm doing this. This is the dumbest thing ever.” Then Jane was like, “Okay, I think she's ready.” Meagan: Usually when there is intense talk and doubt kicks in, it's like, “I think it's happening right now.” Rachel: Exactly. So then Carol came in. She checked me. I was 9.5. I had a little cervical lip and I was like, “Oh my gosh. No. I cannot believe it.” I was just like, “How in the world?” Carol was like, “Okay, I think your husband is almost here so we can wait to pull the cervical lip out of the way.” I'm like, “No. We are not doing that!” I'm not waiting. He should have been here a little bit ago.Anyway, so we did that. I'm about to start pushing. My brother was there at the hospital. He met my husband out in the hospital parking lot and they were literally sprinting. They were like, “Okay, your baby is about to be born. Here you are.” Luke led him to the exact room. Edwin comes in. He has a backward baseball cap on. I'm like, “They're going to think you're a crazy person coming in here.” They're like, “Is this the baby daddy? Okay, come in here.” I was pushing and I'm like, “Oh my gosh. The baby is going to get stuck,” because I've heard stories that the baby is going to get stuck at 10 centimeters. Carol was so amazing. By the way, she has a British accent. She's from Africa and she's the coolest person ever. She's like, “Rachel, you are doing it. You're about to have this baby.” I'm like, “No way. Are you serious?” At that moment, she's like, “Rachel, you're having this baby. This is happening. It's too late to turn back. He's not getting stuck.” I'm crying. I'm like, “This is the best feeling ever.” He was born. He's healthy. He's here. I'm healthy and this is how things are supposed to happen. It was the most amazing thing ever. You just can't explain it. I'm just like, “Oh my gosh.” I just can't believe that it actually happened and everything was great. The births were such polar opposites. No one's birth is less important than the other. I don't ever want my daughter to think, “Oh my gosh. I was a failure birth, and then baby John–”. His name is John Edwin Richard the Third and then John was a regular birth. It's not about that. It's just how God can take our pain and our failures that we have and turn beauty from ashes. That is what happened. This is how it's supposed to be. It was the best feeling in the whole world. I was just so thankful. I can't believe my husband made it there. I didn't think he was but he did. Meagan: So close. Rachel: Yeah. I was like, “Oh my gosh.” I do want to say that I'm not trying to diss C-sections. You need it when you can but who you have as a provider is the most important thing. I trusted them and I knew that if she had recommended that I needed a C-section I was going to say, “Okay. I know that I've tried everything I can. I'm going to trust you guys.” She even said, “The position of the baby is the most important thing.” Baby has to be in the right position to do that. So anyway, it was just the most beautiful thing ever. I'm just so thankful for everything. Meagan: Oh my goodness. It's such a beautiful story honestly from all of it, from the dove in the yard flying away to moving and driving six hours away. Those are hard decisions sometimes to make and sometimes dual care is really hard too because sometimes you will have providers disagreeing with the other provider so that's really hard. But so beautiful. I could see the emotion and I could hear the emotion in your face. You're so happy. It sounds just so beautiful. Rachel: I know. It's amazing. It's the best. Meagan: Well, thank you. I do want to talk about that placenta previa because it's interesting to go from being diagnosed with complete previa to so far away. That's a miracle. It's so crazy but a lot of the time, we hear diagnoses of full placenta previa so I wanted to talk about what that is. You mentioned accreta too but previa is where it covers the cervix. To diagnose complete previa, it should be directly over the innermost side, so the OS. Directly over the canal of the uterus which is the cervix. So with pregnancies 16 weeks or more when this is happening, sometimes they're diagnosed with a low-lying. Low lying is when it's really, really close or the edge is less than 20 millimeters away from the OS, the cervix. 20 millimeters is 1 inch or 2 centimeters. Usually, most providers when it's 20 or more are totally okay and comfortable with that. One of the interesting things, and I'm curious how you had yours, but a transvaginal ultrasound to diagnose the placenta previa has a way higher chance of it actually being accurate than an abdominal. Did you have an abdominal?Rachel: It was transvaginal, yes. Meagan: It was. Rachel: Yes. On both, yeah. Meagan: See? Look at that. That's so amazing. If someone is diagnosing you with previa on the abdominal outside, you can also request a transvaginal because that can bring higher accuracy. If we get diagnosed and there are placenta issues within the pregnancy, then sometimes they will suggest a 34-36 week induction so that's another thing and then if there aren't any complications, sometimes it's 36-37. So just for those who have been diagnosed. I also want to mention that a lot of the time when we have low lying or something like that, it does move throughout pregnancy. Rachel: Yeah, and usually it does take a lot longer than that. I did so much research too. So yeah, just like what you were saying, and if it does migrate upwards, it never will migrate back down because your uterus is growing up, not down. It all is about where the placenta attaches to the uterus. It's this tissue and you can't help it. It's when the baby is conceived, that it attaches. I had a D&C and a C-section which can increase the risk of it. I had a friend that was diagnosed with it and she even had some bleeding. She almost had to have a C-section but it had migrated more than what did you say it was? Meagan: 20 millimeters, 1 inch, or 2 centimeters. Rachel: Yeah, she said it was 3 centimeters so her provider was letting her go. I'm not saying that everybody's just miraculously moves all of the time but the chances are pretty good that it's going to move. If your provider says that you need a C-section, just maybe give it some time. Everybody is different. Meagan: Yeah. Well, yeah. I think it's just something that a lot of the time we don't talk about, placenta previa. It can be really scary when you hear at 20 weeks, “Hey, you've got this possible placenta previa or low lying and you might have to have a C-section,” so at 20 weeks we're hearing, “I might have to have a C-section,” and it immediately starts making our wheels turn. Rachel: It does. It's crazy. Meagan: And then last of all, I really want to talk about teeth. Rachel: Yeah, teeth. Meagan: Our pearly whites. So obviously, you're a pediatric dentist and one of the interesting things that you have found that we didn't realize is that C-sections can affect enamel. Rachel: Yes, it can. If you think about it, at about six months in utero is when the baby teeth are starting to develop. Anything that happens, if the mom gets a fever or you don't have the certain Vitamins A, C, D, or E which are really important for your teeth to mineralize and you don't have the certain minerals, then your teeth can be a little bit weaker when you are born. All of these things in pregnancy affect the development of your teeth. Right at birth is when your adult molars, so you have four adult molars in the back and the front four on the top and the front four on the bottom. Right at birth is when those molars start to calcify. If you have, and I'm not saying that a C-section increases but it's more of a correlation. It's not a cause and effect. It's a correlation. Meagan: It's a correlation, yeah. Rachel: Yes. That's observed if you have anything that happens right around the time of birth. With a C-section, sometimes the baby might be a little bit earlier. When you are born, you have things that happened at birth. The baby might be a little bit earlier. A C-section brings the baby earlier. Sometimes those things can affect the mineralization process of those six-year-old molars and the front four top teeth and the front four bottom teeth. It's called molar incisor hypomineralization. If you have something like that, it's just a really good idea to see a pediatric dentist. You can put sealants on it. Sealants can protect the adult molars from getting cavities and things like that to strengthen it. Also, being on antibiotics right at birth–Meagan: That's just what I was going to ask. What about antibiotics?Rachel: Yeah. I'm not getting into the nitty-gritty of everything, but certain antibiotics are worse than others. Usually, the C-section has a higher chance of having to be in the NICU and taking antibiotics. That can affect the mineralization process of your molars. That in turn can cause them to be weaker which puts them at higher risk for cavities. It's just so crazy that even a C-section can affect your teeth which is my small little bubble of medicine that I do. Even that can have a role. It's not like if you have to have a C-section, you're like, “Oh my gosh. My kid is going to have cavities forever.” It just puts you more at risk for that just like someone could be more at risk of being overweight but there are things that you can do through your diet and all of that to keep yourself healthy. It's not an automatic thing. There are things you can do. Don't drink juice and eat sugar. There are things you can do to keep cavities from forming. But yeah, at around that time is when everything is forming. It's so crazy. Meagan: It's just good to know.Rachel: It is. It is. Meagan: Even if you've had a vaginal birth with a lot of antibiotics from Group B Strep or something like that, it's good to just be aware. Rachel: Yes. It's not necessarily with a C-section, but with antibiotics and stuff. Meagan: Awesome. Rachel: Oh my gosh. Awesome. You guys are the best. I love you. Meagan: We love you back and we are so honored that you wanted to share your story and touch the world around you.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

In episode 135, Miscarriage Hope Desk founder, Allison Schaaf, shares all the details of her experience with Cytotec (also known as Misoprostol or medicated miscarriage). Topics Discussed: Miscarriage options, D&C, Cytotec, Misoprostol, second trimester miscarriage LINKS IN THIS EPISODE Episode 134 - Allison's Most Recent Miscarriage: https://miscarriagehopedesk.com/ep134/ MISCARRIAGE HOPE DESK RESOURCES- Miscarriage Hope Desk aims to help women struggling with miscarriage, pregnancy loss and recurrent miscarriages (RPL), by providing the following resources- Pregnancy After Loss program Moving Forward Program Library of Articles, found here Instagram Community Facebook Community Free Miscarriage Lab Checklist Free Weekly Newsletter FREE MEAL PLANS Do you need help getting healthy, tasty meals on the table? Check out our sponsor Prep Dish, to get 2 weeks FREE! Get a FREE Miscarriage Lab Testing Checklist

We are so excited to have Kaitlin McGreyes from Be Her Village here with us today! Kaitlin began Be Her Village as an avenue for women to register for birth services instead of typical baby shower gifts to help support their transition to motherhood. Kaitlin shares how through her Cesarean and VBAC stories, she learned how to become an empowered and active participant during birth. Kaitlin and Meagan also answer a burning question. What is the real formula for how to have a successful birth outcome? Research, research, research, then trust yourself to make choices that are best for YOU!Additional LinksKaitlin's WebsiteHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Facebook CommunityFull Transcript under Episode DetailsMeagan: Hello, hello you guys. It is Wednesday or maybe Friday or Thursday or Tuesday, whatever day it is that you are listening, today is Wednesday when we are recording The VBAC Link Podcast. I've been a little giddy for this episode because we have our friend Kaitlin. She and I connected. She is with Be Her Village and we actually connected two weeks ago. Maybe a week ago, a little bit ago. We got off the phone and we both felt the same feeling, this energy. Can we just be best friends? That's what you were saying. We're best friends. It's just so fun. We definitely have very similar passions and drives for the birth community and VBAC and all the things. She has a story of her own today that truly led her to where she is right now which I think is one of the biggest things that relates the two of us because my journeys led me to where I am right now at my desk recording this podcast and serving this VBAC community. So I'm going to introduce her a little bit more in just a moment, but we do have a Review of the Week. Review of the WeekThis was actually sent via email as well. We got two emails back to back about reviews. Just a reminder, if you have not had a moment to leave a review, please do so. We love them. They mean the world. Our team loves reading them. You can leave them on podcast apps like Apple or Google. You can send us a social media message on Facebook or Instagram or you can be like Daria did and she sent it to us via email. That is so wonderful as well. She says, “I just wanted to leave a review of my favorite podcast. It's almost an obsession at this point. I had a C-section with my twins almost two years ago and am currently pregnant with baby number three. I'm writing in March as I listen to your podcast on my walks and get ready for VBAC as much as I possibly can. I can't describe how much valuable information and most importantly inspiration it gives me. Maybe it's just pregnancy hormones but I swear I cry every time I listen to moms describing the emotional moments of their birth stories. Nothing feels more precious to me at that moment. I am dead set on having a VBAC in August and all of the episodes of the podcast give me extra encouragement and strength to advocate for myself. I religiously listen to every new episode and maybe I'll get to hear this review soon.”Yes, you will. It is coming up soon, just before your VBAC actually, Daria. It says, “Look out for my next email in August with hopefully a successful VBAC story. Thank you so much again for everything you do for women all over the world.” Oh my gosh. Then she says, “P.S. English is not my first language. I'm from Ukraine but I hope my English is fluent enough to reflect my feelings.” Oh my gosh. Kaitlin, is that not just an amazing review?Kaitlin: I really just feel it. I'm sitting here getting ready to tell my story and I'm getting teared up about the fact that the people listening are in my position right before I had my VBAC. It's such a place of unknown. It's such a place where you need support. It's such a place where there are so many forces working against us unfortunately and the fact that this podcast and my story might help someone in their preparation. It might impact them. It might be what they need to hear to stay and get furiously determined. Oh my god. I love it. I want to give her a hug.” Meagan: I know, right? I just want to squeeze her and say, “I love you. I love you. Yes, you can. Yes, you can advocate for yourself. Yes, you can do the things that so many people in this world believe are unachievable.” It makes my heart so sad to know that there are so many people out there that want a different experience and are told they can't or are told it's not possible. Yeah. I love that you're here. I love that you're in this space. I cannot wait for your email in August myself. Kaitlin's StoriesKaitlin: Oh my goodness. I am so excited. Let's get her her VBAC. Meagan: Yes! Let's do this. Yes. You get so invested Kaitlin. It's so amazing. You get so invested in this community. These people are writing and are like, “Hey, I have a question.” By the way, if you didn't know, you can always email us at info@thevbaclink.com and write us your questions. We love speaking with you. We love doing consults. We love doing all of these amazing things to connect with you and to build you up whether that be through a consult or the blog or just an email or this podcast or our VBAC course. Whatever it may be, we want to help you through your journey.Kaitlin: It's amazing. What you guys are doing, I'm so excited to even be here. This is the work. I've been a doula. I've helped so many people achieve their VBACs and witness them. I've literally been in the room with them, but this platform and everything you've created with it is helping so many people. It's so powerful to have this narrative change. It's so powerful for us to tell our stories and counter what the doctors are telling us, counter what maybe other people in our families are telling us. This fear and this risk and this, “How could you be so irresponsible to think about a vaginal birth? How selfish?”I don't know if we're allowed to curse here, but that is what drives me and that is so powerful to be like, “Nope. I did it. I trusted myself. I trusted my body. My body is not broken. I can do this with the right support, the right advocacy, and a little bit of luck.” Not going to lie, there is a little bit of luck in there. We can do this. That's such an incredible message that we need to keep spreading again and again and again. How awesome is this? Meagan: Oh my gosh. I couldn't agree more. Okay, you guys. We have Kaitlin and if you can't already tell, we just are so passionate about birth and options and birth workers and all of the things. I'm so excited and honored to have you, Kaitlin, on this podcast. You guys, she is the founder of Be Her Village. Be Her Village. Definitely go check it out. She started doula work in 2014 which, you guys guess what? So did I. I didn't know that until actually just barely. We started around the same time. She is so passionate about creating access to maternal care for all. She has a gift registry on this Be Her Village. You guys, it's a platform. It is literally– actually, I'm going to let you talk about it because it is literally amazing and genius. Genius. Kaitlin: Thank you. Meagan: It is such a great tool for people because I'm sorry. I love all baby clothes. I love my baby clothes so much. Kaitlin: I love baby clothes too. I don't tell anybody that, but I also love baby clothes. Meagan: I do, but after my two Cesareans specifically, actually even after my VBAC, luckily my husband was in a situation where he could be with me. He was home all of the time so we had the support but he could have even used some support. I loved all of those cute little baby gifts, but to have some resources or to have that doula that I wanted to hire with my second but my husband was like, “We can't afford it. I don't like the idea.” Right? Tell us about what you are doing with Be Her Village. Kaitlin: Awesome. Absolutely. First of all, thank you for having me. Meagan, I just love you. I love what you are doing. Everyone who is listening, thank you for this space to tell my story. Be Her Village is just my answer to having a baby and having this perfect nursery surrounded by all of the gifts, all of the wonderful, generous things that my friends and family showered me with, and actually having nothing I needed. Just feeling completely alone, being post-C-section because I didn't have a doula. I couldn't afford a doula. I didn't know that I needed a doula. That wasn't the norm. I was just surrounded by all of these gifts and had none of the support. Breastfeeding was hard. The C-section recovery was hard. Life with a newborn was hard. It's just difficult. What I've realized is that our community has so much love to give. They've sort of been tricked into this idea that all I need is stuff. We need stuff.Meagan: Wipe warmers. Kaitlin: Yeah, wipe warmers and seventeen different bouncers.Meagan: You don't really wipe warmers. Yeah. Kaitlin: It's a little extra. I feel like we can get all of the stuff in the baby nursery. You can get a whole baby's store worth of stuff and you're still going to need some support for yourself as a mother. So I thought of Be Her Village. I was like, “Why don't we connect parents with doulas and why don't we give doulas, lactation care, postpartum care, and pelvic floor visits as baby shower gifts?” What an incredible gift to be like, “I'm going to help you get your VBAC. Here's a doula to help you advocate for yourself. Here's a pelvic floor provider so you can get back to running, Cross Fit, or exercise,” which for many of us is a mental health tool. What about impactful gifts that actually care for the mother so she can take care of herself and her baby?Meagan: Yes. Yes. This is something Julie and I did when we were together hundreds of episodes ago saying that you can afford a doula because we are huge advocates here for our doulas. Clearly, we've seen the impact and we just know this impact, but we talk about asking for money towards something else. You don't have to. But this is an actual tool and resource where it is easy to do that. It is easy to do. It is easy to register for that. It's incredible. I'm obsessed with it.Kaitlin: Thank you. Meagan: I'm obsessed with you and I just can't wait to one day actually finally meet you in person. Kaitlin: Oh for sure. Meagan: Yes. Just yeah and just to see you grow because this is so amazing. Women of strength, we understand. We understand that finances are not always in a place to have a birth doula, a photographer, a lactation consultant, a postpartum doula, and a PT pelvic floor or to give birth out of a hospital and all of these things. We know that these things cost. We know that they do but I'm telling you right now there is serious value in this and it is honestly so amazing to have a doula or support versus a baby wipe warmer or one extra pair of newborn onesies. Kaitlin: Yeah. I want to provide insight into that. It's not just that it feels good to moms because that's something that we're not always comfortable with. “I'd rather get something for my baby. I don't need to feel good. I can do hard things.” And we can. We can do more than we know. But using a doula reduces your chance of a C-section. Using a doula reduces your chances of an episiotomy which is where they cut your perineum. It reduces the chance of forceps use or vacuum use. It reduces–Meagan: Time in labor. Kaitlin: Time in labor which I'm like, “Just sign me up right there. Are you kidding? Forget about it.” Meagan: Labor can be shortened by at least 41 minutes. Kaitlin: And you know what? It's more than just the shortness of the labor, it shortens pushing time and it increases the APGAR score of the baby which is literally the baby's health upon being born. There are just so many things that a doula does. It's not a promise that one doula will do that for you but collectively when people line up doula support, their outcomes, and their baby's outcomes are better. If you're thinking about a VBAC which I'm guessing you are if you're listening to this, you need to get a doula. You need to think about a doula. It has always been this thing that I personally even as a doula felt uncomfortable saying and recommending because how can you say, “Hey, doulas are vital. Sorry, you don't have $1000.” Meagan: Or more. Kaitlin: Or way more. It's such an uncomfortable conversation. That's why I created Be Her Village because 12 billion dollars are spent on baby gifts every year for baby showers. It's like, “Well maybe the generosity exists. Maybe the love exists and maybe the money exists. We just need to create a platform where people can line up their doulas and ask for them for their baby shower gifts.” That's exactly what we did and we've had over $135,000 gifted on Be Her Village directly to parents. They're getting the gifts. They're getting the support and it's literally the coolest thing in the world. Meagan: It's so amazing. Kaitlin: It's just so cool to see it come to life and to have people find out about it, then literally get better gifts that are taking care of them and improving their entire experience. Unfortunately, it's because I needed it. I wish I could go back in time and do it again which is something we really often hear is, “Oh my god. Where was this when I was having my baby?” Meagan: Right? That's why I'm here right now. I needed more. I felt alone in so many ways preparing for my VBAC. Everyone looked at me and was like, “What? You're doing what?” I'm like, “Yeah. I want to push a baby out of my vagina. Why does that seem so weird?” Because I had that Cesarean, everyone was like, “No, you can't do that.” I'll tell you what, when I came around to that second C-section and was wanting to have a vaginal birth, it was even more mindblowing to people. It felt very lonely and cold. I was like, “No. No.” There wasn't a lot of inspiration. Facebook was going on and there were stories being shared but there wasn't inspiration like what we have today. There wasn't a lot of knowledge in one spot so that's why we're here today. Kaitlin: I have to say that one of the things too, and there is so much to talk about, but this is actually part of my birth story too so it's such an interesting place to begin. I think people legitimately think that vaginal birth and Cesarean birth are equally risky or quite honestly even the opposite. They think that vaginal birth is more dangerous than Cesarean. It's like, of course. If that's the underlying held belief, the subconscious belief is that vaginal birth is risk and Cesarean is not, then of course, Meagan, why would you do that? Why would you risk your life and your baby's life just to have a vaginal birth? You don't get an award for that. I'm just imagining what these people are thinking. Meagan: They would say that. Kaitlin: You don't get an award and it's like, “Well, hold on a second. What if we actually find out where the risk lies?” That was something. I was not set on a VBAC. Not at all. I was totally disappointed. I was probably the least impactful word I could use but there was just a defeated feeling about my C-section. I just felt like, “Oh, that wasn't really what I wanted.” I also went into my VBAC birth, my second pregnancy sort of like, “I'm not going to take unnecessary risks for my baby or for myself just to get the VBAC badge or the vaginal birth experience.” You have to balance your desires with what's risky and what's safe. So I didn't research. I remember one of the things that stood out for me was that I had this vision of– and I'm sorry. Get your earmuffs ready. This might trigger somebody. But I had this vision of vaginal birth ending in hemorrhage and being very, very, very scary and very dangerous. I don't know. This is what you see in the movies. So I didn't research this. I don't know if you know this Meagan. I'm so excited if I can share this with you for the first time but vaginal birth hemorrhage is 500 ccs of blood loss. Cesarean normal blood loss in a totally run-of-the-mill, we-did-a-great-job, there-was no-extra-bleeding Cesarean, is 1000 ccs. It's double. Meagan: Yes. Kaitlin: As soon as I realized that, I was like, “Oh. We're not talking about the same thing. Everyone talks about vaginal birth and C-section on this leveled playing field and we are not in the same ballpark.” That is incredibly risky when it goes normally. It is twice as risky as when a vaginal birth goes horribly wrong. To me, it's like, “Oh, we're not even in the same stratosphere.” It's a completely different thing. I think once we start talking in facts and figures and we start really sharing that, it takes so much of the fear away. The fear can be such a big monster to deal with when we're talking about VBAC because it's scary. There are unknowns. Every pregnancy is a little scary because fear is what drives us but if you walk away with one fact from this podcast, just know that it is not the same thing. It's not even close to the same thing. Meagan: It's not. It is not. It isn't. Even with vaginal birth after a Cesarean, yes. There are risks to having a vaginal birth after a Cesarean, but it's also not the same thing. There are also risks for a second Cesarean, a third Cesarean, and a fourth Cesarean, and the risks are pretty substantial. It's important and I encourage you if you are preparing to actually look at the pros and cons of both sides. I also want to point out that sometimes the cons of a vaginal birth might make you be like, “Yeah, I don't want to do that. That's actually not what I feel comfortable with. That's not what my heart says.” And that is okay. Also, know the risks and the cons of the other side. So know the pros and the cons of both vaginal birth, vaginal birth after Cesarean, and vaginal birth after multiple Cesareans. Know those risks. Dial in and decide what risk is applicable, safe enough, and comfortable enough for you. My risk, I live a little bit more on the edge. I have jumped out of a plane multiple times and I have a friend who thinks that is the scariest thing and she won't do it because she has children. She fears the risk of dying. I totally understand. Kaitlin: I'm like, “I would VBAC every day of my life and I will never jump out of a plane. They are not the same risks.”Meagan: Right? So not the same risks to you and to me. So I'm like, “Yeah, my risk is nothing. It's not enough for me to not jump out,” and you're like, “Yeah, no. I'm not doing that.” So it depends. There are benefits and risks to both sides. You have to decide what is best for you. What risk is impactful enough for you to make that decision? Know that it's okay if you are not making the decision that Sally is making. It's okay. It doesn't make you any less of a woman of strength. It doesn't make you any less of a mother. Nothing. You're not failing your body. You're not failing your baby if you make one choice or another. Kaitlin: Absolutely. The big thing is that you have to get that information so that you know the right information so that when you have to go talk to a doctor and they write you off and say, “Nope. We do repeat C-sections because it's risky,” that you actually know what they're talking about and you actually know whether you are at risk or not because there is a much bigger picture than what you might get at a standard OB's office. Meagan: Yes. Absolutely, so this information is so important. Cesarean Awareness Month is April and one of the biggest things that a lot of say are, “So are we promoting Cesareans?” It's not that we are promoting Cesareans, it's that we are promoting information about Cesareans, VBAC, and your options. Even though Cesarean Awareness Month is in April, every month is Cesarean Awareness Month in my mind. Every single month and every single day is information that we need to be sharing, that we need to be getting out there because women of strength, you need to know these stats and these facts so that you can make the choice that is best for you. Kaitlin: Yes. Oh, I love that. Meagan: I don't know exactly all of the choices and the things that led up to your Cesarean but for me, I didn't know. I walked in. I was uneducated, you guys. I was young. I was 22. I just knew I was going to have a baby. I went to the same doc that my mom did who delivered me via Cesarean coincidentally and all of these things. I just didn't know. It takes knowledge. It takes time. It takes time. If you are willing to put in that time, you will likely, even if it ends in a Cesarean, feel better about your outcome and carry on with your life. Kaitlin: Yeah, and that VBAC prep, I don't think anyone here is anti-Cesarean. It's such an interesting thing to point out because there's nobody out there that is saying– April is not an anti-Cesarean month. Meagan: No. It's awareness. Kaitlin: It's awareness so that you can go in with intention, with a conscious choice, and with the information you need. You know what? I went through a whole research phase. I was not sure that VBAC was for me. I wasn't because I wasn't sold one way or the other, but the ability to have a choice is everything. That is where your power comes from. It's not from being the loudest, the strongest, the fastest, or even having a VBAC. It's about getting there on your terms. I know people who have had surprise VBACs believe it or not. I should send her to you. A surprise VBAC was not planned and she was kind of traumatized by it because she was planning a repeat C-section. She didn't go through that prenatal that a lot of people listening are going through of, “Okay, so what are my options and how do I step into my path here?” Whatever that path might be, there's a lot of power and a lot of healing in whatever birth you have, but unless you do that work of identifying your choices and not just your risk assessment but also your practitioners and lining yourself up with support, then you're going to be sort of that passive participant. I think, not all of us, some of our C-sections come after being active, but with a lot of us, myself included, there was this passivity where as soon as I hit the hospital, I was stripped of my power, stripped of my clothes, stripped of my humanness, and told to lay back flat. Keep the baby on the monitor. Here's your medication and boom. That's a C-section. It all happened to me and I wasn't actively there. That was a big part of what changed for me. I felt like I benefited from my VBAC whether I had a C-section or vaginal birth. For the record, I absolutely asked for a C-section as soon as I hit transition. I said to my doula, “Okay. I'm done. I'm done with this. Can we just get a C-section?” I'm really glad I asked my doula and not my OB. Meagan: Right? Right? Your doula and your team were probably like, “Wait, wait, wait, wait, wait. Let's give her ten minutes.” That is a very normal thing too to say. We need to hear your stories. Let's hear them. We could chat forever. But let's hear these.Kaitlin: Oh cool, okay. I know. We're already halfway through. I can give you a quick synopsis of the C-section because I feel like it's always relevant when we're talking about VBAC. My C-section was a 41-week induction, the oldest story in the book. Mine was a little bit interesting because I actually planned an out-of-hospital birth and I planned a midwife-supportive birth. I got a little bit of the bait-and-switch. It's a little spicy because in New York where I was giving birth at the time, midwives could not own a birth center. Now they can, there has been a huge push in legislation on that but at the time, I was told that midwives were in charge of my care and they were not. They were on the phone with an invisible OB I had never met. I did not know he was calling all of the shots. I always start off by saying that I planned an out-of-hospital birth with midwives. I thought I was doing all of the right things. That is part of what makes me feel a little extra angry about my treatment because I thought I was doing the right thing and I wasn't. Meagan: They never told you that you were actually under an OB umbrella?Kaitlin: Nope. Everything was midwife-facing. It was really disingenuous the way that they did that and then basically at the 41-week appointment, literally, an OB was on the phone with them in their ear telling them it was time to induce and I was sent to the hospital for an induction. I didn't know that was the bad part. It's only sort of upon reflecting and becoming a doula and realizing that, “Wait. They were never really in charge.” Meagan: You never actually had the midwife you thought you had. Kaitlin: No. I was not in midwifery care. I had a midwife mouthpiece for an OB. Meagan: Oh my gosh. Kaitlin: That wasn't great. It's also awful because that's the only birth center in New York. New York state is so far behind the rest of the country in a lot of ways and birth centers are definitely one of them. I want as a doula, in my heart of hearts, I want to recommend birth centers but I can't recommend that one because of the way that they behaved and their ownership. So I went to the hospital and it was alarming to me how fast the power was stripped away. My voice– my midwife dumped me there and left me there. This is crazy to say because I'm such an advocate and I've doula'd people through so many things that to say I allowed this for myself is kind of amazing. I was given Cytotec, a double dose of Cytotec in the C-section recovery room. That's where they sent me because I was in this busy Brooklyn hospital and I was set up with Wendy, the nurse, who I hate. I still remember Wendy. These people become bigger characters in your story. Meagan: They do. Kaitlin: Because they stay with you. But anyway, long story short, I went from nothing eating a sandwich with my family to absolutely full-blown, every three-minute transition level contractions. I couldn't move. She wouldn't let me move off of my back. I felt like a trapped animal. I ended up getting the epidural because my whole birth plan was out the window. Meagan: Oh, I'm sure. Kaitlin: I was like, “Why am I torturing myself?” and the baby didn't respond well to the epidural. His heart rate went down and I just looked at my team. They all looked very nervous and I said, “What are we doing here?” She said, “The OB is going to come to talk to you in about 45 minutes.” I'm like, “This baby is actively in distress.”Meagan: But your baby is not doing well.Kaitlin: Actively in distress. The OB was going to come in 45 minutes. I looked at her and I say this, the only reason this is okay is because I said it. I would never say this to another person but I looked at her and I said, “I want a healthy baby. I want a healthy baby at the end of this.” I say that because it's really toxic to be like, “At least you had a healthy baby.” It's like, “Okay. I get to say.” What I was trying to say to her in the fog of the labor was, “After all of this misery and all of this horrible treatment, at the very least I would like a baby that's alive and handed to me.”So I did. I got a C-section. It was scary. It was cold literally and otherwise. It was not what I wanted. It was not the ending that I wanted. I ended up in my house. My husband was back at work. He didn't have literally any time off and he was back at work the day that I was released from the hospital two days later. It was just underwhelming. It was not how I wanted to enter motherhood. Meagan: No. Kaitlin: In the least. I felt like besides the physical– the physical recovery was horrible and I recovered really well but it was just so intense. It's major surgery. I also just felt disempowered. I felt highly anxious. I didn't realize it until later that it was postpartum anxiety but I was just so set off-kilter by the whole experience. It just took my power and my voice and my strength away from me and then handed me a baby and a C-section scar. I was like, “Oh. That's not how I thought motherhood was going to go.” Meagan: Oh my gosh, yeah. That's hard and being alone. Oh, man. Kaitlin: Yeah, being alone. Meagan: It started your journey off really intensely. Kaitlin: It was really hard. Then when I had my second, I just knew it needed to be different. I knew I needed to do more research. I actually, this is funny. I did everything the opposite. I planned hospital birth. I planned an OB birth. I hired a doula. Everything I didn't do, I did the opposite. But the thing I did along the way was that I was really intentional about all of my choices. I found the doctor that does VBACs where I live. There's a handful of them and I found Jessica Jacob at North Shore. She does a lot of Orthodox Jewish women who see her. That's her practice. A lot of those women have 6, 7, 8, and 9 babies so when they have a C-section if the thing is “once a C-section, always a C-section,” that can result as we talked about earlier, that can result in really dangerous situations. So she specializes in VBAC, vaginal births, and preventing those primary C-sections.So I went to her. I had done my own research and then I went to her and said, “Knowing my story and looking at my chart, am I a candidate?” She said, “Absolutely.” I was like, “Okay, sold. I'm in.” Meagan: That's awesome. Kaitlin: Yeah, it was really good. This one was so much less traumatic and not even less traumatic. I had a full-blown spiritual experience with my VBAC. It was completely on my own terms. It was private. The day that I went into labor was my due date believe it or not. What a magical little baby. Awesome and obedient and wonderful. Now he's not. He's not obedient at all. He's 8 now. He's not obedient. But it was actually Father's Day in 2014. That was my due date. I woke up with these little Braxton Hicks turned into these contractions that would– you know the Braxton Hicks where they just tighten and release and you have them forever? It was like that except at the very height of it, it was this little squeeze that just took my attention. I was like, “Oh, what? What is this?”Meagan: You're like, “Oh, something's happening.” Kaitlin: Because I had never been in my own labor. This is part of it. I had never been. I had this suspicion, you know that intuition, I just knew that if I could get into labor, I could do this. I went to an acupuncturist, one that my doula recommended. They put these beads on my ears. I don't know if you've ever had this Meagan.Meagan: No. Kaitlin: Okay, so they put beads on my ears in these pressure points and they taped them. Then he told me as much as I could, and I am touching on the actual points because that's where they were. I'll never forget where they were. And to just pinch them and just keep doing that as much as you can to activate. Meagan: Really?Kaitlin: I did it. That was Friday. Friday night was when I went. I pinched and squeezed those until Saturday. I literally ripped the tape and the beads off. I was totally overstimulated and couldn't touch them anymore but I did as much as I could. I remember knowing that I had an instinct that I was going to go into labor because I could not stop eating the day before. It's so interesting how our bodies know. Meagan: It's fueling. They're fueling. Our bodies fuel. I did the same thing with my VBAC. It was so weird. I had all of this energy and was eating all of the stuff. Kaitlin: Everything. Meagan: Everyone was like, “How are you eating that much? You're 9 months pregnant.” I'm like, “I don't know. I'm so hungry.” Kaitlin: My husband, we went out for lunch and he got food for me, him, and my two-year-old at the time. I remember looking at him and I was like, “What are you guys going to eat?” I was insatiable which had been different from any other day. So anyways, I wake up on Father's Day, the day of my birth and it was this incredible, gentle, slow labor which was such a wonderful way to learn how to work with my body. The whole morning was this questioning time of, “Am I in labor?” In between, I was literally like this talking in between. I would convince myself, “No, not in labor.” There was this whole discussion of, “Should we go to Father's Day brunch?” Then I would have a wave come and I was like, “No, no, no. We're not going to sit at a restaurant right now.” Meagan: Yeah, no. Kaitlin: So I labored like that all day with just me and my husband. We watched World Cup soccer. We got lunch. We were eating. I was learning how to move. I was learning how to breathe. Every single contraction was just this opportunity to figure out how to work with my body. Then the nighttime came. It's what you learn in your childbirth classes. At night, the night falls and it signals this privacy and safety. Again, it was still just me and my husband. Things just picked up. Oh my goodness. I remember my doula called me. I had been texting her all day. I didn't want anyone to come. It was so private. She called me and we spoke. I just gave her an update then we hung up the phone and it's amazing the switch. Everything about labor is so mental and emotional. I just kicked into high gear. The waves that I was able to get on top of earlier, it was taking the full essence of my being to work through these contractions. It was so incredibly wild how fast that happened. We labored at home until maybe midnight. Yeah, about midnight. We called our doula. We had called the doctor and said, “Hey, I think we're going to come in.” The doctor said, “Well, she might get turned away. She's not ready.” Because this is what VBAC-supportive looks like. It looks like saying, “You might not be allowed to be here because that's how I keep you safe in this hospital.” I remember that really stood out to me. It was like, “Oh, this is interesting what she is saying. Maybe I shouldn't come.” So we waited as long as we possibly could. We called the doula around midnight. The doula came here to my house. I was on my knees next to my bed. I could not be in my bed for hours and hours. I looked at her as soon as she got there and I said, “Let's go. It's time to go.” She was like, “Oh, okay. I just got here.” Between my bedroom and my car, I had probably five contractions. It was just one after the other after the other. At this point, I'm thinking that I'm going to go to the hospital and spend the day there. My mom will come for the birth. I'm not really getting–Meagan: Where you're at. Kaitlin: Where I am in labor because it's part of labor. You just kind of can't tell. Meagan: It's true. There's no sense of time. There's no sense of understanding sometimes. You're like, “I know I'm feeling this, but it's probably going to be a while.” Kaitlin: Yeah, that's actually literally a part of it. You're not supposed to know. Your brain shuts down. The prefrontal cortex of language analysis shuts down and you're living in this beautiful other existence where you're in a wave. You're out of a wave. You're in a wave. You're out of a wave. So we went to the hospital. I walked all the way up. They offered me a wheelchair and I was like, “I literally cannot sit down. There's not a chance of that.” So I waddled my way and had contractions every few minutes. When I got to the floor, they were like, “Okay, just skip triage. Go right to the room.” They took one look at me. I think they obviously knew that I was much closer than I knew. I went to go pee in the bathroom in the room right before I went to go lay in the bed and get checked or whatever. When I sat on the toilet, I had a contraction and I now know it was spontaneous pushing. But I had this contraction where it was like, “Oooohh.” Meagan: Yeah. Uh-huh, uh-huh. Kaitlin: At the top, the peak, when you're moaning, it just caught. It was like, “Oh my god. I think I'm pushing.” It was this weird thing. It was weird because I hadn't experienced it before. So I got in bed and everything was really a blur because the doctor came. She checked me and she said I was 6 centimeters and +2 station, -2 station. I wasn't ready. When I was pushing and I was working, the best thing she did was she just said, “Okay. Just do your thing. I'm going to be right outside.” The nurses were skirting around asking me so many questions and I just ignored all of them. Where I was, was in the stars. I was just so far away from the hospital room. It doesn't make sense but I just imagined this tunnel from the top of my head to the outer regions of the universe. That's where I went. I went to this place that was just completely apart from the realities and the things that the nurses were worried about. I just could not care less. I was so deeply in tune with what I was feeling and where I was going in my brain and my body. I remember feeling so primal in a good way. The first time, I felt like a trapped animal and this time, I felt like this primal goddess being just feeling deeply connected to every sense of myself and every sense of my body. It was just wild. It's hard to put into words but it was one of the most powerful experiences I've ever had laboring my baby down and pushing him out. There was no other anything at that moment. It was just me, my body, and this baby. It was the coolest thing I've ever done. There were funny moments in it too. This is the reality side of it. At one point, I was curled up on my side against the side of the hospital bed. In the middle of a contraction, the bed starts going up and down, up and down. Meagan: Was your head pushing it?Kaitlin: I snapped at my husband, “Why are you moving the bed?” He was like, “It's you.” Meagan: It's you! Kaitlin: So it was quite the sight. But yeah, and he just flew out. My body just apparently, so I didn't realize this until a lot longer later, but I experienced fetal ejection reflex with my next baby who was a home birth, but I experienced it with him too. He went from inside of me to in the doctor's hands in one big push. It was just wild. It was really wild and it was really, really the coolest thing ever. It's hard to explain how intense the moment is and how good it feels to have that relief.Then the oxytocin was just pulsing. Everything is good. I remember he was put on my chest and he was so alert. He was so awake. He was not drugged. I was not drugged which was not necessarily part of the plan. I just want to throw that out there. I was wanting to go without an epidural but it wasn't–Meagan: Set in stone. Kaitlin: I wasn't deadset on it, yeah. I was open to whatever happened. Meagan: Which is healthy. That's a healthy way. Kaitlin: Because who knows? But it was so cool to have him go through those initial stages and be aware of his surroundings. I remember feeling even in that moment of joy, I remember feeling a little bit like I was experiencing what was stolen from me the first time around. It felt like a little bit of grief associated with that. I'm getting a little teary-eyed thinking about it right now. I honestly think it's why I had a third baby. I should have had this. I should have had this the first time. He looked just like his big brother. It was just this feeling of, “I was really robbed.” I knew I was robbed the first time but I didn't know what necessarily. Meagan: Right, because you hadn't been there yet.Kaitlin: I just knew there was something I was missing. There was this incredible feeling of triumph. That was absolutely the overwhelming feeling but there was this little linger of grief too, of just, “Oof. Now I know what I missed out on.” It was beautiful. I screamed from the top of my lungs, “I just had a baby out of my vagina!” Literally, the entire floor of the hospital could hear. My doula sent me a video of that later on. Meagan: Oh my gosh, I love that. I love that you have that. Kaitlin: Yeah, I'd have to find it but it was just this pure, pure triumph. I was forever changed by that. I was forever changed by the whole experience and that vaginal birth was the culmination of all of the work I put in. It was the culmination of doing the research, lining up my support team, and doing this work to be an active participant in my care. It was the best thing in the whole world and I am forever changed by that moment. Meagan: Yeah. I love that you said being an active participant in your care. It's so important, listeners, for you to be that person in your birth and not have birth happen to you. We know it happens. We know. It happens way too often. I hope in time that we stop seeing it happen so often and it's more of a rarity but right now, a lot of the time– I don't want to make it sound like we are painting a bad picture on providers or the system or anything like that. I mean, look. You were going out of the hospital–Kaitlin: And I still got burned.  Meagan: It depends, right? But it's so important and it all stems back to what we were talking about in the beginning is having the education, having the support, and being prepared to be that active participant and to be that person and finding those supportive providers that will say, “Hey, why don't you stay? You're probably going to get sent home for a little longer.” It's just so important and it can be vital to the outcome of our birth. Kaitlin: Yes. That's such an important thing, Meagan, if people are listening and trying to take things away. I think something that we can do often is, “I'm going to listen to this. I'm going to listen to as many birth stories as I can so I can learn exactly the formula. What did she do? What did she do? What is the thing that I have to do?” The thing you have to do is get the information and then trust your gut. Part of being an active participant is research, research, research, then trust your gut. That's what I always tell people. Do all of that research, but at the end of the day, you're the only person that can make each of these hundreds and thousands of tiny decisions for yourself. That's the real formula. Meagan: Yes. Kaitlin: Trusting our instincts, trusting ourselves, trusting our own wisdom in these moments to steer us and guide us forward. Meagan: Yeah and just like each of our bodies is made out of different things and chromosomes and hormones and all of the things, we are made to be the person we are, we have to trust all of those things. Like she said, and create our own formula because her formula is going to be different than mine. She's not jumping out of a plane. I jumped out of a plane twice because I loved it so much. I had to do it again. Kaitlin: I'm definitely not jumping out of a plane. Meagan: Right, I'm just saying that the formula is going to be different. You have to tune into your own formula and it does start with that intuition, education, and gathering support. Kaitlin: Meagan, you said it earlier too. I know we're running out of time. Meagan: No, you're fine. Kaitlin: You can see all of those stats and also do the opposite. You can see that it's safer to have a C-section and choose a vaginal birth. You can see that vaginal birth is riskier for you and choose that anyway. The evidence is there. The “evidence” is there as part of the decision making but you get to do what feels right for you and your family and your baby and your body and your birth. That is the thing. Evidence is not everything. It's one of the tools that we have. Meagan: Yes. Mic drop right there. Oh my gosh. Thank you so much for being with us today. I mean, I know that we could talk for hours and hours and hours about all of the things. We probably need to do this again because of that. Kaitlin: I would love that. I love you and everything you're doing here. Thank you so much for having me. Meagan: Thank you. Can you tell everybody where they can find Be Her Village?Kaitlin: Absolutely. Behervillage.com is a great place to start. You can just hit the “Get Started” button. You can create a registry or if you're a birth worker and you want to get involved with what we're doing, you can add your services. We have training courses. We have so many great things. You can find us on Instagram and Facebook. Both are @behervillage. I'm in the stories. I'm answering the messages on Instagram so if you want to be in touch, that's the best way. Meagan: Absolutely. We'll make sure to drop all of those links in the show notes. So while you're leaving a review, also go check all of these amazing links out because Be Her Village is incredible, doing amazing things, and is seriously so important. So, so important. Thank you again so much. Kaitlin: Thank you so much, Meagan. Bye, everybody!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

Nicole joins us today from Canada. She has had an induced Cesarean birth, an induced VBAC, and is now pregnant with her third baby! Nicole shares her journey with IVF before pregnancy as well as what it's like to have a subglottic stenosis during pregnancy. Meagan gives tips about the best types of induction for VBAC. You can be induced and still confidently achieve your VBAC!Additional LinksHow to VBAC: The Ultimate Prep Course for ParentsThe VBAC Link Facebook CommunityFull Transcript under Episode DetailsMeagan: Hello and welcome to The VBAC Link. This is Meagan and we have our friend Nicole with you today. She is from Canada and she has a VBAC story which is awesome. One of the things I wanted to talk about today within her VBAC story and her Cesarean story is induction. Induction is a hot topic, especially in the VBAC world. A lot of providers out there will not induce or they'll tell people they can't have a VBAC because of an induction needing to take place or people are scared of induction. I find that a lot of our followers are scared of induction. So at the end, I want to talk a little bit more about induction. Review of the WeekMeagan: We are going to get into our review so cute Nicole can share her stories. Today's review is, let's see if I can get this to pull up. My computer's slow here. It's by Rucca the Silly Frenchie. I love that name. Lucathesillyfrenchie. The title is, “An essential resource if you are VBAC hopeful.” It says, “Writing this review from Columbus, Ohio. I'm a VBAC hopeful with my second daughter due on September 4, 2021.” So Rucca the Silly Frenchie if you are still listening, let us know how things went. It says, “After my first daughter was born via Cesarean due to a footling breech position, I knew TOLAC was in my future. This podcast has been beyond educational and inspiring. Be prepared to be addicted to listening to all of the powerful and unique birth stories from strong women around the country. Regardless of what happens with my upcoming labor, I feel empowered knowing I took a more empowered and educated approach with this pregnancy. Thank you, Julie and Meagan.”Thank you, Rucca the Silly Frenchie for your review. I would love to know how everything went. If you guys have not had a chance to leave us a review, please drop us one. We love them and we love reading them on this podcast. You can leave them wherever you listen to your podcasts. Hi birth workers, this one's for you. In an ideal world, VBAC parents would be treated just like other birthing parents. In today's world, most medical providers sadly don't fully support VBAC parents. However, 90% of parents with a prior Cesarean are good candidates to attempt a VBAC. This is why we have created the advanced VBAC doula certification program. In this doula course, we share evidence-based data for you to educate your clients, teach you the tools on helping them how to process past fears and trauma or help them decide if VBAC is even right for them. You will feel better prepared to support them during this beautiful experience. All VBAC-certified doulas are listed on our website so parents know who you are. To learn more, go to thevbaclink.com.Nicole's StoriesMeagan: Okay. Nicole, I am so excited. Thank you so much for taking the time out of your day. I know that all of you guys here who have recorded your stories are sacrificing time out of your day to be here to share this amazing content for all of these wonderful, hopeful listeners. Nicole: Thank you for having me. I'll jump back to before my Cesarean, but this podcast was such a resource for me in planning for my VBAC so I'm happy to be a part of it in a different way. So thanks for having me.Meagan: Yes, thank you. Nicole: I'll start from the very beginning. My husband and I were high school sweethearts. We got married in 2015 so about a year after we got married we decided, “Okay. We're ready to start trying to have a family.” I stopped taking my birth control pill and literally nothing happened. I wasn't having any cycles or anything like that. So I went to my family doctor. We started inducing cycles and then going from there just on our own. It turns out that notwithstanding the fact that we were inducing a bleed, I wasn't actually ovulating at all. So that's fine. So then we started doing a couple of rounds of letrozole with her just with timed intercourse. We did five rounds of letrosole with that timing with her and then with no luck or success at that point, she referred us out to a fertility clinic where I was diagnosed with classic PCOS and ovulatory PCOS because I don't ovulate on my own. So we did the first IUI with them. Again, no success with letrozole so that's fine. We had another one scheduled. After doing all of that, I had stopped responding to the letrozole at the highest dose so then our only option was either superovulation or IVF and it just worked out timing-wise to do IVF and it made more sense to do that. We ended up going through IVF and because I had PCOS, the numbers that we got in terms of eggs were really, really good. We got 41 eggs which is insane. Meagan: Wow, yeah. Nicole: When it was all said and done, we ended up with 10-day five embryos which was really promising so that was good. We had our first transfer, a frozen transfer, in August 2018. It was successful so we were super excited. I had a really good pregnancy. I never felt sick. Aside from the first-trimester fatigue and exhaustion, I felt really, really good. I loved being pregnant. I was one of those annoying people. I never complained about being pregnant. I felt super good. Even at 41 weeks, I wasn't like, “Oh, get this baby out.” I loved it. It was great. Of course, we did all of the things that you're supposed to do like taking birth classes and all of those other things. I never had a birth plan per se. The birth plan and goal were just a healthy baby and a healthy mom whatever that looks like. Maybe in hindsight, we should have had something more concrete but I'm not sure it would have changed anything. Fast forward, I was 40 weeks plus 10 days, so 41 and a half weeks, maybe a centimeter dilated. Baby was just holding up shop. Meagan: Very comfortable. Nicole: Yeah, too comfortable, arguably. They decided to induce me and I was totally fine with that. They induced me with Cervadil. It was fine. They put in the Cervadil We stayed there at the hospital for about an hour or so. Everything on the monitors looked fine so this one woman said, “Come back when you have contractions for at least an hour lasting a minute,” or whatever the 4-1-1 is.  Meagan: Yeah. Four minutes apart, one minute long, for at least an hour. I want to add in strength because sometimes it can be 4-1-1 and it's not really strong so we go in a little bit early because we are seeing 4-1-1. Add strength in there if you are taking notes for when to go. Add strength. Nicole: Yeah, so when we left the hospital, it was fine. We went out for lunch and just hung around at home. Other things they told us before we left the hospital was if it feels like baby is not moving, if your mother's intuition kicks in, to come back and they'll make sure everything was fine and they'd go from there. It was around suppertime and I started to feel like, “Okay. Maybe baby's not moving as much as she usually does or maybe I'm just being paranoid.” I said, “Let's just go in. Let's double-check just to be safe. I'm not going to get any sleep if I'm worried about her not moving so I'd rather just go in and get it checked.” We went in to get checked a little after supper so in the early evening. That was fine. They hooked us up to the monitors and everything looked okay. I could feel the contractions but I wasn't really in any pain. I wouldn't describe it as being painful yet. Baby looked really good and everything so they said, “Okay. You can go home” because I was still, I think, only a centimeter or maybe 2 being generous. They said, “Yeah, go home,” on the same kind of instructions so that's fine. We went home. A few hours went by at home and now the contractions were quite a bit stronger and quite painful actually. I didn't want to rush off to the hospital again because we had only just been there two or three hours before that but the contractions were very painful and very long. So I had one of those little contraction counters or whatever on your phone and I wasn't sure if I was recording them correctly. I was logging them at two minutes but I was like, “That doesn't sound right. That seems long.” I was like, “I can't imagine spending the night at home with these feelings like this. I need something for my pain.”I actually had my husband call the hospital and say, “Okay. This is what's going on. If we come in, are we able to give her some pain meds and send her back home?” or send me back home if I'm not dilated enough yet to warrant admitting us. They said, “Well, maybe but you were already here for lack of fetal movement so there would be some hesitation about giving you something for it like morphine for example because then you are really probably not going to be feeling the baby. But come in. We will take a look at you and then go from there.” So okay, that's fine. We ended up going back to the hospital maybe around midnight or shortly before then. It was quite late. I could barely walk through these contractions. They were so painful. In the back of my mind, I couldn't imagine it getting any worse but I'd never done this before. Maybe my tolerance for pain isn't as high as I thought it was or would like to think it is so that's fine. We got back to labor and delivery. Right from the moment they hooked me back up onto the monitors in the triage room, you could just tell the vibe and the mood were completely different as soon as they looked at the strip. My contractions were lasting anywhere from 2-3 minutes. More than not as I was having 3, 4, 5 of them in a row without any break in between which was then really hard on baby because there was just no amount of time for baby to recover. So before one contraction would basically fully come down, another one would start. Meagan: Wow. Nicole: They were worried that the Cervadil has essentially hyper-stimulated my uterus. Meagan: Yes, that's what I was going to say. It can do that. Cytotec and Cervadil can hyperstimulate. Nicole: Yep. So the first thing they did was take the Cervadil out. They said, “Okay. We're just going to give you a little bit and see if things go down.” They didn't. Meagan: Yes. But even Cervadil is less likely to stay in your body as long because it is removed so that's a nice thing about Cervadil. Nicole: Yeah. They took it out and it didn't change anything so then they gave me a dose of, I think it's called nitroglycerin. It's a spray. I don't know if it comes in different forms but essentially it was described as what they can use in an attempt to relax the uterus and stop it from contracting. Meagan: They sprayed in your vagina? Nicole: In my mouth. Meagan: I was like, wow. Okay, in your mouth. Okay. Nicole: I think it's also used for cardiac patients because it has the same effect on the heart if someone's heart is having a heart attack or something. Meagan: If it's too high or something. Nicole: Yeah, don't quote me on that. I'm certainly not a medical professional but that was my understanding on that. Anyway, so they gave me something like five doses of that. Again, this is at this point a train that had left the station and nothing was working. Throughout this process, they were having me change positions so I'm being asked to go on my side and my hands and knees. I remember at one point, there was so much commotion and moving parts. I'm still having these super intense and painful contractions that they had asked me to move in some way and I said, “Okay, I just need a minute. I just need to catch my breath. I just need a minute.” The nurse very sternly but kindly looked at me and said, “We don't have a minute. When we ask you to do something, you have to do it. We ask because baby is not doing well.” That's kind of when despite all of the craziness, I clued in. I was like, “Okay. This is obviously maybe more urgent than I appreciate in the circumstance. So it was intense and scary. They decided that even though I was only 2 centimeters just to admit me because what are they going to do, send me home? They put me in a labor room because, until this point, we had just been in a triage room. Things kept going from bad to worse. At some point, it was decided that they would break my waters so that they could put in the little internal monitor to baby's head. They did that. I had a few more doses of nitro. Throughout this whole process, I made it very clear, “I am pro-epidural. As soon as you can give me one, I want one. Give me one right now.”They said, “Okay, we hear you but technically you aren't even 3 centimeters dilated yet so you're not even considered to be in active labor so we can't give you an epidural yet.” I said, “Okay. Just so you know, I want one as soon as you are willing to give it to me.” I'm not sure how much time actually passed after. They broke my water and looked at the monitor until the call was made, “Okay. It's time to get baby out.” But I kind of just remember the OB who was on call coming up to me. He was this big, intimidating man. He had such a gentle and soft voice. He said, “Look. Baby is not doing very well. I think we need to go in and get her. She's not tolerating labor and it's really important that we get her out as soon as we can.” He's like, “Unfortunately, that means we are going to put you to sleep.” I was like, “Okay, that's fine.” As soon as the words left my mouth, it was like, whoosh. A team of people rushed in. Somebody was in my face with a waiver that they were asking me to sign which in the moment, I get. But I was just like, “This is ridiculous.” Someone else was taking off all of my jewelry. My husband was being ushered out of the room. It was madness. We are running down the hall to the operating room which is, in our hospital, literally down the hall. So I'm on the table. They're doing all of their counts or whatever they do. I'm basically awake and the anesthetist is sitting right by my head. He was complaining about how long everything is taking and how I should already be asleep and how we need to get the baby out which was terrifying. I remember he kept saying to me, “Just close your eyes. Just close your eyes.” I had never had surgery before so laying in this chaotic mess with someone telling me to close my eyes was so unsettling. I just remember being so scared to close my eyes because my husband wasn't in the room with me.Meagan: And they never let him in, right?Nicole: They let him in after our daughter was born. Meagan: Being separated, how did that make you feel and being put to sleep?Nicole: It was scary. I obviously wasn't worried about my husband. I didn't think at the moment about how he must have felt. I'm sure it was scary for him too. It just all happened so fast. There was hardly any time to feel anything other than fear because you almost didn't have enough time to process any other emotion. But I just remember laying there. You're strapped to the table naked, having these 10-minute-long contractions. I was almost begging them at this point to put me out because it was so awful. My husband wasn't there so I was so thankful that there was this one nurse. I just remember hearing her voice come from somewhere behind me. I must have had this terrified look on my face because I had this anesthesiologist saying, “Close your eyes. Close your eyes.” She said, “It's okay. You can keep them open. Everything's fine.” It was the only moment of relief or calm that I felt in that entire OR. Everyone was doing their counts. Somebody must have asked where the sponge is for an antiseptic or whatever they use on your belly. The response from across the room was, “Nope. We're just going to dump and cut.” I was like, “Oh.” All of a sudden, you feel this cold splash come across your midsection. Thankfully, they put me out shortly after that so I could stop listening to these conversations that were happening around me. But it was very scary. It turns out that baby was born a couple of minutes later. When it was all said and done, from the time the call was made that they needed to do the section to when she was born was less than 10 minutes. In my mind, it felt like this eternity but it wasn't. It was quite quick. They brought my husband into the OR just as they were walking my daughter over to the warmer. He got to see her right away. She was totally fine. Everything was fine with her which was nice. They heated her. She went up to the nursery while they finished the section and were stitching me back up. I woke up a few hours later and they brought my daughter and my husband over to the recovery to see me after. I had a really good recovery in terms of C-sections. Meagan: That's great. Nicole: Yeah, it was really nice. I don't actually remember being in any pain after the fact either in the hospital or at home but I did struggle in the weeks that followed bonding with the baby which really took me for a loop. We had spent so much time and emotional energy and money trying to have our family and trying to have a baby. Then here's this baby in front of me and it sounds awful to say now to feel almost nothing, to feel indifferent. I didn't have this overwhelming sense of loving joy. I certainly didn't want any harm or anything or have thoughts of harm that way, but the easiest way for me to describe it is that I felt indifferent. It didn't really matter if she was crying to me. I didn't really care if she was there or if I got to hold her or if someone else held her all day. I was indifferent. Meagan: Yeah. I call that a disconnect. You're just not fully connected. It's not that you're not recognizing that she's there or anything, you're just not feeling that full connection that we hear about. Nicole: Yeah. Meagan: But that's also really common when you've had the type of Cesarean that you had or just Cesarean in general too. It happens in vaginal birth too. Nicole: I thought that was the case at the moment. I did think it was because I really didn't have a birthing experience. At one moment, I was pregnant. The next moment as far as I was concerned, I woke up and I'm not without anything really connecting the two. That was kind of the struggle emotionally for those first couple of weeks. It kind of resolved itself around 7 or 8 weeks. It's never been an issue and I'm obviously obsessed with my daughter and I love her. Thinking back on those memories and feelings is hard. Once we got through it, it was good. So that was the birth of our daughter. Shortly after she turned one, we started talking about having another child. We always knew that we wanted more than one. I come from a family of three and my husband comes from a family of four. We always thought that in an ideal world, more than one would be great. We did another frozen transfer in August 2020 which was successful so that was really exciting again. Similar to my previous pregnancy again, I felt really good. I was never sick. I loved being pregnant. Then I found this podcast and I listened to it religiously. I knew that I didn't want to have an elective section. I really wanted a VBAC. That was the goal in terms of if I didn't have a birth plan the first time, the birth plan the second time around was a VBAC. I found a doctor who said that she would deliver our baby. She wasn't delivering babies with our first but she was back delivering them. She said that even if she wasn't on call that day that she would come just for us to do ours which was really nice. She was super supportive and very much like, “If you need to be induced, we can talk about that.” She wasn't insistent that I go into labor on my own or by a certain date or whatever the case was. I felt very much in good hands with her. Meagan: Yeah in not putting those restrictions on ever from the get-go. Nicole: Yes. That was really nice. It was such a weight off of my shoulders from the beginning. But it was the fall of 2020 I guess it was that both personally and many people around me noticed that my breathing was really poor. Part of me just chalked it up to being extremely out of shape. I was a new mom. I wasn't doing as much as I had. But it really hit me when I started noticing that when I would read my daughter her books at her bedtime. You know toddler books. There are five words on every page, but I would have to stop between each page to catch my breath just sitting at rest. Meagan: That's concerning. Nicole: Yeah. So I thought that maybe there was more to this. We went. Through a series of referrals, we ended up at ENT. He said, “This looks like something but I'm not one that can fix it for you,” so he referred us to a further specialist just in the next practice over. I was diagnosed with what's called subglottic stenosis. Meagan: I've never heard of that. Nicole: In the simplest form, it's a narrowing of your airway. It's not scar tissue from my understanding but just normal tissue kind of like an overgrowth of normal tissue that causes this narrowing. It was likely caused by my intubation during my Cesarean. Meagan: During your Cesarean. Nicole: Yep. There was just something about my airway that didn't like being touched and this was the result. The specialist informed me that it was about a third of the size that it should be and that it would be dangerous to attempt to labor without having a surgery to open it back up. Meagan: Wow. Nicole: That was another hard decision but we decided to go ahead and get that surgery while I was pregnant. I got that surgery. It's called a dilation where they open it up with a laser and a balloon and all of this stuff. I had that surgery at 24 weeks and it was amazing how much better I could breathe. I didn't appreciate how bad my breathing was until they fixed it. You don't realize how much of my day and my time I spent just thinking about breathing so that was really nice. Then we were given the green light to TOLAC and try for a VBAC. The rest of the pregnancy was uneventful. I ended up going overdue again. I was 40 weeks and 7 days, I guess 41 weeks. It was decided that at that point, I would be induced because I was only a centimeter dilated. There were no signs of labor. So, fine. This time obviously though, they said, “Under no circumstances can we use Cervadil,” so we decided that I would be induced with a Foley bulb. We went to the hospital. They put in the Foley bulb that morning. They said, “Okay. Come back when it falls out.” It fell out a couple of hours later that afternoon. We went back to the hospital. I should add that during my pregnancy after my dilation surgery, we had an anesthesia consult to make sure, “Okay, what can we do to avoid another intubation?” It was decided, “When you come into the hospital, we'll give you an epidural probably earlier than would usually be offered just in an abundance of caution to try to do everything we can to avoid intubating you.” So that was fine. We got to the hospital. They started me on a low dose of Pitocin. Contractions started to look like they were getting longer again and not really following that nice pattern that they like to see. Our nurse started getting a little nervous and concerned and suggested that we call anesthesia to do the epidural which sure. I'm totally on board with. I was proepidural from the very beginning with the both of them. From my perspective, I didn't need to make my life or job harder than it already was. Anesthesia came in and gave me the epidural. It was great. I felt nothing. Then the contractions actually fell into a really nice pattern after so no one was worried. We hung out for two or three hours at the hospital again contracting. I had no idea. I never felt anything. At one point, I said to my husband, “It feels like I peed a little bit.” He was like, “You have a catheter in.” I was like, “Yeah, but I feel wet.” It turns out that my water broke on its own which was nice but I didn't have any urge to push or anything like that. They said, “We'll let you just hang out for a couple of ours. Just let us know if you feel that urge.” That urge never came so they said, “Let's start pushing anyways because it's been a little bit since your water broke.” I said, “Okay.” We pushed for about an hour and a half and then at that point again, baby started having some decels and it looked like baby was starting to not tolerate labor that well. Slowly, the vibe became a little more tense. The message started to be, “Okay. It's time to get this baby out. We have to push this baby out sooner than later.” At some point, the call was made to use the vacuum to help that happen sooner. That was all explained to us and we said, “Okay, sure.” The vacuum was used and then the baby came out two pushes later. When my son was born, I didn't get to hold him right away. He wasn't crying. They took him over to the warmer right away. He had no tone. His body was completely limp. He wasn't crying. He was breathing, but only barely and had the flared nostrils and all of those telltale signs that he was working really, really hard. Meagan: The traction and all of that. Nicole: Yeah, so they had him on the bag and worked on him for about 15 minutes. In that time, he never cried. He never perked up so it was decided that he needed to go off to the NICU to get some extra attention there. My husband went with him to the NICU. I stayed behind. I ended up having a third-degree tear that required some attention. They took me up to the NICU once I was all ready to go a couple of hours later. It turns out that he had a severe meconium aspiration so he actually ended up spending four days on a ventilator and was in the NICU for nine days. Meagan: Was there any sign of meconium when your water broke?Nicole: Not when my water broke. Before, I think right before the call was made to use the vacuum, I do remember our doctor saying, “It looks like there is a lot of mec in there,” but there was no mention of it when my water broke. Meagan: So maybe during labor. Nicole: So I'm assuming it was sometime after that but during the labor that it happened. That was a scary experience, but he's totally fine now. He's a happy, strong, healthy boy. We just call him as being built to last because nothing phases him. But my VBAC wasn't necessarily what I had envisioned but ultimately it was really successful and a better emotional experience which is weird to describe because there are a lot of emotions around having a child in the NICU. I didn't have any issues bonding with him. I felt that connection to care for him right away. If anything, if nothing else, I'm hoping that having that VBAC, it will help what will hopefully be my next VBAC better. I'm actually currently expecting. Meagan: Awesome! Congratulations!Nicole: Yep, so we're hoping that the third time is the charm. Yes, so I'm just shy of 31 weeks. We are due April 1st. Meagan: Really soon! Actually, right when this episode airs you will have a baby. Nicole: This kid is probably going to be late too. Meagan: You'll either have a baby or just about having a baby. Oh, so fun. Nicole: Or will be preparing for one. My husband and I always joke that getting the babies in and getting them out usually takes quite a bit of work, but baking them is where I thrive. Meagan: Yeah. Nicole: The plan again, even with everything that happened with my son, the recovery was quite difficult with a third-degree tear, but we're going for another VBAC. We're hoping like I said, if anything, my son will help pave the way for hopefully a smoother, less eventful experience. Meagan: Absolutely. Your chances are higher of that. Sometimes that first vaginal birth, even if there is no previous Cesarean, can be a little longer or have things like forceps and vacuum and things like that. It can happen. So hopefully like you said, it will pave the way and be a beautiful redemption. They all have been great but a redemption birth of the two with less drama maybe. Nicole: Less drama. Less excitement. I just want a nice, run-of-the-mill birth. But yes so it will be good. I'm glad that I experienced it. I wouldn't change it. Meagan: Yeah. You are still happy with the outcomes. Nicole: Yeah. I'm still happy we had the VBAC. Everyone is happy and ultimately, that has always been our thing. Healthy baby, healthy mom. Whatever that looks like, we can deal with but hopefully it looks like a VBAC. Meagan: You'll have to let us know. Definitely let us know. Nicole: Yeah, I will for sure. Meagan: That's awesome. I want to talk a little bit about induction. I've been taking notes along the way just about things that you've said. Right before I get into induction, something that you had said during your first, something that they said to you is that they were just going to dump and cut. You heard that and then you were gone. Those longlasting words, I think it is so important to note to everybody listening especially if you are a provider, that words matter. Words matter. Even though you may not be thinking that something that you say that your patient is going to hold onto, it's possible that they will. I don't think that you held onto dump and cut, but I heard that and that is a very scary thing. “We're just going to dump and cut.” I just want to remind everybody to please be mindful of your words when you are with someone especially in a vulnerable state. But induction. I want to talk about induction. I just want to talk about what ACOG says and going over 40 weeks and stuff like that. Because Nicole is proof that induction can happen and VBAC can happen. An induction can happen and a VBAC can happen with no complications. Sometimes it can't and we don't know why. We can't always blame induction at all, but I don't want you to be scared of induction. I don't want you to be so terrified of induction that it consumes you because I know that some of our listeners are in that space especially because they had an induction that spiraled down and went Cesarean. I want to talk about how ACOG concludes that, “Induction of labor between 41 and 7 and 42 and 7 can be considered. 42 weeks to 42 weeks and 7 days is recommended given evidence of increased morbidity and mortality.” Something has changed over time and that is the ARRIVE trial. We have a blog about the ARRIVE trial and we have a blog about induction. We have a blog about going over 40 weeks. Since this has happened, we see a lot more people at 40 weeks and if they haven't had a baby yet, providers are rushing to get babies out. I just want to let you know that doesn't have to happen, but if you choose to induce, that's okay too. Just like Nicole said in the beginning of her induction story, no she didn't qualify for Cytotec or Cervadil because she is a TOLAC, but she had a great induction with a Foley catheter or a Cook catheter. Depending on where you are at, everyone calls it something different. Those are really great alternatives. You do have to be dilated a little. Sometimes they can give Pitocin a little bit and then give a Foley. But talk with your providers. I encourage you to talk with your providers. I feel like her provider really said, “Okay. Here's what we should do and this is why.” It worked out in Nicole's benefit. I want everyone to know that induction doesn't have to be scary. Right, Nicole?Nicole: I don't think the spiraling with our son had anything to do with the induction. Meagan: It just happened. Sometimes we have babies that have a fast transition or during pushing and meconium is really common too. So yeah. I know people who go into spontaneous labor and have meconium and I know people with meconium aspiration with induction. It just happens. I felt like there are lots of people on here who are living proof that induction is possible but Nicole just said it right here. She's been induced and she had two very different circumstances with induction. Take it slow. Speak with your providers. Go over all of your options and remember that words matter.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

Abby has always had a heart for birth. She became doula-certified long before becoming a mother and even introduced her husband to The Business of Being Born on their second date! She knew that undisturbed, physiological birth was the way she wanted to go.But Abby's birth experiences were filled with wild twists and turns including chorioamnionitis, posterior and breech positioning, pulmonary embolisms, hemorrhaging, multiple miscarriages, an ICU stay, and many blood transfusions. With the odds stacked against her, Abby did not give up the fight. She knew deep in her soul that a VBA2C was something she could do.AND SHE DID!Fresh off of her VBA2C, Abby shares every intense, tender, and raw moment of her journey. We know you'll love Abby just as much as we do.Additional LinksAbby's WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode DetailsMeagan: Hello, this is Meagan with The VBAC Link and today we have another beautiful story for you. We are so excited to share all of these stories in this beautiful 2023. It's going to be a great year. That is what I keep saying. It's going to be a great year. No more weird viruses and all of the things. It's just going to be a good, positive year and we are starting this week out with a positive VBAC story. We have Abby with us today and she is from North Carolina. Is that correct? Abby: Yes, Charlotte, North Carolina. Meagan: Yes, I love it. We have quite a few doulas in North Carolina as well. Maybe you guys could all connect. She is actually a doula as well. She is not practicing right now because she has a whole bunch of little bodies around, but this birth has totally motivated and boosted her spirits into the day that she does get back into doula work. So Abby, welcome. Review of the WeekMeagan: I am going to share a quick review and then we will jump right into your beautiful story. Abby: I can't wait. Meagan: Me neither. I really can't wait for your story. This is PaigeBroadway. She shared her review and it was on Apple Podcasts. It says, “Allowing me to believe in myself.” Just that subject right there makes me so happy because that is exactly why The VBAC Link exists is allowing you to believe in yourself. We talk about this all of the time. It's to believe in yourself to make the decision that is best for you. We don't always have to have a VBAC. We don't always have to have a repeat Cesarean. Or maybe a VBAC is chosen to a repeat Cesarean or a scheduled one. It doesn't matter the way we birth, but as long as we believe in ourselves and we believe in our ability to make the right choice for us, that is exactly what this podcast is for. Her review says, “My husband and I are currently trying to conceive. I knew immediately after my C-section that I never wanted to have an experience like that again. This podcast has already given me the strength to switch providers and the knowledge to prepare for a VBAC. I can do this.” Paige, you absolutely can do this. Just like all of the others here, right? Right, Abby? Do you feel like that? Abby: Oh my gosh. That is just the most encouraging thing and that's how I felt about The VBAC Link for five years and now I'm here telling my story. So yes, Paige. You can do it. You really can. Meagan: Yes. You really, really can. We always accept more reviews. You can drop us an email at info@thevbaclink.com or Apple Podcasts or Google Play. You can send us a message on Instagram. Wherever it may be, we love to read your reviews. We love to receive your reviews. So definitely if you wouldn't mind, push pause and drop us a review. Abby's StoriesMeagan: Hello, women of strength. This is Meagan. I am so happy that you are listening to the podcast. When I was preparing for my vaginal birth after two Cesareans, it was hard to find the evidence-based information in one spot. It could lead me to feel lonely or even confused. This is why Julie and I created The VBAC Link Podcast. Did you know that we also send out emails with helpful tips and advice on how to achieve your VBAC all easily digestible in one email form? Just head over to thevbaclink.com. Okay, Abby. We have so many stories on this podcast and I know that like you said, here you've been for five years and now you are here sharing your story. You are just fresh. You are fresh out of it, right? 2 weeks? Abby: Very fresh. I just stopped wearing Depends the other day. Meagan: Oh my gosh. I love it. That is fresh. That is fresh out of it. Abby: Very fresh. Meagan: Fresh out of birth. Sometimes I feel like right out of birth is so fun because again, it's so fresh and it's in the forefront of your mind so you have all of the detailed things to share. I am so, so, so excited for you to share your story. So go ahead. Abby: Oh my goodness. Well, I should start at the beginning about five years ago. My daughter is turning five on January 31st, so it's been almost exactly five years since she was born. I went to a doula training when I was 20-22ish years old way before my husband and I met. On our first date, he told me that he didn't want to be in the room when the baby was born. I literally told him that he should go on a date with someone else because it was so important. I was like, “This isn't going to work out.” I showed him The Business of Being Born on our second date and he has changed dramatically since then. Meagan: Oh my gosh. I'm dying. Abby: But I feel like that just gives a little bit of a background of who I am as a human being. Meagan: And your passion. Abby: I feel very strongly about it. Yes, yeah. I was really quite young. Honestly, I have to give a shoutout to a friend of mine who is now a midwife but was a doula at the time. We went on a mission trip to Africa. We were sitting on a bed in Uganda and she was talking about how beautiful birth was. I was a teenager. I think I was soon to turn 21. It was like, “Why would you not get an epidural?” I was very far away from childbearing years at the time. I just didn't understand. She just sat patiently with me and explained in such a beautiful way how beautiful birth is and that it can create a mother and that it's worth it to go through what you go through and come out on the other side of it. It was just such a meaningful conversation for me. It really shifted my whole worldview and made me who I am today.  It's interesting thinking back on that girl who would have said, “Why would you not get an epidural? Why would you want to have a natural childbirth?” to the way that my stories ended up which is just bananas. Needless to say, I was very crunchy and felt like, “Okay. I'd love to have a home birth.” It was my first baby, so my husband was like, “Maybe we should do a birth center.” At the time, there was a birth center in Charlotte, so that's the direction that we went. I was just picturing the twinkle lights and a tub and all of the things that you see on Instagram for birth. That was the mental picture that existed in my brain. At that time, I was listening to another birth podcast and I specifically remember skipping over C-section stories. I was just not interested in them. I didn't even think it applied. It wasn't intentional. It was, “Oh, well I don't need to listen to those because I'm not going to have a C-section.”Meagan: That's not what I'm doing. Exactly.Abby: Yeah, that's not what I'm doing, so why would I need to listen to that? In retrospect, that really messed me up and I love that y'all's podcast mentions that this is a podcast for all moms. This does not need to just be people who have had C-sections. I think listening to The VBAC Link can help you prepare to a) not have a C-section, but also prepare for a C-section if that's what has to happen for you. It was just a really difficult transition for me from the twinkle light picture to ending up with a C-section. But my pregnancy with Hadley was fine. It's funny because I'm older now and I'm like, “Oh, that pregnancy was great.” I was in great shape and I was much younger. Everything was fine and easier. I did have a rib pop out of place. I know now that she was sunny-side up for almost the entire pregnancy, so my whole third trimester was excruciatingly painful. I had never seen a chiropractor before that, so I went to a chiropractor eventually but it was really just like bandaids. It wasn't really helping because my body was not in the right condition beforehand. I'm a really big proponent of bodywork. That will come back in the rest of my story. But at the time, I didn't know what I didn't know. I was in a lot of pain toward the end, but other than that, everything was fine. I went overdue which I expected. I was excited when I made it to 37 because I was still allowed to be at the birth center. I think I was probably pretty ready. I tried to do some induction acupuncture, and I'm not sure if it actually did anything but a couple of days later, I started having what I felt like were contractions. I had never been in labor before, so they were two minutes apart but really, really short and not getting any longer. I was just confused.My doula-gut was like, “This feels off, but also I'm dying.” I don't know what to do about this. So we called my doula over and went to the birth center after almost 48 hours of having those contractions at home. Again, if I knew then what I know now, I would have taken a bath and had some Epsom salts. It was probably prodromal labor. We went to the birth center and I can't not tell this part of the story. I told the midwife, “If you tell me that I'm 1 centimeter, I'm going to kick you in the face.” She backed up because I was only 1 centimeter. Oh, I was like, “No, don't back up. Come in my face and tell me I'm a 4 or something.” I just knew at that point that it was over because I was like, “I'm so tired. This is the point when I'm asking for an epidural and I'm 1 centimeter.” How could I possibly get through this?The worst news was yet to come. She said, “You have to transfer to the hospital. You have a fever of 100.2.” She thought that I had chorio. I think, I don't know how to say the actual word. It's chorioamnionitis. Meagan: Yeah. That's why they call it chorio. Abby: Exactly. Meagan: Infection. It's an infection. Abby: Right. It's a uterine infection. She said, “I'm sorry. I'm diagnosing you with a uterine infection. You have to go to the hospital.” I was just devastated. Honestly, that was the point of my birth where I feel like I really lost all of my power as a person and a mother. The rest of the birth felt like it just happened to me. I was not an active participant. I went to the hospital and they said, “You actually don't have a fever,” because the hospital system's standard of fever is over 100, and at the hospital, I was 99.7 or something. So they said, “You don't have a fever. We're going to let you labor.”Meagan: So it went down?Abby: I don't know if it went down or if it was just a different thermometer and they were like, “According to us, you don't have a fever so we'll let you labor.” In retrospect, it was good news because if they had just sliced me open the second I got there, I probably would have never set foot in a hospital again and that would have been very bad news for my second birth. So I think that would have really turned me off of the medical system altogether and doctors. I just would have gone real red pill in the other direction. So they let me labor, but I ended up with an epidural at 1 centimeter. I tried to get in the little dinky shower at the hospital and it was cold half water. I was like, “This is doing nothing.” I wanted to be in the tub at the birth center. I ended up with an epidural flat on my back and at that point, you're like, “Well, who cares? If I'm already here, why not do Pitocin? Why not break my water?” So thus began the cascade of interventions ironically that started with an epidural. I feel like that's not always the case, but that was very much the cascade of interventions for me. I did not want them to break my water, but eventually, they did. I was there for three days and they really let me go for a really long time. Meagan: That's actually really impressive for a hospital.Abby: I was so pleased with the care that I received. Both of the OBs that were flipping on and off of call were very patient with me. I think they kind of knew, “Oh, this is one of those birth center moms. We might as well just let her try.” Meagan: Let her do it. Abby: That was kind of a vibe that I got, but it was genuine. They really were like, “Yeah. You can totally do this.” But really, it was an unnecessary induction because I was 1 centimeter and I wasn't really in labor. I wasn't having true labor contractions. I wish that I had just gone home and gone to sleep, but we wouldn't be here having this conversation if that happened. I got to 10 eventually and I made it to pushing eventually. The epidural that I had was so strong that I could not feel from my shoulders all the way down. I was numb. I've never been so numb in my life, but again, I didn't know that's not what an epidural was supposed to feel like. They were telling me to push and I was just like, “What do you mean?” They told me to lift my legs up and I was like, “I can't hold my legs. They weigh 4000 pounds. What are you talking about?” The nurses were not as kind as the OBs and I could tell that they were not approving of my pushing and that it wasn't doing what it was supposed to be doing. But the benefit of Hadley's birth, she asked that I say her name on the podcast, so the benefit of Hadley's birth was that by the time I made it to 10 and pushing, they tried to use the vacuum seven times. They tried all of the things. They really, really let me go. So by the time they said it was time for a C-section, I really trusted them. I didn't feel like it was a snap judgment. I felt like, “You know what? Okay. I agree. If this isn't working, it's not working. There's nothing else we can do.” So come to find out, she was sunny-side up. Meagan: I was going to say, was she sunny-side up still?Abby: She was. She was. So when they had broken my water, she basically got stuck up in that broken rib cage and never made it around my pubic bone. I also did have chorio we found out after. Meagan: Oh no way. Abby: It was just the wildest. We joke that it was a Murphy's Law birth and that every random thing could have possibly happened, but everyone was fine. I was fine. Hadley was fine, but it was deeply traumatic for me. I really did not feel like I was present for it at all. It was really difficult to feel like I wanted to have this empowering, personal experience and it was so impersonal and medicalized. I was separated from Hadley for the first few hours of her life and they took me into, I don't even know what it's called, but it was a terrible experience. My husband was super traumatized because it wasn't what he thought was happening either and it was really, really difficult for us. That is really when I started listening to The VBAC Link right away. I was like, “Done. I'm having a VBAC. That was terrible. I'm not doing that again.” I felt pretty strongly about that. Unfortunately, it took us two and a half years to get pregnant with our second. We had three miscarriages along the way, so a lot of our story has been “not right nows” and “maybe laters”. We are really thankful for the children that we have which is wild how they all got here at the correct time. We were filling out adoption paperwork in January 2021 after so long of trying and found out on February 1st the day after my 5-year-old's third birthday that we were pregnant. It was the darkest line I've seen since I was pregnant with Hadley. It was like, “This is the baby. This is the one. She's going to stick around.” I felt like this was my VBAC. I don't know if that was just my personality and my, “Oh, this is going to happen. I'm going to manhandle this into being the case,” but I very much wanted it to be my VBAC. That pregnancy went kind of similarly with rib pain. I started chiropractic earlier this time, but still really struggled with the rib. Her name is Ginnie. Ginnie was sunny-side up the whole time, so that was against me from the beginning that she was sunny-side up, but again, I don't know how I didn't spend more time thinking about it or trying to get her into a better position, but I just didn't. It was honestly the height of COVID and I had a toddler. Life was just still happening, so I went into labor I thought. I was 39 weeks exactly and my water broke at home. I was elated because, with Hadley, my water didn't break on its own so I felt like, “Oh my gosh. Labor is starting. I'm going into labor naturally. This is exactly what I wanted.”I stood up and it was a gush. It was very much my water. It was no mistaking, “Okay, that's not pee. Definitely, my water has broken.” I was so excited and then nothing happened at all. Meagan: I can totally relate to that. Abby: Yes. I've listened to your birth stories. It was a Sunday so a friend came to pick up our toddler and we were all excited. We were going to have a baby. Nothing. Meagan: Nothing. Abby: Crickets. Not even a single cramp. I walked four miles that day. We did all of the things and it just was like no. We went to sleep that night and I was like, “I'm not going to the hospital until 24 hours and then I'm not even going to tell the hospital that it's been that long,” which is sort of what happened. We went in about 24 hours later and I still had not had a single contraction. Absolutely nothing happened. Meagan: Were you still leaking?Abby: Yes. Yeah. Meagan: Still coming. Abby: Again with the diapers, I need to buy stock in Depends at this point. But yes it was definitely my water and it was definitely not doing anything. I went to the hospital. Triage takes a million hours when you're not in active labor, so we were in triage forever and they wanted to get me hooked up to continuous fetal monitoring. I said, “Oh, okay. So I'll have the wireless one.” They were like, “Oh, it doesn't work.” I was like, “That's not what I signed up for.” My practice was very like, “Yes, you can have a VBAC.” Actually, my midwife was very, “You can have a VBAC,” but she was part of a practice that had OBs and you sort of don't know who you're going to get until the day of. I felt very supported throughout my whole pregnancy. Everyone thought I was going to have a VBAC. I had plenty of those conversations with OBs that they're like, “Okay, so just so you know, here are the risks.” I'm like, “Yeah, yeah. I know all of the risks. I've done the research. Thank you very much for informing me. Have a nice day.” When I think back, I think there were probably some red flags that it was friendly but not supportive.Meagan: Tolerant. Abby: Yes, a tolerant but not supportive practice. But again, I didn't know that until I knew that. I started an induction. My contractions started getting regular. It worked. I was dilating and I made it to about 6 centimeters. I don't think I mentioned this before but my husband had childhood cancer, so he has pretty severe medical trauma and hospitals are particularly triggering for him. Other people being in pain is also triggering for him. Meagan: I'm sure, yeah. Abby: Around 6 centimeters, I was starting to need a little bit more support. My doula, because inductions take forever, was like, “I'm just going to go home and spend the day at home. I'll come back at night when you really need it.” I was chilling. I was just watching Friends and hanging out until I wasn't. It started to pick up really quickly. What made me start to need more support was that they turned off the Pitocin when I had to go to the bathroom and then they turned it back on and didn't change the number. I think it was at a 9, but something about turning it off and turning it back on made my body go, “Whoa. That was really intense.” All of a sudden it felt like insane Pit contractions. My husband started to have a really hard time supporting me through it and my doula was stuck in line at Chick-fil-A. You know, once you're in the line, you can't get out of the drive-thru. Meagan: Of all the places too, darn it. Abby: We wanted it. I was like, “Bring me food. I want to eat something. I'm going to break all of these rules.” Meagan: She's getting everyone food and stuck. Abby: Yes, she's totally stuck. My husband needed to eat dinner. It had been a long day already, so she was stuck. I was like, “You know what? I have peace about this. I'm going to get an epidural. I'm going to ask for an epidural.” I really was pretty okay. I was not dying mentally at this point, but I felt like my husband needed a little break from me not being okay and I felt like, “I'm at a 6. I got an epidural at 1 centimeter last time so all right. We're doing it. This is happening. Things are progressing. Let's do it.” Naturally, my doula got back right before they were placing the epidural. She was like, “What are you doing? We're not doing an epidural. Let me do some hip compressions. What are you talking about?” She's very, “Come on. Let's do this.” That's why I hired her because I needed that, but I had made up my mind mentally. Meagan: Yeah, which is okay.Abby: Yes. Very much so. I think it is honestly what needed to happen for a litany of reasons. But once my doula got back, she noticed that my heart rate kept beeping on the monitor and when you're in hospitals, you hear beeping all of the time so we weren't paying attention to what the beeping was. It wasn't the baby's, so no one was really all that concerned, but my heart rate was insanely high. So much so that my doula was checking my Apple Watch for my history of what my normal heart rate was. She was like, “Give me your Apple Watch and let me look at what this normally is,” but I had only gotten my Apple Watch while I was pregnant, so I didn't have a baseline, “This is my normal heart rate.” Basically, the nurses just turned down the volume on my heart rate monitor that was saying, “Alert, alert! Something is wrong with this woman.” Meagan: That could be a sign of infection. Abby: It could be a sign of a lot of things. Meagan: A whole bunch of other things, yes. Abby: It seemed like my doula was the only one who was concerned about that. I was concerned only about having a VBAC so I was like, “Whatever. I don't want any hindrances to the VBAC. Don't panic about me because I'm good. Baby is good. I'm good. I'm fine.” Again, I made it to 10 and pushing. My heart rate was through the roof and I guess I need to rewind a little bit, sorry. I had a cough for the last four weeks of my pregnancy, maybe more like six. It was a dry cough and it was a the height of COVID, so I had 75 COVID tests because they said that I had COVID.” Meagan: Because you had a cough. Abby: Yes, exactly. They said that if I had COVID, my doula couldn't come into the birth with me. With my husband's history, I was like, “No, no. I have to have my doula. That's not an option.” I took 1000 COVID tests, but it was never COVID. It was never positive. I just had this dry cough that would not go away. The cough combined with the heart rate was really freaking my doula out even when I had an epidural. I took a little nap. I made it to 10 and pushing. When I was pushing, my cough really started to ramp up. I was coughing incessantly. I remember the midwives joking, “We're all going to have COVID at the end of this birth. Obviously, this lady has COVID because she is coughing up a storm.” We were talking about how one of the midwives had just gotten her taste or her smell back or something after having it. She was like, “Oh my gosh. I'm going to get it again.” It was all of this sort of lighthearted conversation, very, “Yeah, haha. We're all going to get COVID I guess.” Yes, except for my doula. She was like, “This is odd.” But she said, “You know, maybe you'll cough your baby out. Maybe it will help you. Maybe those pushes will help you get the baby out.” She was trying to be encouraging. I don't even remember. I should probably look at my notes on how long I pushed. I think it was a couple of hours and again, I had a sunny-side-up baby with my water broken. She was just lodged and would not come down. Meagan: Were they able to try and rotate at all or was she not low enough? Abby: Neither of the girls ever descended. I don't remember what station they were at, but it was high. I looked at a picture of my third baby at 37 weeks and my belly was so much lower at 37 weeks than either of the girls on the day I went into labor. They just never dropped. They were not ready really. So when they said that it was time, an OB came in who I had never met before and was not the kindest about the way that she shared that information with me. For me, I felt like, “Who's going to let me try for a VBAC after two? This is my opportunity to have a vaginal birth and if this is it, this is it. I can't.” But it felt like at that moment, everyone in the room just sort of fell to what she said. I didn't have a choice. Even my doula who I adore was like, “I think it is time.” So when your doula and your husband and your midwives all say, “I think it's time,” then what choice do you really have? Meagan: Well, you trust these people.Abby: Right, right. You also don't want to be the person who, this sounds horrible, but something happened to my baby because I was so hell-bent on having a vaginal birth. At that point, that's how the conversation felt. Her heart rate was dropping and it wasn't coming back up in between contractions. They were like, “Okay. I think it's time.” I reluctantly consented, but really, really struggled. I sobbed through the C-section and threw up through the C-section. I hate having my arms out like Jesus on the cross. It's just the worst thing in the world. It's just terrible. It's not for everyone. I feel like it's important for me to say that that was my experience. I have a friend who just had a C-section and she was like, “I thought that it was really cool to know that they were down there doing all of that stuff.” She had a great experience and I think that's amazing. I'm so glad she did, but for me, it was just so different than what I expected that it was deeply traumatizing for me, especially for the second time. But the baby came out and she was fine. I think it took her a couple of seconds to start breathing. I think she had some meconium or something, but they handed her to my husband. She was all cute and then they brought her over to me. She licked my cheek. I do remember having a very different reaction to meeting her than meeting my first daughter. With my first, I had never had a baby before and so I felt like the first thing I thought was, “I didn't think that's what she would look like.” I didn't feel like, “Oh my gosh, I made this human and I love it so much.” That was just not my experience. But with the second one, I had a three-year-old at the time and was like, “You're going to turn into the coolest little person,” and I knew how to love a child then so it felt much better and different which actually made the next part a lot harder. I still had my cough. It did not go away and after they had sewn me up on the table, every doctor had left the room and it was just the surgical techs and the people that are basically cleaning up the floor. I had to cough and my arms were still out. I was flat on my back and you know when you have a cough, you want to turn to the side or sit up and I couldn't do either of those things. My lips turned blue and they called a code. I was breathing so I don't know what the codes are. They pressed a big alarm and people came running. Brian, my husband, was holding the baby and they took her out of his arms and basically pushed him into the hallway so that he wouldn't see me die, I suppose was the thought, or drop the baby or who knows. I just wanted to turn over and I was trying to explain to these nurses while having a coughing fit, “Can you just let me roll over?” They were trying to put oxygen on my face. I was like, “That's not going to help this tickle in my throat. I don't want you to put oxygen on my face.” I was fighting them off. Meagan: I need to get up. Abby: Yeah, exactly. I was just like, “Why can't you understand me?” But I wasn't speaking words, so that's why. The first person who ran back into the room was my anesthesiologist and she apparently was a cardiac-specific anesthesiologist which I didn't even know was a thing. She took one look at me after I had settled down and said, “I believe that you just had a pulmonary embolism and you need to go to get a CT scan.” At that point, I didn't know what a pulmonary embolism was so I was not all that concerned about it. I was like, “You're silly. I just have a cough. I've had a cough for four weeks. What are you talking about?” I knew that my husband was going to be really upset obviously, but he wasn't going to be allowed to come with me to get a CT scan. I was like, “You have to let me go talk to my husband. I have to go tell him that I'm okay.” It's not funny, but it's now just sort of a dark humor inside joke that when I went to go talk to him, I was like, “Babe don't worry. It's just a pulmonary embolism.” He was like, “Abby, those kill people. That's not a just kind of thing.” They found several bilateral pulmonary embolisms in my lungs. One of my lungs was 98% occluded, so 2% away from not being able to make it. I spent the first two days of her life in the ICU. Again, it was COVID so I wasn't able to see her because everyone in the ICU was there for COVID. They were like, “We don't want your newborn to get sick,” and they were on different floors so they brought her to me one time and then I pumped milk for her that nurses took back and forth but it was really insane. Meagan: Wow. Abby: They gave me blood transfusions and immediately put me on heparin and a drip to start clearing up the blood clots and get them thinned out. When I got finally sent home from the hospital, I had to start blood thinner injections and do those for the next six weeks which unfortunately led to a postpartum hemorrhage. Meagan: Oh my land. Abby: It's a wild ride. This wasn't even that long ago. It was October 2021. I basically didn't have any postpartum bleeding for the first week. I was like, “Man, maybe the C-section is just the way to do it. Maybe this is making the bleeding a lot easier,” but what they think happened is that I had some major swelling and it was basically holding all of the blood in my uterus and by the time it opened up, it was like floodgates. I won't be too graphic, but when they tell you to call the doctor is when I called the doctor. I had a couple of other scary experiences at home. I passed some clots and they had given me some Cytotec which is supposed to squeeze the uterus. Meagan: Clamp the uterus down, yep. Abby: It clamped too much blood out and I lost too much blood in one hour basically. I passed out on the floor and I was on blood thinners so my mom caught my head because you can get a brain bleed if something happens while you are on blood thinners. I had to get a blood transfusion the next day. My postpartum experience was recovering from a C-section, recovering from the ICU, and then postpartum hemorrhages and I think I had three blood transfusions after being outside of the hospital. Meagan: Holy cow. Abby: I don't even know how to end that story and shift to the next one because it really was not that long ago. That daughter is now 15 months old. Like I said, it took us a long time to get pregnant with her so I suppose you could say that we were not all that cautious after she was born. Six months later, we found out that we were pregnant. Well, we didn't know at the time that it was a boy, but we found out that we were pregnant. I had already been asking the hematologist and the pulmonologist, literally everyone. I was like, “So what happens when I get pregnant? Do I need to be on the blood thinner injections on day one? How does this work? What am I going to do?” They all thought I was crazy because they were like, “This chick almost just died. Why is she thinking about getting pregnant?” I was like, “Is this ruling me out of a VBAC?” I had all of the questions. I'm glad in retrospect that I asked them early. I was like, “It could be two years from now, but I want to know what I'm supposed to do on day one. I'm not going to be seeing a pulmonologist on a regular basis when my baby is two, so I might as well just ask now.” I had all of the information that I needed which was wonderful, but I struggled really hard with nursing her. All of my kids had tongue ties and it's just been a difficult journey breastfeeding. Ginnie, the middle one, had colic and food allergies. I was down to seven foods that I could eat.Meagan: That's the worst. Abby: It was terrible. I was off eggs, soy, dairy, gluten, caffeine, tomatoes, and corn. Meagan: You weren't really eating anything. Abby: I really wasn't eating anything. I was losing my mind. I was pumping around the clock to try and get my supply back up. She was still not gaining weight and we just were like, “If this was working, I could maybe keep doing it,” but it wasn't working and she wasn't gaining weight, so I switched her to formula. Once I weaned, we pretty much immediately got pregnant. Very much a surprise but I feel like I need to share the beginning of this story because this is really the start of my VBAC story and I'm really going to try not to cry. I had a postpartum nurse when I was postpartum with Ginnie whom we had never met before, but she just adopted our family. She brought me Uncrustables in the postpartum room and those are the best. She was like, “Here's candy from the nurses' station.” I think you get a little extra attention when you're a pulmonary embolism mom in the ICU, so she just adopted us and became a friend to our family after the baby was born. She called me a week before Mother's Day and said, “Abby.” She was bawling. She told me that she hasn't cried in three years but this was the first time she cried. She was bawling her eyes out and said, “Abby, I just had a dream about you. I have to tell you the dream.” As a nurse, she has seen, in her time, one stillbirth and it really deeply affected her obviously. She had a dream that she went to heaven and saw her stillborn baby girl as a teenager. She was holding three of my children. Carly did not know that I had three losses because she met me after Ginnie was born. She just knew I was a miscarriage mom and in her dream, the reason she was sobbing was because she thought that meant I was going to experience more loss. She was devastated. She was like, “Oh my gosh. She's already been through so much. She just had a pulmonary embolism five months ago,” so this stillborn baby girl who was a teenager in the dream calmed her nerves and said, “No, no. These are supposed to be here but this little boy is coming down soon.”Meagan: I've got the chills. Abby: This is a true story. It's the craziest thing in the world. It's just wild to me that this is part of my story but it is. She said that he looked just like Hadley, my five-year-old, and that his name was John which is our boy name and my dad's name and my grandfather's name. That was always going to be the name. Meagan: Oh my gosh. Abby: We were like, “Okay. That's really weird.” You think that's weird. I think that's weird. It is the reason that I took a pregnancy test. We weren't trying so I wouldn't have taken one. It was the faintest little line. Truly, so, so faint but because I knew that I needed to be on Lovenox day one and because I knew from my miscarriage history, I needed to be on progesterone day one, it was a Friday so I texted my midwife and I said, “I need HCG labs and I need you to call me in progesterone and Lovenox.” My HCG that day was very, very low. I think it was a 5 and the lowest considered viable pregnancy is a 7. They want it to double or triple by 48 hours from now. I went back on Monday. I started my progesterone and Lovenox on that Friday with a very faint test and a very low HCG and it was up to 77 on Monday. It was doubling or tripling in the appropriate amount of time. I kept going back and it kept going. He is sleeping in the other room right now, so he clearly stuck. I really contribute his life honestly to Carly's dream and the fact that I never would have taken a pregnancy test. It was a Friday. I was able to be so proactive about the medicine and care that I needed. I knew when she told me the dream, I said, “I'm pregnant. This is going to be my VBAC.” I just knew it in my bones so intimately. I really don't know how to explain it. It was just a soul-knowing. I just knew. She was like, “The dream wasn't literal, Abby. I'm not saying you're pregnant right now.” I was like, “Nope. I know.” I just knew. I just knew. People always say things like that, but that had never been my experience, especially trying to conceive. You're always like, “Oh, I stubbed my toe. Is that a sign of pregnancy?” You're looking for every little thing and this time it was like, “No. I'm pregnant.” We've wanted a boy the whole time and I was like, “This is going to be my boy and this is going to be my VBAC.” I just knew. So really, on day one I started fighting like hell for my VBAC because it was after two and I knew that I was going to need to basically be a psycho about it. I think that's my biggest VBAC advice for people is that if you really want a VBAC, you have to kind of have to be a psycho about it because no one wants you to have a VBAC more than you want to have a VBAC. You need to advocate for yourself. I think a lot of people can take a sort of, “If it happens, it happens” attitude and that is fine if that is how you truly feel about it. If it happens, it happens but if you really, really, really want a VBAC, you have to really, really, really fight for your VBAC no matter how supportive your providers are, no matter how wonderful your doula is, it's only you who is going to get you that birth. You're the one who has to push the baby out. You're the one who has to do all of the work even if there are people helping you. And I did day one. We would like a large family, so our position from the beginning of the pregnancy was, “Well, if this baby is a C-section, then are probably done.” I really don't want to put myself through more than three C-sections. The other two were so deeply traumatic for everyone in our family. I can't imagine recovering from a C-section with three or four children. We are going to be done. So that really lit a fire under me to fight for it even more. Even if we do decide now to be done, I didn't want surgery to be what decided the size of my family. That was something I felt really strongly about. I started chiropractic on day one. I started doing all of the things. I took obviously all of my medicines and I just took really good care of myself and my body. I think bodywork played a huge part in my pregnancy this time around. We found out at 20 weeks at my anatomy scan that the baby was breech. I'd never had a breech baby. All of my babies were OP before, so I was like, “Okay. Surely this is 20 weeks. He's obviously going to flip at some point.” He really didn't. He was breech until 35, so I went to a Webster chiro twice a week. I did moxibustion. I did all of the Spinning Babies. I hung upside down off my couch 700 times a minute and did everything you could possibly do, handstands in the pool to flip a breech baby. Really, nothing was working. I went to a bodyworker who was like, I don't really even know how to explain what he does, it's something between chiropractic and massage therapy, but he tried to manually move the baby for me. It never worked. Nothing happened. They told me I couldn't have an ECV because I was a VBAC after two and my last birth was so recent and I had an anterior placenta. Meagan: All of the cards were stacked against you. Abby: So many cards. I basically was like, “I have this deadline. If I made it to 39, they're going to schedule me if he doesn't flip by then.” It was really dark honestly because I had that deep knowledge the whole time that this was going to be my VBAC. I really started to doubt that and say, “I've had such shit luck before now.” Sorry if I'm not allowed to cuss on the podcast. Meagan: You're just fine. Abby: Maybe my terrible luck is going to continue and it wasn't a true feeling, it was just a desire. He finally flipped after a lot of tears and a lot of, “I think I'm going to have to have a C-section.” I went to birth trauma therapy for the whole time. We talked a lot about, “Okay, well what happens if you do have to have a C-section? How are you going to be okay with it if that is the outcome?” He eventually flipped which, praise God, was amazing but the minute he flipped, he was LOA. I have never had a baby in a proper birth position. That is intense, girlfriend. He was down low doing what he was supposed to be doing and I was like, “Ow. This is a lot of pressure all of the time.” It was just constant pressure. It felt like a lot of contractions. They were obviously prodromal, but with my experience with Hadley, I just ignored them the whole time. I was like, “La, la, la, la, la. Nothing is happening.” He flipped at 35.5, maybe 36. The contractions really picked up right away. I never had a cervical check, so I don't know this but I have a feeling that I was walking around at a 3 or a 4 for a while. I was having very regular contractions, not necessarily timeable, but they were real for sure and doing something for sure. His position was doing something also. He was putting pressure down low and dilating me in my opinion. At about, I guess it was 38, everyone kept saying, my doula kept saying, “I think you're going to go early. I really think you're not going to make it.” I was like, “I'm going to go 42. Nobody is going to stop me. I will do whatever I need to do.” Meagan: Mentally prepared. Abby: I will have a 42-hour labor, okay? I will have a 42-hour labor if I need to have a 42-hour labor. I will do all of the things. They were all like, “No. You're not going to make it.” But then, when you keep not having the baby, you're like, “This is making me crazy.” Prodromal labor is insane. It's such a mental game. It's just like, “Is this it? Is this it? Is this it?” especially because I'd never gone into labor naturally before. But when it was it, I knew. There's really no denying it. I went to the chiropractor in the afternoon. I'm so excited. I'm about to start telling my VBAC story. Sorry I'm long-winded, but this right here is truly what I've been dreaming of for a really long time, so thank you for giving me this space to share my story. Meagan: Yes. I love it.Abby: I went to the chiropractor on a Monday at 4:00 and I said, “I think I'm going to go early. I've been having all of these contractions.” I had one while I was standing there talking to her. She actually encouraged me to get a membrane sweep. I denied them the whole time with all of my midwives. I was just like, “No, no, no. I'm not doing that.” She was like, “Hey, I went to 42 and I wish I had started the process a little earlier.” It made me doubt all of the prodromal labor I had been having because I was like, “Why do you think I need a membrane sweep? I'm obviously having a baby in the next five days.”Meagan: Yeah. You're like, “My body's working.” Abby: Exactly. That's what I thought. I was like, “I don't know about that.” But I had a contraction while I was standing there talking to her, checking out, and paying. She said, “Are you having a contraction right now?” I was like, “Yeah. This is just what it's been like lately.” I went home and was annoyed by the contractions. I drank a Body Armour with some electrolytes and took a bath because that usually slows the prodromal down. I had five contractions in the bath. I was like, “Hmm.” So I texted my doula and was like, “Usually when I take a bath, it stops the contractions. Surely this means that something is happening.”I didn't mention that for the last two weeks once he flipped his head down, I started bleeding pretty regularly. I'm on blood thinners, so I could get a papercut and it would be like the red sea, so it was not all that concerning. My doctors were like, “Well, it's not your uterus. The baby is okay. You would be in pain if you had a rupture. Everything seems okay.” Meagan: Yeah. Abby: My poor doula, I texted her a lot of pictures being like, “Is this bloody show? Is this bloody show? Do you think that this is bloody show?” But finally, on the night that I took a bath and had contractions in the bath, she said, “That looks like blood show.” I was like, “All right. Okay. Now we're cooking with gas. Something is happening.” I got out of the bath and was very annoyed. We had a long day. We have two other kids and my husband and I were both just so tired and wanted to go to bed. He said, “Can I make you some dinner?” I don't think I had eaten anything. He said, “I have a couple of steaks. Can I make you some steaks?” I was like, “That sounds awesome.” I was like, “I'm just going to sit in bed. I'm going to watch New Girl and ignore these contractions and eat some steak.” I attempted to do that, but the contractions were starting to pick up and I couldn't eat. I had to eat in between contractions and chew and swallow. I was not enjoying the steak at all. I lay down and I felt a pop. I had experienced my water breaking with Ginnie and I was like, “That was my water.” I texted my doula and said, “I think my water just broke.” She had been fielding all of these texts from me for the last two weeks about the blood and contractions and blah, blah, blah so it's not that she didn't believe me, but she was just like, “Okay, so tell me what makes you think that your water just broke.” I said, “Well, I didn't pee.” She was like, “Okay.” I got up out of bed. My husband had just put down a piddle pad underneath the sheets because he was like, “You know, just in case. You're having all of these contractions.” I didn't want to totally ruin the mattress, so I hopped up out of bed really quickly because I wanted to go back to sleep after my water had broken. I was like, “Even if there's a piddle pad, I don't want the sheets to be wet because I want to sleep in them.” It was a flood. It was very much my water. I was like, “Okay. Nope. That's okay. Things are happening.” And things really did start to happen so, so quickly. You know, as a doula, you have all of these numbers in your head of, “Okay, so there's 5-1-1 and you call the doula when it's 5-1-1 and then you go to the hospital when it's 4-1-1 and your contractions are a minute long and not slowing down in intensity.” That was very much not my experience. It was 0 to 60. I think the prodromal that I had been having just ramped my body right up and so there was no real labor. Meagan: That's the thing. Prodromal labor can do that because your body has been working. We call it prodromal labor but it's not like your body wasn't just doing anything. Abby: It did. It felt like it was doing nothing but it clearly was doing work. Meagan: It was. Yes. So listeners, if you have prodromal labor, seriously, just be on the lookout. Sometimes when labor does start and you've had a history of prodromal labor, it can start right out of the gate. Abby: It was aggressive. Meagan: Yes. Abby: So basically, immediately my contractions were two minutes apart and at first, they were 40 seconds. My doula was like, “You know, they can start out intense and maybe taper off a little bit.” That is not the direction that it went. They started ramping up in intensity. I watched about four minutes of New Girl and was like, “That's it.” And we were so tired. I just kept saying, “I want to do this tomorrow. I really just want it to wait.” With my middle child, I had been able to go to sleep after my water broke. I slept all night in my own bed and it just ramped up intensely so quickly. I hadn't washed my hair when I took a bath. It was just a soaky kind of bath, so I was like, “I'm going to go take a shower.” I wanted to wash my hair in the shower. I felt like then my doula could braid it and it would look cute in the morning and I'll just have clean hair. If I ended up with a C-section, I wouldn't be able to wash my hair for five days, so I might as well just do it now. My contractions picked up in the shower and I remember getting back onto my bed and being like, “I don't know how I'm going to get dressed.” Meagan: So intense. Abby: So intense. I just was expecting, even with the second birth, the contractions with the Pit were scheduled essentially. They were intense, but they were scheduled, so you get a break in between them. You get to, “Okay. Let me take a deep breath. Let me reassess.” There was no time for reassessing. Honestly, it was really scary. I have to be honest and say that I've had a lot of people say, “I'm so glad you got your dream VBAC.” I was like, “I don't think I would use those words.” I got a VBAC and I'm so glad that I did, but it was really, really scary because it was just so intense so quickly. Part of the birth plan was to stay at home for as long as possible. You don't want to go too soon and have them tell you that you're 2 centimeters and all of a sudden, you're stuck at a hospital, especially with your water broken. I just remember struggling to get dressed and telling my husband, “I think we need to go to the hospital.” He was like, “It's literally my job to tell her not to go to the hospital. I have one job and it's to not let her go there.” Meagan: It's to say no. Abby: I'm not supposed to do that. These are very specific instructions. So he called my doula and was like, “She's begging for you. She's really starting to moan through them and not be able to get sentences out.” She said, “Let me listen to her.” He put me on speaker and she said, “I'm going to meet you at the hospital. I think it's time to go.” I was like, “Thank God someone is letting me go to the hospital so I could get an epidural.” I was ready for this show to be over. I was like, “If I get an epidural, they'll let me take a nap.” All I wanted was to go back to sleep. I just wanted to go back to sleep. We got in the car. My friend was coming to keep our children and just sleep on our couch while we were going to the hospital and we were about to leave before she even got here. They were well asleep. It was 10:00 at night, but we were like, “We have to just leave the front door open for you.” She ended up making it. She saw me in the front yard and she was like, “Brian, do you think she's in transition right now?” He was like, “I don't know but this is really intense.” The car ride was horrible. We only live 9 minutes from the hospital, but it was just so intense, and just no breaks. It was scary and so painful. I follow pain-free birth on Instagram and they are liars. It is not pain-free. I just don't want anyone to listen to this podcast and be like, “Pain-free is what I experienced” because it is not. It is excruciating. You always think you are a badass until you're not. I was like, “No. Get me an epidural right now. I am dying. I will do anything. Just send me the anesthesiologist right now.” So by the time we made it to the hospital 9 minutes later, I was screaming. Screaming like in the movies and we always joke as my husband and I are now birthy people, I've transformed him to the dark side. Meagan: I love it so much. It all started with the Business of Being Born. Abby: Exactly. Meagan: Second date. Abby: Oh, literally. We always make fun of Hollywood movies where this woman's water breaks and she is screaming in the hospital 20 minutes later and that is exactly what happened to me. It was so instant. My water broke at 8:30. We called my doula at 9:30 and she said, “Holy crap. Go to the hospital.” We got to the hospital. Oh, I wish I had the exact timeline. I might have to look. We got to the hospital and I was screaming bloody murder getting out of the car. I don't even know how I walked out of the car to get to where I needed to be. The woman at the front desk heard me screaming and ran to get a wheelchair for me and run me up to the OB floor because this poor woman was like, “We are not having a baby in the lobby today.” Meagan: Yeah. I'm sure. Abby: She truly was like, “Go. This is my job. I'm going.” She ran me up to the OB floor and my doula apparently pulled in right behind us. She was on the floor but heard me screaming through the elevator from the 8th floor. I was screaming Meagan. It was a lot. I feel like I owe a lot of people some cookies at the hospital. My midwife said that I came in hot. Meagan: You came in hot. Abby: I really did. They were running me down the hall and this poor, I will never forget, this poor girl at the triage desk was very obviously new and she asked me if I could fill out paperwork. I was like, “Do I look like I could fill out paperwork right now?” I was sideways in the wheelchair with my leg up yelling at everyone. I just was like, “No. I will not be filling out paperwork right now.” They took me to triage which honestly was BS. I was like, “I'm obviously having a baby. Why do I need to go to triage?” But they saw me right away which was very helpful. I saw a midwife I had never met before which made me nervous because as a VBAC mom, you're like, “I want to know that it's the right people.” Meagan: Right. Abby: But around the corner comes– they tried to get an IV in my arm. I was flailing. There was just no way that that was going to happen which was awesome. I didn't want an IV anyway. But around the corner comes a student midwife who has been with me through my whole pregnancy. She shadowed a bunch of different midwives and I saw her several times. We actually had a really wonderful conversation. I guess one of the times the baby was breech at the doctor and I told her about my birth trauma and how difficult it was for me and all of the reasons we didn't want another C-section and she just gave me the most trauma-informed care. She just sat and listened to me well beyond the time of the appointment. She made friends with my five-year-old during the appointments. She was just such a light.The midwife came in and she said, “Hi, I'm Barb and I have a student with me today.” I had literally just been screaming at everyone in the room and I said, “Is it Cara?” and it was her. I gave her a big hug. She was like, “It's me!” and it was the most joyful moment of a really, really intense birth. It was 3 and a half hours from start to finish. It was so, so fast. It was a very intense, honestly scary time but seeing Cara was just like, “Okay. You are a safe person for me right now.” It felt like, “I know that you know how badly I want this and I know that you are going to do everything in your power to help me get it and why this is important to our family.” It was just like, “Okay.”But I still didn't calm down. I was not calm. None of it was a calm experience at all. There was just no time to emotionally switch from sitting in my bed watching New Girl to I'm at a hospital having a baby. It was just so quick that I couldn't wrap my head around the change in my life situation. They checked me and it was Cara who checked me, the student midwife. She said, “Well, you're an 8.5.” I was like, “Okay.” My husband was like, “What? I was not supposed to come to the hospital,” and then he was like, “Oh my gosh. Thank God I came to the hospital. I'm so glad I'm not delivering a baby on our toilet right now.” That was not what he wanted at all. She said, “You can start pushing though.” No one ever told me that I was 10 which I thought was interesting. She basically said, “If you're feeling pushy, you can push.” I was like, “I just want this baby out of me because I want this to be over. I'm very much done with this process.” So they took me to an L&D room and tried to switch me from a triage bed to the regular bed and I truly was in so much pain with no breaks in the contractions that I was like, “No. I can't even get on the bed.” They were like, “Trust me. You don't want to be on the triage bed to deliver a baby. Try to get over there.” Every movement that I made felt so challenging and so painful. They asked if I wanted to– I went on my hands and knees and they were like, “Is that comfortable?” I was like, “Do I look comfortable?” It was just the most erroneous question. I was like, “What part of me screaming makes you think that anything about this is comfortable right now?” Of course, it was too late to get an epidural, so when they tell me that it was basically time to push, I was like, “I don't want that. I just want to take a nap. I just want an epidural.” When she said 8, I was like, “Oh no. I have to do this. I have to be here and I have to do this.” Obviously, in retrospect, I'm very glad that it was too late and that I did it, but it was truly just so, so intense. Again, just how quickly it happened just did not allow time for me to even understand what was happening. But I started pushing when we got in L&D and the midwife who was very old school, I'm not going to guess her age but she's older, got in my face. I'm an Alabama football fan, so I kept saying that I needed someone to Nick Saban me in labor. I needed, “All right, Abby. Here's the deal. See you at the finish line.” I had never met her before. She totally got in my face and Nick Saban'd me. She said, “Abby.” I said, “I just want the baby out. I just want this to be over. I just want to get the baby out.” She was like, “We can get the baby out. You can get the baby out, but you have to stop screaming. You're letting all of your power out of the top of your body by screaming. You have to channel that. Take a deep breath and push down.” I just felt totally incapable of that, but I was again, so over it that I just was like, “Okay. I guess I'm just going to do whatever this random lady says.” I started pushing and less than 30 minutes later, my son was born. I was at the hospital for 48 minutes before he was born. Meagan: Oh my gosh. Abby: Truly like a movie. It was just the fastest thing I've ever experienced. It was really scary and apparently, it was also really scary for him because he came out not breathing. Meagan: Fast transition. Abby: Yes. It was so fast. Everything was so fast. It's officially precipitous labor, the timeframe that I experienced. He was just totally unresponsive. My doula said that she saw his chest rising and falling when they took him away, but you want the pull the baby up on your chest experience. I was so shocked when I pushed him out. Pushing was so hard. It was the hardest thing I've ever done in my life and they told me that I could see his head. I touched his head and I was like, “Oh my gosh, there is a baby coming out of my vagina. I can't believe that this is happening.” But the endorphins that you sort of expect to follow didn't really happen because we were panicking. My husband and I were like, bawling and praying out loud and just were so nervous that the baby was not going to be okay. My doula said that it was less than three minutes, but of course, it felt like an eternity. It was terrible. There were eight people around him on the table and oxygen. It was just a very medical experience. Again, I've had a lot of weird birth things and when I first envisioned being a mom, I envisioned a home birth really. All of my births have had reasons that they needed to be at a hospital. With Ginnie, praise the Lord that I was on an operating table when I threw a pulmonary embolism and that there was a cardiac anesthesiologist that knew. Honestly, had I had a vaginal birth with Ginnie, that pulmonary embolism would have flowed up into my lungs walking around my culdesac on a Tuesday and I wouldn't be here. That's just not the kind of thing that you can come back from. They are literally called the silent killer for that reason. It's hard to admit that the way that I wanted things to happen was not the way that they happened, but I am so thankful for all of the medical people and all of the things that happened the way they happened because my children are safe and I'm safe. That doesn't make things any less traumatizing if you've experienced trauma, but it's just really overwhelming to think about how things could have happened had I been more stubborn or insistent on a home birth this time or whatever. So I think my biggest shift obviously once the baby was okay and everything, I had a second-degree tear which was no big deal. She stitched me up. That took forever. I was kind of over it by that point. By the time she was done and they had handed him to me and everything was fine, people had cleared out of the room, I had to go to the bathroom. I had so much water during labor. I have a big Stanley cup and I just kept asking my husband to give me water in between every single contraction. I was like, “Water, water, water.” It was the only thing I said for an hour. I was like, “I really have to go to the bathroom” and the nurse just looked at me and was like, “Okay. It's over there.” I was like, “I can go to the bathroom? I can just stand up and go to the bathroom?” And I did. She was like, “I can help you.” She wasn't trying to be rude or anything. She was like, “Okay, yeah. We can totally go.” I was like, “No, I think I can go to the bathroom.” Totally unmedicated. I had no IVs. The continuous fetal monitoring did happen, but it was someone just holding. They didn't even have time to put anything on me. They just held it down at the bottom of my belly. I was pretty unencumbered and by the time I was done, I could just get up and go to the bathroom. I took a shower in the postpartum room the next day and everything was just like night and day. I have already taken walks with my family. I took the baby out of the house yesterday by myself. I carried his car seat by myself. The recovery is, my birth was not a dream birth. It was terrifying and I'm glad it's over. I'm glad I did it. It's amazing and empowering, so don't hear me saying that it wasn't amazing, but the postpartum experience is what has solidified for me that it was worth every second because for three and a half intense hours, I don't have to have four-plus really terrible weeks trying to recover from a major abdominal surgery, so it was worth every very, very intense second. Meagan: Oh my gosh. Abby: I know, I'm sorry. Meagan: Well congratulations. Abby: Thank you. It's a very long story. Meagan: Congratulations. It's okay. I love it. I love it so much. I appreciate your sharing. I could just feel the intensity. Abby: Oh, it was intense. Meagan: I'm sure for everybody it was just like, “Ahh!” So much was happening and those precipitous births, just recently recording, I think it was last week's episode was accidentally at home. Sometimes there are these babies that just come and they are ready to go. I really appreciate you sharing your story. Abby: I'm so glad. I'm so glad. It was really such a joy and overwhelming to be here. Honestly, thank you. I feel like what you do is just such a service to women. When you have a C-section, you might think that your body is incapable or not able to do what you thought it might be able to do and it's really disempowering to feel that way. So to hear these stories is such a gift. I just ate them up like candy. I listened to The VBAC Link on the day that I went into labor and I was going on a walk before I went to the chiropractor. It just gave me the power to say, “I think I really can do this.” And I did. So thank you for what you do. Meagan: And now, you're one of those stories. Abby: I'm one of those stories.Meagan: Before we go, I just wanted to share with everybody if you guys want to go find Abby on social media, again, she's not actively doula-ing right now, but I can see it in the future. Abby: Definitely. Meagan: She's at @AbbyKraftMac which I absolutely love.Abby: Yes. Kraft with a K. Meagan: Yep. Kraft with a K or abbykraftmac.com. We'll make sure to be tagging you today on Instagram and all of the things. So thank you again so much for being here. Abby: Thank you, friend. I'm so thankful. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all thing

In Episode #38 of Season 3 of the No Such Thing as Normal pod with Natalie Hayes and Jess McKeown we're channeling intuitive messages from Spirit Guides and Spirit Babies for our listeners. We keep it anonymous so that the messages can apply for the entire collective, so if you get chills while listening, then you know it's meant for you! We go deep with questions about women's suffering, childhood health issues, and chronic illness and pregnancy. Natalie's course Intuition: Unblocked comes up as a resource to guide you on your spiritual awakening and growing your intuition, so please check it out! If you want your question answered on a future podcast, DM us on Instagram (@nosuchthingasnormalpod @mcjaguar @intuitivelynatalie) or send an email to nosuchthingasnormalpod@gmail.com. We're also following along on Natalie's postpartum journey, where she introduces her new segment for the podcast: Fresh Anxieties in Motherhood. This week she shares the highs and lows of breastfeeding, including mastitis, tongue ties, choosing a formula, and donor milk. She also shares her experience with opting for the drug Cytotec to augment labor and then learning later that it is not FDA approved and can rupture your uterus. Thank you for your questions and letting us know that you're happy that we're back–we are, too!

Igångsättning av förlossning, eller induktion som det också heter, är alltid ett hett ämne. Det märker vi på era frågor per mail och på Instagram.På senaste tiden har ämnet också blivit aktualiserat genom inlägg i media kring igångsättningsmetoden misoprostol, och de två olika beredningar av det läkemedlet som vi använder i Sverige.Vi vet att ni har många frågor kring effekt, fördelar, nackdelar, aktuell forskning och annat. Det florerar en del myter och föreställningar som vi behöver diskutera och granska vetenskapligt. I veckans podavsnitt ska vi få hjälp med att svara på alla era frågor kring igångsättning med misoprostol. Vår gäst är Tove Wallström, medicine doktor och överläkare inom obstetrik och gynekologi, medicinskt ledningsansvarig läkare vid förlossningsavdelningen på Södersjukhuset.Tove Wallström har många års klinisk erfarenhet av induktion, och har både egen forskning och mängder av andra forskares studier i ryggen när hon hjälper oss att svara på alla kluriga funderingar. Tune in för avsnittet du inte vill missa!Veckans avsnitt sponsras av MAM och vårdappen NUMATips: Lyssna även till vår systerpodd - AMNINGSPODDEN Hosted on Acast. See acast.com/privacy for more information.

Ashley had a baby and refused to give him a name! In this episode of The Undelivered Bailey talks to Ashley about giving birth to her second child. After a miscarriage, a horrible experience with Cytotec, and a dramatic start to her rainbow pregnancy--Ashley and her husband Brandon were blessed with their second son, Bowen. Thank you for listening and for more follow Bailey and Ashley on IG. IG @bailshenry @ashp_worth

It's so hard to believe that 2022 is coming to a close. Today is our last episode of the year! We have had so many inspiring guests on the podcast in 2022 and are so thankful to all of our listeners. No topic is off-limits in today's Q&A episode. Dr. Christine Sterling is a board-certified OBGYN and founder of Sterling Parents. Meagan is here today asking Dr. Sterling questions sent in by our listeners. We cannot emphasize enough the importance of interviewing multiple providers, researching evidence-based information, and paying attention to how YOU feel about their responses! Additional LinksDr. Sterling's Instagram: @drsterlingobgynSterling ParentsBebo Mia's WebinarHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode DetailsFull Transcript Meagan: Turn your love of babies and bellies into cash. If you love babies and bellies and want to provide care and support to families, then Bebo Mia's webinar is the right place for you. Get answers to those burning questions like how to be the voice you wish you had at your birth and how babies and families can be supported by doulas. Learn all about the different kinds of doulas. You can work in fertility, pregnancy, birth, postpartum, or just enjoy working with those squishy babies. Supporting families by becoming a birth worker, aka doula, is perhaps an option that hasn't even crossed your mind. That's why we want you to join this webinar. You can have great earning potential while doing something you love. Bebo Mia is the one-stop shop for education, community, and mentorship. Reserve your spot today at bebomia.com/freewebinar. Meagan: Hello, hello. You guys, this is our last episode of the year. 2022 has come and gone and I cannot believe it. So many things have changed this year as you know. Julie has left the company and I've been solo for a little bit. That was a big, big change for us, but I am doing one of our first, I should say one of my first, episodes with a birth professional Dr. Christine Sterling. I cannot wait for this episode to be aired because it's going to be amazing. Dr. Sterling is a board-certified OBGYN and a founder of Sterling Parents which is a membership that provides the heart-felt support, expert advice, and timeless wisdom people deserve as they grow their families. After becoming a mother herself, she discovered first-hand how little support Western medicine offers to women moving through the life-altering transition into motherhood. Amen to that. It makes me sad. It breaks my heart how little support there is. So now as a mom, she is on a mission and dedicated to ensuring women get the maternal care and support they deserve. Dr. Sterling has developed a signature body, mind, and heart model of care combining cutting-edge science and ancient wisdom with her years of patient care, thousands of births, and long-standing meditation practice. So, Dr. Sterling, we are so happy that you're here. I am so happy. I still say we. We as in The VBAC Link. I don't know if you know, but I used to have a partner named Julie. We had been together for years and years and she has just recently left, so I just can't get out of the ‘I' and the ‘we'. I'm always going to be a ‘we'. Dr. Sterling: You know what? In medicine, we always talk about the ‘we' when you are part of a team, so I will oftentimes always use the ‘we'. Meagan: Yes, yes. Thank you so much. Is there anything else that you would like to share that I did not cover, all of the amazing things that you do? Dr. Sterling: I think we will get all into it, but that is the long and short of it. Meagan: The long and short of it. There's so much because you are so amazing. Okay well then, we will just dive right in. Dr. Sterling: Let's do it. Meagan: As we were getting questions, a lot of people asked very similar questions. One of the number one questions that people are asking is how do you truly advocate for yourself? What is the best way to advocate for yourself? As a VBAC mom, you can feel very much against the world when you are entering a birth space, and sometimes when you are entering a birth space where there's an on-call provider like you said, when you work in a team and you don't know that person and you haven't really established the relationship of them knowing what you want, it can be hard and with different nurses and all the things. So what would you say is one of the best ways to advocate for yourself as a patient? Dr. Sterling: Yeah, so I think that sometimes the word ‘advocate' can sometimes put a lot of pressure onto the individual that, “I need to advocate.” Meagan: “I need to be strong.” Dr. Sterling: Yes, exactly and it feels like this really heavy weight. There's a mental weight to this, “I have to advocate to get what I need.” I completely understand where that comes from especially when you are wanting a VBAC. It can feel like there are policies going against you and that people aren't working with you, so I think that the first thing is to hopefully get into a therapeutic relationship with a midwife, a doctor, or a practice of doctors in which there is a collaborative relationship in which advocating isn't so heavy. It's a conversation. It is a discussion that you are having with each other. For me, I think that oftentimes physicians and patients are communicating to each other on different levels. We are not really understanding where the other party is coming from and we don't understand what's the tape that's playing in their mind. As a patient, you may be playing this tape of, “They're trying to get me to have a C-section and the odds are against me and I've got to fight my way through it.” And as a physician, you have a whole other tape playing. One of the things I encourage with my members is really, I share the behind the scenes and the thought process that is going on for their OBGYN when they're having that conversation so that the patient can show up with a perspective and in the space that creates that really strong, collaborative environment. I can go through some of the things that I typically talk to my members about with that, but I like to tell my members, “This is not about you having to advocate so hard for yourself, but rather to invite your provider into a collaborative relationship with you and there are ways that individuals can do that.” I want to caveat that with I wish that it wasn't something that patients had to do so much. I wish it was something that as physicians, we showed up in that space. A lot of physicians do, but not everybody does. I like to think of it as it's not the problem of each healthcare provider being, “Oh, you're bad and you should be showing up and collaborating with patients better.” It is a system problem very much. We have burnt-out physicians. We have hospitals that are coming down on them so we have a system that does not foster a collaborative relationship between patients and there are things that individual patients can do to invite their providers to have a more collaborative relationship. I wish patients didn't have to do that, but I do think that it can be beneficial. Meagan: For sure. I think sometimes too as a patient coming in, we do know that our providers are burning out a lot of the time. They don't have a ton of time, so you have a lot that you want to bring to the table, but at the same time, you hold back and restrict that because you don't want to drill your provider with a million questions. Sometimes the provider, although they really want to answer, they don't have time to have that conversation. Dr. Sterling: 100% yes. Meagan: It's not even that they don't want to, it's that they can't because they are seeing 60 patients that day. Dr. Sterling: Oh trust me, we would much rather, much rather—when physicians leave and stop taking insurance and go and do a private practice that is just cash-based, which that's how some physicians solve the burnout issue is, “You know what? I'm exiting the insurance realm,” because what do they do? They have longer appointments with their patients. They take fewer appointments. That's what we want. You only want to see 10 patients a day and give each patient 45 minutes. 100%. But you can't if you take insurance. We are locked into this system that makes us not able to have the type of therapeutic relationship with our patients that all of us at our core want. Some of us have awakened to the fact that the patients aren't the problem, the system is the problem. Some physicians will say, “Oh, the patient Is asking too many questions and I'm annoyed at the appointment.” But they're not saying, “You're not annoyed at the patient,” but that patient was paying whatever amount of money for that appointment and if you had a whole hour with them, you would be so happy to show up and educate. Meagan: Yes, yes. Well then and sometimes too on the patient side of things, we can see it as, “Oh, well my doctor is not supportive. My provider is not supportive because they don't even want to listen to me or they are very quick to answer.” From a VBAC standpoint, a lot of the time when we're coming into these providers to ask them these questions, we really want a heartfelt answer. Dr. Sterling: Of course you do. Meagan: We don't just want to hear ‘yes' or ‘no',  so that's another one of the questions that a lot of people have asked is what are some of the signs or red flags I should be watching out for that maybe my provider although probably wonderful, may not be the best provider for me or for that patient, right? How can someone decipher through that and try to understand that that provider doesn't have a lot of time as well? There's this happy medium. What are some red flags or signs that you would say, “That might not be a good provider for you”? Dr. Sterling: Perfect, so there are two main issues here. One, how do we have a conversation about VBAC when we have so little time? I want to address that. The first question though is, what are the red flags? How do you know if you have the right provider to support you in having a VBAC? This is actually really, really simple and very easy to do. What you're going to do is you're going to go to your provider and you're going to say, “What do you think about VBAC?” You're going to be quiet. You're not going to lead them to that you want a VBAC. Nothing. And just let them talk. If you have a provider who is like, “You know, VBACs makes me really nervous. I'll do them but they make me really nervous and I've been burned. I've had some bad experiences.” Or if you have someone who's like, “I love VBAC. When I get a pregnant person who has a quote-on-quote ‘successful VBAC', it makes me happy. It makes my day.” Those are very different people, right? It's not that somebody who has that more negative view of VBAC can't provide you with appropriate medical care, but it's that whole extra level of your experience. Do you know what I mean? If you are going for a VBAC and you feel like your provider already has the scalpel in your hand, it puts extra stress and extra pressure on you to advocate for yourself whereas the person who is in a relationship with someone who loves a VBAC is like, “We're doing it together. We're collaborating.” Also, when that provider who loves VBAC and who is gungho with you says, “You know what? We've got to call it. Let's do it.” You come to that from a place of, “You know what? I trust this person. I know she wanted this for me and I trust that what she's telling me right now that I really do need—” Meagan: It is best. Dr. Sterling: It is best. That's why I think you just ask a question. Stay very quiet. Don't let them know how you feel about VBAC or that you want a VBAC and you just let them tell you their perspective. Both providers can provide excellent medical care, but you want to be in an environment with someone who's into it and who's excited about VBAC. Meagan: Yeah, who's just going to create that extra level of experience because like you said, this provider over here may be more hesitant and is quote-on-quote going to let you ‘try' but may not have that extra oomph, energy, and positivity in your experience but you still might get your VBAC with that provider. That doesn't mean that they're not totally unsupportive. We talk about tolerance and stuff like that, but yeah. This other provider over here may be the perfect provider for your experience. Dr. Sterling: Exactly. There are really great physicians who have attempted VBACs themselves and had bad experiences. The reality is that physicians are human beings and we bring our experiences to the table. Too, ideally, we would maybe do a little less than that but that's just the reality of human beings. We are bringing our experiences to the table. If we've been burned, it can be hard to work past that. Meagan: Well and just like you were saying at the beginning, that provider might be playing a different tape in their head and that was based on their experience, right? Okay, I love that. Anything else you want to touch on with that? Dr. Sterling: Oh, so in terms of the VBAC, how do you have this conversation with your provider about VBAC? I want us to look at having the conversation about VBAC over an entire pregnancy. Please do not try to fit it in—it is okay to start talking about VBAC at maybe not your first appointment because there's so much going on with all of that, but it's okay to start talking about it in the first trimester. I'm a big proponent of that. I'm a big proponent of and I believe that a lot of pregnant people are carrying around this mental weight of uncertainty and unanswered questions and concerns and worries. For me, part of having the VBAC discussion early is let's start relieving some of that weight. So that's really important is if it's on your mind and if your provider is saying, “You know, we'll talk about that closer,” just say, “You know what? I get it. I'm so far away from my VBAC. I totally get it but it's on my mind and I think that it would really help with my stress levels and with my quality of life if I can start having some of these questions answered now so I don't have to carry them around for my whole pregnancy.” Meagan: Right, yeah. Something that one of our followers asked was about—I'm sure you've heard of it—bait and switch where they seem supportive and then at that last minute where you really start talking about it, they kind of shift their gears. Sometimes I feel like if we can do what you said and start talking about it in the first trimester then we may recognize earlier on whether that provider and you are a good match or not because the bait and switch a lot of times feels like it comes at the end where they're like, “Yeah. Yeah, we're supportive,” but they're never having that full conversation. There are so many questions but like you said, there's a whole pregnancy so we can keep asking these questions at each visit taking a little time that a provider does have and having that to avoid that final trimester, the last few weeks, feeling like your provider just switched on you. So I don't know if there's anything that you want to talk about with bait and switch. It seems very negative to talk about people doing a bait and switch but it does happen where providers shift their gears and it sucks to be in that spot at the end. Dr. Sterling: Yeah, so the parting line of the OBGYNS—if you're in the United States and you're an OBGYN, ACOG encourages VBAC. We want people to VBAC. We want people to VBAC. So what it often is is that you're kind of getting the parting line at the beginning of pregnancy because it's far off and it's like, “Yeah, yeah. We support VBAC. You can do a VBAC,” whatever. And then push comes to shove and you do understand that “Oh, this provider has some more nuance to their support for VBAC.” You know? I think it's again, it is about talking to them about and asking very—sometimes you want to hear what you want to hear. Sometimes we have to ask the hard questions and ask in a non-leading way because human beings and all of us to some degree are people pleasers. It's just a natural human behavior thing. So if you can just say, if you can ask more-detailed questions like, “Is there anything about me and what happened to me last time and my personal, medical, and obstetric history that makes you more nervous or reticent to recommending a VBAC?”Understanding that what you're getting at there is yes, you're getting at their medical assessment of what kind of candidate you are for a trial of labor after a C-section, but also, you're getting an idea of what are they going to bring up at the end of pregnancy? Is there anything that I can address now? And really, it is okay to evaluate your provider as you move through and make sure that you are on the same page. Meagan: Yeah, for sure. I love that. I love that question. Write that down, listeners. Write that down. Okay, so one of the questions is, of the VBACs that you have seen, what are some of the things that have stood out to you about TOLAC and about people who go for a VBAC? Is there anything good and bad that you're like, “Okay, this is something that stood out to me in a positive way or this is something that I never knew about and then I saw this and now I'm watching for this for the future births”? Dr. Sterling: Yeah, so I talk about this thing with my members all of the time. The thing that I have found to be most important when we're thinking about the mode of birth is to understand that the most important thing is that regardless if you end up with a repeat C-section or you end up with a successful vaginal birth after a C-section, what we want is somebody who had as empowering of an experience as possible. Hopefully, it was also a beautiful, empowering experience. You can have a beautiful birth experience by having a C-section and have it with a vaginal birth. What I have my members do is have them come up with their birth values. We usually stick to three or five. What are your birth values? And understand the why behind it. “I want a vaginal birth because—” what's my why? And underneath that, there's oftentimes some really good stuff, and if you can bring that to the surface, those values. “I want to feel present in my birth. I want to feel that I have autonomy over my body.” It's different for everybody, but these values come up and what's important is that we talk about how you can honor those values and those deep desires regardless of the mode of birth so that if we set up, “I want a vaginal birth and that is the success for me and if I don't get that, I have failed. The birth has failed” if you can fail at giving birth. What we want to do is to work towards a vaginal birth while also acknowledging that at the core, even if the vaginal birth doesn't happen, we want these values to be honored. Let's talk through how we can honor these values in a C-section. What can we do to prepare you for a C-section that is beautiful and I will tell you, some of the births that really stick out in my mind from experiences I've had with patients were the most beautiful belly births. I mean, really beautiful experiences and experiences that still bring tears to my eyes. I think a lot of times we act like the only time birth can be beautiful is if it's vaginal. Meagan: Is if it's vaginal, yeah. It's not true. Dr. Sterling: It's not true. Oh my gosh. The births actually that I think about the most in terms of a beautiful birth experience was a belly birth. That was me as a provider. That's not me as my personal birth experiences but they can be really, really beautiful birth experiences. Meagan: Yeah, with my second it was undesired. I didn't want a second Cesarean, but it was a beautiful experience and I will cherish it forever. It helped me grow and it helped me heal from my first one too. Okay, I love that. The next question is about induction and VBAC. At what weeks would you suggest induction for VBAC in general and I know further down in the questions there is when would you suggest induction for VBAC with gestational diabetes? Maybe they're the same. Maybe they differ, but yeah. That's one of the questions. Induction and VBAC are also controversial depending on the provider. Dr. Sterling: So the issue with induction with VBAC is that two things are true. This is the part that really trips people up. We have some data that an induction at 39-40 weeks with a VBAC may increase your chances of a vaginal delivery. We also have data that people who go into labor on their own have a higher chance of having a VBAC with a trial of labor so both things are true. If we had a crystal ball and knew that you were going into labor on your due date with a VBAC, we would not induce you before that because that would be best for you to go into labor on your own. However, if we had a crystal ball and we knew that you were not going to go into labor and you would need to be induced at 41 weeks and 5 days, we would have wished that we had induced you at 39 weeks. There is no right answer here. I'm a huge believer in membrane sweeps for people who really want a vaginal birth. Ideally, around 39 weeks, I've had many membrane sweeps myself. They are not necessarily the most pleasant experience. Meagan: And sometimes they work and sometimes they don't. Dr. Sterling: Sometimes they don't. So membrane sweeps reduce the chance that you will need a formal induction of labor. They are kind of considered a method of induction so we usually don't do them too early. They reduce the chance that you will need a formal induction of labor. On average, they are going to shorten your pregnancy by about four days. They don't always work to put you into labor, but with a VBAC, we also want to think about how much medication we have to give you if we do need to induce you. We would like to reduce the amount of medication we give you so that may help your cervix just be a little bit more ripe, ready, and primed for labor. We don't have data to support this so that's why I'm saying this. It may be helpful to reduce the amount of Pitocin we need to use for your induction. That's why I'm a big proponent of membrane sweeps in the right patient and with informed consent. That is very, very critical because unfortunately, that does not always happen and that's absolutely not acceptable for someone to undergo a membrane sweep without informed consent. Meagan: Right, going over anything. Yeah, I love that. Like you said, it's so hard because there's no crystal ball. You have to go through and look at where you're at and what's best for you and your situation. Another question about induction is, are there any methods you will or will not use? We do know through the history of Cesarean, there are certain things like Cytotec that we really don't use but then there are random providers out there who you will hear give Cytotec and things like that. Dr. Sterling: And your other question about gestational diabetes, when you are induced for gestational diabetes depends on how well your glucose is being controlled, if it's requiring medications, and oftentimes, your provider is going to prioritize the recommendations for your gestational diabetes induction especially if you are on insulin or say your fasting glucose is not where we want it because with some types of gestational diabetes and with certain levels of control, there is that increased risk of stillbirth, that is typically where they will put the priority. So if your glucose is poorly controlled, even if it might be the best thing for your potential VBAC to be induced at 38 weeks, if you have poorly controlled glucose and we are looking at an increased risk of stillbirth because gestational diabetes is mostly a risk when the glucose isn't well-controlled, then your provider is going to say, “Yeah. It might not be the best thing for a VBAC situation,” but for the health of the pregnancy, this is going to be our recommendation. I just wanted to answer the gestational diabetes question. Meagan: Yes, so let's go back into induction methods and what you've seen. We talked a little bit about membrane sweeping and I am going to quickly run. My daughter is sick and screaming for me so keep talking. I'm going to block my screen out for a second and I'll be right back, but if you want to talk about induction methods. And maybe too, what you've seen work better and maybe also where the cervix is or not. Does that make sense? If you're not dilated at all, how can you induce and all of those things? Dr. Sterling: There is a bit of a question mark when it comes to induction with a trial of labor after a C-section. There are medications that most OBGYNS are not going to use. Cytotec is one of those medications that when we are inducing labor at term, we don't like to use because there is some data that it has a higher risk of uterine rupture which is when the scar of the uterus breaks open. We really, really want to do everything we can to avoid that. That's the complication that we are most concerned about with  We really, really want to do everything we can to avoid that. That's the complication that we are most concerned about with a TOLAC. Some providers won't do any kind of medication for an induction. They'll only do mechanical, so membrane sweeping, the Foley balloon or a Cook balloon. They'll do ruptured membranes, but once it comes to any medication, that will be a hard stop for them. The reason why some providers don't use Pitocin is that we don't have enough data to say that this level of Pitocin is a-okay but once you get to this level, that's where we see the increased risk. We know that using Pitocin can increase the risk of rupture, but we don't know where the line is. So some providers are like, “Okay. In that setting with that doubt, I'm just going to say no to Pitocin altogether,” whereas other providers will say, “You know what? We will use a lower dose protocol for our people who are undergoing a trial of labor and inform the that we are going to use Pitocin.” It does slightly increase the risk of rupture, but it's not unreasonable to use Pitocin. It isn't, but the person has to be informed that this may increase the risk of rupture. We're going to use a lower-risk protocol to try to mitigate that risk, but we don't actually have the data to say, “This amount is okay. This amount isn't okay.” And so this is where it comes to how different providers land when there's nuance and when there's gray. Some providers are going land in the, “No. I don't want to do anything that could increase your risk of rupture,” and other providers are saying, “Hey, if you're aware of this risk and you're okay with it, I'm okay doing Pitocin.” It just depends. Meagan: Yeah. I know it's such a hard one because there are different providers. With my second, I was begging for Pitocin. First of all, who begs for Pitocin? Not normal, not a lot of people, but I was begging for it. He was like, “No, no, no, no,” but then I was a doula and I started working and I was like, “Wait. There are all of these providers doing Pitocin, but then there are also providers that won't.” It's like you said, “Okay, I'll a Foley or a Cook, or I'll break your water. And sometimes I'll use Pitocin if we have an IUPC and we can monitor the strength.” So it's just so hard. Again, it's one of those questions where there are two answers. Dr. Sterling: That's the thing is that there are some things in medicine and some things in obstetrics where you will get clear answers. That's always really comforting as a patient to be like, “Oh. Everybody agrees on this. Okay. I feel comfortable.” But then when you get to the situations where there is a gray zone and there is nuance and you see some providers doing something this way. Where I trained, they gave Pitocin for vaginal births. That was my standard practice. I left residency and I joined a practice and they were like, “No. We as a group do not do Pitocin for TOLAC.” And so it was like, “Oh, okay. This is different.” Patients would ask me what my perspective is and I'm like, “My perspective is that I'm used to doing this and I think that it can be done safely, but I'm part of a practice where that is a no-go.” Meagan: That is restricted. Dr. Sterling: We're restricted. So you know, one physician could feel a certain way about what they do but then be in a setting where this is not how it's done. Meagan: And that's hard too because a lot of time, they would be viewed as unsupportive, but it's actually not that they're unsupportive but that they're restricted. From a patient's point of view, we have to remember that sometimes it's not that the provider doesn't want to, it's that they can't within the practice that they're in. And again, that's where it's like, “Okay, well maybe that practice isn't the right practice for you.” Dr. Sterling: Exactly. Even if you were with me and you loved me, you're like, “I love Dr. Sterling. We get along so well,” but her practice and some physicians are their own bosses. A lot of physicians are employed and they are dealing with an employed physician that has a group that says, “We don't do this and you are an employee and not an owner of the practice.” Then you're like, “I love her, but she can't offer me Pitocin so I may have to go with someone else, and maybe I don't have the rapport that I had.” So it's unfortunately with physicians, oftentimes you're compromising on something. The question is what do I need? What are my non-negotiables within the practice? Stay firm on those. Your non-negotiables are your non-negotiables. Be clear. Some people may say, “You know what? I don't like that they don't offer Pitocin but the rapport is more important to me.” Other people may say, “You know what? I need to go somewhere that's willing to induce me if that's what I need with Pitocin.” Meagan: Yeah, with my third, I really wanted a VBAC again and I had a super supportive provider. He was top-notch supportive and known in Utah as one of the most supportive providers, but in the end and at the end of things, I was just feeling like I shouldn't be there. Everyone was like, “Why? You have the most supportive provider,” and I'm like, “Because I know that he's going to be restricted. I don't want to have that restriction although there are other providers who just don't have restrictions but not as many,” so I changed. I had a VBAC after two Cesareans and it was beautiful and amazing. Maybe I would have with that provider but I don't know knowing my birth story. I think he would have been cut off. He wouldn't have wanted to but he would have been cut off. Okay, so one of the questions was is a C-section always safer than a vacuum or a forceps delivery? So if you're coming to the point where you're pushing and you're about to get this VBAC and you're so close, but you might need an extra little bit of assistance, do you feel like a Cesarean is quote-on-quote “safer” or a better route than those other assisted delivery methods? Again, everybody has a different perspective and their history of using these things might come into play. But just share some of your thoughts. Dr: Sterling: You can't make a blanket statement that a Cesarean is always safer than a vacuum delivery or a vacuum is always better than a Cesarean. It really is each individual situation. What I can tell you is that if the vacuum is successful, if the forceps are successful and you have a vaginal birth and baby is okay and you're okay, then yeah. That was a better decision than going for a C-section in the second stage of labor. C-sections in the second stage of labor are not risk-free. As we know, there are a lot of risks to that too. The thing that becomes the more unsafe situation is when you have a failed vacuum or a failed forceps and then you go to a C-section. Meagan: That's what I was going to ask. Dr. Sterling: That situation, we want to avoid because that's the highest risk situation. Failed vacuum, failed forceps, then go to a C-section. If we knew that was going to happen, it would have been way better to go straight to a C-section than to attempt a vacuum. So I think that what I would want if I was in that situation, I was going through a trial of labor and my provider offered me a forceps or a vacuum. I would want to know their confidence level with that.  I would not want to be the one pushing, “Can we try a vacuum? Can we try a forceps?” I would want the other person on the end of the table saying, “I think we've got this. I think if I just put a vacuum on real quick, we're going to pop that baby out and we're going to be good. We're going to have a baby.” I want that level of confidence. I want somebody who's like, “Let's do this. I have no problem. I think we've got it.” I do not want somebody who's like, “Mmm, we could.” Meagan: We could, we could. Dr. Sterling: If it was me at the other end of the table, somebody saying, “We could,” is like are you feeling good about this? Meagan: Are you confident? Dr. Sterling: Yeah, when you're about to do a vacuum, I've never done forceps. On the West coast, very few people do forceps. On the East coast, a lot more people are still doing forceps. West coast, we have them on labor and delivery, but not something that we did. It was some reasons for that and some of it is medically legal, just the lawsuits from forceps, departments are like, “We don't do forceps anymore. We're not doing that.” There are patients where I've been like, “Let's do a vacuum. I think with a few pulls, this baby's going to come out,” and then there are vacuums where it's like, “Listen, I could do this. There's a shot,” but I didn't feel really good about it and in that setting, I was always super honest with patients that if they were highly, highly motivated for that vaginal birth, they might be willing to take that risk of, “I'm thinking there's a 50/50 shot here,” but me personally, I would want a provider to feel really good that it's going to work. Meagan: It's going to be [inaudible]. Yeah. That makes sense. Another question, we're just drilling out the questions here. This person had felt during her VBAC, and she did have a VBAC, but she felt burning sensations around her previous incision. She wants to know what that could have been. Could it have been scar tissue? Could it have just been that baby was passing through and stretching out that weakened uterine spot? I will admit, I had that a couple of times with my VBAC where it felt like a muscle being strained. Dr. Sterling: That's how my first labor felt was burning— Meagan: In your abdominal cavity. Dr. Sterling: Yep and I've had other patients where that's how they described contractions was this burning, stretching pain. My thought is that I can't answer that question specifically, but that could have nothing to do with the fact that you had a scar in you because that was my first labor experience. It felt like that, but then with my other labor experiences, the contraction pain felt different. People experience contraction pain differently and depending on the baby. My contractions when I had a baby who was sunny-side up when he was occiput posterior, they felt different than the contractions that I had with my other kids. It could have something to do with the scar, but also, it could just have been how your contractions felt. Meagan: Yeah, yeah. Mine seemed like it was a variant. Right before I started pushing. Maybe baby was just descending and the wider part was stretching. I don't even know. I don't know the details as far as her labor. She just said that she had it. Could it have been scar tissue or what could it have been? Dr. Sterling: It's always so difficult to point out what the cause is of a bodily sensation, but I think that there are a lot of different possibilities of what it could be. Some of them are related to a scar and some of them have nothing to do with a scar. Meagan: Yeah. There was another one in regard to talking uterine scar and VBAC. She said that after her first C-section, she was told that the lower uterine segment was thinner, so she was saying, “Could I still VBAC? Is this a total hard no, I absolutely shouldn't VBAC?” What are your thoughts on that? Dr. Sterling: It's an area of active research. It's an area of active research looking at, can we on ultrasound or even MRI measure the lower uterine segment and thus determine the risk of rupture and successful VBAC? It's still a question mark here, but if you do have an extremely thin lower uterine segment, sometimes we open people up after they've had a C-section and there's a window, right? Meagan: Yeah, that's another one of the questions. They said they had a window. I've actually had a window as well. Dr. Sterling: Yeah. So the window depends. Some of the research didn't really define what is a uterine rupture. Is a uterine rupture only when you get in and you open up the belly and the tissue is bleeding and it's clear that it's just ruptured and this was previously tissue that was together? Or what if you open up the abdomen and you look and there's this separation but it looks like it had been there for a while? Is that a uterine rupture or a uterine window? Not all of the research and the data have clearly said, “This is what we consider a uterine rupture. This is what we consider a uterine window.” Meagan: Or dehiscence. Dr. Sterling: Or a dehiscence, exactly. There are all of these different terms. There's a window, dehiscence, and rupture. Meagan: But sometimes it goes to rupture. Dr. Sterling: Yeah, so I think that personally in this gray zone of where the cut-off is for how many millimeters we want to see the lower uterine segment, it's hard for me to separate that from my own personal experiences having patients have uterine ruptures and have them go through these long labors and then open them up and they've got a window. I think that I would lean more towards if my physician was telling me, “Hey, you have a really thin lower uterine segment,” I personally would probably lean more towards a repeat C-section in that setting because to me, if I'm thinking about being in labor and also having the weight of, “What if my uterus ruptures?” If that weight is too heavy, I feel like that's not what I want to feel and that fear. Meagan: That constant questioning. Dr. Sterling: That constant questioning, and “Oh, they said it was thin. Am I making the wrong choice?” That to me would be very heavy. That isn't necessarily how another person would feel. What I think is important to think through for you as an individual is, “Is that fact that you have been told that you have this thin lower uterine segment? Is that going to be really prominent and heavy for you when you are in labor or do you still feel light? Does your body still feel light and you still feel like that's the right choice moving forward, that's the right path?” With my members, when I take them through—we have our confidence in VBAC path—when I take them through that, I have them ask their body. Ask your body, “Is this a yes and a no?” You have to figure out, “What does a yes feel like in your body? What does a no feel like in your body?” Ask your body, “Does this feel good or does this not feel good?” And then that's part of making a confident decision about whether you go forward with a repeat C-section or a trial of labor. That doesn't make the decision for you because you still get to ask your mind and you still get to ask your emotions and you still get to have a collaborative relationship with your provider, but you need to know how your body feels about the decision. Meagan: Yeah, we talk about intuition all of the time and digging deep into what is that saying. What is that intuition saying? A lot of times, that's the first thing where it's like, “I shouldn't have a C-section,” or “I want a C-section”, but then it's like, “Oh, there's this VBAC thing. Maybe.” But our initial gut was saying, “I think I should have a C-section,” or vice versa, “I want a VBAC.” Dr. Sterling: 100%. Meagan: I think that's such a good thing, talking to your body, asking your body. I love that. Okay. I know we don't have a ton of time left over, but a few more questions we have. Would you suggest an ECV for frank breech wanting to VBAC or would you just say C-section or would you say maybe find a provider if there is one in your area that could support that? Dr. Sterling: Yeah, okay. Meagan: Breech is a whole other podcast. Dr. Sterling: Breech is a whole other thing and it's so funny. For me, when people talk about breech vaginal delivery, all OBGYNs have birth trauma themselves. It's called the second victim. We all carry. I don't know a single OBGYN out in the world who doesn't have their own trauma from birth. One of my traumas is breech. Of course, this is an unplanned breech so it's different. I have to always calm myself when breech vaginal birth is brought up because I want to talk about it in an impartial way. An ECV, an external cephalic version, when we do a procedure to turn baby from a non-cephalic, non-head presenting position down into the head presenting position is going to increase your chances of having a vaginal birth. We know that. It also has some risks to it. Some of the risk is that your water breaks. We cause a placental abruption. We cause the placenta to separate. We injure the fetus. That would be super rare, but it's always something that we educate people about. I've never seen it but it could certainly happen. One of the things is that we typically do an external cephalic version before 39 weeks because we know it's more successful. We typically do them around 37 weeks. If your water does break at 37 weeks because you had an ECV, then we've got to do a C-section at 37 weeks and that's a higher-risk situation for your baby. We want babies to get to 39 weeks if we can. There is that risk of an earlier delivery or an emergency C-section because something happened, but it does increase your chances of vaginal birth. To me, it's how confident is your provider that they can turn the baby? It depends. There are different characteristics of a person and of how good of a candidate they are for ECV. If you have a provider who's like, “I'm super confident.” Sometimes I'd be ultrasounding patients and I'm like, “I feel like I could in the office, I'm not going to do it, but I feel like I could push this baby down. There's a lot of laxity to the uterus. Baby seems to be letting me move them.” So sometimes, it's like this is a very clear yes. Sometimes it's a very clear no. Meagan: Then there's all of the gray. Dr. Sterling: Yeah and then there's everything in the middle. So what risk do you feel comfortable with? If you want to be able at the end of the day to say, “I did absolutely everything to get that vaginal birth,” then yeah. ECV may be the way to go for you. Most of the time, even if it doesn't work, everybody's fine. But there's that 1% of the time where we're running back to the OR because baby is having a heart rate deceleration and not recovering. I have certainly been in that situation more than once so it happens. It's not common, but I don't classify it as rare. Meagan: But also not that it doesn't happen. Yeah. It's just less common. Dr. Sterling: Yeah. To me, rare things are things that I may never see but if I see them every year I'm doing it, to me, that is not rare. Meagan: Right. Right. Someone asked if you've ever seen VBAC after multiple Cesareans. ACOG says VBAC after two Cesareans is reasonable for VBAC, but it really kind of falls of the ledge after that. VBAC after three, four, all of the things and we know they happen. They're out there, but there is very little research. So someone just said, “What about a VBAC after three C-sections?” What would you say and again, I think it's important to note that it depends on every certain person that you're with and it also depends on your whole history and the reasons and all of those things, but anything that you would like to bring to the table for VBAC after 3+ Cesareans? Dr. Sterling: After more than two C-sections, yeah. At the end of the day, you have to consent to a Cesarean. You have to consent to a Cesarean. A Cesarean cannot be performed on you without your consent unless you were unconscious and you were brought into the ER and we needed to perform a Cesarean to save your life or you are not medically capable of making your own medical decisions. Meagan: Usually then, they have someone else too. Dr. Sterling: Sometimes. I trained at the place where we got most of the data on VBAC. I trained at LA County Hospital, USC. That's where back in the heyday of 1% of the US population was born there. It was such a maternity ward that we got the data on VBAC because we couldn't get those patients back to the OR. They were giving birth in the halls. So a lot of the VBAC data, the initial VBAC data comes from where I trained. Where I trained, we had a lot of people who would come in and give birth and they were very unfortunate stories and circumstances with drug abuse, homelessness, and mental illness. They would not know how many C-sections they had had. They would be coming in and they would give birth and sometimes after they gave birth, we would dig in through the charts looking for who this person could be and we found out that person had had four Cesareans before. Meagan: Wow. Dr. Sterling: I have been part of that. I have never had a patient who had three C-sections where we did that intentionally. I want to be upfront about that, but I think that it's all about what had happened. Let's say your first birth was a C-section for breech and then you go on to have a vaginal birth and then you had another C-section for breech and then you had another vaginal. If you've had multiple vaginal births, then you've had three C-sections, then I'm like, yeah. You are at increased risk of rupture. You've got three scars on your uterus for sure, but that's a very different situation than somebody who's had three C-sections in a row for failure to progress and then you're like, “You haven't had a vaginal birth. We are just putting you at a lot of risk with very little prospective of it being successful.” I have never been in a situation where somebody has had three C-sections and we've made the decision to proceed despite the risk with vaginal birth, but I have been part of deliveries where they had had multiple C-sections and we didn't know because they were actively giving birth and were not able to communicate how many C-sections they had to us. Meagan: That's an interesting thing to me in my mind. In so many ways, I wonder. Like you said, you didn't know. But if you would have known, would care have changed? Dr. Sterling: Yeah, it probably would have. We would have made a different recommendation because-- Meagan: Because of what you knew. Dr. Sterling: To us, getting up to a 2% risk of rupture or higher, it's a difference of perspective on percentages in a risk. As a physician, 2% is a lot of freaking people. That's 2 out of every 100 and when you're doing hundreds of deliveries a year, that 2% with a potentially very dire outcome, that 2% weighs much more heavily than somebody who's like, “Well, 2% is so small.” There's a whole different weight to that 2%. Meagan: Well, and we talk about that. We talk about how you have to decide what percentage is enough for you. If 2% is fine, then go find that provider that is supportive in that because it might not be like you said, a 2% from your standpoint is a lot but then to someone else, it might not be a lot. Dr. Sterling: Exactly, exactly. Meagan: It's interesting, yeah. Okay well, that's good to know. That's just so interesting. I wouldn't have even thought of that. You don't even know the history and you have to go find out who that person is. Wow, I'm sure that was an experience. Dr. Sterling: Unfortunately, I had that experience quite a bit. Meagan: Oh my goodness, yeah. Crazy. Okay well, last question. This one is what can cause a swollen cervix and what would you suggest if anything to help get that unswollen? Is there anything from an OB standpoint that you can do to help the swelling? This is something that a lot of people are like, “Oh, well I went in and I was 8 centimeters dilated and then all of a sudden, I was a 5.” It's not that you are literally going backward, but swelling can happen based on a lot of things like disruptions of checks and heads and babies' heads and all of these things, but yeah. Anything you would like to speak to about swollen cervix? Dr. Sterling: Yeah, we don't necessarily know why sometimes the cervix swells. It's a really unfortunate situation. What I have seen anecdotally in my experience is oftentimes when a cervix swells and then I have ended up doing a C-section not just for cervical swelling because that's not an indication for a C-section, but if that person did not progress after that is oftentimes, we have found that baby is not in the optimal position to move down the birth canal. That is something I have experienced personally and it's very frustrating because when you're in labor and when you're giving birth, you feel like it's all you and your body. We put a lot of pressure on ourselves. I want to remind people that you are only half of the equation at birth and babies can be cooperative and they can be very uncooperative. I have had an uncooperative baby and it was really, really hard. We can try things like Benadryl. We can try. Sometimes, it's like, if everything is safe, if you're on Pitocin, maybe we turn it down. We just give it a little break. We can try some Benadryl. We can try some Tylenol. These are things that are aimed at anti-inflammatory. Meagan: Do you take that orally, I assume? Dr. Sterling: You can, or you can give it intravenously if somebody is not tolerating oral. There are some mixed data out there about Tylenol and about Benadryl and their use in labor. But fixing the swelling once it's occurred doesn't always happen. Sometimes you can dilate past it. You certainly can dilate past it and I have seen that many times, but I think that the important thing to keep in mind is that it's not something that you have done wrong. We don't necessarily know why sometimes that happens. It may be that baby's just not in the ideal position because really, baby is dilating your cervix. It's this nice feedback loop whereas baby descends into the birth canal, it sends signals into your brain to release oxytocin. It's a collaborative process between you and baby. I have had three births and in my first birth, I pushed four contractions and baby was out, phenomenal. Then all of a sudden, my third birth, I was pushing for an hour and nothing. Not a budge. Not a budge. We thought that maybe he was sunny-side up, but we also knew that he was big. He was essentially 11 pounds when he was born, so he was big. I was so down on myself. I was like, “I shouldn't have pushed the epidural button the last time. Why did I forget how to push?” Meagan: You blamed yourself. Dr. Sterling: Oh my gosh and I know better, but I did. I was blaming myself like, “Why can't I do this? How did I forget to push?” OB comes in and she's like, “Yeah, I agree with you. I think he's OP. I can try a manual rotation.” I looked at her and I was like, “Girl, just do it.” Meagan: That's another one of the questions by the way. Dr. Sterling: So she goes in and she does. Listen, she was better at manual rotation than I am. I have not had as much success. The fact that this manual rotation worked was a little bit of a surprise to me because in my experience it has always been really hard to do. She went in. She pushed him up. She turned him down and he came out. I didn't even have to push. The whole time, I'm thinking, “I'm not pushing correctly. How did I forget how to push?” putting all of the pressure on myself. There we go. It wasn't me. It wasn't me. Meagan: I love that. That just gave me the chills. Dr. Sterling: I didn't even have to push. I had to push past my perineum but he came all the way to crowning once he was in the proper position and that was a huge eye-opening moment for me. I instantly felt bad for all of the patients who I had coached and tried to get to push correctly. I was like, “What?” Meagan: Yeah. Dr. Sterling: Yeah, yeah. Meagan: We really do as a society. We need to stop not just in birth but in all things. Motherhood, so many things like, “I'm a bad mom because I did this” or “Oh, this happened.” We put so much pressure and going right back to the very beginning of this whole conversation is being an advocate saying that we have to advocate for ourselves, it puts all of this extra pressure because not only are we saying that you have to go into labor. You have to dilate. You have to efface. You have to bring your baby down in the right position. Then you have to push the baby out. Then you have to nurse the baby. All of these things, right? So it's like, why are we adding all of this extra pressure onto ourselves where you were doing all of the right things? You were doing everything but it was just this little factor that you needed to change and it was out of your control. You were trying to do everything you possibly could. Dr. Sterling: Exactly. Meagan: I love it. And going back, I said the last question but that was one of the questions. Can you as an OB help if I have a posterior baby? I've seen it as a doula. I've seen the same thing. This provider who I think is amazing goes in. He did the same thing. Goes up and I could just see him. He closes his eyes and he does this whole thing with the head and he's like, “Okay, we're good.” It's like okay! That is a thing. The very, very last question is how as a patient if you're like, “I think my baby is OP” or your doula, or your nurse, or your doctor is saying, “I think this baby is OP,” how can you as a patient ask? If we say, “Can you help me rotate this baby? I'm having a hard time doing it with pushing.” Dr. Sterling: Yeah. You do have to be completely dilated. You have to be completely dilated and I find that it can be really difficult to perform, but in the right patient, it is a wonderful tool to have in your toolkit. But there are some providers who are so good at it and there are some providers who haven't done it as much. I was really impressed by this OB. She was a newer graduate. She had just graduated that year from residency and I actually have some friends in common. She had trained where I had friends do their fellowship, so I texted them after and I was like, “She was so good at that manual rotation.” They were like, “Yeah. That program really pushed manual rotation. They do a ton of it so they come out really well trained in that.” I was like, “That's so awesome,” because I feel like in our training, that wasn't something that we did a ton of but I always was like, “Yeah, I can do it” and I would try and once in a while, I would have succeeded but I didn't feel super confident in that skill. That's the thing. Where you train really depends on the skills that you pick up. But anyway, so yeah. I think that if you think that your baby is OP and your provider really does have to feel like they're OP because they don't want to turn a baby that is OA. You don't want to turn it the opposite way. But you can say, “Hey, if we think this baby is OP, can we do a manual rotation and try to get him head down?” I think it's important to ask what the risks are and communicate to your provider if that is something you want. You have to say, “Yeah, I'm okay with those risks,” and then you put your provider in a place of comfort. We get uncomfortable when patients, for me, when a patient is signaling to me that they don't understand the risk or they don't believe the risk is possible, that's when you put your provider into a nervous situation. Meagan: Right, yes. I love that when your patient is confident, it helps you. Yeah. That makes so much sense. Dr. Sterling: If they're like, “Well, I don't think that would happen,” then you're like, “I need you to understand that this very much could happen.” Meagan: Yes, it could happen. This one provider that I was talking to about how there was one time where he was going the way that you would normally go and he was like, “Nope. This baby has to go the other way.” I was like, “What?” And seriously, just rotated it and was like, “All right, now it's good.” Sometimes too, talk to your provider and say, “Can we try one more time?” or “I understand that it's not working. Can we take a little break and try again?” Or whatever, assessing. Dr. Sterling: And asking questions. I think it's really good to just ask questions. If somebody is saying no, it's okay to say, “Can you walk me through your reasoning?” Meagan: Yeah, I love that. Can you tell me why? Dr. Sterling: It's totally okay. It's totally okay to ask that and sometimes when they walk you through your reasoning, you may say, “You know what? I'm actually okay with that risk” or when they walk you through your reasoning, you might be like, “Yeah. I feel you there. I feel much more confident about this decision. It's not the outcome that I wanted, but I am resonating with your thought process and thus I feel more comfortable with this decision,” so that a month later after this birth, I'm not thinking back on that situation and wondering, “Should I have pushed just a little bit harder?” Even if you're not getting the birth outcome that you had envisioned, it's important for you to understand the why-- for many people, I should say, it's important to understand the why so that your birth story becomes part of your story. I don't want people to always be questioning, “Should I have done this? Should I have done that?” I think a lot of the time because we feel uncomfortable asking for more explanation and we're not necessarily always given the explanation then we have all of these questions that we carry with us for literally years. Women who gave birth 20 years ago will comment in my DM's and be asking questions about that and it breaks my heart that they've been carrying that weight for so many years. Meagan: Yeah. I think that is such a great spot to end on is ask questions. It's okay. It's okay to ask those questions. It's okay to have that doubt too. It's okay to have that doubt and have that question because sometimes it's like, “Oh, well it's a stupid question,” but it's not a stupid question because it's a question that you want to know. Dr. Sterling: It's a question you have and there really is no such thing as stupid questions. There really is no such thing. Meagan: Well, thank you so much for taking the time. I know that so many people are going to be just waiting so patiently for this episode to air because we had so many questions we didn't even get to. Again, thank you so much. Dr. Sterling: Oh, you're welcome. It was an honor. Meagan: Can you tell everyone where to find you on social media and maybe talk a little bit more about your program? Dr. Sterling: Yeah, yes. I'm @drsterlingobgyn on TikTok and on Instagram and then I have a membership where I support people through trying to conceive, pregnancy, postpartum, and the whole journey and that's sterlingparents.com. We have a beautiful curriculum that we put people through to help support them through the physical and emotional challenges of the whole journey. We have a really lovely database that I'm really proud of that really can replace all of the internet searches and Google. That database all has three E verifications so all of our information is evidence-based, expert-based, and experience-based so we like to talk about things and with people who have had that experience themselves. Meagan: Yeah, I love it. Awesome. We'll make sure to drop all of those links in the show notes, so listeners, check out the show notes. We'll also have you on our social media today and we'll have everything tagged as well. If you're not knowing how to do it in the show notes, go to our Instagram. Thank you again, so much. Dr. Sterling: Oh you're so welcome. Thanks for having me.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

In dieser Folge erzählt Ina über ihre verminderte Fruchtbarkeit nach Absetzen der Pille und wie sie trotzdem schwanger wurde. *** Die Shownotes findest du hier. Hier geht es zum Geburtsgeschichten Newsletter. Unterstütze den Podcast auf buymeacoffee.com/geburt Wenn du dir auch ein Tens-Gerät nach Hause holen möchtest, würde ich mich freuen wenn du das über meinen Affiliate-Link machst: https://www.geburts-tens.de/?ref=216

You will NOT want to miss today's episode!With her first pregnancy, Taylor was committed to having an unmedicated, vaginal birth. But after a 5-day induction at 37 weeks due to cholestasis and no cervical change or dilation, she knew it was time to consent to a C-section. Taylor knew she would fight for her VBAC even before she became pregnant again. 18 hours after her water broke, Taylor was barely 1 centimeter dilated. Labor continued for hours with transition-like symptoms. She knew she was close. Taylor agreed to a cervical check. She was 2 centimeters dilated. Find out how Taylor's resilience helped her overcome that HUGE discouragement we feel when labor isn't progressing the way we think it is.Additional linksHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Meagan: Welcome, everybody. You are listening to The VBAC Link podcast. This is your host, Meagan. Guys, I am so excited about this story today. This is Taylor.Taylor, we are so excited to have you on today. I am going to share a little bit about our course. Normally, we dive into reviews before we start the story, but I want to share a little bit more about our course. I wanted to let you guys know. We have a VBAC Prep Course. This prep course is for anybody wanting to explore their options for birth after Cesarean. You may or may not know if VBAC is right for you. This course is going to help you learn the pros and the cons of both VBAC and repeat Cesarean. We are going to dive into the history. We are going to give you tools. We are going to give you things to help you take with you to your provider to help establish a better relationship and help find out if that provider truly is supportive of you. Of course, there are some more stories in there and so much more information. This course is created for any birthing parent looking to know their options. And also, any birth worker wanting to expand their knowledge of VBAC and the history of VBAC and how to support future clients, especially if you are a doula on VBAC. Taylor is a labor and delivery nurse which is super exciting so we are going to talk a little bit more about that. I want to ask her some questions but even labor and delivery nurses, midwives, and birth workers, this course is going to be great for you. Learn more about our course at thevbaclink.com.Taylor's StoryMeagan: Okay, Taylor. I cannot wait for you to share your story. I was telling you in the beginning, when I saw your face pop up on our Zoom when we were getting ready to record, I just knew exactly who you were from your image. I just remember seeing it and having all of the feels so I can't wait to hear from you. Right from your voice, so thank you so much for being here with us today. Taylor: Yes, thank you for having me. I am so excited. Meagan: Seriously, I'm so excited. I would love to turn the time over to you. Share away. Share this wonderful story with the world.Taylor: Okay well, gosh. There are so many things. My first pregnancy was in 2020. July 2020 was when I had my first baby. That pregnancy was very uneventful. It was great. I didn't have any issues. I strongly desired an unmedicated, vaginal birth. I got my husband to read The Bradley Method twice. Yeah. I just was chugging along. I actually wasn't working labor and delivery yet. I was working in the mother/baby unit. That will kind of come into play later because I didn't know what I didn't know at the time. So just chugging along and then I got to about 36 weeks and I just felt like my feet were really itchy at night. I ended up telling a friend and she said that in her first pregnancy, that happened to her and she ended up having cholestasis. Meagan: Mhmm. I was going to say, cholestasis. Taylor: Yes, and so of course, I was just like, “Oh wow.” I went down the Google hole and I was like, “Oh, I have to tell my doctor. This sounds so scary.” I know y'all have talked about cholestasis on your podcast before, but basically, it's a random issue with your liver during pregnancy. The worst-case result is a stillbirth or arrhythmias in the baby and things like that. My mind was just going straight to that. I told my doctor and she was of course like, “Oh yeah. We need to draw some labs.” They ended up drawing some labs and sent me on my way. They take about a week to come back, so I just was going on with life. Meagan: Which is so crazy to me. Can I just say that? This is a potentially serious thing and it takes a week. Taylor: Right, yep. So yeah. She gave me some medicine that was supposed to help with the itching and things like that. Meagan: I think it helps lower your liver enzyme levels right? Taylor: Yeah. It really is supposed to slow things down. I took it and I didn't really feel like it helped, but I took it. Of course, I wanted the best thing for my baby. So I get to a little over 37 weeks at this point. I think I was 37 + 3. I was just at home. We had this really bad storm. My husband was normally off this day. It was a Monday. He was working late. The power went out. After the storm, I went outside to try and send him a text. He was calling me and said, “Hey. Have you talked to (one of my best friends who works at the hospital with me)? She's been calling me. She's been trying to get a hold of you.”I just was like, “No. I haven't had service. We lost power so the Wi-Fi went out.” So I called her and she was at work. She just said, “Taylor. The doctor's been trying to call you. Your labs came back and you have cholestasis. They want you to come in tonight.” I was just like, “What? What? Hold on.” You know, I just was—Meagan: Yeah, yeah, yeah. You've got to wrap your mind around it for a sec. Taylor: Yeah. I could tell that she was really sad to be the one to call me because she knew that I just really wanted this Bradley Method birth. So my husband came home and I just was like, “No. This is not what I wanted at all. Ugh.” I just was so sad. We ended up going in, of course, because I thought that was my only– they didn't give me any other options. I just thought, “Okay, well I need to do what they say.”So I went in and yeah. I was a little over 37 weeks. They got me admitted. I ended up having a Cervadil that night and I was closed by the way. My cervix was closed, thick, and high. So I had a Cervadil just thinking, “Oh great. I'm going to have my baby probably tomorrow.” The next day rolls around. It's still closed, thick, and high. I had another Cervadil which, if anyone has not had a Cervadil, it's like a sandpaper tampon. It is horrible. Meagan: Mhmm, yeah. Taylor: It's really horrible. So I had a second one with those and by the end of that day, still closed. I went in Monday night and between Monday night and Friday, I had had three Cervadils, Cytotec orally and vaginally, and a whole day of Pitocin. They tried to put a Cook Catheter through because, at some point, the furthest I got was a fingertip basically. The midwife was really, she was just trying so hard because I worked there and she knew I really wanted a vaginal delivery. So she was actually really awesome. But they tried to put a Cook catheter through my fingertip cervix. It was horrible. And yeah. So Friday morning rolls around and they came in. They were just like, “Yeah. There is really nothing else we can do at this point. I don't know why nothing is working.” The doctors had already been trying to have a C-section on Wednesday and this was Friday. I just remember feeling so exhausted, so tired, and honestly, just in so much pain from all of the things. I looked at my husband and I was just like, “I guess I just know. I know that I'm going to have to have a C-section.” They were just like, “Yeah. That's kind of your only option.” I ended up asking, “Can I go home? Can I go to antepartum? Can I just have some more time?” They just said, “No. We've done so much. You have cholestasis already. If it was going to work, it probably would have worked already.”I ended up having a pretty good C-section. It wasn't bad. It wasn't rushed. Nothing was wrong with my baby. He wasn't in distress or anything. We actually didn't know it was a he. We didn't find out what he was until he was born. But yeah, I just was pretty devastated. My husband was pretty devastated for me. We both were crying in the labor room all day until my C-section and then we just came to terms with it and it was fine. I had my C-section. I had my healthy little baby boy, Mason. And yeah. I had an easy recovery. I went home and I just knew that I was never going to have another C-section. That was my mindset when I went home because even though it was smooth and nothing was an emergency or anything, I just felt pretty devastated. I just remember even months after he was born, I would just cry in the shower thinking about it. I was like, “Why am I feeling like this?” I just never knew that your birth experience was just– now I know. It's just truly one of the most important things that you'll ever go through in life. Yeah. So I was determined that if I was going to get pregnant again, I was going to have my VBAC. So fast forward, my little Mason turned one. That was in July and I ended up finding out I was pregnant in September, so he was a little over one. I was ready. I was going to do all of my research and yeah. I started reading all of these books on VBACs. I went to the doctor and I knew– at this point, I was a labor and delivery nurse. My hospital is actually a community hospital and we don't have in-house anesthesia, so we technically don't do VBACs there. I went to see my doctor for my new appointment. She said, “Okay, well, we can put you down for a repeat C-section since you've had one.” I said, “No. I really want to have a VBAC.” She was great. She said, “Okay well, we, unfortunately, don't do them here. The hospital that does is 2 hours away.” I said, “Okay,” because I already knew that. I knew she was going to say that. I was like, “ I am doing this.” Of course, then comes the VBAC calculator. The biggest thing that everyone kept saying was, “Well, your cervix never dilated with your first pregnancy, so that's kind of a concern. We don't know why that happened.” But anyways, I just knew that I still had a chance. They did the VBAC calculator, and yeah. I just planned on having my VBAC. I went through my pregnancy and all of my appointments just knowing that that was what I wanted. I found The VBAC Link podcast and listened to y'all every day. Meagan: Aww. Taylor: Yeah. I listened to VBAC birth stories. Yeah. It was just the best. I was listening to all of those and I remember I was 20-something weeks pregnant and I was at work one day. Someone I worked with was just like, “You know, I am totally for VBACs. I think they're awesome, but I just don't know if you're a good candidate. There was a reason why you never dilated. I just remember I went in the bathroom and I just cried. I was devastated. She was not mean at all. It was like an honest conversation, but I texted my friend who had a VBAC after two C-sections. She ended up being my doula with my VBAC. I will tell you more about her. But I texted her and I was just so devastated. She was like, “Taylor. That is just not even true. You can do this.” I went forward and later in pregnancy, I went to the chiropractor, ate all of the dates, and drank the red raspberry leaf tea. I walked every day. I was chasing my toddler. I felt like I was healthier during this pregnancy, and yeah. I ended up being referred to that hospital that is two hours away when I was at 36 weeks. It's a big teaching hospital, and so of course, they were like, “We prefer probably to be induced around 39 weeks.” I said, “Nope. I am not going to be induced. I don't want that.”“Okay, well, we definitely want you to deliver by the time you are at 40 weeks.” I said, “Nope”. Meagan: “Thanks, but no thanks.”Taylor: I said, “Nope. I don't want to be induced.” The doctor was just like, “Okay. Well, then what we will do is every week we will check your cervix and do a membrane sweep and see if we can get things moving. After 40 weeks, you'll just have to come back for NSTs and things.” I said, “Nope.” I was like–Meagan: Way to advocate for yourself. Taylor: Yes. I, oh my gosh. That was just comical looking back. In the moment though, it was really scary because it is scary to tell a doctor, “No,” especially because we just assume that they know everything. Even being a labor and delivery nurse, sometimes it's hard for me and I have to advocate for my patients and things. In the moment, it was scary, but now, I'm just so glad I did. I ended up having an appointment at 39 weeks at my local OB here. She was like, “Can I just check you, and maybe can I do a sweep?” I was just like, “Okay,” but telling myself, “Okay. This is not going to change anything whether I'm closed.” I just knew that it could be a trigger for me because the whole week of being induced with my son, everyone was just like, “Oh, you're still closed. You're still closed. Closed, closed, closed.” This time, I was like, “Okay. I am not going to let it be a trigger. It doesn't mean anything.” I let her check me and of course, I was closed. But honestly, it didn't bother me. Of course, the doctor was like, “We'll have to talk to the other hospital and they're probably going to want you to be induced. If you're not dilated by 40 weeks, then I feel like they're going to want you to have a C-section.” I just left there and I was really just like, “Seriously, no. No. I have come so far,” because I had my other baby so early. It ended up being 38 weeks because I was there for so long. I was like, “No.” I did not schedule another appointment. I was like, “I am not going back until I have my baby,” which probably was not that smart, but I just knew I was going to pay attention to my body, pay attention to baby moving, and if I went too far past, I definitely would make an appointment, but I was like, “I'm not right now. I can't think about that because I don't want them to check me again. I don't want to have a weak moment and be induced.” So anyways, I went on my way. The day before my due date, I ended up drinking some midwife's brew castor oil. I drank that the day before my due date and I ended up within a couple of hours just having intense contractions every 1-3 minutes. This lasted for a few hours. My husband was like, “Okay. Is this labor? Do we need to go?” Because we have a two-hour drive. He ended up calling my friend, Cami, who was going to go as my doula. She, like I said, had a VBAC herself at the same hospital two hours away. So he calls Cami. She comes over and I was just really into these contractions. She said, “Yeah. We have a long drive. Let's just go.” These contractions continued the whole way down there. We get there. At this point, it had been past midnight, so I'm 40 weeks on the dot. They checked me and I was closed. Closed, thick, and high. Meagan: Oh, I bet that was hard. Taylor: Yeah, it was. I had actually had some bloody show on the way there, so I just knew I was going to be dilated. Meagan: Yeah. Taylor: I was like, “Okay, I am not dilated. This isn't real. This is just from the castor oil. I'm going home.” The resident was just like, “Oh yeah. I don't think that's going to happen. You're 40 weeks. You have a previous uterine scar and I just don't think we can discharge you.” I just said, “Yes, you can actually.”Meagan: “I don't think we can discharge you.” Huh. “Hello, I'm leaving.” Taylor: I just remember that my husband was like, “No, no, no,” because we had already been through so much with my first birth, and so I was like, “Yeah. Actually, can you go talk to someone else? Your attending or someone? I'm leaving. I know if I sleep, my contractions will stop. I'm not worried. I know all of the risks.” They tried to tell me the risks so many times. I was like, “Yeah. I know all of the risks and I still want to go home.”Anyways, they came back in, and actually, they made me sign out AMA. I was like, “Oh my gosh. I'm a nurse and I'm signing out against medical advice.” Meagan: AMA. So against medical advice is AMA, everybody. They'll say scary things like, “If you sign this AMA, you might not be welcomed back,” or “If you sign this AMA, insurance won't cover you when you do come back,” or “If you sign this AMA, no one is going to help you.” They scare you.Taylor: Yes. Yep, definitely. And honestly, if I hadn't just listened to so many people's birth stories and done so much research and I didn't know everything I knew, I probably would have been scared into staying which makes me sad for a lot of people because I know I would not have had my baby vaginally if I would have stayed. So I signed out AMA. I went home, slept the whole car ride home and sure enough, my contractions stopped. I was 40 weeks at this point and slept most of the day. I woke up in the middle of the night with these intense-seeming, regular contractions. I was like, “Oh wow. Maybe it's starting for real.” It happened for a couple of hours and ended up stopping. I was like, “Oh wow. Okay. Well, I guess that wasn't real.” So fast forward a few more days and that happened every night. It was horrible. I had some nice prodromal labor. Yeah. It was horrible because I just felt like, “Is labor ever actually going to start? What in the world? What is this?” I just remember my friend, Cami, who was my doula, she was just like, “Taylor, with every contraction, your body is just getting ready. Okay? It's doing what it's supposed to do. Don't be discouraged. You can do it.” She was just so encouraging. I just have to stop and say that a good doula is so key. Oh my gosh. I never even realized. Even as a labor and delivery nurse, I never realized how important. Meagan: It's so true. It's so true, yeah. Taylor: Yes, yes. My husband was so great too. He was awesome. It was the day before I was 41 weeks, so I was 40 + 6. It was my birthday, so my husband and I just went to a quick dinner out and we ended up stopping at the grocery store. I kind of had some random contractions that afternoon every 15 minutes, but again, I had this prodromal labor for a week, so I didn't believe anything was real. We go to the grocery store after dinner and I felt just like, “Maybe I peed my pants.” I went to the bathroom and I was like, “Maybe I did,” because there wasn't much of anything. I was like, “Caleb, I think maybe I accidentally peed my pants or something. I don't know, but we need to go home.” We go home and I just laid down. When I stood up, I felt a big gush. I was like, “No. No, my water's not breaking right now,” because I definitely was not in labor and that was kind of my worst nightmare was my water breaking and not being in labor. Yeah. I definitely knew my water broke. I was like, “Okay. I still feel baby moving. Everything feels fine. I am laying down. I'm just going to try to wait it out and see if maybe contractions will start.” I texted Cami and told her, “I think my water broke, but I'm going to lay down and see if maybe some contractions will start up.” They did. They ended up being every 4-5 minutes for two hours, but I ended up noticing some meconium in my fluid. I just knew, “Okay. Well, I guess we do have a two-hour drive.” I wanted to just stay home so badly just because of the last time driving down there and still being closed. But then I just knew, “Okay. There's meconium and I have been contracting for about two hours. Maybe we'll just go head down.” On the way down there in the drive, I could totally tell that the contractions were spacing out. I just kept trying not to think about it. I had my AirPods in. I was just listening to music trying to be comfortable, trying just to relax as much as possible. We get down to the hospital and get checked in. Basically, they remembered me from the week before. It was actually the same nurse. Meagan: They remembered me.Taylor: They did. They remembered me and basically, instead of a triage room, they took me straight to a labor room. They were not going to let me go home this time which, of course, I didn't. I go in and there were just so many doctors because like I said, it is a teaching hospital. There were so many people in the room. They were just telling me all of the risks again of having a uterine scar and, “Are you sure you don't want a C-section?” I was just like, “No. I don't want one. I've said this so many times.”“Okay. Well–” And I was super uncomfortable because all of these people were there. Bright lights were on and at this point, no contractions whatsoever. Of course, they checked me and I was closed. I was just like, “No. This is not real. This is my worst nightmare. I can't believe this is happening,” because immediately–Meagan: So frustrating. Taylor: Yeah. Immediately, it was, “Okay. Well, you need to sign this form saying you don't want a C-section and then we really want to start Pitocin.” I just said, “Yeah, no. I just need everyone to please leave me alone for a little bit. Can I just be alone in here?” I was so overwhelmed and it was the middle of the night. They were like, “Uhh, sure. We don't have much time because your water has been broken for a few hours and you're not having any contractions, so just know that we are going to come back and talk to you about Pitocin.” I said, “Okay. That's fine. I just, please, want to be left alone. I just want to sleep.” So we ended up being able to sleep for a couple of hours. The next morning came around because it was already 5:00 a.m. when we were there. I wake up and the day shift nurse comes on. She said, “Yeah, they're going to want to come in and talk to you.” I said, “Okay. I just want one person coming in.” I was determined because I tend to be a people pleaser and so I was just like, “No. I am not going to do that again because last night was so uncomfortable with all of those people here. Labor totally sucked. I just want one doctor coming in.” She said, “Okay.” A couple of hours later, a midwife walks in. I'm sure they were like, “This girl's crazy. Who wants her?” A midwife walked in and she was just so awesome and so calm. She asked me what I wanted. I said, “I just really don't want Pitocin. I want a VBAC so badly.” She was like, “Okay” and basically just said, “Well, how about you pump for a little bit, try and do some nipple stimulation to get some contractions started.” She's like, “I really wish that I could tell you to take some midwife's brew.” I guess she had worked at a birth center for 12 years before this teaching hospital. I said, “I have all of the ingredients. Don't worry.” She said, “Okay. Well, if you take it, don't tell me. It could take a few hours, so I'm just going to leave you alone for a while and we'll see if your contractions start up.” I was just so thankful. That just kept the momentum going because I kind of felt at a loss before that like, “Oh, I'm going to have to have Pitocin.” Anyways, I take the midwife's brew, pump, and that afternoon, it was a few hours later, and I did start having contractions. At this point, it was 18 hours after my water had broken, so yeah. I started having contractions and the midwife went off. A new doctor came on and they checked me and I was 1. I was 1 centimeter. I was just like, “Oh my gosh. My cervix dilated. Oh my gosh. I can't believe this is happening.” Even though I was just 1, I remember high-fiving the resident. I was like, “Yes. This is happening.” Little did I know, I still had a long way to go. But yeah. So they were like, “All right. We really want to start Pitocin. You're just really not progressing very much, but 1 is good. But we want to start Pit.” I said, “Okay. I want the absolute lowest dose and I want it as low as you can go basically.” They said, “Okay. We can do that. We'll start low.” My night shift nurse was amazing. They started Pitocin. Literally, after an hour, they had to shut it off. I just started contracting so much. It was really intense. It was, I mean, every two minutes at least. Every 1-2 minutes. They had to shut it off because I was contracting too much. I was in and out of the shower, just throwing up. It felt like I was in transition. It was that intense for hours. I think maybe 4 hours of just sleeping between contractions, again, up to the shower, just walking around the room, not being able to focus on anything but the contractions, my husband and my doula were like, “Man, we really feel like she's been acting like transition for hours. Maybe, Taylor, do you want to be re-checked?”So at 2:00 a.m., they came back in and I was 2. After all of that, legitimately thought the baby was coming and I was 2. The doctor was actually very happy about that. She was like, “You're 2. That's awesome.” I just really actually loved this doctor that was on. But of course, my husband, my doula, and I were like, “Seriously? A 2?” It just felt like all of the air was sucked out of the room because we were all exhausted and I just truly didn't know what I was going to do. They really wanted to start the Pitocin back up because they were like, “Maybe these contractions just aren't strong enough.” I was like, “I can't. I just don't think I can do this plus more Pitocin. This is just so intense.” So they were talking to me. I'm still having these really intense contractions while we are talking. They leave the room. My husband goes out because he just wants to know how he can continue to be positive for me because he basically just wanted to know if something was wrong. So he leaves the room. My doula and I, I was just telling her. I was like, “Is something wrong with me?” I'm crying and I'm just like, “Maybe my body wasn't meant for this. Maybe I really can't do it.” We all were sitting there and she was just trying to be encouraging. The doctor comes back in and she was like, “Taylor, I just really think you need to rest.” Because at this point, I did not have any pain medicine. I didn't have an epidural. I was still determined that I was going to have my unmedicated birth. I ended up going back and forth for a while. “No, I don't want an epidural.” I agreed to some pain medicine. I got to sleep for a little bit. I did end up getting an epidural around 5:30 in the morning and we all got to sleep for a little while. I woke up the next day. My day shift nurse came on and she was like, “Okay. We are going to change your position. We are going to get on this. We are going to have a baby.” I still hadn't had much Pitocin because I was still just contracting so much on my own. My nurse was just amazing. We did a whole circuit of all of these positions which actually, I already knew from being a nurse but a lot of people don't do them. I had actually taken a class that she had taken too. It was kind of like a Spinning Babies class. So I was just like, “Oh my gosh. What are the odds that I get this girl?” I just was so happy. So we did all of the stuff and I started feeling all of the contractions again. I was like, “Okay. Well, maybe the baby is in a weird position or whatnot.” They came in to check me and the doctor was in there for a while. I was like, “Great. She's trying to find my cervix. Can't find it. Oh wow. Still a 2 probably.” Meagan: Or it's gone. Taylor: Yeah, or it's gone.She was like, “Okay. Well, you are a 9.” Meagan: Oh! Really, actually, it was gone. Taylor: Yeah. I was like, “Oh my gosh! What? Are you serious? I'm 9? Because all of this emotion just came flooding because everyone had said, “You probably won't dilate again” or all of these things. I was just like, “I'm 9. Oh my gosh.”Anyway, so I ended up just having a super smooth delivery. I was complete. I just felt like the baby was coming out. I told my doula. She was like, “Yep. Baby is coming out.” I went and got my nurse and I pushed a few times and boom. She came out. I didn't know it was a girl until she came out. Yeah. I just remember being like, “Y'all. I did this. I cannot believe this.” I just was in so much shock. I didn't cry or anything. I just was like, “Yes to everyone who told me I couldn't do it.” It was just amazing. Yeah. I just couldn't believe that I did it. I still can't believe that I did it. Meagan: Yeah. Well, when so many people place doubt, even though we believe that we can do it, we start believing that we can't. We start believing that doubt, right? Taylor: Yes. Meagan: Then having to go through all of what you had to go through and sign an AMA then return at the same stage. All of these things, yeah. That could be a time when you would let self-doubt get you. But you did it. Taylor: Yeah, it was amazing. I did. Oh, I still can't believe it. Meagan: You did it. Oh, that's awesome. Congratulations. I kind of love the doubt stories. I know it sounds really bad, but I have this weird thing. I love proving things wrong because I did the same thing. My doctor doubted me and was like, “Yeah. No one is going to want you there.” I was like, “Yeah. You watch me. You watch me.” It drove me even further, so I love it. I love that you stuck with it. You advocated for you and your husband together. Just so awesome and then having that total shift of positivity and “Let's do this. We're going to have a baby.”It's so important. I want to talk a little bit about labor and delivery nurses as you are a labor and delivery nurse. What tips or suggestions would you give to people that are on the other side like you were? Giving birth and wanting certain things and maybe having a labor and delivery nurse that maybe isn't as supportive of your wishes or pushing hard whether it be them or the provider pushing hard against them. What would you suggest? Taylor: Yes. So my number one thing is to try so hard to research and just educate yourself before you go in. But the biggest thing is asking questions. If you're not sure about something or if you– let's say they want to come in and break your water. You're just like, “Okay. I don't know anything about that, but I don't actually know that I want to do that,” and you don't feel good about it, you don't have to do it. You can say, “No.” I think people don't realize that they can say, “No” or at least ask more questions about it. That is what even as a nurse, I always tell my patients. If a doctor comes in and wants to do something, I say, “Okay. Are you okay with that? Do you have any questions?” Just really advocate, advocate, advocate for yourself because luckily I had an awesome doula. And get a doula!I had an awesome doula and my husband who could bring me back down to Earth and say, “Taylor, no. You don't want this” or “Are you sure about that? Why don't we ask some questions?” But definitely just advocate, advocate, advocate. Ask questions. If they want you to be induced, why? Is there an actual reason? What other options do you have? Ask for options. When I had cholestasis, I didn't know that I could have had another option. My value was not high, my bio acids. It was only 16. Meagan: Ohh. Taylor: Yes. I didn't know. Maybe I could have asked. Could you trend that? Do I have to come in tonight? Meagan: Yeah. Taylor: Yeah. I didn't know and I didn't know then. I think a lot of people probably are like that. You don't know. Meagan: You don't even know that there are different numbers that could make it seem like you don't need to go in right then. Taylor: Right, yes. So advocate for yourself. Ask questions. You know yourself better than anybody. Meagan: Yes. Oh, I love that. I love that so much. Thank you so much again for being with us today. I love your story. It's just so hard coming in. There are so many times where you were like, “It's not going to happen. It's not going to happen. It's not going to happen. It's not going to happen.” But look at what patience and time did for you, and making choices like getting an epidural and getting some rest. Your body was able to rest and get the rest it needed to progress and the relaxation that it needed. A lot of people say that you can't have a VBAC without an epidural. Some people say that you have to have a VBAC with an epidural. It just is dependent on that person and that situation. You make the decisions that are best for you. It looks like you nailed it. Taylor: Yes. Thank you so much for having me on here. I still. Thank you so much, Meagan.Meagan: Oh, thank you. Okay, I can't wait for everyone to hear your story. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link. Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

When Ana found The VBAC Link podcast, it was Meagan's VBA2C that inspired Ana to go for her own! Though VBA2C is thought to be possible only without medical interventions, Ana had a nice, gentle induction, an epidural, and only pushed for 20 minutes! Meagan and Ana discuss different VBA2C induction methods including some non-traditional ways that could be just what you will need. Make sure to listen closely because providers are not likely to offer them unless you ask!Additional linksThe VBAC Link Blog: VBAC Induction MethodsThe VBAC Link Blog: VBA2CThe VBAC Link Facebook CommunityHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Meagan: Good morning. Good afternoon. Good evening. Whatever time it is where you are listening, welcome to The VBAC Link. This is Meagan Heaton and as always, I'm excited to be with you today and share another story. A couple of months ago when my kids went back to school in August, I asked out on The VBAC Link Facebook and Instagram page what people wanted more of. What that was was vaginal birth after two Cesarean specifically stories. I am going to deliver that to you today. Actually, Ana is going to deliver that to you today. We have a guest sharing her VBA2C story with an induction which is also something that a lot of people don't know. A VBAC after two C-sections can also be induced. We are excited about her story and so grateful for her for being with us today. She even wants to be a doula here in the future, so I'm so excited to talk with her more about her journey, her story, and her desire to be a doula. Review of the WeekMeagan: But of course, we have a review of the week so I don't want to miss that. Today, we have EmilyRessman and this is from Apple Podcasts. She posted it back in June, so not too long ago. She says, “Prepping for my VBAC in August.” Oh, that's actually right now when we are recording, guys. “I found this podcast and it is so inspiring. Hearing facts from experienced doulas and successful VBAC mamas has given me the confidence I didn't know was possible. I now feel comfortable talking to my OBs as well as my family and friends about why I want to VBAC and feel informed about the risks. I also love hearing about the CBAC stories as well so I will be able to find healing however my next birth plays out. Thank you for all you do.”Well, thank you, Ms. Emily. There was another review. Hopefully, I didn't just reread this review, but there was another review that was also talking about loving hearing the CBAC stories and I love that. I love that you guys love that. It's something that can be triggering and hard to hear, but it is really good to listen to because sometimes birth ends in a Cesarean birth. It may not be desired, but it can still be healing and beautiful. My second C-section, although not desired to be a C-section, I really found it healing and it was nice. It was peaceful to be a part of my birth and to know those options. These CBAC stories are beautiful and I'm so grateful for all of you guys who have shared them. We welcome all stories here. VBAC, even uterine rupture, CBAC, VBAC after multiple Cesareans, you are welcome here. So if you haven't and you want to share your story, feel free to apply. We are sharing both on podcasts and social media because we have so many wonderful submissions. We want to try to share all of your stories. So if you haven't had a chance, head over to thevbaclink.com/share and submit your story today. Also, if you haven't had a chance, we would love your reviews. We are in need of more reviews. So if you wouldn't mind pressing pause right now before we get into Ana's beautiful story and leaving a review on Apple Podcasts, Google Play, or wherever you are, you can just Google The VBAC Link and leave a review there as well. Or on Facebook, or send us a message at info@thevbaclink.com. We would love, love, love to read your review on the podcast. Ana's StoryMeagan: Okay, Ana. I am so excited for you to share this story. So excited because I think the induction is something that makes me really excited because we don't have a ton of induction VBAC after multiple Cesarean stories, and so I'm excited to hear about how your induction went and how you navigated through that, where you were, and all of the fun things. So if you wouldn't mind, I'm going to turn the time right over to you. Ana: I have to say that I can't stop smiling because it feels surreal. I'm such a big fan of the podcast. Meagan: Oh! That makes me so happy. Seriously, we are so grateful for you and all of the listeners and all of the stories shared because we wouldn't have this. We would not have this without you. When Julie and I were together, we could sit and probably talk VBAC until we were blue in the face because we love VBAC. We are passionate about VBAC, but the stories. These stories are what make this podcast, so we are so grateful to you today for being here.Ana: Yeah, so I guess I'll start with my first birth. I was 18. It was a long time ago. I was very, I would say, uneducated about birth. It was also an induction at 41 weeks. Meagan: Okay.Ana: That's important to know because it's the same as my VBAC story, how it started. Meagan: Mhmm, yeah. Ana: I went in for my induction. I was 1 centimeter, 50% effaced. Again, same as my VBAC. Meagan: That's kind of funny, same stats. Same stats. Ana: Yeah. Yeah, so that was a battle in my mind, actually, for my VBAC because I was so nervous. But everything went well up until a certain point. They started with Cervadil which I hated. It was super intense with super painful contractions as soon as they started it. I got an epidural because of the Cervadil before even Pitocin or anything. I stalled at 5 centimeters for about 12 hours. There was no change. I don't know. I was super upset. I remember when my doctor was like, “Okay. Well, you haven't made any progress. It's been 12 hours.” It was just so devastating to me. I did not want to have a C-section at all. During that first C-section, I was really young. I was 18. It was traumatizing for me. I felt so scared and I didn't have, I had my boyfriend but he was also 18, so we had no idea what to expect or anything. The worst part of that one was that they actually had my boyfriend leave with my baby, so they left me alone in the OR to be stitched up. I'll never forget that. It was horrible. I wanted to see my baby and they left with him. It was terrible. Meagan: Yeah, you can feel abandoned sometimes. Ana: I did. Meagan: And you don't know anyone around you. I'm so sorry. Ana: Yeah, it was definitely something hard. So fast forward to my second birth. Originally, I planned for a TOLAC for this birth as well. That was with my current partner now. I should have said. I had a boy and then another boy. So this is my second son. Yes, anyway backtracking all over the place. I wrote notes and everything and I'm still all over the place. Meagan: That's okay. Ana: So my second birth, I planned to TOLAC, but I did not really prepare as I should have. I think I went into it just like, “It didn't work the first time. What are the odds it's not going to work the second time? I'm going to be fine. I'm just going to wing it.” That did not go well. I think I had prodromal labor. Meagan: Oh yeah. Ana: Yeah. I didn't know what it was at the time though. I just had really intense contractions. They started at 39 weeks and 4 days with him. They didn't cause any cervical change at all because I went to the hospital two nights in a row because they were so intense. I'm like, “What is happening?” And I couldn't get any sleep. So they did medicate sleep for me which was nice. Meagan: Oh, really? Ana: Yeah, so I could get a little bit of sleep. But when they told me that nothing had changed after that, I just felt ready to meet my baby. I was tired of being in pain and nothing was happening. I had no idea what prodromal labor was and I had no idea that it could have been the positioning of the baby or The Miles Circuit. I didn't know what any of that was. I just was like, “I'm done. I want to meet my baby. Sign me up for a C-section.” It was actually healing. It was much more peaceful. They never separated us. I got skin-to-skin in the OR. That experience was healing for me because I did get a much more peaceful and better experience, but it was not a VBAC. Meagan: Right. It's not that it wasn't the birth you desired, but it was still great. Ana: Yeah. Meagan: That's how it was for me too. I didn't desire another C-section, but I still was able to make it healing and positive for the birth that it was. Ana: Right, exactly. Meagan: Yeah. Ana: So my VBAC after two C-sections. Honestly, when we were trying to get pregnant, I was still thinking about options, but I really was considering a repeat C-section actually because of the prodromal labor. I didn't know what prodromal labor was still at this point. I was just very ignorant of it all, I guess. To me, I was like, “Oh, well. You know.” I didn't even know that VBAC after two C-sections was an option. So actually, what happened was that I looked up VBAC on the podcast and this VBAC Link came up. Meagan: Aww. Ana: Meagan, I heard your story and I was like, “Oh my gosh. This is a thing. I can do that too.” Meagan: Yes. I love it. Ana: And then I think I listened to every story probably a million times my whole pregnancy. Meagan: There's something about having those stories when you are prepping that heals you. Ana: Oh yeah. It's huge. It is for sure. And then I feel like you learn so much too from other people's stories. Meagan: Mhmm, absolutely. Ana: So thankfully, the hospital I deliver at is very VBAC friendly. I didn't even have to fight for a chance to TOLAC at all. It was so supportive which is so great because battling with yourself mentally, at least for me, was a huge part of my journey, so I'm happy I didn't have to fight with somebody else to get what I want. At my first doctor's appointment, my midwife asked me, “Do you want a TOLAC or do you want a C-section?” I was like, “Oh wow. I want a TOLAC.” I originally told her that my plan was to, if I went into spontaneous labor, I would TOLAC but I didn't want to be induced again because of how the first experience went which is ironic. I was like, “Before 41 weeks, I'll try and if I get to 41 and I don't go into labor, I'll just have a scheduled C-section.”The whole time until the last month, that's what I thought, but obviously, that changed. To prepare this time, I just completely absorbed everything I could find about birth and VBAC. I took The VBAC Link course actually, too, which was super helpful. I read Ina May. I think I read all of her books. I read, I think it was, How to Heal a Bad Birth. Meagan: Such a good book. Ana: Yes. Yes, it was huge. I just realized from my second birth that I had a lot of things that I needed to work on to be able to believe in myself. Also, a huge part of my story too before I get into my birth story was that my mom had all C-sections and then my older sister had four C-sections herself. So to me, there was a huge belief with my mom and my sister that, “Oh, we just can't do it. We just can't give vaginal birth. None of us can. That's just how it is.” So when I told them that I wanted to have a VBAC after two C-sections, they were a little taken aback like, “What? Why do you want to do that? You've tried twice. Why do you want to do it again?” Especially my mom, I would say. I was actually a TOLAC, so she was trying to have a VBAC with me. Meagan: Oh really? Ana: Yeah, and this was the ‘90s so that's when it took off. It was in the '90s. She was induced though. She didn't progress and she had another C-section. She really believed that “My body doesn't work. It's broken,” and then she thought that it was genetic. We got into some arguments actually. I love my mother, but it was hard to work through. That was another thing I had to shut out with my mom and my sister. I was kind of like, “I know. I understand and respect your concerns, but I don't want to talk about this with you,” because it was that negative voice that was like, I know when I'm going into labor that's what I'm going to think about. I had to really tone that down. Meagan: Yeah. Ana: Coming into my birth story, I hit 40 weeks, and then it just kept dragging once I hit my due date. I'm like, “I really thought I'd go into labor by now.” I actually decided– I think it was my 39-week appointment– that all of a sudden, I did want an induction at 41 weeks. That was actually because of The VBAC Link Facebook Community. There are a lot of stories there too that I thought were super helpful. When I was looking up VBAC after two C-section stories, I came across quite a few that were induced. I talked with a midwife and I decided that was something that I wanted to do. So 41 weeks came and I was scheduled for my induction. My partner and I got there and they completed all the intake. It took a while. We started with the Cooks catheter. That started at about 1:30 in the afternoon. They placed it. That went well. A little bit after, I started contracting. It was manageable and then it got really uncomfortable, so that's when I was looking for relief. I got into the shower which was amazing. Hot water is amazing for contractions. That went on for a few hours. I tried the TENS machine. I did not like that. I tried the nitrous. That made me nauseous. I was like, “Nope.” Those were the three things I wanted to try were water, nitrous, and the TENS machine. I was like, “Okay, now I want an epidural.” I was like, “I can't do it anymore.” I was just so tired because obviously I have two kids at home and then I was there all day. This was probably at 8:00 or 9:00 p.m. at this point.I was just really ready to get rest. I knew I had a long way ahead of me. At around 9:30-10:00, I got the epidural placed and I felt amazing at that point. I immediately got some sleep and then the Cooks Catheter didn't come out on its own actually. But when they took it out, I was a 3 or a 4. Meagan: That's great. Ana: Yeah, so that helped a lot. They started Pitocin at around 3:30 a.m. and then my water broke on its own with one contraction which I was really proud of because it never happened before. Then I started feeling, I think after my water broke, that was at about 6:00 a.m. I think. I started to feel more pressure and the contractions were coming back. I got more medicine for my epidural. The nurses were amazing. I have to say that was the best thing about the hospital I delivered at. It was just amazing and all of the nurses were great. My nurse was coming in switching sides. I had the peanut ball which I think helped so much in making the difference between my first experience with induction and this experience. Around 3:30 in the afternoon, that's when I was experiencing a lot of pressure that I'd never experienced before. It wasn't pain. It was just pressure. Meagan: Was it vaginally or rectally? Ana: Everywhere. Meagan: Everywhere. Ana: Yeah, it was really intense pressure. My midwife came in. She checked me and said, “You are 8 centimeters.” I was like, “What?!” I stalled at 5 centimeters with my first so right there, I felt that feeling of, “Okay, my body is not broken. It made it past 5.” That was the big moment where I was like, “Oh my god. It's happening.” At that point, it was the waiting game. Waiting to be complete because she was at 0 station, so she was coming lower. That's what all the pressure was. She was starting to come down. I remember that this was such an out-of-body experience from this point on. My epidural just stopped working that well. I started to feel everything again. I was at 8 centimeters hitting transition. I didn't know what to do to cope. I remember my partner and the nurse were just like, “Just breathe. Just breathe.” I got the sweats. I was like, “I can't breathe.”Meagan: It's hard. Yeah. Ana: I was trying to stay calm, but I was like, “Oh my goodness.” That was another moment in my head when I was like, “Why did I sign up for this? Why am I doing this to myself?” Even though it was what I wanted, it was such a mental battle every step of the way. My partner was such a huge help in bringing me back to reality. He was like, “You can do this. You can do this. I believe in you.” He was great. At about, I remember I was complaining about more pressure, so actually, at this point, it was probably at 5:00 p.m. Every time I had a contraction, I was actually bearing down. Unless you've had the feeling of the fetal ejection reflex, it's hard to explain. It was an uncontrollable bearing down just like when you poop which, the nurse was telling me–Meagan: I always tell my clients that it's the cutest poop you're ever going to take. Just embrace it. Embrace the feeling.Ana: Yeah. I was right. I was like, “Oh shoot.” I had that feeling. I was complete when the midwife came in. They got everything ready for me to push. Baby was having a couple of late decels that they had been monitoring. They were monitoring the whole time. It was starting to get, I think, to the point where they didn't really like it as much. I felt the pressure in the room change. They were telling me to push, teaching me how to push, but after a couple of times, the OB that was there explained to me what was happening. She said, “If you can't get her out in the next couple of contractions, you have an option. We can do a vacuum delivery or a C-section.” She said, “A vacuum delivery is going to be much faster to get her out.” But her heart rate was not what they wanted. So that part was intense. It got a little scary there for a minute, but I only pushed for 20 minutes. When she told me that, I just gave it all I had. I pushed her out and it was the most intense thing I ever felt, but also as soon as she was out, it was all worth it. They put her on me for the first time and I never experienced that before. It was amazing to be the first person to hold your baby. She came out perfectly healthy, so that was good. I will never forget it. After they put her on my chest and I looked over at my boyfriend, I literally was just like, “Why did I even want to do this more than once?” My nurses started to laugh. They were like, “Because you forget it all.” I felt like I just could not, I couldn't believe it. I just couldn't believe I did it. I just kept saying over and over again that I did it. I did it. I did end up having a second-degree tear which was not fun, but I'm actually kind of grateful. I felt like it could have been worse with how hard I did have to push to get her out because of the heart rate decels that were happening. I mean, my first vaginal delivery and only pushing for 20 minutes is really good. It was pretty fast. Meagan: Yeah, I was going to say for stalling, not progressing and all of these things, it was pretty quick. It makes me think that with your first, “Oh, it's been 12 hours.” But the same thing with me. My first was also 12 hours where he was like, “Yeah, it's been 12 hours.” We're first-time moms. My body had never done this before. It just seems like the first time, we weren't given a chance. And look, it took time. This induction took time, but amazing. You just needed someone to trust your body and its ability and your ability to do this. It is hard when it comes down to it and they are like, “Hey, we're talking about all of these inductions. We've got to get this baby out fast.” That's a lot of pressure on you. It can be scary, but you went it and you did it. You totally did it. Oh, I love it. For the Cook's catheter, in some places, they call it a Foley. In some places, they call it a Cook. That is such a great way to induce. A lot of people say that it's contraindicated, but we see it happen all the time. It does have success. Ana: Yeah, definitely. My first birth, I should add, was at a different hospital. That's why I did not go back there because I felt like the team you have around you plays a huge role in your birth outcome. The experience was night and day at the hospital I delivered at this time. Actually, I had my second and third birth at the current hospital. They both were amazing experiences. Meagan: They really sound supportive, loving, and encouraging. It really helps when they educate and tell you their options like, “Hey, we're going to do this. These are some options, but we don't want to do that. Let's just get this baby out.” Ana: Right. They never did anything without talking to me which is huge. Because sometimes, I know in my first birth, I definitely felt that things were just happening to me. I didn't have a say. It was very like, “Oh, we're going to break your water now. We're going to do this to you now.” This time, it was not like that at all. I was a part of my care which I think is really important.Meagan: Mhmm, absolutely. That's one of the things. Even if the birth doesn't end up exactly how you wanted or envisioned, I feel like being a part of your care and being an advocate in your space and having someone talk to you as though you are someone making these decisions because you should be. It really makes a difference in the overall view of birth. I'm not saying that it totally takes away from any sad feelings or anything like that, but it makes a big deal when you are a part of your birth and you are helping to call the shots in making the decisions versus having people just say, “We're doing this. We're doing this,” or “We did this.” Not even like, “We're going to do this.” It's, “We've done this. This is what we did.” That happens too.Ana: Right. I didn't realize how much it did happen until I went on this journey of reading everything I could and reading stories and watching documentaries. I'm happy that a lot more women are educating themselves so now I feel like we are taking back our power with birth. Meagan: Absolutely. We are taking back our power with birth. I love that. Oh my gosh. I love that. Okay, let's talk a little bit about– so you kind of mentioned a few of them. How were you induced with your first? Ana: They did Cervadil and then Pitocin. Meagan: Cervadil and Pitocin, okay. We know that Cytotec, Cervadil, and those types of things are usually not used with VBAC because they are contraindicated and there's a whole history with that. That's probably why they didn't do that with this baby. But sometimes, the cervix isn't soft enough, open enough for a Foley or a Cook. They can't get it in. That's where a lot of people feel stuck. They feel like they don't have any other option other than scheduling a C-section. I also just want to say on a side note that scheduling a C-section is okay too. That is not a bad thing. If that's something that someone desires, that is okay and we encourage everyone to follow their heart. If they are like, “Okay. In my mind, I'm going to do everything I possibly can on my mind and if my baby doesn't come by this date, I'll schedule a C-section.” That's similar to what you were thinking. That's fine. That is totally okay. But there are other ways to induce. Like I was saying, sometimes the cervix isn't in a prime state for those balloons. There are other things that they can do. They can actually start Pitocin on a really low, slow drip. The thing about Pitocin is that it's not something that is going to open your cervix. It's got to cause contractions and do its work. But it can get your cervix just enough where you can get a Foley or a Cook catheter.A long time ago, Julie had a personal client who was a VBAC after three C-section mom. In fact, I think she's on the podcast. It was kind of that way where nothing was happening with her cervix at all. They were like, “No. We really suggest a C-section.” She was like, “No. Just start me on Pit.” She was on Pit for a really long time, but it got her open. It got her a catheter and went from there. You can start and you can do that where you get a low dose of Pit. These aren't things that are normal. They are not as common, I should say. These are things that you are going to have to request and really talk to your provider to see if they are on board with doing this and if they can help you in that way. Sweeping membranes is a softer VBAC induction method. Sometimes scraping the membranes can stimulate, evening primrose oil, or nipple stimulation. Quite frankly, sex is a great, great tip to start softening that cervix. But if you're past that point, yeah. Slow-dose Pit before a catheter is really wonderful. Sometimes providers are like, “Oh, we'll just break your water right off the bat.” That's fine too. It's called artificial rupture of membranes, but it's not necessarily as ideal because if you have a high baby or baby is in a wonky position or labor is not ready to start, then we still have Pitocin and things to come after that. I love how you were like, “My water broke on its own this time and I was so proud of my body.” It's awesome. It's more ideal for us to wait for our water to break spontaneously, but sometimes, artificial is the answer. Doing what is best for you and what is the most comfortable thing for you in that state. Going through this now, having had an induced VBAC after two C-sections, are there any tips that you would give to the listeners out there walking into that space? Ana: I would definitely say that an induction can take a long time. Do not feel pressure because even this time, it was 28 hours from start to finish. That's a long time but everything was going fine. I mean, it doesn't matter how long it takes as long as you are healthy and your baby is healthy. It can take days to be induced. Meagan: Mhmm, exactly. Ana: Don't go in with the expectation, “I have to have a baby in 12 hours or 24 hours,” because that's often not the case especially if it's your first vaginal delivery. Pushing, usually, the second stage in your first delivery can take longer as well. I also would say to educate yourself on every method of induction even for VBAC specifically just so when every step you get to, you are educated and you can make whatever choice is best for you. Meagan: Absolutely. Absolutely. Again, whatever choice is best for you. Exactly what you were saying, that is how you find what choice is best for you. You get the education. You learn about VBAC. Learn about CBAC. You learn about induction. Learn about all of the things and then you are able to take charge and make the choice that is best for you, your family, your baby, and your experience. I love that so much. I'm so proud of you for going in and going for it and taking charge of your care and learning, listening, watching the stories, and all of the things so you could feel prepared. I'm so glad that you had a beautiful experience. Ana: Thank you. When I think about it, I'm still like, “I can't believe I did that. I did that.” I'm like, “If I can do that, I can do anything.”Meagan: Right? Don't you feel untouchable?Ana: Yeah, it's so empowering. Meagan: Yes, it really is. That's amazing. Birth should be empowering. Birth should be empowering. This is a big deal in our life. You might have little details fade, but you will never forget the day. I will never forget the day that each one of my kids was born. Our family was growing. Our family was transforming into this beautiful family of two, three, four, and five. It's just something that I won't ever forget. I want those memories to be happy and positive. Like I said, I didn't desire either of my two C-sections, but I still can find the positive in them and have found healing. I'm so grateful for them because I wouldn't be here probably today. I honestly wonder. I always wanted to be a labor and delivery nurse but I even wonder if I didn't have those two C-sections if I would be here with you today and be so passionate about VBAC and understand VBAC the way I do. I don't know if I would or if I wanted to be a doula. I don't know. I wonder. I know you mentioned maybe wanted to be a doula one day. Do you feel like these births have inspired you from that or have you always wanted to be a birth worker?Ana: It's actually kind of funny because when I was a little kid, I had a million baby dolls and I always would pretend to be a mom. I think that I was always drawn to being a mom and motherhood. Through my birth experiences and discovering all of the different aspects of the birth world, I think that came from my desire to just be with women. I'm so passionate about women and being empowered. Every woman should be educated and should never feel like they had no options or no choice. I think that's the part that makes me so passionate. Definitely, experiences like my first experience in birth were traumatic and that definitely lit a fire in me to seek out all of the education and other women with like minds who had gone through similar things. I stay at home now, but I was a nail tech, so I would talk to women all of the time, all of my clients, and held their hands through them getting married and having babies. I'm always the person when they get pregnant, I tell them everything. I'm like, “You need to get this book. You should do that. Oh, do this.” They always say, “You would be so good at that. You would be a good doula. You would be a good nurse. You would be so good at that.” Meagan: It's coming your way. It's coming. You're going to do it. You've got the passion. Oh, well thank you so much again for being with us today. Thank you for sharing your beautiful story. I know that just like everybody else you're going to touch someone out there. There is going to be someone that connects to your story so much and listens to it on repeat because they are trying to do the exact same thing that you did. So thank you so much. We will have the induction blog in the show notes if you want to learn more about those methods of induction. Feel free to check that out and then we will also have a link for more about VBAC after two C-sections as well.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 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

Big babies can come out of vaginas! During her first pregnancy, Lucy was told that she had a macrosomic baby. She was pressured into an induction which ultimately led to a C-section. Her baby was just over 8 pounds. Lucy later learned she was closed up with internal staples and only glue on the outside. Her incision popped open not long after surgery, she developed an infection, and she spent her first few weeks of motherhood traveling to the hospital to get her incision packed. The second time around, Lucy refused to take no for an answer. Though she stayed with the same hospital practice, Lucy equipped herself with an amazing VBAC doula and lots of VBAC Link education. She trusted the birth process and her team, safely delivering a 10-pound, 2-ounce baby!Additional linksAussie Doula5 Tips to Deliver a Large Baby Vaginally BlogBaby Weight Prediction and Third Trimester Ultrasound Blog5 Steps to Get Your Partner on Board with VBAC BlogHow to VBAC: The Ultimate Prep Course for ParentsFull transcriptNote: All transcripts are edited to correct grammar, false starts, and filler words. Meagan: Hello, everybody. Guess what? We are doing an impromptu episode today. This is our friend, Lucy. You're listening to The VBAC Link and we can't wait to hear her story. We are going to talk about big babies. We hear it all the time. Big babies. “I can't have a vaginal birth because I have big babies” or “My pelvis is too small.” But she is here to share her story with you today and let you know that big babies can come out of vaginas. That is the big statement today. Big babies can come out of vaginas. Review of the WeekMeagan: I'm going to hurry and read a review, and then we will jump into her story. This is from bjmg104 on Apple Podcasts. It says, “This podcast is empowering and positive. As a home birth transfer turned Cesarean, this podcast has been so instrumental in helping me shed the shame and sense of failure I have been feeling since my son's birth. Armed with the knowledge gained in this podcast, I now feel more confident than ever in my next pregnancy. VBAC is possible for me. Thank you for this podcast.” Well, thank you, bjmg104 for sharing your review. Lucy's StoryMeagan: Okay, Lucy. We are jumping right in. I am going to turn the time over so you can have all of the time to share your story about big babies. Tell us about it. Tell us about your experience. Lucy: Oh my goodness. You know, I see all the time “big babies, big babies” and from 18 weeks pregnant, the second pregnancy now, I was told all the time. They would measure my belly and they would say, “You know, he's measuring two weeks ahead. He's measuring two weeks ahead.” Part of me was like, “Well hopefully, he's big like one of his Uncle Nicks,” because I have an Uncle Nick, my brother-in-law,  and an Uncle Nick, my brother, and I was like, “Maybe he'll just be a big dude.” It's okay. My mom had 10-pound babies so I was like, “I think we'll be okay.” But obviously, I was really, really hopeful for my VBAC and I left my previous practice after my first birth because my first birth was something that was just really, really traumatic to me. It didn't go at all the way that I had planned. It really came down to me just even talking to myself and my husband and us looking at ourselves and saying, “Being educated is just such a big thing.”I remember from the day that I found out I got pregnant, I would go on walks every day with my daughter and I would listen to The VBAC Link. I would say, “These women know what the deal is.” They are educated. They understand what's going on. They're empowering themselves. I was like, “You know? I've heard so much about doulas.” I didn't really know if a doula would be for me. I talked to a couple of different companies and I found Aussie Doula here in Charlotte. I spoke to Helen and she said, “You have to meet Raquel. She's my VBAC queen.” I was totally swept away after meeting Raquel. My husband and I joke because Raquel has that spiritual vibe to it where she really centered me, but then she also had a voice for me. From the beginning, Raquel helped me make that decision and stand up for myself from those appointments where maybe you don't want a cervical check right in the beginning because anything can happen. That's kind of what I'm going to share. I don't know if I need to touch at all on my first experience with my firstborn. Meagan: Yeah, feel free. Feel free.Lucy: So with my first, I was pregnant. I had a really healthy pregnancy, with not one issue whatsoever. I was the girl that people didn't really want to talk to when they asked me how my pregnancy was. I was like, “It's really rainbows and butterflies. That's how it is. It's great.” People were like, “Ugh. Not even morning sickness?” I was like, “Literally nothing.” So I was told that I had a macrosomia baby. I really trusted my doctor. I had been with that practice for five years. He was like, “Listen, if you don't do an induction, you're basically asking for a C-section.” I didn't know who to ask. I wasn't part of the different groups online, so I just trusted. At 39 weeks and 2 days, I went in on a Thursday and I got induced with Cervadil and Cytotec for two days. I was completely zero dilated. Nothing was happening. On Saturday, they hit me with Pitocin, then about 30 minutes later, my water exploded. I still wasn't dilated.Then, I got an epidural at 6 centimeters and I just plateaued. During that time, I got a fever and an amniotic fluid infection. Everything that could go wrong was going wrong. I remember from the first night on Thursday, a doctor walked in and said, “You know, we don't have to do this.” He goes, “You could just have a C-section and you don't have to go through this pain.”At the time, I laughed it off, but in hindsight, I was like, “He was so not supportive and that should have been my red flag from that moment.”Meagan: Yeah. Lucy: But I really trusted the process. He was someone at the practice I didn't know and I had never met. Turned out that he was the guy who did my C-section on Sunday. So that Sunday when I had my C-section, I started to feel a lot of things and a lot of pressure down there. I don't really do great medically when it comes to– everything grosses me out. Towards the end of my C-section, I was hollering. Josephine came out, my daughter, and she wasn't really crying or doing anything. That's another sign to me that she wasn't ready, you know? She didn't have her full time to be ready and do what she needed to do and my body needed to do for her to have the birth that also she deserved. I was closed up in a way that really wasn't grand to me. I had internal staples and outside, I had only glue. I say this because I've empowered so many of my friends already to just know, “How are you closed up in the case that maybe you do have a C-section?” It's something that many of us don't talk about or think about because we are like, “Well, a C-section won't happen to me.”Well, after a three-day filled induction, you can only imagine how swollen I was. By the time we got home on Tuesday, I popped my incision open. My top layer. I ended up back in the ER. Meagan: Oh man. Lucy: It was awful. We got home Tuesday. Thursday, that happened. So in the hospital, they swabbed me for COVID. I'm positive for COVID, so now I'm like, “Well, the world's ending, surely.” So then I have an infection in my uterus. I need antibiotics. They want to admit me for three days and I'm just like, “I can't.” If you want to put a woman into postpartum depression who is surviving it and getting through it, take her away from her baby for three days and put her in the hospital. I was like, “I can't physically do that. Not mentally.” I just had this sweet little girl that I want to be next to. I want to have my moments with her and my husband so I was like, “There's just no way.”Thankfully enough, I was given antibiotics, but I did have to drive all the way to uptown which is 30 minutes from where I live in Fort Mill, South Carolina, and have my incision packed every two days by the doctors because it needed to close up. It was just such a nightmare. For five good weeks, I looked at my husband and I was like, “Maybe we're only child kind of people.” We come from big, Greek and Italian background families and I always thought I wanted four kids. I was like, “I just don't think I could ever go through that again.”The time passed and like all women, we forget our trauma. So then the time came when we were like, “Let's add to the mix.” I'm more educated. I've been reading a lot on this. Things are possible. Just because I had a C-section doesn't mean that I am now married to that. I had family that still lives in Greece and even my aunt was like, “Well, now that you had that, that's all you can ever have.” I was like, “No, that's not true. I'm going to show the world that that's not true.”So when I got pregnant, I looked for a practice that was supportive. I went on The VBAC Link and I just got on Facebook and I read about different doctors. I went to this one practice in Charlotte at around my 18-week appointment. I was told that at 40 weeks to the day that I would have a C-section. I asked, “Why?” He said, “That's what we do with all women.” I said, “Well, I'm not all women. My name's Lucy and I have a unique medical history. I'm me and my own pregnancy.” He said, “That's just not the risk that this practice takes.” I said, “Well, I've heard that Pitocin is safe. Foley bulb if necessary. There are other mechanisms and other things that we can do.” He said, “That's just not something that we are willing to do.” I said, “Well, going back to our first visit and our other conversations, you're not VBAC supportive then. You're barely VBAC tolerant.” He said to me, “Well, I'll give you my suggestion, and then worst case scenario, you just don't come to the hospital.” I said, “Well, I'm not here for that worst-case scenario. I'm here to fully trust in my doctors and my provider.” I said, “So that's just not the option that I'm looking for.” He responded with, “Well, we're going to part ways. Better sooner than later.” So that was my hint. I came home, looked at my husband, and said, “The one appointment you didn't come to.” I was like, “Everything hit the fan.” I was like, “No way.”So I reached out to my old doctor, Dr. Graham, who had left the OB part of the practice and stuff. She had gone on her own to a different practice and I said, “Who do you recommend?” She said to me, “There's a great doctor at Midview OB/GYN. His name is Dr. Gibbons.” So my husband and I made an appointment. We went out there and we spoke with him. From the first second that I sat there, he said, “Macrosomia baby? Why is this on your chart? She was 8 pounds, 4 ounces.” He said, “This is irrelevant.”Meagan: Ahh!Lucy: He said, “There is no practical reason that you had a C-section.” I said to him, “Thank you. That's exactly what I'm saying.” I said, “I'm just here for a fair chance.” He talked to me and he said, “If it does end up in a C-section, I don't want you to think that you failed.” I said to him, “By no means if that's how the ending happens and I have a healthy baby and a healthy mama, that's not how I'm going to feel.” I said, “However, I do want the full experience, the full opportunity to be able to have a trial of labor and achieve my VBAC.” From there on, every time we met, he would talk about the size but he never told me that the size meant that I needed to get that baby out. So as things progressed in my pregnancy, I would hear a lot that he was large. Around 40 weeks, I had an ultrasound. I also had one at 36 and they said that he was big. And then I had one right at 40 weeks to the day which was two Thursdays ago. The ultrasound tech was the sweetest. I loved seeing her at this one location. She measured him and he measured in the 97th percentile. Then she did one whole measure again, everything, and she goes, “I'm getting the same exact number.” She's like, “I just feel so confident that he's 97%.” I said, “Okay, great. Thank you.” She said, “He looks healthy. The amniotic fluid is healthy.” I was like, “Great.” So then, Friday, I went in to the doctor– so I guess earlier in the week on Monday, I just decided that I would have a membrane sweep, but I was only 1 centimeter dilated. I was 50% effaced. I didn't really know if doing that was for me. I hadn't had one check my entire pregnancy and every time I said, “No,” it was a question when I went to the doctor. It was, “Would you like to be checked?” I said, “No, thank you.” And then that was the end of the conversation which was perfect to me. I will stop and just say one day I was having some pain. I want to say that I was early 30 weeks pregnant. I went to an urgent care OB here in Charlotte and it just so happened that my doula was in the area so she went with me. When I got there, I was having some pain. That's why I went. The nurse practitioner opened the door and she said, “Go ahead and undress from the waist down. You're in labor.” As she closed the door, my doula went, “Is that what you would like?” The lady opened the door and just looked at me. I said, “No, that's not what I would like and frankly, you don't even know the color of my hair. How would you even know that I'm in labor?” I said, “What I would love is for you to come in and have a conversation with me and if we feel the need to do something, we will be on the same page.” She goes, “Well, I am going to have to mark your chart that you declined it.” I said to her, “Do what you've got to do.” At this point, I said, “But I would appreciate it if you could come in and you could feel my belly. We could just talk through it.” She just had the worst attitude the whole time and then when the ultrasound tech came in, she did a scan and she was so sweet. She was showing me the baby and she was like, “Look, everything looks great here,” and blah blah blah. I was just so thankful that she brought me back down. I'm not one to leave a review, but I made sure. I was like, “I want the world to know that if you are going to come here, you're going to have to have a voice,” and then I realized there was a theme at that urgent care that you really didn't have a voice when you went in. I was so thankful that Raquel was with me, my doula, to help me have that first experience of standing up for what I wanted in my birth plan and in my pregnancy. That's why I thought it was such a big deal when I would go to a Midview OB/GYN that it was just a question of, “Would you like this?” So around 39 weeks when I had my first sweep, 39 and a few days, I had that ultrasound and I saw Dr. Gibbons on Friday prior to going into labor. At that point, I was 1.5 centimeters and he did a sweep. I had actually lost a lot of my mucus plug during that sweep. He just said to me, “Well, the goal is to go into labor naturally. That's what we're going to keep saying.” That was really it. He didn't tell me my baby was big or I needed to get him out. That night, I started having contractions all night every eight minutes for hours. The next day, they were gone. I was like, “Oh no, was that not real? What's going to happen now?”Of course, the later you get in your pregnancy, you're like, “I really want to go into labor. Is this going to happen for me?” So on Sunday, I was 40 weeks and 3 days. Around 6:00, contractions started happening again every ten minutes. I hung out on my yoga ball. I walked around. We went for a walk in my neighborhood. Around 9:00 p.m., I was like, “Okay, it's time to lay down and relax.” I lay in bed and they kept getting closer and closer and closer, but they were still more than five minutes apart, and then around 12:25 a.m., I felt a pop. I was like, “That's got to be my water.” So I stood up and sure enough, it was my water. I called Raquel and she said, “I'm going to come by the house first” because the goal was not to get to the hospital too early as well. Although I had trust in the process and the doctors, I was still really nervous that someone would try to force an epidural on me or even just a catheter in case I needed a C-section so we were trying to really get to the hospital at the right time. I started to get ready though and Raquel was on her way to my house. My husband was packing the car. Something didn't feel right. I felt a little bit of extra pain and I'm very high pain tolerant. I called Raquel and I said, “I just want to go to the hospital.” My contractions at that point were five minutes apart and she said, “Absolutely.” She had just pulled up to the house, so we left. We went to the hospital. We got there. The nurse came into triage and she checked me. She didn't say anything. I said, “Well, good news? How dilated am I?” She looked at me in a sad little voice and she said, “Have you ever been checked?” I said, “Yeah, I was checked on Friday. I'm 1.5.” She said, “You're still 1.5.” I was like, “Oh no.” She goes, “That was your water and your baby has meconium.” The monitors were reading a really high heart rate for him. All of a sudden, my world crashed down. I was like, “That's it. This is it. I'm going to have a C-section.” Raquel looked at me. It makes me all sad and I just want to cry as we talk about it. Raquel looked at me and she said, “It's a marathon. It takes time.” She goes, “You have to remember to release and allow your body to do what it needs to do and surrender.” She goes, “The beginning is going to be slow. It's going to happen so fast once it gets going. You're not going to expect it.” I believed. I believed at that moment that Raquel was telling me exactly what I needed to hear and know for my body. We hung out in triage for maybe an hour and by the time we got to a room, I was 3.5. I was like, “Okay, progress.” Thirty minutes later, I was 6 centimeters. I was like, “Okay.” We got to the hospital at 1:45 at night. By 4:45 a.m., I was 8.5. I was 8 centimeters dilated. Raquel had been constantly moving me. She would not let me stay in one position. I was just like, “Is this really happening? Everything is happening so fast. These contractions are so hardcore.” But she recommended nitrous for me because we were trying to stay away from the epidural at least in the beginning. At that point, I was begging for it. She said, “If you make it to 5, we will get an epidural, but just try the nitrous for me.” I tried the nitrous and while it didn't remove the pain, it took the edge off. I don't know if you've heard of other women using it, but I will say that it definitely was a great tool to have in your belt in the delivery room. Meagan: Yeah, I used it as well. It was great. Lucy: Yeah, I had no clue. If you had told me, I would have had no idea. So by that point, when I got to 8 centimeters, Raquel was like, “Listen.” She goes, “We've got this.” She goes, “I'm going to have you get up. You're going to sit on the yoga ball. We're just going to keep moving.” I was still asking for the epidural. She said, “Can you try asking for the epidural when you're not in the middle of a contraction so I can believe you?”I was like, “That's not fair.” The nurse comes over and she hangs a bag of liquids. She says to me, “When this bag is finished, I'll get you an epidural.” I said, “Y'all are so setting me up right now.” There's no way there is going to be time to get an epidural. Everybody is looking at each other and not looking at me like, “She ain't not getting an epidural.” So by the time I got up and sat on the yoga ball, I was like, “Oh my god, I have to push.”They get me right back on the bed. They check me and I'm 10 centimeters dilated, but he's not perfectly face down. He's not all the way sunny-side up, but he's not all the way down either. Raquel manhandled me. She totally flipped me on my side. It was Spinning Babies to the max in the middle of contractions that are happening every couple of seconds. I just relaxed into what she was doing. It was the flying cowgirl and he just flipped right back to where he needed to be, the perfect position. I pushed for an hour. So at 5:00 a.m., I started pushing. By 6:06, he was here. I just can't say enough for a hospital that I went to and didn't have a great experience with my first, I had the most phenomenal redemption birth that I could have dreamed of. The nurses, even the NICU team that was in there just in case. The doctor from the practice that I had never met, Dr. Rogers was at the end of my bed for the entire hour that I pushed stretching me, helping me to the point where I only have a midline of a vaginal tear. I didn't tear any other way with a 10-pound, 2-ounce baby. It's just so unreal to me that you're told all the time, “Big babies. You can't get them out.” I've been reading these posts online for days since I had my little one on the 18th of the month and I feel the need every single time a woman posts in distress to respond and be like, “You have this. You've got this.” Meagan: The 18th of this month?!Lucy: I just had him!Meagan: Like not even 10 days ago?Lucy: Not at all. Meagan: Oh my gosh. Lucy: Yeah, he's so fresh. That's why I'm so in all my feels about it. But I did. I looked at Raquel and I don't know if I'm allowed to say bad words here, but I looked at her and I said, “I got my f-in VBAC.” And we high-fived in the room.I was like, “Yeah.” We high-fived. I was like, “This happened.” I was like, “I need the world to know.” Meagan: Yes! And here you are. You're sharing it with the world. You're sharing it. Lucy: Yeah, absolutely. Meagan: And it is. It is possible. We've seen big babies come out of vaginas. We have seen it. We really, really have. Lucy: Yes. I think that we just need the opportunity to allow our bodies to do what they need to do. I mean, he was born at what? 40 weeks and 4 days? Meagan: Yeah. Lucy: A healthy, happy boy. Meagan: Yes. Well, you know what? In the show notes, we are going to include a couple of blogs about getting big babies out. So five tips to avoid a C-section and delivering a large baby. We are going to post that in the show notes. So if you want to read more about big babies and how possible it actually is, check out the show notes. If you don't believe this story alone because a 10-pound baby, that's a good size baby. It's possible. You're not a big person. Lucy: I'm 5'5”. Meagan: Yes. You're 5'5”. It's not like you're 6 feet, super, super tall because a lot of the time, taller people, when I say big, I mean tall torso and stuff like that, but 5'5” is still pretty small. Lucy: He was 23 inches long too. So he's a long, tall boy. Meagan: Way long, yes. Lucy: Yeah. Meagan: Oh my goodness. Well, congratulations. I cannot believe it was seriously less than 10 days ago, but we are so happy that you shared your story with us. I know that you are going to inspire so many out there. You know, also too, there's a lot of times where providers will say, “Oh, you've got a big baby in there,” and then the baby's not that big. Seriously, we've had clients that were told that their babies were 12 pounds and they had to have a C-section and then they had a C-section and their baby was 7 pounds. Lucy: That's why I feel like I'm here on The VBAC Link because I was told that with my first. Meagan: Yep, exactly. Lucy: That's my story. Meagan: And it was. And your baby was 8 pounds. It's so hard. You've got to follow your intuition. Good for you for sticking with it and fighting through everybody even when there was some tension. You were fighting through, so congratulations and thank you so much. Lucy: Thank you. Thanks, Meagan. This VBAC Link just has empowered me through this whole process.Meagan: Oh, that makes my heart so happy. Lucy: Mine too. My husband, too. He was so on board with everything. I can't ask for a more supportive partner. Meagan: We are going to drop that one too, talking about supportive partners and how to get yours on board because that truly makes a big difference when you have that support, especially if there's not a ton of support coming from the provider or they're not as gung-ho if you can have that support from your partner, oh my gosh. It makes a world of difference. Lucy: Absolutely. Thank you so much. Thanks for all that you do and all of our voices that are heard. Meagan: Absolutely, 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 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

Unterstütze den Podcast auf buymeacoffee.com/geburt Wenn du dir auch ein Tens-Gerät nach Hause holen möchtest, würde ich mich freuen wenn du das über meinen Affiliate-Link machst: https://www.geburts-tens.de/?ref=216 *** Nicole weiß schon in jungen Jahren, dass sie eine große Familie haben möchte und stellt das auch sofort klar, als sie ihren jetzigen Mann kennenlernt. Nachdem die beiden ein Jahr zusammen sind, beschließen sie das Thema Familienplanung anzugehen und Nicole wird sofort schwanger. Sie befindet sich noch in der Ausbildung und schreibt ihre letzten Prüfungen kurz nach der Geburt ihres ersten Kindes. Die gesamte Schwangerschaft hindurch wird Nicole von Übelkeit geplagt. Ihre erste Geburt wird in der 41. Schwangerschaftswoche im Krankenhaus mit Cytotec-Tabletten eingeleitet. Zunächst spürt Nicole gar nichts, obwohl das CTG regelmäßige Wehen anzeigt. Irgendwann verspürt sie einen Druck nach unten im Becken und denkt, dass sie auf die Toilette muss. Auf der Toilette sitzend, fängt Nicole an die Wehen zu spüren, denn es beginnt ein Wehen Sturm. Nur wenige Stunden später ist ihr Sohn dann auf der Welt. Da sie eine Hohl- und eine Flachwarze hat, fällt ihr das Stillen zunächst schwer, aber mit Hilfe der Hebammen im Krankenhaus entwickelt sie das Selbstvertrauen, dass es klappen kann und bleibt dran. Als ihr Sohn neun Monate alt ist, stillt Nicole ab, um ihren Zyklus wiederzubekommen, das sie und ihr Mann ein zweites Kind planen. Wieder wird sie sofort schwanger und wieder ist ihr die ganze Schwangerschaft hindurch schlecht. Die zweite Geburt geht noch schneller als die erst. So schnell sogar, dass Nicole und ihr Mann ihren anderthalbjährigen Sohn mit ins Krankenhaus nehmen müssen, weil keine Zeit mehr ist, ihn zur Babysitterin zu bringen. Mann und Kind müssen vor dem Kreißsaal warten, während Nicole innerhalb von Minuten nach Ankunft im Krankenhaus ihre Tochter zur Welt bringt. Das dritte Kind hat den errechneten Termin Ende März 2020. Nicole und ihre Familie sind grade in ein neues Haus gezogen, als der erste Corona-Lockdown beginnt. Da keine Begleitpersonen im Krankenhaus erlaubt sind, bietet die Hebamme an, Nicole bei einer Hausgeburt zu begleiten. Nicole setzt alles daran, dass sie sich so schnell wie möglich heimisch fühlt um sich eine angenehme Atmosphäre für die Geburt zu schaffen. Die dritte Geburt beschreibt sie als die schwerste, da sie zum einen das Gefühl hat, dass alle von ihr erwarten wieder schnell zu gebären und zum anderen macht sie sich Sorgen um ihren Beckenboden, der unter den bisherigen Schwangerschaften und Geburten gelitten hat. Ihr zweiter Sohn kommt gesund zu Hause zur Welt und die beiden älteren Geschwister beobachten die Geburt gespannt. Die vierte Geburt findet auch wieder zu Hause statt und wieder sind alle Geschwister dabei und schauen zu. Durch regelmäßiges Beckenbodentraining hat es Nicole geschafft, dass ihr Beckenboden nach vier Schwangerschaften und Geburten stärker und gesünder ist, als je zuvor.

In this episode, Founder of Enhanced Recovery After Delivery™, Dr. Rebeca Segraves, Co-Founder of Entropy Physiotherapy, Dr. Sarah Haag, Owner and Founder of Reform Physical Therapy, Dr. Abby Bales, and Co-Owner of Entropy Physiotherapy, Dr. Sandy Hilton, talk about the consequences of overturning Roe v. Wade. Today, they talk about the importance of taking proactive measure in communities, and the legal and ethical obligations of healthcare practitioners. How do physical therapists get the trust of communities who already don't trust healthcare? Hear about red-flagged multipurpose drugs, advocating for young people's education, providing physical therapy care during and after delivery, and get everyone's words of encouragement for healthcare providers and patients, all on today's episode of The Healthy, Wealthy & Smart Podcast.   Key Takeaways “Our insurance-based system is not ready to handle the far-reaching consequences of forced birth at a young age and botched abortions.” “We do need to know abortive procedures so that we can recognize when someone has been through an unsafe situation.” “We really need to take into consideration the ramifications of what this will do.” “This is not good healthcare and we need to do more.” “We're going to have to know our rules, our laws, and what we're willing to do and go through so that we can provide the care that we know our patients deserve.” “We're looking at the criminalization of healthcare. That is not healthcare.” “We know who this criminalization of healthcare is going to affect the most. It's going to affect poor, marginalized people of color.” “We can no longer choose to stay in our lane.” “We need to have a public health physio on the labour and delivery, and on maternity floors.” “We don't get to have an opinion on the right or wrongness of this. We have a problem ahead of us that is happening already as we speak.” “We need to create more innovators in our field, and education is the way to do that.” “This is frustrating and new, and we're not going to abandon you. We're going to figure it out and be there to help.” “Our clinics are still safe. We are still treating you based on what you are dealing with, and we will not be dictated by anybody else.” “If you need help, there is help.” “If we believe in the autonomy of an individual to know all of the information before making a decision, then we still believe in the autonomy of an individual to know all of the information that is best for their body.” “This affects everyone. We're dedicated to advocating for you.”   More about Dr. Rebeca Segraves Rebeca Segraves, PT, DPT, WCS  is a physical therapist and Board-Certified Women's Health Clinical Specialist who has served individuals and families within the hospital and home during pregnancy and immediately postpartum. She has extensive experience with optimizing function during long-term hospitalizations for high-risk pregnancy and following perinatal loss and pregnancy termination. In the hospital and home health settings, she has worked with maternal care teams to maximize early recovery after delivery, including Caesarean section, birth-related injuries, and following obstetric critical care interventions. She is the founder of Enhanced Recovery After Delivery™, an obstetrics clinical pathway that maximizes mental and physical function during pregnancy and immediately postpartum with hospital and in-home occupational and physical therapy before and after birth. Her vision is that every person will have access to an obstetric rehab therapist during pregnancy and within the first 6 weeks after birth, perinatal loss, and pregnancy termination regardless of their location or ability to pay.   More About Dr. Sarah Haag Dr. Sarah Haag, PT, DPT, MS graduated from Marquette University in 2002 with a Master of Physical Therapy. She went on to complete Doctor of Physical Therapy and Master of Science in Women's Health from Rosalind Franklin University in 2008. Sarah has pursued an interest in treating the spine, pelvis with a specialization in women's and men's health, becoming a Board-Certified Women's Health Clinical Specialist in 2009 and Certification in Mechanical Diagnosis Therapy from the McKenzie Institute in 2010. Sarah joined the faculty of Rosalind Franklin in 2019. In her roles at Rosalind Franklin, she is the physical therapy faculty liaison for the Interprofessional Community Clinic and teaching in the College of Health Professions. Sarah cofounded Entropy Physiotherapy and Wellness with Dr. Sandy Hilton, in Chicago, Illinois in 2013. Entropy was designed to be a clinic where people would come for help, but not feel like ‘patients' when addressing persistent health issues.   More About Dr. Abby Bales Dr. Abby Bales, PT, DPT, CSCS is the owner and founder of Reform Physical Therapy in New York City, a practice specializing in women's health and orthopedic physical therapy. Dr. Bales received her doctorate in physical therapy from New York University and has advanced training through the renowned Herman and Wallace Pelvic Rehabilitation Institute, Grey Institute, Barral Institute, and Postural Restoration Institute, among others. She also holds her Certified Strength and Conditioning Specialist certification from the NSCA and guest lectures in the physical therapy departments at both NYU and Columbia University, as well as at conferences around the country. Dr. Bales has a special interest in and works with adult and adolescent athletes with a history of RED-S (formerly known as the Female Athlete Triad) and hypothalamic amenorrhea. A lifelong athlete, marathon runner, and fitness professional, Dr. Bales is passionate about educating athletes, coaches, and physical therapists about the lifespan of the female athlete. Her extensive knowledge of and collaboration with endocrinologists, sports medicine specialists, pediatricians, and Ob/gyns has brought professional athletes, dancers, and weekend warriors alike to seek out her expertise. With an undergraduate degree in both pre-med and musical theatre, a background in sports and dance, 20 years of Pilates experience and training, Dr. Bales has lent her extensive knowledge as a consultant to the top fitness studios in New York City and is a founding advisor and consultant for The Mirror and the Olympya app. She built Reform Physical Therapy to support female athletes of all ages and stages in their lives. Dr. Bales is a mom of two and lives with her husband and family in New York.   More About Dr. Sandy Hilton Sandra (Sandy) Hilton graduated with a Master of Science in Physical Therapy from Pacific University in 1988. She received her Doctor of Physical Therapy degree from Des Moines University in 2013. Sandy has contributed to multiple book chapters, papers, and co-authored “Why Pelvic Pain Hurts”. She is an international instructor and speaker on treating pelvic pain for professionals and for public education. Sandy is a regular contributor on health-related podcasts and is co-host of the Pain Science and Sensibility Podcast with Cory Blickenstaff. Sandy was the Director of Programming for the Section on Women's Health of the American Physical Therapy Association from 2012 - 2017. She is now on the board of the Abdominal and Pelvic Pain special interest group, a part of the International Association for the Study of Pain.   Suggested Keywords Healthy, Wealthy, Smart, Roe v Wade, Abortion, Trauma, Sexual Trauma, Pregnancy, Advocacy, Pelvic Health, Healthcare, Education, Treatment, Empowerment,   To learn more, follow our guests at: Website:          https://enhancedrecoverywellness.com                         https://enhancedrecoveryafterdelivery.com                         https://www.entropy.physio                         https://reformptnyc.com Instagram:       @sandyhiltonpt                         @reformptnyc                         @enhancedrecoveryandwellness Twitter:            @RebecaSegraves                         @SandyHiltonPT                         @Abby_NYC                         @SarahHaagPT LinkedIn:         Sandy Hilton                         Sarah Haag                         Abby Bales                         Rebeca Segraves   Subscribe to Healthy, Wealthy & Smart: Website:                      https://podcast.healthywealthysmart.com Apple Podcasts:          https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify:                        https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud:               https://soundcloud.com/healthywealthysmart Stitcher:                       https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio:               https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927   Read the Full Transcript Here:  00:07 Welcome to the healthy, wealthy and smart podcast. Each week we interview the best and brightest in physical therapy, wellness and entrepreneurship. We give you cutting edge information you need to live your best life healthy, wealthy and smart. The information in this podcast is for entertainment purposes only and should not be used as personalized medical advice. And now, here's your host, Dr. Karen Litzy. Hey everybody,   00:36 welcome back to the podcast. I am your host, Karen Litzy. And on today's episode, I am very fortunate to have for pretty remarkable physical therapists who also happen to be pelvic health specialists. On to discuss the recent Supreme Court ruling in the dobs case that overturned the landmark ruling of Roe vs. Wade. How will this reversal of Roe v Wade affect the patients that we may see on a regular basis in all facets, facets of the physical therapy world. So to help have this discussion, I am very excited to welcome onto the podcast, Dr. Rebecca Seagraves and Dr. Abby bales and to welcome back to the podcast Dr. Sandy Hilton, and Dr. Sarah Hague. So regardless of where you fall on this decision, it is important that the physical therapy world be prepared to care for these patients. So I want to thank all four of these remarkable physical therapists for coming on to the podcast. Once the podcast starts, they will talk a little bit more about themselves, and then we will get right into our discussion. So thank you everyone for tuning in. And thanks to Abby, Rebecca, Sandy, and Sarah.   02:03 I, my name is Rebecca Seagraves, I'm a private practice pelvic health therapist who provides hospital based and home based pelvic health services and I teach occupational and physical therapists to provide their services earlier in the hospital so that women don't have to suffer.   02:20 Perfect Sarah, go ahead.   02:22 I am Sarah Haig. And I'm a physical therapist at entropy physiotherapy in Chicago, and I'm also assistant professor and at a university where I do get to teach a variety of health care providers.   02:35 Perfect, Abby, go ahead. My name is Abby bales. I'm a physical therapist, I specialize in pelvic health for the pregnant and postpartum athlete. I have my practice in New York City called perform physical therapy, and I do in home visits and I have a small clinic location.   02:54 Perfect and Sandy. Go ahead.   02:56 Sandy Hilton. I'm a pelvic health physical therapist. I'm currently in Chicago with Sara entropy. And I'm in Chicago and online. Because we can see people for consultations wherever they are, and we may be needing to do more of that.   03:13 So the first question I have for all of you lovely ladies, is how will the recent Supreme Court ruling in the dobs case, which was overturning Roe v. Wade? How is that going to affect people who give birth that we see in our clinics in the hospital setting in an outpatient setting in a home setting? So let's start with Sara, go ahead. I'll start with you. And then we'll just kind of go around. And and and also feel free to chime in and you know, the conversation as you see fit? Got?   03:58 That's such a big question. And I get to go first. So the question was how, how is this decision going to affect people who give birth? And I would say it just it affects everyone in in kind of different ways. Because I would say what this will undoubtedly do is result in us seeing people who didn't want to give birth. And and I think, you know, the effects of that are going to be far reaching and that we I think maybe we in this little group can have an idea of, of the vastness of this decision, but I think that even we will be surprised at what happens. I think that how it will affect people who give birth. Gosh, I'm kind of speechless because there's so many different ways. But when we're looking at that person in front of us with whatever they need to do For whatever they need assistance with after giving birth, we're going to have to just amplify exponentially our consideration for where they are and how they felt going into the birth, how they got pregnant in the first place. And, and kind of how they see themselves going forward. We talk about treating women in the fourth trimester. And it's, I mean, I'm in that fourth trimester, myself, and I can tell you that it would be harder to ask for help. And I'm really fortunate that I, that I have that I do have support, and that I do have the ability to seek help. I have a million great friends that I can reach out to for help, but I'm just how the how it's gonna affect the women, I'll say, I'm scared, but it's not about me. I'm very concerned for other women who won't be able to access the care that they that they need.   06:05 Yeah, Sandy, go ahead. What do you think? How do you feel this decision will affect people who can give birth, especially as they come to see physical therapist, whether that be during pregnancy? As Sarah just said, the fourth trimester, or perhaps after a procedure, or abortion that maybe didn't go? Well? Because it wasn't safe?   06:30 Yeah, so I work a lot with pain. One of my concerns is, but what is the future gonna hold for some people who did not want to be pregnant not added some sort of convenience or concern for finances, both of which, you know, your spot in life determines whether or not you have the the ability to raise another person at that moment. So there are individual decisions that people should make, in my opinion, but also, there's the if something happens to you, that you did not give permission to happen. And then you are dealing with the consequences. In this instance, pregnancy, and you happen to have back pain or have hip pain, or have a chronic condition, or a pelvic pain history, where you didn't not want to be pregnant. How's that going to affect the pain and the dysfunction that you're, you are already happening? And will it sensitize people to worse outcomes and recovery afterwards, because this is a, you know, there's a perceived injustice scale, I want to pull that back out. I hadn't been using it very often in the clinic just didn't seem to change the course of care. But I think that when I'm working with the people pre post, during pregnancy, I think I'm going to pull my perceived injustice scale back out and see if that might be a nice way to find out. If I need to hook someone up to a counselor, a financial counselor, psychologist, sexual therapist, anyone who might be able to support this person, we already don't have good support systems for pregnancy. I just am astounded at how much what a bad choice it is to add more need to a system that isn't currently handling the demand. I know we're gonna need to get creative because these people will need help. But I am a little awestruck at the possible quantum s we're gonna walk into   08:51 an abbey you had mentioned before we started recording about you know, some of the folks that you see that may have a history of different kinds of trauma, and how that may affect their abilities are to kind of wrap their head around being pregnant and then being forced to give birth because now they don't have any alternative. So how do you feel like that's going to play out in the physical therapy world, if they even get to physical therapy if they even get to a pelvic health therapist?   09:34 Yeah, that's, that's one of the things that I was I was thinking about as everyone was chiming in was, we really are just at the precipice in our niche of our profession, where people who give birth are seeking or even hearing about pelvic health and postpartum care, pregnancy care there. Just barely hearing about it. And my I have, you know, a concern, a very deep concern that these people will go into hiding if they have had an abortion in the past, because are we obligated to report that, and what is the statute of limitations on that, and the shame that they might feel for having had an abortion, or having had give birth and didn't want to, and the trauma that my patients who have, for the most part, not everyone who have wanted pregnancies that either the birth is traumatic, the pregnancy is traumatic, they get to a successful delivery, or they have a loss during the pregnancy, the trauma that they are experiencing, and for the most part, I'm seeing adults, and I cannot comprehend children, because it's this gonna be a lot of children who are forced to give birth, or who are having unsafe abortions, and the trauma that they're going to experience, and how, how much it takes for a person who has sexual trauma or birth trauma to get to my clinic, how these young people how these people who feel that shame, I don't know how they're going to get to me, or any of us, except for a real team based approach with pediatricians, with hospitals, with OB GYN, with your gynecologist with people who might see them first before us. I just don't know how they get to us to be able to treat and help treat that trauma. And like Sandy said, that pelvic pain that might be a result of the trauma if if it's unwanted sexual intercourse, I just don't know how we get to them. And that is something that we struggle with now, with, for the most part, wanted pregnancies. And I don't know how we get there. And I don't think we're prepared as a profession. for that. I think the advocacy for getting ourselves into pediatricians offices into into family medicine offices, is going to be so crucial in getting to these patients. But there aren't enough of us. We are not prepared. And our insurance based system is not ready to handle the far reaching consequences of forced birth at a young age and botched abortions. It is not ready to handle that.   12:52 Rebecca, go ahead. I'm curious to hear your thoughts around this because of your work in acute care systems.   13:00 Absolutely. I believe that I'm beyond the argument of whether this is right, or whether this is wrong. I think that as a profession, we're going to have to quickly change to a mindset of can we be prepared enough to handle what Abby was saying the amount of trauma, the amount of mental health I think, comes to mind when when someone's autonomy is taken away from them in any regard. I was very vocal as to how dangerous it was to force, you know, mandates on people even last year. And now here we are, we're at a point in our profession where we have to now separate our own personal beliefs and be committed to the oath of doing no further harm because this will result in harm, having treated individuals after an unplanned cesarean section or a cesarean hysterectomy, because of severe blood loss. They had no choice in those procedures. And they had no choice in the kind of recovery or rehabilitation they would get. I had to fight an advocate for our services, physical and occupational therapy services to be offered to individuals. So when you're looking someone in the eye who has lost autonomy over their body as last choice has gone through trauma that changes you it changes me really as a profession, even on this a professional or even on this issue. I'm now pivoting as quickly as I can't decide, do I have the skills that's going to be needed to address maybe hemorrhage events from an unsafe abortion that's performed? Maybe the mental health of having to try All across state lines so that you can find a provider that will treat you maybe the, you know, the shame around, you know, even finding Well, you know, is there a safe space for me to be treated for my pelvic health trauma from you know, maybe needing to carry this pregnancy longer than then I would have wanted to, there's, there's so much around this that we really have to start looking at with a clinical eye with a very empathetic or sympathetic eye as pelvic health therapists because of the fact that there's so few of us. And because now we're in a scenario where there will be more people who will be needing services but not knowing who to turn to. So my my biggest hope from this conversation, and many more that we'll have is that there's some how going to be a way to designate ourselves as a safe space for anyone, no matter what choice they've made for their body, period, I'm really done with being on one end of the spectrum with this, I'm a professional that doesn't have that opportunity to just, you know, be extreme on this, I advocate for the person and for their choice over their body period.   16:17 I think we need to, and it's just beautifully, beautifully said, the the getting getting some small systemic procedures in place in the communities we live in, is most likely the first step is reach out to the pediatricians and the chiropractors and the massage therapists and the trainers and the school athletic trainers and whoever you find that can have a connection with people and let them know on an individual basis. So like how do you tell people hey, I'm a trustworthy clinic to come to is not usually by writing it on your website. But if you can make connections in your community and be a trusted provider, that's going to go further, I suspect. I'm assuming there's going to be a fair bit of mistrust. And we have to earn it once it's lost. We've got to earn it back. So yeah, I like the proactiveness of that.   17:22 I, I totally agree on something you said Sandy sparked something that I would love for a health care lawyer to start weighing in on is we want, I am a safe space. I think every patient I have ever met who sees me cries. And I hold I hold that part of what I do. Very close to me, it's it's an honor to be someone that my patients open up to. And I know all of you on this call feel the same way because we we are that place that they they I love hearing birth stories. I love it. Even it just gives me an insight into that person into that experience. I feel like I'm there with them. And I understand better what they have gone through. But what happens when the legal system is going to come for us? Or them through us? What happens to that? How do we continue to be a safe space where they can share their sexual trauma, their birth trauma, their birth history, their pregnancy history, their menstruation, history, their sexual history? All of those really, really intimate things? How do we continue to be that for our patients?   18:56 I think we've had to do this I've had to do this previously, for in some very, in situations of incest in for the most part, we need a trigger warning on this. But, you know, there you have an individual that is a minor, or, or for some reason not independent that is being abused in what is supposed to be their safe space. And then that person, the abuser can be like, Oh, look, I'm helping you get better. And they're actually not safe. So there's some things and if the person you're treating is a minor, that adult has access to their records. And so I've worked in places not I don't know how to do with an EMR but I've worked in places where we have our chart that we write down the official record and sticky notes, which are the things that will not get put in the official record. But we need to have written down so people know it. And we've had to do that in situations where the patient wasn't safe. We all knew the patient wasn't safe. was being worked on to get them safe, but they were not yet safe. And you had to make sure there was nothing in their records that was going to make them more unsafe. I don't know how to do it as an EMR, if someone has a clever way to do that, that'd be great. Or we go back to EMR plus paper charts.   20:18 Even to to add to your point, Abby, if we're looking now at possible, you know, jurisdiction, you know, lead legal their jurisdiction or subpoena of documentation, you know, after having intervened for someone who may have had to make a choice that their state did not condone? Yeah, no, I, I'm completely, you know, on guard against that now, and that those are things that I'm thinking about now and thinking about, well, what would my profession do? Would we back, you know, you know, efforts on Capitol Hill to advocate for, you know, someone who, who has lost their, their autonomy, or lost their ability to, to at least have a safer procedure, and we've had to intervene in that way. You know, I think about that now, and I, that makes me fearful that this is such a hot topic issue that, you know, we might not as an organization want to choose size, but we as professionals on the ground as pelvic health therapists, I don't think that we have that luxury and turning someone away. And so So yeah, I think more conversations like this need to be had so that we can form a unified front of at least, you know, pelvic health specialists that can really help with the the after effects of this.   21:38 And I think a big barrier to that legal aspect of it is, you know, what is our legal responsibility. And what happens, if we don't do XYZ is because a lot of the laws and a lot of these states, some of these trigger laws and other laws being that are being passed, the rules seem to be a bit murky. They're not clear. And so I agree, I think the APTA or the section on pelvic health needs to come out with clear guidelines as to what we as healthcare professionals, can and should do. But here's the other thing that I don't understand and maybe someone else can. What about HIPAA? Isn't that a thing? Where did the HIPAA laws come in to protect the privacy between the provider and the patient? And I don't know the answer that I'm not a lawyer, but we have protection through hip isn't that the point of a HIPAA HIPAA laws? I don't know what   22:44 you would think so. But unfortunately, one of the justices who shall not be named has decided that abortion does not fall under HIPAA, because it involves the life of another being in so I can only state what has been stated or restate. But yes, the those are the very things that I'm afraid we're up against as professionals.   23:12 Yeah, I think they're going to try to make us mandatory reporters. for it. I think they're gonna try to make all healthcare we are mandatory. For some things, the thing that's good for some things. Yeah, the   23:24 thing that bothers me about that is the where I'm in Illinois right now, Illinois is a designated, look, we're not, we're not going to infringe on people's right to health care. Just great. But some of the laws and I've lost track, I was trying to keep track of how many have are voting on or have already voted on laws that would have civil penalties, penalties of providers from other states, regardless of the Practice Act of that provider, to be able to have a civil lawsuit against that provider. So that's fun. And then we go back to what ABBY You had mentioned before we started recording about medicine, that that is considered an abort efficient, I have a really hard time with that word. But that is also used for other conditions that we see in our clinics for pain for function and things like that. And then where's our role?   24:33 Right, so does someone want to talk about these more specific on what those medications are and what they're for? So that people listening are like, Okay, well, what medications, you know, so do you want to kind of go into maybe what those medications are, what they're for and how they tie back into our profession. Because, you know, a lot of people will say, well, this isn't our lane. So we're trying to do these podcasts. so people understand it's very much within our lane.   25:03 Well, I yeah, it's just from a pharmacology standpoint, the one of the probably most popular well known drugs that's used for abortion is under the generic name of Cytotec misoprostol, and that's a drug that's not only only used for abortion, but if individual suffers a miscarriage is used to help with retained placenta and making sure that the uterus clears. What other people don't know is is also used for induction. So the same drug is used for three or four different purposes. It's also used for postpartum hemorrhage. So measle Postel, or Cytotec is a drug as pelvic health therapists we should be very familiar with. And we should be familiar with it. Not only you know, for, you know, this this topic, but it's also been a drug that's been linked with the uterus going into hyperstimulation. So actually putting someone at risk for bleeding too heavily. And all of this has a lot of implications on someone's mental health, who's suffered a miscarriage who's gone through an abortion that maybe was not safely performed, which I have had very close experience with someone who's been given misoprostol Cytotec, it didn't take well, she continued bleeding through the weekend, because she lived in a state where emergency physicians could opt out of knowing a board of medications. So as professionals, we do need to know, a board of procedures so that we can recognize when someone has been through an unsafe situation it is, it is our oath as metal as medical professionals to know those things, not to necessarily have a stance on those things that will prevent us from providing high quality and safe care.   26:52 Another one of the medications is methotrexate, and it's used to treat inflammatory bowel disease. And as public health specialists, we'd see people who have IBD, Crohn's and Colitis, who have had surgery who are in flareups who are being treated like that treated with that medication. And it is again used in in abortions. And when you're on that medication, you have to take pregnancy tests in order to still be able to get your prescription for that medication. And as a person who I myself have inflammatory bowel disease and have been on that medication before, I can tell you that you don't go on those medications lightly. It is you are counseled when you are of an age where you could possibly get pregnant, and taking those medications. And it's very serious to take them. And you also have to get to a certain stage of very serious disease in order to take that it's not the first line of defense. So if we start removing medications, or they start to be red flagged on EMRs, or org charts, and we become mandatory reporters for seeing that medication, God forbid, on someone's you know, they're when they're telling us what type of medications they're taking, that there would be an inquiry into that for for any reason is just it's it's horrifying. I mean, it's, we treat these patients and they trust us, and we want them to trust us. But as we get farther and farther down this rabbit hole of, of going after providers, pharmacists, people who help give them information to go to a different state, I just it is. Like I said before, the breadth and the depth of this decision, reverberates everywhere. And if if PTS think that they are in orthopedic clinics, that they are somehow immune from it, you're absolutely not. And for those clinics who have taken on or encourage one of their one of their therapists to take on women's health because it's now a buzz issue. It's really cool. You are now going to see that in your clinic. And you know, like Rebecca was saying before, you know any number of us who have really strong and long term relationships with patients who are pregnant who are in postpartum I have intervened and sent patients to the hospital on the phone with them because they have remnants of conception and they have a fever and someone's blowing them off and not letting them into the IDI and sending them home. And we we are seeing those patients, they have an ectopic they're, they're bleeding, is it normal, they're calling me they're not calling their OB they can't get their OB on the phone. They're texting me and saying what should I do? And they have that trust with me and what happens when they don't? And they're bleeding and they're not asking someone that question and they don't know where to go for help. And so I know I took this in a different direction and we talked about pharmacology, but I just thing that I have those patients whose lives I have saved by sending them to the emergency department, because they are sick, they have an infection, they are bleeding, they have an ectopic, it is not normal. And I don't know what happens when they no longer have that trust with us not not because we're not trustworthy, but because they're scared.   30:26 The heavy silence of all of us going   30:31 you know, it's, it's not wrong. And I think the like, it just keeps going through my head. It's just like, so what do we do? I mean, Karen, you mentioned like, it'd be great if somebody came out with a list of, of guidance for us. And I just, that just won't happen. Because there's different laws in different states, different practice acts in different states. And no one, you know, like you even if you talk to a lawyer, they're going to say, this would be the interpretation. But also, as of yet, there's no like case law, to give us any sort of any sort of guidance. So that was a lot of words to say, it's really hard. I can tell you in Illinois, like two or three weeks ago, I'd be like, like, I'm happy, I feel like Illinois is a pretty safe space. We have, we have elections for our governor this year. And I have never been so worried, so motivated to vote. And so motivated to to really make sure to talk to people about it's not just like this, this category or this category, it's like we really need to take into consideration the ramifications of what this will do, I think there was a lot of this probably won't affect me a whole lot. But I think I'm guessing I think a lot of us on this call maybe I think all of us on all of us on this call, have lived our lives with Roe v. Wade. And, as all of this is coming up, and just thinking about how it impacts so many people, and how our healthcare system is already doing not a good job of taking care of so many people, the fact that we would do this with no, no scientific, back ground, no support scientifically. Like I pulled up the ACOG statement, and, and they condemn this devastating decision. And I really, I was like, it gave me gave me goosebumps. And this was referred to in our art Association's statement. And it makes me sad that we didn't condemn it. Hope that's not too political. But I'm really sad that we didn't take a stronger stance to say, this is not good health care. And we need to do more. Again, and that's like, again, so many words, to say we're gonna have to make up our own minds, we're gonna have to know, our rules, our laws and what we're willing to do, and go through, so that we can provide the care that we know our patients deserve. And that's going to be really hard. Because, you know, if I talk to someone, and if I call Rebecca in Washington State, she's going to have something different than if I talk to Abby in New York. And you know, that so it'll be, it'll be really hard even to find that support. That support there's going to be so much support, I think, from this community, but that knowledge and that, that confidence, we have to pull together so we have to pull together with all the other providers, but also we're gonna have to sit down and figure this out to   33:59 the clarity. So it's, I think a practical step forward would be each state to get get, like, every state, come up with a thing. So pelvic health therapists in that state come up with what seems to work for them get a lovely healthcare lawyer to to work with them with it. And then we could have a clearinghouse of sorts of all of the state statements. I don't know that that needs to go through a particular organization. I I know that they're in the field of physical therapy, two thirds of PTS aren't members. And we need this information to be out there for every single person so that they know   34:44 that we'll have to be grassroots there's I don't think that there's going to be widespread Association support from anywhere. But that being said, I think it's a great idea.   34:58 What are we going to do about it? Hang on issues that are too divisive, you're absolutely right, individual entities are going to have to take this on and just put those resources out to therapists who need them need the legal support, need the need to know how and how to circumvent issues in their states. And, you know, like I said before, even how to just provide that emotional support, there's going to be needed for their, their, their patients, so, and that's okay, if the organizations that were part of are not willing to take a heavy stance, you know, even like last year, if you're not willing to take a heavy stance, on an issue where someone feels their autonomy, and their choice is being threatened, then it's okay, well, we'll take it from here. But, you know, that's, that's really where these grassroots efforts come from and abound, because there are a group of individuals who are willing to say, No, this is wrong. And I'm going to do something about this so that our future generations don't have to suffer.   36:02 Yeah, and I think, you know, we're really looking at the criminalization of health care.   36:09 That is not healthcare.   36:12 And we also know who this criminalization of healthcare is going to affect the most. And it's going to affect poor, marginalized people of color, it is not going to affect the wealthy white folks in any state, they'll be fine. So how do we, as physical therapist, deal with that? How do we, how do we get the trust of those communities who already don't trust health care, so now they're going to stay away even more, we already have the highest mortality, maternal mortality rates in the developed world, I can only imagine that will get worse because people, as we've all heard today are going to be afraid to seek health care. So where do we go from here as health care providers? I,   37:10 Karen, you're speaking something that's very near and dear to my heart, I act as if you had to take this on, I am very adamant that we can no longer choose to stay in our lane, we do not have that luxury. And I as a black female, you know, physical therapist, I don't have the luxury to ignore that because of the color of my skin, and not my doctor's degree, not my board certification and women's health, you know, not my faculty position, I when I walk into a hospital, and I either choose to give birth or have a procedure, I will be judged by none other than the color of my skin. That is what the data is telling me is that I am three times likely to have a very severe outcome. If I were to have a pregnancy that did not go as planned or or don't choose a procedure, you know, that affects the rest of my function in my health. And so given the data on this, you're absolutely right there, there is going to be very specific populations that are going to receive the most blowback from this. And as a pelvic health therapist, I had to go into the hospital to find them, because I knew that people of color and of marginalized backgrounds, were not going to find me in my clinic. And we're not going to pay necessarily private pay services to receive that care. But I needed to go where they were most likely to be and that was the hospital setting or in their home. And so, again, as a field of a very dispersed and you know, not very many of us at all, we're going to have to pivot into these areas that we were not necessarily comfortable in being if we're going to address the populations that are going to be most affected by the decisions our lawmakers are making for our bodies.   39:11 You know, there's something that I think about, often when I hear this type of conversation come up in, in sexual health and in in whenever I am speaking with one of my patients and talking about their menstruation history, and, and them not knowing how their body works from such a young age is I just wonder if we should be offering programs for young people like very young pre ministration you know, people with uteruses and their parents, and grandparents and online, online like little anonymous. Yep. nonnamous   39:51 for it's just   39:52 Yes. Yes, it's it's just, you know, Andrew Huberman talks a lot about having data Back to free content that scientific, that's factual. And I think about that a lot. And I think, to my mind, where I go with this, because I do think about the lifespan of a person, is that creating something that someone can access anonymously at any age, and then maybe creating something where it's offered at a school? You know, it's it's ministration health. And it doesn't have to be under the guise of, you know, this happened with Roe v. Wade, but this it could be menstruation, health, what is a person who menstruating what can you expect? What you know, and going through the lifespan with them, but offering them? You know, I think I think about this with my own children, as our pediatrician always asks the question of the visit, who is allowed to see under your clothes who is allowed to touch you? And it's like, you and my, I have a five year old. So it's Mom, when when when I go number two, a mom or dad when I go number two? And that's it. And you know, I think about that, and I think about how we can educate young people on a variety of things within this topic, and kind of include other stuff, too, that's normal, not normal, depending on their age. Absolutely, there   41:22 was what I was excited about in pelvic health. Before this was people like Frank to physician and his PhD students and postdocs are working on a series of research about how if we identify young girls that are starting their period, and having painful periods, treat them and educate them, then that they will not go on to have as much pelvic pain conditions and issues in the future. So we look at the early childhood events kind of thing, but also period pain. And How exciting would it be if we could get education to young girls about just how their bodies work. And to know that just because you all your aunties have horrible periods doesn't mean that you're stuck with this, just like maybe they just didn't know, let's help you out and constipation information and those basic health self care for preventative problems. So I was super excited about all that. And now it's like, oh, now we have to do it. Because in that we can do little pieces of information. So people have knowledge about their body, that's going to be a little bit of armor for them, that they're going to need and free and available in short, and you know, slide it past all the YouTube sensors. This is this is doable, but it's gonna take time money doing, but we can do it. Well, it sounds like, ladies,   42:52 we've got a lot of work to do. One other thing I wanted to touch upon. And we've said this a couple of times, but I think it's worth repeating again and again and again. And that's that expanding out to other providers. So it's expanding out, as Rebecca said, expanding out to our colleagues in acute care, meaning you can see someone right after a procedure right after birth right after a C section. And, and sadly, as we were saying, I think we they may start seeing more women, I'm not even set children under the age of 18. In these positions of force birth on a skeletally immature body. So the only place to reach these children would be maybe in that acute care setting. How what does the profession need to do in order to make that happen? And not not shy away from it, but give them the information that they need. Moving forward?   44:07 I was just gonna say that I've given birth in the hospital twice. Not at any time was I offered a physical therapist, or did a physical therapist come by and I am in New York City. I gave birth in New York City, planned Solarians because of my illnesses. And nobody came by I did get lactation nurses, any manner of people who were seeing me I was on their service. But that has been something that we needed anyway. We mean to have a pelvic health physio on the labor and delivery and on the maternity floors, who is coming by educating as to what they can start with what they can expect. When can they have an exam if they want to have one? Who is a trusted provider for them to have one. And we need to get the hospitals to expand acute care, physical therapy to labor and delivery and, and the maternity floors. As a routine, it's not something you should have to call for, it should be routine clearance for discharge the same way you have to watch the shaking baby video to get discharged.   45:27 I'm happy older than all of you. I don't have it either. But taking baby video is not something that even existed back in the day. But that makes sense. I mean, I once upon a time was a burn therapist, and I was on call at a regional Trauma Center. And you know, it's like you're needed your, your pager goes off, because that's how long ago it was. And you just came in, did your thing, went back home went back to bed. There is no reason other than lack of will, that PTS couldn't be doing that right now.   46:03 I'm now of the opinion where it's unethical to not offer physical or occupational therapy within 24 to 48 hours of someone who had no idea who did not have a planned delivery the way they expected it who has now and a massively long road to recovery. After a major abdominal surgery, I'm now of the opinion that is unethical for our medical systems to not offer that those rehabilitative services. And I've treated individuals who had a cesarean section but suffered a stillbirth. So the very thought of not providing services to someone who has any kind of procedure that's affecting, you know, their their their not only their pelvic health, but their mental function. That to me is now given the you know, these these, this recent decision on overturning Roe v Wade, is now now we're never, you know, either we're going to now pivot again as pelvic health therapists and start training our acute care colleagues, as we did with our orthopedic colleagues, as we've done with, you know, our neurology colleagues, whatever we've had to do as pelvic health therapists to bring attention to half of the population, you know, who are undergoing procedures, and they're not being informed on how to recover, we will have to start educating and kind of really grow beyond just the clinics and beyond what we can do in our community or community. But we are going to have to start educating our other colleagues in these other settings, we don't have a choice, we know too much, but we can't be everywhere. And not all of us can be in the hospital setting, we're going to have to train the individuals who are used to seeing anything that walks through the door and tell them get over to the obstetric unit. Okay, there's someone there waiting for you.   48:06 Yeah, I totally agree. I mean, when I think back I remember as a student working in acute care and how we had someone who's dedicated to the ICU, we had someone dedicated to the medical floor, we had somebody who was dedicated to the ortho floor, and most of the time they had their OCS, their, their, the one for for, for ICU care, the one for NeuroCare, or they have a specialty. And I think it is just remnants of the bygone era of it's natural, your body will heal kind of BS from the past. It's just remnants of that and it's just, we don't need the APTA to give us permission to do this, this is internal, this is I'm going into a hospital, and I'm presenting you with a program. And here is what this what you can build this visit for here's the ICD 10 code for this visit here is here is here are two people who are going to give you know, one seminar to all of your PT OTs, to you know, so that you are aware of what the possible complications and when to refer out and that kind of thing. And then here are two therapists who are acute care therapists who are going to also float to the maternity floor one of them every day, so that we can hit the we can get to these patients at that point, and that is just that's just people who present a program who have an idea, who get it in front of the board that that it is not permission from anybody else to do it. And, you know, it really it fires me up to to create a world in which you know, when you know people who are the heads of departments and chairs and you know on the boards of directors You know, being in big, big cities or small cities, when you know those people, you know, you can, your passion can fire them up. And if you can fire people up, and you can advocate for your patients and you can in that can spread, you can make that happen. And this is, you know, I feel radicalized by this, I mean, I'm burning my bra all over the place with this kind of thing. And I just feel like, if we can, if we can get to young people, and if we can get to day zero, of delivery, day one, post delivery, or post trauma, then then maybe we can make a dent, maybe we can, maybe we can try, maybe we can really make a go of this for these people. Because, like I keep feeling and saying I, we are not prepared for the volume.   50:54 If individuals are going to be forced to carry a pregnancy, that they may not want to turn because it's affecting their health, we're going to have to be prepared for this. Again, this is not an option really, for us as pelvic health therapists, because we know what's down the road, we've seen mothers who have or you know, or individuals who have suffered strokes or preeclampsia or seizures, or, you know, honestly, long term health issues because of what pregnancies have done to their body. And now if they want the choice to say, you know, I'm not ready, they don't have it anymore. So we really don't have a choice. We have to start expanding our services into these other settings, making our neurologic clinical specialists in the hospital, see people before they have a stroke before they have a seizure actually provide services that can help someone monitor their own signs and symptoms after they've had now a procedure or given birth or even had, you know, a stillbirth, unfortunately, because the doctor had to decide, well, yes, now we will perform the abortion because you know, your health is like on the cliff, I mean, we're going to be seeing these and we just have to prepare. And if it's not our organizations that are laying the foundations, we will, we'll take it from here,   52:15 we need to reach out across so many barriers, like athletic trainers, they're gonna see the young girls, they're gonna see their track stars that is not reds, it's pregnancy. And it could be a very short lived traumatic pregnancy, in girls that are just not develop. They're developed enough to get pregnant, they're not developed enough to carry a healthy baby to term. Kind of just makes me like. But Rebecca is right as we don't get to have an opinion on the right or wrongness of this, we have a problem ahead of us now, that that is happening already, as we speak, that people are going to need help. I love that we have more technology than my grandma did when she was fighting this battle. And we have YouTube and we have podcasts and we have ways to get information out. But we need to use every single one of them in our sports colleague or athletic trainer colleagues. They need to know the signs. Because they may be the ones that see it first.   53:21 Yeah. And Sarah as being the most recent new mother here. What kind of care did you get when you were in the hospital?   53:36 I was sitting here thinking about that. And I mean, I will say that the care I had while I was there, that I had an uncomplicated delivery in spite of a very large baby. And I was fortunate enough to leave the hospital without needing additional help. But I wasn't offered physio. Nobody really they're just really curious to make sure you're paying enough. And that's about it if you're the mom and my six week visit was actually telehealth and that was the last time I had contact with a health care professional regarding my own health so it is minimal even if you're a very fortunate white woman in a large metropolitan area and but I'm working now further north and with a pro bono clinic clinic and in an area where we do a lot of work with communities of color and I'm I'm like I honestly don't even know the hospitals up here yet. But I'm gonna I have so many post it notes of things that are gonna start happening and start inquiring because Rebecca like we need to get into the hospitals like if if I can Do that. And honestly, up until now, like my world and entropy was, and pre this decision was it, there's so many people out there who need help with pelvic issues in general, like we can do this forever. And we set our clinic up so that people who weren't doing well in the traditional health care system could find us and afford us. At least some people could, I realized that it wasn't in companies, encompassing everybody who could possibly need help, but we were doing trying to figure out another way. And so again, like, like, again, the offer of assistance I got was minimal. But also I didn't need much. And I was in a position where also, I knew I could, I could ask for it if I wanted it. And I could probably get it if I needed it. And I'm just thinking about, again, some of the communities I'm interacting with now, in some of my other roles and responsibilities, and I cannot wait to take a look and see, how can we get in there? How can we be on that floor? How can we? What What can we make, make happen like, because it needs to happen, these are these, this is the place where I'm scared to start seeing the stats,   56:21 wouldn't it be amazing if you can get the student clinic part of that somehow somehow and get, you know, young beyond that bias, but younger, most younger but but like the physicians the the in training the PTs and training the PAs the you know, and get like Rebecca had said, let's get let's get the team up to speed here, because there aren't enough pelvic health therapists already. And they're heavens, we need, we need to get everybody caught up.   56:58 And there's so much I was telling you that being around student health care, providing your future health care providers is really energizing and also really interesting. I mean, the ideas that come up with in the in the connections they make and and the proposals they make are just amazing. But two things that I've noticed that I think probably we run into in the real world, real world, outside school world as well, is one. The that's being able to have enough people and enough support to keep it sustainable. So you have this idea, you have the proposal, you made the proposal, how are we going to keep it going and finding the funding or the energy or the volunteers to keep it going. Things ebb and flow, you get a great proposal, you're like yes. And then I literally today was like, I wonder what's up with that one, because it was an idea for a clinic to help was basically for trans people to our tree transitioning and might not have the support that they need. And also I was reached, they come up here for women's health clinic. And I'm going to reach out to them now. Because this again, this decision changes that because it is a pro bono clinic that they would like to set this up in and before it was going to be much more more wellness. And now it could turn out to be essential health care. So that's one thing. But then the other thing is still the education, that in school, we're not taught about what everyone else can do. And I think again, figuring out a way to make sure that future physicians really know what physical therapists have to offer, especially in this space. Most people know that if their their shoulder, their rotator cuff repair, they should send them to pt. But really, we need to get in with OB GYN news, we need to get in with the pediatricians. And I don't want to say unfortunately, but in this regard, unfortunately, we're going to have to really make sure that they know what we're doing. And again, I'm already kind of trying to think like how can we make this just part of how we do health care.   59:20 So I think I'm following in your footsteps by going into education and by by being a part of our doctor of physical therapy programs. You know, I especially chose the program in Washington state not because you know, of just the the the opportunity to teach doctors or incoming doctors but it was also an opportunity to teach doctors of osteopathic medicine and occupational therapy therapists. It was you know, very intimate program and opportunity to make pelvic health or women's health or reproductive health apart of cardiopulmonary content, a part of neurology content, a part of our foundations a part of musculoskeletal and not a special elective course that we get two days of training on, I had the opportunity to literally insert our care, our specialized and unique care and every aspect of the curriculum, as it should be, because we are dealing with, you know, more or less issues that every therapist generalists or specialists should be equipped to handle. So in the wake of Roe v Wade, to me, this is an opportunity unlike any other for pelvic health therapists to really get into these educational spaces where incoming doctors are, you know, MDS or PA programs, or NP programs are our therapy practices, and start where students are most riled up and having those ideas so that they can go out and become each one of us, you know, go into hospitals and say no, to obstetric units being ignored, go into hospitals and give and services to physicians. You know, we need to create more innovators in our field and education is the way to do that.   1:01:12 I just wrote down check Indiana and Ohio, and then I wrote border clinics, because Because Illinois is a it's like a not a prohibition state. Having so many flashbacks, because Illinois, is, is currently dedicated to maintaining health care access for everyone. We have cities that are on the border. And I was thought of that when you were talking, Sarah, because you're up next to Wisconsin now. But we have we have the southern part of the state and the western part of the state. And those those border towns are going to have a higher influx than I will see in Chicago, maybe. But I would anticipate that they would,   1:01:56 you know, and again, this is where laws are murky. Every state is different. It's I mean, it's a shitshow. For lack of better way of putting it I don't think there's any other way to put it at this point. Because that's kind of what what we're dealing with because no one's prepared, period. So as we wrap things up, I'll go around to each of you. And just kind of what do you want the listeners to take away? Go ahead, Sandy,   1:02:33 this is this is frustrating and new, and we're not going to abandon you. We're gonna figure it out and be there to help.   1:02:41 I would say that our clinics are still safe, it is still a safe place for you to open up and tell us what you wouldn't tell anybody else. It's still safe with us. And we still have you as an entire person with all of your history. We are still treating you based on what you are dealing with and not. We will not be dictated by anybody else. Our care won't be mandated or dictated by anybody. Sarah, go ahead.   1:03:22 What I would say is I would echo your safe. If you need help, there is help. And I'm sorry, that that this just made it harder than it already was. And I would say to healthcare providers, please let remember, let us remember why we're doing what we're doing. And, you know, we do need to stand up, we do need to continue to provide the best care for our patients. Because to be honest, I've been thinking like, I think it's a legal question. It's a professional question. But ultimately, if we can't give the best care possible, I'm not sure I should do this.   1:04:01 Ahead, Rebecca,   1:04:02 for our health care providers, in the wake of Roe v. Wade, being overturned, wherever we are, you know, as an organization or on our stance, if we believed in the autonomy of an individual to know all of the information before making a decision, then we still believe in the autonomy of an individual to know all of the information that is best for their body. And that is the oath that's the that's the that's the promise that we've made as professionals to people that we're serving, and to the people that we're serving to those who are there listening to this. You have safe spaces with providers that you trust and we're going to continue to educate one another, our field and also you we're going to put together resources that really bring During this education to your families so that you don't have to feel like you're in the dark and you're alone. This is not something that is per individual or per person. This affects everyone. And we're dedicated to advocating for you.   1:05:18 Perfect, and on that we will wrap things up. Thank you ladies so much for a really candid and robust discussion. I feel like there are lots to do. I think we've got some, some great ideas here. And perhaps with some help and some grassroots movements, we can turn them into a reality. So thank you to Rebecca to Sarah to Abby and to Sandy, for taking the time out of your schedules because I know we're all busy to talk about this very important topic. So thank you all so so much, and everyone thanks so much for listening, have a great couple of days and stay healthy, wealthy and smart.   1:06:03 Thank you for listening and please subscribe to the podcast at podcast dot healthy, wealthy smart.com And don't forget to follow us on social media    

Cytotec ist ein Magenmedikament, wird aber vielfach in der Geburtshilfe genutzt, weil es Wehen auslöst. Der Hersteller hat es zu diesem Zweck nie vorgesehen, es gibt keine Anwendungsvorschriften. Das hat teils fatale Folgen für Mutter und Kind. Stefanie Unsleber, Reporterin bei WELT, hat betroffene Familien getroffen und berichtet von ihrem Schicksal. •••• Mehr Infos findet ihr hier: www.instagram.com/truestory_podcast Redaktion: Julia Sommerfeld, Eike Mitte Einsprecher: Michael Reinhardt Produktion: Wake Word Impressum: https://www.axelspringer.com/de/impressum Datenschutz: https://www.axelspringer.com/de/datenschutzerklaerung

This episode will cover exaclty what to expect from your labor induction.  From addmission to the hospital to delivery of the baby, we've covered everything and the order of events so you can undertand the labor induction process.    There are several reasons why your OB/GYN or midwife may suggest induction of labor and several pregnant patients prefer labor induction, electively.  Labor induction has been shown to improve maternal and fetal outcomes for the right situations and conditions.  Some condditions that may warrant induction of labor include: high blood pressure, pre-eclampsia, diabetes in pregnancy, low amniotic fluid, and decreased fetal movement after 40 weeks.   Traditionally, it was not suggested that prengancy continue after the 42nd week and gestational age was used as a reason for induction of labor.    Our practice website can be found at: Maternal Resources: https://www.maternalresources.org/ Remember to subscribe wherever you get your podcasts.  Please consider leaving us a review.  Our Social Channels are as follows Twitter: https://twitter.com/integrativeob YouTube: https://www.youtube.com/maternalresources IG: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB

Eine Frage, zu der ihr mir immer wieder schreibt ist die Geburtseinleitung. Viele Frauen haben Angst vor der Geburtseinleitung weil sie im Internet oder auf Social Media Horrorstories zur medikamentösen Einleitung mit Cytotec (Misoprostol) gelesen oder gehört haben. In diesem Podcast erkläre ich euch, warum eine Geburtseinleitung notwendig sein kann und welche Methoden zur mechanischen oder medikamentösen Einleitung der Geburt es gibt. Und natürlich spreche ich mit euch auch über die Problematik von Cytotec bzw. die "Cytotec Stories" und erkläre euch, was es mit dem neuen Medikament Angusta so auf sich hat! ---

The pope tells the truth! I'm right and Russia is moving to a gold/commodity backed currency. Justice Roberts is a joke. Overturning Roe vs Wade. What's Cytotec? Who owns it? Who runs Planned Parenthood and who is her husband intimately tied to. S.O.R.O.S.

Bienvenid@s a otro episodio de ¡Hola! Maternidad El Podcast. En esta ocasión tenemos el relato de Celina que es otra de las mamás que ha sido increíble ayudando a esta comunidad con sus relatos, experiencia y tips. Celina es Salvadoreña y vive en Alexandria, VA. En este episodio Celina nos narra con detalles la historia de nacimiento de su hijo, y nos cuenta de cómo un embarazo y trabajo de parto “de libro” (sin riesgos) se convirtió en una cesárea inesperada y casi de emergencia. Y nos confirma el poder que tiene el vínculo piel con piel durante las primeras horas posparto para sanar, regular, y calmar a mamá y bebé. Celina nos narra: -Durante el embarazo todo es ilusión y consumí todo tipo de información [2:28] -Aplicaciones y libros que recomienda [4:50]: What to Expect when You're Expecting - libro y aplicación durante el embarazo Babylist - website y aplicación para ayudarte con las lista de productos para el bebé Expecting Better y Crib Sheet - libros de Emily Oster Bringing Up Bébé - libro sobre la filosofía francesa de la crianza infantil por Pamela Druckerman -Contaba con el recurso familiar, con el apoyo de mis padres y hermanos pero aún así hay menos sentido de comunidad [7:28] -Tomé una prenatal clase con una enfermera certificada me que me informó sobre las rutinas del parto tradicional, cuando vas al hospital, los medicamentos y sus procedimientos, indicó como eran horas antes y después del parto, cuidados del recién nacido [8:55] -Infant CPR class [11:38] -Semana 40 y no llega bebé [12:00] -Inducción a la semana 41 - Me administraron Cytotec para comenzar el trabajo de parto. [14:42] -Trabajo de parto comenzó, rompí fuente, todo estaba saliendo como se esperaba, contracciones más fuertes [16:10] -La epidural..ahora o nunca?! [18:39] -Llegue a los 9 ½ cm de dilatación….se frenó el proceso [22:17] -Complicaciones después de 15 horas de romper fuente [23:30] -Cesaría casi de emergencia [26:43] -Seguimos con las complicaciones…tensión alta, me fallan los riñones…Y NO HE VISTO A MI BEBÉ [30:45] -El poder del piel con piel [34:40] -Cuando llegó mi mamá, me sentia mas segura de abogar por mi misma durante el posparto [43:13] -La importancia de seguir tus instintos y ser escuchada por los profesionales de la salud [45:25] -Recomendaciones de Celina [49:33] 1. Aceptar tu experiencia de parto aunque no sea lo que tu esperas o deseas- informarte de los diferentes tipos de parto, natural, vaginal, cesárea. Y no olvides que tú tienes más control de lo que tú piensas 2. Hacer preguntas y buscar el apoyo que necesitas - Poner más énfasis en aprender durante la citas prenatales, toma el tiempo de indagar sobre tus inquietudes, y formar un círculo de confianza con tu profesional de la salud 3. Rodéate de personas de gente que está dispuesta ayudarte y delega responsabilidades, ayuda en el día y día Te invitamos a que te unas a nuestra comunidad de ¡Hola! Maternidad y compartas tus experiencias, comentarios y preguntas al seguirnos por Instagram @holamaternidadelpodcast o nos mandes un correo a hola.maternidad@gmail.com Este podcast no debe de ser usado como sustituto a la consulta médica prenatal, pediatra, o psicológica. El contenido es solo para uso informativo y los temas discutidos son relatos y opiniones de las conductoras y sus invitados. #maternidad #mamaprimeriza #mama #bebe #cesárea #madreextranjera #mamaextranjera #maternidad #birthstory #historiadenacimiento #holamaternidadelpodcast #podcastenespañol --- Send in a voice message: https://anchor.fm/hola-maternidad/message

Sie erlebe es als «sehr aggressives Mittel», das für viele Frauen «grässlich» sei, sagt eine Hebamme mit 40-jähriger Berufserfahrung, die anonym bleiben möchte. Gemeint ist das Medikament Cytotec. Der darin enthaltene Wirkstoff Misoprostol ist eigentlich für die Behandlung von Geschwüren im Magen-Darm-Trakt gedacht – und die Arznei auch dafür zugelassen. Doch sie wird von Ärztinnen und Ärzten auch seit Jahrzehnten eingesetzt, um bei Gebärenden Wehen auszulösen. Dieser Einsatz von Cytotec ist mehr und mehr umstritten. 114 Meldungen wegen teils schwerwiegender Vorfälle sind in der Schweiz in Abklärung. In Deutschland oder Frankreich wurde die Einfuhr bereits gestoppt – selbst der Hersteller des Medikaments warnt vor dem Einsatz bei Schwangeren.  Wie riskant ist Cytotec in der Geburtshilfe wirklich? Wieso ist sich selbst die Fachwelt darüber uneins? Und welche Erfahrung machen Spitäler, Gebärende und Hebammen damit? Darüber spricht Catherine Boss, Co-Leiterin des Tamedia Recherchedesks, in einer neuen Folge des Podcasts «Apropos».Lesen Sie auf tagesanzeiger.ch die Recherche zum Thema.

In this episode of The Miscarriage Doula Podcast, Arden chats with Allison who experienced a loss at 8 weeks pregnant with her third child. She recaps the events of her loss and talks about her regrets, what she wishes she knew, and gives a lot of helpful advice for fellow loss moms going through this right now. Some topics discussed: use of Cytotec, having a rainbow baby, advocacy, and supportive healthcare professionals Follow Allison: @allisonnicole.rd Follow Arden: @ardenmcartrette Follow TMD: @themiscarriagedoula For 1:1 services, resources, and more, visit themiscarriagedoula.co --- Send in a voice message: https://anchor.fm/arden-cartrette/message Support this podcast: https://anchor.fm/arden-cartrette/support

Episode 63 **Margaret opens up about a very physically painful miscarriage and Cytotec use along with care providers offering very little support.** **DONATE** through our website, [ManagingMiscarriage.com](http://ManagingMiscarriage.com) or via Venmo by searching @Miscarriage *MORE EPISODES!* 30+ more interviews & exclusive content on [our Patreon page.](http://Patreon.com/miscarriage) -- Managing Miscarriage 40+ page eGuide is available here: [Free eGuide by Dr. Wittman](http://www.managingmiscarriage.com/eguide.html) -- Sign up to share your story on [Calendly.com/MelissaWittman](http://Calendly.com/MelissaWittman) Review this podcast! [Managing Miscarriage Podcast](http://podcasts.apple.com/us/podcast/managing-miscarriage/id1286938644?mt=2) -- Connect with us on [Instagram](http://www.instagram.com/managing.miscarriage/) and [Facebook](https://www.facebook.com/MiscarriageNonprofit)

Ich habe einen großen Unterschied empfunden zwischen den Wehen und führe diesen u.a. auf die verschiedenen Einleitungsmethoden zurück. # Einleitung # Misoprostol # Cytotec # Akupunktur # geburtseinleitende Akupunktur # natürliche Wehen # Wehen- Intensität # Verbindung # Verbindungsgefühl

Deutschlandweit wollen dutzende Frauen ihre Geburtskliniken wegen des Einsatzes des Wehenmittels Cytotec bei der Geburt verklagen. Vertreten werden die inzwischen über einhundert Mandantinnen von einer Medizinrechtskanzlei.

Lisa (@expectingtheunexpected1) opens up about her miscarriage and infertility journey. Topics include: recurrent pregnancy loss, a Cytotec experience, traumatic bleeding, IVF, premature labor, and motherhood after loss Follow Arden: @ardenmcartrette Follow The Miscarriage Doula: @themiscarriagedoula themiscarriagedoula.co --- Send in a voice message: https://anchor.fm/arden-cartrette/message Support this podcast: https://anchor.fm/arden-cartrette/support

We’ve reached an incredible milestone! We’re celebrating 3 million podcast downloads in less than 15 months. I wanted to celebrate with a guest that helped me reach a personal milestone: a beautiful birth story. Dr. Lisa Karamardian is Board Certified in Obstetrics and Gynecology at Newport Center Surgical, California, and was the guiding force in the healing birth of my second boy, Taschen.  I tackle the subject of birth with an expert in the field who truly empowers a woman’s labor while taking charge and providing guidance and tools to provide a safe delivery. The truth is, there is no such thing as a “right” birth, and birthing plans can go out the window when push comes to shove.  Dr. Lisa Karamardian brings her years of experience to the table and talks about all of the treatments available to create a beautiful birth. She demystifies “old-wives tales” around epidurals, breaking water, Pitocin, and Cytotec, and we both reflect on my second birthing experience.  You will learn about... Her OB-GYN education and professional backstory  Birth plans vs birth  Healing from the trauma from my first birth The purpose of NST (non-stress testing) Advanced maternal age pregnancies Misconceptions around the birth process  Understanding Pitocin and Cytotec  Postpartum needs and resources  Resources: Website: https://www.pacwha.com/ (pacwha.com) Instagram: https://www.instagram.com/drlisakaramardian/ (@drlisakaramardian) Thank you to our show sponsor, Kettle & Fire! Go to https://offers.kettleandfire.com/kelly-leveque-2021/?utm_campaign=&utm_medium=paid_sponsor&utm_source=podcast&utm_content= (kettleandfire.com/bewell) and use the code: BEWELL for 20% off your order. Thank you to our show sponsor, Public Goods! Go to https://www.publicgoods.com/?utm_source=podcast&utm_campaign=KELLY&utm_medium=partner (publicgoods.com/kelly) or use the code: KELLY for 15% off your first order.  Connect with Kelly: https://kellyleveque.com/ (kellyleveque.com) Instagram: https://www.instagram.com/bewellbykelly/ (@bewellbykelly) Facebook: https://www.facebook.com/bewellbykelly/ (facebook.com/bewellbykelly) Be Well By Kelly is a production of http://crate.media/ (Crate Media)

Savanna shares her journey through a missed miscarriage at 10 weeks pregnant and her experience with taking Cytotec and how her Catholic upbringing played a role in her loss. Topics Discussed: Getting your rainbow baby after miscarriage First-trimester loss Religion Follow Savanna: @savvy281_ Follow Arden: @ardenmcartrette Follow The Miscarriage Doula: @themiscarriagedoula themiscarriagedoula.co Support from today's show comes from our partners through affiliate marketing. By shopping our affiliate links you are supporting TMD and giving Arden the ability to work on content and projects that better the miscarriage community. 25% of all affiliate income goes directly into TMD Fund for loss moms to receive services and products for free. Learn more: themiscarriagedoula.co/support --- Send in a voice message: https://anchor.fm/arden-cartrette/message Support this podcast: https://anchor.fm/arden-cartrette/support

In dieser Folge erzähle ich dir, welche Möglichkeiten es gibt, mit einer kleinen Geburt umzugehen. Mein Wunsch ist, dass jede Frau ihren eigenen Weg gehen kann, der in diesem Moment zu ihr passt. Dies geht für mich am besten, wenn die Möglichkeiten klar sind. Diese Folge ist dazu da, aufzuzeigen, welche Möglichkeiten es gibt, welche Vor-und Nachteile ich sehe und wie jede Variante konkret aussehen kann. Der Fokus liegt auf dem Abwarten auf die kleine Geburt, weil darüber sonst so wenig gesprochen wird und nach meinem Gefühl hier noch die größten Unsicherheiten existieren. Sie ist vielleicht auch für Hebammen interessant, die noch wenig Erfahrung in der Begleitung von kleinen Geburten haben. Kurz bevor diese Folge raus kam, gab es einen Importstopp nach Deutschland für das gängigste Medikament zur Einleitung einer kleinen Geburt, Cytotec, so dass bei der 2. Variante des Umgangs aktuell einige Unklarheiten bestehen, ich werde diese jedoch sobald mehr Klarheit herrscht, direkt verlinken, wo ich dazu mehr sage.

Welcome to the first episode of The Miscarriage Doula Podcast! Arden (@ardenmcartrette) remembers her first two pregnancies that ended in loss and shares her story of loss with all of you. Follow us on Instagram: @themiscarriagedoula Leave a review on Apple Podcasts! (this helps others find the show) *Support The Miscarriage Doula Podcast for as low as $0.99/month! Click here to learn more. --- Send in a voice message: https://anchor.fm/arden-cartrette/message Support this podcast: https://anchor.fm/arden-cartrette/support

Leider endete meine erste Schwangerschaft mit einer Fehlgeburt. Beim ersten Ultraschall in der 9. Schwangerschaftswoche war zwar eine Fruchthöhle zu sehen, allerdings kein Embryo. Daher wurde ich mit Verdacht auf Missed Abortion (verhaltene Fehlgeburt) oder Blasenmole in die Klinik überwiesen. Es handelte sich tatsächlich dann um ein Windei (Abortivei) - also eine Schwangerschaft ohne nachweisbaren Embryo. Mir wurde sowohl der medikamentöse Abbruch mit Cytotec als auch ein abwartendes Verfahren auf Spontanabort oder eine Kürettage (Ausschabung / Abschabung) angeboten. In diesem Podcast berichte ich euch von meiner persönlichen Erfahrung mit der Kürettage und erkläre euch die verschiedenen Optionen mit Vorteilen und Nachteilen. Leider blieb bei mir ein Rest in der Gebärmutter zurück und mein HCG fiel nach Ausschabung erst nicht ausreichend. Daher habe ich außerdem noch Cytotec genommen - auch hier berichte ich euch von meinen Erfahrungen. Ich weiß, dass viele Frauen nicht über Fehlgeburten sprechen und es sich immer noch um ein Tabuthema handelt. Aber ich hoffe, dass dieses Video anderen Frauen in einer ähnlichen Situation helfen und vielleicht sogar Mut machen kann. Es ist Zeit, dieses Tabu zu brechen und zu beginnen, über frühe Fehlgeburten zu reden. Es passiert so vielen Frauen und es muss nicht sein, dass wir uns auch noch alleine fühlen, obwohl wir doch so viele sind!

Von Wehenstürmen und anderen Komplikationen berichten Frauen, die Cytotec zur Einleitung der Geburt bekommen haben. Wie gefährlich ist Cytotec? Und was können Frauen tun, die Angst vor der Geburt haben?

Anfang des Jahres ist eine heftige Debatte um das Medikament Cytotec entbrannt - nachdem BR und Süddeutsche Zeitung über den Umgang damit in deutschen Geburtskliniken berichtet hatten. In einzelnen Fällen war es bei Geburtseinleitungen mit dem Medikament zu schweren Komplikationen gekommen: Kinder erlitten Hirnschäden; es kam zu Gebärmutterrissen. Unter anderem haben sich Familien zusammengeschlossen, weil sie Probleme mit Cytotec bei der Geburtseinleitung erlebt haben. Eva Achinger und Ann-Kathrin Wetter sind an dem Thema über Monate drangeblieben. Es hat sich viel getan - genug? Das ist der Stand Ende 2020.

Schüler in Quarantäne - Wie lange ist die Isolierung sinnvoll? / Medikamente gegen Covid-19 - Ist Remdesivir gescheitert? / Projekt Lost Species - Auf der Suche nach verlorenen Arten / Wehenmittel Cytotec - Neue Leitlinien sorgen für Diskussion.

CRAP É A GRAVAÇÃO DA CONVERSA DE ZAP DE ALGUNS IMBECIS FALANDO SOBRE ALGUMA COISA. MUSICA, POLITICA, TECNOLOGIA, QUALQUER MERDA SENDO OU NÃO JOCOSO, IRÔNICO QUASE SEMPRE MUITO ÁCIDO. Se liga na dica: loja virtual e física de LPs Tchá Por Discos - Vinyl Store E se liga que essa parte não é ironia, anota aí: - sem racismo, sem deuses, sem homofobia, sem machismo, sem rock stars, não seja um zé roela! crap666999666@gmail.com

In a perfect world everything works like it is supposed to, your body is ready, your baby is fully mature and ready to make their entrance into the world, and you naturally go into labor.  As you probably know, everything doesn’t always go the way we plan and many women end up getting an induction to jump start labor.  The key is knowing when an induction may be medically necessary, and when it may be better to wait it out.  There are many reasons your doctor or midwife may suggest an induction and this episode really dives deep into the reasons an induction may be necessary, as well as some reasons it may be better to wait.  There are many ways your labor can be induced and we go through each method, how it works, what risks are involved, and what the benefits of each method are.  We get into the details on stripping and sweeping membranes, misoprostol (Cytotec), dinoprostone (Cervidil & Prepidil), synthetic oxytocin (Pitocin), using a laminaria or balloon cathedar, and breaking your water.  You will definitely want to listen to this episode to get all the information you need to determine whether induction is right for you, when is the best time to do it, and what methods you want to use.   You can read the full article and resources that accompany this episode by clicking here.   For more evidence-based information visit the Pregnancy Podcast website.

Why is the practice of inducing labor so ubiquitous? What does it mean to have someone else decide when your baby should be born? What are the long term ramifications of giving a synthetic form of oxytocin, the bonding and love hormone, to so many women during birth? Join Lynnea Laessig (@mamatukibirth) and I for a philosophical discussion about labor induction. Please note, nothing we say in this episode should be considered medical advice. Support us on Patreon! https://www.patreon.com/healingbirth

Is weight alone a pregnancy risk factor requiring intervention?     Brylee is a mom to 3 precious babes, and she’s experienced both negative and positive birthing experiences.  Today we’ll jump into the reasons behind both.   Show Notes Brylee had been told for many years that pregnancy would be very difficult, as she was diagnosed with PCOS as a teenager.  She and her husband became pregnant as soon as she stopped taking birth control. Her OB was so convinced that she wouldn’t be able to become pregnant, that she said she’d give her 6 months to try for a baby before exploring other options. Little did her OB know, she was already pregnant at that appointment!   Brylee had terrible implantation cramps with her first daughter.  They were so bad that she was scared it was a miscarriage (the day after her positive pregnancy test).    Her interest in birth began early, as her mother had Brylee’s brother in a birth center unmedicated.   After watching The Business of Being Born, Brylee let her OB know that she wanted a natural birth.  The OB always dodged the questions and said “we’ll see”.   Brylee woke up with (what she now knows was typical bloody show) and called the on-call doctor.  The doctor acted as if the bleeding was an emergency, and had her come in.  The OB did everything she could to pin pre-eclampsia on Brylee, which she feels was because Brylee is a plus-size mother.   She had one high blood pressure reading, which she feels confident was related to the stress of the situation… she had had zero high readings throughout the pregnancy.  Brylee refused induction, finally was released the next morning, and went home for the weekend.    On the following Monday, Brylee saw the same OB again, and had another high reading.  She told her mom, “I am TERRIFIED of that woman.”  She felt it was a case of White Coat Syndrome, just as her dad has.   The OB sent her straight to the hospital to be induced:   Cytotec 4 times   Ina May’s Guide to Childbirth gives an informative review of why Cytotec can be dangerous   They then started Pitocin.  After laboring for a long time, Brylee received an epidural.     After 30 minutes of pushing, Brylee had her baby.   There was absolutely no continuity of care for Brylee: Her Doctor was on vacation, another OB sent her in for the induction, another started the induction, and another delivered her baby.   With her second birth, Brylee knew she wanted to have a different experience.  Her friend had a birth with them that was wonderful, so Brylee was excited to use the practice of 8.     Brylee had one high blood pressure reading, and so her midwives sent her Maternal Fetal Medicine.  They put her on medication, and the medication constantly made her pass out, as it was bottoming out. At her 3rd midwife’s appointment, the midwives used a blood pressure cuff for a plus-size woman, and low and behold… she had a normal reading.   Because of Maternal Fetal Medicine’s diagnosis (Chronic Hypertension— which she knew was not the case), the recommendation was for Brylee to be induced at 38weeks.   She failed the first Gestational Diabetes test, so she was required to take it again, which she passed.   One doctor at MFM told her that if she’d been in any other state, her blood pressure would not be an issue.  For whatever, in the south, particularly in Tennessee, this doctor said that other doctors hold very strongly to very specific numbers.   Brylee convinced her doctors to let her wait to be induced until 39 weeks.  After a long day of waiting for a room, and laboring, Brylee’s doctor told her they needed to break her bag of waters.  The baby was high, and they did not tell Brylee the risks associated with this.   Fortunately, the baby was fine, and once she began pushing, the baby was out in two pushes.   Unfortunately… soon after she gave birth, a nurse came into her room and switched her blood pressure cuff from the larger size to the standard size.  Brylee’s blood pressure numbers then spiked with the new cuff.   Because of her terrible experience, Brylee decided she was NOT going back to the hospital.  Her third baby was a huge surprise!     Brylee began searching for a homebirth midwife in her area that would take her.  In a local birthing center, her BMI was too high to deliver.      She found a midwife who serviced her area, and set up a meeting.  After deciding to work with her, several appointments in, Brylee had a high blood pressure reading.  Her midwife mentioned that she thought this was likely due to the blood pressure cuff being the wrong size, not her actual blood pressure.  Her midwife ordered a new cuff, and Brylee never had a high reading again.   Brylee’s midwife referred her to a CNM just to have check her out as a backup, and the CNM was incredibly encouraging.  She said Brylee was a perfect candidate for homebirth.   During her anatomy scan, the tech that saw her ended up ripping her skin.  It was a horribly painful experience for Brylee.   As she entered labor… Brylee’s water broke at her parents’ house on their couch.  She tried to get contractions going by walking, dancing, and using a breast pump.   Her midwife had come over in the morning to see what her dilation was (she was a 2).   Brylee decided to try the Miles Circuit    When Brylee called her midwife to let her know it was time for her to come, her midwife responded that she had a fever, so she was going to have to send her partner.   Brylee went from 4cm to pushing in a matter of minutes.       Episode Roundup Wow, what a difference in care.  As we head into the episode roundup, that’s the topic I want to discuss.  What I love about midwifery, particularly the homebirth variety, is the level of individual care.  The midwifery model of care lends itself to truly learning about the mother, gaining a full understanding of her health, and then proceeding with the intention of keeping her risk factors low and in check. Conditions were never pushed on Brylee based off of the fact that there “just must be something,” and she was given the opportunity to absolutely rock her birth, which she did.     Individualized care, my friends.  That’s what it’s all about.  Okay, that’s all I’ve got for you this week.  I look forward to seeing you back here next week.   Links From today's Show:   Miles Circuit Ina May’s Guide to Childbirth The Business of Being Born     Join the Facebook Group!

Sarah and her husband live in MA and are both doctors of chiropractor. They have two boys aged 3 & 1. Sarah shares about the benefits of chiropractic care in pregnancy. She suffered a miscarriage and had to take Cytotec after not fully miscarrying 5 weeks after learning of her miscarriage. She lot trust in her body and moved forward with IUI and a hospital birth. She describes her hospital experience as feeling like a product of their system and ending in a cesarean section without a strong medical reason. She shares about nitrous oxide and what to ask your local hospital. Her first birth emphasizes the need for everyone to be familiar with Spinning Babies. We question what informed consent means to a laboring mom. Finally she walks us through how she arrived at birthing autonomously-free-birth-at home as a VBAC with her husband's support. This beautiful water birth story opened up my mind on what it really means to take ownership of your body and to make informed and empowered decisions that are right for you, no matter what that looks like. Her favorite baby product is the Bum Genius cloth diapers.  You can follow Sarah on Instagram @birthuprising You can follow me on Instagram @birthstorypodcast or @mydoulaheidi if you are interested in a doula in Charlotte, NC

059: Wie selbstbestimmt und sicher kann eine Geburt sein? Denise und Ninia sprechen über das Mittel Cytotec - das in der letzten Woche durch die Medien ging. Über ihre eigenen Geburtserfahrungen, was sich seit Jahren in der Geburtenmedizin und in der Situation der Hebammen ändern muss und warum es nicht hilft, ein Medikament zu verteufeln. Außerdem geben wir euch einen tollen Kinotipp - und damit ist tatsächlich ein Kino und nicht ein Filmtipp gemeint, nämlich das beste Kino Deutschlands, das natürlich in Hannover steht! Und wir reißen kurz das Attentat von Hanau an, werden dabei aber sehr wütend, wen wundert es? Plus: Zwei tolle Literaturtipps. shownotes:Teresa Bücker über Cytotec: https://www.zeit.de/gesellschaft/2020-02/wehenmittel-cytotec-geburtseinleitung-schwangerschaft-gesundheitInsta-Story von Karen Dannhauer: https://www.instagram.com/kareendannhauer/ (Highlights)Roses Revolution Day: https://www.mother-hood.de/sichere-geburt/informationen-fuer-eltern/missachtung-und-gewalt-in-der-geburtshilfe.htmlLodderbast: http://www.lodderbast.de„DAD“ von Nora Gantenbrink: https://www.rowohlt.de/hardcover/nora-gantenbrink-dad.html„Nix passiert“ von Kathrin Weßling: https://www.ullstein-buchverlage.de/nc/buch/details/nix-passiert-9783961010387.htmlTour Weßling: https://www.ullstein-buchverlage.de/nc/autoren/unsere-autoren-live-erleben.html?tx_publisher_pi1%5Bautor%5D=Kathrin%2BWeßling„Der Weg des Künstlers“ von Julia Cameron: https://www.droemer-knaur.de/buch/julia-cameron-der-weg-des-kuenstlers-9783426878675„Why are we creative“: https://whyarewecreative-film.de ——— Ninia „LaGrande“ Binias

Das Medikament Cytotec fördert Wehen und wird in Deutschland gelegentlich eingesetzt, um die Geburt auszulösen – obwohl es dafür nicht zugelassen ist. Es komme auf die empfohlene Dosierung an, verteidigen Ärzteverbände den Einsatz der Tablette.

Unterschätzen Eltern den Digital-Konsum ihrer Kinder? / Digitalisierung im Gesundheitswesen: Was bedeutet das für die Patienten? Gespräch mit Carola Sraier, Gesundheitsladen München e. V. / 24 Stunden Neurochirurgie: Eine junge Ärztin erzählt über ihre erste Schicht in der Notaufnahme / Geburtseinleitung mit Cytotec: Reaktionen auf Berichterstattung

Nachdem BR und SZ über den falschen Einsatz des Medikaments Cytotec berichtet haben, melden sich immer mehr Frauen, die über Komplikationen bei Geburten berichten. Das Magenmedikament soll u.a. in Deutschland zur Geburtseinleitung verwendet worden sein.

Gefährliche Geburtshilfe - Wie riskant ist Cytotec? / Allgegenwärtiges Mikroplastik - Was leisten Filter? / Intelligente Stromzähler - Was taugen "Smart Meter"? / Bedrohte Insekten - Welche Rolle spielt der Klimawandel.

Das Medikament "Cytotec" wurde zugelassen als Mittel, um Magenprobleme zu behandeln. Einige Kliniken nutzen es heute aber in der Geburtshilfe - mit bisweilen dramatischen Folgen für Mutter und Kind.

Themen: Cytotec: gefährliche Tablette zur Geburtseinleitung; Mit Satelliten die Meeressäuger aus dem All beobachten; Alzheimer: Früherkennung und Vorbeugen; Das Problem des illegalen Haustierhandels; Lithium-Schwefel-Akku: Gut 1000 Kilometer Reichweite?; "Ozean-Plastik": eine aktuelle Variante der Grünfärberei; Amazonas: Wenn Urwald zur Savanne wird; eSports: Neue Studie über Gesundheitszustand von Gamern. Moderation; Franz-Josef Hansel

Die Hälfte der Kliniken in Deutschland verwendet einer bisher unveröffentlichten Umfrage der Universität Lübeck zufolge zur Geburtseinleitung ein Mittel, das in der Geburtshilfe gar nicht zugelassen ist: Cytotec. Nach Recherchen des BR kann das gefährliche Folgen haben.

Ärzte nutzen die umstrittene Tablette Cytotec in der Geburtshilfe. Doch die deutsche Überwachungsbehörde erfasst die schweren Nebenwirkungen nur selten.

Episode 63 Margaret opens up about a very physically painful miscarriage and Cytotec use along with care providers offering very little support. DONATE through our website, ManagingMiscarriage.com or via Venmo by searching @Miscarriage MORE EPISODES! 30+ more interviews & exclusive content on our Patreon page. -- Managing Miscarriage 40+ page eGuide is available here: Free eGuide by Dr. Wittman -- Sign up to share your story on Calendly.com/MelissaWittman Review this podcast! Managing Miscarriage Podcast -- Connect with us on Instagram and Facebook

Episode 63 Margaret opens up about a very physically painful miscarriage and Cytotec use along with care providers offering very little support. DONATE through our website, ManagingMiscarriage.com or via Venmo by searching @Miscarriage MORE EPISODES! 30+ more interviews & exclusive content on our Patreon page. -- Managing Miscarriage 40+ page eGuide is available here: Free eGuide by Dr. Wittman -- Sign up to share your story on Calendly.com/MelissaWittman Review this podcast! Managing Miscarriage Podcast -- Connect with us on Instagram and Facebook

Episode 57 Sheri went through 3 miscarriages and shares her experience with passing them naturally with the help of herbs and essential oils verses using Cytotec. This experience prompted Sheri to start a company helping women recover from miscarriage physically and emotionally, and to prepare for the next step. She uses nutrition, essential oils and mindset coaching to do this. Visit her lovely and informative website SheriJohnson.ca for free meditations and information on how to work with her. DONATE through our website, ManagingMiscarriage.com or via Venmo by searching @Miscarriage DONATE through our website, ManagingMiscarriage.com or via Venmo by searching @Miscarriage MORE EPISODES! 30+ more interviews & exclusive content on our Patreon page. -- Managing Miscarriage 40+ page eGuide is available here: Free eGuide by Dr. Wittman -- Sign up to share your story on Calendly.com/MelissaWittman Review this podcast! Managing Miscarriage Podcast -- Connect with us on Instagram and Facebook

Episode 57 Sheri went through 3 miscarriages and shares her experience with passing them naturally with the help of herbs and essential oils verses using Cytotec. This experience prompted Sheri to start a company helping women recover from miscarriage physically and emotionally, and to prepare for the next step. She uses nutrition, essential oils and mindset coaching to do this. Visit her lovely and informative website SheriJohnson.ca for free meditations and information on how to work with her. DONATE through our website, ManagingMiscarriage.com or via Venmo by searching @Miscarriage DONATE through our website, ManagingMiscarriage.com or via Venmo by searching @Miscarriage MORE EPISODES! 30+ more interviews & exclusive content on our Patreon page. -- Managing Miscarriage 40+ page eGuide is available here: Free eGuide by Dr. Wittman -- Sign up to share your story on Calendly.com/MelissaWittman Review this podcast! Managing Miscarriage Podcast -- Connect with us on Instagram and Facebook

Show Notes:  Mia and her fiancé have been together for 7 years and have two precious sons together. She comes for a naturally minded family- some of her aunts had had homebirths. However, she was not very educated on the subject.  She planned for a hospital birth and had a pretty good experience.  She later experienced a friend’s homebirth (about 8 months after her own hospital birth) and realized that’s what she would want to do with any subsequent children. Mia found out that she was pregnant with her second son right after her first son turned one. When she found out she was pregnant, she knew she wanted her friend’s midwife to act as her own midwife. Interestingly enough, both Mia and the midwife did not make it in time for the actual birth of Mia’s friend’s child! However, Mia loved how the midwife interacted with her during the home visit and immediately postpartum enough to know that homebirth was the way she wanted to go.  “It made me more aware that homebirth isn’t a scary thing.” Mia admits that she procrastinated a bit with her prenatal care- she began going to prenatals at 20 weeks. One way that Mia educated herself was by joining several homebirth and natural birth Facebook groups. Every afternoon when she would scroll through her feed, she would gain more insight into the choice she was making.  With her first birth, her water broke before labor began. Once she went in, Mia mentions how many steps there were before she was actually able to focus on her labor: She had to get checked in through labor, assigned a room, they had to bring a birthing tub in in pieces, her water line was broken in her room so she had to wait for maintenance—Because of this the hours seemed to pass by like minutes.  “Looking back at it now, the hours passed by like minutes.” After laboring for 3-4 hours in the tub, Mia was checked and found to be 9 ½ centimeters. After a few more contractions, she was ready to push. Mia says that pushing was the time that things became more uncomfortable. She was on her back, bright lights shining directly on her, nurses and doctors hustling and bustling, etc.  Mia felt that the discomfort of the situation slowed her labor dramatically.  She ended up pushing for 3 hours, and when her baby finally came, he was tangled up in his cord.  Mia wishes she had been able to push in a better position, thinking that could have helped her situation dramatically. With her second child, Mia had been having Braxton Hicks contractions for weeks. She woke up at 3 am one morning with contractions that were different from what she’d been experiencing.  Her fiancé works nights, so unfortunately this was right when he was coming to bed.  She remembers having to tell him, “Hey, you can’t go to sleep- I’m having contractions!” They decided to wake up and straighten up the house a little bit. After, Mia decided that it might be a good idea to eat a little something and begin timing her contractions.  She was contracting every 5 minutes and they were lasting about 30 seconds.  However, because they were consistent for an hour, she decided to call her midwife and let her know what was going on.  Her midwife agreed that she was in labor, but recommended that she try to go to sleep for a bit. Mia took her advice and after about an hour of trying, she was able to fall asleep and stay asleep for 4 hours. She woke up and had a normal day. Mia was even able to get a small nap in when her son did later.  Once she awoke, she decided it would be best to head to the grocery store to get a big haul of groceries so she wouldn’t have to leave her house any time soon! She remembers her son running away from her in the store. As she chased him, she began having a contraction and though people must think she was crazy! “I think that I was so busy trying to relax that day that I didn’t nourish my body the way that I should” Mia stayed in touch with her midwife throughout the day. At 7:30 pm, Mia’s mother arrived at her house.  Around that time, Mia called her midwife and asked her to begin heading her way.  Her midwife said, “Well, you’re still talking through your contractions.  I’ll call you back in about half an hour to reevaluate.”  About 15 minutes later her midwife received another call—this time from Mia’s mom—telling her she couldn’t talk through contractions anymore! Mia says that she had a perfect birth team. Her aunt, who has had homebirths, and her mom, played a huge role in her first labor, so she knew they would be important in her second birth, too.  Her two cousins came, and even Mia’s little sister, who is 6 wanted to be a part of the special day.  Mia had a photographer, and of course her midwife, as well as a second midwife and an assistant.  Her fiancé was there taking care of her, too!  Everyone was at her house by 9pm. “And really what helped me most through contractions this time was listening to worship music and just trying to sing through them, which I loved.”  Mia’s midwife kept asking her to go pee, but Mia was unable to each time. Her midwife finally said that she felt like Mia was a bit overstimulated with having everyone around her.  She asked her to go lie down in her bed with her fiancé, promising that they would come in and check on her.  Mia laid in her room for the next 2 hours, her midwife coming in to check on her every 30 minutes or so. At one point, her midwife said again, “Listen, you need to go pee, or I’m going to catheter you.  If you’d like, I can check and see how dilated you are.” Mia decided to be checked, and when checked, her midwife let her know that she was fully dilated. She notes that she had been feeling the desire to push, but was thinking it couldn’t possibly the right time. She though she needed to let the pain do its job, and if she had pushed, it would be counter to what she needed.  Mia says she thinks her midwife came in right at the perfect time, because she probably would have had the baby alone in her bed had she come in any later! “Get in the water and push your baby out!” About 5 pushes later, Mia had her baby! Mia describes how with her first baby, even though they didn’t find out the gender, she knew she was having a boy. With this baby, she was completely convinced it was a girl.  However, once baby was born…. She reached down and found a surprise! “I was so convinced I was having a girl this time….I reached down and I felt balls!” After having the placenta, Mia got out of the tub and realized that she was hemorrhaging. Her midwife began doing all of the common interventions for too much bleeding.  She began by giving Mia hem-halt, which is an herbal supplement to help stop the bleeding.  Her midwife then gave her a catheter since she knew that Mia hadn’t been able to pee for quite a long time.  Neither treatment worked, so her midwife examined her internally to see if there was any clear reason as to why she was bleeding. Upon examination, nothing could be found.  The bleeding continued, so her midwife gave her a shot of Pitocin and 3 Cytotec (another drug used to contract the uterus) rectally. After all of these interventions, Mia was still bleeding. Her midwife made the decision to have someone call 911 and transport her to the hospital, as the bleeding was not stopping.  As the ambulance was on its way, Mia’s midwife recommended that she put together a hospital bag, should she have to stay for any reason. She also told her that her baby’s car seat needed to be installed so that he could come to the hospital.  At this point, Mia refused. Her baby had only been on her chest so far, and she was not going to put him in a car seat so quickly.  Her midwife told her that when EMS arrived, they would tell her that she couldn’t take him with her in the ambulance.  Mia said, “Well I’ll just throw a fit, because he’s not going away from me.” Once the ambulance arrived, Mia did as she said she would and advocated for herself. She told the EMS team that the baby would be riding on her chest- that she would take responsibility.  They conceded and Mia was able to take the baby with her. Once they arrived at the hospital, they had to wait for the OB to come down from the maternity floor. While waiting, Mia’s midwife April checked her again and told her that her bleeding was much better.  She said they would probably just check her out and send her home.  Before being sent home, the OB wanted to physically feel inside of Mia to see if she could figure out why she had been bleeding. She felt internally as deep as she could, and Mia describes this as the worst pain she can remember experiencing.  After receiving IV fluids and stitching, Mia was able to return home. “It doesn’t always have to be 100% perfect at a homebirth. Your midwife knows what’s going on and is going to send you in when you need to be sent in.” (Katelyn) Mia mentions how she didn’t feel any panic during the hemorrhage because she knew her midwife was on top of the situation.   Episode Roundup:   The body works so much better when given space to work! During her hospital birth, Mia ended up pushing for 3 hours lying on her back.  With her second birth, she was in a pool of water on her knees.  Her baby was out within just a few pushes.  Position makes such a difference! Always, always, always advocate for yourself or have someone present who will. When Mia had to be transported for bleeding, she made sure that her baby was able to stay with her the entire time (clearly, she knows the importance of postpartum skin to skin!).  She stood up for herself and her baby and kept him with her at all times, even when it was considered unconventional.  Having a “Happy Homebirth” does not mean everything has to go perfectly. It’s not always going to be butterflies and rainbows.  Sometimes things go awry.  The Happy Homebirth experience is being supported and surrounded by care providers that you trust to keep your health and safety (not only physical, but mental and emotional) as the top priority.  Sometimes this includes hospital transports.  This can also include hospital births! 

This is a story about loss - In memory of Tatia Oden French & Baby ZorahTatia's story began like many, she had a healthy pregnancy, she and her family were excited to be growing, and when they went in for her induction, they were expecting to walk away with a healthy baby. However, things did not go as planned and sadly both Tatia and her baby Zorah died in the operating room.We had the honor of having Tatia's mother Maddy Oden to share Tatia's story with us. Maddy and her family knew that they didn't want others to go through the same experience. From their loss, they developed the Tatia Oden French Memorial Foundation in March 2003 to continue Tatia's memory and provide education to others."It gives ALL women of childbearing age complete information concerning medical interventions and drugs which are administered during childbirth. We do this hoping that women may then be able to make FULLY informed decisions regarding the birth of their children." - Tatia Oden French Memorial FoundationThis experience highlights the importance of informed consent, the medicalization of birth specifically with the induction drug Cytotec and infant/maternal mortality. We hope that as you listen, you don't sit in fear from their story, but instead take in the information, share it with others and help extend the mission of the foundation.We can't control birth, and we can't predict outcomes, but we can gather information to ensure decisions are lead by our informed voices!Resources:Tatia Oden French Memorial Foundation | foundation website with resources, videos, articles and more information on their workTatia Oden French Memorial Foundation | Facebook pageSponsors:Fringe22 | Design & Creative StrategyToday's programming is in partnership with FRINGE22 design & creative strategy. A design studio focused on brand development and creative strategy aimed at connecting with people who are committed to social impact. For sneak peaks of their work, you can also follow them on Facebook and Instagram at @fringe22studio.

{Ilana} Ilana graciously takes us through her "never-ending miscarriage", including a D&C, Cytotec, and weekly blood draws for almost 2 months. Our culture refuses to talk about miscarriage, so very few women (or doctors!) know what to do or what to really expect when it happens. And it happens a lot- more than current statistics reflect. Some celebrities have talked briefly about their painful experience, but ultimately it's glossed over outside of hushed message boards. Especially how to get through it and recover at home. We're changing that. Managing Miscarriage is a new nonprofit initiative to fill the void. As a nonprofit, we run completely on donations. Our services help thousands of women so please support us by donating through our website, ManagingMiscarriage.com Managing Miscarriage 40+ page eGuide is available here: Free eGuide by Dr. Wittman

{Ilana} Ilana graciously takes us through her "never-ending miscarriage", including a D&C, Cytotec, and weekly blood draws for almost 2 months. Our culture refuses to talk about miscarriage, so very few women (or doctors!) know what to do or what to really expect when it happens. And it happens a lot- more than current statistics reflect. Some celebrities have talked briefly about their painful experience, but ultimately it's glossed over outside of hushed message boards. Especially how to get through it and recover at home. We're changing that. **Managing Miscarriage** is a new nonprofit initiative to fill the void. As a nonprofit, we run completely on donations. Our services help thousands of women so please support us by donating through our website, **[ManagingMiscarriage.com](http://managingmiscarriage.com)** *Managing Miscarriage* 40+ page eGuide is available here: [Free eGuide by Dr. Wittman](http://www.managingmiscarriage.com/eguide.html)

{Sergia} After experiencing 2 miscarriages at 9 weeks, a failed Cytotec course resulting in a D&C, and lots of time reflecting, Sergia shares her all too relatable story with us. MORE MISCARRIAGE EPISODES! --> Patreon.com/Miscarriage Our culture refuses to talk about miscarriage, so very few women (or doctors!) know what to do or what to really expect when it happens. And it happens a lot- more than current statistics reflect. Some celebrities have talked briefly about their painful experience, but ultimately it's glossed over outside of hushed message boards. Especially how to get through it and recover at home. We're changing that. Managing Miscarriage is a new nonprofit initiative to fill the void. As a nonprofit, we run completely on donations. Our services help thousands of women so please support us by donating through our website, ManagingMiscarriage.com Managing Miscarriage 40+ page eGuide is available here: Free eGuide by Dr. Wittman

{Sergia} After experiencing 2 miscarriages at 9 weeks, a failed Cytotec course resulting in a D&C, and lots of time reflecting, Sergia shares her all too relatable story with us. ## MORE MISCARRIAGE EPISODES! --> [Patreon.com/Miscarriage](http://www.Patreon.com/Miscarriage) Our culture refuses to talk about miscarriage, so very few women (or doctors!) know what to do or what to really expect when it happens. And it happens a lot- more than current statistics reflect. Some celebrities have talked briefly about their painful experience, but ultimately it's glossed over outside of hushed message boards. Especially how to get through it and recover at home. We're changing that. **Managing Miscarriage** is a new nonprofit initiative to fill the void. As a nonprofit, we run completely on donations. Our services help thousands of women so please support us by donating through our website, **[ManagingMiscarriage.com](http://managingmiscarriage.com)** *Managing Miscarriage* 40+ page eGuide is available here: [Free eGuide by Dr. Wittman](http://www.managingmiscarriage.com/eguide.html)

{Megan Truax Grube} Megan has gone through 3 miscarriages and had a terrible stomach flu-like reaction to Cytotec, all in her first year of marriage. MORE MISCARRIAGE EPISODES! --> Patreon.com/Miscarriage Our culture refuses to talk about miscarriage, so very few women (or doctors!) know what to do or what to really expect when it happens. And it happens a lot- more than current statistics reflect. Some celebrities have talked briefly about their painful experience, but ultimately it's glossed over outside of hushed message boards. Especially how to get through it and recover at home. We're changing that. Managing Miscarriage is a new nonprofit initiative to fill the void. As a nonprofit, we run completely on donations. Our services help thousands of women so please support us by donating through our website, ManagingMiscarriage.com Managing Miscarriage 40+ page eGuide is available here: Free eGuide by Dr. Wittman

{Megan Truax Grube} Megan has gone through 3 miscarriages and had a terrible stomach flu-like reaction to Cytotec, all in her first year of marriage. ## MORE MISCARRIAGE EPISODES! --> [Patreon.com/Miscarriage](http://www.Patreon.com/Miscarriage) Our culture refuses to talk about miscarriage, so very few women (or doctors!) know what to do or what to really expect when it happens. And it happens a lot- more than current statistics reflect. Some celebrities have talked briefly about their painful experience, but ultimately it's glossed over outside of hushed message boards. Especially how to get through it and recover at home. We're changing that. **Managing Miscarriage** is a new nonprofit initiative to fill the void. As a nonprofit, we run completely on donations. Our services help thousands of women so please support us by donating through our website, **[ManagingMiscarriage.com](http://managingmiscarriage.com)** *Managing Miscarriage* 40+ page eGuide is available here: [Free eGuide by Dr. Wittman](http://www.managingmiscarriage.com/eguide.html)