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"Let us know what you think about this episode"We explore epidurals in childbirth, examining what they are, their risks, and why unmedicated birth options deserve equal consideration in your birth plan.• Epidurals are regional anesthesia using local anesthetics and opioids to block pain signals from the waist down• Research shows epidurals can slow labor progression, especially during the pushing phase by up to 90 minutes• Associated with higher likelihood of requiring vacuum extraction or forceps during delivery• Can contribute to a cascade of interventions including Pitocin, continuous monitoring, and potentially C-section• Side effects include maternal hypotension in 14-33% of cases, which can reduce blood flow to the placenta• Rare complications include post-dural puncture headaches and nerve damage• Can cause maternal fever (15% higher risk), potentially leading to unnecessary antibiotic treatment for baby• May affect baby's alertness and rooting reflexes, creating challenges with early breastfeeding• Despite risks, epidurals have benefits including pain relief, stress reduction, and making complicated labors manageable• Create a "moment of crisis plan" to determine your first step when you need help during laborIf you found this episode helpful, please share it with a friend, leave a review, or subscribe for more evidence-based discussions on pregnancy and birth. Thank you for your support.Links to research: Epidurals effect on second stage of labor -https://pubmed.ncbi.nlm.nih.gov/24499753/Epidurals effects on vacuum or forceps use in birth -https://pmc.ncbi.nlm.nih.gov/articles/PMC6494646/Reducted risk of cesarean delivery with discontinuation of pitocin in active labor - https://www.ajog.org/article/S0002-9378(25)00161-9/fulltextEpidurals and maternal fever - https://www.ajog.org/article/S0002-9378(22)00480-X/fulltextEpidurals and early breastfeeding difficulty - https://www.ncbi.nlm.nih.gov/books/NBK501222/
Send us a textWelcome to the April Q&A episode! Today's episode begins with your answers to our question: How do you cope when you are at your breaking point in parenting? If you are looking for some creative ideas, you will find them here! And someone, please tell us where one Mississippi, two Mississippi came from?Next, we get down to birth and answer the following questions: Why do some women choose unmedicated, physiological births despite societal pressures and perceived difficulties? Why not just get the epidural?Is it ok to push if you are not fully dilated? How dangerous is this and what is the risk with early pushing?My friend had to have an emergency cesarean when her baby was already in the vaginal canal. They pushed the baby back up and caused severe damage to her vaginal tissue. Was this necessary or were her providers just impatient?In the extended version of today's episode, which you can hear by subscribing on Apple Podcasts or joining any of our Patreon tiers, we answer these additional questions:What are the risks of using castor oil to induce labor?If I had a big baby in my first pregnancy, does it mean I will have gestational diabetes in my next pregnancy? Does it even mean I had gestational diabetes in my first? My doctors put this in my records with no evidence beyond a big, healthy baby.How do I gently night wean?In quickies, we discuss tongue ties and white tongues, hemorrhage and C-section, breath work resources for labor, retained placentas, protein for breastfeeding, decreasing milk supply, risk of infection with broken water, windmilling the placenta, and lastly, if you would only watch one movie for the rest of your life, what would it be?Plus, don't miss today's long and hilarious outtake. Watch the full videos of all our episodes on YouTube!**********Our sponsors:Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort.Needed -- Our favorite nutritional products for before, during, and after pregnancy. Use this link to save 20%DrinkLMNT -- Purchase LMNT with this unique link and get a FREE sample packENERGYbits--the superfood every mother needs for pregnancy, postpartum, and breastfeedingUse promo code: DOWNTOBIRTH for all sponsors.Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Watch the full videos of all our episodes on YouTube! Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.
244: This week, I'm joined by Lindsey Meehleis, a certified midwife, doula, lactation consultant, EMT, CPR instructor, and neonatal resuscitation provider. Lindsey brings a truly holistic approach to birth, and our conversation dives deep into the importance of honoring the natural physiology of labor. As someone on my own fertility journey, I asked all the questions I've been curious about — from how to find a midwife to what real support during birth looks like. We explore the over-medicalization of birth in the Western world, how to prepare for a more empowered and informed birthing experience, and why individualized care matters so much. Lindsey's wisdom and passion for supporting women through this rite of passage is incredibly inspiring — I left this conversation wanting her by my side when I give birth someday. Topics Discussed: What is the difference between a midwife and a doula? How can I prepare for a natural birth in a medicalized world? Are epidurals and Pitocin necessary for every labor? What are the risks of relying on baby formula over breastfeeding? How to find a trustworthy midwife or doula? Sponsored By: Our Place | Use code REALFOODOLOGY for 10% off at fromourplace.com Timeline | Go to timelinenutrition.com/REALFOODOLOGY and use code REALFOODOLOGY for 10% off Qualia | Go to qualialife.com/REALFOODOLOGY for up to 50% off and use code REALFOODOLOGY at checkout for an additional 15% off. Pique | Piquelife.com/Realfoodology That's P-I-Q-U-E life dot com/REALFOODOLOGY. Graza | So head to Graza.co and use REALFOODOLOGY to get 10% off of TRIO which includes Sizzle, Frizzle and Drizzle, and get to cookin' your next chef-quality meal! Cozy Earth | Go to cozyearth.com and Use code REALFOODOLOGY for 40% off best-selling sheets, pajamas, and more. Trust me, you won't regret it. Timestamps: 00:00:00 – Introduction 00:03:42 – How birth became medicalized 00:06:51 – The "PuberTea" and early health education 00:08:17 – Navigating pregnancy in the Western world 00:13:18 – Epidurals, fentanyl, and early latching challenges 00:18:10 – The risks of baby formula 00:22:25 – The impact of high fructose corn syrup 00:24:14 – Maternity leave and postpartum support 00:26:34 – Latching tips & working with lactation consultants 00:31:51 – The truth about breastfeeding 00:33:46 – A brief history of birth practices 00:35:01 – C-sections, vaginal seeding, and gut health 00:37:40 – Learning to trust your body 00:39:31 – Pitocin, natural birth, and informed choices 00:44:11 – Advocacy and the MAHA Mom Coalition 00:48:44 – Environmental toxins: Glyphosate and fertility 00:51:52 – Understanding gestational diabetes 00:55:40 – Birth centers vs. hospitals 01:00:04 – How to find a midwife or doula 01:02:13 – Managing emergencies during birth 01:07:10 – Why individualized birth care matters 01:09:10 – Midwife vs. Doula: What's the difference? 01:10:53 – Addressing concerns about home birth 01:13:58 – Where to find Lindsey Meehleis Show Links: Sperm counts have declined by over 50% globally The U.S. fertility rate has dropped from 2.48 in 1970 to just 1.64 toda The U.S. maternal mortality rate has increased by over 60% in two years Black women are 2.6 times more likely to die from pregnancy-related causes than white women. Hispanic maternal mortality rates The World Needs 900,000 More Midwives Breastfeeding rates Worker protections need to be implemented Check Out Lindsey: Instagram https://www.theremembering.com/media https://www.maha-mom-coalition.com/ Check Out Courtney: LEAVE US A VOICE MESSAGE Check Out My new FREE Grocery Guide! @realfoodology www.realfoodology.com My Immune Supplement by 2x4 Air Dr Air Purifier AquaTru Water Filter EWG Tap Water Database Produced By: Drake Peterson
Welcome to Episode 100!!We're welcoming back Dr. Kelsey Marr to the Bringing Up Baby podcast! In this episode, we're uncovering ALL the research and details on Epidurals. We're answering questions like: - Is it too late to get an epidural during labour? - How is the epidural administered? - What are the risks and benefits? - What is a "walking epidural"? - Is it more likely to require a C-Section delivery if given an epidural? Listen + share! For more information:HOST: Ashley Cooley, owner/operator of Birth Baby Sleep Education & Support ServicesWebsite | Instagram | Facebook GUEST: Kelsey Marr, PhD, owner of Collective Care HalifaxWebsite Thank you to our lovely sponsor - Nurtured Products for Parenting! A local-to-Halifax shop that can also ship to you ;) www.nurtured.ca Want to get your hands on your own Birth Sling? Go to THIS LINK and use code: birthbabysleep for $10 off your order!
In this episode of Moments With MamasteFit, Roxanne and Gina (a labor nurse and a doula) discuss the concept of the labor curve and share diverse experiences on dilation rates during labor. They compare the historical Freedman's Curve to contemporary understandings, emphasizing that dilation can be irregular and is just one part of assessing labor progress. They also highlight other important indicators such as temperament, movement patterns, and specific fetal heart rate changes, providing invaluable insights for both expecting individuals and birth supporters.00:00 Introduction to Moments With MamasteFit00:22 Understanding the Labor Curve00:42 Real-Life Labor Stories01:50 Freedman's Curve vs. Contemporary Labor Curve03:12 Indicators of Labor Progress07:11 Movement Patterns and Labor Progression10:51 Epidurals and Labor Signs16:39 Conclusion and Resources——————————Get Your Copy of Training for Two on Amazon: https://amzn.to/3VOTdwH
Lily's VBAC birth story episode is finally here!!! You know and love her just like we do. She not only manages the social media content here at The VBAC Link but also spends so much time connecting with you personally. She has the biggest heart for VBAC and champions all types of empowered birth.Lily walks us through her experiences with ectopic pregnancy, loss, her traumatic Cesarean, and how she persisted through a 66-hour long labor without an epidural to achieve her hospital water birth VBAC.If you followed her pregnancy journey, you saw that Lily was incredibly proactive during her pregnancy. She built the strongest team of birth and body workers. She was specific in her desires, yet remained open-minded. This served her so well in labor and made all the difference during her birth!Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. You guys, today is a very exciting day. We have recently had two of our VBAC Link team members have their babies. Paige was one with the first Maternal Assisted Cesarean in Korea, and today is the second with Lily. Oh my gosh. If you guys have been on our social media, you have seen our cute Lily. She is just so amazing. She's so fun. She's in the DMs on Instagram literally every day chatting with you. I just absolutely adore her. She's so incredible. Lily is a born and raised Colorado-- I don't even know how to actually say this. Lily is a born and raised Coloradoan.I think that is how you say it.She's from Colorado, living in northern Colorado with her husband, son, and daughter. She is a kinesiologist who works in community health and a dual-certified fitness instructor passionate about movement and wellness. After an unexpected Cesarean two and a half years ago, Lily found The VBAC Link and began planning her VBAC and is excited to share her story today. I cannot wait for you to hear it. This was actually the first time that I got to hear it in its entirety. It's just amazing, and I'm excited for you to hear it. Like I mentioned, Lily is also our social media assistant at The VBAC Link and is truly honored to empower and hold space for all the Women of Strength in our community. You guys, she is absolutely amazing. We love her so, so, so, so much. We do have a review that we're going to share, and then we are going to turn the time over to our sweet Lily to share her stories. This review is by Savannah, and it says, "Started listening to The VBAC Link Podcast around 16 weeks pregnant and continued throughout my pregnancy. It was so good and encouraging for me as a mama who was preparing for a VBAC. It helped me gain confidence, and helped me know what to look for and watch out for in my providers. Hearing other stories was so encouraging and helped me gain so much knowledge. I had my hospital VBAC unmedicated with an 8-pound, 15-ounce baby and I know the knowledge I gained from this podcast played a huge role in being able to advocate for myself and get a better birth outcome." Congratulations, Savannah. We're going to talk a little bit about this today as well with Lily on the podcast how sometimes the thought of going to the hospital is scary because of stories you've heard or things you've heard. But VBAC can happen in the hospital, and it can be beautiful, and it is beautiful. I think it always dials back to me to finding the best provider for you, finding the best location that feels right for you, building your team, and doing what is best for you in the end. So I really am so excited one minute after the intro to turn the time over to Lily. Okay, Ms. Lily, I really am so excited because I was even texting you the day you were in labor. I don't really know all the details, but I've seen your incredible pictures. Oh my goodness, your pictures are so incredible, and I've heard a little bit from you so I really can't wait. So let's talk. Let's talk about these births.Lily: Okay. Yeah. So every Cesarean story is what starts us off, so I will go with that. But I'm going to try to be fast because I feel like my birth was really long. I have a lot more to say about my VBAC, but I always try to really honor our story in that before we had our beautiful, amazing rainbow baby boy, we also experienced a miscarriage and an ectopic pregnancy prior to having our son. I lost my right fallopian tube. I always like to be the encourager that you can get pregnant naturally with one fallopian tube. It turns out fallopian tubes are not fixed body parts, so when we got pregnant with our son, I ovulated from the side I didn't have a fallopian tube on, and my other tube was able to come over and grab the egg and sense the ovulation which feels so miraculous.Meagan: So incredible, so incredible. I love that message that you're dropping for our community because I think if someone was in that situation as you know, it could feel very defeating and uncertain.Lily: Yeah, it feels really scary. I remember thinking, "I'm at less than 50% fertility if I've lost one tube," but that's not true. Statistically, it's really pretty equal to people with both fallopian tubes, which is kind of neat.Meagan: Yeah.Lily: After that, I started acupuncture. My sweet friend, Montana, we had been friends for years and she's always been like, "You should come see me." She specializes in women's health and fertility and loss and all the things. I started acupuncture then, and I say that now cause it has continued. I always say I'll never not be a patient of hers ever again because she's the best. I started to do that, and then we got pregnant. we found out we were pregnant on the last day of week of prayer at our church, which was really incredible and just felt like such a tangible miracle. We chose to go with a birth center for our care. We did that because I had a lot of hospital trauma. I just didn't think that a hospital was a safe place for me to have my baby. I'm a big believer that we should birth wherever feels the safest. We went for birth center care and had a great experience at our birth center.We loved our midwives and were really excited for birth. I think I hear so many times as women tell their VBAC stories that often we feel underprepared going into our first birth, and it leads to a cascade. I think I was the birthiest nerd of all. I felt like I was really prepared going into birth. I was excited for it. I had a lot of birth education. I had been a birth podcast listener forever and ever. I just felt really empowered in birth and all the things I was doing, chiropractic care and acupuncture and all the stuff. We did get to 41 weeks, and at my 41-week appointment, my midwives gave me a 3-page-long induction protocol because in our state, we have to transfer at 42 weeks. So it was their, "This is the last-ditch effort when you are 41--", and I can't remember how many days, "we want you to do this big thing." It was a daily schedule. "You're going to wake up and you're going to go for a drive on a bumpy road, and you're going to eat this, and you're going to do this." It was really overwhelming. Meagan: Yeah.Lily: Well, the night before we were supposed to do that protocol, the doula who was on-call at the center was texting me and was like, "Hey, how are you feeling?" I was like, "I don't know. I feel really nervous to do this big long thing." She suggested that I journal out all of my fears about birth and see if that did anything. I journaled all my fears, and I burned it in our kitchen sink. As I walked up the stairs, I had my first contraction. I'm also a huge believer that our emotions play such a huge role in our labors. So I was really stoked that my labor started and all the things. That's the same doula that we had for our next birth too, which is really cool. So yeah, I labored all of that night. It was Friday that I went into labor, that evening. Saturday, I labored. My midwives came and checked in eventually. My doula did come over, did some stuff with me, hung out and helped me labor, did some homeopathy, some emotional release work, and all the good stuff. But my labor was really, really long.So by Sunday, my midwives were like, "Hey, you are super exhausted. We want you to take a Benadryl and try to take a nap." I am a girly who does not take a lot of medicine. So this Benadryl knocked me on my booty. I had six really awful contractions trying to take a nap. After I got back up from the nap, I got back on the toilet which is where I was loving to labor. I stood up because I was like, "Okay, I think maybe things are starting. I'm finally getting a pattern. Maybe I can finally go to the birth center." I stood up, and I checked the pad I was wearing. There was a copious amount of meconium. Not water, but meconium which is scary, you know? I knew right then that I was going to have to transferred. It was thick. It was poop.Meagan: Yeah, yeah.Lily: There was no water stained. It was just meconium. And so I called my midwife, and in her sweet midwife voice, I said, "Do I have to transfer?" And she goes, "It's definitely a conversation we have to have." I was like, "Okay. So, yes." She explained that because of the way the meconium came out, she now thought my son was breech because his butt was right up against my cervix, and it just came right out. Soo she came over. Actually, she wasn't even on call. She happened to live in our neighborhood. She came over and checked me and all the things, and she's like, "Yep, this feels really different than a few hours ago. He's definitely breech. We do have to transfer." And so as we're transferring, in my mind, I know that we're probably going to have a Cesarean. My midwives were really great in that they called ahead and they were like, "Hey, we called ahead. No one's willing to do a vaginal breech delivery, or at least they're not trained in it." But my midwives were also really encouraging that, "If this is something you want to do, you have a right to deny a surgery. You have that right. We will be here in support of that." They don't have hospital privileges. They were out-of-hospital midwives, so they had to transfer me. They could go with me and essentially be that emotional support, but we were still kind of in COVID times, so I had to also choose who I wanted to be in there with me. It was 2022. I just felt so defeated. I was so mad that I wasn't going to get the birth that I wanted. I started screaming through contractions. I can confirm that does make it worse. I was just pissed. And so I opted for a Cesarean. It was really tough. I remember as we were leaving my house, asking my midwives, "I can have a VBAC at the birth center, right? Like, you can do VBACs?" They were like, "Yep, but let's get this baby out first." So I transferred. I had my Cesarean. I think it went as smoothly as it could go. I remember there was this a sweet tech who-- I was just in a lot of pain, and she gave me the biggest hug as they put my spinal in and was stroking my back saying, "This is the last one. This is the last one. You can do this." And it was like, "Okay." There was some tenderness there. But post that was a lot of grief, and I think we've all experienced that and a lot of hard. I never saw the surgeon who did my surgery ever again. None of my follow-ups were with her. It was just some random OB. I was so thankful that I had been at the birth center because I got all of their postpartum care, so I had a couple of home visits and a lot of really tender care from my midwives, which was exactly what I needed. And then I found The VBAC Link. I remember finding it on a walk because I had listened to birth podcasts for years, like I said, and suddenly it was grievous to listen to this thing that I loved hurt my feelings to listen to. It was like, "Oh gosh, I don't want to listen to the first-time mom who had an amazing waterbirth, and it was pain-free." It just was grief. Meagan: Right.Lily: So when I found The VBAC Link, I was like, "This is exactly what I needed. This is stories of women that give me hope and not just that trigger jealousy," which I think is a very real and valid emotion.Meagan: Very, very real. Very real and valid.Lily: It's okay to feel that way, but I remember going for all of my postpartum walks and listening to The VBAC Link and crying through every episode and all of the things. And then, just in that postpartum time, I got back into fitness. I have a background in kinesiology and teach a lot of fitness classes. So I got back to the community and finding that, and then I also got to work here which is so fun a year ago in November which is so cool. I think it's really a cute thing that my year anniversary was in November, and that's when I had her, so how cool that I spent a year empowering other women and also getting to plan my own which was really fun. So if you've ever DM'd us on Instagram, you're probably talking to me.Meagan: Yep, yep. She's in there every day a lot of the day because we get a lot of messages. We really do.Lily: And we want to answer all of them. I want you to feel seen and known and all the things. So if you're getting an answer, you're not getting a robot.Meagan: Yeah, you're absolutely not.Lily: You're getting me or Meagan or Olga or Ashley. You're getting one of us which is really neat.Meagan: Yep. Yeah.Lily: Okay. So then we got pregnant again, eventually. So we had planned to start trying when our son was two. We got pregnant a couple months before his second birthday. And again, it was such a redemptive moment of going from having a really hard trying to conceive to me, a girly with one fallopian tube getting pregnant on accident. Are you kidding me? It's crazy. But it was so great. It was really scary at first. We did have some early pregnancy bleeding. We thought we were having another miscarriage. And at the same time, my dad had his appendix rupture, so he was in the hospital septic while I'm early pregnant bleeding. It was just a hellstorm at first and felt really scary. But I knew that I was going for my VBAC, and that was really grounding. I won't share a ton of this journey. My midwife, Paige, and I were on the podcast earlier in 2024, so if you want to listen to that podcast about finding care, but I'll just quickly cover essentially the birth center that I was supposed to be at that I always dreamed would be my redemptive birth again was the same midwives. Oh, Matilda is grabbing my ears.Meagan: Also, the episode is 342 if you want to go back and listen.Lily: Yes. For midwife stuff.Meagan: Yes.Lily: So essentially, my midwives were amazing and I love them, but the birth center just wasn't in our financial capability. They don't take insurance. This time around, it was just not something that we were able to do. I started my care at the birth center and was really grateful to be there because they really knew my story, so they held me through the worry about miscarriage. And then we ended up having to navigate transferring care, so I interviewed another birth center that was in-network with our insurance that was about an hour away. I interviewed my midwife, Paige, and her practice partner, Jess. I told my husband when we went in to interview them, I was so terrified to like these hospital midwives and that I would have a hospital birth. And I did. I fell in love with them. I think that's so important. One thing I get really frustrated with, I think, especially in the more crunchy birth community is that we are often told that hospital birth can't be beautiful and that you can't have a physiological birth in a hospital.Meagan: Yep.Lily: I'm here to tell you that that's wrong. We have to stop telling women that the place that they feel safest is less than in any way. If a hospital is where you end up, then that is incredible and amazing and that's where you should birth if that's what feels right for you and your baby.Meagan: Yeah. It's the same thing with like epidural versus non-epidural. It doesn't matter. You're not any less powerful or strong or amazing if you birth without an epidural versus an epidural or out of the hospital versus the hospital or a planned Cesarean versus not going for a VBAC or if it goes to a Cesarean.We have to start having more love for one another in our community. Even though it might be something really great for one person, and they believe that, and that's okay that they believe that, that doesn't mean it's right for that next person.Meagan: Totally, totally.Lily: Yeah. So we navigated what hospital care was going to look like. At the time, our hospital was under construction, so they were "letting"-- I put that in quotes-- letting you labor in the tub, but you couldn't deliver in the tub at the time. The tubs were home birth tubs that they were blowing up in the rooms and all these things. But by the end of my pregnancy, the low-intervention rooms were open, and they were supporting waterbirths which I think is so neat to see from a hospital. So yeah, we were really excited. This time, I did more acupuncture. I continued to see my amazing acupuncturist. She's amazing. Montana Glenn if you ever need her in northern Colorado. I did switch chiropractors. Last time, I went to just the chiropractor that I'd always gone to. She wasn't Webster-certified. This time, I did go see a Webster-certified chiropractor. Laura is amazing. That really changed a lot of my pelvic pain and things like that.I was way more active in this pregnancy. With my son, I was working at a Barre studio, and the fitness studio closed about halfway through my pregnancy. I kind of just petered off the train of staying active. But with my daughter, we were able to, I say we because she was there. I worked out until the day before I was in labor. I teach spin, strength, and yoga. It's a combo. It's called Spenga. I was there all the time. I did stop on the spin bike at 34 weeks pregnant because I learned that that's not great for baby positioning, and it can shorten some of those ligaments. I stopped doing the spin bike at that point to be really cautious of position. Speaking of that, I had a standard kind of pregnancy. I would talk with my midwife forever and ever. I came in with questions about my birth probably on day one. She was like, "Girl, you're 16 weeks pregnant. Chill, no." But I had questions, and I would come in every time. I did feel like a first-time mom in that sense because the last time, I had a lot of expectations of I knew what the birth center was going to look like, and I had no idea what a hospital labor was going to look like. How many nurses are going to be in my room? Who's going to be up in my space? What does this look like? How do I do intermittent monitoring and all the things? Paige was great about, my midwife, saying, "Hey, this is what the hospital protocol is. Hospital protocol is not a law. You get to do what you want to do, and we support you in that." She was awesome. At 32 weeks, though, Matilda was breech which was really scary as a mama who had a surprise breech baby. I did all the things. If you want to know all of those things, we have an Instagram Live that is saved on our page of literally the kibosh of things that I did for flipping her. We did flip her. I also saw a bodyworker in town and a doula who's amazing. Her name is Heather Stanley, and she's the breech lady here in northern Colorado. I did some bodywork and stuff with her and worked through emotional stuff and birth stuff. It was, I think, really what I needed. Heather said that in our session, and I kind of rolled my eyes. She's like, "I think sometimes babies go breech because we've got some stuff to process." And I think that I did. I thought I processed. I went to therapy after my Cesarean. I did all the things, but I still had some stuff. I think she was teaching me, like, "Hey, let's work through this now."Meagan: Yeah, I mean, I had the same thing with Webster. He kept flipping breech. I had never had a breech baby before, but I was like, "If I have to have a C-section because you're breech, I've done all the things." I was really frustrated. We'd get him to flip, and then he'd go back. My midwife was like, "We need to stop." And I believe that it was the same thing. I needed to work through some things. He needed to be in those positions during that time for whatever reason. We had to gain more trust in our bodies and our abilities and processing. Right?Lily: Yeah, totally. So yeah, so then she flipped, and it was great. And then I just felt so seen by Paige in all of it, because she knew like, "Hey, when you get to the hospital, we'll check with an ultrasound and double-check that she's still head down because I know that's anxiety-inducing for you." I just felt so empowered with all of our decision-making. It felt like a big partnership. One thing that I struggled with with my son was I was at home laboring for 44 hours. I never got to go to the birth center. What I loved is this time, it was my call when I got to go to the hospital. It was my decision, all of it. Paige was so great about saying, "Hey, this is your labor, and we're here to make this happen." I just think she's such a unique human. I don't think care always looks like this in a hospital for sure, but it can. What if we advocated for what we deserve, you know?Meagan: Just talking to her, I love her. I love her so much, and I one day hope to meet her in person.Lily: She's the greatest human being. I tell her all the time, I'm like, "You're changing the world, and so many women need you." Actually, their practice was at one point so full of VBAC patients that they've had to unfortunately turn a couple of people away because their practice is getting full which is really amazing, though.Meagan: Yeah.Lily: And we need that.Meagan: It's a good thing. Yeah.Lily: Yeah. So super cool. All right, I think we've got labor coming. Here we go. I never felt pressure of when am I going to go into labor or any of that. Paige was super great about, like, "Hey, if you're dilated before labor, that's great. If not, whatever. Most people dilate while they're in labor," and it was just super helpful. I knew that there was no worry about when I would go into labor. There was no worry about just any of that stuff. So it was really nice to just be at peace. That's one of the reasons that I actually loved having a hospital provider because I had a lot of anxiety about transferring from a birth center again. Actually, as I tell my story, I think I would have been a transfer again. I remember them saying that in my initial consult appointment. Jess, who practices with Paige, said, "You know, what's beautiful about hospital care is that we can induce you if you need to be induced, and we have the hospital privileges, and you can have the interventions if you need them." And I did. Spoiler alert, and it was great. I got to 40 and 1. I started contractions around 11:00 PM on Tuesday night. I was already felt like it was such a blessing because I finally had contractions that were normal. I didn't have contractions like that with my son. They started out fast and furious and they were seven minutes apart or less my whole 44 hours. With this, I felt the wave of a contraction for the first time. And I remember texting my doula like, "This is already so redemptive just that I can like breathe through a contraction. This is nuts. This is so cool." There were a couple that I had to get on all fours in my bed and sway back and forth and eventually, my husband like leaned over and he was like, "You need to go to sleep. What are you doing?" I was like, "I'm having contractions." And he's like, "Oh." So it was fun. I texted my doula and just said, "Hey, I think I'm in labor," which was weird for me to say. And again, what's so great is Jessie, my doula, had been with us in our first birth and she's also a VBAC mom. It was just like God had His hands on exactly what we needed and the people that we needed even from our first birth to carry into our second. So on Wednesday, Jesse also lives in our neighborhood now, so that's fun. She came over, and we went for a walk. We did some homeopathy, and she gave me a great foot massage, and then she said, "Okay, hey. Let's try to pick things up a little bit. I want you to take a nap with your knees open." She's like, "We don't have a peanut ball," so I grabbed the triangle pillow from my kid's nugget couch. It works really well by the way. I napped with that between my legs and was able to get things to pick up a little bit. My contractions did get pretty intense, but they were still spread out. She went home for a little bit, and then I took a nap and labored. I went downstairs. We live multi-generationally, so my parents live in our basement in a basement apartment. My niece also lives with us. They have custody of her. My parents have a way cooler shower than I do because they got to customize their basement. I went down and took a shower in their shower which has three shower heads and all the stuff. I was like, "This is like a being at a birth center." So I hung out in their shower. I took a two-hour shower. My mom's like, "Our water bill is going to be insane."Meagan: How did you have hot water long enough?Lily: We have that-- I don't know what it's called.Meagan: Reverse osmosis thing?Lily: I don't know.Meagan: I don't even know. That's not the water heater. Lily: I don't know what we have. I don't know what it's called. Anyway, we did have hot water. Meagan: That's amazing, though. Lily: I was just in there chilling and music on and lights off. When I could get into the mental space of labor, my contractions would come way closer together, and things would intensify. But if I did the advice of living life, it was like they just stayed really far apart. So I was like, "I know that some of this is prodromal labor a little bit because I'm not getting into consistency unless I'm forcing myself to be there."So amongst all of this, my husband is not feeling well. I'm looking at him like, "You seem sick." My husband never gets sick. And he's like, "I'm fine, I'm fine, I'm fine." And I was like, "No, I think that you should go get tested for something." Something in my gut was like, "You need to go in." So he went and got swabbed for the flu and all the things, and he had strep. And so I was like, "See? Good thing that we got you tested." So he started antibiotics right away. And then that night, my sweet doula came and spent the night because Jared was just not up for being a labor support and yay for having a doula because I needed someone to be there physically with me, and I needed that support, but he couldn't be there in that moment.Meagan: Wow, what an incredible doula. I love hearing that. Yeah.Lily: So she came and spent the night, and we did some like side-lying releases, which from my first labor, I knew I was going to hate it. It's just the position that, to me, is just the absolute worst when I'm in labor. It's awful. My doula was like, "Hey, so we should do some of that." And I was like, "No, we're not. I don't want to." She was like, "I think we should then."So we did some of that, and then eventually, she drifted off to sleep. My contractions again, were still staying spread out. They would get close together and then they'd fizzle. But they were intense, and that's what's hard is you think prodromal labor, and at least in my brain, it's like, "Oh, contractions are mild and really far apart," but that's just not how they were for me. They were really intense. Meagan: They can be. Eventually, I went upstairs and took a bath because I was like, "Okay, I'm just going to force them to shut down then." I need some rest. So I went and took a bath upstairs, and got them to slow down enough that I could sleep for the rest of the night.Meagan: Good.Lily: That was Wednesday, and like I said, my labor was long. On Thursday, we woke up. My doula was here with me. We made breakfast, and she forced me to eat protein. Yay, doulas. I had already a scheduled appointment that day for my 41-week or whatever it was. 40 weeks, I guess. We went into the clinic and my contractions were, I mean, maybe 30 minutes apart at this point. I remember we drove all the way. My clinic is 20 minutes for my house. We drove all the way there, and I didn't have a contraction in the car. I was like, "Okay." So we went. I was 4 centimeters dilated and 90% effaced. I did ask for the membrane sweep, but I asked for the cervical check. Not one time ever did I get a check that was like, "Hey, we should check you now." It was like, "Hey, I want to be checked now."Meagan: Yeah.Lily: It was so empowering. So 4 centimeters. She was like, "You know what? You're doing it. Yes, prodromal labor, sure, but also, your body's making progress. You're doing something."Meagan: But also not prodromal. It was a prodromal pattern and acting that way, but progressing. So, it was on the cusp.Lily: Yeah. It was weird but encouraging to hear that, okay. I've done a day and a half work. Yeah. But at this point, I'm like, ticking in my brain, like, "Okay, how long has this been?" Because my first labor was 44 hours, and I was 10 centimeters when we transferred to the hospital. I had told myself my whole pregnancy, "I can do anything as long as it's less than 44 hours." It was not. It was not. Spoiler alert. So we went home, and then my sweet chiropractor actually lives in our neighborhood. I texted her and was like, "Hey, I don't know if this is a positional thing. She feels really low and engaged, but can you come adjust me?" So she came and brought her table to my house and adjusted me. She did this thing called adductor stripping.Meagan: Oh.Lily: And so I had done an actual membrane sweep with my midwife, and then my chiropractor took her knuckles and went on my inner thighs and pushed all down. It hurt so bad.Meagan: I'm doing it to myself barely, and I'm like, oh.Lily: It was awful. But she was like, "This is the big hip-opener thing." So we did that. She even taught my doula how to do it. I looked at my doula and I said, "You're not doing that to me. So glad you learned you can do it to another client, not me." My doula went home again. I got back in the shower and was moving around. And at 4:00, I decided like, "Okay, I'm exhausted. I am ready for a change." I am the type of person who likes to go somewhere and do something. It's part of why I didn't ever feel like a home birth was the right option for me because I know that I get stuck in a space. I like the idea of going somewhere to have my baby. It felt like a good change. So I was ready, but I wasn't having contractions that were there. And I was like, "I also don't want to go to the hospital and be stuck there for a million years." So I decided to go upstairs and put myself into labor. I'm like, "Okay, I'm doing this." I turned off all the lights, and started to labor, and my mom came up and gave me a back massage. It was also cool to see her shift because in my first labor, she was super anxious. And then in this labor, she was really trusting of my process and was more just like, "Hey, what do you need?" So she gave me a really big back massage, and I listened to music, and I finally got my contractions to six minutes apart. I texted my midwife and I said, "If these stay this way for an hour, I want to come because I am exhausted. I'm ready for a change. I need this." And she's like, "Great, awesome. Let me know. Keep me posted." So I did have some bloody show, and I thought maybe my water broke. It had been an hour, and I was like, "Hey, we're going." My mom had just made dinner, so I'm scarfing meatloaf on my way out the door. Great last meal.Meagan: I love it.Lily: And then we head to the hospital. I got to the hospital, and I was 4.5, maybe a 5. So again, earlier that day, I had been a 4. So I had made a little bit of progress, but not a ton. But Paige was great. She's like, "Great, you're here." What I love about their practice is their direct admittance, so you don't have to go through triage and have some sort of evaluation to decide if you're supposed to be there or not. She was the one who made that call, and we made it in partnership with each other. I was like, "I feel like I need to be here." She's like, "Great, you're here."Meagan: Yeah.Lily: And so I chose no IV and to do intermittent monitoring which will come up in my story in a little bit, but that's kind of where I was. We started to fill up the tub, and I was laboring in the tub, and then I started to get nauseous and throwing up and all the things. In my head, I'm like, "I'm in transition. This is very transitiony." I'm watching as the baby nurse comes into my room and starts to set up the bassinet. I'm starting in my head to tell myself, "I'm so close. I'm in transition. This is happening." And as I talked to my doula afterward, she was like, "Yeah, we all thought you were in transition, too, dude. You were in it." I started to get frustrated and say, "I want to push." Not that I felt pushy, but I was just like, "I want, again, a change. I want to have a baby." And so I asked for another check, and I was 6.5 centimeters. I cursed so much, and I was like, "I just want to have my effing baby." I screamed that so loud. My poor, sweet doula and midwife. They dealt with my sass, and it's like my body knew, "Okay, we're defeated now." Everything shut down. My contractions spread apart to 20 minutes apart again. They had been 5 minutes. My mental space was not ready, and my body was like, "Okay, we're going to rest." Meagan: Yeah. Lily: And so I get out of the tub and dry off, and we decide that I'll do a little bit of pumping. My midwife put some clary sage all over my belly, and she does try. I asked to rupture my membranes because we thought maybe they had not ruptured when I thought they did. She was like, "They're definitely intact." She goes, "Nice protein intake girly because these are hard, and I can't rupture them." She's like, "You have a really strong bag of water." And I said, "Thanks, Needed, for all of the amazing collagen that I took."Meagan: I was going to say, collagen protein right there.Lily: I'm terrible at protein intake, so really the collagen from Needed was one of the strongest ways I got protein in during my pregnancy. So pat on my back for my protein intake and things to need.Meagan: Very, very good job. Very impressive. Well, because really, a strong bag of water, it is hard to get that protein and that good calcium in. It really is. To the point where she can't even break it, that's pretty cool. Pretty cool. Good job. Lily: Yeah. So then at this point, it's later in the evening, like 9:00 or 10:00. And so I started to just be exhausted. I started falling asleep between contractions. My doula is like, "We're going to wind down. Let's turn the music just to instrumental. I'm going to go take a nap." Our birth photographer is napping on the floor. Paige goes and takes a nap, and they tell my husband to curl up next to me.That was such a sweet moment of disc connection that I needed of, "This is my person and we're here. We're doing this together." We snuggled up on the bed and got through contractions together all night long. I did at one point ask to try the nitrous oxide because, in my head, that was the only pain relief that I could think of that was available to me in this low intervention room because the way that the hospital works is if you're not going to have a waterbirth, if you decide to get an epidural, they will transfer you out of this room because there are two of them, and at that point, you can't use the tub. So I was like, "Okay, I think nitrous might be my only option." So I tried that. It sucked.Meagan: You didn't like it.Lily: She was like, "You know, it's really not helpful for people that are coping with contractions well." And she said the same thing when I started asking about an epidural later on. She was like, "You're coping well, and you're relaxing." These types of things can be really helpful for people that are in the fetal position in between their contractions, but you're not, so it's probably not actually going to help because you're already relaxed. All it did was make me feel a little dizzy, and then I was like, "Well, this is silly." I got in the shower again there. It was not as good as my parents' shower, so I did get right out of the shower. It was very cold. And so the next morning, now it's Friday. So reminder, labor started on Tuesday. Meagan: Tuesday, Wednesday, Thursday. Now we're here. Lily: Thursday morning. And so Paige comes in, and we had a really long talk about options. At this point, I am mad, and I'm just feeling like I can't do it. I keep having contractions and saying, "I can't do this anymore. I can't do this anymore. I can't do this anymore." In my head, I'm like, "Well, at least I'm going to get a VBAC. Hopefully, I can get an epidural," and then rest and those stories. I'm trying to be really open-handed because I think that's what you have to be in birth is really surrender to the process. Paige comes up with this idea to do some therapeutic rest to which I had never heard of before. I think I was texting you during this and I was like, "What is that?" She's like, "We can give you some morphine. You can either stay here at the hospital or you can go home, and hopefully, you'll nap for 4 or 5 hours. Typically, people wake up in active labor." I was like, "Sweet, sounds awesome. Give me that nap." My doula was like, "Why don't we go for a walk, first? Let's remind ourselves that it's daytime. Let's go on a walk. We'll talk about it together, and then we can come up and do our next steps." So we went out for a walk in the parking lot of the hospital. It was cold, and I threw up a couple of times. Yay. I was like, "I think I really need this. I can't continue to do this without any progress." She's like, "Great, I'm excited for you." So we went up, and they put an IV in cause I didn't have an IV. What was great was that the hospital staff was so accommodating. I was really nervous about nurses being like, "Hey, we don't like this," or whatever. Paige was also great about choosing my nurses to be the ones that are going to be more supportive. But they put an IV in. They gave me the morphine, and then they took it out. I didn't just then have an IV.We did that, and then we decided we would break my water and try to get things progressing. She did end up being able to break my water because I could sit still. I was way more relaxed with the morphine. It was supposed to be a 4-hour nap. I woke up 20 minutes later. We had sent my doula off to go run errands thinking that we had hours. I wake up 20 minutes later with really intense contractions that are peeking through the morphine, and they're super close together. I was like, "Well, crap. Let me call my doula back and get her to come back." And so that really picked things up again. It was kind of discouraging because I was expecting to get to rest, and then to have intense contractions again was like, "Oh gosh, okay. Here we go." But we did it. We labored the whole day doing that, but my contractions would never get closer than 5 minutes apart. They would stall out at that space. At 2:30ish, I asked about morphine again because I was like, "Can we do that again? If that was an option, can we try that again?" The nurses were like, "Hey, we actually think maybe you should just do some IV Fentanyl." My older brother is an addict, so I am someone who was super cautious. I had actually said it when I got there that my preference is no opioids. But this felt like, "Okay, maybe it's an option." When Paige came in and we talked a little bit, she was like, "Why don't we do that? And would you be open to doing a low dose of Pitocin?" And I was like, "Absolutely not," because in my brain, Pitocin means epidural. Pitocin is scary and hard. My contractions are already intense. I can't imagine Pitocin. Like, absolutely not. And so Paige said, "Hey, what's cool is you're already in active labor, so Pitocin is not likely going to make your contractions more intense. It will likely bring them closer together.Meagan: It's what you might need.Lily: "You might be able to wait it out, or this might be an option. Let's do the pain medicine so that you feel mentally like you can handle it." I was like, "Okay." So they placed another IV because I didn't have one in, and they gave me Pit. We started at 2 at 3:30, and then we upped it to a 4 at 4:00.Something that I will mention while I have the IV thought in my brain is I had said I was doing intermittent monitoring, and I ended up hating that. I was just irritated by people coming into my space. It felt like it interrupted my labor pattern. They had to reach down into the water if I was in the tub. I was moving, and I felt like I couldn't move or they wouldn't get it. They were just in my space a lot more. So when we started the Pitocin, the hospital policy was continuous monitoring, but they have the wireless monitors that are waterproof. They were like, "Do you feel okay with that?" I said, "Yeah, I think so, actually. I think I'm ready for people to stop touching me," because at one point, I looked at a nurse and I was like, "I understand why this is important and why you're here to check on my baby. Please go away." I hated it, but I also felt like I wanted some sort of monitoring.Meagan: I can see that though.Lily: Yeah, it was just disruptive. It's funny because in my brain, I thought that the continuous monitoring would feel disruptive, but it was great because they just put these two little dots on me. I had a belly band that went over. They were wireless. I could still move all around. It was great. Meagan: That's nice.Lily: Yeah. So at this point, I'm hooked up to Pit on the little IV pole, but I can still go wherever I want. I decided to go labor in the bathroom. This is the part of my labor that gets a little fuzzy. I was really thankful to have had a conversation with my acupuncturist prior to labor because she had a great labor experience, but she was actually a home birth hospital transfer too. She had talked about how I had said, "I don't want to do medication because I want to be really present. There's so much of my son's birth that I don't remember because of the medication." She had told me, "Hey, there is a place sometimes in labor land that your body just naturally goes fuzzy, so don't be taken aback if that's your experience." That was really helpful to know that in this transition time, things feel a little fuzzy, but I'm at peace with that versus my son's birth where it felt invasive to not have those memories.Meagan: Yeah.Lily: So we were laboring in the bathroom, and then I remember at one point yelling for Paige because my doula is in there with me. I was like, "I'm feeling pushy and ring of fiery." She's like, "Okay." We came out of the bathroom. They unhooked me from the Pitocin. They did keep the hep lock in. And again, they were really respectful and asked like, "Hey, since we've already been doing Pit, we've already put two in. Do you mind if we keep the hemlock? And we'll wrap you up. You can do whatever you want." And I was like, "That's fine. It's already there. Let's not bruise up my arm anymore." We came out, and I was laboring on all fours. I had gotten sick of the tub, and I had actually said, "I don't want to be in the tub anymore," at some point during the day, because this thing that was so great, and it is helpful, but every time I get in, I get discouraged because my contractions pick up. But then, it seems like I have to get out. My doula is looking at me, and she's like, "Hey, are you sure you don't want to get in the tub?" This was your goal. This was your goal. Are you sure?" I'm laboring on all fours, and I'm feeling pushy, and she's like, "We can fill up the tub so fast. Do you want us to just fill it up? This was your goal. Are you sure?" I was like, "Okay, yeah. Fill up the tub." The one other thing that I think was funny is that I was wearing a really ugly bra because I had had two black bras that I really wanted to wear, and they had gotten wet over two days of being at the hospital. I looked at her, and I was like, "I'm wearing my ugly bra." She was like, "Change." So my birth photographer ran over and grabbed my black bra that I wanted to have on, and I changed really fast which was really funny, and then hopped in the tub and started to just labor there. My doula and midwife coached me to wait for the fetal ejection reflex. So they were like, "If you can just breathe through these contractions, let's wait and see if your body just starts to push." I was like, "Okay, I guess we'll be here." I was in this really deep, low squat. I have 20 years of dance in my history. I teach Barre. I'm on one tippy toe. Paige told me after, "I have never almost broken a mirror trying to get so low to see what was going on because you were in such a low squat." I did deliver my daughter on my tippy toes. It was like, if I put my heel down, it hurt more. I don't know why, but my tippy toes felt great. Meagan: Interesting. Like pointe in ballet?Lily: Standing on my tippy toes.Meagan: Yeah. Yeah. Oh my goshLily: Yeah. I was in a lunge with one leg up on a tippy toe.Meagan: With bent toes, yep.Lily: I was laboring there, and these contractions felt different, which again, is so cool to have gotten to experience. At this point, Fentanyl wears off after 30 minutes, and so I really feel like it was perfect because I got it for the hard Pitocin part, which actually wasn't bad at all, by the way. It was exactly what Paige said. It just got them closer together. They didn't hurt anymore.Meagan: Increase, yeah.Lily: Yeah, it was awesome. So I highly recommend if you need it at the end to know that it probably won't increase intensity. It just can help. I was fully unmedicated at this point. I would feel the beginning of my contraction. I could breathe through. And then when that fetal ejection reflex hits, man, it is crazy. I had heard someone describe it as the feeling of when you have to throw up and you just can't stop. That is exactly what it feels like. Now I'm pushing.My body just did it by itself, and I didn't have to worry about, "Okay, how do I breathe? How do I do?" There was no counting. I pushed for 52 minutes on my tippy toes. It was so cool. My husband really wanted to catch her, and so he was right there. He'll joke forever that I bruised his hand in labor because I was death-gripping it.I remember feeling the ring of fire and all of the things. And then she just came out and her whole body came out with her head, and it just felt like the biggest relief in the world of, whoo. And then I grabbed her. So Jared's like, "You kind of stole my thunder." I was just so excited, so both of us had our hands on her and got to bring her up to my chest. What we realized is I had a really short chord. The theory is that so much of my labor was probably held back because she didn't have a lot of bungee room to descend. It kind of explained a couple of things. Yeah. She was on my chest in the tub and hanging out. And then we got off and got to the bed, and she was hanging out on my chest. And then as the cord stopped pulsing, she forgot to breathe.Meagan: Oh.Lily: And so they had to cut the cord really quickly, take her off my chest, and take her over to the warmer, and she was fine. They called in the neonatalist and all of the things, and she did eventually just come back to me after I had delivered the placenta, but that was the only scary moment. The theory is that she was still relying on the cord, and then it stopped pulsing, and she was like, "Oh shoot, I need to breathe now. Got it. Okay."Meagan: Yeah.Lily: It was great. I got to see my placenta, and I did have a marginal cord which we knew, which is when your cord is kind of off to the side of your placenta. Again, we knew that my whole pregnancy, and it was never like, "This is going to prevent you from having a VBAC" conversation. But yeah, we got to do the thing and catch a baby, and it was just the coolest thing ever. I can look back and say gosh, yeah. I probably would've been a transfer because of how long my labor was. I'm so thankful that I took the interventions when I needed them and that I had a provider who I trusted was in my corner. Never once did I think, "Oh, she's recommending this so that it goes faster," or "Ohh, she's" bothered or anything. And Paige actually had specialed me in that she wasn't on call that night, but she came in for me which was really special. I don't know. I never expected that I would have a hospital birth. I never expected that I would have Pitocin or pain medication or any of the things and yet feel so at peace with how it played out. It was absolutely beautiful and absolutely physiological in all of the ways that it needed to be.So that was her birth.Oh my goodness. I'm so happy for you. I'm so happy. I can just close my eyes, and I can see your picture. So many feels and such a long journey. Such a long journey for you to keep shifting gears. But going back into your team and all the relationships that you established working up to these days and this moment, you had all of those people come into your labor too, at some point whether it was mentally thinking about something that they had said or they physically came down the street and we're able to serve you and touch you and adjust you and work with you that way. There were so many things along the way that it's like, wow. You should be so proud of yourself for building that team, for getting the education, for having this big different experience, and for trusting your instincts. I do think in the VBAC world, in all birth world, but for the VBAC world, we do sometimes get into this, "Oh, Pitocin can be bad. Epidurals can be bad. Hospitals can be bad. This can be bad," You know, all of these things, and a lot of the times it's based on negative experiences that one has had.Lily: Or stories that you hear.Meagan: Or stories that we hear, yes. Because, I mean, how many stories have we heard about the cascade? Lily: Absolutely.Meagan: We've heard so many. But like you said, these things needed to come into your labor at the points that they did, and they served you well. When you said that you didn't expect to have these experiences, and then find them healing and positive, but I truly believe when we are making the decisions in our birth experience, when we have our birth team that we trust and know are there for us, for us, and in our corner, like Paige is and was, it's very different.Lily: It makes a world of difference.Meagan: It's very different. I mean, I have had clients where I've had providers actually say with their words, "I like to manage my labors. I like to manage my labors." So if we hear that, and then we hear the experience, you guys don't do those things because they led down a negative path. But those are so different, and so we need to remind ourselves as we're listening to stories about Pitocin and epidurals or hospitals, have a soft part in your heart for them because you never know. They may be something that you need or want in your labor. Lily: Totally.Meagan: And if we can have the education about those things and then make the choice that feels right for us in our labor, I mean, here you are saying these things. You're saying these words. "I had these experiences. I experienced Pitocin. I experienced Fentanyl that I didn't know I wanted. I had all these things, and it was great."Lily: It was beautiful. Yeah. And Paige was like, "I've never seen someone dilate to a seven with such an irregular contraction pattern."Meagan: Yes. Yeah.Lily: What I love is that a couple of days before I went into labor, someone had posted this quote. We posted it just recently to our page, but it was from the Matrescense podcast. And it says, "For every birth video that you watch where a woman calmly breathes her baby into the world, make sure you watch one where she begs, pleads for, swears, doubts, and works incredibly hard to meet her baby." I know I cried.Meagan: That just gave me the chills.Lily: "So that if that is your experience, you are not caught off guard by the intensity of birth." I had seen that before I went into labor. Someone posted it in The VBAC Link Community on Facebook. And that is exactly my experience. I screamed and I begged and I roared. Oh my god. There was no quiet breathing during my pushing. My throat was sore the next day so much so that I had them swab me for strep because my husband had strep and I was like, "Did I get strep?" But my throat was just raw from screaming. Not screaming. I would call it roaring because I wasn't high-pitched screaming. It was just the natural, primal thing.Meagan: Guttural roar.Lily: It doesn't make it less than. It was pretty dang cool. So, yeah, so that was all the things. And then in this postpartum experience, it's been so great. Paige is awesome. We've been chatting over the phone, and we had a two-week postpartum visit. I just have the best community. I feel a deep sense of gratitude for the community that I have this time compared to my first and sweet friends who literally right before I came on were like, "Hey, update. How are you? What's going on? How's Tilly? What do you need?" That community has made a huge difference, too. And also, I feel like I could run a marathon because I didn't have a C-section, you know? Holy cow.Meagan: Yeah, your recovery is feeling a lot better. Lily: Oh, my gosh. Yeah. Yeah. And I was super active prior to having her, so I think that helps too, you know?Meagan: Yeah.Lily: Just feeling that strength is there and resilient. So, yeah.Meagan: Oh, my gosh. I love you. I'm so happy for you. Seriously, I can't wait to even go back and re-listen to this once it airs. You're just incredible. You're such a ray of sunshine. And truly, it is an honor to have you here on our VBAC Link team and then to be part of this story. You had said before that you haven't really even shared it in this entirety, and so I feel tickled that I get to be one of the first to hear it in its entirety.Lily: Well, thank you, friend. It's an honor to be on the team to get to hold space for everyone else's stories, and I have a squeaky baby, but it is just a joy and a dream to get to be here. So thanks for holding space for all of us who have needed it for years. We love you.Meagan: Oh, I love you back, and 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
232: In this episode, I sit down with Sally Fallon Morrell, founding president of the Weston A. Price Foundation and author of Nourishing Traditions. Her book was required reading in my master's nutrition program, so this was a special conversation! We dive into ancestral nutrition, covering raw milk, healthy fats, and real foods that support fertility and overall health. As I navigate my own fertility journey, I was eager to learn what foods best promote conception and a healthy pregnancy. We also discuss the baby formula vs. breastfeeding debate with a compassionate and informed approach. Sally shares advice for moms who struggle with breastfeeding and natural alternatives for those who need them. Topics Covered: Why raw milk is beneficial The truth about healthy fats & butter Diet's role in fertility & pregnancy Baby formula vs. breastfeeding Regenerative farming & traditional food prep Sponsored By: MANUKORA Go to Manukora.com/REALFOODOLOGY to get $25 off the Starter Kit, which comes with an MGO 850+ Manuka Honey jar, 5 honey travel sticks, a wooden spoon, and a guidebook! LMNT Get your free Sample Pack with any LMNT drink mix purchase at drinklmnt.com/realfoodology BIOptimizers For an exclusive offer go to bioptimizers.com/realfoodology and use promo code REALFOODOLOGY Pique Get 20% off on the Radiant Skin Duo, plus a FREE starter kit including a rechargeable frother and glass beaker, with my exclusive link: Piquelife.com/Realfoodology Paleovalley Save at 15% at paleovalley.com/realfoodology and use code REALFOODOLOGY Timestamps: 00:00:00 - Introduction 00:05:53 - Sally's background and journey 00:08:28 - Bone broth and chicken soup benefits 00:11:03 - Baby formula, hormones, and cholesterol 00:14:40 - Infertility and nutrition's role 00:17:23 - Fertility diet, low-fat myths, and subsidized foods 00:20:31 - Why eating fat is essential 00:23:37 - Commercial vs. regenerative farming 00:24:50 - Baby formula vs. breast milk 00:27:07 - How to support breast milk production 00:30:02 - Raw milk vs. grass-fed milk 00:31:42 - Fermented foods and gut bacteria 00:35:31 - Baby formula industry and lobbyists 00:37:45 - Homemade baby formula alternatives 00:39:20 - Why women struggle with breastfeeding 00:41:50 - Epidurals, fentanyl, and birth interventions 00:43:48 - Weaning foods, salt, and electrolytes 00:46:29 - When and how to introduce foods to babies 00:49:49 - Best first foods for infants 00:51:01 - Raw milk myths and lactose intolerance 00:54:02 - Common myths about fats 00:57:32 - Beef tallow, palm oil, and healthy fats 01:00:01 - Concerns about high-meat diets 01:03:45 - Debunking raw milk misconceptions 01:09:02 - Environmental impacts of farming 01:13:24 - Sally's hopes for the future of nutrition Weston A Price Foundation: Website Instagram Podcast Sally Fallon Books RealMilk.com NourishingTraditions.com Check Out Courtney LEAVE US A VOICE MESSAGE Check Out My new FREE Grocery Guide! @realfoodology www.realfoodology.com My Immune Supplement by 2x4 Air Dr Air Purifier AquaTru Water Filter EWG Tap Water Database Produced By: Drake Peterson
Follow Madison: @madisoncicconeWork with Madison 1 x1: https://stan.store/MadisonCicconeMadison's Website: https://madisonciccone.com/Buy the Gratitude Journal on Amazon PrimeRide with her at SoulCycle in Boston
EP. 227 In today's episode of the podcast, we explore a deeply important and often contentious topic—vaccines. I sit down with Alexandra, founder of Just The Inserts, who has made it her mission to help people make informed medical decisions by providing transparency around vaccine inserts. Her website offers a wealth of information directly from vaccine manufacturers and government sources, ensuring that all facts are well-sourced and unbiased. This conversation covers everything from childhood vaccines to the COVID vaccine, shedding light on adverse reactions, ingredients like mercury and formaldehyde, and the broader implications for health. Whether you agree or disagree, this episode is about empowering you with the truth so you can make the best choices for yourself and your family. FOR REFERENCES CLICK HERE Sponsored By: LMNT Get your free Sample Pack with any LMNT drink mix purchase at drinklmnt.com/realfoodology BIOptimizers Order now at bioptimizers.com/realfoodology and use code realfoodology for 10% off any order. Timeline Timeline is offering 33% off your order of Mitopure while supplies last Go to timeline.com/REALFOODOLOGY33 and use code REALFOODOLOGY33 Timestamps: 00:00:00 - Introduction 00:03:05 - Social Media in 2020 00:07:23 - The Beginning of Just The Inserts 00:14:17 - Finding the Right Doctor and Vaccine Conversations 00:16:47 - Misunderstandings Around Vaccines by Doctors 00:18:34 - Discussion on COVID Vaccines 00:20:04 - Childhood Vaccines: What You Should Know 00:22:54 - SIDS, Big Pharma, and Vaccine Risks 00:27:40 - Combo Vaccines: Are They Safe? 00:30:10 - Mercury, Formaldehyde, and Other Vaccine Ingredients 00:33:32 - The 1986 Vaccination Act and Its Impact 00:37:40 - Sources of Adverse Reactions and How to Spot Them 00:40:01 - Virus Shedding & Herd Immunity 00:44:46 - Advice for Parents Navigating Vaccines 00:48:47 - The Financial Side of the COVID Vaccine 00:52:15 - Vaccine Exemptions: What You Need to Know 00:56:21 - Vaccines During Pregnancy 00:59:31 - Birth Control and Vaccine Interactions 01:00:44 - Medical Provider Directory and Resources 01:05:50 - VAERS: Reporting Adverse Reactions 01:09:11 - Breakthrough Infections 01:13:11 - Epidurals and Vaccines 01:16:44 - Antivax vs. Provax Further Listening: How To Win The FIght Against Corruption In Heath & Agriculture | Senator Ron Johnson Check Out Just The Inserts: Website Book Motherhood Guide Instagram FOR REFERENCES CLICK HERE Check Out Courtney: LEAVE US A VOICE MESSAGE Check Out My new FREE Grocery Guide! @realfoodology @realfoodologypodcast www.realfoodology.com My Immune Supplement by 2x4 Air Dr Air Purifier AquaTru Water Filter EWG Tap Water Database
Join us as we open up about the comedic mishaps and heartfelt moments from our family life, and how these experiences shape our relationships. We share a laugh over our driving antics and reveal the candid, yet adorable, language faux pas of our son, while also touching on the challenges of parenting our teenage daughter. Listen in as we recount these personal anecdotes with a blend of humour and reality that any family can relate to, giving you a peek into the chaotic, yet joyous, balance of work, parenting, and maintaining a loving partnership. As we navigate the often misunderstood world of labour and postpartum care, we aim to shed light on epidurals' true impact on labour progression and breastfeeding, backed by current studies and medical insights. From debunking the myth of a 'lazy baby' due to pain relief choices to emphasizing the significance of immediate bonding after a cesarean section, our conversation is geared toward empowering mothers with knowledge and confidence. Tune in for an informative session that breaks down misconceptions and encourages a guilt-free approach to birth and breastfeeding, reassuring moms that their presence and connection with their newborn is paramount for a healthy start. Learn more about your ad choices. Visit megaphone.fm/adchoices
In this episode of the MamasteFit Podcast Birth Story Friday, Roxanne welcomes Sam, who shares her personal journey of her two birth experiences. Sam's first birth was a challenging C-section following an induction due to high blood pressure, which led her to seek a different path for her second pregnancy. Determined to have a VBAC, Sam finds a supportive provider and prepares extensively through prenatal courses, pelvic floor exercises, and Hypnobirthing. Despite facing another induction for preeclampsia, Sam successfully delivers her baby vaginally. Her story emphasizes the significance of having a supportive medical team and the importance of preparation and advocacy in achieving a desired birth experience. 00:00 Introduction to the MamasteFit Podcast 00:01 Meet Sam: Two Birth Stories 01:27 Sam's First Birth: A C-Section Journey 14:30 Preparing for the Second Pregnancy 25:17 Sam's Second Birth: A Successful VBAC 36:13 Postpartum Reflections and Advice 41:17 Conclusion and Final Thoughts === Get Your Copy of Training for Two on Amazon: https://amzn.to/3VOTdwH —— ****Freebies***** Early postpartum recovery course: https://mamastefit.com/freebies/early-postpartum-recovery-guide/ Pp sample https://mamastefit.com/freebies/postpartum-fitness-guide/ Prenatal Sample: https://mamastefit.com/freebies/prenatal-fitness-program-guide/ Pelvic Floor https://mamastefit.com/freebies/prepare-your-pelvic-floor-for-labor/ Birth Prep for Labor Guide https://mamastefit.com/freebies/prepare-for-labor-guide/ Birth Partner Guide https://mamastefit.com/freebies/birth-partner-guide/ Birth Plan https://mamastefit.com/freebies/birth-plan-guide/
Happy New Year! Join Dr. Rebecca Dekker and EBB research fellows Morgan Richardson Cayama and Sara Ailshire as they celebrate the evidence from 2024. From updating key research on waterbirth, doulas, and elective inductions to launching new handouts, webinars, and pocket guides, it was a busy and rewarding year for Team EBB. Plus, get a sneak peek at what's ahead in 2025, including an updated virtual conference, fresh podcast episodes, and exciting new research. Let's celebrate the wins, reflect on the research, and dream big for what's next! (00:04:06) Benefits of Water Birth in Hospitals (00:05:13) Positive Outcomes of Water Birth Research (00:10:58) Water Birth Safety: Preventing Infections and Complications (00:14:16) Water Birth Cord Avulsion Risk Factors (00:23:23) Cultural Relevance in Doula Support Services (00:25:23) Integral Role of Doulas in Childbirth (00:30:40) Elective Inductions at 39 Weeks Impact (00:44:11) Vitamin K Update: Black Box Warning Insights (00:52:20) "Top 10 Evidence-Based Cesarean Risk Reduction Strategies" The Evidence on: Waterbirth EBB 300: The Evidence on Waterbirth EBB 318: Advocating for Waterbirth in Hospitals EBB 287: Positive Hospital Waterbirth Story EBB 268: Debunking Myths about PROM, GBS, and Waterbirth EBB 258: Waterbirth Story with Cord Avulsion EBB 230: Inspirational Home Waterbirth Story The Evidence on: Doulas EBB 309: The Evidence on Doulas The Evidence on: The ARRIVE Trial and Elective Induction at 39 Weeks ARRIVE Trial Signature Article Pain Management Series EBB 312: Injectable Opioids EBB 317: Epidurals for Pain Management EBB 320: Epidurals and the Pushing Phase of Labor Rh Incompatibility EBB 329: Blood Types, Rh Incompatibility, and RhoGAM Shot For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.
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
“Hospital Policy means the principles, rules, and guidelines adopted by the Hospital, which may be amended, changed, or superseded from time to time.”Julie and Meagan break down hospital policies today, especially common ones you'll hear when it comes to VBAC. They chat all about VBAC agreement forms and policies surrounding continuous fetal monitoring, induction, and epidurals. Women of Strength, hospital policies are not law. They vary drastically from hospital to hospital. Some are evidence-based. Some are convenience-based. Do your research now to make sure you are not surprised by policies you are not comfortable with during labor!Defining Hospital PolicyBirth Rights ArticleNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Welcome, everybody. We are going to be talking about policies today. What do they mean? Why are they created? And when do we have the right to say no or do we have the right to say no?And I have Julie discussing this with me today. Hey. Julie: You know I'm a policy fighter. Meagan: Yes, we do. We do. The longer I have gone– in the beginning, I was not a policy fighter. I really wasn't. I was a go-with-the-flow, sure, okay, let's do it, you know best. That's really how I was. Julie: A lot of people are. Meagan: That's true. I think a lot of the time, it's because we don't know what our options are. We just don't know, so I'm really excited to get into this with you today. I always love it because we kind of get into this spicy mood sometimes when we have topics like this that we are very passionate about. We are going to be talking about policies today. I do have a Review of the Week, and this is actually a very recent review which is so fun. We just posted on our social media for Google reviews. We were specifically looking for Google reviews and podcast reviews. These are so, so important for us but also for other people to find this platform. We want people to hear these stories. We want people to feel inspired and get educated and know their rights. Your reviews truly do matter, so if you have not yet, please, please, please do so. You can leave a review on your podcast platform, or you can go over to Google and just type in “The VBAC Link”, and then you can type in a review there. This reviewer is by Savannah, and she says, “I started listening to The VBAC Link Podcast around 16 weeks pregnant and continued throughout y pregnancy. It was so good and encouraging for me as a mama who was preparing for my VBAC. It helped me gain confidence, helped me know what to look for, and what to watch out for in my providers. Hearing others' stories was so encouraging and helped me gain so much knowledge. I had my hospital VBAC unmedicated with my 8-pound, 15-ounce baby.” You guys, 8-pound, 15-ounce baby is a perfect-sized baby let me just say. “And I know that the knowledge I gained from this podcast played a huge role in being able to advocate for myself to get my birth outcome.” Huge congrats, Savannah, on your beautiful VBAC for your perfect-sized baby. I say that because you guys, let's get rid of the “big baby” term. Let's just title these babies as perfect-sized because an 8-pound, 15-ounce baby for some providers may be categorized as larger or maybe even macrosomic. it's really important to know that your baby is the perfect size and your pelvis is amazing. You can do it just like our reviewer, Savannah. Julie: Your pelvis is amazing. Meagan: Seriously. All right, you cutie. Look at you. Did you just get a haircut, by the way?Julie: I did, yesterday. It's a little short. We did some color. It's a little smidgey shorter, but then I think I wanted it to still go in a low ponytail for births. That was my goal. Meagan: I'm totally digging it. Julie: Thank you.Meagan: I should be having fresh hair, but my cute hair lady bailed on me the morning of my hair appointment. Julie: Oh no! Meagan: Sometimes we have matching nails, but we would have had matching nails. We don't have them today. You guys, we just miss each other. I miss you. Julie: Yeah. We need to go to lunch again. Meagan: We do. Yes. We love shopping, you guys. Let's talk about hospital policies. Julie: Let's do it. Meagan: We know that so many people go into– not even just birth, but really a lot of things in the medical world. They just go to a doctor's office visit or go to a small procedure, or whatever it may be, and these places have policies. I want to talk about what it means. What does a hospital policy mean? What is the definition? The definition, according to lawinsider.com, says, “Hospital policy means the principals, rules, and guidelines adopted by a hospital which may be amended, changed, or superseded from time to time.” Julie: Oh, I love that addition. Amended, changed, or superseded. Meagan: Yep. Julie: Yeah. Meagan: Yeah. It can. Julie: And it does. Meagan: And it does. It does. Julie: It does. Meagan: You guys, let's just start off right now with the fact of a hospital policy– or a policy, okay? A policy in general is not law. It is not law. If you decide to decline a hospital policy– Julie: It is well within your rights. Meagan: Well within your rights. You could get some kickback. You could probably expect it. Julie: You probably will. Meagan: But, that's okay. That's okay. My biggest advice is if you are receiving or being told that this is a hospital policy, and you disagree with the policy, or maybe you agree with the policy for someone else, but for you, it's not working, and you say no, and they say, “Well, –”Julie: “It's hospital policy.” Meagan: “This policy is policy, and if you choose to break it, then you can sign an AMA.” Julie: You are so funny. “This policy is policy.” It's like that though. Meagan: That's literally what they say. Julie: They say, “It's hospital policy.” And you say, “Well, I don't agree with that policy.” “Well, it's hospital policy.”Meagan: “Well, it's policy.” Okay. Well, I'm telling you I don't like your stupid policy. Julie: I don't like your stupid policy. We are spicy, huh? Meagan: I mean it, though. I think I maybe shared this a little bit, but I had a client who had a home birth planned. She decided to go to the hospital because she had preeclampsia, and this nurse was not giving her her baby. She kept saying, “It's policy. It's policy. It's policy.” I was like, “This mom's word trumps your policy.” As a doula, I was getting into some rocky, choppy waters I was feeling. I could just feel the tension building. It did not feel comfortable at all. I looked at my client. Julie: You're just like, “Give her her doggone baby.” Meagan: They could kick me out. They could. I need you to know that they really could kick me out. She was like, “That's okay. I want my baby.” So I pushed. I pushed. I pushed and I pushed. We did get her her baby, but we had to fight. We really, really, really had to fight, and it sucks. It really, really sucks. So there is a website called pregnancyjusticeus.org. We're going to have this. I have not actually gone through all of it. It is– how many pages is this, Julie? It is a lot of pages. It is 65 pages, you guys. It's 65 pages of birthright information, going through a lot. Julie: It will be linked in the show notes. Meagan: Yes, it sure will. If you want to go through this, I highly encourage it. It is from Birth Rights and Birth Rights Bar Association, the National Advocates for Pregnant Women. Like I said, it's 65 pages, but what they said in here I just think is so powerful. It says, “There is no point in pregnancy in which people lose their civil and human rights, and yet all over the world, people often experience mistreatment and violations of their rights during pregnancy and birth and postpartum.” We see these things. Julie: You need to make that a social media post. People need to know this. Meagan: Yes. Down here even further, it says, “We also know that doulas and other people providing support to pregnant and birthing people often bear witness to rights violation of clients of loved ones. In a recent survey, 65% of doulas and nurses indicated that they had witnessed providers occasionally or “often” engage in procedures explicitly against their patients' wishes.” This is a serious issue. Julie: It is a serious issue. I feel like it's really frustrating, especially as a birth photographer where my lines as a doula are very separate, but I always doula a little bit at every birth I go to. It's not hands-on stuff always, but it's hard when you see people getting taken advantage of and they don't know they are being taken advantage of and they don't know that they have options or choices and they don't know that they can decline or request changes, and that's probably the hardest part is that people just don't know. I have a little tangent, but I'm in this Facebook support group for this medication that I'm on. It really amazes me continuously about how little people know about a medication that they are taking, a pretty serious medication that they are taking, and how little their doctors inform them of what the medication is and what some of the side effects and issues are, and what they can reasonably expect from it because some people have completely unreasonable expectations because they haven't dug into it at all. The other day, somebody said something like, “I've been really, really tired and fatigued since I started this medication, but I called my doctor and she said that fatigue is not a common side effect with this medication,” and I'm like, “What?” It's literally listed on the manufacturer's website that it's a side effect. It's listed on the insert for the medication. It's talked about all the time in this Facebook group, and it can be caused by a number of things that this medication affects. The fact that either her doctor didn't know or just told her– anyway, it leads me. I promise there's a point to this. It leads me to the fact that your doctor does not know everything about everything, especially a family doctor. This medication is prescribed by family doctors sometimes and endocrinologists. It is impossible for them to know everything about everything. Something like obstetrics and gynecology is more specialized so it is more focused. It is a more centralized area of study, but still, your doctor doesn't know everything about everything. It is not uncommon for them to not keep up in advancements in medications and technology and practices as they evolve. It's very, very common for the medical community to be 10-15 years behind the current research and evidence. It just is. Doctors and nurses and all of these things who have to have to have a certain number of contact numbers per year to keep up with training and education, but it is impossible for them to keep up with everything. It is okay for you to have different opinions than your provider. It's okay for you to want different things than is hospital policy, and it is perfectly reasonable for you to make those requests and for those requests to be honored. It is also okay for you to know more about a particular thing than your provider might. Meagan: Yep. Julie: Period, exclamation point, shazam. Meagan: Well, we've talked about this with other providers. We've heard other stories where people come in. They have stats that their providers haven't even seen. They just get stuck in their own way and their policies, and there are other things going on outside, so they just point-blank say, “No, this is how it is,” and you might have more information. That doesn't mean you are more educated or qualified or whatever to be a doctor. Julie: Yeah, exactly. Meagan: It doesn't mean, “Oh, I might as well be a doctor because I know this information and you don't,” but it means that you may have found information that your provider is not aware of. It is okay for you to bring that to their attention. In fact, do it. Congratulations for them to find out the information that they might not have known yet, so they can do better for the next patient. Julie: I want to say that there is an attitude with some medical care providers of, “Don't confuse your Google search with my medical degree.” Meagan: Yes. Julie: Come on. I really have a big problem when people get like that because first of all, and I've said this before, and I will continue to say it again, we have at our fingertips access to the largest amount of information ever available in humankind ever at our desktops. We can sit down, and you can go and find information and studies related to anything ever. Yes, don't go looking at Joe Blow down the street's opinion about childbirth or whatever. Yes, that might be a credible source. It might not be, but you can literally find these same studies, the same research, and the same information that these providers have access to in their path to their medical degree. Is it extensive? No. Are you going to have the hands-on experience that they have doing these procedures and C-sections and things like that? No, you're not, but you still have access to the same information that they have access to. I have a big problem when providers have this arrogant attitude that they know more. Yes, they do know more generally. They might not know more when it comes down to specific things that have been updated since they have gotten out of school. Meagan: Yeah. I feel like in a lot of ways, we hear these policies and these things come up, and you're like, “But where?” Then they can't show you the policy or stat. Julie: Yeah, then they'll be like, “You're 20x more likely to rupture.” You're like, “Can you send me the research?” They're like, “It's the way we've always done it.” Meagan: I did a one-on-one consult, and a provider told someone that they had this astronomical amount of percentage of rupturing, and I was like, “Wait, what?” Julie: Seriously. Meagan: I was like, “Please challenge your provider and ask them for that.” She did, and they were unable to give her that. We can just hear things, and if we just take them, it can be scary, and it can impact decisions when maybe that's not true. I also want to talk about policy for providers. Their policy should be that everyone should have informed consent. They have policies, too, that not only you have to follow or that they have to follow. It's a whole thing. There are many policies. Your provider really has to explain the risks, benefits, and alternatives for any medical procedure, intervention, or anything coming your way, but we see it not happening most of the time. We just see people doing stuff because it's within their normal routine but it's breaking policy which is so frustrating to me. So you can break policy? I want intermittent monitoring. I don't want consistent monitoring. I'm breaking a policy? Julie: So what?Meagan: So what? Julie: So what? Sorry. Meagan: Let's talk a little bit more about VBAC and policies surrounding VBAC. We know that policies are just there. They've been created. During COVID, holy Hannah. We saw these policies change weekly, you guys. Julie: Daily. Meagan: Yeah, seriously. They went in and they were like, “This is our new policy. This is our new policy. This is our new policy,” and I was like, “What?” Julie: It was freaking whiplash.Meagan: Yes, it was horrible. It was horrible. But they can change a policy just like that. You can say no to a policy just like that. So, okay. Sorry. I digress. Let's go back. Let's talk about what policies often surround VBAC. I know a lot of the time, in hospitals all over, it's a policy that midwives cannot treat VBAC. Or you can't be induced because it's a policy. You can't induce VBAC. We talked about this before we started recording, and I said it just now. It has to be consistent monitoring. Julie: Yeah. Well, can I just do a little bit of a timeout and a rewind for half a second? Hospitals are businesses, okay? I just want to explain this to everybody. Hospitals are businesses. I think we know that. You don't have to have that explained. Businesses, in order for them to run efficiently and smoothly, need to have policies, guidelines, best practices, standards of care, procedures, and things like that. It is a business. It is okay for them to set parameters for which they want their providers and nurses and everybody who is at the hospital to operate under, right? It's okay for them to have those things. It's okay for them to set those because if you didn't have those, the business would fall apart. Everybody would be doing whatever the heck they want. There would be a lot of disorder, right? Meagan: Yes. Julie: So policies and procedures and these best practices and things like that are created in order to keep things aligned and have a nice model of care so that they can be more cost-efficient so that the patients know what to expect so that the providers have a routine and things like that. Meagan: Yeah. Julie: There are reasons for these things. However, when we like to push back, when we are bothered, and the thing that really is frustrating about these policies is when they are put in place so rigidly that there's no flexibility and that it takes away a patient's autonomy, and that it removes individualized care from the birth experience. So this is why we want to talk about this. This is why we don't think all policies are dumb. No, we don't. We see the reason. We understand why they are in place. However, we want you to know that it is well within your rights as a human to decline and request changes for these policies, and to desire something different, and to have that desire respected. It's hard when some providers and nurses get so stuck in the fact that, “This is policy,” that they take away your autonomy and your right to choose. That's what we're pushing back against, and that's what we want you to know. These policies are not law. You have the right to want something different and to request something different, and to have that right respected. Okay.Meagan: Absolutely. Absolutely. I couldn't agree more. I do think it can be really hard because they have these things to keep order and to keep things tidy.Julie: And with the intention to keep you safe. Meagan: Yes.Julie: But sometimes intentions don't always translate well. But anyway. Meagan: Yeah. But really quickly before we get into what policies surrounding VBAC are, when we start questioning policy, there are things that can come into play where there are threats, there is coercion, there is gaslighting that starts happening because they are really panicked that you are questioning their policy. They feel very uncertain that you are questioning that. Julie: They may even feel unsafe, or they might never have had the policy challenged before so they don't know what to do about it. Right?Meagan: Yeah. Yeah. Just know that if people are coming at you with, “Well, if you don't do this, then this,” or whatever it may be, then it can get intense, but you can still say no. You can also ask for a copy of that policy. Again, even though that policy isn't law, you can still ask for it. Julie: Ideally, you can do this before labor begins because it's really hard to fight and bump up against these policies during labor. Meagan: Yeah. Julie: It's going to be a lot harder. Meagan: Yeah. Yeah. Okay, so let's go in. I talked a little bit about fetal monitoring. Julie: Induction. Meagan: Not being seen by certain people. No induction. Or the opposite. Julie: You have to be induced. Meagan: You have to be induced. Julie: By such and such a date. Meagan: Yes. It's just so funny because it varies all over. Julie: It does vary all over. Meagan: Let's talk about it. Okay, so fetal monitoring. Julie: Don't forget epidural placement too. Meagan: Yes. Epidurals. Julie: We can talk about that. That's my favorite one to argue against. Anyways. Okay.Meagan: There are so many. Okay, let's talk about fetal monitoring. What is the policy typically behind continuous fetal monitoring?Julie: Yeah, so most hospitals– in fact, I've never met a hospital where this hasn't been the hospital policy– is that continuous fetal monitoring is required for everybody, but especially for VBAC. They double down for VBAC because one of the first signs of uterine rupture, especially for someone who has an epidural, is irregular fetal heart tones. That can be one of the first signs of uterine rupture. Most hospitals are very, very adamant about having continuous fetal monitoring, especially for people who are undergoing a TOLAC which is a trial of labor after a Cesarean. It's not a bad word. It's just how it's defined in the medical community before you have your VBAC.The reason they do that, like I just said— but honestly, if you don't have an epidural and if you aren't under any type of pain medication, the first sign of uterine rupture for you is going to be really intense pain. That's going to be your first sign. Especially if you are going unmedicated, I think it's perfectly reasonable to request intermittent monitoring. Do you want me to go into why they introduced fetal monitoring in the first place?Okay, in the early 1970s, we saw lots of rapid advancements in the medical field and technology related to the medical field. Things like continuous fetal monitoring got introduced. Antibiotics became more readily accessible. The procedures themselves, especially the C-section procedure, became perfected and easier to do with fewer complications and fever rates of infections. All sorts of things started happening at a really rapid pace in the early 1970s. One of the things that got introduced was continuous fetal monitoring. The intention behind the continuous fetal monitoring when it got introduced was to decrease the rates of cerebral palsy in infants. Cerebral palsy usually happens when during either pregnancy or labor, oxygen is deprived to the brain of the baby. It can cause a stroke and damage part of the white matter in the brain. The idea behind it was if you could catch the reduced flow of oxygen to the baby by monitoring its heart rate, you could intervene and do a C-section in time to get the baby out before cerebral palsy happens, essentially. The interesting thing about that is that after continuous fetal monitoring was introduced, there was no change in the rate of cerebral palsy. It stayed the same. It still is very similar. But what it did do is that it was one component that increased the rates of C-sections and other interventions. They are more likely to take a baby out due to nonreassuring fetal heart tones, and we've seen no improvement in maternal mortality and morbidity rates and infant mortality rates either with the introduction of all of these interventions. Meagan: Yeah. One of the reasons why they say that it's mandatory for VBACs specifically is because fetal heart tones decelerating is one of the signs, one of many, that a uterine rupture may be taking place. Julie: Right, right. I said that. Meagan: Oh, you did. Julie: Yeah. Meagan: I was reading the link. I missed that. Julie: No, no. You're fine. Say it again. It's okay.Meagan: No, you're fine. Okay. So with uterine rupture, fetal heart decels are not always a symptom of uterine rupture. What do you feel like it means? I feel like so many people feel more comfortable having their baby on the monitor so they can hear them. Julie: Oh, they do. You know what? The staff is more likely to do that too. This is really sad, but we have a labor and delivery culture that is very, very comfortable sitting at a desk down a hall watching a monitor to see how a patient is doing rather than remaining in the room and watching them. They rely more on what is going on on the contraction monitor and the heart rate monitor than they do the visible signs of the patient. It's how they've been trained. It's how they monitor dozens of people at once in a labor and delivery unit, and I feel like continuous fetal monitoring and the contraction monitor are other ways that de-individualizes care. I don't know if that's a word. It takes out the individuality. It takes out the rights to the human and it takes out really watching the person, and relies too much on the data. Data is good. I love data. Don't get me wrong. I am a data junkie 110%, but data can only take you so far. I feel like that's why people freak out about the continuous fetal monitor thing. “How are we supposed to know if you're doing okay at the desk because we can't see the chart on the screen if we're not monitoring you continuously?” It puts more work on them, which is okay. I can't imagine being a labor and delivery nurse because sometimes you have more than one patient that you're monitoring and watching, and you've got lots of other things to do including charting and all of this stuff. Meagan: Yeah, this is one of those things that was created that even though the evidence didn't prove that the reason why it was created worked out, it stayed because it brought ease to monitoring labor, and monitoring it not in the same room, and being able to have five other patients while seeing a chart. Okay, so fetal monitoring is one. Let's talk about the induction or the non-induction that we've seen policies on both ways which also is so weird to me. I know it's hospital to hospital, but why aren't we going off of evidence?Julie: Dude, dude. Do you know what is so funny to me? I will also cry this out from the rooftops until I die, but if you really want to understand what maternal healthcare is like in the United States, you've got to talk to a doula or a birth photographer because we see not only hospital births and home births and birth center births, but we see all of the different hospitals and how they vary in hospital policy. It is so funny to me sometimes the conversations that I hear or have with labor and delivery nurses who insist one thing, then the next labor and delivery nurse in the next hospital insists on something completely different. “Oh, it's not safe to go past 20 for Pitocin on VBAC,” then the next hospital will be like, “Yeah, it's perfectly safe as long as you are monitored and the OB signs off on it.” It's so up, down, and sideways based on whatever this specific hospital policy is. It's not their fault which is why sometimes I like travel nurses in labor and delivery units because they go all around the country and have vastly different experiences with all the different hospitals. It's fun to see the culture shift that can come in when that happens. Meagan: Yeah. Okay, so in some hospitals, it is policy that you have to go into labor spontaneously. Julie: Yeah. They will not induce for VBAC. Oh, but if you haven't had your baby by 40 weeks, it's hospital policy to do a C-section. Meagan: Yeah, they will not induce you, but then if you don't go into labor by 40 weeks, they have to schedule a C-section. What's the evidence there, and why is that even being a policy?A lot of providers after 40 weeks fear or they say that VBAC uterine rupture chances skyrocket after 40 weeks because, “Oh, that baby is getting bigger. They're stretching that uterus out,” but that's really not necessarily the case. We're seeing it happen more and more and more where people are then doubting their body's ability to give birth or go into labor. They are so scared that their baby's going to get so big that they're going to cause uterine rupture if they go past 40 weeks. I mean, really. You guys, the amount of things that we see coming in The VBAC Link's DM's– I love that you guys write us. Please keep writing us, but it's frustrating, not that you're writing us, but that these providers are telling people these things. Then we have the opposite that we have to induce by 40 weeks. Julie: Can I read you this thing? There's a post in The VBAC Link Community today. It was a VBAC agreement form. If you're birthing at a hospital, you're more than likely going to have to sign a piece of paper showing all of the risks of VBAC, but they don't ever make you do that for a C-section. This hospital VBAC policy, hold on. I was reading it this morning. Listen to this. This is word for word from this VBAC agreement form from a hospital. “I am aware that the best chance for a successful VBAC is to go into spontaneous labor, and that the risk of Cesarean section is increased past my due date. In an effort to afford me the best chance of achieving VBAC, I agree to be induced the 39th week of pregnancy or sooner if medical issues are present if I am still pregnant.”In that same paragraph, they say that the best chance of a successful VBAC is going into spontaneous labor, but if you don't go into labor by 39 weeks, we're going to induce you. Meagan: It also says that after 40 weeks, Cesarean chances increase so we have to induce a whole week before. Julie: Yeah. Right? Meagan: I'm sorry. Julie: This is real life. How is this even a thing? Blah, blah, blah. That's what I say. Screw your policy. How can you contradict yourself like that? It says, “The risk of a Cesarean section is increased past my due date, but it's also increased if you induce me, so either way I have increased risk.” This is literally what they are telling you in this form that they make you sign. Meagan: You know, those forms are so important to pay attention to, you guys. As you are getting these forms, the VBAC consent forms, or VBAC agreement forms or whatever. They title them all differently. Julie: I'm just reading this hospital policy more. Sorry. “I am aware of the hospital policy requiring two IV access sites.” Meagan: Okay. Today, which you guys, was last– I'm trying to think. It was a month ago. Okay, a month ago– I recorded the episode today, but a month ago, when this is coming out. Go listen to Paige's midwifery episode. She just was talking about that. That is a policy within the hospital that she helps people at. They have two hep locks. This was news to me as of today, and now you are seeing this in this policy. Why? Why? What is the evidence behind that? Why?Julie: This VBAC agreement form is every single thing that we are talking about. “I agree to have continuous fetal monitoring. I am aware of this policy by this obstetric group–.” I won't say it because maybe we shouldn't call them out. Maybe we should. “--to require epidural placement by the time of active labor. I am aware of the implication that certain complications of labor can be life-threatening to myself and my baby. These can only be addressed promptly at the hospital. To lessen the risk of delay during a complication, I agree (in bold)--”Meagan: Yes. All of the agrees are in bold.Julie: “--to come to the hospital immediately if I am in labor or if my water breaks.”Meagan: Ugh. Julie: “I have been adequately about the risks, benefits, and alternatives of VBAC, and have the opportunity to ask questions. I am aware that no one is able to guarantee a successful VBAC and that repeat C-section may be indicated if my baby is breech, I do not adequately dilate, I am able to push my baby out, my baby does not tolerate labor, there is a concern for uterine rupture, or if any unforeseen medical issue arises during my pregnancy which makes labor unsafe–” according to who?Anyways, “certain methods of induction of labor are not permitted to be used in patients with prior Cesarean sections. I understand that if I am induced, the only safe options include medical dilation with a balloon, Pitocin, and breaking my water.” That, I feel like, is accurate. Meagan: That is valid. That is valid. Okay.Julie: That's the only one. Cool. Meagan: Cool. Out of ten. Julie: Are you reading this right now? Do you have it up?Meagan: Yes. I pulled it up. Let's talk about epidural. You guys, this has 86 comments already. One of the commenters said, “You absolutely do not need to get an epidural, have continuous monitoring, or go into the hospital when labor begins. These are often things to avoid when trying for a VBAC.” Julie: Yes. Yes. Meagan: You absolutely can have these things. “You can have these things, but having an epidural before 6 centimeters can put you at a higher risk of Cesarean including continuous monitoring. Your rights override policies.” This is what she said. She said, “Are you in the States? Did you sign this?” Julie: But I love what Flor Cruz with Badass Mother Birth said. “This is atrocious. Run. I would rather give birth in the woods by myself than to agree with this monstrosity.” Meagan: Really, though. We have so many things coming at us. We're so vulnerable when we are pregnant, and we want a VBAC so badly. We have forms like this being given, or we have policies being thrown at us, and we say, “Just say no,” but when you're in that moment, it's really difficult. I think something that I want to say is, as you are learning these policies, as you're learning more, figure out if you are someone who can stand up to these policies and say no, or figure out if there's someone on your team who you need to have be there to help you find the strength to say no. Also, make sure that your family knows and your team knows what's important to you when it comes to these policies. What triggers you? It is very difficult to say no or, “I am not going to do that,” or to not even say a word because they just strap the monitors on you, or call anesthesia because they just did a cervical exam, and the nurse logged that you're 6 centimeters, so anesthesia is just coming down, but you might be doing really well and not want an epidural. Okay, I want to talk about epidurals. Julie: Let's talk about epidurals. Jinx. Let's do it. This is my favorite policy to tear apart and rip apart. Here's the thing. The reason why they tell you they want an epidural placed, but you don't have to have it turned on, just to have it placed just in case, is if a uterine rupture happens, you can dose up the epidural and go back to surgery, and they don't have to put you under anesthesia. It sounds great, right? Cool, yeah. Let's do that. That sounds great. I don't want to go under general anesthesia if I have to have a C-section. Here's the problem with that. First of all, going under general anesthesia does carry more risks than having surgery with a spinal or an epidural. It does. That's just common knowledge. Nobody is going to argue that here. We get that. The problem is that in a true emergency, we're talking about seconds matter. Minutes matter. If you have a catastrophic uterine rupture and baby has to be out now, baby has to be out in minutes or less. They are going to do a splash and dash. They are going to throw the antiseptic, the orange stuff– Meagan: Iodine? Julie: Iodine. They're going to throw iodine on your belly, and they're going to slice you open. Sorry, that was a very not-sensitive way to say that. They're going to take the baby out as fast as possible once you're in the OR. They have to knock you out under general anesthesia. There is not enough time to dose an epidural, especially if it's not ever turned on. But even if it is turned on, it takes 20 minutes or more to get an epidural dose to surgical strength to where you will not feel the incision and the surgery that comes with a C-section. 15-20 minutes at minimum in order to get you dosed to surgical strength. If you have an epidural, and it is urgent where minutes matter, you will have to go under general anesthesia no matter what, period. If a C-section is needed, there is time to give you a spinal which takes effect in just a few minutes, 3-4 minutes. It takes some time to get the anesthesiologist in and the OR prepped and things like that, but usually and realistically, if it's something that's urgent but not emergent, you can get a baby out in 10-15 minutes without already having an epidural placed. Here's the thing. Placing an epidural is preparing you for surgery, period. If there's an emergency, you will have to be put under general anesthesia, period. If a C-section is needed, and minutes don't matter, but we need to get this baby out soon, you can get a spinal, period. So, screw that epidural hospital policy. It's literally for convenience so you already have an epidural placed so that they can take you back to do a C-section. Meagan: Yeah. But again, the epidural just doesn't get in fast enough even if it's placed or not. Julie: Exactly. Meagan: Ugh, I hate it. I hate when it's like, “I don't want an epidural, but I'm getting it just in case.” Okay, then going back to this policy that she was just reading, “will not labor at home. If my water breaks, I have to come right in.” You guys, if you want to labor at home, do your research. I understand. Always, always– I don't even care if you are a VBAC or you're planning an induction or what. Always learn the signs of uterine rupture, always. It's so important to know. Even though it happens very little, it happens, and we need to know the signs. But, it's okay to labor at home. Talk to your provider about that. If they are like, “The second you have a contraction, you have to come in,” that is a red flag. You guys, they also start monitoring and pushing induction even though your labor has been going. They induce your labor more. They get it going further. What if you're having prodromal labor, and it's just going, and then it stops for 5 hours? There are so many things. I'm no provider. I can't say, “You must labor at home,” or “You should really labor at home,” but really look at these things and understand what could happen if you choose to go in the second your water breaks. Let me tell you what happened to me. My water broke. I went straight in. Within an hour, I hadn't progressed too much, so they started Pitocin. They immediately started Pitocin. They kept cranking it up. My body was struggling. I was struggling. My baby had a couple of decels. They called it. It's just really, really frustrating. I mean, you guys. We have so many comments in this here that I could just read all of them because they say a lot. They say a lot. This is fear-based care. I'm sorry that you're having to go through this.” “This is the dumbest thing I've ever heard,” someone said. Julie: Seriously. Meagan: When it comes to hospital policy, it's not a law. It's really not a law. Stand up for yourself. Understand the policies surrounding VBAC. When you are looking for a provider, we cannot stress this enough. Ask them about their policies. If their policy is that you must get that just-in-case epidural, you have to have that baby by 40 weeks or we induce or we schedule a Cesarean, you have to come in the second a contraction starts, if your water breaks, you must come in. You have to come in. They're making people sign these policies like they are the law. Julie: Yeah, like it's a legal document like you can't change your mind. That's what it does. It makes people think they have to agree to things. “I signed the document, so here I go.” Meagan: Here I am. I have a written agreement, but they can change. What did it say? What did the very first definition say? It says, “It can be amended, changed, or superseded.” Supersede. Julie: Superseded. Yes. But here's the thing, too. I'm kind of glad when hospitals do this because it shows you all of the red flags. It lines out the red flags, no questions, black and white, red flags laid out for you. Then you know either how to address them before labor, or how to hightail it out of there and find another practice because nothing is worse than getting blindsided during labor by a policy that you don't agree with and having to advocate to change that during labor.I would encourage you if your provider doesn't make you sign a wonky form, then before you even start care with them, find out what their hospital policies are about VBAC. Find out so that you can address them ahead of time. Have your provider sign off on changes to policy that you want, and put it in your medical records so that if you get a different provider on the day that you go into labor, that provider can access your records and see that it has been signed off, or approved, or whatever your changes are that they are going to make to the policy for you and your specific needs. It is okay to ask for that. It is okay to fight for that. It is necessary to fight for that sometimes. Obviously, it would be ideal for you to find a birth location whose policies align with the things that you want. Sometimes, somebody might want continuous fetal monitoring. Maybe it makes them feel better mentally. Maybe that's just their preference, and that's okay. It's okay to want that, but it's not okay to let a system dictate how you want to birth when you want something different. Meagan: Yes. Absolutely. It's also not okay for you to feel cornered or like you're bad, coerced, or you're a bad mom because you're making a decision that goes against a policy. I don't like that. I do not like that. It's not okay. I highly suggest going and checking out the show notes and reading more about your birth rights, what they mean, and all of it. In part of that little birth rights document pdf, the 65-page document, it talks about down in the first 4 or 5 pages– let's see. It says, “I have the right to–”, and then it has a whole bunch of things. It says, “To say no and be heard. To have my basic needs be met. To labor in the way that works for me. To birth vaginally. To know all of my options. To change midwives, doctors, and nurses. To not be touched. To ask people to leave. To feed my baby human milk. To leave the hospital or the birth center.” You guys, you have rights. You have rights. You are amazing. Use your rights if you are in a corner that feels like they are being taken away or they're gaslighting you, or coercing you, or whatever it may be. You have rights. Check this document out. I highly suggest it. Talk to your providers. Check out their policies. Dissect the policies. Dissect them. Really break it down. What does that mean? Why is this being put on as a policy?In one policy that Julie just read, it said that they will not induce, and that VBAC is not applicable to being induced with certain things other than x, y, and z. Okay, if you do the research and you learn about that, that is pretty dang valid. That is understandable. That policy has been put in place for your safety. Okay? But there are others that I would say no to. They may be thinking that it's for your safety, but there is no evidence behind them. Dissect them. Learn them. Learn how to advocate for yourself. Get your team ready. Know it's not a law, and love yourself because you deserve more. Okay. Anything else you'd like to add, Julie?Julie: No. I love that. Love yourself. Take ownership. Take ownership of your own birth experience. Don't give it to somebody else. Stand up for yourself. Take ownership. I love what you just said. Love yourself. You deserve to have choices in how you are treated during your birth experience. Meagan: Yes, absolutely. Okay, thanks, 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
In this episode of the MamasteFit Podcast, Gina and Roxanne explore the topic of pain relief during labor, focusing on epidurals. They explain what an epidural is, its benefits, potential concerns, and debunks a few myths. They discuss the steps involved before, during, and after the epidural procedure, how to prepare for it, and how to manage labor and pushing with an epidural. The episode provides practical tips on positioning, movement, and pushing techniques for a more effective and comfortable birthing experience with an epidural! 00:00 Introduction to Pain Relief Options 01:05 Benefits and Considerations of Epidurals 02:31 Understanding Epidurals: What to Expect 07:28 Questions to Ask About Epidurals 17:43 Epidural Administration Process 21:14 Sponsor Break: Needed Nutrition 22:44 Epidural Placement and Experience 27:37 Monitoring and Adjusting Epidural Effects 28:47 Foley Catheter and Epidural Side Effects 30:51 Epidural and C-Section Concerns 32:28 Tools for Movement with an Epidural 36:54 Pushing with an Epidural 46:01 Advocating for Your Preferred Pushing Position 52:49 Recap and Final Thoughts on Epidurals 55:27 Additional Resources and Sponsorship === Get Your Copy of Training for Two on Amazon: https://amzn.to/3VOTdwH —— This podcast is sponsored by Needed, a nutrition company focused on optimal nourishment for your perinatal journey. Use code MAMASTEPOD for 20% off your first order or three months of subscription. ****Freebies***** Early postpartum recovery course: https://mamastefit.com/freebies/early-postpartum-recovery-guide/ Pp sample https://mamastefit.com/freebies/postpartum-fitness-guide/ Prenatal Sample: https://mamastefit.com/freebies/prenatal-fitness-program-guide/ Pelvic Floor https://mamastefit.com/freebies/prepare-your-pelvic-floor-for-labor/ Birth Prep for Labor Guide https://mamastefit.com/freebies/prepare-for-labor-guide/ Birth Partner Guide https://mamastefit.com/freebies/birth-partner-guide/ Birth Plan https://mamastefit.com/freebies/birth-plan-guide/
In this episode, Labor Junkie RN joins us to dive deep into everything you need to know about epidurals. Listen along as they debunk common myths and provide crucial insights on epidurals. Understand the administration process, potential side effects, and the importance of informed consent. They dive into the details of epidural placement, the role of medical professionals, and possible complications. This episode covers everything you need to know about making informed, empowered decisions regarding epidurals during labor and delivery, ensuring you have the knowledge to navigate childbirth with confidence. Understanding Epidurals: Basics and Misconceptions Epidural Placement Process Addressing Common Fears and Concerns Hospital Policies and Procedures Informed Consent and Timeouts Epidural Placement and Initial Relief Managing Epidural Effectiveness Positioning and Movement with an Epidural Eating During Labor with an Epidural Walking Epidurals: Rare but Possible Common Complications and Risks of Epidurals Epidurals and Labor Progression Understanding Epidural Side Effects Making the Decision: To Epidural or Not Who Can Administer Your Epidural? Catheterization with an Epidural Removing the Epidural: What to Expect Final Thoughts on Epidurals and Birth Choices Guest Bio: Sara is a nurse of 15 years, the past decade of that in high risk OB and is the mom of 3! INSTAGRAM: Connect with HeHe on IG Connect with HeHe on YouTube Connect with Sara on TikTok Connect with Sara on Facebook BIRTH EDUCATION: Join The Birth Lounge here for judgment-free childbirth education that prepares you for an informed birth and how to confidently navigate hospital policy to have a trauma-free labor experience! Download The Birth Lounge App for birth & postpartum prep delivered straight to your phone! Check out Birth Brigade Podcast to hear HeHe chat with Dr. Bill Chun, OBGYN!
We are so excited to bring back Mackenzie from Mackenzie.On.Motherhood on Instagram. She was with us for episodes 27 and 28 where we talked about what an L&D nurse wants you to know about labor and what actually happens after a hospital birth. So we thought it would be perfect for her to come back and educate us about epidurals! Whether your birth plan will include an epidural or not, this episode will be a great opportunity to educate yourself on the option of an epidural and what that process of having one looks like. It's better to be over prepared than under prepared!We start off with defining what exactly an epidural is and Mackenzie walks us through the step-by-step process of how an epidural is placed and who does the procedure. We then go through some of our listeners' most requested questions about epidurals. Can you get out of bed and change positions? Will I still feel pain? What are the risks and benefits? We go through it ALL!If you enjoyed listening to this episode, we would love it if you could share it to your Instagram stories and tag us, @mackenzie.on.motherhood and @expectingandempowered. As we like to say, knowledge is power, and we just really want to give more people the information that they may need on their childbirth journey!Follow Mackenzie on InstagramMackenzie's WebsiteMackenzie's Online CoursesLinks & ResourcesEpisode 27 - What a Labor and Delivery Nurse Wants You To Know About LaborEpisode 28 - What Actually Happens After a Hospital BirthExpecting and Empowered App - Check out our Labor Day Sale and enter code ‘LABORPOD25' at checkout!Expecting and Empowered WebsiteExpecting and Empowered Instagram
In this episode we discuss what you can do to manage pain during your labor. We will cover the medication free techniques for managing pain and then we'll also talk about medications such as narcotics, Nitrous Oxide, Local injections and Epidurals. Our goal is to let patient's know what is available so you can make the best informed decisions about your care.
Hey Mama, this episode is an educational training on key information and common questions about epidurals.Trish covers when to get an epidural, its effects on labor, and debunks myths such as epidurals increasing the likelihood of a C-section or causing permanent back pain.Other topics covered include epidural side effects, such as blood pressure drops and epidural shakes, and the importance of purposeful positioning after receiving an epidural. Trish encourages everyone, whether or not you're getting an epidural, to be prepared for laboring at home, to understand your pain management options, and know how to navigate epidural-related decisions. Tune in for practical tips for getting an epidural and resources. 00:00 Introduction and Fearless Birth Experience00:33 Uncommon Facts About Epidurals01:27 When to Get an Epidural05:52 Myths About Epidurals10:09 Side Effects of Epidurals13:09 Practical Tips and ConclusionMore from this episode: Comment #EPIDURAL on any Labor Nurse Mama Instagram post or reel for your FREE Epidural Prep Kit.Read the blog Birthing with an Epidural? Here's What You Need to Know About Laboring DownResources: 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 you learn with your team. See my Disclaimer here! Also, We make a small commission from some of the links (you don't pay...
What does a self-described Type A do when her birth plan derails? Tara Langsdorf (who finished her second master's degree and took a promotion managing a team of 25 while pregnant!) shares with Adriana how leaning on the structures and support she'd set up during pregnancy allowed her to go deep into her labor process, despite her starting to develop preeclampsia and having a cascade of interventions. Sponsor offers - TIME SENSITIVE! NEEDED - Get 20% off at ThisIsNeeded.com with code BIRTHFULHONEYLOVE - Get 20% off at HoneyLove.com/Birthful JENNI KAYNE - Get 15% off at JenniKayne.com/Birthful with code BIRTHFUL15AQUATRU - Get 20% off at AquaTru.com with code BIRTHFULACORNS - Go to acorns.com/birthful to start investing for your future today!PAIRED - Practice love every day with Paired, the #1 app for couples. Download the app at https://www.paired.com/BIRTHFUL Get the most out of this episode by checking out the resources, transcript, and links listed on its show notes page. If you liked this episode, listen to our interview on Epidurals & Breastfeeding and our episode on Evidence & Eating During Labor.You can connect with Birthful @BirthfulPodcast on Instagram or email us at podcast@Birthful.com. If you enjoy what you hear, download Birthful's Postpartum Plan FREE when you sign up for our weekly newsletter! You can also sign up for Adriana's Own Your Birth online BIRTH preparation classes and her Thrive with Your Newborn online POSTPARTUM preparation course at BirthfulCourses.com.Follow us on Goodpods, Apple Podcasts, Amazon Music, Spotify, and anywhere you listen to podcasts.Our Sponsors:* Check out Acorns: acorns.com/birthful* Go to acorns.com/birthful to start investing for your future today!* Practice love every day with Paired, the #1 app for couples. Download the app at https://www.paired.com/BIRTHFULSupport this podcast at — https://redcircle.com/birthful/donationsAdvertising Inquiries: https://redcircle.com/brands
The impact of epidurals on the second stage of labor has sparked a lot of discussion. Research suggests that epidurals can prolong this stage... and a prolonged second stage can be associated with increased risks of infection, severe tears and the need for interventions like forceps-assisted delivery or Cesarean. But does an epidural mean that you are higher risk for complications during the second stage of labor, or are there ways to lessen your risks? In this episode, Dr. Dekker explores the physiological effects of epidurals (and how they impact your body's birthing reflexes), the correlation between epidurals and the duration of the second stage of labor, and nuanced perspectives from professional guidelines worldwide— including a brief discussion of "laboring down" (aka delayed pushing). References: To access all the scientific references that go along with this episode, visit our blog article here. Access the rest of our EBB Pain Management series go to this page and click on “Pain Management Series.” Check out the EBB Pocket Guide to Comfort Measures here. Find an EBB Childbirth Class near you here. For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.
Join Andie and Angie as they explore the hilarious world of parenting styles that are as unique as your own kids! Over the past few months, Andie has realized that she is a Permissive Marshmallow Grandma! She's all about spoiling her grandson with love and cookies! But hey, back in the day, she was a Passive Helicopter Bear Mom! She hovered with ease and let her kids spread their wings. Andie and Angie talk about Silky Moms who glide through the parenting journey with the latest technology and medical advancements. Epidurals and bottles? You betcha! Convenience is key for these mamas. Scrunchy Moms, are a combo of Silky Moms and Crunchy Moms. These fabulous moms are all about the best of both worlds—embracing modern products and homemade baby food. Now, here's a little secret, mama: there's no one-size-fits-all parenting style! The Mommy Wars need to end so each mom can shine in her own unique way, doing what feels right for her and her kiddos. In this episode, Andie and Angie swap stories and laugh until they cry! Who knew calculus could be so funny, right? So, if you're ready to laugh, learn, and embrace the craziness of parenting with a sprinkle of silliness, you've come to the right podcast.Send us a Text Message.
Gain a comprehensive understanding of epidurals and their role in labour pain management. Join us on the Baby Tribe as we tackle listener-submitted questions about the procedure. We promise to provide you with clear, compassionate, and evidence-based information to help you navigate your pain relief options during labour confidently. Our discussion underscores that your choice of pain relief does not diminish your birth experience's strength or value. We begin by demystifying what an epidural is, walking you through the placement process, and detailing how it effectively alleviates pain while maintaining crucial sensations of pressure. Whether you're anxious about needles or curious about the sensations you might experience, we break it all down to offer reassurance and clarity. Communication and comfort are paramount, and we emphasize their importance throughout the procedure to ensure a positive experience. From exploring the risks and side effects to tracing the evolution of epidural analgesia, we provide a balanced understanding of epidural safety. We address rare risks, common side effects, and debunk outdated myths about labour duration and cesarean sections. Additionally, we touch on the impact of modern epidurals on breastfeeding success and explain phenomena like epidural fever. Don't miss our light-hearted interludes, including a humorous story about a past episode's bad hair day and a funny anecdote about directions in the West of Ireland, adding a personal and entertaining touch to the episode. More info n: https://www.labourpains.org/ Learn more about your ad choices. Visit megaphone.fm/adchoices
Women's Health, breast cancer screening, epidurals, and GP voices New U.S. guideline on breast cancer screening have been extended to women in their 40s - Katy Bell, from the University of Sydney, and Stacy Carter, from the University of Wollongong explain why the good intention of that change wont be mirrored in outcomes - and may even induce harm. Research in The BMJ shows epidurals during labour can reduce severe maternal morbidity Rachael Kearns describes why analgesia may improve those outcomes, and why some myths about epidurals may be reducing their usage. Lastly, a GP confronts the Prime Minister on the disintegration of the NHS and its effects on general practitioners. 02:23 Breast cancer screening guidelines 14:00 Epidurals and maternal morbidity 26:42 A GP confronts the Prime Minister Reading list: Breast cancer screening from age 40 in the US Epidural analgesia during labour and severe maternal morbidity: population based study GP who confronted Rishi Sunak received “hundreds” of supportive messages from doctors
Have you ever wondered what the evidence is on epidurals for pain management during labor? Join us on today's podcast as we discuss most recent evidence on epidurals, spinals, and combined spinal-epidurals! We'll begin with some background on these methods, including how common they are in the U.S. and around the world, before moving on to the effectiveness, benefits, and risks for use during labor. We'll also talk about alternative methods of pain relief during labor, and share recommendations from professional healthcare organizations. [Bonus addition to the podcast at 20:00: We talk about the study on epidurals out of Scotland [Kearns et al. 2024] that is generating lots of news headlines!] Join us to learn more about pain relief options during labor! Content Note: Topics related to epidural use, how they're provided (including needles and catheters), and the benefits and risks of this intervention. Discussion of assisted vaginal delivery (forceps and vacuum deliveries), severe maternal complications, surgery, perineal tears, and postpartum depression. References: To access all the scientific references that go along with this episode, visit our blog article here. Access the rest of our EBB Pain Management series go to this page and click on “Pain Management Series.” Check out the EBB Pocket Guide to Comfort Measures here. Find an EBB Childbirth Class near you here. For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.
This episode goes back to the basics and is a great place to start on your VBAC journey! Julie joins Meagan today as they talk about many common questions beginning with reasons why providers tell women they can't go for a VBAC. Topics today include: Nuchal cordsBig babiesSmall pelvisesArrest of descentThird-trimester ultrasounds Cervical dilationInductionDue datesThe ARRIVE TrialWhy there is so much contradicting VBAC infoPregnancy intervals EpiduralsMeagan and Julie also reflect on how their perspective toward each of these topics have changed over the years. Allowing for nuance is so necessary when approaching birth. Know that you always have options and never feel pressured to make a decision that doesn't feel right for you.The VBAC Link Blog: Pregnancy IntervalsNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 04:24 Review of the Week07:48 Intro to the basics09:53 Nuchal cords13:30 Big babies, small pelvises, fluid levels, and third-trimester ultrasounds17:08 How will this change my care?18:47 Cervical dilation25:54 Due dates28:18 Vulnerability and the ARRIVE trial30:44 Inducing a VBAC36:15 Julie's social media story38:29 Contradicting information41:36 Pregnancy intervals46:38 Epidurals54:13 Allowing for nuanceMeagan: What's up, everybody? This is Meagan. We have Ms. Julie with us today and we are going to be talking to you about what we need you to know about VBAC. We obviously like to talk about different topics but Julie and I decided this morning as we were getting ready to record that we need to do an episode on just the basics again. Don't you feel like it's the basics? It's not to shame anyone for not knowing the information. It's honestly to– I don't even want to say the word shame– but providers are not educating their patients. They are just not. We see it time and time and time again where people just don't know. We saw a post, I don't know, maybe a month or so ago. I think maybe Julie sent it to me. It was just saying, “Hey, so can you have a VBAC no matter what reason the C-section was for?” Someone said, “Well, it depends because if it's something like a cord wrapped around the baby's neck, if that was the reason you had your previous C-section and if your last baby had its cord wrapped around their neck and was having struggle, yes. You have you have a C-section.” Julie: I am getting a little salty. I feel like maybe salty is not the right word, but direct. I jumped in and I'm like, “That's actually not true. The cord wrapped around a baby's neck preventing them from descending is a perfect VBAC candidate because it's not anything to do with the pelvis or labor stalling or anything like that.” Anyways. Meagan: Even with that said, even with that said– Julie: People still argued with me. Meagan: Well, but even if it was due to someone being told that their pelvis was too small or their baby didn't descend– Julie: That's also false. Meagan: That's also false. Julie: I mean with actual pelvis trauma where it's actual CPD and is legitimately diagnosed and that type of thing. Honestly, most people are good candidates for VBAC but we are going to talk about that. Meagan: Yeah, we're going to talk about that today because it's obviously something that we are really passionate about and it's something that we want you guys to know so let's talk about it. 04:24 Review of the WeekMeagan: We do have a Review of the Week. You guys, it's a really long one and I might have specifically been waiting for Julie to come on with me so she can read it because she's a lot better at reading long reviews sometimes. I'm just going to pass the time over to Julie to read this amazing review. Julie: Now I feel pressure, man. Meagan: Don't mess up. Julie: The pressure's on. Are you ready for this? This review says, “This is such a tremendous resource for VBAC mamas.” See? There I go. I knew it. I'm going to start BBAC mamas. Try and translate that, Paige. Anyway, okay. It's fine. I'm going to circle back around. “This is such a tremendous resource for VBAC mamas. I sadly only discovered your podcast after my VBAC in April 2022 but having caught the birth bug during my prep for that birth, I still listened to each episode as if I'm preparing for my VBAC all over again. I think having a special place for this very unique scenario helps those planning and hoping for a successful VBAC feel less alone, more supported, and very well-informed. “The balance of evidence-based information with the age-old practice of sharing birth stories makes this one of the best birth resources out there. I only wish I had this when I was planning my VBAC but maybe someday I'll get to share my own story and help inspire a fellow Woman of Strength. “Prepping for and achieving the unmedicated birth of my daughter absolutely flipped a switch in me and I feel determined to become a birth worker one day.” I feel like all of us go through that, right? “Knowing that this podcast team also has a course for prospective doulas like me thrills me to my core. I want to be there for other anxious, hopeful VBAC mamas like me and the amazing work that you are doing is changing birth and lives everywhere. Keep it up. It is so needed and appreciated. Adrianne.” I love that so much. I feel like that's all of us like you and me. We all go through this journey like, Hey, I had a really bad birth experience or I had a really bad one and then an empowering one and I want to be part of this change so that other people don't have to suffer like I did. I love that and I feel like almost all birth workers' stories start like that. I know mine did and yours too, Meagan. We all are there at some point. Meagan: We are. Yeah. I couldn't agree more. I definitely have been there. 07:48 Intro to the basicsMeagan: Okay, all right. Let's talk about the basics. What basic do you want to talk about first? We were talking about just a second ago where we were like, Hey, this was being told to you and you are being told you may not get to have a VBAC. So maybe we just start with reasons people are told that they have to have a C-section and they can't have a VBAC. Julie: My gosh. I want to speak to a couple of different points in that direction. I have a couple of different ideas in my head. First of all, I feel like it's important to acknowledge that we are all ignorant to things at some point. Right? We all have to learn that VBAC is an option at some point or maybe we always knew. For me, I feel like I never was like, Oh, I can have a vaginal birth? I just always thought I could have one, but I also feel like the age-old “once a C-section, always a C-section” thing is so ingrained in some parts of our culture that you really do have to have that awakening that, Oh, I can do this. It is safe.So I just want to acknowledge that. Sometimes, even for me, I'm scrolling through Facebook and I see this post about something or the ARRIVE trial with induction at 39 weeks is safer and it's really easy to eye roll or it's really easy to be like, Oh my gosh, how come you don't know this? But I feel like let's circle back when I see these things and remember that we all start somewhere. Not all of us have access to supportive providers, supportive hospital systems, supportive families, supportive providers. We don't all have access to those things. If you're advanced in your VBAC thoughts or thinking or whatever, I encourage you to still stay on the episode because you never know when you're going to learn something new. You never know when something is going to click right for you and you never know when you're going to gain the perspective that you need. If you are a seasoned VBAC pro, please also stick along with us. 09:53 Nuchal cordsJulie: I feel like I hear a new reason why someone is told they can't have a vaginal birth every day. Not every day, that's a little dramatic. Meagan: But a lot. Julie: It still surprises me. I've been a doula in the birth scene for 9 years now and I still get that cord prolapse one. I have never heard that as a reason why someone would have a repeat C-section. I mean, I had a VBAC client. She was trying for a VBAC at home and it ended up in a hospital transfer. The baby's cord was wrapped around her neck four times. They had to cut the cord in four places to get the baby out via C-section. Meagan: I remember you saying that. Julie: Yeah, that baby was stuck so tightly in there. In those circumstances, that C-section was necessary. That baby was not coming out, but that doesn't mean she can't try for another VBAC. I think she is done having kids, but that is completely circumstantial and specific to that pregnancy. So I feel like that's a really important thing to note is that most things are circumstantial. Even stalled labor or arrest of dilation or failure to progress or a big baby or whatever these things are circumstantial. The cord around the neck preventing baby from coming down– totally circumstantial. I feel like even the American Pregnancy Association– did I say that right?-- says that 90% of women who have had C-sections are good candidates for VBAC. I think that's important to note is that if you're being told that you are not a good candidate for a VBAC, I would really question why because most of the time, you are a good candidate. Big baby, sure. That's one. We can throw these around. People say, “Oh, your baby is too big. You have to have a C-section.” That is not evidence-based. Even ACOG says that big babies are not a reason for either induction or automatic C-sections. Meagan: Suspected big babies. julie; Right, suspected big babies. Meagan: Let's just say that they're not always big. Julie: They are not always big and we know this is something we automatically know like, everybody knows this but not everybody does. Your ultrasound measurements can be off by 1-2 pounds in either direction. They can measure small or big. The only accurate way to determine how big your baby is is to weigh it after it is born. Meagan: To birth your baby. Right, to birth your baby. Julie: Not only that, but big babies come through petite pelvises all the time. Babies' heads mold and squish through pelvises that flex and open and move to work together. The baby and the pelvis are this really cool diad where they have this great relationship of working together and the pelvis opens and the baby's head smooshes together. Anyway, I feel like that's probably the biggest thing that I'm hearing lately, “My baby's too big and my provider won't let me.” Or there was a post in the community today that Meagan shared with me and she said, “Is it really possible to have a VBAC after a C-section? Because I feel like you always have to have C-sections. Is it really possible to have a vaginal birth after a C-section?” We need to remember that we live in a country and in a world where many people still have this way of thought. Many people don't question their options and many people, most people go in and just automatically schedule a C-section because that's what their provider says, that's what's most convenient, and they don't take the initiative to learn and ask questions. 13:30 Big babies, small pelvises, fluid levels, and third-trimester ultrasoundsJulie: it's a failure in the system. We were just talking about this before. Meagan, go ahead. Meagan: Yeah, I was just going to circle back around with the size thing. What I'm seeing more is people doubting their ability because we have people saying, “Well, your baby is this size,” but the reason why they are even saying that is because I'm seeing an increase in third-trimester ultrasounds. Julie: Yes. Third-trimester ultrasounds are trouble. Meagan: They are trouble. Julie: Just routine to check on baby's size and check fluids– no. Just say no to third-trimester ultrasounds unless there is a valid concern for baby. Meagan: Yeah. Yeah. It is getting me. It is getting me that I'm seeing it so often. It's just getting me irked a little bit. Julie: Gosh, Meagan, I swear though. The reason you are getting irked is because we have seen these things go south so many times. Guess what happens? They go in for a third-trimester ultrasound and there are no published statistics for this. I don't know. I haven't looked. But I feel like people go in and they get their third-trimester ultrasound and then they are like, “Well, my baby is measuring big,” and then they start to get worried like, “I don't know if I can have a big baby,” because their provider is like, “Oh, your provider is measuring big.” Their provider is saying it like that. It casts doubt. It casts that doubt in their mind and that little seed of doubt gets planted. That little seed of doubt gets nourished like, “We will let you try for a VBAC but your baby is kind of big so we will just have to see how it goes,” and then these parents get set up for wanting to have an earlier induction for big baby because they don't want their baby to get too big or just scheduling a repeat Cesarean because they are terrified of a bigger baby and the problems that a big baby could have which are not actually that many. The risk of shoulder dystocia I feel like doesn't increase significantly more with big babies. We just think it does. Smaller babies get shoulder dystocia just like bigger babies do. Or, “Oh, my fluids are too big or too little,” and those ultrasound measurements are just so inaccurate first of all, but most of what they find isn't evidence-based either. You're walking into a situation where your provider will cast doubt on you whether intentionally or not. I don't want to villainize providers because most providers I don't think have ill intentions. They are just doing what they know and doing what they are comfortable with. But that happens nonetheless. So if your provider is recommending a third-trimester ultrasound, here is something that I encourage people. Ask them, first of all, why. If they will be like, “Oh, just to check on baby and check the size.” I feel like you can politely decline unless you want to. It's fun to see your baby and things like that, but what would change? This is what you can ask your provider. “What will change in my plan of care based on what we find in the ultrasound?” What will change? What direction would shift? What answers are we looking for? What will change in my care based on what we find in the ultrasound? If your provider says, “Well, we just want to make sure that your baby is not too big,” that's a red flag. Right? Meagan: Yes. Julie: “We want to make sure your waters are okay,” which could be a legitimate reason. If you are measuring more than 10 weeks ahead or behind, it's probably a good idea to get your fluids checked by ultrasound but if you are only measuring 3 or 4 weeks ahead or behind, that's not necessarily an evidence-based reason to do that. I would just ask that. I mean, that's a good question to ask for any type of intervention or checks or whatever.17:08 How will this change my care?Julie: “You want a cervical check at 36 weeks? Okay. What would change in my care? What are we looking for? What would change in my care plan if this happens and if that happens?” because most of the time, cervical checks before labor– actually cervical checks during labor too– don't tell us anything. They don't tell us anything. I just missed a birth a month ago or about three weeks ago because a first-time mom went from 3 centimeters– she was at 3 centimeters for 12 hours and went from 3 centimeters to baby in less than an hour and a half. Cervical checks tell us nothing. Anyway, before I get off on a little more of a soapbox there. Sorry, I've been rambling. Meagan: You're just fine. I absolutely love that you pointed that out and that you specifically said that it can really apply to anything in your care. What does this thing do or how does it change my care? I just think everybody should take that nugget from this episode right now and just hold onto it tightly. Put it right in your pocket and keep that because you nailed it right there. How does this change my care? If you're getting things like she said, yeah. That's dumb. It's silly. Or with a cervical exam, it's like, “Oh, we just want to see what your BISHOP score is. We just wanted to see if you're progressing.” Why? At 36 weeks? First of all, that's preterm. Second of all, to actually be, especially if we never made it to 10 centimeters before in our first labor, the chances of us being very dilated at 36 weeks–18:47 Cervical dilationMeagan: Okay. This is going to lead me to the next thing that we see all of the time. The chances of you being dilated at 36 weeks is pretty low actually. This is something else I see that breaks my heart actually in our community and not even just in our community, in other communities, and honestly even in consults I've had people talk about this. “Oh, I'm 37 weeks or 38 weeks and I'm not dilated so my doctor is telling me that it's probably not going to happen.” Do you see this all the time, Julie? “Oh, guys. I'm so sad because I'm 38 weeks and my provider is telling me that I'm not dilated so I probably need to schedule a C-section the next week.” Women of Strength, if you are not dilated at 36, 37, 38, 39 or even 40, even 41 weeks honestly, that's okay. Your body will do it. Some bodies don't do it until they are in labor. They just don't. Julie: Yeah, and honestly at 36 or 37 weeks, anytime before labor starts and you're not dilated, guess what? Your cervix is doing exactly what it's supposed to do which is keeping your baby safe and keeping your baby in until it's ready to come out. I can't reiterate that enough. You're not supposed to be dilated before it's time for the baby to come out. I say supposed because some bodies shift and change a little bit sooner and that's okay. But whenever I was a doula, I mean I don't get to talk to people prenatally as much anymore since I'm just doing birth photography, but I would always say, “You know what? If you want a cervical check, that is totally fine. You get to decide. You get to make the choice about whether you get a cervical check or not.” But if having a cervical check, if you go in and you have a cervical check and you know that if you're not dilated at all that it is going to make you depressed and frustrated, then don't do it. If you go in and you're like, “Hey, I'm prepared to be low, hard, and closed and I just want the information because I love information,” and you are not going to be sad if you hear that you are low, hard, and closed, then sure. Get one if you want. But just know that anything beyond being low, hard, and closed is just– Meagan: Lucky, great, awesome. Julie: Lucky, sure, great and awesome, but it's also not an indicator because guess what? I've also had a client, a first-time mom, walk around at 4 centimeters dilated for 10 days and then she went into labor and had a 24-hour labor at home and ended up in a hospital transfer and a C-section. I swear. Your cervix is not telling you anything before labor and during labor most of the time, it's not telling you anything. It's telling you that you have progressed this far. It's doesn't tell you how anything is going to go in the future. It doesn't tell you how anything is going to look moving forward. It just doesn't. Meagan: Yeah. So if you are having someone tell you, “You're not dilated” or “Oh, it's probably not going to happen. You should probably schedule a C-section–”Julie: Just say, “Julie Francom said–” Meagan: If you want that, do that. But if it's not what you want, don't let someone bully you into believing that your body is not working when it's actually doing exactly what it's supposed to be doing. Julie: Exactly. that's the thing too. Sometimes at the end of pregnancy, it is hard. Being pregnant is hard. Being close to your due date is hard. Everybody is asking you, “Have you had your baby yet? What are you going to do? What are your plans for induction?” We've all been there and it is really, really hard to stay strong. I feel like some people could just benefit by just saying no. Just saying no because it's so easy if your baby is measuring big or if you feel like your cervix is hard and closed. Be like, “Aw, flip man. I'm going to be pregnant forever and my baby is going to be big and it's going to have a hard time coming out so I might as well schedule a C-section.” If you feel like you could be easily swayed by those things which a lot of people are. It's so easy to be swayed by those things, especially at the end of pregnancy. Then maybe just say no. Obviously there is nuance here so if there is a true medical need and there is some medical concern for baby or if there is some worry for your cervix being in preterm labor or things like that, obviously those are valid reasons but if it's a just because, I'm not a big fan of doing medical things just because. Meagan: Just because I agree. Yeah. Exactly. If there's no real reason, then just because doesn't. Unless you want it. Unless that's really what you want. 25:54 Due datesMeagan: Okay, so we talked about babies. We talked about dilation before due dates and can we also talk about due dates? Julie: Ew. Meagan: Ew. Julie: Yeah, just kidding. That was weird. I don't know why I said that. I'm a weirdo sometimes. Meagan: Well, due dates are hard. Due dates are a really hard topic because especially after the ARRIVE trial which Julie Francom herself wrote the blog about the ARRIVE trial if I recall. I don't think I did. I think you did.Julie: I'm pretty sure I did. Meagan: I think you did. I feel like since the ARRIVE trial, we really have seen a major shift in due dates. Julie: You mean induction? A major shift in interventions? Meagan: Well, sorry. Induction because of due dates. Julie: Right. Gotcha. Meagan: We see people at 38 weeks being checked, not dilated, being told that they either like I said, have to have a C-section or have to be induced in the next week because they are 39 weeks but really, do we have to? We do not. We do not have to. A lot of bodies do go over that 40-week mark. I think it's important to know when you are approaching your due date that you may start getting an influx of pressure to do those things, to sweep your membranes, to induce, to schedule a C-section, and I think that is something that I find frustrating. I mean, you guys, obviously as a doula, I work with a lot of pregnant people and Julie even being a photographer now, I'm sure you have situations where you are like, Oh, this person is being induced now, and now you're planning and induction. We'll get to induction in a second. But the pressure that starts coming at people at 38 or 39 weeks for induction or a scheduled C-section is unreal to me when sometimes we just need to let the body be. Julie: Yep. Meagan: Right? 28:18 Vulnerability and the ARRIVE trialJulie: I agree so much. It's so funny because we all know that induction is safe and we're going to talk about that in just a minute. It's safe for VBAC when it's necessary. it does slightly increase the risk of uterine rupture and a couple of other things, but it's frustrating when we have providers taking advantage of this vulnerable group of people. Meagan: Very vulnerable. Julie: By offering induction at 39 weeks and who doesn't not want to be pregnant anymore at 39 weeks? I think everybody. There's a small group of people who just like being pregnant and that's totally fine. I like being pregnant but by my last one, I was like, Get this baby out! I was content for baby to pick their birthdate every time, but with the last one, I was like, Get this baby out! Anyway, I feel like most providers don't think they are taking advantage of these people when they are offering 39-week inductions, but it really is. It's taking advantage of a woman in a vulnerable position and could skew their birth plans in ways that they don't want. It's hard to say no when you are that pregnant and unless you have a super strong resolve which even the strongest resolve can weaken in that type of emotional and hormonal state. It's really frustrating because we have this ARRIVE trial that was published in– what was it? It wasn't 2020. Meagan: 2019. Julie: In 2019 and the medical world jumped on that so fast. They were like, Yes. Let's induce at 39 weeks. Meagan: It was a leech situation. Julie: Yes. And then now that multiple studies have proved it invalid and it has been picked apart and even ACOG doesn't recommend that anymore. It doesn't stand by the validation of the ARRIVE trial, there have been multiple studies showing otherwise since then, but guess what? Oh my gosh. This is so frustrating. It normally takes 10-15 years for the medical community to catch on to updated information, but this one took on so fast and now it is going to take 10-15 years to undo that. Meagan: To go back. I agree. Julie: Yeah. It's frustrating. Meagan: It is. It's so frustrating. 30:44 Inducing a VBACMeagan: It's hard to see so many people, like you said, in a vulnerable state feel that pressure of induction. I think where I even struggle more is seeing people in the last weeks of their pregnancy which can be hard because they are uncomfortable and Julie wanted to get that baby out. They actually can be some of the most precious times with your other kids before your family grows and your husband before you have a baby and you are a family of three or your partner. They can be really great spaces and a place where we can really get our head in the space for labor and delivery and for birth. But we have so many people out there being scared that they are going to have to have a scheduled C-section. We know that even though evidence shows induction for VBAC is safe and reasonable, there are many people and many providers out there all over the world who absolutely refuse to induce a VBAC. They refuse and induction. It's either a scheduled C-section, spontaneous labor, or that's it. Those are your options. We see so many people out there spending these last few weeks that could be so amazing and getting ourselves in that positive headspace in frantic mode because they are trying to induce themselves. They are trying to do all of the things. Julie: Yeah, they are like, Oh my gosh. My provider is going to schedule a C-section at 40 weeks or induction at 39. Meagan: What can I do to get this baby out? Julie: Yep. Meagan: It makes my heart hurt because it just really isn't where you deserve to be in your last weeks of pregnancy. Let me tell you one thing, when you are so hyper-focused on getting your baby out, tension and cortisol is high in the body and when we are stressed, that's typically not a space where we can let our cervix go and have a baby. So when we are doing those things, we are entering a space full of tension and we are already setting ourselves up for a harder experience. Julie: Mhmm, it's true. You go in there ready to fight then your cortisol levels are high and cortisol is the opposite of oxytocin which gets baby out. Your stress hormones are fighting your baby coming out and it's not optimal. Can it happen? Yeah, sure. People do it. But it's going to be harder. Meagan: It is. Julie: It's just going to be harder. Meagan: It is. Like I said, back to the head space, it really puts us in the wrong head space. It just is not optimal. Know that if you are receiving pressure to have a baby because you're not being supported in an induction that you should just change your provider. No, really. You need to take a step back and decide if that provider is the right choice for you and if that's the right space for you to be birthing in and if what you are doing in your mind and to your body because a lot of people do some crazy things, is really what is going to be the best for your labor journey. Julie: And sometimes, people don't have that much of a choice too. Sometimes, that's the only choice you have. Sometimes, home birth is illegal in your state for VBAC even and– Meagan: You have no providers in your area. Julie: You have one hospital within 6 hours and sometimes that's going to be your only choice and it sucks that people have to choose between that and an unassisted birth at home which I feel like if you are going to have an unassisted birth at home, that's a whole other topic. You should do it because you are educated and informed and that's what you want not because you don't want to have this horrible hospital birth where you are going to have to fight the whole time. Meagan: Yeah. It's a tricky spot. To Julie's point, we understand that. There are so many people who are just flat-out restricted and they feel like they are walking in with their hands tied behind their back and just have no choice. But there are other options too. There are other options. But laboring at home a little longer or just saying no. Just saying no which is really hard. Julie: Yeah, it is really hard especially when you are in labor. Especially, maybe you have this resolve and your partner doesn't have that resolve. Maybe you can't find a doula in your area. You can't afford one. It really sucks to be your own biggest supporter and believer in birth. You have to have other people in the room who are just as resolved and want this for you as much as you do if you are birthing in that type of environment. 36:15 Julie's social media storyJulie: Okay, back to basics. What are we doing next? Oh, let me tell this story about induction. I think this is so funny because there are so many people who think that induction isn't safe and they think that induction isn't safe for a VBAC to go past 40 weeks so you have a provider who won't induce you and won't let you go past 40 weeks so what are you supposed to do? It's really interesting because I hired someone recently to post on my social media recently for my birth photography. She is a birth photographer and doula and has attended many births before. She just recently shifted over to social media and website management for birth photographers. She knows that I'm really passionate about VBAC so I want one post a week to be about VBAC. She'll write up posts for me to approve and one of the things that she wrote up for me about VBAC was things you can do to– I think it was things you can do to increase your chances of having a VBAC or something like that. In her post, she even made the comment and I'm glad I read through these all in detail because she said something that, “We know that induction isn't safe for VBAC because it increases the chance of uterine rupture.” She said in my post that is on my page that is supposed to be written in my words that induction isn't safe. I deleted it. I shot her a little message to be like, Hey, VBAC induction is safe. Does it slightly increase the risk of uterine rupture? Yeah, it does, but as long as it's managed well, the increased risks are very, very small. Meagan: Still pretty low. Julie: Yeah. It was just so funny that someone who has been in the birth world still for so long operating on more of an evidence-based side of things has that view still. I don't know. It's just interesting. We all have things that we need to learn still. Meagan: We do. We are always learning and we are even still learning here at The VBAC Link. It's just important to know that if you see information and you're like, Oh, I already know that, you still need to check it out and see if there is something new to that. 38:29 Contradicting informationMeagan: Okay, so back to the basics. We've talked about the pelvis. We've talked about induction. We're talking about due dates. We are talking about the cervix dilating. We've talked about baby sizes. What else do we have? Julie: Epidurals. Meagan: Oh yeah. Epidurals. Julie: This is so funny. The opposites. It's the same thing about the opposite. VBAC has to be induced before 40 weeks. I will not induce VBAC at all. You have to have a C-section by 40 weeks. All of these things. Epidurals are the same way. You have to have an epidural placed in order to do a VBAC and then we also have you cannot have a VBAC with an epidural. Meagan: Yeah. Yes. I've seen that. Julie: Isn't that so stupid? I'm sorry. I just think it's so stupid, all of these polarizing things. It's so funny because sorry, time out. I will let you talk about that. I promise I will let you talk about that. I think it's so funny because we know that Facebook can do so much good and it can also do so much bad. There will be a post like, “Hey, my provider said I have to have an epidural with a VBAC,” and there will be 50 comments on there and every comment will be different like, “Oh, yeah. You absolutely have to. It's safest in case you have to have an emergency C-section.” Then the next comment will say, “No, you don't. You can't because then you won't notice the signs of uterine rupture.” Everyone says something different and it's really funny because it's the same thing about the length between pregnancies or C-sections to VBAC. People will be like, “My doctor said it has to be 18 months from birth to birth. My doctor said that you can't get pregnant within a year of having a C-section. My doctor said–” or they say. I love it when people say, “They say 18 months birth to birth is best. They say don't get pregnant within 9 months. They say 2 years between births is the best.” Who is they, first of all? Who is they? Whenever someone says they, I say, “Who is they?” Because there are so many sources and everybody is so resolute in their answers. “My doctor said this. They said that this is the right answer. 6 months, 9 months, 12 months, 24 months, 3 years.”Everyone is so firm in their answers. How freaking confusing is that? Meagan: Very. Julie: P.S. the optimal range for births actually hasn't had any definitve say yet because there are different studies that show different lengths, some as short as 6 months between pregnancies. Some are as long as 24 months between births. Is it between births? Is it between pregnancies? I just laugh every time I get on Facebook and see these people who all say, “They say” in their resolve. I don't know. I just think it is so interesting and can be so overwhelming and confusing which is why we started The VBAC Link so we can bring you the evidence so that you know. Sorry, go ahead and let's talk about epidurals. I had to go on that tangent. Meagan: Well, you just brought that up and that's another big basic. When can I get pregnant? 41:36 Pregnancy intervalsMeagan: When can someone get pregnant? We'll buzz back to epidurals. Julie: Yeah, luckily we wrote a blog. We will link it in the show notes with the studies cited. Meagan: A lot of people are confused. Is it birth to birth? Is it birth to conception? Right? Julie: Yeah. Yeah. Meagan: Do you want to talk about that? I'm going to sneeze. Hold on. Julie: Yeah. It's really interesting because you are getting these different numbers– 6 months, 9 months, 24 months, 15 months. You're getting all of these different numbers then you are also getting these different ranges. Between birth to birth, so between the time when your C-section baby is born to when your VBAC or your attempted VBAC baby is born is different than from the time you have your C-section to the time you conceive the baby. 18 months birth to birth is 9 months pregnancy to pregnancy so 6 months pregnancy to pregnancy is 15 months birth to birth. Of course, everyone is confused. That's all I have to say about that. What do you want to add, Meagan? Meagan: It is confusing. It is absolutely so confusing and I think when you are talking to a provider, it's important to talk to them about their view on intervals because there are different views. People, like she said, do have different views. People will say, “If you are pregnant before 15 months from birth to conception” or not before 15, before 24 months even sometimes or before 18 months, that's not okay when it really might be from birth to birth. We do have a blog about it. We're going to link it so you can see the studies and how they view it, but I also want to point out that if you are being told you absolutely can't VBAC because you have a shorter interval, say from birth to conception is whatever, 15 months. You conceived 15 months after your C-section and providers are saying, “No, it's too close,” there are studies that show and talk about an increased risk of uterine rupture but I also want to point out that a lot of people do it with no complications. Julie: A lot of people do it. What it all comes down to is what is the acceptable level of risk to you and can you find a provider who is willing to take on that risk with you? In our blog, I'm just remembering off the top of my head. It might not be 100% true but one of our studies showed that a 6-month pregnancy interval so after you have your C-section, you get pregnant 6 months or beyond, there is no increased risk of uterine rupture. Within that 6 months, there is an increased risk of uterine rupture. I think it is 2.4% up from 0.5%. Now, a 2.4% risk, I think it's that. I think it's 2.4%. You'll have to look at the blog. I'll send you on a treasure hunt for the blog. But that level of risk might be acceptable for some parents and providers and it might not for other parents. For me, I would go totally try it. I would do it because that means I have a 97.5% chance of not having a uterine rupture. Heck yeah. That's pretty solid to me, but it might not be solid to you. That's what matters. The other one showed that an 18-month pregnancy interval is optimal. 24 months birth to birth, I think, was the other one. We are having a bunch of different ranges and all three studies that were cited the blog are credible studies. The real answer to that pregnancy interval question is we don't know what is the optimal pregnancy interval. We just don't know. They say, they will tell you– I feel like most people and most providers are about on the 18 months birth to birth side. Some providers want 12 months between pregnancies. Meagan: Yeah. I see a lot of people saying that. I even see 12-24 months or 12-18 months before conception. I see a lot of conception as well. It's just important to talk to your provider about that and when you are looking at the studies and you see a 15-month, see what it is talking about. Is it talking about C-section to VBAC or to birth or to conception? Julie: Yeah. 46:38 EpiduralsMeagan: Okay, epidurals. We were talking about it a minute ago where so many providers say, “Yes, you have to have an epidural. No, you can't have an epidural.” I think I've shared this story before. The only uterine rupture I have ever witnessed in my life was with an epidural. I'm going to guess that she probably had a delayed feeling because I'm assuming she would have felt it sooner and this pain. She felt it later on and when she felt it, it was above where the epidural site numbed so up in her rib area, up below the breast. That was where she felt it with an epidural. There weren't any heart decels or anything like that. There were other signs of things like a stalled dilation and things like that but she still felt it with an epidural. A lot of providers are telling people that they can't have an epidural. I think that this scares a lot of people. Julie: Mhmm. Meagan: Birth unmedicated can scare someone who doesn't want to birth unmedicated so the thought of going unmedicated can scare someone to the point where they are like, I'll just schedule a C-section. My point in sharing this story is that even with an epidural, you can often still feel a uterine rupture happening and there are usually other signs that are happening even before that that are pointing things out. There is a pretty, I think it's a debate in the medical world, on if epidurals actually increase Cesarean. Have you seen the blogs and different things? Julie: I absolutely do think they do. I've seen it. My gosh. Meagan: I know. I know. A lot of the evidence out there or a lot of the opinions out there on the blogs and the National Institute of Health publications and things like that show that maybe not, but then there are things that show actually it does seem like it can. Julie: I think it's how you act when you have the epidural. If you have a nurse in there who is content on changing your positions every 30 minutes or whatever, I don't know. Maybe not. Keep the pelvis moving. But if you are flat on your back for 20 hours, then yeah. It probably increased that risk. Meagan: Yeah. There's not a lot of evidence showing that it for sure does increase the risk of Cesareans but as doulas and people who have gone into a lot of births– obviously, there are a lot of providers who have gone to way more births than we have as doulas. I don't know if it's a cause, but it does seem to correlate. It can correlate and there are a lot of different things. We see an epidural come into play and I actually have seen moms dilate really fast. I have seen an epidural be the best tool–Julie: That's true. That's true. Meagan: –for a laborer to get a vaginal birth. I really, really, really have seen this, and not even just vaginal birth after Cesarean, just vaginal birth. Julie: That's true. There is a lot of nuance there for sure. Meagan: But to what you are saying, a lot of the time it really does depend on what comes after the epidural. A lot of the time after an epidural comes in, we know that there are two things for sure that have a higher chance of happening. One, you have a higher chance of sitting and doing nothing. Just hanging out like Julie said. Not really moving, working with the pelvic dynamics, and getting baby out and down. And two, we know that PItocin often comes into play after an epidural because a lot of the time, it can stall labor. We want to get labor going again and sometimes instead of just waiting and letting the body– I use the body acclimate a lot, but really, the body has to acclimate so much in labor. We are going from home to a hospital. We have to acclimate from that place to the car to the hospital and then we are getting there and we are not even just acclimating to that space. We are acclimating to new voices. Julie: Mhmm, new smells, new sensations, new temperature, new germs– that's probably not really a thing. Meagan: Yeah. It's not even just being in a different place. It's all of the things that come with the different place. So we get an epidural and our body is like, Oh, cool. I can rest. This is my opinion, okay? I don't have any research to show this. But my opinion is that when an epidural is placed and a body “stalls”, that is our body saying, “Thank you. I'm going to take this opportunity to rest.” Can it continue laboring at some point? Yes. Will it always? Maybe not. Maybe Pitocin does need to come into play at that point because it has decreased our bodies' ability to register and acclimate, but sometimes I feel like with getting the epidural, we need to just acclimate to that and see what happens versus just immediately starting Pitocin and acclimate to new ways to change. But yeah, did you want to say anything, Julie?Julie: It's interesting because I like that and I feel like sometimes that is exactly what a body needs maybe not necessarily for the body as much as for the psyche to just be able to rest and relax and let go because a tense body and a tense mind sometimes isn't going to be very efficient at laboring because of that. Again, we talked about this before with the cortisol levels so if you can get someone to relax easier and let the body take over what it is supposed to do intuitively or instinctually– and it doesn't always and it's okay if it doesn't and it's okay if we need other things to help us, but sometimes just that rest and relaxation and that 30-minute power nap is exactly what the body needs to continue on throughout the rest of it. I think a lot of people when they are going for a VBAC think they need to go unmedicated to have their best chances. While yeah, that may or may not be true, it just is completely dependent on the person and the labor and how things go and how long it is and all of those types of things. I just think about the cascade of interventions. 54:13 Allowing for nuanceJulie: I was going off on a daydream over here when you were talking about the cascade of interventions because we always demonize that a little bit or villainize it like, Oh, the cascade of interventions as soon as you get to the hospital or as soon as you get the epidural or as soon as you whatever. You know, it's true. We've seen it a dozen times, but I've also seen the cascade of interventions help parents have the exact birth that they wanted as well. So like with all things in birth, there is that nuance there. I've used the word nuance a lot and I feel like maybe it's a thing for my life lately and everything that we have to allow for the nuance and we can't be super rigid in our thinking. I think maybe at the beginning of The VBAC Link, Meagan, you and I did a lot of that villainizing of the cascade of interventions. But as we have grown and talked more to people and had more experience as doulas and in the birth space, I feel like we are allowing ourselves to be a little more fluid in that thinking and allow for that nuance to come into play. Meagan: Yes. Yes. 100%. Julie: But I will say this. I will say this with 200% certainty, okay? There is no nuance allowed here. People who tell you that you have to have an epidural for a VBAC are 100% full of crap. This is why. Because the reason why they say you have to have, and I say “they say”, I'm saying they like your provider or anyone who says that. The reason why is because in case of a uterine rupture, the epidural is already placed and they can get you back for a C-section faster and not have to put you under general anesthesia which is riskier. That is true. General anesthesia is riskier than an epidural. That is 100% true. It is safer overall to have an epidural for your C-section than it is to go under general anesthesia. Now, here is where I call B.S. because even with an epidural placed and dosed, when you have an epidural going, it is not at the strength it needs to be in order to do a C-section without feeling any pain. Meagan: It's not enough. Julie: From the moment the epidural is dosed up, now keep in mind it takes time for the anesthesiologist to come in and everything like that too, you're looking at a minimum of 12 minutes if the anesthesiologist is there and pushing the bolus. 12 minutes for the epidural to take effect enough to have surgery. Now, listen to me. If it is a true emergency and a catastrophic uterine rupture, you do not have 12 minutes to save the baby. You will be put under general anesthesia because minutes matter. Seconds matter in those true emergent situations. So, Karen, if you have an epidural placed and it's a true emergency, then you will have to be put under general anesthesia. If it's not a true emergency, then guess what? You have enough time for a spinal block which takes effect in about 3-5 minutes. Go into the OR. You can still have your baby out in 15 minutes or more but usually what we see called an emergency C-section, they're like, “All right. Baby's heart rate is not looking good. Let's get the doctor in here. Let's have you put your scrubs on. Oh, look Dad. Let's get your scrubs on.” You get dressed and you are getting wheeled in the OR 45 minutes later, that's not an emergency. Having an epidural placed when you don't want one or need one– some people need one and some people want one and that's fine. Having an epidural placed is preparing you for surgery. It's preparing you for surgery. That's why I say there is no room for nuance because you just can't magically make an epidural surgical strength in minutes. You just can't. There's no nuance there. It doesn't happen. Meagan: Okay. We'll just end right there. You guys, there are so many things but hopefully, we covered a lot of the basics. Know that you always have options even if you feel like sometimes you don't have options, there probably is another option there. It's crazy, but there really is so keep looking at your options. Look at your blog. Look at the show notes. We'll create and leave the links today. Check out our How to VBAC course. It's going to cover a lot of information and help you hopefully find the right stats and evidence-based information so when you see posts on Facebook or TikTok or anything like that that are saying things like, “If your baby's cord was wrapped around their neck the first time, you can't have a VBAC the second time,” or if you are told that your pelvis was too small the first time and you can't have a VBAC or going on and on, that you will be able to know the evidence-based information. All right, okay. All right. Julie: Yeah. Meagan: See you guys later. Julie: Bye! ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Our Sponsors:* Check out Dr. Mom Butt Balm: drmombuttbalm.comSupport this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
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This week Zorba and Karl look at new research that shows Ozempic cuts the risk of chronic kidney disease complications, and they discuss new research that supports epidurals are linked […]
This week Zorba and Karl look at new research that shows Ozempic cuts the risk of chronic kidney disease complications, and they discuss new research that supports epidurals are linked […]
In this information packed episode, Erin sits down with her friend Dr. Courtney Kahla, Nervous System Chiropractor, to discuss all things baby – tongue ties, plagiocephaly, belly sleeping, breastfeeding, chiropractic care, epidurals and more. Connect with Courtney: Dr. Courtney Kahla's Instagram OUR WELL HOUSE Instagram Nervous System Chiro Directory Instagram Dr. Courtney Kahla's Website OUR WELL HOUSE Website Connect with me: Instagram Website About Courtney: Dr. Courtney is a wife, mother, Doctor of Chiropractic and the owner + founder of Our Well House in Frisco, TX. She specializes in fertility, preconception, prenatal, pediatric, women's health and whole family wellness. Her firm belief in the body as self-healing and self-regulating permeates her online presence as she shares health + wellness from a normal human physiology perspective which is often backed by peer-reviewed literature, natural living, and her raw, real, and vulnerable heart as she navigates everything life brings. She has made it her mission to empower others to take control of their health by living a lifestyle that honors their God-given innate ability to heal.
In this episode of MamasteFit Podcast's Birth Story Friday, Megan shares her experiences with two hospital births with epidurals. Megan shares about the challenges of having a short pregnancy interval (finding out she was pregnant again at 5 months postpartum with her first), and how it impacted her birth preparation for her second child. Megan recalls how prenatal workouts and a childbirth education course helped prepare her for motherhood. She details her labor and delivery stories, including the support from Gina as her doula, and the changes in care from the first to the second birth, emphasizing the impact of a midwife's emotional support. The episode also covers Megan's postpartum recovery, her journey back to fitness, and her efforts to connect with herself outside of parenthood again, reflecting on the long-lasting effects of pregnancy and the importance of adjusting expectations for postpartum recovery. Check out Megan's podcast here: https://podcasters.spotify.com/pod/show/montessorimomsinthewild And find Montessori Moms in the Wild on Instagram here: https://www.instagram.com/montessorimomsinthewild?utm_source=ig_web_button_share_sheet&igsh=ZDNlZDc0MzIxNw== 00:00 Welcome & Megan's Birth Story Introduction 00:25 Announcing 'Training for Two' Book Pre-Order 01:26 Meet the Hosts: Empowering Your Perinatal Journey 02:40 Megan's First Pregnancy Preparation & Birth Experience 20:24 Unexpected Second Pregnancy & Initial Reactions 22:45 Discovering Pregnancy While Nursing 23:10 Navigating Pregnancy and Birth During 2020 25:08 A Different Birth Experience with a Midwife 32:43 Postpartum Reflections and Recovery 34:02 Embarking on New Challenges: Training for a Half Marathon 34:19 Ultra Marathons: Going Beyond the Limits 36:34 Sharing Birth Stories and Podcasting on Parenthood 38:18 Prenatal and Postpartum Fitness Trainer Certification Course Review 40:40 Staying Hydrated During Pregnancy with LMNT 41:50 Supporting Your Pregnancy, Postpartum, and Beyond —— Try LMNT hydration support for yourself at drinkLMNT.com/mamaste https://partners.drinklmnt.com/free-gift-with-purchase?utm_campaign=agwp&rfsn=5986352.39a795&utm_medium=affiliate&utm_source=mamaste&utm_content=&utm_term=&rfsn_cn=EXCLUSIVE+GIFT+FOR+THE+MAMASTE+COMMUNITY ----- Pre-Order Training for Two on Amazon: https://amzn.to/3VOTdwH —— This podcast is sponsored by Needed, a nutrition company focused on optimal nourishment for your perinatal journey. Use code MAMASTEPOD for 20% off your first order or three months of subscription. ****Freebies***** Early postpartum recovery course: https://mamastefit.com/freebies/early-postpartum-recovery-guide/ Pp sample https://mamastefit.com/freebies/postpartum-fitness-guide/ Prenatal Sample: https://mamastefit.com/freebies/prenatal-fitness-program-guide/ Pelvic Floor https://mamastefit.com/freebies/prepare-your-pelvic-floor-for-labor/ Birth Prep for Labor Guide https://mamastefit.com/freebies/prepare-for-labor-guide/ Birth Partner Guide https://mamastefit.com/freebies/birth-partner-guide/ Birth Plan https://mamastefit.com/freebies/birth-plan-guide/
In this Rapid Fire Friday episode I am off-the-cuff answering questions all about epidurals in labor. As a labor and delivery nurse of over 10 years, I have a lot to say about epidurals! In today's episode, I'll be addressing questions such as: - 3 months PP and still have pain in my back from my epidural. Had a horrible experience. The lady had to redo my epidural 3 times.- I know I want to get an epidural. When is the best time to get it?-My epidrual wore off after 1.5 hrs. Got 2nd epidural and same thing. PTSD. What do I do next time? -Can you talk about the effects of IV meds vs Epidural on baby? In a debate with a friend....and more! Connect with Heather:@alifeinlaborhttps://alifeinlabor.comResources Mentioned in the episode:The Empowered Birth AcademyEnjoy Your Birth Ebook - FREEJoin the Conversation: The Labor Room Facebook group is a place to connect with other moms for support.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.com*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.
Sierra Schultzzie, Riayn Christina & Paloma Malfavon enjoy one last episode before Sierra's maternity leave! They chat the realities of giving birth, IUD's and more!Find Twenty Whatever on Other Podcast Platforms//Youtube: https://www.youtube.com/channel/UCW7gxdcCY7rDteu3VRj7K3w Apple Podcasts: https://podcasts.apple.com/us/podcast/id1470690716 Google Podcasts: https://www.google.com/podcasts?feed=aHR0cHM6Ly9hbmNob3IuZm0vcy9jNjFmODgwL3BvZGNhc3QvcnNzWoo Girl Minute!We will pull comments from Youtube, IG, & this Google Form
Rhea Dempsey is one of the foremost thinkers on the topic of working with pain in childbirth. She shares with Adriana the physiological purpose of pain during labor, why it gets such a bad rap, and suggests the pain relief paradigm is a medical construct that undermines our capacity for peak performance and body potency that ultimately facilitates birth. In other words: bring it on!Sponsor offers - TIME SENSITIVE! BIRTH CLASS RETREAT - Get an amazing 10% off at BirthClassRetreat.com with code BIRTHFULNEEDED - Get 20% off at ThisIsNeeded.com with code BIRTHFULHONEYLOVE - Get 20% off at HoneyLove.com/Birthful JENNI KAYNE - Get 15% off at JenniKayne.com/Birthful with code BIRTHFUL15ONESKIN - Get 15% off at https://www.OneSkin.co/ with code BIRTHFULHOMETHREADS - Visit HomeThreads.com/birthful to get a 15% off code for your first order!FAMILYALBUM APP - Download the app for free, wherever you get your apps! AQUATRU - Get 20% off at AquaTru.com with code BIRTHFULMY LIFE IN A BOOK - Get 10% off at MyLifeInABook.com with code BIRTHFULGet the most out of this episode by checking out the resources, transcript, and links listed on its show notes page.If you liked this episode, listen to our interview on Working with Childbirth Pain and our episode on Epidurals and Breastfeeding. You can connect with Rhea on Instagram @rheadempseybirth. You can connect with Birthful @BirthfulPodcast and email us at podcast@Birthful.com. If you enjoy what you hear, download Birthful's Postpartum Plan FREE when you sign up for our weekly newsletter! You can also sign up for Adriana's Own Your Birth online BIRTH preparation classes and her Thrive with Your Newborn online POSTPARTUM preparation course at BirthfulCourses.com.Follow us on Goodpods, Apple Podcasts, Amazon Music, Spotify, and anywhere you listen to podcasts.Our Sponsors:* Visit HomeThreads.com/BIRTHFUL today and get a 15% off code for your first order!Support this podcast at — https://redcircle.com/birthful/donationsAdvertising Inquiries: https://redcircle.com/brands
Experience the intrigue of unraveling the complexities of sciatica with Dr. Paul Bagi and Dr. Steve Aydin as they take us on an insightful journey through the symptoms and risk factors of this common condition. Uncover the silent contributors to back pain, from our daily activities and habits to lumbar disc problems, and learn how they interplay with age and occupation to leave us vulnerable. Knowledge is power, and this episode equips you with an understanding of how posture and spinal alignment directly impact your comfort and health, setting the stage for an empowering discussion that could change the way you manage back pain.Feel a wave of hope wash over you as our experts illuminate the transformative potential of physical therapy and proper muscle support for spinal health. Together with Dr. Bagi and Dr. Steven Aydin, we navigate the delicate intricacies of the spine's natural curvature and the pivotal role these structures play in our overall well-being. Their conversation moves beyond mere theory, offering real-world insights into the progression of treatments for sciatica, from trigger point injections to the cutting-edge advances in less invasive spine surgeries. Discover the evolving landscape of back pain management where individualized care promises better outcomes, less discomfort, and a quicker path to recovery.Cap off this informative session with a deep dive into the latest breakthroughs in interventional pain management and endoscopic spine surgery techniques. As our esteemed guests articulate the careful balance between intervention and the body's innate healing processes, you will gain a fresh perspective on pain management that prioritizes patient safety and optimized recovery. By the end of our dialogue, you'll be motivated by the promise of current and emerging treatments that not only alleviate pain but transform lives. This is a must-listen episode for anyone touched by the shadow of back pain—patients and practitioners alike will find valuable takeaways to carry into their journey towards a pain-free existence. Support the show
Hearing about risk is hard. Interpreting risk is even harder, but deciding which risks are comfortable for you is an essential part of birth!Meagan and Julie discuss how to tell the difference between relative and absolute risk, and what kind of conversations to have with your provider to help you better understand what the numbers mean. They also quote many stats and risk percentages around topics like blood transfusions, uterine rupture, eating during labor, epidurals, Pitocin, AROM, and episiotomies. And if you don't feel comfortable with accepting a certain risk, that is OKAY. We support your birthing in the way that feels best to you!Risk of Uterine Rupture with Vaginal Birth after Cesarean in Twin GestationsJournal of Perinatal Education ArticleWhat are the chances of being struck by lightning?Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details 02:52 Review of the Week06:08 Determining acceptable risk for you and your provider 08:00 Absolute versus relative risk15:21 More conversations need to happen25:29 Risk of blood transfusion in VBAC, second C-section, and third C-section30:37 Understanding the meaning of statistical significance 32:05 “The United States is intervention intensive” 36:27 Eating during labor and the risk of aspiration under anesthesia43:03 Epidurals, Pitocin, AROM, episiotomies, and C-section percentages44:43 The perspective of birth doulas and birth photographersMeagan: Hello, hello everybody. Guess who I have today? Julie!Julie: Hello. Meagan: Hello. It's so good to have you on today. Julie: Of course. It's always fun to be here. Meagan: It really is. It's so fun. When we sit and chat before, it just feels so comfortable like that is the norm still for me even though it has been a while, it just feels so normal and I love it. I miss you and I love you and I am so excited to be here with you today. You guys, we are going to talk a little bit about risk. We know that in the VBAC world, there's a lot of risk that comes up. I should say a lot of talk about risk that comes up whether it be is it safe to even have a VBAC? Is it safe to be induced? What are our real risks of uterine rupture? Is it safe to VBAC with an epidural or without an epidural? What about at home out of the hospital? Is that safe? I don't know. Let's talk about that today. Julie: Let's talk about it. Meagan: Let's talk about it. I think it's really important to note that no matter what— and we're going to talk about this for sure today, but no matter what, you have to take the risks that you are presented and that is given and still decide what's best for you. That risk doesn't mean that is what you have to or can't do. Right? So I think while you are listening, be mindful or kind of keep that in the back of your mind of, “Okay, I'm hearing. I'm learning.” Let's figure out what this really means and then let's figure out what's truly best for you and your baby.02:52 Review of the WeekI do have a Review of the Week so I want to hurry and read that, then Julie and I will dive into risk and assessing. Julie: Dun dun, we're ready. Meagan: We are ready. Okay, holy cow. This is a really long review, so—Julie: You can do it. Meagan: Thank you to Sara R-2019 on Apple Podcasts for leaving this review. I love how Julie was like, “You can do it,” because she knows that I get ahead of what I'm reading in my mind and then I can't read, so let's see how many times it takes to read this review. Julie: You've got this. Meagan: Okay. It says, “A balanced and positive perspective.” It says, “As a physician myself I think it is unusual to find balanced resources for patients that represent the medical facts but also the patient experience and correct for some of the inaccuracies in medicine. This podcast does an amazing job of striking this balance!“I had an emergency C-section with my daughter 2 years ago. Despite understanding that the CS was medically appropriate and my professional experience, I still found the whole experience to be mildly traumatic and disappointing. This podcast was the main resource I used to help prepare for my second child's birth and my plan to have a VBAC. I am now holding my new baby in my arms with so much pride, love, self-confidence, and trust because I had a smooth and successful VBAC.“I am thankful for this podcast which gave me ideas, confidence, strength, and a sense of community in what is otherwise a very isolating experience. I especially appreciate the variety of stories that are shared, including VBAC attempts that result in another C section so that we can all prepare ourselves for the different outcomes. No matter what happens we are strong women and have a welcome spot in this community, even when we may feel alone with our thoughts and fears. Thank you, Julie and Meagan!Julie: Aw, I love that. Meagan: Yes, that was phenomenal. Congratulations Sara R-2019. If you are still listening here, congratulations and we are so happy for you and thank you for your amazing review. 06:08 Determining acceptable risk for you and your providerMeagan: All right, Julie. Are you ready? Julie: Here we go. Here we go. Can I talk for a minute about something you mentioned before the review? You were talking about risk and how it's not a one-size-fits-all because we were talking about this before. We all know that the uterine rupture risk is anywhere between .2%-1% or whatever depending on the study and what you look at. The general consensus among the medical community is .5%-1% is kind of where we are sitting, right? Now, some people might look at that risk and be like, “Heck yeah. That's awesome. Let's do this,” especially when you look at a lower risk than that that it's a catastrophic rupture. Some people might look at those numbers and be like, “This feels safe. Let's go.” Some people might look at those numbers and be like, “This feels scary. I just want to schedule a C-section.” Meagan: No, thank you. Julie: And that's okay. It is okay. However you approach risk and however you look at it is okay. We're not here to try and sway anybody. Obviously, we're The VBAC Link, so we are going to be big advocates for VBAC access, right? But we're also advocates for having all of the information so you can make the best decision no matter what that looks like. But also, I think another very important part of that is finding a provider whose view of risk is similar to your view of risk so that you guys have a similar way to approach things because if you find a provider who thinks that 1% risk of VBAC is really scary, it's not going to go good for you if you think a 1% risk for a VBAC is acceptable. So yeah, I just want to lay that out there in the beginning. Meagan, you touched on it in the beginning, but I feel like provider choice in risk is really important there. Meagan: It is. Julie: For sure. 08:00 Absolute versus relative riskMeagan: It is and also, one of the things we wanted to talk a lot about is absolute risk versus relative. So many times when people, not even just the actual percentage or 1 out of 5 is shared, it's the way it's shared. The way the words are rolling off of the tongue and coming out can be shared in a scarier way so when we say 1 out of 5, you're like, “Okay, that's a very small number. I could easily be one of those 5's.” It's the way these providers sometimes say it. A lot of the time, that's based on their own experience because now they are like, “Well, I am sharing this number, but I'm sharing a little extra behind the number because I've had the experience that was maybe poor or less ideal.” Does this make sense? Julie: Yeah. Meagan: Sometimes the way we say things makes that number seem even bigger or even worse or scarier. Julie: Right. It really comes down to absolute risk versus relative risk, right? Relative is your risk in relation to another thing that has risk. Absolute risk is the actual number. It's like 1 in 10. That is an absolute risk. You have a 1 in 100 chance of uterine rupture. That is an absolute risk. Your chance of uterine rupture doubles after three Cesareans. That's not true. That's not true. But that's a relative risk. I really like the example that I feel is really common for people to relate to is stillbirth after X amount of weeks. Evidence-Based–Meagan: That's a huge one. Julie: Yeah, it's a big one that gets thrown around all of the time and it sounds really scary when people say it. I love Evidence Based Birth. They have this whole article about due dates and risks associated with due dates and why due dates should really be adjusted and look at differently. They don't say that. They just present all of the data, but what I really like about that is they have a section here about stillbirth and they talk about absolute risk versus relative risk. I feel like that would be a great thing to start with. I'm just going to read it because it's so well-written. They said, “If someone said that the risk of having a stillbirth at 42 weeks compared to 41 weeks is 94% higher, then that sounds like a lot.” Your risk of stillbirth doubles at 42 weeks than if you were to just get induced at 41 weeks. Your baby is twice as likely to be stillborn if you go to 42 weeks. Meagan: Terrifying. Julie: Okay? 94% higher. That's almost double. That is scary. For me, I'd be like, “Uh, yeah. That is super scary.” Meagan: Done. Sign me up for induction. Julie: Right? Sign me up for induction. But when you consider the actual risks or the absolute risks, let's just talk about those numbers. 1.7 per 1,000 births if they are at 41 weeks. Stillbirth is 1.7 per 1000 births. At 42 weeks, it's 3.2 per 1000 so it's a .17% chance versus a .3% chance so you are still looking at really, really, really small numbers there. So yeah, it's true. 3.2 is almost double of 1.7 if you do the math. Sometimes math is hard so that's fine. We have to get out the calculator sometimes, but while it's true to say the risk of stillbirth almost doubles at 42 weeks, it could be kind of misleading if you're not looking at the actual numbers behind it. So I think that it's really important when we're talking about risks and the numbers and statistics to understand that there are different ways of measuring them and different ways of looking at them and different ways of how they're even calculated sometimes. So depending on how you look at them, you could even come up with different risks or different rates which can really sway your decision. We're not talking about a 5%-10% double which is still true. It's still double, but it's just a really small number. Now, I also want to do a plug-in for people who have been in that .3%. It might as well be 100%. I can't even imagine the trauma of having to have a loss like that. I can't. I have supported parents through that. I have documented families like that and documented their sweet babies for them. I can't imagine the pain that goes with that. But I also think it is very important to look at the actual numbers when you are making a decision. Now, maybe that .32% is too high for you and that's okay, but maybe it's not and that is a risk you are willing to accept. I feel like approaching it like that is so much better. If somebody ever says to you, “This risk of that is double” or whatever, I don't know. I'm just going to make up some random stuff here like, “If you drive in your car to school, you have a 1 in 10 chance of getting in a car crash but if you drive on a Wednesday, your risk doubles so now you have a 2 in 10 chance or 1 in 5 chance of getting in the car crash,” so maybe you would want to avoid driving to school on Wednesdays, but maybe you wouldn't. But if you say you're risk is higher of dying in a car crash if you go to school on Wednesdays, they would be like, “I'm not leaving the house on Wednesdays or ever.” I'm not leaving the house today because it's so dog-gone cold and I'm warm in my blanket. I don't know. I feel like looking at it like that. Actually, 1 in 10 is really high for getting in a car crash, but I don't know. I just feel like looking at that is really important for providers telling you, “Oh, your risk of uterine rupture doubles if we use Pitocin so I'm not going to use Pitocin.” Okay, we're looking at a small increase to an already small risk. We know that any type of artificial induction could lead to an increased risk of uterine rupture especially if it's mismanaged, but what we do know is that it's not– I don't want to say that because that might be wrong. When you are presented with the actual numbers, yes. It might double. I don't know what the actual numbers are, to be honest off the top of my head. I feel like maybe it doubles, but if you are already looking at a .2% to a .4% or a .5% to a 1% chance, what's the tradeoff there? What are your risks of just scheduling a repeat C-section instead of doing an induction? Is that worth it to you? What are the risks associated with repeat Cesareans? Are they bigger than that of using Pitocin to induce labor? What is that compared to the other one because there is another that is relative risk? The absolute risk is what the percentage is. I'm not even going to say the number. But if there's a risk of rupture using Pitocin relative to the risks that come with repeat Cesareans, those are risks that are relative to each other, so how does that compare? Because when we talk about it in just that singular form or that singular amount of risk without considering the other risks that might be associated with it because of the decisions we made from that risk– am I making sense here? Then you know, I don't know. I feel like there is just a lot more conversation to have sometimes when we are talking about risk. 15:21 More conversations need to happenMeagan: Yes. There are. There is a ton more conversation and that is what I feel like we don't see happening. There's a quick conversation. Studies show that 7 minutes are spent in our prenatal visits which is not a lot of time to really dive into the depths of risk that we are talking about when we say, “We can't induce you because Pitocin increases–”. This is another thing I've noticed is significantly. You have a serious–. Again, it comes down to the words we are using. Sometimes in these prenatal visits with our providers, we do not have the time to actually break down the numbers and we're just saying, “Well, you have a significantly higher risk with Pitocin of uterine rupture so we won't do that.” When we hear significantly, what do we do? We're like, “Ahh, that is big.” You know? Julie: Yeah. Meagan: We're just not having the conversation of risk enough and again, it's kind of being skewed sometimes by words and emotion. We were talking about this before. I remember we made a post– I don't know, probably a year and a half ago maybe. It seems like a while ago about the risk of complications in a repeat Cesarean meaning you have a C-section and then instead of going for a VBAC, you go for a repeat Cesarean which as you know, if you've been with us, is totally fine and respected here from The VBAC Link. A lot of the time, we don't talk– and when I say we, I mean the world. We don't talk about the actual risk of having a repeat Cesarean, right? Don't you feel like that, Julie? I don't know. As a doula, I feel like our clients who want to go for VBAC know a little bit more of the risk of having a VBAC, but they have not been discussed at all really with the risk surrounding a repeat Cesarean. We made a post talking about the risks of repeat Cesarean and I very vividly remember a lot of people coming at us with feeling that we were fearmongering.Julie: Or shaming. Meagan: Shaming, yep. A lot of people were feeling shamed or disrespected. People would say, “You claim to be CBAC supportive, but here you are making these really, really scary numbers.” Anyway, looking at that post and going into what we've talked about, in some of those posts, we did say things like, “You are going to have a 1 out of 10 chance of X, Y, Z,”Julie: Or twice as likely to need this. Twice as likely to need a blood transfusion or 5x more likely to have major complications. Things like that. Meagan: Yeah. We would say things like that. I remember specifically in regards to miscarriage. It's a very, very sensitive topic, but there are risks there. So a lot of people were triggered. In the beginning, we talked about the way providers say things and the way they put them out on paper and the absolute risk versus the relative and way they do that. We're guilty of that too. Right here at The VBAC Link, we were like, “This is the chance. These are the chances. You are 5x more likely to X, Y, Z.” So know that I don't want to make it sound like we are shaming anybody else for the different ways that they give the message of risk. Am I making sense? Julie: Yeah, and you know what? I feel like sometimes it's just about giving people the benefit of the doubt. We want to give providers the benefit of the doubt just because it's probably something that they've continuously heard and spoken and that's okay because we do it too sometimes. We go on that thing like, “Oh my gosh, maternal death.” I think the risk of maternal death is 10x higher in a C-section than it is in a VBAC which sounds really scary and makes me never ever want to have a C-section again, but when you look at that, it's .00001% to .0001% or whatever is 10x more. It is such a small level of risk, but it is higher. I feel like trying to look at both absolute and relative risk for any given thing together is really, really important. Yeah. Give people the benefit of the doubt. Give us the benefit of the doubt. We are in such an awful cultural climate right now where it's easy for people, especially on social media to jump on the attack train for anybody when we feel triggered or when we feel like people are being unjust to us or to other people and I hate that so stinking bad. Whenever I catch myself with those feelings, I try to take a step back and I've actually gotten pretty good at that, but it's so easy for us to get on that bandwagon of just railing against people who present information in certain ways or railing people without getting all of the information about that person.Before I go off too much on a soapbox in that direction, yeah. I feel like your provider when they are saying those things is probably not trying to coerce you into anything. Our providers, especially our hospital providers are incredibly overworked. They are incredibly stressed. Their time management skills have got to be off the charts because they are so overloaded with everything and they just don't have time to automatically sit down and explain things. But you know what I have found? Most of them, when you stop them and ask questions, they are more than happy to answer and explain. Sometimes, they are just repeating things they have heard all the time or that they have learned at some point or another without giving them a second glance. Do you know what? We all do that too. Me, Meagan, you listening right now. We all do that. We hear things. We regurgitate them. We hear things. We regurgitate them and we don't even think about questioning or challenging those things until somebody else brings it up to us to question or challenge those things. So, don't be afraid to ask your provider for more information or ask them what the real numbers are to those things. I have a really special place in my heart for our CBAC moms because there are lots of things that they are working through, so many emotional things, but I challenge not just people who have had a repeat Cesarean that was unwanted, but people just in all life, when something triggers you online, stop and explore that. Stop and question because that is probably an area of your life that you could use a little healing and work on. It could be a little bit of work. It could be a lot of work, but usually, when something triggers you, it's a challenge to look into it more because there is something that your body and mind have an unhealthy relationship with that needs to be addressed. Julie: Anyways, circling it back to risk. Meagan, take it away. Meagan: I just want to drop a shameless plug on our radical acceptance episodes that we did, so kind of piggybacking off of what she just said. We dive into that a little bit deeper in our radical acceptance episode. It really is so hard and like what she said, our heart goes out to moms that have a scheduled C-section that didn't want to schedule a C-section or felt like they were in a corner or felt like that was the best option, but not the option they wanted. There are so many feelings, but definitely go listen to radical acceptance part one and part two. 25:29 Risk of blood transfusion in VBAC, second C-section, and third C-sectionMeagan: I just want to quickly go down a couple of little risks. Blood transfusion– we have a 1.89% or 1 in 53 chance of a blood transfusion with a VBAC. To me, 1.89% is pretty low, to me, but it might not be to some. I don't know, Julie. How do you say the other? Okay, then blood transfusion in a repeat Cesarean is 1.65% in the second C-section. It's lower. So for vaginal birth, it's higher. I'm not good at math. Julie: No, vaginal birth, yeah. That's true. So 1 in 53 for VBAC versus a 1 in 65 for a repeat Cesarean. Yes, right. Meagan: For a third Cesarean, the chances of a blood transfusion go to 2.26%. Julie: Yes, so it's like 50% higher than if you have a VBAC for the third Cesarean, but it's slightly lower for the second C-section. See? I feel like we could have talked about this before, but I don't know if we say it often enough. When you are talking about overall risk for VBAC versus C-section, when you are looking at just the second birth, right? So first birth was a C-section, what are you going to do for your second birth? The risks overall are pretty similar for vaginal birth versus Cesarean. The overall total risk is pretty similar as far as your chances of having major complications and things like that. But when you get into three, four, five, six C-sections and vaginal births, that's when you really start to see significant changes in those risks. See? I used the word “significant” again, but we're going to talk about where the more C-sections you have, the higher your chances of having complications you have. The more vaginal births you have, your chances of complications actually go down. So when you are looking at if you want more than two kids, that might be something that you want to consider. If you are done with two kids, then that might be something that is not as big of a player in your choices. So yeah. Meagan: Yeah. Then there are things like twins. So when I was talking about it earlier, the word significantly, there was a systematic– I almost said something– systemic. Julie: Systemic review? Meagan: Yeah, see? I can't say it correctly. I can't. Published– oh, I'm trying to remember when it was published. We will get it in the show notes. It talks about the risk of uterine rupture with twins and it does say. It says “significantly higher in women with twin gestation”. That's kind of hard, I feel like because again, like we were saying, some reviews and studies and blogs and all of these things wouldn't say the word significantly. They may share a different one. I'm going to see if I can find the actual– maybe Julie can help me while I'm talking– study. Okay, it says three out of four studies in a group of zero cases of uterine rupture. Notably, the study with the largest patient population reported cases of uterine rupture in both groups and demonstrated a significantly greater risk of uterine rupture in the VBAC group. Meanwhile, the other three studies found no significant difference between rates of uterine rupture among groups 31-33. Nevertheless, the study shows that electing–”Okay, so I'm just going to say. It says, “Electing to have a PRCD reduces but does not eliminate the small risk of uterine rupture.” So what I'm reading here is that in some of them, it showed significantly greater, but then in 3 out of 4 reviews, and I don't even know actually how many people were in each of these reviews, but in 4 reviews, one had a greater risk and three didn't really show much of a difference, but we see that in the very beginning right here. “Uterine rupture is significantly higher in women with twins.” What do you think? If you are carrying twins and you see that, Julie, significantly higher enters into the vocabulary at all, what do you think?Julie: Well, I think I would want to schedule a C-section for my twins, probably. Meagan: Probably. 30:37 Understanding the meaning of statistical significance Julie: I want to just go off on a little tangent here for a second. I think it's really important when we are talking about studies that we know what statistically significant means because sometimes if you don't know much about digging into studies and things like that which I'm not going to go into too much right now– Meagan: It's difficult. Julie: It is difficult. It's really hard which is why I'm not going to go into it because I feel like we could have a whole hour-long podcast just for that. Statistically significant really just means that the difference or the increase or the change that they are looking into is not likely to be explained by chance or by random numbers which is why when you have a larger study, the results are more likely to be statistically significant because there is less room for error basically. A .1% increase can be just as statistically significant as a 300% increase because it just comes down to whether they are confident that it is a result that is not related to any chance or external environmental factors. I feel like it's really important to clarify that just because something is statistically significant doesn't mean that it's big, catastrophic, or a lot, it just means that it's not likely to be due to chance or anything random. 32:05 “The United States is intervention intensive.” Meagan: Yeah. I love that. Okay. There was one other thing I wanted to share. This was published in the Journal of Perinatal Education and it is a little more dated. It's been 10 years or so, but I just wanted to read it because it was really interesting to me. It doesn't even exactly go with risk and things, but it just talks about your chances which I guess, to me– do you know what I”m trying to say? Julie: They kind of go hand in hand. Meagan: To me, at least, they do. So when I read this, I was like, “Well, this is interesting.” I just wanted to drop it here and I think it's more just eye-opening. It says, “Maternity care in the United States is intervention intensive.” Now, if we didn't know this already, I don't know where I've been in the doula world for the last 10 years. Right? You guys, as doulas, obviously, we're not medical professionals, but as doulas, we see a lot of intervention and a lot of intervention that is completely unnecessary and a lot of intervention that leads to traumatic birth, unexpected or undesired outcomes and then they lead to other unnecessary interventions. It's the cascade. We talk about the domino effect or the cascade of interventions, but this is real so for them to type out, “Maternity care in the United States is intervention intensive–”Julie: You're like, “Yeah, where have you been?” Not you, but the writer. Meagan: Yeah, the writer. Yeah. It says, “The most recent national survey–” Now, again keep in mind it is 2024. This has been a minute since this was written. Julie: About 10+ years. Meagan: 10-12 years. Just keep that in mind. But it was interesting to me that even 10-12 years ago, this was where we were at because I feel like since I started as a doula, I've seen the interventions increase– the inductions, the unnecessary Cesareans increase a lot. Julie: Some of them, yeah. Yeah, especially inductions and Pitocin. Meagan: Not all of the time. I cannot tell you that in 10 out of 10 births that I attend, this is the case but through the years of me beginning doula work and what I have witnessed, it's increased. At least here in Utah, it seems that it has increased. It says, “The most recent national survey of women's pregnancy, birth, and postpartum experience reports that for women who gave birth in June 2011-2012,” so a little bit ago, “89% of women experienced electronic fetal monitoring.” Okay. Julie: That seems actually low to me for hospital births. Meagan: It does seem low because to me–Julie: I wonder if there had been a ton of stop and drops or something. Meagan: I don't know, but I agree. 89%. I feel like the second you get into the hospital, no matter VBAC or not, they want to monitor your baby. Julie: Strapped onto the monitor, yeah. Meagan: It says, “66% continuously.” So out of the 89%, it says 66% were continuously meaning they didn't do the intermittent every 30 minutes to an hour checking on baby for a quick 15 minutes to get another baseline, they just left that monitor on them which makes me wonder why. Usually, when a client of mine goes in and has that, they're like, “Oh, your baby had a weird decel so we are going to leave the monitor on longer,” and then they don't say anything. They just keep it on there. Maybe that's– I don't know. It says, “62% received intravenous fluids.” Julie: IV fluids. Meagan: Which to me, is also a lot. 36:27 Eating during labor and the risk of aspiration under anesthesiaMeagan: “79% experienced restrictions on eating.” 79%. You guys, we need to eat. We need to fuel our bodies. We are literally running a marathon times five in labor. We shouldn't be not eating, but 79% which doesn't surprise me, and “60% experienced restrictions on drinking in labor.” Why? Why are we being restricted from drinking and eating in labor unless we have other plans for how labor may go? Julie: That's exactly what it is. They're preparing you for an emergency Cesarean. That's what they're doing. That's exactly what restricting non-IV fluids is. It's not only that, but it is preparing you for the incredibly low risk of you having to go under general anesthesia, and then even people that go under general anesthesia have an incredibly low risk of aspirating and that is what it's coming down to. Don't even get me started on all of the flaws in all of the studies that went over aspiration during general anesthesia anyway because they are so significantly flawed that we are basing denying women energy and fuel during labor based on flawed studies that are incredibly outdated and on incredibly low risk during an incredibly already low risk. I mean, you probably don't want to down a cheeseburger while you're having a baby. I don't know. Maybe me. Just kidding. Even I didn't want a cheeseburger, but I wanted some little snacks, and some water to keep you hydrated. Yes. Oh my goodness. Let's please stop this. Sorry. Stepping off the soapbox. Meagan: You know, there is a provider here. I actually can't remember her name. It was way back in the beginning of my doula career and actually, it was in an area that is not one of my more common areas to serve. It was outside of my serving area. Anyway, we were at a birth and there was an induction. I remember being in there with her and the provider, an OB, walks in and is like, “Hey, how are you doing?” He was so friendly and kind and asked some questions like, “How are you feeling? What are you thinking about this?” Then she was getting ready to leave and she turned back and said, “Hey. I just thought about this. Have you eaten anything?” The mom was like, “No.” She was like, “Uh, you need to eat.” Julie: Yeah!Meagan: She had an epidural at this point. The mom was like, “Wait, what?” She was like, “You need to eat.” I literally remember my jaw falling, but had to keep my mouth up because I didn't want to look like I was weird. Anyway, I said, “That's something I've not usually heard from an OB especially after someone's had an epidural.” She was like, “Oh, I am very passionate about this.” She was like, “When I was finishing up school and graduating,” she had to write some big thing. Julie: Her dissertation probably. Meagan: Time capsule, I don't even remember what it was called. Some really, really big thing. She was like, “I specifically found passion about the lack of eating and drinking in labor.” She was like, “I did all of this stuff and what I found was you are more likely–” Here comes risk. “You are more likely to be struck in the head twice by lightning–” This is what she said. “Twice by lightning than you are to aspirate in a Cesarean after having an epidural.” Julie: I love this lady. Who is it? Meagan: I can't remember. I will have to text my client. Julie: Where was it? What hospital? Meagan: It was up in Davis County. Julie: Oh, interesting. Meagan: It was not an area for me. I said, “Whoa, really?” She said, “Yeah. You need to get that girl some food.” I was like, “Done. 100%.” Julie: More likely to get struck by lightning. Meagan: More likely to get struck by lightning twice in the head than you are to aspirate in a Cesarean after receiving an epidural. That stuck with me forever. Literally, here we are 10 years later. Julie: I love that because first of all–Meagan: I don't have documentation to prove that. She just said that. Julie: That is 100% relative risk. Aspirating during a C-section relative to getting struck by lightning twice. So that's cool. What are the numbers? I know that the numbers are super incredibly low and I feel like when you put in context like that, getting struck by lightning twice, I don't know anybody that's been struck by lightning once and who has been alive to tell about it. I know of a friend whose sister got struck by lightning and died when she was very young. I only know one person in my entire life who has been struck by lightning. Meagan: I just looked it up really quick. I don't even know if this is credible. I literally just looked it up really quickly. It says that the odds that one will be struck by lightning in the US during one's lifetime is 1 in 15,300. Julie: Wow. Meagan: Okay. Julie: So twice that is 1 in 30,000. That's a freaking low risk. Anyway, what I'm saying is that I love that OB first of all. I feel like from what I've read about aspiration under general anesthesia during a C-section seems right in line with those numbers and those chances because it's so rare, it's almost unheard of especially now with all of the technology that we have. It's fine because I'm not going to go on that soapbox. I love that. I love that analogy and that we're talking about that because 10 years from now or when our daughters are having babies, they're going to talk about how their poor moms couldn't eat when they were in labor because of the policies just like we talk about the twilight sleep and how our poor grandmas had to undergo twilight sleep when our moms were being born. I feel like that's just going to be one of those things where we will look back and be like, “What were we thinking?” 43:03 Epidurals, Pitocin, AROM, episiotomies, and C-section percentagesMeagan: Okay, I'm going to finish this off. It says, “67% of women who gave birth vaginally had an epidural during labor and 37% were given Pitocin to speed up their labors.” Sorry, but come on. That also may go to show, that we're going to do an epidural episode as well, that epidural maybe does really slow down labor. Maybe it really does impact the body's response to continuing labor in a natural way, so 31% of those people had to have help and assistance. It says, “20% of women had their membranes artificially ruptured,” which means they broke your bag of water artificially with the little whatever, breaking bag water hook thing versus it breaking spontaneously. Julie: Amniohook. Is it an amniohook? Meagan: Amniohook, yeah. “17% of women had an episiotomy.” I don't know. Julie: I feel like those numbers are probably lower now. Meagan: I think that's changed, yeah. “31% had a Cesarean.”Julie: That is right in line with the national average. Meagan: It is, still. “The high use of these interventions reflects a system-wide maternity care philosophy expecting trouble. There is an increasing body of research that suggests that the routine use of these interventions rather than decreasing the risk of trouble in labor and birth actually increases complications for both women and their babies.” 44:43 The perspective of birth doulas and birth photographersJulie: I believe it. Do you know what? Can I just get on another tangent here because I know that you all love my tangents? I really wish that somebody somewhere would do something and I don't know what that something is, to get the voices of birth doulas and birth photographers heard because this is why. Doulas and birth photographers– I've said this before. We see births in all of the places. We have a really, really unique point of view about birth in the United States because we attend births at home. We attend unassisted births. We attend births at home with unlicensed providers. We attend births at home and births at birth centers with licensed providers. We attend in-hospital births with midwives and we attend in-hospital births with OB/GYNs and some of us are lucky enough to attend out-of-hospital births with OB/GYNs because there are a handful of them floating around. We see birth in every single variety that it takes in the United States. I really wish that someone somewhere would do something to get those voices lifted and amplified because I feel like yes, a lot of that is going to be anecdotal, but I feel like the stories there have so much value with the state of our system in the relationship between home and hospital birth, how birth transfers happen when births need to be transported to hospitals, the mental health of the people giving birth, the providers and the care, and all of that. I feel like, like I said, somebody should do something to do something with all of that information that we all carry with us. I think it could provide so much value somewhere, right? I don't know what yet, but if anybody has an idea, message me. Find me on Instagram at @juliefrancombirth. Find me. Message me if you have any ideas. Maybe write a book or something. I don't know. Meagan: I've wanted to do an episode and title it “From a Doula's Perspective”. We could do that from a birth photographer and all that, but it's crazy. It's crazy. Julie: We see it all. Meagan: There was a birth just the other day with one of our sweet, dear clients where the provider was saying things that seemed scary even though the evidence of what was happening was really not scary, went into a scheduled induction, and the way they were handling it, I felt so guilty as a doula and I was like, “This is going to turn Cesarean. This is not good.” Sure enough, it did and it broke my heart because I was like, “None of that needed to happen,” but again, it goes to us deciding what's best for us. That mom had to decide what was best for her with the facts that we were giving, what the doctor was giving, and all of these things. Again, we don't judge anyone for the way they birth, but it's sometimes so hard to see people not get the birth they wanted or desired, or to have people literally doubt their ability because someone said something to them. Julie: Yeah. Meagan: You know–Julie: Yeah. I agree. It's just interesting. Anyways. Meagan: We are getting off our topic of risk, but risk is a hard conversation to have because there are different numbers. It can be presented differently and like I said, it can also have a tone to it that adds a whole other perspective. So know that if you are given a risk, it's okay to research that and question it and see if that really is the real risk and if that's the evidence-based information. We like to provide them here like we were saying earlier. We may be guilty and I hope you guys stick with us if we share some that might be a little jarring on both sides of the VBAC and C-section, but we love you. We're here for you. We understand risks are scary. They are also hard to break down and understand, but we are here for you. I love you guys and yeah. Anything else, Julie?Julie: No. I just want to say be kind to each other. Give each other the benefit of the doubt. Do everything you can to make the best decisions for you. Trust your intuition and find the right support team. We're all just trying to do our best– us at The VBAC Link, you as parents, providers as providers, and if you feel like you need to make a change, make it. Meagan: Make it. All right, okay everybody. We'll talk to you later. Julie: Bye!ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands
Join our Patreon Community!https://www.patreon.com/badassbreastfeedingpodcastDid you realize that birth can be connected to breastfeeding and breastfeeding problems? Have you experienced this or know anyone who has experienced breastfeeding problems due to birth problems? It's not uncommon. Today Dianne and Abby talk about how birth can impact breastfeeding and what to expect. If you are a new listener, we would love to hear from you. Please consider leaving us a review on iTunes or sending us an email with your suggestions and comments to badassbreastfeedingpodcast@gmail.com. You can also add your email to our list and have episodes sent right to your inbox! Things we talked about:Breastfeeding and birth are connected [4:10]Feeling disconnected [5:40]Pitocin [7:30]Epidurals [10:22]Fluid and flat nipples [12:28]Baby's second night [16:00]Traumatic birth [22:20]Blood pressure issues [26:36]Cesarean delivery [28:38]Interventions lead to interventions [35:11] Today's episode is brought to you by Peapod Mats! Say goodbye to troublesome milk puddles with our 100% leak-proof and super absorbent mats. Use code BADASS for 15% off at www.peapodmats.com! Code valid through March 10, 2024. Today's episode is brought to you by BoobieJuice! BoobieJuice freeze dries your very own breast milk into shelf stable powder that you can take on the go. Use code BADASS for 15% off your order to freeze dry your breast milk. Links to information we discussed or episodes you should check out!https://badassbreastfeedingpodcast.com/episode/antenatal-hand-expression-of-colostrum/https://badassbreastfeedingpodcast.com/episode/cesarean-births-and-breastfeeding/https://badassbreastfeedingpodcast.com/episode/how-birth-interventions-affect-breastfeeding/ Set up your consultation with Diannehttps://badassbreastfeedingpodcast.com/consultations/ Check out Dianne's blog here:https://diannecassidyconsulting.com/milklytheblog/Follow our Podcast:https://badassbreastfeedingpodcast.com Here is how you can connect with Dianne and Abby:AbbyTheuring ,https://www.thebadassbreastfeeder.comDianne Cassidy @diannecassidyibclc, http://www.diannecassidyconsulting.com Music we use:Music: "Levels of Greatness" from "We Used to Paint Stars in the Sky (2012)" courtesy of Scott Holmes at freemusicarchive.org/music/Scott Holmes
Heidi Montag joins Katie and Hallie for today's episode of 'Between Us Moms.' The reality star opens up about her motherhood journey like never before, revealing what her mornings are like, how she and husband Spencer keep things spicy after 15 years of marriage and shares they are in talks to return to reality TV! The 'Hills' star reveals her upcoming music plans, shares why she opted for no epidurals and gushes over Taylor Swift and Travis Kelce's relationship -- predicting they will get married! New episodes of Between Us Moms air Tuesdays and Fridays. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
YOUR BIRTH, GOD’S WAY - Christian Pregnancy, Natural Birth, Postpartum, Breastfeeding Help
Today, in the second part of my interview with Dr. Stuart Fischbein, we talk about SO MUCH including the following topics: maternal intuition in pregnancy, epidurals, Michel Odent's theory of the potential impact on baby girls of pre-labor c-sections, the role of maternal oxytocin, the symphony of hormones present in pregnancy & labor, the new postpartum depression pill, what a study of colds reveals about society's attitudes toward medical care and MORE! Helpful Links: 2 WAYS TO WORK WITH LORI: --> Sign up HERE for the Your Birth, God's Way Online Christian Childbirth Course! This is a COMPLETE childbirth education course with a God-led foundation taught by a certified nurse-midwife with over 20 years of experience in all sides of the maternity world conducted LIVE this summer. Learn more or sign up HERE! --> Sign up for your PERSONALIZED Pregnancy Coaching Midwife & Me Power Hour HERE These consults can include: birth plan consultation, past birth processing, second opinions, breastfeeding consultation, and so much more! Think of it as a special, one-hour appointment with a midwife to discuss whatever your concerns may be without any bias of practice policy or insurance policy influencing recommendations. Lori's Recommended Resources HERE Sign up for email updates Here Be heard! Take My Quick SURVEY to give input on future episodes you want to hear --> https://bit.ly/yourbirthsurvey Got questions? Email lori@yourbirthgodsway.com Socials: Follow Your Birth, God's Way on Instagram! Follow the Your Birth, God's Way Facebook Page! Join Our Exclusive Online Birth Community -- facebook.com/groups/yourbirthgodsway Learn more about Lori and the podcast at yourbirthgodsway.com! FREE Bible Study - If you die today, do you know where you're going? Can you be sure? Let there be no doubt! Let's study together here! DISCLAIMER: Remember that though I am a midwife, I am not YOUR midwife. Nothing in this podcast shall; be construed as medical advice. Listening to this podcast does not mean that we have entered into a patient-care provider relationship. While I strive to provide the most accurate information I can, content is not guaranteed to be 100% accurate. You must do your research and consult other reputable sources, including your provider, to make the best decision for your own care. Talk with your own care provider before putting any information here into practice. Weigh all risks and benefits for yourself knowing that no outcome can be guaranteed. I do not know the specific details about your situation and thus I am not responsible for the outcomes of your choices. Some links may be affiliate links which provide me a small commission when you purchase through them. This does not cost you anything at all and it allows me to continue providing you with the content you love.
We have a special guest today and it's our poor Mom!! We get into how she didn't have any epidurals for all three of our births, how tiny and smollll she was on her wedding day (typical mom of millennial!!), and how ugly Jade was in college! Submit your stories and/or advice questions and we will read them on the episode! Email us at yourpoordad@gmail.com or DM us on Instagram at instagram.com/yourpoordadpod
Welcome to another episode designed specifically for all the expecting moms out there. Today, we're diving deep into a topic that's often shrouded in myths and misconceptions: Epidurals. With the help of my long time experience as a labor and delivery nurse, I aim to arm you with all the information you need to make empowered choices for your birthing experience.What's Inside this Episode:What is an Epidural?: Understand the medical science behind epidurals and how they can impact your labor.The Best Timing for an Epidural: Get the lowdown on when you should consider getting an epidural for a seamless labor experience.The Epidural Placement Process: Know what to expect during the actual procedure and pick up some relaxation techniques to ease the process.Types of Epidurals: From 'walking epidurals' to standard ones, explore the options that best suit your labor goals.Pros and Cons of Epidurals: Navigate the benefits and risks, and learn how to discuss them effectively with your healthcare provider.Resources & ExtrasEpidural Empowerment Kit: Comment '#Epidural' on our latest Instagram post to get your hands on this invaluable resource filled with FAQs, checklists, and practical tips. or click this link:Epidural Labor Prep ToolkitQuestions to Ask Your Provider: Don't miss our bonus list in our toolkit where we share essential questions to discuss with your healthcare provider, ensuring you make an informed choice.Final ThoughtsMaking decisions about your birth plan can be daunting, but knowledge is power. This episode is designed to provide comprehensive insights into epidurals, helping you take control of your labor and birthing experience.Connect with UsDon't forget to subscribe, rate, and review the podcast. Share this episode with anyone you think could benefit from it.Resources: 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...
We give some theory and new science on epidurals. These are things you ought to know. Blyss tells a tale of two births while Dr. Stu spreads real information around the globe.First up, we reflect on our recent webinar on home birth hesitancy, discussing fear-inducing tactics used by the medical industry. We question scientific experiments and discuss gaslighting around polio.We then share powerful birth stories and address the challenges faced while navigating the medical model of birth. We underline the unpredictability of birth and the pivotal role of doulas. We also examine the motives of the pharmaceutical industry, especially concerning misinformation about birth control, and question the possible link between the approval of vaccines for pregnant women and the surge in infant mortality rates. Finally, we scrutinize the use of epidurals in childbirth and their impact on labor, portraying the contrasting rates of epidural use across various countries and hospitals. We explain that labor pain serves a purpose and is not merely a negative experience.Key highlights:Advocacy for Natural DeliveryBirth Control MisinformationHospital Birth Experience and ConcernsThe Impact of Epidurals on Labor and BabyEpidural RisksEpisode resources:Birthing Instincts - Episode 190: Epidurals Are Not Candy!Article: U.S. Infant Mortality Rates Rise for First Time in 2 DecadesThe Bridge Midwives: Skye's songThe Holistic OBGYN Podcast: Dr. Victoria Flores' Unconventional Journey in Medicine and Midwifery Moms Off The Record Podcast: Informed Consent and Thinking Critically about Pharma & Vaccines with Just The InsertsThe Spillover with Alex Clark Podcast: “The Ultimate Home Birth Episode: Breech, VBAC, Twins & More!” - Dr. Stu Fischbein, MDYouTube video: “The Ultimate Home Birth Episode: Breech, VBAC, Twins & More!” Dr. Stu Fischbein, MD | The SpilloverThis show is supported by:LMNT | Go to drinklmnt.com/birthinginstincts to get a free sample pack with every orderNeeded | Use code BIRTHINGINSTINCTS for 20% off your first month or first 3 months of a one-month subscription at thisisneeded.com.BIRTHFIT | Go to birthfit.com and use the code INSTINCTS1 for a discount on the Basics Prenatal program, or INSTINCTS2 for a discount on the Basics Postpartum program.Connect with Dr. Stu & Blyss:Instagram: @birthinginstincts / @birthingblyssWebsite: birthinginstincts.com / birthingblyss.comEmail: birthinginstinctspodcast@gmail.com Call-in line: 805-399-0439Podcast webpage: birthinginstinctspodcast.com
In todays episode Danielle hosts to speak on her birth experience, and how it was an overall really positive journey despite having COVID at the time. She speaks on the anxiety she had surrounding both being sick and so close to labor, fears of being alone due to hospital regulations and how it really felt to hold her baby for the first time. This story is filled with lighthearted energy, childbirth, epidurals, and reminders of how powerful we, as women, truly are. Watch this episode on Youtube! https://youtube.com/@MysticMamasPodcast?si=1OiduiSVrLMLebsJ Follow us on Socials: Tiktok: https://www.tiktok.com/@mystic.mamas?is_from_webapp=1&sender_device=pc Instagram: https://www.instagram.com/mysticmamas.podcast/?igshid=NHRnMXI4dzFhd29y&utm_source=qr
Sponsor: Needed: Use code BIRTHHOUR for 20% off at thisisneeded.com. The Birth Hour Links: Know Your Options Online Childbirth Course Beyond the First Latch Course (comes free with KYO course) Support The Birth Hour via Patreon!
You spoke (literally!), and we listened! In this episode, I'm diving into two more questions from our podcast listener line. Today we'll be talking in depth about breech positioning and what that means for birth, the recurrence rate of breech pregnancies, how to VBAC after a breech Cesarean, and more. Then we'll be unpacking pregnancy anxiety and fear related to birth too! This is actually a topic I'm really passionate about, and one of the main reasons I started Mommy Labor Nurse (and this podcast!) to begin with!! If you have a burning question about pregnancy, birth, or postpartum that you'd like me to answer on the show, all you have to do is call 919-213-8719 and leave a voicemail! Want to erase anxiety and actually feel excited about birth? Get instant access to my FREE Birth Workshop to learn tons of pain-coping strategies and actionable tips today! Have an even better birth! CLICK HERE to learn more about our online birth classes that will help you feel prepared and in control - no matter how you deliver. And be sure to follow @mommy.labornurse on Instagram to join our community of over half a million for education, tips, and solidarity on all things pregnancy, birth, and postpartum! Related Episodes Episode 168: Ask Me Anything Episode 174: Ask Me Anything: Talking Placentas, Epidurals, and Second Pregnancies Episode 191: Me Anything: Placenta Previas to Postpartum Recovery
Recently, Ashley had a conversation with a fellow new-ish mom that made her realize lots of women out there don't have the full story when it comes to childbirth and epidurals. When she asked you guys, it turned out that so many of you have really great, thoughtful questions about how epidurals work, possible complications, why they might fail, and how a pregnant woman can best advocate for herself when it comes to epidurals and childbirth. Luckily, we know someone who can help answer all of these questions and more: long-time anesthesiologist, Dr. Iaconetti (AKA, Lauren and Ashley's dad). Of course, this episode isn't meant to convince you whether or not you should or shouldn't get an epidural when it comes to your own labor and delivery. We just know there are so many questions out there, and we want to share what we've learned with you!I Don't Get It is sponsored by Better Help. Let therapy be your map, with BetterHelp. Visit BetterHelp.com/GETIT today to get 10% off your first month.I Don't Get It is sponsored by Care/Of. For 50% off your first order with Care/Of, go to TakeCareOf.com and enter code idgi50.Leave summer stress behind and upgrade your CBD. Go to NextEvo.com/GETIT to get 25% off + a FREE bottle ofPremium Pure CBD ($50 value, limit 1 use per customer).Stop wasting money on things you don't use. Cancel your unwanted subscriptions – and manage your money the easy way – by going to RocketMoney.com/getit.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
In this episode we talk with Jessica King, an EBB Childbirth Class graduate, about their journey to parenthood and the importance of finding support networks before, during, and after pregnancy. Jessica grew up in Upstate New York and then moved to Boston to get her Master's in architecture. While in Boston, she met her wife and fellow upstate New Yorker, Sarah. They started working on creating their family three years ago, and they welcomed their daughter this past November! Jessica and Sarah are graduates of the Evidence Based Birth Childbirth Class with EBB Instructor, Anna Sutkowski. Their family currently lives in St. Louis with their two dogs. Jessica and her wife, a surgical resident, decided to take the EBB Childbirth Class to ease their anxieties and demystify the process of labor and delivery. In this podcast episode, Jessica opens up about her family's struggles, setbacks, and joy in their journey from assisted reproduction to postpartum. Jessica also shares how she was able to use the skills and knowledge learned in the course to advocate for herself postpartum when she had difficulties with lactation and a postpartum mood disorder. We wrap up this episode by talking about how knowing you are not alone can make all the difference in the world. Trigger Warning: assisted reproduction, ovarian hyperstimulation syndrome (OHSS), pregnancy loss, bleeding in pregnancy, epidurals, preeclampsia, newborn jaundice, and postpartum mood disorders. Resources: Learn more about Anna Sutkoski and her EBB Childbirth Class here For more information and news about Evidence Based Birth®, visit www.ebbirth.com. Find us on: TikTok Instagram Pinterest Ready to get involved? Check out our Professional membership (including scholarship options) here Find an EBB Instructor here Click here to learn more about the Evidence Based Birth® Childbirth Class.
Today, we dive into one of the most common questions that I get asked about epidurals: How do you push a baby out with an epidural? This is a question that can cause a lot of anxiety for expectant mothers. So, I'm going to share all the juicy details on epidural pushing positions, tips, and tricks to make pushing a breeze. I'll also talk about what to expect during labor and how to work with your body to help you deliver your beautiful baby. Want to feel confident before your epidural birth? Get the FREE Epidural Birth Prep Pack to gain a sense of control before the big day! Have an even better birth! CLICK HERE to learn more about our online birth classes that will help you feel prepared and in control - no matter how you deliver. And be sure to follow @mommy.labornurse on Instagram to join our community of over half a million for education, tips, and solidarity on all things pregnancy, birth, and postpartum! Related Episodes EP171: Epidurals 101: Get Informed About Epidurals for Birth Sponsors Aeroflow Breastpumps Did you know that your health insurance will cover the cost of a breast pump? It's true! In fact, many health insurance plans also cover milk storage bags, breastfeeding prep courses, and more. At Aeroflow Breastpumps, you can shop top-rated breast pumps from brands like Medela, Spectra, and Motif without ever opening your wallet. Fill out their quick and easy insurance eligibility form and they'll take care of the rest! It might just be the easiest thing you do this pregnancy. Visit aeroflowbreastpumps.com/mommylabornurse to find out why more than 1 million moms have chosen Aeroflow Breastpumps to get their pump through insurance. Simply Magnetic Me Simply Magnetic Me offers GOTS certified 100% organic cotton essentials like footies, coveralls and bodysuits—all featuring safety-tested magnetic closures. No fumbling with tiny snaps or buttons during those middle of the night diaper changes. You can get your baby dressed quickly so everyone can get back to sleep! You may have heard of Magnetic Me. Simply is their new sister brand that offers the same beloved magnetic closures at a more affordable price. You can create a custom bundle on their website, combining the prints, styles, and sizes you want, with outfits as low as $15. The more outfits in your cart, the more you save. And trust me, babies need a lot of outfits. Say no to snaps and head to simplymagneticme.com to stock up on no-fuss essentials and use code MLN20 for 20% off your order.
While last week's episode was my deepest one up to that date, this one today takes the icing on the cake. In early 2021, I was diagnosed with an extremely serious back condition that was going to lead to a 14-hour back surgery. I was already burnt-out. I was already shot. I had just had my 2nd knee replacement 6-weeks prior. And I was now facing my biggest physical challenge in my 50-years of living. And today, I discuss ALL OF IT and why this episode will go down as my deepest episode in the history of the IMPACT SHOW. And I hope I don't have one in the future that tops this one. Specifically, in today's episode, I share: - What happened to my back, the diagnosis, and why my doctor asked me if I had served in Afghanistan. - What happened on Feb 17, 2021, and how my 20th wedding anniversary soon changed from a great day to one of misery. - My trip to Sedona, AZ, and how I couldn't even walk. - Why I was sleeping only 3-4 hours a night and why I was relying on Tylenol PM to try and sleep more. - My back brace and why I didn't tell anyone about my back. - My visit to the “Back Deformity Specialist” and how and what he said to me was permanently etched in my head. - My breakdown in March 2021 and what Melanie said to me that I will never forget. - What happened to my back in Cabo, Mexico, and how it almost led to a trip to an Emergency Room in Mexico. - Dropping my son Luke off to college his freshman year but why I was stuck in my hotel room. - Epidurals, painkillers, 6 back-doctors, and a lot of PAIN! - What pain does to your mind, how pain zaps your energy, and why it's so hard to serve others when you are in chronic serious pain. - My Top Lessons from the “Year of hell” and what I would say if/when you go through a bout of serious pain. - Broken or blessed? How my faith carried me through the desert when I had very little left. - What happened, how I avoided surgery, some of my top hacks to “get out of pain” almost a year later. My friends, this was a very difficult episode to share. It's one of the darkest periods of my life. While most didn't know what I was battling, I found solitude and peace in serving & creating as it fed my soul. I think it will make sense when you listen to the story but I'm so grateful and happy today that I got through it. I share it because you can probably relate in some way. Whether you had physical pain or mental anguish, a massive challenge you had to overcome, or perhaps you are there today….or tomorrow, my hope is that you can come back to this episode at any time and realize that “GETTING YOUR MIND RIGHT” is way more than just a saying or mantra. It's a way of life. Thank you. Thank you for giving me this space & podcast a great place to share. And thank you for listening or watching. And thank you for your feedback. I read every single text, DM, email, or message. Please keep them coming. If you can please SHARE this episode on your social media, I'm confident that there is someone in your circle that can benefit from this very episode. SHARE & TAG: IG & Twitter: @ToddDurkin FB: @ToddDurkinFQ10 Linked-In: @ToddDurkin Additionally, please make sure you: 1. Please make sure you are subscribed to the Todd Durkin IMPACT SHOW podcast. 2. Be a part of my TEXT COMMUNITY. 619.304.2216. Sign-up to not miss a single text from me. And yes, it is ME on the other side of that. 3. After listening to today's episode, can you please text me or email me any QUESTIONS you have stemming from the episode. 4. Lastly, I have my new 2.0 version of “Dose of Durkin” emails and messages beginning to drop next week. You will get 1 workout challenge and an inspirational verse or quote every Thursday. Check it out by making sure you are SUBSCRIBED to my email list at www.ToddDurkin.com Get Your IMPACT JOURNAL today at www.ToddDurkin.com https://fitnessquest10.infusionsoft.app/app/orderForms/IMPACT-Journal It's not too late to plan - get your God-Sized Dream 2023 planner today: https://fitnessquest10.infusionsoft.com/app/manageCart/addProduct?productId=288 ATTN: FIT-Pros, Trainers & Coaches Are you a trainer, coach, or fitness business owner seeking to make a massive IMPACT in your business & life and you would like to be coached to your full potential? Are you looking to level-up your business in 2023 and make an even bigger IMPACT in people's lives? Are you a trainer, coach, or fit-pro who is constantly pouring into others, yet your “well” runs dry and sometimes you need some more “juice” poured into you? If so, I invite you to be a part of my Todd Durkin Mastermind for Fit-Pros and surround yourself with the most passionate, purposeful, and IMPACTFUL life-transformers on the planet. Being a part of the TD Mastermind gives you the opportunity to connect, share, and grow with the fitness industry's top coaches, trainers, and entrepreneurs on a daily-basis. The MASTERMIND is for passionate and purpose-driven fitness professionals who are committed to creating success & significance in their personal and professional lives and want to be coached by Todd and surrounded by some of the brightest, sharpest, and most passionate trainers on the planet. If that sounds like you, visit: ToddDurkinMastermind.com to sign-up for the INSTITUTE Level or email Frank Pucher, Director of Todd Durkin Mastermind, at frankpucher1112@gmail.com for a FREE CLARITY CALL today. www.ToddDurkinMastermind.com Join my TD Community for FREE: Simply text me “IMPACT” to (619) 304.2216 and you are on your way to receiving exclusive content and even more motivation & inspiration. Sign-up TODAY! Please keep your questions coming so I can highlight you on the podcast!! If you have a burning question and want to be featured on the IMPACT show, go to www.todddurkin.com/podcast, fill out the form, and submit your questions! Don't forget that if you want more keys to unlock your potential and propel your success, you can order my book GET YOUR MIND RIGHT at www.todddurkin.com/getyourmindright or anywhere books are sold. Get Your Mind Right now available on AUDIO: https://christianaudio.com/get-your-mind-right-todd-durkin-audiobook-download Want more Motivation and Inspiration? Sign up for my newsletter The TD Times that comes out on the 10th of every month full of great content. Sign-up here… www.todddurkin.com ABOUT: Todd Durkin is one of the world's leading coaches, trainers, and motivators. It's no secret why some of the world's top athletes have trained with him for nearly two decades. He's a best-selling author, a motivational speaker, and founded the legendary Fitness Quest 10 in San Diego, CA. He currently coaches fellow trainers, coaches, and life-transformers in his Todd Durkin Mastermind group. Here, he mentors and shares his 25-years of wisdom in the industry on business, leadership, marketing, training, and personal growth. Todd was a coach on the NBC & Netflix show “STRONG.” He's a previous Jack LaLanne Award winner, a 2-time Trainer of the Year. Todd and his wife Melanie head up the Durkin IMPACT Foundation (501-c-3) that has raised over $250,000 since it started in 2013. 100% of all proceeds go back to kids and families in need. https://todddurkin.com/impact-foundation/ To learn more about Todd, visit www.ToddDurkin.com and www.FitnessQuest10.com. Join his fire-breathing dragons' community and receive regular motivational and inspirational emails. Visit www.ToddDurkin.com and opt-in to receive his value-rich content. Connect with Todd online in the following places: You can listen to Todd's podcast, The IMPACT Show, by going to www.todddurkin.com/podcast. You can get any of his books by clicking here! (Get Your Mind Right, WOW BOOK, The IMPACT Body Plan, What's Next?)
During labor, you want contractions that are longer, stronger, and closer together. But why? Dr. Sarah Buckley and Adriana take a deep dive into the amazing and fascinating hormonal dance that happens during the birthing process, and how interventions such as synthetic oxytocin or an epidural can lead to a cascade of interventions that negatively impact the process for both the birthing person and their baby. They also talk about ways to support the physiology of birth (regardless of what path it takes) in order to help fill any ‘hormonal gaps' that may occur.Get the most out of this episode by checking out the resources, transcript, and links listed on its show notes page. If you liked this episode, listen to our interview on Your Baby, The Mammal, and our episode on Epidurals and breastfeeding.You can connect with Sarah on Facebook at drsarahbuckley. You can connect with us on Instagram at @BirthfulPodcast and email us at podcast@Birthful.com. If you enjoy what you hear, download Birthful's Postpartum Plan FREE when you sign up for our weekly newsletter! You can also sign-up for Adriana's Own Your Birth online BIRTH preparation classes and her Thrive with Your Newborn online POSTPARTUM preparation course.Follow us on Goodpods, Apple Podcasts, Amazon Music, Spotify, and anywhere you listen to podcasts.Our Sponsors:* Visit HomeThreads.com/BIRTHFUL today and get a 15% off code for your first order!Support this podcast at — https://redcircle.com/birthful/donationsAdvertising Inquiries: https://redcircle.com/brands