Podcasts about evidence based birth

Struggling with low milk supply can feel overwhelming, isolating, and confusing. In this episode, Dr. Rebecca Dekker talks with midwife and International Board Certified Lactation Consultant Katie James to demystify the realities of low milk supply. Together, they explore the hormonal, medical, and systemic factors that can affect lactation, as well as the critical importance of early postpartum support. Katie shares how birth interventions, lack of education, and misinformation can interfere with lactation—and how reclaiming knowledge, honoring instinct, and receiving timely help can make all the difference.   (07:21) How Birth Interventions Impact Breastfeeding (09:30) Prolactin, Oxytocin, and the Critical First 3 Days (11:18) What is Low Milk Supply—and Can it Be Prevented? (14:58) Medical Conditions That Can Affect Milk Production (19:27) Gestational Diabetes, Cesarean Birth, and Milk Supply (23:42) The Trap of “Perceived” Low Supply (28:48) Why Judgment-Free Support Matters (36:56) When and How to Get Help from an IBCLC (38:16) The Rule of 3s: Key Windows to Boost Milk Supply (44:39) Why Partners Need Breastfeeding Education Too   Resources Follow Katie: katiejames.site | Instagram Listen to her podcasts: The Midwives' Cauldron and The Feeding Couch Find an EBB Childbirth Class: evidencebasedbirth.com/childbirthclass Learn about the EBB Instructor Program: evidencebasedbirth.com/instructor   For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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.

Special Announcement from EBB! If you're an experienced birth worker or health care professional and you're interested in becoming an Evidence Based Birth Instructor, applications for 2025 are opening soon for a limited time only!   Podcast listeners who are interested in becoming an EBB Instructor are invited to join us for a live Q & A session on Wednesday, May 28 at 1:00 PM EDT.    We'll be answering your questions about who is eligible to apply, what the application process looks like, and the support and training you'll receive as an EBB Instructor.   Whether you're thinking about teaching the EBB Childbirth Class or leading EBB Pro Workshops, this is a your opportunity to learn more. Can't make it live? Register anyway and we'll send the replay straight to your inbox. Just head to ebbirth.com/instructor to attend.    Want to listen to a few podcast episodes about being an EBB Instructor? EBB 310: Joyce Dykema, EBB Instructor & Doula, talks about teaching the EBB Comfort Measures for L & D Nurses Workshop! EBB 222: Jen Anderson, Nurse, Doula, and EBB Instructor, breaks down for us how she tailors her EBB Childbirth Class to high-risk birthing families EBB 226: Dana Patterson, Doula & EBB Instructor, joins her client Mandy on-air to talk about serving as both her client's doula and childbirth educator!  EBB 252: Leslie Green, Doula & EBB Instructor, explains how the EBB Childbirth Class has advanced her ability to advocate for her clients EBB 283: EBB Instructors Tania Silva Meléndez, Doula, and Tamara Trinidad González, Certified Professional Midwife, share how they use EBB Instructor resources in Puerto Rico. 

  In this Q&A episode, Dr. Rebecca Dekker answers questions submitted by EBB Pro Members—each exploring a different facet of evidence-based maternity care.   First, she explores the latest evidence on early induction for gestational hypertension, including findings from the WILL trial and other recent studies. What are the real risks and benefits of inducing labor at 37 or 38 weeks for gestational hypertension? And how should families weigh these decisions with their providers?   Next, Dr. Dekker shares new insights into the effectiveness of acupuncture and acupressure for labor pain, anxiety, and Cesarean recovery. From systematic reviews to randomized trials, the data is growing!   Finally, she looks into the evidence on interpregnancy intervals. What does the research say about the risks associated with short or long gaps between pregnancies? And how might this information apply to those who are pregnant again after a five-year or more break?   (00:00) Intro to Mini Q&A and EBB Pro Membership (02:17) Early Induction for Gestational Hypertension – What the Research Says (06:20) WILL Trial Findings and Recommendations from ACOG and NICE (08:23) Outcomes at 37 vs. 38 Weeks – Cesareans, NICU, and Respiratory Distress (10:15) Balancing Induction Timing and Risks of Continuing Pregnancy (11:03) Acupuncture and Acupressure – New Research and Applications (12:41) Studies on Pain, Anxiety, and Nausea During Labor and Cesareans (14:46) Acupuncture and Cesarean Recovery – Mobility and Pain Management (16:54) Interpregnancy Intervals – Definitions and Research Challenges (19:39) Risks of Short and Long Pregnancy Spacing (23:22) Global Perspectives and Meta-Analysis on Birth Outcomes (26:49) Public Health Implications and Final Thoughts   View the full list of resources and references on ebbirth.com.   For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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.

A traumatic first birth can shape everything that follows—but with the right support, education, and advocacy, it's possible to turn fear into empowerment.   In this episode, Dr. Rebecca Dekker sits down with EBB Childbirth Class Graduates Rivka and Steven Dubinsky as they share the transformative journey from a traumatic hospital induction and birth injury to a redemptive second birth experience centered on autonomy, education, and trust. Rivka opens up about how her first birth left her physically injured and emotionally shaken, and how she didn't initially recognize it as trauma. Over time—and with therapy, research, and support—she came to understand what had been taken from her. Determined to have a different experience with her second child, she carefully selected a trauma-informed OB, dove into birth education, and found strength in preparing for every possibility.   Together, Rivka and Steven share how they prepared as a team, how Steven stepped into his advocacy role during labor, and why they chose to “fire” a hospital-assigned doula. They also reflect on the surprising power of reclaiming their voice—even in the midst of pain—and how a supported birth experience can shift everything.   Content Note: This episode includes discussion of birth trauma. This episode also contains mild language at 45:55.   (01:48) Rivka's First Birth and the Silent Cost of Lost Autonomy (07:13) Steven's Reflections on Feeling Unprepared to Support (10:45) Moving to Ohio and Choosing Trauma-Informed Care (14:02) Becoming an “Information Junkie” and Taking the EBB Childbirth Class (17:02) Steven Learns Advocacy Through EBB (22:14) From Elective Cesarean Plan to Informed Induction (29:18) Navigating Nursing Styles and Hospital Systems (36:00) Epidural Differences and Listening to Her Body (40:50) Hands-On, Informed Support During Pushing (43:39) A Sunny-Side-Up Baby and Immediate Skin-to-Skin (45:53) Feeling Empowered, Present, and Powerful (50:06) Advice for Families Seeking Trauma-Informed Birth Care   Resources Learn more about Rivka and Steven's EBB Instructor, Aly Romot: @alyromotdoula For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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.  

On this week's episode of the Stacking Your Team Podcast, you'll meet one of my longtime clients, Dr. Rebecca Dekker, founder of Evidence Based Birth®. We jump into the tough leadership lessons learned from over a decade of running a purpose-driven remote business. We talked about trusting your instincts, navigating boundary setting, mastering conflict resolution, and how to handle when team members project their own trauma onto you.  If you're looking to build a resilient, empowered team while staying true to your values, you won't want to miss these actionable insights from a leader who's been in the trenches and come out stronger. Connect with Dr. Rebecca Dekker: Evidence Based Birth® Website YouTube Instagram Podcast Book Work with Shelli Warren: Book a call with Shelli to talk about how coaching can help you elevate your leadership capability. Apply to join the Leadership Lab. Confidence Starts Here: Get the Ask Shelli scripts to know what to say and how to say it. Free Resources: Click here to get the guide on positioning your role as their next best career move. Click here to get our list of red flags to watch for during interviews. Click here for 12 ways to motivate your team without a pay raise. Click here to access essential coaching questions for impactful 1:1 meetings. Connect with Shelli Warren: Email: leader@stackingyourteam.com Instagram LinkedIn Subscribe to the Stacking Your Team Newsletter

Every pregnant person deserves the information—and support—they need to make truly informed decisions about labor induction. In this episode, Dr. Rebecca Dekker talks with Dr. Ann Peralta and Kari Radoff, CNM, co-creators of Partner to Decide, a nonprofit initiative improving decision-making in perinatal care. They discuss the creation of their free, multilingual decision aid that supports families in understanding their options around routine induction of labor—and empowers them to advocate for their values, preferences, and autonomy.   Ann shares how her own birth experience, shaped by access to education and privilege, sparked the creation of the tool. Kari offers insight into how the decision aid has changed conversations in clinical settings—bringing clarity, reducing bias, and fostering truly shared decision-making. Together, they illuminate how access to balanced information can reduce anxiety, improve trust, and shift the culture of perinatal care.   (03:02) What Is a Decision Aid and Why It Matters (07:12) Ann's Birth Story and the Origins of Partner to Decide (11:09) Gaps in Shared Decision-Making from a Provider's Perspective (14:24) Personal Values, Intuition, and Cultural Differences (18:19) Designing the Decision Aid with Equity and Accessibility (23:49) The Power of Absolute vs. Relative Risk in Birth Conversations (25:01) Surprising Patient Feedback: From Access to Empowerment (30:31) Provider Reflections and Challenging Bias (36:11) Why “Routine” Induction Language Matters (43:59) How to Respond to Pressure or Coercion Around Induction (46:16) How to Access the Free Decision Aid and Support New Tools   Resources Access the free Induction of Labor Decision Aid in seven languages: www.inductiondecisionaid.org Learn more about the nonprofit: www.partnertodecide.org For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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 today's episode, we're diving into the evidence on perineal tears and the importance of avoiding episiotomies during childbirth. We'll talk about what perineal tears are, the different types that can occur, and the potential health consequences that can follow. You'll also hear about the various factors that may increase or decrease the risk of tearing during birth. Finally, we'll cover why it's so important to avoid an episiotomy during childbirth. Content warning: Discussion of perineal tears during childbirth, severe tears, episiotomy, and obstetric violence related to cutting episiotomies without consent. (05:58) Understanding Perineal Tears (09:15 Midwife Care Reduces Birth Tears (13:06) Risk Factors for Severe Birth Tears (16:08) Postpartum Tear Impact Study Findings (21:59) Episiotomy History and Controversy (24:02) Episiotomy Study on Routine vs. Restricted Use (28:02) Episiotomy Risks vs. Natural Tears (31:39) Episiotomy Awareness and Informed Consent Resources For the full list of references, visit the EBB website here. To watch the EBB YouTube video with visual props, visit here.  View graphics from the Mayo Clinic that show the different types of tears here. Read Dr. Klein's story here. For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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.

Navigating a neonatal intensive care unit (NICU) experience can be overwhelming and emotionally taxing. In this episode, Dr. Rebecca Dekker talks with Mary Farrelly, a certified NICU nurse, doula nurse educator, and founder of The NICU Translator. With over a decade of experience in a Level 4 NICU, Mary shares how families can find empowerment and confidence in the NICU.   Mary discusses the importance of emotional, social, and informational support for families, and how NICU-informed doulas can play a critical role in bridging the gap between parents and medical teams. From understanding the different levels of NICU care to navigating postpartum challenges, Mary offers compassionate and practical guidance. Learn how early preparation, trauma-informed care, and advocacy can make a difference in the NICU experience. Plus, Mary provides actionable tips for doulas supporting families through this journey.   (03:18) Discovering the Path to NICU Nursing (06:16) Emotional Impact of NICU Nursing and Family Connections (11:25) Understanding NICU Levels of Care and Medical Needs (17:57) Staffing Shortages and Challenges in NICU Care (21:48) Families' Most Common Questions: "When Can My Baby Go Home?" (25:02) Transitioning from NICU to Home and Navigating Anxiety (29:11) Parental Mental Health and PTSD After a NICU Stay (33:14) The Role of NICU-Informed Doulas in Supporting Families (39:08) Effective Support Strategies for NICU Families (45:52) Resources for NICU Families and Doulas   Resources: Connect with Mary Farrelly on Instagram: @thenicutranslator Visit The NICU Translator website: www.thenicutranslator.com Download the free NICU Birth Plan template: www.thenicutranslator.myflodesk.com/birthplan For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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.

  How can art serve as a powerful way to honor pregnancy, birth, and parenting experiences—especially for families who are often underrepresented in birth spaces?   In this episode, Dr. Rebecca Dekker explores this question with Lauren J. Turner, a Baltimore-based artist, birth worker, and founder of Birth Nerds. Lauren shares how her own home birth experiences, her journey with postpartum and neurodivergence, and a diagnosis of multiple sclerosis shaped her path into birth work and fine art.   Together, Rebecca and Lauren explore how art can be a healing, meditative process for birthing families, and a meaningful tool for birth workers to honor their clients' journeys. Lauren opens up about creating paintings that reflect diverse parenting experiences—from lactation to the NICU—and how she uses bold colors and imagery to bring visibility to Black and Brown families in maternal health.   (03:44) Lauren's First Home Birth Experience and the Impact of Midwives (06:28) A Challenging Second Birth and the Role of Trust and Teamwork (11:19) Starting Over with Doula Training and the Importance of Comprehensive Education (12:27) Living with Multiple Sclerosis and Being Dismissed by the Healthcare System (19:29) Redefining Rest through Art and Creativity (27:51) Exploring Themes in Maternal Health and Parenting Art (28:34) How Parents and Birth Workers Can Use Art to Process Birth (35:41) The Beauty of the Placenta in Art (37:10) Fiber Arts in Birth Work and Creative Expression (40:21) Uplifting Lactation Through Art and Community   Resources Explore Lauren's art: laurenjturnerfineart.com Follow Lauren on Instagram: @birthnerds Shop prints, shirts, and stickers: birthnerds.com Learn more about Mamatoto Village: mamatotovillage.org EBB 92 – Impacts of the Community Birth Worker Model with Aza Nedhari Discover MamAmor Dolls: mamamordolls.com For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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.

  Dr. Rebecca Dekker is joined by Camilla Costa Goetz, a graduate of the EBB Childbirth Class, to share her story of advocating for herself during labor. Camilla, a former fashion student turned full-time mom, opens up about navigating pregnancy with POTS (Postural Orthostatic Tachycardia Syndrome), preparing for birth while her husband was away at Army Ranger School, and making the bold decision to push back against hospital norms to have the birth she wanted.   Tune in as Camilla and Rebecca discuss why self-advocacy is crucial in birth, how hospital policies can conflict with evidence-based care, and how standing firm can make all the difference in your birth experience. Learn tips for preparing your birth team, confidently saying no to interventions you don't want, and making sure your birth preferences are honored—even in a hospital setting.   (02:11) How Camilla Discovered Evidence Based Birth® and Her Pregnancy Challenges (05:11) Navigating Pregnancy with POTS and Health Concerns (10:27) Preparing for Birth Without Her Husband by Her Side (17:31) Planning for an Unmedicated Birth and Overcoming Fear of Hospitals (23:06) The Problem with Hospital Birth Policies and Misinformed Providers (26:13) How Camilla Switched Hospitals to Avoid an Unwanted C-Section (34:26) The Surprising Lack of Support for Unmedicated Birth in the Hospital (39:50) How Camilla Stood Her Ground in the Delivery Room (45:57) Her Husband's Emotional Reaction to Missing the Birth (51:06) Postpartum Challenges, Military Life, and the Strength of Advocacy   For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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.

Some call birth risky. Others know it's a normal bodily function. Today, we're dismantling the fear-based narratives surrounding birth with a podcast favorite—Dr. Stuart Fischbein (Dr. Stu). He began as a mainstream obstetrician with over 35 years of experience, but eventually discovered a whole new approach to birth after working with midwives. (You can hear more about his story in episode 13 of this podcast.) Since then, he's attended hundreds of home births, published peer-reviewed studies on breech, twin, and out-of-hospital births, and now travels the world teaching physiological birth and informed consent. Let me tell you—he's the voice you want to hear when it comes to a balanced and healthy perspective on both the risks and the natural design of birth. In this episode, we're diving into some of the hottest birth topics every woman needs to know—covering what's true, what's fear-based, and the science to back it up. From the political layers of modern maternity care to the financial incentives, routine interventions, and the myth of “high-risk” pregnancies—this episode will challenge what you've been told. It's time to trust your body, question the system, and reclaim your right to birth on your own terms.  In this episode, you'll learn: • Why pregnancy isn't a medical emergency—and how fear is used to control outcomes. • What the research really says about knots and tangled cords around the baby's neck.  • How interventions like epidurals and constant monitoring can disrupt natural birth. • Why informed consent is often overlooked in hospital settings. • How to plan ahead, find a supportive provider, and protect your birth choices.  This isn't anti-doctor—it's pro-mother, pro-education, and pro-truth.

In this episode, I chat with Dr. Rebecca Dekker, founder of Evidence-Based Birth®, about her three very different birth experiences and how they led her to create a global resource for evidence-based information on pregnancy and childbirth. Follow us on Instagram for photos and more from today's episode. EPISODE SPONSOR: ergoPouch (the beloved sleepwear brand) is thrilled to offer an exclusive 30% off sitewide* sale. Ideal as winter is coming. At Australian Birth Stories, we love ergoPouch because they simplify how to safely dress your child for sleep with their ultra-handy What to Wear guide and thermometer, which is precisely what tired parents need. Don't miss your chance to save 30% off* sitewide now!See omnystudio.com/listener for privacy information.

In this mini Q&A, Dr. Rebecca Dekker digs into the evidence on three important questions submitted by EBB Pro Members. Tune in as we explore: The evidence on peanut balls during early and active labor—do they really shorten labor and increase vaginal birth rates? Whether induction at 39 weeks is necessary for IVF pregnancies—what does the research actually say? Dysphoric Milk Ejection Reflex (D-MER)—what is it, what causes it, and how can parents cope?   (02:30) How to Join the EBB Pro Membership & Submit Questions (04:15) (Q1) Peanut Balls in Labor – What does the research say about their use in early labor vs. active labor? (06:50) Key studies on peanut ball use—impact on labor duration, mode of birth, and satisfaction (13:30) (Q2) Induction at 39 Weeks for IVF Pregnancies (16:40) SMFM recommendations, lack of randomized trials, and shared decision-making in IVF pregnancies (20:00) (Q3) Dysphoric Milk Ejection Reflex (D-MER) (22:45) Hormonal theories behind D-MER, coping strategies, and available research (30:00) Recap & How to Find More Evidence-Based Resources   For the full list of references and resources, visit the EBB website here!   For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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.    

Molly joined us for Episode 84 talking about her unexpected breech Cesarean and first VBAC story. Today, she returns sharing her second VBAC story!Molly shares her powerful journey through loss, IVF, selecting her powerhouse birth team, preparing for different outcomes, post-dates, a multiple-day induction, a beautiful delivery (where her husband caught their sweet baby!), and navigating a placental lobe.Allison, one of our VBAC-certified doulas, joins Meagan as a co-host talking about her work as a virtual doula and the importance of how women are treated during their births. Coterie Diapers - Use code VBAC20 for 20% offHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. I hope you guys are having a fantastic day or evening and are excited for another episode of The VBAC Link. We have our friend, Molly, today, and she is from central Alabama, and then we also have a co-host today. She's one of our doulas. Her name is Allison. Hello, Allison.Allison: Hi, Meagan. Hi, Molly.Molly: Hi.Meagan: I was going to say, and hello, Molly. Molly: Hi.Meagan: Welcome to the show you guys, and thank you for joining us. Allison is actually one of our doulas. I don't know if you've noticed along the way here and there, we have one of our doulas on as a co-host. I think it's so fun to hear an educational topic from them and then, of course, share where they are at because I truly believe hiring a doula is so impactful. In fact, on Molly's form, that is one of the tips that she gave. Right, Molly? You're like, hire a doula.Molly: Yes, absolutely. It made all the difference this birth.Meagan: Yes. Doulas are incredible. So if you can, hire a doula. Before we get into Molly's story, Allison, I wanted to just turn the time over to you really quick and have you share a little bit more of where you are at. So for the listeners, maybe in your area, they can find you.Allison: Absolutely. Well, listeners, you have a treat because I serve everyone all over the world, globally. All of my work is online. My business name is The Cesarean Doula because I actually support women and birthing people emotionally after having emotionally difficult or traumatic Cesarean births. I do all of my work primarily over the Internet over Zoom. My focus is actually not on birth but on postpartum and on recovering from the feelings of grief, sadness, loss, overwhelm, and confusion that we often have after a Cesarean that's undesired or that goes in a difficult direction. I had one of those. That's what brings me to this work.Meagan: Yes. I love that you mentioned that you're like, this is what brings me here. I think in a lot of ways for doulas, that's what brings us to doing this work is our own experience and wanting to set a different pace and make change. So I love what you're doing. We're recording in 2024, everybody, but hopefully now, it's 2025, and you can go to our website because we're hoping to have a different option for searching doulas where you can actually go and search for online only because we do have a big chunk of doulas that do virtual support. So let's hope that that is the thing. If not, email me and say, "Meagan, get on it. Do this, because I want this option." Okay. Well, Ms. Molly, welcome to the show. You guys, Molly is a full-time mama, a part-time vet technician, and a soccer coach. That is a lot of things all at the same time. Yes. My husband is a soccer coach and just that alone is a lot. Like I said, she lives in Alabama with her husband and her two sons, her mom, and lots of dogs, cats and horses. She said that she also has two daughters in heaven. I'm sure you're maybe going to talk about that a little bit today, Molly.Molly: Yes, it is part of our story.Meagan: Yes. Okay. Well, thank you guys again for being here. In just one moment, we're going to dive in. All right, Ms. Molly. I don't know why I keep calling you that Ms. Molly, like you're a teacher.Molly: It's the song. It'll get you.Meagan: It comes together. Yeah, seriously. Okay, thank you so much for being here and yeah, I would love to turn the time over to you to share all of these stories.Molly: Thank you very much. So if you guys, if you listen to The VBAC Link, I was on a couple years ago talking about my first C-section and then the subsequent VBAC with my first daughter. Unfortunately, a couple years after that, my daughter passed away. And shortly after that, the desire to have another baby was laid on our hearts, and so we decided to try that.For various reasons, that meant we had to go through IVF. We were very lucky in that our IVF journey was short. That's a whole other podcast on its own, the IVF process. We ended up with three embryos, and then in December of '23, we did our first transfer. That one unfortunately failed. And so that's my second daughter in heaven. We did another test after that to see why the transfer had failed and determined that we needed another day of shots. Well, I say we-- me. I needed another day of shots to do the transfer. So in March, we did another transfer with the extra day of shots, and that one was successful. I had the teeniest bit of spotting the next day and just woke up knowing I was pregnant. It was pretty magical, actually. The at-home pregnancy test, seven days after that, was positive. Then the blood tests after that were positive. I did have a little bit of spotting after that which was a little scary. I talked to my doctor, and she upped the progesterone in oil shots I was taking. The amount of those seemed to clear out the spotting. And then we went in for our first ultrasound. I was diagnosed with a subchorionic hematoma, I think is what it's called, which is essentially like a bruise between the placenta and the uterine lining. That cleared up on its own. Fortunately, after that, I was a "normal" pregnancy. We weaned off the IVF shots. My last one was actually on Mother's Day which was a magical little sign. And that's when we dove right into labor prep. We did the Spinning Babies and bouncing on the birth ball. I walked every day. We went back through our birth plan. We tried to cover every single contingency from a repeat Cesarean which wasn't the goal, but we wanted to be prepared just in case. We prepared to labor at home as long as humanly possible. We even prepared to have a car baby. We had a bag with a bowl to catch the placenta and towels and puppy pads just in case we labored at home so long that we had a car baby.We hired a doula this time around. We had originally played around with the idea of doing a home birth, but in Alabama for VBACs, midwives still cannot attend VBACs at home in Alabama. We did find a midwife who was willing to do that for us but because of the restrictions, it wasn't covered by insurance, and that priced it out. So the compromise was that we would do a hospital birth, but I could have a doula this time. We interviewed doulas and found one who's actually certified by The VBAC Link. She's taken y'all's class and she was wonderful. Her name is Jolonda, and she was fantastic. And actually, in the end, my husband said, "I'm so glad we had a doula for me." Not necessarily for me, but for him. He needed her more than I did, and that was pretty cool. We also, this time, instead of going with an OB, went with midwives. They were associated with an OB practice, but we went just to the midwives. That was an interesting and much different experience. It was more like a conversation and less like an exam. We go in, and they would take my blood pressure, and then we would just talk. It was wonderful. She went through my birth plan point-by-point, and then signed it and scanned it into my chart. Anything that wasn't possible, she'd say, "Well, we can't do this because of the hospital we were at, but we can do this or we can try and do this and make that work." She was completely accepting of anything that I wanted to do differently. We decided not to do the erythromycin eye ointment. She said, "Yes." She was fine with that. We delayed, I think, the Vitamin K shot then and the delayed cord clamping. She was all 100% supportive of everything that we wanted to do. I did have to see the OB once just so they could sign off on me being a, quote, healthy pregnancy, and that was a quick in and out. There was a doctor visit, and they said, "Okay, we'll see you back in a couple of weeks." I said, "No, I'm going to go back across the street to midwives. I'll see them in a couple weeks." So that was all. My pregnancy really in itself was pretty normal. And then we got closer and closer to my due date. Now, I was due on November 18, and we got closer. I stopped working as a veterinary technician on the end of October right before Halloween. We had our baby shower. We were getting close to all the guess dates. Everybody had guessed when your baby's going to come. I would text them, "Nope, you missed it. It wasn't today." And so we slowly passed all those days, and then we passed my due date. We were doing everything-- the tea and bouncing on the birth ball and the dates and the pineapple, walking, The Miles Circuit, curb-walked. I knew the closer we got to 41 weeks and 42 weeks even, the more that there was going to be pressure for a repeat Cesarean. Now, to my midwife's credit, she never mentioned a repeat Cesarean. That was the very last thing that she ever talked to us about. We had talked about it in our birth plan, of course, but as we passed the due date, she didn't mention that as a course of action. As a joke, we asked our son, "When do you think Mama will have the baby? Now that we're past our due date, when do you think Mom will have the baby?" And he said, "I think she's going to wait until December." I said, "Buddy, please don't put that on me." So we'll let you know how that goes towards the end.Meagan: Yeah, I mean that would be what, two and a half more weeks? Three? Yeah, two and a half more weeks.Molly: Yeah, it was a long time. And I said, "Bud, please don't put that on me. That's a long more time." So then we made it through Thanksgiving. I consented to a cervical check at 39 weeks and there was no action the cervix, but you and I know that that can change in an instant, and it's not an indicator of anything. Meagan: Nope.Molly: At 40 weeks, I consented to another check and to a sweep of the cervical membranes. That made me feel crampy but really didn't do anything. We started talking about induction at that appointment. We talked about starting with the Foley bulb over breaking the waters or maybe Pitocin. We talked about those options and which ones I was most comfortable with. And so then after the 40-week appointment, they sent me in for a biophysical and non-stress test, and we passed those with flying colors. No problem. Baby was fine, I was fine. She just was very, very comfortable. Then at the 41-week appointment, we did another sweep and this time I was dilated to a really tight 1. But again, that didn't really do anything. We made our next appointment for 41 weeks and 3 days. And the ladies in the front office said, "We hope we don't see for that appointment." And I said, "I hope you don't either," but we did see them for that appointment. So at 41 weeks and 3 days, we talked about the induction again. They did another sweep just in the hope that maybe it would start things. It didn't. So we talked about and scheduled the induction. We'd agreed to start with the Foley and see how that went, and then maybe talk about breaking waters and maybe, maybe Pitocin being our last resort. We stopped for dinner. That was Wednesday evening. We stopped for dinner on the way in because I was like, "We're going to have a baby, and I need my strength. I've got to eat before we go in." So we stopped for dinner, and we got checked in. They got me strapped in with a wireless monitor, which was new this time and was so much better than the wired monitor because I could move. It was much better. And this is the start of what we like to jokingly call birthatory, because it's birth purgatory. I was stuck there in the room. I couldn't leave. My husband left just to get us food, but it just felt like we were there forever with nothing to do. And time moved strangely as well. I watched Friends at night to help me sleep, and I watched Parks and Rec during the day to keep me entertained. We did a lot of walking up and down the room as much as we could. And that Wednesday evening was just to start us monitoring. Jolanda came in, and she was in and out and checking with us that night. They also started me on the Group B strep meds. I think I forgot to mention I was positive this pregnancy. I had a weird reaction to whatever med they put me on first, like my scalp was on fire. It was a really bad reaction. Meagan: Interesting. Is that a common reaction?Molly: I believe they said it could happen, but it's not super common. I wish I could remember which medicine it was they gave me. But, I mean, it felt like my scalp was on fire. I was itching. It was horrible. So they gave me some Benadryl which fortunately helped me nap, so I got some rest. But we didn't want to do too much of that, so they switched me to a different medication. And again, I wish I could remember the name of it, but I can't. And that, I did not react to, so we stayed with that one for the rounds of the Group B Strep meds. So that was Wednesday night, and they were really just monitoring me. Thursday morning, the OB and the midwife on call came in to discuss my case. They discussed options. Pitocin. I consented to a check because we were going to start with the Foley, but I was at a 3 already. So that put the Foley out of commission because the Foley will only work up to 3. We talked about Pitocin versus artificial breaking of the membranes. The OB did do a little bit of pressuring, but we were all prepared for it. He said, "Well, at this point, this many post dates, you're probably definitely going to have meconium." And behind his back, my doula, my sweet doula rolled her eyes. It was what I needed, that support in that moment for the doctor to say, "Oh, well, there's definitely meconium." And my doula would be like, "No, there's probably not." So we asked for time to discuss between us and what to do. And Yolanda had these little informational cards with different affirmations. There was affirmation cards, but different, like facts about, induction from-- oh, I'm blanking.I can't remember. But they were little printed out laminated cards with different facts about different types of induction, and they were really helpful.It's Evidence Based Birth. That's what it was. It was all evidence-based and backed up by studies and stuff. So we discussed what we wanted to do, and we agreed to breaking the waters on Thursday morning. So the midwives came in and broke my waters, and there was no meconium. So that doctor can just go sit somewhere else. My waters are broken. I walked up and down the room, but nothing really happened. That night, there were some surges that we did time, but they petered out, and nothing really happened. So we woke up Friday morning, and that was December 1st. I, with despair in my voice, looked over at my husband and I said, "It's December. We've made it to December." I felt like a balloon that was beyond needing to pop and was just discouraged and tired. I was at the end of my rope, really, honestly. They came in, and I agreed to another check. This was the first check that they'd done since they broke my waters. And so if you're keeping count at home, my water's now been broken for about 26 hours. We happen to be watching an episode of Friends where the character, Rachel, is in labor, and she's having trouble dilating as well. And Ross makes a joke about, "I'm dilated 3." Well, they did the cervical check and checked, and I was still dilated 3. And Michael goes, "I'm dilated 3," and everybody laughed. It was a good break in the tension. After that, they left to go discuss my case. Michael went to go get me some hot water so I could make tea. But he came back in and he said, guess who's here and looking at your chart?" And I had no idea. He said, "It's Vicky," who's the midwife who helped deliver my first VBAC baby. She had retired, but come out of retirement and was only working on the weekends in the hospital. And I looked at him. I said, "We're having a baby today." Just something told me that with Ms. Vicky there with us, we were in good hands, and we were going to be okay. So she came in and talked to me about starting Pitocin. She also told me, because at this point, I was worried about a repeat Cesarean. And she told me, she said, "I'm no longer looking at you as a VBAC patient. You've had a successful vaginal birth. I'm treating you just like any other birth now." And it was such a healing statement for me. It wiped the worry about a repeat C-section out of my mind. It was just the perfect thing to say.Meagan: Yes. I don't want to interrupt you too much, but I love that you pointed that out, because most providers, they're actually looking at no matter if you've had a VBAC or not, you're always a VBAC. But what you just said to me really is gonna connect with so many others. It connected with me because we just want to be viewed as someone going in and having a baby. We don't want labels and these things that loom over our head even if we've had a VBAC before or if we haven't had a VBAC before. We just want to be looked at and treated as someone coming in and having a vaginal birth just like anybody else coming in and having a vaginal birth. So I love that you pointed that out, and I'm sure that that really did just connect and feel so good.Molly: It was a huge release of stress knowing that I didn't have to worry about the repeat C-section, the VBAC anymore, and I could just focus on having the baby and what I was doing and just doing what we needed to do that day to have the baby.Meagan: Yeah.Molly: So we did agree to the Pitocin she suggested. And we got very into the details, and we're almost a year out. I should have written them down sooner. I can't remember the numbers we started at, but she wanted to start at a certain amount over a certain time, and I disagreed. I said, "Let's start lower and slower." And she said, "That's fine. I'll do whatever you want to do." So we started really low and really slow, and I was starting to feel some things, but still not very much. It wasn't anything I had to stop to get through. It was really more just like a tightening. Jolanda came to hang out with us, brought us more food and water, and she brought a puzzle to help distract us. We were going crazy being stuck in that room. Vicky came in later that afternoon, and because still no progress was really being made. They didn't check me, but they could just tell from the contractions on the monitor. She talked about wanting to up the Pitocin a little bit faster and more frequently. I told her that I was worried about the difference in the Pitocin contractions versus natural contractions because I had heard and read so much that the Pitocin contractions are much more intense. And she told me that she'd given birth with and without Pitocin, and the only difference for her was that Pitocin births were faster. I agreed for her to bump it up a little bit, a little bit faster, that. After a little bit of time to talk about it, we agreed to do that. They did check me at that point, and I had worked my way up to a 5, and baby had moved from a -1 to, I believe, a +1. We dilated some, and baby had descended a little bit. At that point, the contractions did start to pick up, and I lost interest in the puzzle. We turned a movie on for me to watch. They were a little bit more intense, but still easy, and I could still talk through them and walk through them. Jolanda did an excellent job. She reminded me to go to the bathroom. And so I went to the bathroom, and when I walked out, I felt the baby drop. I don't know any other way to explain it, but I felt her drop in the birth canal. It was like she was sitting high, and then suddenly she dropped. I said that. I said, "Oh, I felt the baby drop." My sweet doula said, "You felt the baby drop?" I couldn't respond to her because then a contraction hit so hard that I could not talk through it. So, at that point, I told them, I said, "Please turn the movie off," because I couldn't handle the sound of movie. My husband turned on music in the background real low of our birth playlist. I needed to get down on all fours, so I got down on my knees, and I was bent over a birth ball swaying back and forth and moving forward and backwards, swaying my hips and vocalizing through them. Keep your mouth loose and low, moaning through them. At some point I didn't need the ball anymore and Jolanda brought in this inflatable thing. It was U-shaped and it was inflatable, but you could be in it and lean over it. And again, I wish I remember the name of it, but it wonderful because you could inflate and then deflate it to move it and get it out of there. But it was just perfectly shaped for me to be able to lean over it and even sit on it if I needed to, but I just was leaning over it. The contractions were getting more difficult, and she reminded me to relax my hands because my hands had gotten really tight. She was reminding me to breathe and relax my hands. She also suggested counter-pressure on my tailbone. I did not want it on my hips, but she tried it on my tailbone, and that felt incredible. Suddenly, the contractions were so much easier to bear, and they just felt more productive. It was fantastic. So she and my husband, Michael, took turns wearing their arms out, pushing my tailbone through the surges. At, that point, then the wireless monitor got weird because it had been on me for so long. The stickers, I guess, had just given out. So a poor nurse was on her knees underneath me holding the monitor on my belly, and there was either Jolanda or Michael behind me pushing on my tailbone through the contractions. And then I started grunting and felt pushy. Juolanda recognized my grunting because we talked about during my consult during my first VBAC. I get grunty when I'm pushing. She recognized the sound and she said, "Are you pushing?" But I didn't want to answer her because I didn't want to stop pushing because it felt so good to push. I hadn't been checked. So I didn't want them to know that I was pushing and check me and tell me that I couldn't push. And also, at this point, I was practically sitting back against the counter-pressure. The surge would hit, and I would sit back into whoever is doing counter-pressure and practically put my full weight back on my tailbone on their hand and the counter-pressure. Then, my knees got tired being on the floor. So I asked to move to the bed and they asked to check me. The midwife, Ms. Vicky, said, "I would love to check you right now." I said, "As long as I can be on my hands and knees, you can check me however you want."So I got up on my hands and knees on the bed, leaned over, and they checked me, and I was good to push. So at that point, we started actively pushing. Not just me pushing because it felt good, but pushing because we knew we were pushing a baby out. And pushing, it felt so good to push. I needed to push. It felt so good. I could feel her moving through the birth canal. I could feel her head coming down, and it was amazing. And just like with my first birth, it's frustrating to feel the baby move and then go back and then move forward and then go back, but you can tell you're making progress. I don't know how long I pushed for because I was way off in who knows where. Nobody else looked at the clock. Michael would have, but he was getting ready to catch. He had prepped to catch this baby. So I pushed her out into her papa's hands. He had prepped. He watched all kinds of videos meant for midwives, and he was so ready. He did such a great job. Baby Nora was there, and she was perfectly healthy. She was 7 pounds and 2 ounces, and 19 inches. For being 41 weeks and 5 days, she was still just perfectly cooked. I passed the placenta at some point after that. We did the golden hour, and we snuggled in. He cut the cord after it stopped pulsing. That was all very much a blur to me, just a golden, snuggly haze of love. So we passed the placenta, and it was declared complete. We looked at it, and we put in our little cooler to take home and freeze to plant her little birth tree. I did tear a little bit, so they stitched me up and we took some pictures. And then Ms. Vicky went home. She'd stayed 45 minutes late for us. She went home at that point, and I started nursing Nora. At that point, however, I was still in pain. So they said, "Would you like something for pain?" I asked for just Tylenol. I didn't want anything heavier than that, but I was still pushing. I was still feeling the urge to push, and it was getting worse. So the nurses applied some pressure to my uterus, external pressure. It hurt so bad I could barely stand it. Michael took the baby at that point, and Jolanda suggested me trying to avoid my bladder, and maybe that would help. But I couldn't. I couldn't get those muscles to work, so they put a catheter in. That didn't really help. The surges were still coming and I couldn't stop pushing. They put more pressure on my uterus, external pressure, and I passed a huge blood clot. It was like a softball-sized blood clot. That felt a little better, but I was still pushing and I could not stop the pushing. So they gave me some stronger pain meds and talked to the OB who was on call and all agreed that I needed to go the OR and see if something had been left. So we agreed to that and went under sedation into the OR, and they removed a golf ball-sized portion of the placenta. Meagan: Whoa.Molly: Yeah. It was confusing because they had declared my placenta complete and after talking about it, and they looked at all the pieces, and it turns out that I had a lobular lobe.Meagan: I was going to say you probably had a lobe.Molly: Yes. And so after I mentioned "Oh well, I had some spotting early in pregnancy," they figured that the spotting had contributed to that, and that's why the placenta looked complete and there was a lobe and the hematomas all contributed to the early bleeding and the lobe in the placenta. I came out of the OR fine. I got two bags of blood but felt fine. When I woke up, I got to hold Nora in the OR. Well, not in the OR, but in the recovery and nurse her again. And everything was really fine after that. Jolanda checked on us a couple of hours after that. She brought us food. We had talked about what I wanted to eat post-birth. I wanted to eat a cheeseburger with bacon from a specific place near the hospital with fries. She brought it all, and we ate it at like 11:00 PM. It was wonderful. And Michael, like I said before, said later that having a doula this time around was 100% worth it mostly for him because she was suggesting things that he wouldn't have known to offer like the counter-pressure and, "Hey, maybe she needs to pee," and things like that. It saved him and helped him know what to do while I was off in labor land. For that, our sweet doula was so worth it. And after that, recovery was great, and we were fine.Meagan: That is awesome. So still had a little bit of a hiccup there in the end, but overall a really great experience.Molly: It was awesome. And I said before, with the birth plan, we tried to plan for all contingencies, but the one thing we did not plan for was three days trying to be induced naturally. Meagan: Yeah.Molly: I mean, they say time isn't linear, and I have never felt that more true than we were stuck in that room for three days. It was very weird just not being able to get out. It's not something I would do again, the induction part, but we made it through thanks to great support from midwives and doula and my wonderful husband. I would do the birth part, and maybe not the hemorrhaging at the end, but the birth part I would do again.Meagan: Yeah, yeah, for sure. I mean, that's just less ideal. I don't know. Did they ever talk to you? Because I know that IVF parents do have a slightly increased chance of hemorrhaging. Did they ever relate it to IVF, or was it mainly just, "Hey, you had a subchorionic hematoma earlier, then you have this lobe." Maybe it was just that they.Molly: The doctors didn't. No, we were very aware that she was an IVF baby, and we had done a lot of research before that IVF babies have a very "sticky" placenta.Meagan: Yeah.Molly: That was one of the factors why we didn't do a home birth was because if the placenta sticks, and then you're at home, it can be a rush to the hospital. But the doctors at the hospital didn't mention the IVF possibility as the reason I hemorrhaged. Maybe it played a part. I don't know. They seemed to put it on the sub-chorionic hematoma. But it could have been both. I don't know.Meagan: Yeah. Yeah. All of the little factors could have been. The best thing is that it seemed pretty minor and a quick fix. A quick fix. I just wanted to remind everybody, so I'm pretty sure this is your episode. It's Episode 84. So if you want to go hear the breech Cesarean and the first VBAC, definitely go back and listen to those on Episode 84. Thank you so much for sharing your story, and I'm so glad that it was so great and that your husband got to catch a baby. That's like my favorite, you guys.Just to let you know, that's happening more and more. At least it has been here in Utah as we're attending births. Sometimes, all you've got to do is ask. So if you have a partner who is interested in that, I think asking is not harmful. Just ask. It can seem intimidating, but it's not too bad. It's not too bad. They really help these partners catch these babies. Allison, I would love to have you share your two cents and your educational topic on healing after Cesarean. We're doing these topics instead of reviews sometimes when we have guests. I love what you do because just like Molly and myself, we've been there having an unexpected-- well, maybe with the breech it was kind of planned. I'm trying to remember back in your story.Molly: So with the breech, with the Cesarean, we had planned a C-section, but then he broke my water early, so it was not necessarily an emergency Cesarean, but we had to go in before we were "scheduled" to for the C-section.It was planned, but unexpected at the time. The wrong timing. Yes. Okay. Well, tell us more, Allison.Allison: Yeah, and I want to say thank you so much, Molly, for sharing your story. I actually want to point out a few things that I think are really important here. I work with so many people who have had a birth that feels difficult or traumatic. And oftentimes, there are women who come to me who say, "I don't understand why I feel upset about my birth even though I have this baby who's healthy and alive, if we're lucky enough to have a living baby or a healthy baby or both." And one of the things I talk a lot about is that oftentimes it's not the events themselves in the birth that create a difficult or traumatic birth, but it's how we feel, right? And so, what makes a birth feel good or bad? Like, I listen to you talk about this experience where you had some challenges leading up to it, right? Especially preconception, and then during conception. I felt your joy. I felt your connectedness, and I felt your power throughout your story even as you talked about the really difficult part at the end with the placenta needing to be retrieved. I want to just point out that that's what I heard, and you've got to tell me if this feels right for you, Molly. But what I heard was many moments where you talked about feeling connected. You talked about your sweet doula. You talked about that surprise midwife coming in to support you. You felt connected. You felt seen like that moment where you said, "Oh, well, the monitor wasn't working, but then the nurse got underneath me," so instead of actually you accommodating the hospital's protocol and policy, I love this idea. I'm imagining a nurse laying on her back under you while you're on all fours. You're empowered. That's truly centering you. Right? You're in control in a lot of these moments. You said you wanted the Pitocin lower. The doctor or the midwife honored that. It sounds like you were informed. You used some examples of the cards from Evidence Based Birth, and a lot of the information you engaged with prior to birthing. One of the things I talk about with my clients is maybe you even feel sexy during birth. You didn't mention that at all, but that might have been. There might have been moments, maybe not. Are there any other emotions that come up for you? Did I leave anything out hat you're like, oh, I really felt another positive emotion?Molly: No, you've nailed it 100%. I felt very supported this birth from the midwife listening to me and, like you said, honoring my requests and my husband being there and the doula. I felt very supported. So even the end and the hemorrhaging which should have been scary, I don't look back on as scary. I don't want to repeat it, but I wasn't scared in that moment because I felt taken care of and supported.Meagan: Mhmm. Allison: Right. That is so textbook. I love this story because that's a really, really scary thing. And if you hadn't had that support, that attunement, that communication and that safety, it could have felt different. It could have made your story feel like there was this turning point into a dive. I love that your advice was getting a doula, because in your story, I really feel how your relationship and respect for her are a big component of your support and empowerment. So I just want to end by saying that birth is really about those emotions, not the modality or even the environment where we birth. If we can create those experiences for ourselves as much as possible, we don't always have the ability to do that. Lots of things have to come together, but if we can focus on, how do I make myself feel empowered, connected, sexy, seen, in control, informed during my birth, however I birth, then the likelihood of having a positive outcome emotionally is so much higher. And when we have a better emotional experience, we're more likely to be able to have a supported breastfeeding experience and also go into motherhood feeling centered, feeling capable of taking on this new role or another baby when we already have littles at home. So thank you so much for sharing your story. I feel really touched, and I can imagine that others are too.Molly: Thank you.Meagan: I do love that you pointed that out, Allison. The way we feel during our labor, the way we're treated, the way we're communicated to, it really impacts that next step going into that motherhood era. I think back on your story. I remove your doula from your story, and I remove your supportive provider. That birth very much could have unfolded very differently especially because it was a longer induction. Right? And so when you put that powerhouse team with that true love and support back into the story, it's like, well, I don't understand why it wouldn't unfold that way anyway.But really, if you look back without that, it's questionable sometimes. And so we talk about it, you guys. I think I will probably talk about it until I die. I mean, truly, I will probably not even be in this work when I'm 80 years old, but I will still be educating people on hiring a supportive team and provider because it really does impact. I had an interview the other day with a first-time mom and she was telling me who her provider was, and I very much remember this provider as a resident. And she was fine, but not great, right? She wasn't my favorite. I very much knew, oh, in the future I would not suggest her as a provider. And so as I was talking, and I didn't want to project my opinion on her, and I was talking to her, she said that her and her husband had actually been feeling a lot of pressure and that when she goes into her visit that she normally has a voice, but when she's there, her voice is muted. She feels like she can't say these questions and can't communicate. I think right there is that big red flag that if you cannot communicate with your provider in a prenatal appointment, then that is a big sign that you will not be able to communicate with your provider efficiently during labor, and they're not going to respect you. I love that your midwife came out of retirement and started working on the weekends because she probably loves this so much and that you got her. It worked out so, so well. But guys, again, find a good, supportive provider. If you're feeling like my interview did the other day, don't hesitate. Move, change, find that support because you want to be like Molly where you're in the situation and you feel that love and empowerment. And even though there was something that ,went awry and not according to plan, Molly felt that support. And so like Allison said, that could have been a very traumatic point in your labor where it wasn't ideal. You wouldn't do it again. You wouldn't choose it. You wouldn't suggest it. But even though it happened, and I don't want to downplay it like oh, least everyone's happy and healthy. I don't want to do that. But it happened, and because you had that support, your overall view is different. So great tips, Allison. Beautiful story, Molly. Again, go back and listen to Episode 84 for the rest of her stories. And once again, thank you for being with us.Molly: Thank you so much for having me.ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Dr. Shilpa Babbar, a double board-certified maternal-fetal medicine specialist and OB/GYN, joins Dr. Rebecca Dekker to discuss the role of integrative obstetrics in pregnancy and birth. Dr. Babbar shares her journey into maternal-fetal medicine, how she became interested in yoga and breathing techniques, and the growing body of research on prenatal yoga. They discuss how breathwork can support pregnant individuals, the physiological effects of deep breathing, and how birth workers can incorporate these techniques into prenatal care. Dr. Babbar also shares her experience using alternate nostril breathing to manage blood pressure during pregnancy and her vision for making integrative therapies a standard part of obstetric care.   (01:41) Dr. Babbar's Journey into Maternal-Fetal Medicine (04:16) How Yoga and Prenatal Yoga Research Began (09:37) Studying the Effects of Prenatal Yoga on Pregnancy (12:46) Yoga's Impact on Labor Duration (14:33) The Role of Breathwork in Pregnancy (17:48) How Dr. Babbar Used Breathing Techniques for Her Own Pregnancy (22:30) The Science Behind Alternate Nostril Breathing (28:52) Guided Demonstration of Deep Breathing Techniques (35:10) Applying Breathwork During Pregnancy and Labor (39:08) The Future of Integrative Obstetric Care   Resources Learn more about Dr. Shilpa Babbar's work at drshilpababbar.com Follow the Integrative Obstetric Care Conference on Instagram: @IOBCare   For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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.

Madi van Tonder is a birth photographer, doula, and educator based in the Netherlands. Originally from South Africa, Madi has lived in multiple countries and brings a unique perspective to birth work, particularly for families navigating new healthcare systems.   Join Dr. Dekker and Madi as she shares insights into the Dutch maternity care system, where midwives play a central role, home birth is considered a national heritage, and postpartum families receive in-home support through the Kraamzorg system. We explore how Dutch birth culture prioritizes physiological birth, minimizes unnecessary interventions, and encourages parents to trust in their bodies. Madi also highlights the challenges faced by immigrant families and the importance of informed decision-making, regardless of where you give birth.   (00:03:16) Overview of the Dutch Maternity Care System: Midwife-Led Model (00:05:52) Home Birth as National Heritage: Dutch Birth Culture & Trends (00:06:54) Role of Doulas in the Netherlands & Their Place in the System (00:10:33) Dutch Approach to Birth Interventions & Cesarean Rates (00:12:46) Pain Management Options: Non-Medicated Comfort Measures First (00:16:18) Early Hospital Discharge & the Kraamzorg Postpartum Care System (00:20:01) Dutch Parental Leave Policies & Family-Friendly Work Culture (00:22:54) Challenges in the System: Protocols, Immigration, & Language Barriers (00:28:47) Lessons from the Dutch Birth Model: Autonomy, Education & Low-Intervention Birth (00:31:08) Madi's Advice for Expecting Parents & Birth Professionals   Resources Learn more about Madi van Tonder and her work at Meraki Madi. For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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.

EBB Childbirth Class graduate Krista DeYoung joins us from her hospital room to share her journey through a high-risk pregnancy, an extended antepartum hospital stay for partial placental abruption, and preparing for a scheduled Cesarean at 37 weeks. Krista opens up about the challenges of long-term hospitalization, advocating for herself in a complex medical system, and the emotional toll of being away from her family. Dr. Rebecca Dekker walks Krista through creating a Cesarean birth plan, covering topics like delayed cord clamping, optimizing the operating room experience, and postpartum recovery expectations and strategies.   (00:03:01) High-Risk Pregnancy & Partial Placental Abruption Diagnosis (00:07:35) Managing an Antepartum Hospital Stay: Challenges & Coping Strategies (00:12:09) Navigating Medical Information & Self-Advocacy in the Hospital (00:26:53) Mental Health Strategies & Staying Positive in a Prolonged Hospital Stay (00:31:36) Preparing for a Cesarean Birth: Creating a Birth Preferences Plan (00:36:28) Discussing Delayed Cord Clamping & Other Cesarean Options (00:45:17) What to Expect Physically & Emotionally During a Cesarean (00:48:52) Postpartum Recovery: Healing, Movement, and Emotional Processing (00:53:29) Building a Postpartum Support Plan   Resources EBB 304 – Q & A on PPD/Pitocin, Delayed Cord Clamping, Nubain, and Placental encapsulation EBB 305 – A High-Risk Pregnancy and Miraculous Birth with Krista and John DeYoung, EBB Childbirth Class Graduates EBB 343 – Top Ten Evidence-Based Strategies for Lowering the Risk of Cesarean For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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, Dr. Rebecca Dekker is joined by Trish Ware, Registered Nurse, childbirth educator, and host of The Birth Experience with Labor Nurse Mama. With 16 years of labor and delivery nursing experience, Trish shares her journey from feeling disempowered during her first birth to becoming an advocate for changing the birth culture one birth at a time. Tune in as Trish and Rebecca discuss how to effectively advocate for yourself during labor, overcome fears of being "that patient," and navigate common labor scenarios like refusing unnecessary interventions. Learn tips for building a strong birth team, empowering your partner to advocate for you, and ensuring your voice is heard in the delivery room.   (01:31) Trish's Journey to Becoming a Labor and Delivery Nurse (05:42) Early Birth Experiences and the Importance of Advocacy (10:59) The Power of Human Dignity During C-Sections (13:38) Why Parents Struggle to Advocate for Themselves (17:07) Changing the Power Dynamic in the Labor Room (20:43) Thinking Outside the Bed: Encouraging Movement in Labor (25:43) Advocating for Yourself with Simple, Firm Responses (34:57) Protecting Yourself Against Unwanted Interventions (38:59) Empowering Birth Partners to Advocate Effectively (43:31) Building Strong Birth Teams with Nurses and Doulas   Resources Join the virtual EBB Conference here.  Explore birth classes and the Mama Membership at Labor Nurse Mama. Listen to The Birth Experience with Labor Nurse Mama podcast here. Follow Trish on Instagram for educational content and reels: @LaborNurseMama. Learn about induction and informed consent with the Induction Pocket Guide here. For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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.

Jen McLellan, founder of Plus Size Birth and host of the Plus Mommy Podcast, is joining Dr. Dekker to explore how birth workers can provide compassionate, size-inclusive care for people in larger bodies. Jen shares her journey to founding Plus Size Birth, the impact of size bias in healthcare, and practical advice for both expectant parents and birth professionals. Together, they discuss how to challenge assumptions about plus-size pregnancies, the importance of self-advocacy, and how to create a welcoming and supportive environment for all bodies during pregnancy, birth, and postpartum.   (01:41) Jen's Journey to Founding Plus Size Birth (03:42) Misconceptions About Plus-Size Pregnancy (07:35) The Effects of Weight Bias in Healthcare (10:09) Navigating Healthcare as a Plus-Size Person (14:36) Tips for Birth Workers to Provide Size-Inclusive Care (17:46) The Power of Language in Size-Inclusive Care (24:06) The Impact of Healthcare Bias on Other Areas (28:50) The Challenge of Anesthesia for Plus-Size People (33:09) Addressing Bias in Fertility and Pregnancy (43:40) The Future of Ozempic and Weight Loss in Pregnancy (46:17) Empowering People Through Size-Inclusive Support (50:47) Body Image and Advocacy   Resources Get the Plus Size Pregnancy Guide and Audio Book here. Sign up for the Size-Friendly Birth Course for Birth Professionals here. Tune in to the Plus Mommy Podcast here. For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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.

“I am not a TOLAC patient. I am a VBAC!”Julie sits down with Colleen, a mother from Long Island, New York, who shares her journey towards achieving a successful VBAC despite facing challenges such as gestational diabetes. Colleen recounts her traumatic first birth experience and the uphill battle she faced with her second pregnancy. She was bombarded with messages that her baby would suffer permanent nerve damage from shoulder dystocia, but her intuition told her otherwise. Though her baby's weight was predicted to be off the charts, Colleen's daughter was born weighing just 7 pounds, 15 ounces. This episode emphasizes the importance of understanding your options, having a supportive team, and trusting your instincts during birth. The VBAC Link Blog: The Facts About Shoulder DystociaEvidence Based Birth® - The Evidence on Big BabiesEvidence Based Birth® - The Evidence on Induction for Big BabiesCoterie Diaper ProductsHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details ​​Julie: All right. Good morning, Women of Strength. It is Julie Francom here with you today. I am super excited that we have with us Colleen here today. Colleen is going to share her story about her VBAC with gestational diabetes and the struggle that she had working towards her VBAC. Now I am really excited to introduce Colleen to you. She is from Long Island, New York. I do not have a Review of the Week. I forgot to pull that up, so we are going to just do a little fun fact about birth preparation instead of a review because I forgot to look at the review. So sorry, Meagan. I think probably the best thing that you can do to prepare for any type of birth is to find out what all of your options are. I feel like that's like such a good tip for first-time moms or going in for a VBAC or even if you want to schedule a repeat C-section or even an initial C-section. I think that one of the biggest disservices we can do to ourselves is not knowing the options that are available to us and not standing up and speaking up for ourselves when the things that we want are not what is done, normally or typically in whatever setting we're choosing to birth at. I love the phrase "if you don't know your options, you don't have any". I think that that is true. And I think that there's never a circumstance where we can be too prepared going into any type of birth experience. So if you're listening, I know that you're already on top of that because you want to get educated and inspired about either VBAC or what your options are for birthing after a C-section. So stick in there. We have a VBAC prep course for parents and for doulas to learn more about VBAC as well. You can find that on our website, thevbaclink.com.All right, let's go ahead and get into it. I would love to introduce you to Colleen. She is a mom of two. She's a teacher living in Long Island, New York. Her first birth and postpartum experiences were incredibly traumatic. She says, "The moment that they wheeled me to the OR for my C-section, I knew I wanted a VBAC. After being diagnosed with gestational diabetes in my second trimester, I faced an uphill battle to achieving my VBAC." And finally, after delivering her daughter, it was the most healing experience she could have ever imagined. We're going to talk a little bit more about those struggles and gestational diabetes and maybe a bait-and-switch, it sounds like, from her new provider at the end of the episode. So hang in there. I'm excited to hear from Colleen. Colleen, are you there?Colleen: Hi.Julie: Hi. All right, you go ahead and get started, and I am super excited to hear your story.Colleen: All right. I guess I'll start with my C-section because that's, I guess, where every VBAC starts. So my pregnancy with my son was textbook perfect. Everything that you want to go right did go right, so I naively expected my birth to follow that same pattern. Hindsight is 20/20. I know I shouldn't have, especially since I've been listening to different birth podcasts for a while, and I know that's really not how it goes, but I guess as a first-time mom, I didn't think about that stuff. So when I went into labor with him, I think I was 38 weeks and 5 days, just shy of 39 weeks. It was an incredibly long labor. I was in labor with him for 40 hours. We stayed home that first day, and then when things started to progress the next day, we headed to the hospital. When I got there, they checked me and did all of the administrative type of things, and I was already 4 centimeters dilated, so they kept me. The first thing that they asked was about an epidural. I knew that I had wanted one, but I didn't know when in my labor I had wanted one. I just heard from a bunch of different people that sometimes anesthesia can take a very long time to get there. So I requested it immediately, not anticipating them to show up five minutes later. I think my husband walked out of the room to fill out another piece of paperwork when he came back there. The whole anesthesia team was in there. I got it at about 4 centimeters dilated, and then just expected for things to go as birth is "supposed" to go. I ended up dilating very, very quickly. Within 10 minutes, I was 8 centimeters dilated. But with that, because it was such a rapid jump, my son's heart rate wasn't able to keep up with it. So there were a ton of people in the room in a matter of seconds. They ended up giving me shots in my thighs to slow my labor. I'm not sure what the medication was. They just did it, and then that was that. And then I stayed in the bed for about 10 hours. I'd asked my nurse to come in and help me move a little bit, and she told me no. She told me because I had an epidural, I could not move. But things were taking a very long time. So at one point, she came in. She's like, "I'll just give you a peanut ball." But at that point, I was still on my back. They had me laboring on my back. She told me to just shift my legs over, and she draped them over the peanut ball, and then left again. And then later on, I started feeling pressure. They came in and they were like, "Okay, yeah, we can do some practice pushes," or, no, let me backtrack. I'm sorry. It took a while, so they ended up pushing Pitocin before I started feeling the pressure, and then a little bit after that, that's when that happened. So they came in and they were like, "Okay, we can do some practice pushes." And I think they let me do two. During those pushes, my son's heart rate dropped dramatically. At that point, it was me, my husband, the hospital OB, not even my OB, just the staff one, and a nurse in the room. But when his heart rate dropped, I think there were 30 people in the room. So at that point, they flipped me over on all fours and just ran out of the room with me. They didn't tell me what was going on. They didn't tell my husband what was going on, so he was in the corner panicking. They were really shoving him back into the corner. I remember being so, so terrified of what was going on just because I didn't know what was happening. All I knew was they were rushing me to the OR. This was 2022. So it was the end of COVID. I remember crying so hard that my mask was just absolutely disgusting. When I got into the OR, there was still no information on what was happening, and they just pushed the full dose of the epidural or spinal, whatever it was, for the C-section. My OB was in the OR at that point. So the practice I was with was so large that even though I had met with a different OB every single appointment, I'd never met this one. She ended up being absolutely phenomenal, but it was very intimidating not meeting the person who was delivering my baby ahead of time. So they have me in the OR, and she says, "Okay, if you are okay with it, we can try to deliver him vaginally with a vacuum." I agreed to that because the last thing I wanted was a C-section. The idea of major surgeries really freaks me out. I definitely didn't want that if I could avoid it. With the vacuum, they let me push three times to try to get him out. Obviously, that did not work. So I ended up having a C-section. The first thing that my OB had said to me after I delivered was that I was a perfect candidate for a VBAC. She said the incision was low. Everything went beautifully. She told me that the C-section was not my fault, which I didn't realize how supportive that was in the moment because I was already beating myself up from it. So then we move into recovery and the mother/baby unit, and everything seemed to be going okay. And then the day that I was supposed to be discharged, I started having, like, I wouldn't even call it a headache because I get migraines so a headache to me is different than to other people, I guess. But I couldn't move. I couldn't walk. When I would stand up, I felt like I was going to fall over. So they added a couple of extra days to my stay, and I ended up having a spinal fluid leak, but the anesthesia team didn't want to say it was that. They were saying it was everything other than that. They said I pulled a muscle when I was pushing. You name it, and they said it was that. It was everything other than a spinal fluid leak. I ended up having some-- I don't even know what kind of procedure it was. It was like a COVID test on steroids. They put long swabs up my nose and essentially numbed my sinus cavity and sent me home because it helped a little bit. And then five days postpartum, I had to go back to my OB because my liver numbers were elevated. She took one look at me and she said, "You have a spinal fluid leak, and you need to go back for a blood patch." Five days postpartum, I was away from my son for literally the entire day. The hospital did not offer me a pump or anything like that. It was just very scary and traumatic, and it set the tone for my whole postpartum experience. Looking back on it now, I describe it as like being in a black hole in comparison to where I am now. So after that whole experience, my husband and I knew that we wanted more kids, but we also knew we needed to change some things because I didn't want to end up with another C-section, and he was very on board with whatever my birth wishes were because he wanted me to have a very different experience than I did the first time around. So then when I was pregnant with my daughter, at the beginning, they were fine, but also the pregnancy was very, very different. While my son was textbook perfect, this one felt like what could go wrong was going wrong.  I know there could have been worse things, but in the moment, it felt very big. I ended up having a subchorionic hematoma. The early bleeding was very, very scary, and my OB still wouldn't see me even though I'd been bleeding for a while. Everything ended up being fine with that. I stayed with the same practice at that point. I was going through everything. Later on in my pregnancy, I obviously did the glucose test and ended up with gestational diabetes. That was in the back of my mind. But then as I was going forward with it, there was very little support or information about gestational diabetes. I got a phone call on a Friday that said, "You have this, and here's a number for you to call, and good luck". The first meeting I had with a diabetes educator, I was under the assumption would be a one-on-one meeting. I didn't realize until 10 minutes before the meeting that it was a group meeting. In bold, capitalized, underlined lettering, it said, "You cannot talk about anything personal because of HIPAA." I had so many questions that I knew were specific to me, and I couldn't ask them. We were sitting in this meeting, and the educator is just going through a PowerPoint of doom and gloom situations of what could happen if gestational diabetes isn't controlled. Then she emailed us all a PDF with like a specific carb goal for the day or whatever it was, and then gave us all prescriptions for the glucose monitors and all of that stuff, but no direction or anything, and was kind of just like, "Okay, well let's make a follow-up appointment for individuals with you guys." And then that was that. I still had no idea what was going on. I picked up the prescription and was just like panicked the whole time. I didn't know what I could eat, what was safe and what wasn't. And then on top of all of that, I felt like I did something wrong and there was just a lot of guilt and heavy feelings surrounding it. When I started to try to research things for gestational diabetes, there was very, very little that I could find. It just felt almost like gestational diabetes wasn't something that we can talk about. It's just something that happens and you've got to deal with it. So eventually I figured out what worked for me and I realized that it was very, very different from that blanket carb gold sheet that they had given us. Their goals were like 60 grams of carbs or something like that for certain meals, and my body just couldn't handle that. My goal was to try to avoid medication if I could because I knew that could impact my chances of having a VBAC because of different providers' thoughts about it. So after I got diagnosed with gestational diabetes and started navigating all of that, I was still talking with my provider about a VBAC and how that was the goal, that was the plan, and I didn't want anything else. I started finding that some OBs okay with it while others weren't. They wouldn't say that they weren't okay with it. I would go back and look over my notes, and there would be a line that said we talked about a C-section. I'm like, no, we didn't. What are you saying? A C-section never came up. I don't know what you're saying. I got a call out of nowhere one day to schedule a C-section. I'm like, "I have no idea what's going on here, and that's not what I want. That's not what I want to do, so I'm not doing it." At my next appointment, the doctor I had met with was saying like, "Oh, since you had a C-section before, we just schedule one just in case. It's what we do with all previous C-section patients." So at that point, I was like, okay, whatever, I'll schedule it with them, but I'm also going to start the process of switching because I wasn't liking how it was very inconsistent.I thought I wanted a smaller practice. I ended up switching to one that my sister-in-law used. At first, everything was fine. I met with two of the three doctors who could potentially be delivering my baby. One of them was very supportive right off the bat. "Yeah, I'm looking at all of your notes, you seem like a great candidate as long as gestational diabetes stays under control, then there's no problem. You can have a VBAC." And then the other provider had a completely different view on it. My first appointment with her, when we were going through everything, she was kind of just like, "Well, you have gestational diabetes, so you should really think about how important a VBAC is for you, and you might need to switch practices." That really caught me off guard. I had never left an OB appointment feeling that upset. I remember crying in my car for a half an hour before I could even pull out of the parking lot because I was just so overwhelmed and upset and had just so many different feelings that I couldn't put my finger on. At this point, I had hired a doula. I was talking to her before I left, and she was really helpful in calming me down. As my pregnancy went on, that was really the role that she ended up playing before I gave birth was really just keeping me and reminding me what I wanted because as things went on, there were the growth scans and all of the other good things that they do during pregnancy. The first growth skin I had, she was measuring big. And they're like, "Oh, she's in the 80th percentile. As long as she stays here, it's fine, but if she gets to be any part of her gets to be over 90%, then you have to have a C-section. You will have to deliver at 39 weeks and there is no shot of anything else."Julie: Oh my gosh, that's overwhelming.Colleen: Yeah, it was a lot thrown at me and this is where the uphill battle started because every scan that they did after that, she was measuring big. Toward the end, she was over the 90th percentile. And in the last month of my pregnancy, I had the weekly non-stress tests and scans, measuring my fluid and all of that stuff. But every single week was a conversation about the risks of a VBAC. They really, really, really were pushing a C-section, but they didn't talk about any risks of a repeat C-section which I find interesting now. But something else that I thought was unkind was the way that they were explaining their risks of a VBAC. They really were focusing on shoulder dystocia. So when my mom had me, I was a very big baby and I actually did have shoulder dystocia. I am physically handicapped from it. So them hammering on the risks of shoulder dystocia as if I didn't know and I was unaware of what could happen was really offensive. One of the providers actually at one point had said that my birth injury wasn't that bad. I was so caught off guard by that comment that I didn't even know what to say.Julie: Wow. Can I ask what it is? Do you mind sharing? You don't have to share.Colleen: No, that's fine. I have left herbs palsy. So it's like a nerve damage essentially. The way that they had to get me out of my mom without using forceps or anything like that, they just put too much pressure on one side and ruined the way that the nerve endings are connected. Julie: Oh.Colleen: Yeah. So when I was born, the doctor told my mom I wouldn't have any use of my left arm. My mom had me in physical therapy from the time I was 6 weeks old until I was 12 years old. Because of that extensive physical therapy, I do have a really decent range of motion in my left arm. It's one of those things where I think about it and I'm like, if I had lost the use of it at some point, I think I'd be more upset. It's annoying, but it's my normal. It's my everyday, and it really doesn't impact my everyday lifestyle, I guess.  I'm able to take care of my baby. One of the comments that the provider made was actually along the lines of like, "Oh, well, yours is fine. You can actually do things. But what if your baby has shoulder dystocia and your baby can't use their arm at all?" They kept bringing up the risks of stillbirth with it, and it was just very scary. Especially because I personally know what can happen with shoulder dystocia. I guess going through it, I had like this deep, deep sense that that was not something that I was going to experience. I don't know what that feeling was, but I knew in my bones that it wasn't happening. But every week, they were talking about the risk of shoulder dystocia and really expanding on how serious it could be. And my last appointment before I gave birth-- so that appointment was on a Wednesday and I had my daughter on Friday. So that Wednesday appointment, my doctor is going through everything again with the risks of shoulder dystocia. They had made me schedule a just-in-case C-section for the day after my due date. They were really trying to get me to switch it to some time in 39 weeks. Every week they were like, "Oh, just give us a call if you change your mind." I was not changing my mind at any point. So the last appointment, right before I was going to leave the room, my doctor was like, "What was your last growth scan?" And then he looked it up, he's like, "Oh, it's been a month. Let's have another growth scan today."Julie: Oh no. Colleen: Two days before I gave birth.And think you back. I'm like, who does that? There's no room for anything in there so obviously, the baby's gonna look huge. I go in. They do the scan. My fluids are fine. But her belly was what was constantly measuring huge which is why they were so insistent that she was going to have shoulder dystocia. The way that this practice is run, they do the scans after you meet with the doctor. Typically, you don't even talk about the scan until the following week which I found very strange. They did this scan. I was like, "I'm not even going to talk about it with my doctor, so whatever, you do what you want." But he had forgotten to write me a doctor's note, and when I asked about it at the front, they had to call him forward. It was at the same time that the ultrasound tech was logging all of the measurements, so he was asking her about it. They ended up having me go back into the office. And in that moment, I knew it was not going to be a good meeting at all. They're going over it, and the ultrasound tech is talking about the way that the measurements work. They do the diameter of the belly and it'll spit out whatever week gestation that matches. She was essentially like, "This baby's belly is off the charts. I can't even get a gestational week because it's so big." Yeah. So I'm standing there like, this is not going to go how I want it to. So my doctor pulls me into a different exam room, and we're talking about what the ultrasound tech had said. And again, shoulder dystocia. Before that appointment, I had gone in and I was like, "I don't even know if I want a cervical check. I know that they really mean very, very little." So before I had the cervical check, I asked, "If I'm dilated at all, instead of jumping right to the C-section that we have scheduled, can I come in that day and can we try for a Foley induction?" And he was like, "Yeah, I'm okay with that." So then he sees the results of the growth scan and backtracked and was like, "No, I'm not comfortable with that. If you walk in in active labor on your due date, we are going to send you right to the OR." It was very devastating. I'd already talked with him about my previous birth and how I was very scared of another C-section. I was scared of an epidural. My plan was to do an unmedicated VBAC because I didn't want to even risk another spinal fluid leak. He brushed all of that off and was like, "Oh, well, it's a planned C-section, so it's going to be very different. The needle they use for a spinal is so much smaller than an epidural, so the risks of that are so much lower." He was not acknowledging anything that I was saying. He was just still pushing, "You need a C-section. You need a C-section. You need a C-section." A week or so before that, he had even told me if I had wanted to go to 41 weeks, that he was going to give me my files and tell me to find another provider because he did not want to be a part of malpractice. At that point, I think I was just so thrown off and confused by everything that I didn't see it as big of a red flag as it actually was. But also when he told me it was too late to switch, no other provider would have taken me at like 37-38 weeks, especially with the gestational diabetes. I went home after that appointment feeling absolutely devastated. It was the pattern of the last month, just completely devastated talking to my doula about it and her reinstalling that confidence in me. That night, I went to sleep and was starting to be like, "All right, I guess I have to start really thinking about, what if this is another C-section?" The following morning I woke up and I guess because the last thing that I had talked about regarding my birth was with my doula and her telling me, "You can do this. I've never seen somebody as confident. You can do this. Your body grew this baby. Your body can birth this baby. You can do this." I had that in my mind when I woke up. And I was, I guess, a little bit extreme in my thinking because I called a midwife group and was going to switch at over 39 weeks pregnant. I'm like, I'm gonna make this work. Some way or another, I'm doing it. I planned on not showing up for the C-section that I had scheduled the following week because when I woke up, I was just like, they cannot cut me open if I don't consent to it. If I walk in in labor, legally, they cannot deny me care. I'm having this baby the way that I want to, and everyone else can just get on board or they can get out. That was Thursday morning, and I had taken off of work for Thursday-Friday because I just couldn't do it. I couldn't teach and give my students the all that they deserved. I was coming home so exhausted. I took that Thursday as my last hurrah with my son. We ended up walking around. I took them to a local farm, and we had a really good day together. The whole day I was like, I'm walking all day, so maybe I'll go into labor. It did not happen. So then the next day, same kind of thing. I had originally intended to go out with my son, but I woke up and I had this overwhelming feeling of, I just can't leave today. I need to stay near my house. I had listened to an episode of The VBAC Link, and I think the woman whose podcast episode it was, it said that either her midwife or her doula told her to go for a two-hour walk. I'm like, you know what? I'm gonna go for a very long walk. They can't hurt anything.I ended up walking for an hour. While I was walking, I started having some contractions, but they weren't consistent. I really wasn't convinced it was anything because I'd been having such intense Braxton Hicks contractions for a month or so that it was just like, this can't be it. So we got home, and I was just going about the day with my son. Nothing was going on. I decided to pump a couple times, so I did that, and by the time his bedtime rolled around, I was having fairly consistent contractions, but I still was not convinced. I was like, this is prodromal labor. There's no way this is actual labor. I'm just gonna have to be mad about this for another day. I even texted my doula, "If this isn't actually it, I'm going to go build a hut somewhere and hide there until I give birth," because I was so tired of talking to my doctors and seeing them and being upset by everything they were saying. So the night's going on, and my contractions are picking up and getting closer together. I still was not convinced that I was in labor. I got to the point where I was like, "All right, well, if this is actually it, I should rest." So I tried to lay down, but I had one contraction, and I could not stay on my back for it. I had to get up and move. I decided to get in the shower, and I didn't think anything of it, but after I had a contraction or two in there, I asked my husband to just keep an eye on how far apart they were. At that point, I wasn't paying attention to the clock at all. I was in there, and my husband opened the bathroom door, and he's like, "Colleen, your contractions are three minutes apart." I'm like, "Oh, okay. Maybe we should call the doula." So we did that, and I'm still laboring. I listened to podcasts where women talk about being in labor land, and I didn't understand what that was until looking back on my birth experience because after I told my husband to call my doula, I have very little recollection of interacting with him or talking to her on the phone or anything because the contractions were just so intense. I got to my bedroom and was leaning over the side of my dresser. I didn't move for I don't even know how long it was, but I was there. I couldn't move. I was drinking a little bit of water, and then all of a sudden my water broke. I guess at that point, that's when I was like, oh, okay, I guess I am in labor, and this is happening. So my husband was on the phone with his brother asking him, "Hey, potentially, you might need to come over and watch our son." And while he's on the phone, my water broke. So he's like, "No, you need to come now." In that time, he had his brother on one phone, my doula on the other, and he's trying to corral me to the car, but I was paralyzed and could not move. I was there until all of a sudden I had this mental break almost where I was like, "I need to move right now. If I don't move, I'm having this baby in my bedroom. and that is not the plan." So I waddled myself to the car, and it was hands down the most dangerous car ride of my life. I didn't buckle my seatbelt. I was backward on the seat just trying to like get through everything. My doula had given me a comb, so I was squeezing that during every contraction. I lost my mom when I was pregnant, so I had a very deep connection with her at that point and was talking to my mom, like, "Don't let me give birth in the car, Mom. Do not let me do that." So we eventually get to the hospital, and I had no recollection of this car ride. I remember being at the last major intersection before the turn for the hospital, but other than that, no idea that we were even in the car really. We get to the hospital, and things were picking up so quickly that my husband didn't even find a parking lot. He just pulled into the drop-off area and stopped the car, turned it off, and we made our way into the hospital. My doula met us there, and we had an off-duty nurse end up bringing us a wheelchair, and one of the security guards at the front ended up literally running us back into labor and delivery. That was around 11:00.When I got into the delivery room, it was three or four people, but it felt like a lot of people were there, and they were all trying to get my information and all the forms that I would have filled out beforehand. So at one point, somebody had mentioned a C-section. I remember saying, "I'm not having a C-section." The OB who was on call had said something about me being a TOLAC patient. I yelled at her, "I am not a TOLAC patient. I am a VBAC."They got me onto the bed finally, and they're trying to get the monitors on me. When they finally did, the way that I was kneeling on the bed, the baby's heart rate wasn't liking it. Again, the OB was like, "Okay, maybe we need to think about a C-section." When she said that, I said, "I'm not consenting to a C-section if I'm not guaranteed skin-to-skin afterward." The nurses were kind of a little nervous with the way that I was responding there. My doula was like, "Okay, before we jump to that, let's turn her over and see if things change." So after that contraction, they moved me, and the baby's heart rate was fine. In that moment for me, I didn't really recognize what was happening. But afterward, my husband said that he was very nervous, and he was just yelling for the doula to help in that situation because he didn't know what to do. At that point, when they finally got me situated, I was ready to go at 10 centimeters, fully effaced. Baby was at a zero station, ready to go. And somebody was like, "Oh, do you want an epidural?" And me, my husband, and my doula were all like, "No, there's no epidural happening." So, they got me situated, and I think I pushed maybe five times before the baby was born.Julie: Wow.Colleen: Yeah, I came in hot.Julie: Yeah, you did.Colleen: I pushed. I felt the ring of fire. And the most incredible feeling was after that, feeling her body turn as it came out. It was the ring of fire, and then she flew out after that. There was absolutely no shoulder dystocia there. She was born at 11:38. We parked the car at 11, and she was born at 11:38. At my last scan, they were saying she was going to measure over 9.5 pounds. She was born, and she was 7 pounds, 15 ounces. My doula looked at me and she's like, "If you had had a C-section for a baby that wasn't even 8 pounds, I would have been so mad for you." I got my golden hour. I got skin-to-skin for that entire time. They did all of the baby's testing on me, and they were so respectful of that mother/baby bonding time that I really lost out on with my son. I didn't realize how much it impacted me until after I had my daughter, and I got what I had my heart set on. It was the most healing thing. I didn't realize I had things that needed to be healed in ways that they were. I felt so incredibly powerful, especially after everything was said and done. The nurse who stayed with us and then ended up bringing us to the mother/baby unit, I had asked her, "How often do you see unmedicated VBACs?" And she was like, "It's very, very rare because the providers are nervous about it. They want to have the epidural in place as a just-in-case." But I knew, for me, the fear of a repeat spinal fluid leak was bigger than the fear of any of the pain that would have happened. I know from listening to The VBAC Link that if it were a real emergency, having an epidural ahead of time wouldn't have done anything because it takes a while for the epidural to kick in. Even if I had gotten an epidural when I got to the hospital, it would not have helped me in any way. But she was completely healthy. There were no issues. She passed all of her blood sugar testing which I was really worried about. And then, my blood sugar was fine afterward also. Even still, it's very confusing trying to navigate this super strict diet that I had for so much of my pregnancy to now just being like, "All right, you're fine. It didn't even exist. Go back to eating however you wanted." I don't know. It's very, very confusing. Out of all of the things from my pregnancy, having no support from my providers on the VBAC side of things, and then having no guidance, I should say, with gestational diabetes, those were hands-down the most difficult things. But I did it and I'm still feeling very powerful for that.Julie: Yes, I love that. How old is your baby now?Colleen: She's four weeks.Julie: Oh, my gosh. You are fresh off your VBAC, girl. Colleen: Yeah.Julie: Ride that high as long as you can, man. I still feel really awesome. My first VBAC baby is 9.5 now. 9.5 years old. Okay, so this might sound really weird, but I wish that it wasn't something that we had to feel so victorious about. Does that make sense? I wish it was just way more common and just a normal thing, but it's not. Lots of people have to overcome lots of challenges in order to get the birth experience that they want, and that is sad. As empowering and incredible as it is when it happens, it's also kind of sad that, you know what? I don't know. Does that make sense? Colleen: It makes complete sense. I was going back and trying to research things on VBAC statistics and this, that, and the next thing and listening to other podcasts.Julie: You have to work so hard. It's sad that we have to work so hard.Colleen: A lot of it came down to providers being scared of the consequences that they would face if anything went wrong. I'm like, well, that's not fair because you're not even giving somebody a chance. Everything that I read was if the quote-unquote problem is on the baby's end, then mom has no reason to think that she can't have a VBAC, but so many providers don't see it the same way.Julie: Yeah. Yeah. I have 500 things that I want to talk about right now. First of all, I feel like this is the gospel according to Julie. This is not, I don't think, anything that I could find any evidence for or not. But I think sometimes when we, we as in the medical system. We have a parent who has gestational diabetes and change their diet drastically and so completely and eliminate carbs and sugars and all of these things. I feel like when that happens more often, I see babies with significantly smaller birth weights than if we were to make more subtle adjustments to their diets.Colleen: Yeah. I had a couple of gestational diabetes groups on Facebook. So many of the women who would post, after their baby was born, they had either very small babies because they changed their diet so drastically, or their babies were larger because of the insulin, so I agree with the gospel according to Julie.Julie: Yeah, thank you. So that's two of us. I'm pretty sure Meagan would agree as well. So three out of however many. Okay. Let's just leave that right there, first of all.Second of all, just saying that ultrasound measurements are grossly inaccurate. It's not uncommon for them to be. My sister-in-law, right now, is going to get induced on Monday as a first-time mom, completely ignorant to a lot of the birth process and everything and doesn't have a desire to-- she's completely the opposite of me. They're inducing her at 38 weeks because she has gestational diabetes, and they expect her baby's going to be big, and they don't want shoulder dystocia, etc. etc. etc. We know the whole thing, right? I was looking up evidence on shoulder dystocia, and it's really interesting because there are some studies that say first of all, Evidence Based Birth has a really great article on the evidence for induction for C-section or big baby. That will be linked in the show notes. Now it's really interesting because I was looking up rates for shoulder dystocia for big babies versus regular-sized babies. There are some studies that show that smaller babies have up to a 2% chance for shoulder dystocia, and larger babies have anywhere from a 7 to 15% chance of having difficulties with birthing their shoulders. There are other studies that show half of shoulder dystopias occur in babies that are smaller than 8 pounds, and 13 ounces. I feel like there's a little bit of disconnect out there in the research. However, like Colleen, permanent nerve damage occurs with shoulder dystocia in 1 out of every 555 babies, Permanent nerve damage will occur due to stuck shoulders in 1 out of every 555 babies who weigh between 8 pounds, 13 ounces, and 9 pounds, 15 ounces. I'm curious, Colleen, how big were you? Do you know what your birth weight was?Colleen: Yeah, I was 9 pounds 2 ounces.Julie: Okay, so you were barely a big baby.Colleen: Yeah, I was born three weeks early.Julie: Oh my goodness, girl. Yes. Okay, so yes, that was definitely large for gestational age too. But that's okay. Honestly, that means 1 out of every 555 babies will have permanent nerve damage from shoulder dystocia. When we get babies that are 10 pounds or bigger, it's actually 1 out of every 175 babies. I don't want to discount when that happens, but I mean, 554 out of 555 babies don't have that permanent nerve injury, too. I think it's really important that when we look at risks, that we have a really accurate representation of what those risks are in order to make an informed decision. So just like with uterine rupture, we don't want to discount when it happens because it does happen, and it's something that we need to look at. But what are the benefits compared to the risks? Why? What are the benefits of induction compared to the benefits of potentially avoiding a shoulder dystocia? The Evidence Based Birth article is really amazing. I don't want to go on and on for hours about this, although I definitely could, but most of the time, when shoulder dystocias happen, they're resolved without incident. I mean, it can be kind of hard and kind of frustrating and difficult to get the baby out and maybe a little traumatic, but yeah, most of the time everything works out well. Colleen, I'm glad that your birth injury is--I mean, I just feel so proud of your mom for putting into therapy and stuff like that earlier on because it could have had the potential to be a lot worse if she didn't do that. So kudos to your mom. I'm super excited for you. When you were talking-- not excited for you. That is the wrong word to say. I'm grateful that you had access to that care to help you. When you were telling me about your injury, it reminds me of my oldest who has cerebral palsy. It's really, really mild. Most people don't know. He has decreased motor function in his right arm and his right foot. He walks on his toe. He can't really use his right hand too well and his ambidexterity is a little awkward for him. But you said something that really stuck with me. That's just your normal. That's just what you know. I feel like that with my son too. While his disability is limiting in certain ways, he's also found lots of very healthy ways to adapt and manage and live a very full and happy life despite it. I might be putting words in your mouth, but it kind of sounded like you had said similar to that.Colleen: Oh, absolutely. It's just what I know. I don't know anything different.Julie: It's just let you know and yes. It's really fun. It's really not fun. Oh my gosh. Words are hard today. Please edit me out of all of these words. Gosh, my goodness. So not to discount any of that because it does happen, but we also want to make sure that we have accurate representation of the risks. Also, I want to touch on Colleen leaning into your intuition and following that and letting that guide you because I think that's really important as well. Sometimes our intuition is telling us things that don't make sense, and sometimes it's telling us things that makes absolute perfect sense and align right with our goals and our vision. I encourage everyone to lean into that intuition no matter what it's telling you because those mama instincts are real. They are very real. I feel like they deserve more credit than sometimes we give them. So, yeah. I don't know. Colleen, tell me. I know that you had a really awesome doula helping you. Besides hiring a doula and doing your best to find the best support team and advocating for yourself, what other advice would you give people who are preparing for a VBAC?Colleen: I think, like you said at the beginning of the podcast, looking at your options. I didn't know what my options were with my son, and then this time around, I had a better idea of what the options were. And then listening to positive VBAC stories. So, like, I remember maybe six weeks before I had my daughter, just trying to find anything. I searched VBAC on Apple podcasts, and this was the first thing that came up. I listened to two episodes a day until I ended up giving birth.Having all of that positive information was really helpful, and then having my husband so be on board with everything and my doula really talking me off those ledges of absolute devastation after my appointments to the next morning having that confidence again. So those are the things. Julie: I love that too. Yeah.Believe in yourself. Not everyone that tries to VBAC is going to have a VBAC. That's just the unfortunate reality of what it's like. But I think believing in yourself to not only have your best birth experience and having that belief in order to have a VBAC, but also having belief that if your birth doesn't end up in a VBAC that you can navigate those circumstances in order to still have a powerful and satisfying birth experience. Trust yourself. I think that's really, really important.Coleen: Yeah, I agree with that.Julie: Cool. All right, Colleen. Well, thank you so much for spending time here with me today. I loved hearing your stories. I love hearing the little baby noises in the background. Those always make my heart happy. And yeah, we will catch you on the flip side.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 very important episode, Dr. Rebecca Dekker is taking a look at the updated evidence on Vitamin K for newborns. Vitamin K deficiency bleeding (VKDB) is a rare but serious condition that can lead to life-threatening complications in infants. Dr. Dekker breaks down what Vitamin K is, why newborns are at risk for VKDB, and the different supplementation options available—including the Vitamin K shot and oral drops. This episode also tackles myths and misinformation surrounding Vitamin K, including concerns about safety, the so-called “gentle birth” exemption, and the controversial "black box warning." Armed with new research, we explore the effectiveness of various oral Vitamin K regimens, and go over the global recommendations for Vitamin K supplementation.   (00:04:01) The Essential Role of Vitamin K for Blood Clotting (00:08:10) Significance of Vitamin K in Newborns' Health (00:14:31) Preventing VKDB: Vitamin K Shot vs Drops (00:16:14) Vitamin K Shot vs. Oral Drops Debate (00:20:00) Effectiveness of Oral Vitamin K Drops vs. Injection (00:31:39) Vitamin K Transfer Through Placental Barrier (00:41:33) Preventing VKDB in Newborns: Pros and Cons of Vitamin K Options   Resources: Read the full-length EBB Signature Article on Vitamin K (includes all scientific references + a FREE 1-page handout!) at https://ebbirth.com/vitaminK EBB Pocket Guide to Newborn Procedures: https://ebbirth.com/shop EBB Childbirth Class: https://ebbirth.com/childbirthclass CDC Real stories: People with Vitamin K. Deficiency Bleeding CDC VKDB information Watch this YouTube video from Dr. Matt and Dr. Mike about Hemostasis and the Clotting Cascade (and why Vitamin K and Calcium are important) International Federation of Library Associations and Institutions: How to Spot Fake News University of Chicago: Evaluating Resources and Misinformation Web Literacy for Student Fact Checkers (and other people who care about facts) For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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, Dr. Rebecca Dekker and investigative journalist Sarah Kliff of The New York Times explore the intricate world of cord blood banking. Sarah shares insights from her article, "Promised Cures, Tainted Cells," which explored cord blood banking practices, their marketing claims, and the stark contrast between public and private banking systems.   Together, they discuss: The differences between public and private cord blood banks Marketing tactics and their impact on parents The decline in the medical utility of cord blood over the last decade Ethical concerns, such as contamination, low stem cell counts, and hidden collection fees Sarah also shares the stories of families who invested in private banking, only to find their samples unusable when needed. This episode sheds light on the decisions surrounding cord blood banking and provides a look at the system's pitfalls.   Join us at the EBB Conference (virtually) this March by registering here! You can also see if the EBB Pocket Guide to Newborn Procedures is in stock here.    (00:05:56) Paid vs. Donated Cord Blood Storage (00:08:06) Stem Cell Storage for Future Medical Use (00:09:32) "Cord Blood Marketing: Promises and Concerns" (00:21:44) Rising Financial Burden of Cord Blood Storage (00:25:46) Unregulated Growth in Private Cord Blood Banking (00:26:14) Quality Control Concerns in Private Cord Blood Banking (00:34:48) Cord Blood Banking Implications in Delayed Clamping (00:41:52) Unregulated Risks of Cord Blood Storage   Resources: Read "Promised Cures, Tainted Cells" here Check out the American Academy of Pediatrics recommendations on cord blood banking here For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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.

Porsche Holland-Otunba, CEO of Reclaim Black Motherhood, joins Dr. Dekker to share her personal journey from trauma to advocacy in the birthing world. Porsche opens up about her own traumatic birth experience, which ignited her passion for fighting for better care for Black families. She discusses how a lack of informed choice, systemic biases, and inadequate lactation support affected her pregnancy and birth, leading her to become a passionate birth worker, doula, and lactation consultant. Porsche emphasizes the need for trauma-informed, culturally competent care, particularly for Black families, and offers invaluable advice for healthcare workers and birth professionals on how to center the needs of families through active listening and compassionate support.   Register for the EBB Conference here!    (02:29) Porsche's Birth Story and the Impact on Her Approach to Trauma-Informed Care (05:34) A Call to Action: Rising Up After a Traumatic Birth (07:19) The Systemic Failures and Lack of Representation in Healthcare (10:20) Advocating for Change and Getting Involved in Maternal Health Initiatives (13:13) Generational Trauma and Preeclampsia in Black Families (15:33) The Future of Preeclampsia Care and Prevention (17:56) The Intersection of Preeclampsia and Mental Health (22:06) Lactation Challenges: Generational Trauma and Cultural Barriers (25:40) The Role of Lactation Support in Hospitals (29:43) Trauma-Informed Lactation Support: Practical Tips for Birth Workers (35:29) Prioritizing Basic Needs in Trauma-Informed Care (38:04) Supporting Families Beyond the Birth: A Holistic Approach to Care (46:04) The Importance of Perinatal Mental Health Awareness Learn more about Reclaim Black Motherhood Visit the Preeclampsia Foundation Get mental health resources and support from Postpartum Support International (PSI) Read Black birth people's stories of preeclampsia with the Take 10 Campaign EBB Podcast #342: Lifelong Lessons in Lactation with Dr. Kimarie Bugg, the First African American IBCLC and President of Reaching Our Sisters Everywhere EBB Podcast #344: Crash Course in Perinatal Mood Disorders and Treatment with Dr. Kat Kaeni, Perinatal Psychologist and Past Board Chair of Postpartum Support International For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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 today's episode, we're revisiting an inspiring birth story featuring Emily Chandler and Taylor Washburn, graduates of the Evidence Based Birth® Childbirth Class. They share their journey of navigating an informed and empowered hospital birth experience, along with the challenges they faced during an extended hospital stay for their newborn's jaundice diagnosis.   Emily, a marine scientist, and Taylor, a teacher and rowing coach in the Boston area, enjoy an active lifestyle filled with hiking, biking, and rowing. While preparing for parenthood, Emily immersed herself in learning about pregnancy, birth, and the state of maternity care in the U.S. This journey led them to take the EBB Childbirth Class with instructor Chanté Perryman, where they gained valuable knowledge and advocacy skills.   Emily and Taylor share how the EBB Childbirth Class empowered them to make informed decisions about their birth plan—including Taylor's memorable experience of “catching” their baby. They also highlight the importance of the advocacy skills they learned, which helped them effectively communicate with healthcare providers and navigate unexpected challenges, such as breastfeeding difficulties and securing the right support during their baby's jaundice treatment.   Be sure to listen all the way to the end of the episode for an exciting update from our guests!   Content Note: This episode covers topics such as extended hospital stays, breastfeeding challenges, jaundice testing and treatment, and the racial disparities affecting Black and Brown infants with jaundice. (00:03:15) Doula Guidance During Pregnancy (00:09:24) Minimal Intervention Birth Plan Worries (00:17:45) Unexpected Labor Challenges (00:24:45) Efficient and Caring Nurse's Impact (00:34:34) Newborn's Breastfeeding and Jaundice Journey (00:40:03) Newborn Care and Feeding Challenges (00:43:17) Optimal Umbilical Cord Clamping Timing (00:47:27) Risk Factors for Infant Jaundice (00:52:18) Jaundice Warning Signs and Emergency Help (00:55:57) Home Birth Journey and EBB Impact Resoures: Get the Evidence Based Birth® Pocket Guide to Newborn Procedures here You can learn more about jaundice here at the Mayo Clinic site, or here at the Cleveland Clinic website. Access the Evidence Based Birth Signature Articles on: The Evidence on Premature Rupture of Membranes here The Evidence on Group B Strep here The Evidence on Pitocin in the Third Stage here Listen to EBB 145- Fatherhood and Advocacy in Birth with JacMichael Perryman here Listen to EBB 244 – Evidence on AROM, AVD and Internal Monitoring here Learn more about Chanté Perryman's EBB Childbirth Class and services here Learn more about the Nest Collaborative here For more information about Evidence Based Birth and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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.

Julia knew something was off during her first pregnancy and birth experience. She knew she didn't feel right about consenting to a Cesarean, but it wasn't until she started diving into research that she realized how much her care lacked informed consent. She discovered options that should have been offered to her that never were.Julia's research led her to choosing the midwifery model of care in a home birth setting. She felt in control of her experience and free to birth the way she felt she needed to. Meagan and Julia discuss stats on uterine rupture, stillbirth, continuous fetal monitoring, induction, due dates, and how our birthing culture can highly influence what we think is safe versus what scientific evidence actually tells us. Evidence-Based Birth: The Evidence on Due DatesThe Business of Being BornNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello. Women of Strength I am so excited for today's guest. Our friend, Julia, is from Texas. She is a wife and a stay-at-home mother living in, it Spring, Texas, Julia?Julia: Spring, Texas.Meagan: Close to Houston, yes, with her two sons. And she has had a Cesarean and then an HBAC. We get a lot of questions in our inbox every day, but a really common question is dates. "Hey, I'm 40 weeks. My doctor is telling me I had to have my baby by tomorrow or even approaching 39 weeks." People are being told they have to have their babies or really bad things will happen. And Julia's story is proof that you don't have to have a baby by 40 weeks or 41 weeks, would you say? Almost 42 weeks is what you were. So we are excited to hear this story. And I know if you are one that goes past your due date and you're getting that pressure, you're definitely gonna wanna listen. Julia: Thank you so much for having me, Meagan, I'm really, really happy to be here.Meagan: I'm so happy that you are here. I would just love to have you share your stories.Julia: Okay, so my firstborn, he came during the height of the COVID pandemic. It was August 2020.I just saw my OB who I had been seeing for regular gynecology visits. And from the very first appointment, it just, I just kind of got an off feeling. She had seen a small subchorionic hematoma on my ultrasound at my very first appointment at eight weeks. And she just told me, "Don't Google this. It's going to scare you." She basically just said, "Just enjoy being pregnant now because when you come back next week, you may not be." So as a first-time mom, it was obviously pretty upsetting and caused a lot of anxiety. When I went back for my next appointment, she just kind of shrugged it off after she saw the ultrasound. She just said, "It cleared up on its own." There really wasn't any explanation of how it resolved.But that being said, that start to my prenatal care kind of set the tone for the rest of that pregnancy and birth. From then on there was just a lot of fear-mongering going on, and a lot of problems were brought up that really never turned out to be an issue. Around 20 weeks at the anatomy scan, they saw that my son was in the bottom 10th percentile.She had said that she classified that as IUGR, intrauterine growth restriction. We had a lot of extra testing done. Everything was normal. I felt confident and very comfortable just waiting it out. And that really wasn't what she wanted.Actually, starting around 35 weeks, she had started talking about delivering early. I was pressured at each appointment by my OB and the nurses to stay that day and deliver solely because of his size, even though everything was looking great on the monitors. Keep in mind, you know, during COVID, I wasn't able to have my husband or anyone with me during these appointments. And so just being asked that question each time I came in as a first-time mom by myself was just really hard and made me second guess a lot of things and second guess my intuition. I had explained that, "I think he's just a small baby. He needs more time to grow."She basically just said at my 38-week appointment if I didn't deliver that day, it would not be her fault if my baby died and that she or the hospital was--Meagan: What?! Julie: Right?Meagan: She said that she or the hospital, if I walk out that day, they're not liable if something happens because I'm going against her recommendations. I was even seeing a high-risk doctor as well at that point. And even he was saying, "Everything's looking fine. There's no problem with waiting if you want to."The reason she wanted to schedule the C-section because he was breech. I knew that I wasn't even going to have the opportunity to go into spontaneous labor. There were really no alternatives presented at the time. I knew nothing about out-of-hospital birth or about midwives. She offered an ECV, but she said she didn't recommend it because of his size.She didn't really explain why. So I just kind of felt backed into a corner. I remember I had left the office that day at 38 weeks and called my husband immediately and explained what she had said. We felt like, "Okay, well, I guess, we obviously don't want our baby to die, so maybe we need to just stay." I remember pushing my gut feeling aside the whole time. As they were prepping me, I just felt, This isn't right." I wanted to give my baby more time to grow and also to flip so that I wouldn't be backed into a C-section. Had I known then what I know now, I definitely would have opted for a home birth with my midwife who's trained in breach delivery.Just at the time with COVID, I didn't have the resources or the information, so we went through with the C-section that ended in a four-day hospital stay. I didn't sleep at all. Meagan, I'm not even kidding you. I did not sleep those four days. The nurses were really concerned about the baby's size, even though he was growing. He was actually back to his birth weight by the time we were discharged.But I'll never forget this one-Meagan: That's quick!Julie: Right? I know. And so there was so much fear-mongering, so much uncertainty by medical staff, despite how great my baby was doing. And I remember this nurse frantically coming into the room just a few hours after my C-section with this Medella hospital-grade pump. She was just like, "You need to start pumping now on top of breastfeeding because your baby's small. He's not going to grow."It just kind of left me feeling like, I feel confident in what I'm doing, but now all these medical professionals are telling me like, I'm in danger, my baby's in danger. It triggered a lot of feelings of postpartum anxiety. I really struggled that first year. And so it wasn't a very good experience.I just felt like my power had been taken away in the birthing process and felt defeated and like I didn't have a say for my first birth.Meagan: Yeah, I was just listening to an episode the other day, not on our podcast, on another podcast about that experience after baby is born and that postpartum within the hospital and how crazy it is that sleep is one of the best things we can get when it comes to energy, milk production, getting our babies fed and helping them grow, and doing all these things. But then we're not allowed that time. And then on top of it, it's all the fear-mongering and the doubt when it's like we should be being built up like, "Oh my gosh, look how good you're doing. Look how good this baby's doing. Look how good you're doing. Let's keep doing this." Instead of making you doubt that what you're doing isn't good enough and not letting you sleep and doing all these things. It's just weird to me. It doesn't make sense.Julia: Right, and as a first-time mom, you're just like, okay, they know what's best, obviously. I'm going to listen to them and what do I know about birth? They're the doctors. But yeah, it was just really eye-opening, and I really knew I wanted a completely different experience the next time around.Meagan: Yeah, I don't blame you. I don't blame you for wanting a different experience.Julia: So after I had my C section, pretty soon after that, I started digging and doing a lot of research and realized I felt really cheated by the lack of informed consent. I had mentioned that my doctor just had said, "You need a C-section because he's breech."I had no idea that there were even midwives and out-of-hospital birth options where they delivered breech vaginally and not only that, but were highly trained and qualified to do so. I had no idea that in other parts of the world of similar economic status to the US that they were routinely delivering breech babies vaginally with better outcomes than we have here in the US hospitals. So I really didn't feel like there was informed consent there. Even the fact that she didn't even want to try the ECV was upsetting to me. I just felt like I really wish I would have done more research at the time. But I just put all my energy into this next birth. I knew even before I got pregnant that I wanted a VBAC.Pretty early on in the process of my research, I became really fascinated with physiological birth and I knew that I really wanted to experience that. For someone who may not be familiar with that term, physiological birth is natural unmedicated childbirth with no intervention unless medically necessary. It sees birth as a safe biological function rather than a medical event or something that that's inherently dangerous which is how I felt I was treated my whole first pregnancy and birth. I felt like a walking hazard, to be honest, when in reality I was an extremely healthy 25-year-old, first-time mom with a healthy baby with no issues. So the fact that I was gaslit into thinking there was a lot of danger was sad. So I knew that for my next birth I wanted to do a physiological birth and I knew that it would kind of be a fight to achieve in the hospital. I did a lot of research, I watched The Business of Being Born. I read a lot of natural childbirth books. I also knew that on top of the regular hospital policies, I would have some excess restrictions because of the fact that I was a VBAC.Meagan: Yeah, yeah. Julia: I did go back to that same OB at first. I presented my birth plan early on to her and it included things like I didn't want an IV. I wanted freedom to eat or drink. I didn't want any drugs whatsoever for pain relief. I didn't want them pushing an epidural. I would have liked a water birth, but I knew that wouldn't have been possible in the hospital. But I at least would have liked water immersion in labor, minimal cervical checks. I wanted to go into spontaneous labor. I wanted no coached pushing and fully delayed cord clamping.I could tell, right away she was more so just VBAC-tolerant rather than supportive. She really used a lot of fear-mongering. Right away she mentioned the uterine rupture risk. She had said, I think she had said she had just had a mom die from a VBAC not too long ago.Meagan: Goodness. Holy moly.Julia: Without any explanation. Who knows where she was going with that? But she had also said, it may be better to just have a repeat C-section because with the risk of rupture, you may need a hysterectomy after giving birth. She commonly used the word TOLAC which also I didn't really like. I didn't want to feel like I was having to try. I felt like I'm planning a VBAC. I don't need to try for it. It is what it is. I wanted someone to encourage me. She really also highly, highly recommended I got an epidural because she said, "Well, with your increased risk of rupture, if something should happen, then they're just gonna have to knock me out."She also said, "Unmedicated moms tear the worst," which was not at all the case for me. She was saying that because it hurts so bad that you just can't control your pushing. I knew all of this was not true. I was kind of in a funny position because I didn't want to be fighting with her, but I knew the evidence in the back of my mind and all of that scary language. I knew it was not evidence-based. I really wanted someone on my team who was really going to believe in me, who knew the evidence, and who believed in my ability to have a VBAC.  I didn't want to spend all of my energy and labor fighting for this VBAC and for this birth experience that I knew was possible and that I knew that I deserved.My heart really had always deep down been set on a home birth from the very beginning. I loved watching home birth videos and hearing positive home birth stories. I just loved everything about it and also about the midwifery model of care and how much more comprehensive that was. I had heard about a local group of midwives on a Facebook group that I'm in for holistic moms in my area. I found out that this group of midwives offered a HypnoBirthing class. So my husband and I signed up for that. We took the six-week course and we just never looked back after that. We knew that a home birth VBAC would be the way to go. I felt deep in my heart confident about it and that's really what I wanted. I just knew I had found my dream birth team.My midwife was just amazing and I just really couldn't imagine birthing anywhere other than in my own home with her and my husband by my side and someone that didn't look at me differently because of my previous Cesarean.Meagan: Right. And I love that you just pointed that out. Someone who didn't look at me differently because of my previous Cesarean. This is the problem, not the problem. It's one of one of the many problems when it comes to providers looking at VBAC moms. We talk about this in our VBAC course. We should just be someone going in and having a baby, but we are not viewed that way. And it's extremely frustrating because not only do they not view us that way, they make us know and feel that they don't view us that way.Julia: Right, right.Meagan: It's just, it feels crummy.Julia: Absolutely. We knew we were making the right decision. I was really excited about the whole thing. That was another thing that I talked to my OB about. I was like, "I'm excited to be in labor. I want to welcome all these sensations of birth. I know it's going to be hard work, but that experience means something to me and I want that." And she had said, "Well, if you ask other moms who had been through labor, they would say it's painful, it's hard." She was basically saying, I shouldn't want this birth experience. I just didn't want to be fighting that or dealing with someone who had this view on birth that it's just this dangerous medical event. I didn't want to go through feeling defeated like I did last time.Meagan: Absolutely. Good for you for recognizing that and then doing what you needed to do to not have that experience.Julia: Right? Thank you.So I had mentioned that I really wanted to go into spontaneous labor. I didn't want to be induced at all. That's another reason why I'm so thankful that I was with my midwife because I went almost all the way to 43 weeks pregnant. I went into labor at 42 weeks and 5 days in the middle of the night. Had I had been with my OB, I'm positive that I would have had to deliver much earlier and I would have probably been scheduled for a repeat C-section. So I'm just really happy that I was with my midwife and I felt really confident about waiting. I had NSTs and BPPs, non-stress tests and biophysical profiles done daily starting at 42 weeks just to monitor baby's health and to make sure that everything is normal and it was.So we just opted to wait for spontaneous labor. I'm really glad that I did so that I could go through with the home birth.Meagan: Absolutely. What you were saying, yeah, I know I probably would have been scheduled Cesarean and definitely would have been pressured. I mean, even if you would have said no, the pressure would have been thick, especially going over 41 weeks.Julia: Right.Meagan: And then, let alone 42.Julia: Right. Yeah. The pressure was there. Everyone was well intentioned, asking, "Have you had your baby yet?" But I was getting these questions as early as like 38 weeks, 39 weeks. I'm like, "Whoa, I'm not even at my due date yet."Everyone was just excited to meet the baby and had friends asking about that. But my immediate family was so supportive and I'm so, so happy that I had that support because just feeling that from my midwife and from my parents and my husband, knowing that they all really believed in me and we were confident with waiting. As long as everything looked good with baby, that was really what was most important. So I just kind of tuned everything else out and tried to relax as much as possible.We just went out to dinner a few times and cherished these last couple weeks as a family of three. It finally happened in the middle of the night at 42 weeks and 5 days. I remember when the contractions were first starting. I'd had some contractions on and off for the past few weeks, but nothing consistent. So I just kind of thought, okay, well, this is just some Braxton Hicks or something like that.I noticed that around 2:00 AM, they started getting more consistent. I told my husband and they were getting more intense and a little closer together. We called our midwife around 6:00 AM and she was like, "Yeah. Sounds like you're in early labor." I was just so, so happy and grateful to be in labor.Yes, it was hard work, but I can honestly say I really enjoyed the experience. I thought it was extremely empowering. I just remember thanking God through the surges. We called them surges in HypnoBirthing. Just knowing the awesome work that my body was doing from within to give birth to my baby. I really, really enjoyed the freedom of just being able to eat and drink in labor freely wherever I wanted in my home without any restricting policies. I wasn't tethered to any IVs or monitors. I think that's another thing. In the hospital, that would have added anxiety seeing the monitor constantly. We know that continuous fetal monitoring isn't really evidence-based and leads to more C-sections. I knew in the hospital that would have been something that would have been required so I'm really glad that that wasn't the case at home. I just think the freedom and the autonomy is really what helped my labor to progress so smoothly without any complications.There weren't people coming in and out of my room, and I just really enjoyed the whole experience. Listening to birth affirmations helped me. I was swaying through the surges. My husband had helped me put up twinkle fairy lights in our room, and we had some flickering votive candles on my dresser. It just created this really nice ambiance and a calming atmosphere.It just felt so good to know that my husband really, truly believed in my ability to do this. I mean, I really have to give him a shout-out because he was right there with me not only through all of labor, but when I knew that I wanted a VBAC from the very beginning, he was right there with me reading all the natural childbirth books, doing all the research on VBAC with me.He was just really supportive. That's something I would say is very important for a VBAC mom is to have a support person who's not just present, but truly supportive of you and knows what you're going to need and does the work with you ahead of time so that you can just focus on laboring and they can be there to make sure you have water, and you're fed if you're hungry, so I was really blessed to have him and to have his full support.Meagan: Absolutely.My husband told me, he said, "I just don't understand." He just didn't understand. I get that he didn't understand, but I love hearing this where we're learning together. I want to say to couples or to partners, even if you don't understand, understand and trust that it's important to your partner and be there for them because, like you were saying, it can make such a big impact in the way you feel, the way you view your birth, and your overall experience.Julia: Right. No, and that's so true because I feel like, most people's support person is their husband, and a lot of men feel like maybe they can't really help as much or just say, "Well, the doctor knows what to do. I'm just here, like, for emotional support."But it's so much more than that. My husband learned ahead of time how to do counter pressure, and I actually really didn't need it. I think he had done it once, but what really helped me the most was just leaning on him. I did that most of the time. Just leaning into him, and letting him support my weight. He also did a really great job of reminding me to just focus on my breathing techniques and just relaxing between the surges.All of those natural pain relief remedies were really, really helpful. I bought a TENS machine and a heating pad, but I ended up not needing any of those.Meagan: But you at least were prepared with them.Julia: I was. Yeah, I was definitely prepared. We also had hung up all my birth affirmations. We had done a lot of meditation and visualization exercises throughout pregnancy, and so I used some of those as well. He was really great at reminding me just saying, "I love you. You're doing it. You're doing a great job." That was very helpful just feeling him there.Meagan: Yeah, absolutely.So with postpartum, this is also another common question. Is it better postpartum from my Cesarean versus my VBAC? What would you say? And any tips that you have for healing through your VBAC?Julia: Yeah, so my postpartum experience this time around is so much better. It's a night and day difference, not just physically healing like that. My VBAC is nothing compared to the C section. I think a lot of people fail to realize that a C-section is major, major abdominal surgery. Anyone else who had major abdominal surgery would be sent home to be on bed rest for weeks and you have to care for a newborn on top of that. With my C-section, I was a first-time mom. It was so overwhelming. Everything was new to me. I had a lot of pain with breastfeeding at first. I attribute a lot of that to the nurses making me pump. I was never sized for flanges. I just used the ones that came with the Medella and they weren't sized to me.I think that caused a lot of nipple damage. I ended up getting mastitis at two weeks postpartum the first time around and had to go back into the hospital for that and just had so much pain with latching that I ended up exclusively pumping for my son. I'm really proud because I was able to do that for two years, so he had breastmilk for two years.Meagan: That is a commitment.Julia: Yes, it was such a commitment. But I'm really, really happy that I did it and it was worth it to me. I just didn't want that negative experience of the birth and all that damage that happened early on from the pump to affect this because I really knew I wanted to breastfeed, and I was able to do it with exclusive pumping.And then this time around, it was just so much better. Breastfeeding is going great, and I've seen some research on that too. When you have a positive birth experience, that can also affect breastfeeding and even the first latch and everything.Just your emotions surrounding postpartum, when you go through something like that and you feel supported and in charge of your birth, you go into motherhood feeling the same way.Meagan: Yeah.Julia: I can't explain how much better it is this time around. That's why I really encourage all moms to know that you can do your own research and especially VBAC moms, there's so much out there about uterine rupture, and when you look at the relative risk versus the absolute risk, these are the kinds of things that you may not know to do because your doctor is just going to present the statistics one way. But we know that the way that those statistics are presented really greatly impacts what decision you make. And it's important to understand that.And so I would say my biggest tip for VBAC moms is to just really do your own research and find a provider who you feel like in your gut is going to be there for you, and is going to really believe in you. Meagan: Absolutely. Absolutely. And that's what I was looking for with my crazy interview process was someone who I didn't just think would be there to be there, but be there to support me and really root for me and really be on my team, not just be there. I just think it makes such a big, big difference. And kind of going away from provider but coming into due dates and waiting longer. When I say longer, past the traditional 39 to 41 weeks. Now you were mentioning, people were even saying at 38 weeks, "Hey, have you had your baby? When are you gonna have your baby?" Oh my gosh. And these people, most of the time, I would say 99% of the time, they really just are excited for you to have your baby. And so if you're listening and maybe you have this situation, do say things like, "Hey, oh my gosh, I'm just so excited for you," not like, "When are you going toa have this baby?" Because it does start taking a toll sometimes on mom's mental health at the end.I wanted to also talk a little bit about due dates because Evidence Based Birth-- Rebecca Dekker, she's incredible. If you guys don't know them yet, go check out Evidence Based Birth. They've got a lot of really great blogs. But there is just a little part of a large blog that I wanted to read about and her little bullet point says, "Is the traditional due date really your due date?" I think this just fits so well here because you were 42 weeks and which day again?Julia: 42 weeks and 5 days.Meagan: 5 days, that's what I was thinking. So 42 weeks and 5 days. So obviously your traditional due date that you were given weeks before wasn't really true. Right? So it says, "Based on the best evidence, there is no such thing as an exact due date, and the estimated due date of 40 weeks is not accurate. Instead, it would be more appropriate to say that there is a normal range of time in which most people give birth. About half of all pregnant people will go into labor on their own by 40 weeks and 5 days for first-time mothers or 40 weeks and 3 days for mothers who have given birth before. The other half will not." Then it says, "Are there some things that can make your pregnancy longer? By far, the most important predictor of a longer pregnancy is family history of long pregnancies, including your own personal history, your mother, your sisters, etc. and the history of the baby's biological father's family history as well." In 2013, there was a large study that was looked at with more than 475,000 Swedish births, most of which were dated with an ultrasound before 20 weeks in that they found that genetics had an increasingly strong influence on your chance of giving birth after 42 weeks. Okay, there's so much more you guys. It talks about if you've had a post-term birth before, you have a 4.4 times more likely chance of having another post-term, if I can read, with the same partner. If you've had post-term birth before, then you switch partners, you have 3.4 times the chance of having another post- term birth with your new partner. And if your sister had a post-term birth, you have a 1.8 times the chance of having a post-term birth. You guys, it goes on and on and on. This is such a great article and eye opening in my opinion. I'm going to attach it in the show notes and it does continue to go on for risk for mothers, risk for infants.What about stillbirth? We know that is a huge topic when it comes to going past your due date just like uterine rupture is a huge topic for VBAC. I feel like when due dates come in, it's stillbirth. And she actually says that. It says up until the 1980s, some research thought that the risk of stillbirth past 41 to 42 weeks was similar to the risk of stillbirth earlier. She's going to go back and talk with how it definitely is a different measurement here, but the stats are there. The evidence is there. But look at you. You went. You trusted your body. You went with your body. You did what you needed to do to take extra precautions and had a beautiful, beautiful experience.Julia: Yeah, I'm really happy that I did trust my intuition and I did the research. All those things that you were talking about like risk of stillbirth and everything that you hear, there's a common thing that goes around social media like, "Oh, nothing good happens past 40 weeks." But that's just not the case.If you look at other countries that are like very similar in economic status to us in the US, due dates are calculated differently everywhere, so who's to say that this mythical 40-week due date is the end all be all? A lot of other countries won't even induce prior to 42 weeks unless there's like an issue. In the US, we see so many people routinely getting induced at 39 weeks, so I just think's it's really a cultural thing, so we we come to believe that it's the safest thing.But when you step back and do your own research, you can get a full picture and you can see, why are we inducing without any, any contraindication? Like why are people being presented Cesarean section as if it's just a minor procedure?I feel like in the Business of Being Born documentary, if you haven't seen it, I would highly recommend everybody watching it really, because it shows how C-sections have become so much more popular and the reasons why they think that is and just the flaws in the medical system. It was just really eye opening and really encouraged me on my VBAC journey. It gave me a lot of tips and information and led me to find other resources. VBAC Facts was another really great thing that I referenced a lot. Evidence Based Birth like you had mentioned, and then of course, listening to The VBAC Link Podcast and podcasts of moms who have really positive VBAC stories because you only hear the negative a lot of the time.With birth in general, I feel like, it's just presented as such a scary thing. I really want to encourage women to know that birth is made to be this way. It doesn't have to be some scary out of control thing where you're at the mercy of a doctor or a provider telling you when to push or telling you to do something that you don't feel comfortable doing. When we trust nature and we surrender to the power of labor, it's really sacred. It's beautiful. It's normal, and most of all, it's safe in most cases.We don't have to fight it or medicalize it. And in the words of Ricky Lake, who gave birth in her bathtub in that stellar documentary Business of Being Born, she had said, "Birth is not an illness. It's not something that needed to be numbed. It needed to be experienced." For anyone who's planning or would like to plan an unmedicated birth, you can get a lot of resistance or people who don't understand. But I really encourage you to know that you can do it, that women have been doing it for generations. And just keep those affirmations in your mind and believe in yourself. You have to do that.Meagan: Exactly. I love that you pointed that out. There are so many times that we do treat birth as this medical event, this illness, this problem, and it's just not. It's not. It's not. I don't know what else to say. It is not. And we have to change our view. And just like you were re saying, it's a cultural thing. We have to change or it's just not going to get better. It could get worse. We're seeing the Cesarean rate. We're seeing these things happen. And there's a problem. There's a problem out there. We have to start stepping back and realizing that birth is not that medical event and we can trust this process. And our bodies were meant to do this. And they do it every day. Every day, all over the world. Every single day, a baby is born, probably thousands. I don't even know the exact number. But we can do this. We don't have to, we don't have to treat it like that.Julia: Right. That's what I really liked about the midwifery model of care. It was just so different to my experience with, with my OB. I think a lot of people fail to realize that in most other parts of the world, low-risk women are attended by midwives and the obstetricians are there to take care of the percentage of women who are having issues. With home birth, you can think, oh well, what if something goes wrong and you're not in the hospital setting?But what a lot of people don't realize is that oftentimes these interventions that are routinely done in the hospital that most of the time they don't even ask for permission to do, or they present it in a way that they're helping you actually lead to some of these devastating consequences, like low-risk women going in and then ending up with a C-section for reasons that they often can't even understand.And so that's something that I really feel passionately about is just encouraging women to advocate for yourself and to know ahead of time, what is routine and why are they offering this? Is this for your benefit or for the doctor's benefit? With all these risks of these different things that can happen, like Pitocin, which is commonly used to induce or augment labor, you might not need that. Or did you know that if they started that you can ask for them to shut it off?You should be in charge of your birth. When you're in that setting, it can be intimidating and you might feel like you don't have a voice, especially when you're already in a vulnerable position in labor. So I was really confident with my midwives' ability to look out for anything that may go wrong. But I love her hands-off approach. She didn't intervene. She just stood back and was just there to witness. There was no telling me when to push. I was able to experience the fetal ejection reflex which was really cool. I just felt my body pushing for me and surrendered to that. She was there to make sure that everything was going smoothly. I was the one who picked my baby up out of the water and she just stood back while my husband and my baby and I met each other for the first time. It was just all really special. That's something I want to say. With the risk of uterine rupture that you hear about with VBAC, that wasn't even in my mind. I didn't have someone there constantly telling me, "Oh, well, we're seeing this on the monitor," or scaring me with the very, very slim chance of rupture.Meagan: Exactly. Oh, so many good tips, such a great story. I am just so grateful that you are here today sharing it with us.Julia: I'm really grateful to be here and to share my story with 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

Dr. Rebecca Dekker welcomes Dr. Kat Kaeni, a perinatal mental health certified psychologist, author of The Pregnancy Workbook, and host of the Mom & Mind podcast. Dr. Kat shares her personal journey with postpartum depression, anxiety, and OCD, and how it shaped her commitment to supporting parents during the perinatal period. They explore the spectrum of perinatal mental health conditions, from baby blues to postpartum psychosis, and discuss the stigma, barriers to care, and strategies for managing symptoms. Dr. Kat explains the power of Cognitive Behavioral Therapy, mindfulness techniques, and the importance of accessing resources like Postpartum Support International.   Content Warning: This episode includes discussions of perinatal mental health disorders, including postpartum depression, anxiety, OCD, and psychosis. Sensitive topics such as intrusive thoughts, stigma, feelings of guilt and shame, and the potential for harm to self or others are addressed. Listener discretion is advised, and we encourage anyone who may be affected by these topics to reach out for support through Postpartum Support International or a trusted healthcare provider.   (00:07:28) Unique Challenges in Perinatal Mental Health (00:11:05) Caregivers' Mental Health and Bonding Challenges (00:16:32) Parental Isolation Stemming from Anxiety and Depression (00:21:53) Emergent Postpartum Psychosis Symptoms (00:27:08) Overcoming Stigma in Perinatal Mental Health (00:31:54) Thought and Behavior Change Therapy for Depression (00:36:56) Perinatal Mental Health Challenges and Support   EBB 197 – Addressing Perinatal Mental Health for Communities of Color with the Co-Founders of the Perinatal Mental Health Alliance for People of Color, Divya Kumar, Jabina Coleman, and Desirée Israel Postpartum Support International The Mom & Mind Podcast The Pregnancy Workbook: Manage Anxiety and Worry with CBT and Mindfulness Techniques For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! 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, Dr. Rebecca Dekker and Morgan Richardson Cayama, EBB Research Fellow and doctoral candidate in public health, are sharing the top 10 evidence-based strategies for reducing your risk of a Cesarean birth. Drawing from the latest research, including insights from the ARRIVE trial and EBB's Signature Articles, Rebecca and Morgan discuss actionable methods such as choosing a provider and birth setting with low Cesarean rates, receiving midwifery-led care, using labor support like a doula, staying mobile during labor, and avoiding non-medically indicated interventions. They also talk about the impact of tools like peanut balls, the role of intermittent fetal monitoring, and options for breech pregnancies.   (04:38) Provider Attitude Impact on Cesarean Rates (08:34) Cesarean Risk Reduction Through Midwifery Care (11:03) Lower-Risk Birth Settings for Cesarean Prevention (19:34) Reduced Cesarean Risk with 39-Week Induction (22:21) Optimal Timing for Hospital Admission in Labor (27:53) Upright Positions and Cesarean Risk in Labor (33:24) Upright Birthing Positions for Safer Delivery (34:53) Reducing Cesarean Rates through Intermittent Auscultation   Check out the ARRIVE Trial Signature Article for evidence on elective induction at 39 weeks Friedman's Curve and Failure to Progress: A Leading Cause of Unplanned Cesareans Evidence on: Induction or Cesarean for a Big Baby Evidence on: Doulas EBB 45 – How do peanut balls support labor? Evidence on: Birthing Positions Evidence on: Fetal Monitoring EBB 296 – Evidence on Breech Birth with Dr. Rebecca Dekker and Sara Ailshire, MA EBB 297 – Frequently Asked Questions about Breech with Dr. Rebecca Dekker and Sara Ailshire, MA Use Leapfrog Group Hospital Ratings, a Tool to compare Cesarean rates and maternity care statistics by hospital. Get a copy of Dr. Dekker's book, Babies are Not Pizzas. 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, learn how Dr. Kimarie Bugg's lifelong dedication to lactation and health equity is transforming lives nationwide. Dr. Bugg is President of Reaching Our Sisters Everywhere (ROSE) and the first African American International Board Certified Lactation Consultant (IBCLC). Dr. Bugg shares her journey into the field of lactation, sparked by personal challenges breastfeeding her first set of twins in the late 1970s. She recounts the evolution of breastfeeding support, her groundbreaking work at Grady Hospital in Atlanta, and the founding of ROSE, a nonprofit addressing breastfeeding inequities in the African American community. Dr. Bugg discusses the systemic barriers to breastfeeding, including workplace challenges, access to lactation support, and the lack of consistent education for healthcare providers. She emphasizes the importance of policy change, workforce development, and healing generational trauma through initiatives like ROSE's "Breast Friend" and the Reaching Our Brothers Everywhere (ROBE) programs. Tune in for a conversation about the critical role of breastfeeding equity, the unique challenges faced by African American families, and the power of community-driven solutions.   (09:34) Empowering Black Nurses in Breastfeeding Support (8:08) Supporting Breastfeeding in African American Community (27:08) "Breast Friend Program: Reducing Breastfeeding Disparities" (28:22) Empowering Communities for Inclusive Breastfeeding Support (32:46) Reframing Breastfeeding Narratives in African American Community (34:54) Enhancing Breastfeeding Equity Beyond Hospital Stay (41:39) Community Transformers: Empowering Maternal Health Support   Explore ROSE's programs, including Breast Friends, Community Transformers, and more here. Learn about Boston Medical Center's Community and Hospitals Advancing Maternity Practices (CHAMPS), a Baby-Friendly hospital initiative, here. Learn more about the Academy of Breastfeeding Medicine 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.

Happy New Year to all our listeners! Join us in listening to a mini story about how our team got together last fall... and be the first to learn about a major event we're planning for you in 2025! To get on the waitlist for the upcoming event, visit ebbirth.com/waitlist

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.  

Dr. Rebecca Dekker talks with EBB Childbirth Class graduates Kat Sullivan and Ben Winston about their journey through pregnancy and birth. Kat shares her deeply personal experience of living with emetophobia—the fear of vomiting—and how it impacted her pregnancy and decision to pursue a home birth. From navigating intrusive thoughts and panic attacks to finding a supportive care team and discovering the power of SSRIs, Kat and Ben open up about their challenges and triumphs. Hear how they prepared for labor, the role of their midwives, and how the EBB Childbirth Class helped them feel informed and empowered. Whether you're curious about home births, mental health in pregnancy, or simply love heartfelt birth stories, this episode is a must-listen! Content Note: The first half of the interview will discuss distressing symptoms related to emetophobia, panic attacks, and OCD, as well as considering pregnancy termination due to emetophobia. (00:01:24) Joyful Home Birth Experience despite Challenges (00:04:56) Empowered by Supportive Providers for Emetophobia (00:10:17) Navigating Mental Health in Parenthood Transition (00:17:53) Navigating Challenges with a Strong Support System (00:30:10) Unpredictable Transitions in Labor and Birth (00:35:03) Empowering Decisions Through Evidence-Based Home Birth (00:36:07) Empowering Parents Through Evidence-Based Childbirth Education Learn more about Kat and Ben's EBB Instructor, Emily McMichael, here or follow her on Instagram 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.

Dr. Rebecca Dekker and EBB Research Fellow Morgan Richardson Cayama tackle your questions about the ARRIVE trial and elective inductions at 39 weeks. They explore the evidence behind this controversial study, discuss the implications for Cesarean rates, and unpack the concept of patient autonomy in maternity care. Plus, they share practical tips for managing pressure to induce and delve into how the ARRIVE trial impacts outcomes like breastfeeding, epidurals, and costs. Tune in to hear this Q&A session originally broadcast to listeners worldwide.   Episode 334: The ARRIVE Trial and Elective Induction at 39 Weeks (03:38) How often are we seeing pressure from obstetricians to induce? (07:20) How can you manage pressure from an obstetrician to get an induction at 39 weeks? (12:00) What are the geographic trends in induction rates? (15:30) What are the statistics on infant death and mortality? (19:56) What happens if a midwife or obstetrician refuses a 39-week elective induction requested by a birthing person? (21:50) Why did the ARRIVE trial report such high rates of preeclampsia and hypertension? (32:16) Is induction considered to be more cost-effective? (34:54) Are inductions affecting breastfeeding and epidural rates? (36:54) Is there research around maternal satisfaction and birthing experience? (40:11) Why are IVF and advanced maternal age clients often pressured or offered induction? (41:24) What strategies can doulas use to support clients facing discussions about 39-week induction with their provider?   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.    

Dr. Jessica Brumley, a Certified Nurse Midwife and President of the American College of Nurse Midwives, joins Dr. Dekker to explore the transformative impact of respectful maternity care. Dr. Brumley reflects on her journey to midwifery, inspired by a lifelong commitment to equitable and compassionate healthcare. Together, they discuss the importance of supporting normal physiology in birth, the guiding principles of the midwifery model, and the need for systemic change to foster respectful care in hospitals. Dr. Brumley also shares insights from her work with the Florida Perinatal Quality Collaborative, including initiatives to reduce unnecessary interventions and amplify patient voices. Tune in to learn how respectful care can improve outcomes, build trust, and why a “midwife for every community” could change the landscape of maternal health in the United States. (00:07:30) Equitable and Respectful Maternity Care Advocacy (00:28:57) Promoting Respectful Maternity Care in Workplaces (00:30:28) Creating a Culture of Respect in Healthcare (00:30:49) Cultural Respect in Healthcare Settings (00:34:24) Promoting Equitable and Respectful Healthcare Practices (00:43:11) Elevating Midwifery Practice for Improved Healthcare (00:44:47) Retention Strategies for Midwifery Professionals   Resources: EBB 324 – Blending Birth, Science, Technology, and Storytelling with Erica Chidi, Co-founder and CEO of LOOM EBB 332 – Advocating for Yourself during Prenatal Visits with Retired Obstetrician Dr. Leslie Farrington, Co-Founder of the Black Coalition for Safe Motherhood Read Protecting Your Birth: A Guide For Black Mothers in The New York Times. Learn about the International Confederation of Midwives (ICM) and the ICM's RESPECT Presentation (mentioned by Jessica) Learn about the Florida Perinatal Collaborative Learn more about Dr. Brumley and her work Learn about the American College of Nurse Midwives 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, I'm joined by Camden Crane Wachowiak—a health coach, EBB Childbirth Class graduate, and new mom—who shares her high-risk pregnancy and birth journey. Camden walks us through her induction experience after her water broke at term and her decision to labor with non-pharmacological comfort measures. We also talk about Camden's approach to navigating unique health considerations during pregnancy, including antiphospholipid syndrome and a cardiac pacemaker. She reflects on the empowering choices she made with her partner, such as hiring a supportive doula, and the role of the EBB Childbirth Class in helping them feel informed and confident. Discover how Camden built a team of providers who respected her strength, addressed her concerns without excessive intervention, and supported her in achieving a safe and positive birth experience. (05:45) Experienced Doula Enhancing Birthing Experiences (09:52) Personalized Obstetric Care Based on Medical History (17:50) Natural Methods for Inducing Labor Contractions (19:39) Natural Comfort Techniques During Medication-Free Labor (23:32) Enduring labor pains without medical intervention (25:05) Breathwork and Support in Intense Childbirth (35:26) Vital Importance of Newborn Resuscitation Training (37:27) Embracing Motherhood: Navigating New Priorities and Routines (43:26) Transformative Role of Postpartum Communities   Learn more about Camden's fitness coaching business, Camden C3 Fit here. EBB 288 – From Birthing in the Pandemic to Birthing a Career as a Postpartum Doula and Chef with Malisa Dekker of Planted Postpartum EBB 305 – A High-Risk Pregnancy and Miraculous Birth with Krista and John DeYoung, EBB Childbirth Class Graduates 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.

Alma's first birth was an emergency Cesarean after an induction at 40 weeks due to gestational diabetes. Due to COVID-19 policies, Alma's husband was not allowed into the OR. She did not expect the induction process to end the way that it did, and felt robbed of the positive birth experience she hoped to have. Alma made sure to educate herself on all of her options for her second birth. She was very proactive about her health and did not have gestational diabetes the second time. She went into labor earlier than she expected at 38 weeks. She woke up in the middle of the night to her water breaking, and intense contractions began. Within minutes, Alma knew she had to go to the hospital immediately. Alma felt pushy as they made the 45-minute drive. She was admitted to a room, and her beautiful baby was born just two pushes later!Evidence Based BirthⓇ: Induction for Gestational DiabetesThe VBAC Link Blog: VBAC with Gestational DiabetesBirth Ball Amazon LinkNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, hello. It is almost the end of November. It is crazy to think that the year is coming to an end. But guess what, you guys? We still have so many amazing stories coming your way. Today's story is from our friend, Alma. I'm already messing it up. It looks like Alma, but you say it. Tell me how to say it correctly.Alma: Alma, but any way you say it is fine. Meagan: Perfect. I want to say it correctly though. She is sharing her stories today. Now, you are in New Jersey now, but you weren't in New Jersey when you had your VBAC. Is that correct? Alma: When I had the C-section, I was in New Jersey, so we just zigzagged a little bit. Meagan: So she's in New Jersey, but the VBAC wasn't in New Jersey. I know a lot of people when they are listening are like, “Where was this VBAC?” We will talk a little bit more about that when we get into the story, but let's give them a little teaser of what your episode is going to be. Your first C-section, I feel like was the steps. It was the steps or the cascade, and then a little bit of what you went through. Tell us a little bit of a teaser before we get into the episode. Alma: I had a lot of interventions in my first pregnancy and did end in an emergency C-section, then for my son, my second pregnancy, it was exactly the opposite. There wasn't time for any intervention. He just flew out. My whole labor was 2 hours from the first contraction to when he was born. I almost delivered in the car. He was too fast, but it was exactly the experience that I wanted to have. Meagan: Yes. Oh my gosh, so a precipitous labor after a lot of interventions, an induction, and all of these things. I'm so excited to get to this episode today, but we do have a Review of the Week. As usual, if you haven't done so yet, please leave us a review. We absolutely love them. Okay, this episode reviewer is Desiree Jacobsen. She actually just left this review this year in August of 2024. It says, “Thank you”. It says, “This podcast and parent's course is amazing. I'm not a VBAC mom, but I have been listening since 2020. I binge-listen toward the end of pregnancy to remember everything I need to remember in the birth process through my previous births. This time around, I felt more prepared than ever before having plans in place just in case. We were able to have a quick birth for my fifth baby. I love the education, passion, love, and support this podcast gives. I recommend it to everyone I know, and I have learned so much from it. I am so grateful for this podcast. Thank you”. Oh, I love that. I love that, love that, love that. That was actually sent to us via email. If you didn't know, you can email your reviews at info@thevbaclink.com. Your reviews on the podcast and on Google are what truly help other Women of Strength find this platform and find the courage and the information that they need to choose the birth that they desire. Okay, girl. Let's get into this story. So first birth, lots of interventions. Let's talk about it. One, what types of interventions, and two, why? What led up to needing those interventions or I don't know if it's “needing” or really medically needed? Tell us more. Alma: Well, my first pregnancy was very normal and healthy up until I was diagnosed with gestational diabetes. That's where things started to change a little bit. I just failed the test by just a point, so my blood sugar was elevated, but it wasn't as bad as it could be. I wasn't even on insulin. I was just on diet control. Everything was going fine so I thought, but I would say a week before my due date, I was told that I needed to be induced because of the gestational diabetes. That was the first red flag of things going out of my control because I didn't expect to be induced. Although I had gestational diabetes for a while already, I wasn't told that this would probably be the case that I would be induced. I agreed to the induction of course. I understand why it's done, so I went along with it. I think my daughter just did not want to be born. On that day at least, we went in on my 40th week, and I was on Pitocin for hours, and it did nothing. I tried some exercises. I tried a bunch of things. Nothing worked.Eventually, the doctor suggested to manually break my water. That's where I wish I had asked to do other things first. I wish I had rejected that choice, but I went along with it. From that point, the labor went from 0 to 1000. I was in so much pain in a matter of minutes. Everything happened so fast, and I wasn't ready for that. I asked for an epidural really fast. I got the epidural, and that's also when things got worse because my blood pressure started to decrease. I didn't know that could happen actually. Later on, I scoured through every detail of what happened, and I tried to figure out exactly what went wrong. I realized that could happen with an epidural. When your blood pressure is affected, of course, the baby's blood pressure is affected so my daughter started to have some fetal decelerations. It was very concerning. They put me on my back to deliver to push her out. I wasn't even 10 centimeters yet. They were going to stretch me, but her blood pressure just declined in a way that was really concerning. I was rushed to the OR and the C-section was done. Everything happened so fast. I hesitate in using the word traumatic just because in the end, everybody was fine. I was fine. My daughter was fine. She was healthy, but it was very traumatic because nothing was in my control in that moment. I felt almost robbed of the experience that I expected to have. That was my first birth. Meagan: Well, and when things are rushed like that and you are left in a sense of– you said panic, but in a sense of urgent need to save something or save someone, it does. It sets all of your alarms off. Alma: That's exactly what happened. Meagan: Everyone has trauma differently. They view trauma differently. Someone may see one things as traumatic, and someone would be like, “How is that traumatic?” It's okay, I think, that you're using that word because that is how you are perceiving this. Your feelings and your alarms that were going off in your body as everything was being rushed and all of these things left that traumatic feeling. Alma: Yeah, definitely. In that moment, I felt like I couldn't breathe. At this time too, there were a lot of COVID restrictions, so my husband wasn't let into the OR. It was like, “What happpened to her?” He was more concerned than me probably. He thought both of us were going to die, my daughter and myself. It all just happened so quickly. Thankfully, we were okay in the end, but I had no idea I would be coming back with a C-section scar. That requires more recovery. As a new parent, we were already new to everything. It was a lot to deal with, I think. Meagan: Yeah, what you were saying, I'm sure your husband had a lot of trauma through that experience too. We know that COVID especially– I mean, birth in general comes with a lot of things especially the unexpected, but when you through COVID in with that, it's a lot of ick. It's a lot of icky feelings. It's a lot of ick. Alma: Yes. Meagan: So everything was good. Baby was good. You were good. Overall, it was a less-ideal situation, but where did that leave you after you had the baby and you were starting to recover? Where was your mind? Alma: I think I had to process a lot of what happened. I think I went into the first pregnancy very naive. It's important to be educated, and I really appreciate this podcast for that reason to encourage us to be educated. It's not that we are doctors. At least, many of us are not medical professionals, but we need to be aware of our bodies and just what the process looks like, and even some terminology. I was totally clueless on everything. I think that what I tried to do in between both pregnancies was just learn. What's going on in my body? What can I say no to in terms of interventions?You don't have to agree to everything. I never want to argue with a doctor of course, but if I really feel like that's not the best choice, I can always ask for another choice. I can consider other options. Meagan: Yes. Alma: I just didn't know I could do that the first time. I definitely tried to educate myself as much as possible, and I think that contributed a lot to how the second delivery went. Meagan: Yeah. I just wanted to thank you so much for pointing that out and seeing that because if I were to guess, we all didn't know that. We may have heard that you can always say no, but I don't if we realized how much we really could say no to or ask for another opinion. Maybe we knew it, but didn't really feel like we could. It can be hard. It can be hard to say no, but I love that you are like, “I want a different option. I'm going to say no to this right now. Give me another option.” It's always okay. Alma: Definitely, definitely. Wanting to wait if the time allows, “Can we try this later?” There's a conversation that needs to happen. It doesn't have to be one thing that is suggested. Meagan: This way or no. Alma: For sure. Meagan: Where did your education start stemming from? Where did you start when you were like, “Okay, I want to do something different next time”? Alma: The podcast. The VBAC Link. I listened to a bunch of podcasts. There is All Things Pregnancy with Dr. Nicole Renkins, and of course, The VBAC Link Podcast. Meagan: We've had her. We love her. Alma: That's just what I did all the time before I went to bed. I'd listen to an episode driving. I'd listen to an episode. It was very helpful. I felt like I could digest information better that way as opposed to reading, so that was a very helpful tool. I also tried to find professionals around me who could speak to my specific situations. I had a doula, and of course, I had my providers as well. They were all so helpful with helping me navigate some of the things that might have gone wrong the first time, and how I could prevent them going forward. Meagan: When they talked about some of the things that maybe went wrong the first time– I don't want to say wrong. They went south. Alma: Yes. Meagan: I don't know why people say that. I love south. I love the south. What were the kinds of things that stood out to them?Alma: Well, I think the first thing was the induction in the first place. I completely understand the risk with gestational diabetes, but I think there could have been more conversations with that in my specific case. Seeing as I did not have diabetes that was really out of control, it was very well controlled with my diet, and there could have been room to say, “Maybe we can go a couple days past my due date.” I wouldn't recommend that for everyone. I think it depends on your case, but I could have tried to have that dialogue, and maybe we didn't need to have an induction. I also could have considered different methods of induction, and I think that was the first thing because I felt like that was the first domino piece. If I didn't have the induction, it might not have led to a C-section in the first place. Another point was also the breaking of the water. Those things, I could have just said, “Let's wait.” I was already there for the induction, so I could have just asked for a little more time. But the big point for me too was the epidural. That was, I think, the immediate reason for the fetal distress. Meagan: The response. Alma: The response, yeah. Understanding how I could avoid that. I was told that now with the second epidural, I may not have the same reactions because I've had it before. Also, if you get flushed with some IV fluids– Meagan: Yeah, I was going to say if you hydrate and not even just intravenously, but literally drinking water before. If you know that you're going to want to get an epidural, or it's heading that direction, start hydrating. The more you can hydrate, the better. Alma: So I learned those things, then also, I tried to prepare myself for not even having an epidural, although that wasn't my goal, because I experienced the pains before. Even though I had the C-section, I went through some labor pains. I was accepting the fact that I might just need the epidural, but I considered that as well. How can I overcome this pain without any kind of medication? Those were things I was trying to consider about how we could do it differently so it doesn't result in the same thing. Meagan: Okay, I love those tips. So now, you're pregnant, and we have baby number two. Tell us this journey. Alma: Yes. I guess from the time of conception, it was about 18 months apart from the C-section. My pregnancy went perfectly fine. There were no issues. The difference being I had a toddler, so I was more active, of course. I was on my feet. I took at least 10,000 steps a day. I didn't sit much just because of my daughter. I think that definitely helped in preparing my body. I was really focused on how I can work on my pelvic floor and was just preparing for what it would take to push a baby out. I also did a lot of exercises that I found online. I never did a class or anything, but these were just Instagram videos where you could see the top three videos for strengthening your pelvic floor and things like that that were just free and available. I had an exercise ball that was a lifesaver. I highly recommend that exercise ball for anybody who is pregnant, especially in the third trimester. You can sit on it. You can lean on it. You can squeeze it between your knees. All of those things provide relief, but they also strengthen your muscles down there. I did the Miles Circuit. All of those things were super helpful, and I did it daily to prepare my body. I guess going into the actual labor, I'll start by saying that first of all, I didn't have very supportive providers. I learned from this podcast that that's very important. I do 100% agree that it's half the battle if you have someone who is on your side and wants to help you make intelligent decisions. I would say my providers were not completely unsupportive, but there were a lot of policies from the hospital side that I think restricted them from encouraging a VBAC. There were a lot of if's, and's, and but's. There were so many stipulations for when or if I could have a VBAC. Meagan: Can I ask which ones stood out where you were like, “These for sure are alarms”?Alma: The biggest one was that I would have to deliver before 40 weeks. I felt statistically that doesn't happen. People usually birth after their due dates, so I felt like I was already set up for, this is not going to happen probably. I felt really discouraged by that. Also, I guess the due date was a big thing, but also if I were to have gestational diabetes again, then the whole conversation on the doctor's side was just completely mute. I would just need to go for the induction if I had gestational diabetes. Statistically, you do have it with each subsequent pregnancy according to what I have known. I was also expecting, okay. I'm most likely going to have gestational diabetes. I'm most likely not going to give birth before 40 weeks. It seemed like I was most likely going to have to agree to a C-section. Those things were not encouraging, but I did feel like the doctors were trying to help me find some safe loopholes. One of them being that they had to– I don't know if this is law, but they had to schedule me for the C-section even though I didn't want one. But they explained to me that I could go in and say to them that I didn't want a C-section. I could ask for more time. I could ask to be induced, and hopefully, the induction wouldn't lead to a C-section although it could. I guess they were trying to explain to me that there are some routes you could take, but given the fact that you had a previous C-section, we do have to just assume that you're going to have another one. I felt really alone on that journey of trying to do something that I felt like I could do, especially given that the reason for the first C-section was an emergency. I was dilated. It wasn't a failure to progress. I felt like my body was perfectly primed to do it, but because of time, we had to go for the C-section. I also had to have some conversations with myself accepting that if I do need to have another C-section, it's not the end of the world. I guess what frustrated me about the first time was that I felt like I didn't need to have it. C-sections save lives. They're great tools when they're needed, but I felt like I didn't. Aside from the distress and all of that, I felt like I didn't need it, so I wanted to really try for this vaginal birth. I was just in between trying to accept what might happen, but still trying to hold on to what I believed I could do. So, I guess fast forward to my 37th week, I had an appointment and I had to sign off that I would come in for a C-section, but my plan was to go in that day. This was on the 39th week. I would have the C-section. I could go in and say that I didn't want to have it. On the night of my 38th week, my husband just finished putting together the crib, and it was midnight. He put together the crib. We went to sleep, and at around 2:45, I wake up because I thought I peed on myself. Now, I think I realize that it was my water leaking. I got up, and at that point, I had maybe cramping, but it wasn't really painful. To make a long story short, 10 minutes later, I was having full-on contractions. They were super painful. I got out my phone to time it, and within two taps, the app was telling me to go to the hospital now. It was two taps. Everything was happening so fast. Meagan: They were coming so close. Alma: Yes. They were so close. I don't remember how to count them. All I did was tap, and it was telling me to go. This was at 38 weeks, so I honestly didn't have anything ready. I didn't have my bags ready or nothing. Within a matter of minutes, I was just on the floor trying to remember the HypnoBirthing and everything, but it was all slipping because it happened so fast.We get in the car, and I'm still in a whole lot of pain. At a certain point though, I got a grip. I was doing this Christian HypnoBirthing which really helped me. I finally grasped myself and was able to calm down, but the pain accelerated very, very fast. At a certain point, though, I started to feel a lot of pressure. I was still driving, by the way. We had about a 45-minute journey to the hospital. I started to feel a pressure to push. I just couldn't resist it, so I pushed. I hammered down really hard. It sounded like a fire hydrant was cracked open. My water busted open in the car. I'm sitting behind the driver's seat on my knees, and my water just gushed open. At that point, I really felt like he was coming out. I couldn't hold back the desire to push because it also relieved the pain a little bit. It was more like a pressure as opposed to a pain. I just gave into that feeling, but I did feel like he was between my knees and was about to come out. My husband made a few wrong turns, but eventually, we got to the hospital. I couldn't even sit, actually. They put me in a wheelchair to go to the place where you would give birth. I couldn't sit down. He was just about to come out, and when I got there, I was already beyond 10 centimeters at that point. Later, the doctor told me when she came down to see me that she could already see the hair of my son's head. He was already so close. Remember, the talk about the epidural? I wanted the epidural. I was asking the security guard, the person at the front desk– everybody I saw, I was asking for the epidural. I noticed that they didn't respond to me on that. I overheard them telling my husband that it was way too late for the epidural. My son was already halfway out, and they couldn't give me the epidural. Once the doctor came, she told me to give a good push. I pushed one time. His head came out. The second time I pushed, he flew out. I had five nurses dive in to grab him. Meagan: Oh my gosh. Alma: He was born, and that was the whole thing. It was super duper fast, unmedicated, and yeah. The most touching part to me was that he came out, and they put him on my chest. That was all I wanted. When my daughter was born in the C-section, I had to beg them to let me see her. I didn't see her until minutes later. I didn't hold her until the next day, but this time, they put her right on my chest, and it was just so redemptive. It was everything that I really wanted to experience. Meagan: Absolutely. It was probably a lot all at the same time, very shocking, but then to have that baby be placed on your chest, oh, what an amazing moment for you. Alma: Yes, yes. It was. Meagan: Oh my goodness. Super fast. I was just going to say that was super fast. Alma: It was. It was so fast. I think this is a thing with my kids. For my daughter, too, when they broke my water, everything went very fast. I don't know. They are just really urgent, but my son was definitely in a rush. He came very, very fast. Meagan: Did your doula even make it?Alma: No, she didn't. She did not. She couldn't. It just happened too fast. She didn't make it on time, but she was happy to hear everything went fine. Meagan: Yes, of course. Of course. Oh my goodness. So after you had the baby, and you had him on your chest and everything, did all of the rest of everything go okay and smoothly?Alma: Yeah. I was bleeding a lot, and that was a concern, but I thankfully recovered fine from that. I had a second-degree tear which I hear is not terrible for the first time doing that. So yeah. I recovered pretty quickly afterward. In my experience, it really didn't compare at all to the C-section recovery. I was in a lot of pain after my C-section, but this time, it was just maybe a week or two of taking some pain medication for the stitches and stuff, but overall, I was fine. Yeah. I was able to go home the next day actually, so that was also very good. Meagan: The next day? That is awesome. Alma: Yeah. Meagan: How did your medical team feel about it? Did they say anything? Did they have any worries?Alma: Everyone was just so shocked at how quickly everything took place. I think that was the main theme was just the speed, and also how determined my son was. With just two pushes, he just came out really fast. The concern of obviously dropping him because they all dove in to get him. I think that was the talk. This happened in the morning, so the whole rest of the day, they were just chatting about how quickly everything happened. Meagan: Oh my goodness. I bet. I think sometimes those births are kind of a lot for medical staff where you come in and your baby is crowning, but I feel like those births are the type that they really do talk about for a really long time, and they were like, “Look at this.” A lot of the times, here in Utah, anyway, they call them stop and drops where you show up at 10 centimeters. You just stopped in and dropped your baby. I feel like in a lot of ways, it shows people that labor can happen at home, and then you come and it can so beautifully happen without getting an IV, getting a heart trace, setting up fluids, doing this, having a cervical exam. There is just so much that doesn't need to happen, and I love when medical staff can see that birth can just happen like that. It really, really can if we just leave it be. Alma: Yeah. That's exactly another point of how I felt before because I had gestational diabetes, and because I had a previous C-section, they did make it sound like I needed to be hooked up to every machine, and I could never give birth at home. I just felt almost like a robot connected to everything. That's how it had to be, but yeah. This time, I wasn't even in a hospital gown. It was just so organic how it happened. That was exactly what I wanted to experience, but I think it was a good experience for the nurses as well to see that it was okay. I was fine without the IV and the other stuff. Meagan: Yeah, I love that. You had listed some tips. One of them was doing pelvic floor exercises on the ball which we kind of talked about. I love the ball so much. If you guys are interested in a ball, I'm going to link a ball in the show notes because they are actually really inexpensive and can do a lot of really good things. What other tips do you have for someone preparing for a VBAC?Alma: The number one tip which I've heard constantly here is about being educated and understanding what your options are. Unfortunately, I think that most providers are not going to make it easy to have a VBAC just because of the risks that are associated with it. Of course, they may have your well-being in mind, but there are also a lot of hospital policies and protocols that they need to follow. They may not make it easy, but if you understand what your options are and what the research says, it opens the door for dialogue. When you open that conversation, I think you will find that doctors will probably give you more options than what they may have initially suggested. I always spent time talking with the doctors about, “So what if this happens? How about this? How about that?” I feel like that did wiggle in some room for me to not do things just following the protocol. Meagan: Yeah. Alma: That's really important. Meagan: It's so interesting how if you show up showing that you're educated, there's this different sense of– I don't want to say respect, but I do want to say respect because I feel like these providers are like, “Oh. They get it. They understand. I can't just say whatever. This needs to be an educated discussion.” It should always be like that, but I also think a lot of the times, providers don't have time to really sit down and talk about the evidence, or their evidence is flawed because of personal experience. When you come in and you're like, “Hey, what about this?” and they're like, “Oh, she knows stuff,” it just really gives you some wiggle room. It gives the providers respect just a little bit more because they realize how important this is that we are educating ourselves. We are learning. We know the options, and we're not just going to be like, “Okay, cool.” I love that tip. That, and finding the supportive provider. In the beginning, you had said that the hospital policies may have trumped these providers' stance. I think not only just finding your supportive provider, but really understanding the hospital policy. You can call, and you can talk to the head nurse. You can talk to the board and the directors of the hospital. You can say, “Hey, I need to know the hospital policies surrounding VBAC.” Alma: Yeah. You know, I believe it was on this podcast where someone mentioned that the best way to know how a provider feels about a VBAC is just to ask them very straight, “What do you think about VBACs?” Their expression will say it all. You don't have to have a preamble about it. Just ask directly, and I think that helps. I definitely did that. It wasn't favorable in my case, but I definitely think looking into the hospital C-section rates is really important too. How often do they have C-sections? How often do they have VBACs? If they have that information available, that's also really helpful. In my case, I found out too late that it wasn't the highest, but it was pretty high. Also, from this podcast, I learned that it's never too late to switch providers if you want to. I didn't take that route. I stuck with who I was with, but I guess I was just trying to be adamant with what I wanted to do as much as possible. Meagan: Absolutely. Do you have any tips on how to possibly find the hospital's Cesarean rate? It used to be out there on cesareanrates.org. It used to be out there, and you could look up your hospital. You could look up your state. You could look up your provider, even. That's gone down a little bit and changed a little bit, but do you have any advice if someone is wanting to know their hospital's Cesarean rate? Alma: In my case, I just searched the hospital name and the Cesarean rate. This was a pretty big hospital. This was in Florida. It was a hospital with a very big network, so that information was readily available on their website. You do need to dig around, but it was on their website. If you are dealing with a big hospital with many departments and so on, they may have that information on their website easily with a Google search. You could also talk to people who work at the hospital as well. If it's not online, I think that information is quantified normally. They might not quantify how many VBACs they have, but definitely the C-section rate is information that they are following and tracking. Meagan: Yeah. I feel like it's always fair to ask your provider, “What's your Cesarean rate?” A lot of the time, they will say, “I don't know.” They know. They know. That's something that they need to be able to give you. It's okay to ask that. “What percentage of your deliveries end in a Cesarean?” Alma: Yeah. Being direct is really the easiest way to know clearly where they stand. Meagan: Yeah, absolutely. I wanted to really quickly talk just slightly about gestational diabetes. There's a lot when it comes to gestational diabetes. We know, just like you had experienced, that most providers suggest an induction. They just do. According to the American Pregnancy Association, gestational diabetes occurs in 2-5% of pregnancies which is decent. For those who are at a higher risk in their pregnancy, it may be even higher up to 9%, but a lot of them are controlled like yours were through diet or even through insulin and things like exercise. A lot of people are controlling them. Evidence Based BirthⓇ, which I want to make sure that this is linked in our show notes and our blog so if you want to go read more about gestational diabetes or you had gestational diabetes with your last pregnancy and you may have it again, definitely go check it out. They talked about how there is actually very little data in how often people are actually induced because of the diagnosis of gestational diabetes. But in one of the retrospective studies, they found that out of 330,000 births from 2001-2007, they saw– okay, let's see. It says, “The people in the study came from six health insurance plans, many different hospitals and regions, and represented a large and diverse population. Health insurance plans datas were linked to birth certificate data in order to improve accuracy compared to using birth certificates alone.” Going down a little bit further, they said, “Overall, 30% of labors were induced. When they looked at the reasons for induction, 59% of labors were induced for an accepted medical reason and 41% were considered to be elective.” Those are pretty big numbers to me. Alma: Yeah. Yes. Yeah, those are big. Meagan: Yeah, those are really big numbers. It goes on. It talks about, does gestational diabetes always mean induction? What's the evidence for randomized controlled trials? They go way into it because Rebecca Dekker is amazing, and their team is incredible. We will also have our blog linked because I believe this is a really important topic to know more about especially if you've had it so you can make the right decision. And how you said, you were like, “I was in a controlled state. Everything was controlled through my diet, and I could have likely gone further,” but you didn't. You weren't really encouraged to go further. It was like, “Let's induce.” Alma: Yeah, it literally was just like that. There was no conversation about it. Meagan: Yeah. No conversation about it. I think that's where we're going wrong a lot in the medical system. A lot of the time, there is no conversation. Even though we have the power to start that conversation, sometimes it's really difficult when we're being told, “Your provider thinks this. Your baby is in danger. You're in danger if you don't do these things.” It's like, “Okay. Okay. I'll do those things,” but we need to have those conversations. I think that again, having the education and knowing the evidence behind it, and the risks and the benefits and all of those things, it will help you have that conversation if and when the time is needed. So, thank you so much for chatting with us today and sharing your stories and giving us advice, and leaning into more conversations for gestational diabetes. I think it's something that is happening. A lot of people are getting it. There are things we can do even before pregnancy like really increasing our protein and things. But sometimes, it just happens. It just happens. Alma: I will say just to be clear, the second pregnancy, I did not have gestational diabetes. Meagan: Okay. Alma: That was also something. That was my biggest concern. The two points I mentioned were that the conditions were that I couldn't have gestational diabetes, and I needed to deliver before 40 weeks. But this goes along with education. I did my best to improve my diet even pre-pregnancy to avoid that diagnosis. It was actually a miracle that my blood test came back really well. I almost thought this was the wrong test because it wasn't elevated at all. I was really, really thankful that through some dietary changes and lifestyle changes, I didn't have gestational diabetes at all. Then the second point about giving birth before 40 weeks, it was a spontaneous labor at 38 weeks which also was so supernatural. I really thank God. Everything happened really perfectly. Yeah. That was really a blessing.Meagan: Yes. Oh, thank you so much for everything. You are amazing.Alma: Oh, thank you. Meagan: We just love you.Alma: Thank you so much. I had a great time sharing the story, and I hope it encourages other women as well. Meagan: It will, for sure. Alma: Great. 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

Team EBB's Chanté Perryman, Rikki Jenkins and Sara Ailshire are taking over the podcast to share their tips for transitioning home from the hospital and supporting new parents postpartum! Rikki, a seasoned childbirth educator, International Board Certified Lactation Consultant, and Instructor Program Coordinator at EBB, stresses the importance of having a strong support system and being open about postpartum mental health. Sara, a Research Fellow at EBB, draws from cultural practices and her own journey into parenthood to discuss the importance of accepting help and cherishing special moments with a newborn. Together, with Chanté, Director of Programs at EBB, they remind us to celebrate the transition into parenthood and practice self-compassion during this transformative period.   Don't forget to sign up for the waitlist for the new EBB Pocket Guide to Newborn Procedures!    (00:04:59) New Beginnings: Homecoming Baby Celebration (00:11:15) Building a Strong Postpartum Support System (00:12:34) Postpartum Support through Meal Trains (00:13:36) Setting Boundaries for Postpartum Support (00:31:04) Multilingual Breastfeeding Support and Resources (00:31:20) Partners' Support in Postpartum Hydration Plan (00:41:04) Neglecting Self-Care: Early Postpartum Warning Signs (00:46:48) Supportive Partner Role in Preventing Postpartum Depression (00:50:30) Navigating Postpartum Mental Health Challenges (00:53:28) Transformative Self-Compassion in Parenthood   Resources on Nursing and Pumping La Leche League UpToDate: Pumping Breastmilk Learn about the PUMP act, which protects many working parents. See the CDC's Guidelines for Breast Milk Storage. Learn about common issues in breastfeeding. Watch Global Health Media breastfeeding education videos in a variety of languages. Resources for Car Seats Child Passenger Safety Certified Technicians The Car Seat Lady: Safe newborn head position Chicco newborn car seat position Resources for Postpartum Depression and Anxiety Get an overview on PPD from The Office on Women's Health Learn about PPA What to Expect: Postpartum Anxiety Support Organizations Postpartum Support International (PSI) PSI Perinatal Mental Health Alliance for People of Color   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.

Navigating evidence based birth isn't easy. Should you move around during labor? Are water births beneficial? What about ongoing electronic fetal monitoring and the glucose drink? There's a lot of misinformation and conflicting advice out there.  This week on The Momwell Podcast, I'm joined by Dr. Rebecca Dekker, founder of Evidence Based Birth, to discuss what evidence based birth is and how moms can make the best decisions for themselves. Show Notes: https://bit.ly/3CwnrNt Book a free 15 minute consultation: momwell.com/booking Follow Momwell on Instagram: instagram.com/momwell  Sign up for our weekly VIP Newsletter: momwell.com/newsletter  Browse our popular guides and courses: momwell.com/shop Learn more about your ad choices. Visit megaphone.fm/adchoices

We're celebrating the upcoming release of the brand new Pocket Guide to Newborn Procedures! Join us as Dr. Dekker explores essential aspects of newborn care: the evidence on 1) pain management during newborn procedures, 2) baby's first bath, and 3) whether and how newborns should receive screening for low blood sugar. In this episode, you'll learn about newborn comfort techniques like skin-to-skin care, massage, "tucking in," and the use of pacifiers. You'll also walk away with a new appreciation for the evidence on delaying the first newborn bath to 24 hours, and the causes and management of newborn low blood sugars (also known as neonatal hypoglycemia).   (00:05:58) Parental Involvement in Newborn Comfort Care (00:08:34) Pain Relief Techniques for Newborn Procedures (00:12:01) Enhancing Newborn Comfort and Pain Management (00:20:22) Newborn Immersion Tub Bathing Advantages (00:31:45) Factors Contributing to Neonatal Hypoglycemia (00:39:31) Managing Newborn Hypoglycemia with Blood Sugar Testing (00:42:49) Enhancing Newborn Comfort and Pain Relief   Join the waitlist for the Newborn Procedures Pocket Guide here. Learn more about ingredients in infant cleansers here.   Click here for the full list of references.   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 Dr. Rebecca Dekker and EBB Research Fellow Morgan Richardson Cayama as we explore the ARRIVE Trial and its impact on elective induction at 39 weeks. Together, we'll break down what elective induction involves, examine the trial's findings and critiques, and discuss the latest evidence on this increasingly common practice. Elective inductions have surged since the Trial's release. In this podcast episode, we'll talk about the latest post-ARRIVE research, and the benefits, risks, and professional guidelines on elective induction at 39 weeks. Additionally, we'll focus on the crucial role of respectful maternity care when making decisions about induction.   This podcast episode is a companion to the Evidence Based Birth® Signature Article on "Evidence on: The ARRIVE Trial and Elective Induction at 39 Weeks." You can access all of the resources, scientific references, and a free 2-page handout at ebbirth.com/arrive. If you prefer to learn via video, check the EBB YouTube channel for the video version of this episode.   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.

On this week's episode, we welcome Rebecca Dekker, PhD, RN. Dr. Dekker is the founder and CEO of Evidenced Based Birth. We discuss evidence-based birth and why we have such a gap between the research and actual practice in obstetrics.On this episode, you will hear:- what is evidence-based birth- personal experiences shaping evidence-based birth- researches and practices in labor and delivery- evidence/practice gap in obstetrics- preventing birth trauma through better practices- the importance of communication in the medical setting- empowering patients through consent- navigating birth education and trauma- advocacy skills for parents and healthcare workers- systemic challenges in maternity careCheck out Evidence Based Birth HERE!Follow them at @ebbirthGuest Bio:Dr. Rebecca Dekker, PhD, RN, is the founder and CEO of Evidence Based Birth(R). After earning her Bachelor's, Master's, and PhD in Nursing, Rebecca embarked on a career as a nurse scientist and teacher. In 2016, she left academia to become a full-time entrepreneur and consumer advocate for evidence based care. Rebecca lives in Lexington, Kentucky, where she and her husband Dan are raising three children and an assortment of pets. Babies Are Not Pizzas is her first book.For more birth trauma content and a community full of love and support, head to my Instagram at @thebirthtrauma_mama.Learn more about the support and services I offer through The Birth Trauma Mama Therapy & Support Services.

In this episode, we're talking about uterine fibroids and their impact on pregnancy and birth with Dr. Veronica Gillispie-Bell, a board-certified OB/GYN and nationally recognized expert in fibroid treatment. Dr. Gillispie-Bell shares her wealth of knowledge on this critical, yet often overlooked, topic—explaining everything from what fibroids are to the various treatment options available. We cover how fibroids affect reproductive health, debunk myths about Cesarean versus vaginal birth, and discuss the racial disparities in fibroid care that Black women face. Dr. Gillispie-Bell also opens up about her personal connection to this field, tracing her passion for fibroid treatment back to her own mother's journey. Content Note: This episode contains discussions of maternal mortality and pregnancy-related death. Please take care while listening.   02:30 Understanding Uterine Fibroids and Their Prevalence 04:22 Symptoms and Health Consequences of Uterine Fibroids 08:05 Dr. Gillispie-Bell's Interest in Fibroids and Racial Disparities 16:13 Minimally Invasive Procedures for Fibroids 19:12 Hysterectomy as a Treatment Option 21:55 Considerations for Fibroid Treatment in Relation to Fertility 24:19 Safety and Impact on Fertility of Certain Fibroid Treatments 26:11 Primary Surgical Procedure: Myomectomy 28:19 Hysteroscopic Fibroid Removal   Resources Follow Dr. Gillispie-Bell on Instagram here. Help prevent maternal mortality with the CDC – Hear Her Campaign. Learn more about fibroid advocacy by visiting the White Dress Project and the Fibroid Foundation. Follow the work of the Louisiana Perinatal Quality Collaborative.   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.

Dr. Leslie Farrington, an African-American retired OB/GYN, birth justice advocate, and co-founder of the Black Coalition for Safe Motherhood, shares how her early experience with midwifery inspired her passion for patient-centered care. As a physician who later recognized the harmful effects of “physician supremacy” in the medical system, she details her transformation into an advocate for liberation and anti-racism in healthcare. She discusses how systemic issues impact Black maternal health and introduces the ACTT (Ask, Claim, Trust, Tell) framework, a powerful toolkit designed to empower birthing families to advocate for themselves during prenatal care. Dr. Farrington also offers practical strategies for building confidence, addressing power imbalances in medical settings, and ensuring patients are heard and respected. (00:00) Empowering Pregnant Individuals in Prenatal Care (14:13) Advocating for Black Maternal Health Equity (17:55) Empowering Patients in Prenatal Healthcare Settings (26:23) Fostering Collaborative Relationships for Patient-Centered Care (32:50) Enhancing OB/GYN Care for African American Parents (42:00) Advocacy Training for Black Maternal Health Learn more about the Black Coalition for Safe Motherhood here. Download the Irth App 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.

Chiropractor Dr. Lisa Vawter is all about women's health, especially when it comes to prenatal and postpartum care. With certifications in the Webster technique, Spinning Babies®, and BirthFit™, she's got all the tools to support expectant and new moms in a holistic way. Dr. Vawter is a firm believer in the power of chiropractic care to ease pregnancy symptoms like low back pain and sciatica, focusing on things like posture, muscle engagement, and body balance. Inspired by her own pregnancy journey, Dr. Vawter provides personalized and compassionate care to make sure birthing people have a safe and comfortable journey into parenthood. Listen as we talk about: Dr. Lisa Vawter's journey of being pregnant while in chiropractic school An overview of the anatomy of the spine, hips, and pelvis The kinds of normal bodily changes that happen in pregnancy How body mechanics and everyday movements can impact comfort in pregnancy Simple, bite-size exercises to help with re-alignment of your neck and pelvis Types of chiropractic adjustments used in pregnancy, including the Webster technique Information on the safety of chiropractic care in pregnancy Visit Dr. Vawter's website here, or follow her on Instagram here. Learn more about Spinning Babies® and BirthFit™. 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.

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

In this episode, we're joined by EBB Childbirth Class graduates Dr. Emily Guilfoy and her husband, Doug, as they share their unmedicated birth story. Dr. Emily, a chiropractor, walks us through her preparation for birth using self-hypnosis and the mental and physical strategies she employed for a calm, empowering labor. Together, they discuss their experience in the EBB Childbirth Class, working with their doula, and how they created a serene birthing environment in a hospital setting. Dr. Guilfoy also tells us how her personal history of having a hip replacement surgery impacted her pregnancy and birth options. From managing labor to navigating hospital policies, tune in to hear about how they achieved the birth experience they envisioned. Resources: Learn more about Hypnobabies here. EBB 322 – Harnessing the Power of the Mind to Enhance Joy and Comfort in Childbirth with Kerry Tuschhoff, Founder of Hypnobabies   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, we're exploring the fascinating science of blood types and blood incompatibility in pregnancy. You'll learn about the basics of blood types, how they are inherited, and why knowing your blood type is crucial—especially during pregnancy. Rebecca and Sara also discuss the implications of Rh incompatibility, ABO incompatibility, and other rare blood types on maternal and fetal health. (17:15) Rhogam Injection: Preventing Rh Incompatibility Complications (18:23) Hemolytic Disease of the Newborn: RH Incompatibility (20:24) Rh Sensitization: Newborn Hemolytic Complications (21:33) Rh Incompatibility Risk in Pregnancy Testing (22:45) Global Shortages Impacting Postpartum Rhogam Access (25:15) ABO Incompatibility Impact in Pregnancy (35:44) Critical Need for Anti D Immunoglobulin Access (35:44) RhoGAM: Preventing Newborn Disease through Donations   For the full list of references and resources, visit the EBB website 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.

Neysha Reyes Cruz's journey to becoming a birth doula was sparked by witnessing the inadequate support and resources during a friend's hospital birth in Puerto Rico. Her personal experiences and those of her family have further fueled her commitment and passion for advocating on behalf of women, particularly within Hispanic and Latinx communities. Neysha recognizes the significant need for more bilingual doulas to ensure culturally competent care and clear communication for non-English speaking patients. In response, she is actively working to train and certify young Latina women as bilingual doulas in Kansas City, aiming to address this critical gap and improve maternal health outcomes. Learn more about Olas de Amor here, or follow them on Instagram here! Find resources from Nuture KC here. Get support from Parto En Casa here. Get support from Esperanza Birth here. Get the EBB pocket guide in Spanish here! To view this episode's transcript in English or Español, click 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.

We are joined by Kimberly Turbin and Michele Monserratt-Ramos, staunch advocates against obstetric violence driven by personal experiences and a commitment to marginalized communities. Note: Read the transcript in English or español here! Or watch with closed captions on the EBB YouTube channel.  Kimberly's advocacy began after a traumatic birth experience in 2013, which she courageously shared publicly to ignite awareness and debate on obstetric mistreatment. Michele, with her extensive background in public interest and healthcare safety, collaborates with Kimberly to address maternal health issues, particularly affecting Latina women in California. Their joint efforts focus on systemic change, emphasizing the need for resources, education and support to ensure informed healthcare decisions and improved maternal health outcomes. Content Warning: This episode contains discussion of obstetric violence. Listener discretion is advised.   Learn about Consumer Watchdog here. Watch Kimberly Turbin's birth video here. Follow Kimberly Turbin on Instagram.   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.

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

Lisa Smith, a registered dietitian and host of the Pretty Well podcast, joins us on the EBB podcast to discuss the crucial topic of reducing toxins in the home during pregnancy and postpartum. Lisa shares her personal health journey, including her experience with Hashimoto's disease (an autoimmune condition impacting the thyroid), and highlights the importance of reducing environmental toxins to promote optimal health. Listen and learn about the connection between toxins and gut health, how industrial chemicals are found in umbilical cord blood, and steps expectant parents can take to lower toxin levels in their environment. From understanding the dangers of heavy metals and "forever chemicals" to making informed choices about food and household products, Lisa shares practical tips to creating a healthier home for you and your family. Tune in to Lisa's podcast Pretty Well, here, and follow the show on Instagram 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.